“Positive Deviance” Bulletin

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to only provide technical support. The two RW health committees are committed to being accountable and managing the donations and establishing a reporting mechanism to the community forum on monthly basis. daya mereka sendiri dan mereka hanya meminta bantuan teknis dari PCI. Kedua Tim Kesehatan RW bertekad untuk mengelola donasi masyarakat secara bertanggung jawab dan mengembangkan suatu mekanisme pelaporan kepada masyarakat dalam forum pertemuan bulanan. A PD Posyandu Orientation By Randa Wilkinson – SC 3 day Orientation training in Positive Deviance was conducted by Jerry Sternin, Nanang Sunarya, and Randa Wilkinson to orient DHO and Puskesmas staff from Cianjur in how to apply the PD Approach to Posyandu Performance and Goiter. Participants included staff from the Cianjur DHO departments of Community Mobilization, Vaccinations, Nutrition, and Health Services, Puskesmas staff from several sub districts, Mercy Corps PD team members; Vanessa Dickey and Pak Ma’ad and Pak Solet, the village secretary from Makasari, Naringgul where a PD goiter pilot project will begin later in the year. Pak Jerry facilitated the first morning with stories and power points about Positive Deviance, and coached everyone in the correct process for using this approach. The participants then broke up into small groups to find PD situations in their own lives not related to nutrition. The task was to define exactly what the problem is and what the desired outcome would be. This first step- DEFINE is sometimes quite difficult to articulate. After presenting back to the whole group, we then looked at Posyandu performance. What is the problem? After much debate, the following definition was agreed upon by the group – PROBLEM: Lack of ownership of poysandu by the community leads to decreased participation, lack of support by community, leaders, other sectors and to lack of quality services. POSITIVE OUTCOME: Community has sense of ownership of posyandu which is demonstrated by high participation, quality health services being provided, and support from community, leaders, health and other officials. The next step in the orientation workshop was to discover if there were any PD Posyandus. Out of the 2295 posyandu being run in the district of Penimbangan dilakukan oleh ibu dan kader / Weighing done by mother and cadres Orientasi PD Posyandu Oleh Randa Wilkinson – SC uatu pelatihan orientasi 3 hari mengenai Positive Deviance telah dilaksanakan oleh Jerry S Sternin, Nanang Sunarya dan Randa Wilkinson sebagai orientasi Dinkes dan staf Puskesmas Cianjur dalam hal penerapan pendekatan PD pada kinerja Posyandu dan gondok. Peserta orientasi terdiri dari staf Dinkes Cianjur yang mewakili departemen Mobilisasi Masyarakat, vaksinasi, Gizi, dan Pelayanan Kesehatan, staf Puskesmas dari beberapa kecamatan; anggota tim PD Mercy Corps : Vanessa Dickey, Pak Ma’ad dan Pak Solet; sekretaris desa Makasari, Naringgul dimana pilot proyek Gondok PD akan dimulai pada akhir tahun ini. Pak Jerry memfasilitasi sesi pagi hari pertama dengan ceritera dan presentasi slide mengenai PD, dan membimbing setiap orang kedalam proses yang benar bagi penerapan pendekatan ini. Para peserta dibagi dalam beberapa kelompok untuk menemukan situasi PD dalam kehidupan mereka yang tidak ada hubungannya dengan gizi. Tugas kelompok adalah menentukan secara tepat apa masalah yang dihadapi dan apa hasil yang ingin dicapai. Langkah pertama ini – MENENTUKAN –kadangkala sulit dipahami. Setelah presentasi kembali dihadapan semua kelompok, kemudian melihat pada kinerja Posyandu. Apa masalahnya? Setelah berdebat panjang lebar, akhirnya menyepakati definisi sebagai berikut : MASALAH : masyarakat kurang merasa memiliki Posyandu, menyebabkan berkurangnya partisipasi, dukungan dari masyarakat, tokoh masyarakat, sector lain dan menurunnya kualitas pelayanan. HASIL POSITIVE : masyarakat merasa memiliki Posyandu yang ditunjukkan oleh partisipasi yang tinggi, pelayanan yang berkualitas dan dukungan masyarakat, tokoh masyarakat, petugas kesehatan maupun sektor lainnya. Langkah berikut dalam lokakarya ini adalah menemukan apakah ada Posyandu PD, yang dimiliki 6
