Qualitative Impact Study for PNPM Generasi and PKH on the Provision and the Utilization of Maternal and Child Health Services and Basic Education Services in the Provinces of West Java and East Nusa Tenggara


ABSTRACT

This study aimed to examine the impact of PNPM Generasi and PKH on the provision and the utilization of maternal and child health (MCH) services and basic education services. The study was conducted in 24 villages in two provinces, West Java and East Nusa Tenggara (NTT), which were divided into treatment and control areas. The qualitative panel method was used by comparing the results of the impact study with the baseline study conducted in 2007. Overall, the study found an increase in the provision and utilization in the sample areas, especially in PNPM Generasi treatment areas. PNPM Generasi contributed to the provision of services via building physical and supporting facilities of MCH and basic education as well as incentives for service providers. Contributions to improvement of utilization took the form of direct aid to households, including aid to cover childbirth expenses, supplementary feeding, scholarships, transport and dormitory allowances, and school equipment. On the other hand, PKH contribution to the improvement in service utilization was evident only in NTT Province. Improvements were indicated by the increase in mothers’ attendance at posyandu (integrated health service posts)i and of students attendance in class. These increases were encouraged by the role of PKH facilitators in motivating the beneficiaries, the possible consequences of PKH fund deduction or fund withdrawal, and the relatively large proportion of beneficiaries in each village. However, a number of problems regarding the provision and the utilization of MCH and basic education services were still evident, especially in NTT. The problems included geographical and economic barriers, unavailability of service providers (of village midwives and teachers), and the villagers’ beliefs in traditional customs.

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iA posyandu or an integrated health service post is a medium for a village/kelurahan/RW community to provide basic health services for its own members. The main objective is to help reduce Under-five and maternal mortality rates. The services, provided by local cadres assisted by a puskesmas medical staff member, include immunization, weight measuring, and general health checks for children under the age of five as well as general health checks for mothers and the elderly.