Over the past two and a half years of MADANI’s support for Nasyiatul Aisyiyah, they have deepened their collaboration with various stakeholders, becoming more knowledgeable of and relevant to addressing development challenges in the region.
One of Garut District’s development priorities is the reduction of maternal and newborn mortality. To achieve this goal, they have formed health cadres at various community health centers (Puskesmas), organized midwives at the village level, and improved health infrastructure. However, despite some progress, maternal and newborn mortality in the district remains too high; in 2021, 112 women died in Garut due to complications of pregnancy and childbirth and 216 newborns died.
In response, Nasyiatul Aisyiyah established the FAASIH (Forum Advokasi Anak Sehat dan Ibu Hebat) multi-stakeholder Learning Forum in July 2020. The Learning Forum, which is comprised of nine CSOs, aims to bring together like-minded organizations and ensure that their collective voices are shared with the government and other stakeholders, while also helping to increase the wellbeing of mothers and newborns in the district.
In 2021, Nasyiatul Aisyiyah and FAASIH conducted an assessment on maternal and newborn mortality. They organized focus group discussions and implemented a community score card (CSC) – a citizen-driven monitoring and social accountability tool – at a rural healthcare center. After collecting feedback from community members and service providers, they analyzed the results, identified the underlying causes, and made recommendations.
The findings revealed a variety of contributing factors to mortality rates: 1) community reluctance to utilize Puskesmas due to a mistrust in the quality of services that they offer, travel time and costs associated with them, and the abundance of – and cultural preference for – traditional midwives; 2) pregnant women receive insufficient assistance from local health cadres, husbands, and other family members during pregnancy and childbirth; 3) only 30 of the 72 Puskesmas across rural Garut are equipped with basic emergency services facilities for pregnant women.
After conducting the assessment, Nasyiatul Aisyiyah and FAASIH established two teams of local volunteers, called SAKINA RAPIH (Stop Angka Kematian Ibu dan Anak – Relawan Pendamping Ibu Hamil or Pregnancy Volunteers to Stop Maternal and Child Mortality), in villages with the highest maternal and newborn mortality rates. The teams aim to improve pregnant women’s knowledge of and attitude toward pregnancy. This support places special emphasis on mental health, as many participants are young or first- time mothers. Nasyiatul Aisyiyah trained the teams on topics related to pregnancy duration, diet and nutrition, the importance of antenatal visits, and family member assistance during childbirth.
The SAKINA RAPIH model has achieved success in the initial villages and recognition by the Government of Garut. Since inception, the teams have educated 200 pregnant women, all of whom have complied with the Ministry of Health’s minimum requirement of six antenatal visits. In addition, one village allocated part of its village fund’s budget to help volunteers continue their activities beyond MADANI’s support. Furthermore, the district government provided resources to replicate the model in two additional villages.
On the policy front, Nasyiatul Aisyiyah and FAASIH are launching an advocacy campaign to convince the district government to revise current policies related to medical care, especially for pregnant women. Policy recommendations include establishing a task force on reducing maternal and infant mortality, upgrading all Puskesmas to have basic emergency services facilities for pregnant women, replicating the SAKINA RAPIH model, and including representative of SAKINA RAPIH in the task force.
In June 2022, Nasyiatul Aisyiyah signed an agreement with the local branch of the philanthropic organization LAZISMu (Lembaga Amal dan Zakat Muhammadiyah). The collaboration between these two independent associations of Muhammadiyah aims to support maternal and newborn health, as well as adolescent health through youth healthcare centers (posyandu). Asep Muslim Nurdin, Director of Garut LAZISMu, commented: “We are proud to support Nasyiatul Aisyiyah’s health programs…to date, we have distributed nutritious food packages to 75 pregnant women from low- income households.”
Nasyiatul Aisyiyah’s story exemplifies MADANI’s critical role in community empowerment, mobilization, and collaboration. Through technical assistance, MADANI has strengthened Nasyiatul Aisyiyah’s confidence in its advocacy work and relationship building skills, empowering it to create synergies with government agencies, philanthropic organizations, and other CSOs. Most importantly, Nasyiatul Aisyiyah’s increased capacity and involvement has helped the District of Garut to pursue its development agenda more effectively and reduce maternal and newborn mortality.