Cianjur, there are 27 that meet the criteria of providing the community with the desired services, reflected in a consistent monthly attendance rate for growth monitoring activities of over 90%, and quality health services. The 2nd day of the training the participants spent studying and learning from two Posyandu taking place that morning, one was in a rural setting, and the other in the city of Cipanas. Posyandu PD observations included; pre and post natal care; growth monitoring, immunization, community mobilization. PD Posyandu behaviors identified by the participants included – direct and immediate results of KMS (growth monitoring) are communicated to the mother or care giver, the KMS cards are kept by the family and not by the kaders, the religious leaders announcing the Posyandu dates and immunization dates to the community, and the Bidans consult with pregnant women in a semi private area. The third day of training was spent on action plans for the participants. Because this was an orientation, before the participants can implement a program on Posyandu performance they need to prepare their communities and receive more training and technical assistance. The awareness of PD examples in everyone’s lives provided the participants with “new eyes” for program development. oleh masyarakat. Dari 2.295 posyandu yang ada di kabupaten Cianjur, ada 27 posyandu yang memenuhi kriteria menyediakan pelayanan yang diinginkan oleh masyarakat, dengan melihat angka kehadiran bulanan yang konsisten mengikuti Posyandu lebih dari 90%. Hari kedua lokakarya, para peserta belajar dari 2 Posyandu yang berjalan pagi hari, satu dari daerah pedesaan dan satu lagi dari daerah perkotaan di Cipanas. Observasi Posyandu PD mencakup : pemeriksaan kehamilan dan setelah melahirkan; penimbangan, imunisasi, dan mobilisasi masyarakat. Praktek Posyandu PD yang diidentifikasi peserta adalah : hasil penimbangan pada KMS dikomunikasikan kepada ibu atau pengasuh anak secara langsung dan segera, KMS disimpan oleh ibu dan bukannya kader, tokoh agama mengumumkan hari posyandu dan imunisasi kepada masyarakat, dan Bidan melakukan pemeriksaan kehamilan di tempat yg semi tertutup. Hari ketiga digunakan untuk menyusun rencana kerja dari para peserta. Karena hal ini baru merupakan orientasi, maka sebelum peserta dapat melaksanakan program kinerja Posyandu mereka harus menyiapkan masyarakat mereka dan menerima pelatihan dan bantuan teknis. Kesadaran terhadap contoh PD dari kehidupan masing-masing peserta akan “membuka mata” mereka bagi pengembangan program. SUCCESS STORY KISAH KEBERHASILAN Reducing Costly Snacking By Maria (CARE) srudin (Aas), a 37 month old little boy from A Longkali, East Kalimantan, was identified as being moderately malnourished at the beginning of NERS; He weighed 11.8 kg and his young mother Dursti (18 years old) usually spent Rp 5,000 to Rp 10,000,- per day just to buy CHIKI snacking for Aas. Most of the mothers in Longkali are “rubber tapper” and they would prefer to earn money and provide snacking money rather than care for and provide affection to their children. Some mothers say “ my child is very difficult to feed taking too much time to feed” and the mother would preferred going to the field to earn money, “rubber tapp” After attending 2 PD NERS of 12 days, Dursti looks differently on caring for Aas. Now she always washes her hands and Aas’s hands with soap before feeding Aas whereas she often forgot before. She is trying to actively feed her child now whereas before she was impatient when Aas ran away. She now only spends Rp 3000,- over 2-3 days on snacks compared to Rp 5,000-Rp 10,000 per day before. A Mengurangi Jajanan Mahal By Maria (CARE) srudin (Aas),seorang bocah laki-laki usia 37 bulan dari Longkali, Kalimantan Timur, diidentifikasi sebagai anak kurang gizi sedang pada awal mengikuti Pos Gizi; Berat Badannya 11,8 kg dan ibunya yang masih muda berusia 18 tahun biasanya menghabiskan Rp 5000,- sampai Rp 10,000,- per hari hanya untuk membeli jajanan CHIKI untuk Aas. Kebanyakan ibu-ibu di Longkali adalah “penyadap karet” dan mereka lebih cenderung mencari uang dan memberikan uang jajan dari pada merawat dan memberi kasih sayang kepada anaknya. Beberapa ibu mengatakan bahwa “anak saya sangat sulit makan” menghabiskan banyak waktu untuk menyuapinya dan para ibu lebih suka pergi ke ladang untuk menyadap karet yang mendatangkan uang. Setelah mengikuti 2 sesi Pos Gizi (12 hari per sesi), Dursti kelihatan berbeda dalam hal mengasuh Aas. Dia selalu mencuci tangannya maupun tangan Aas dengan sabun sebelum memberi makan Aas dimana sebelumnya dia sering lupa melakukannya. 7
Page 1 and 2: POSITIVE DEVIANCE Pendekatan pemeca
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Page 9 and 10: fore joining the PD NERP and acted

“Positive Deviance” Bulletin

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