Public Health of Indonesia
E-ISSN: 2477-1570 | P-ISSN: 2528-1542
Perspective AuSTOP PneumoniaAy Ae A successful advocacy campaign for preventing and protecting IndonesiaAos children from Tata Sudrajat1.
Wahdini Hakim1.
Taskin Rahman2, and Rashed Shah3* 1Save the Children Indonesia 2Save the Children Asia Region 3Save the Children USA Doi: https://dx.
org/10.
36685/phi.
Received: 4 February 2021 | Revised: 22 February 2021 | Accepted: 3 March 2021 Corresponding author:
Rashed Shah.
DrPH.
Sc.
MBBS
Child Health Advisor.
Save the Children USA Mailing Address: 899 N.
Capitol St.
NE.
Washington DC 20002.
USA Telephone: 1 202 308 6438 Email: mshah@savechildren.
Copyright: A 2021 the author.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: STOP Pneumonia.
Indonesia.
Pneumonia is seen as one of the leading causes of child mortality under-age-five around the world, of which a child dies every 39 seconds (UNICEF, 2.
As the second-highest cause of under-five child mortality (UNICEF, 2020.
, childhood pneumonia alone claimed more than 19,000 childrenAos lives under age five in Indonesia in 2018, according to UNICEF (UNICEF, 2020.
This means more than two children die every hour, and 16% of under-five child deaths (UNICEF, 2019, 2020.
Such high numbers of pneumonia deaths among children rank Indonesia among the highest in the worldAi outranking all other Southeast Asian countries (International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health (JHSPH), 2.
One of the most effective ways is to provide immunization for children (Madhi.
Levine.
Hajjeh.
Mansoor, & Cherian, 2.
Today, several effective vaccines are available for the prevention of childhood pneumonia, and pneumococcal conjugate vaccines (PCV.
are one of them.
The Government of Indonesia (GOI) has introduced PCV as a pilot in October 2017 in five districts of Nusa Tenggara Barat (NTB) (Lombok Barat.
Lombok Timur.
Lombok Utara.
Lombok Tengah, and Matara.
and three districts of Bangka Belitung province (Pangkalpinang.
Bangka and Bangka Tenga.
With a high burden of childhood pneumonia, this pilot phase of PCV rollout was expanded in 2019 to more However.
Indonesia lacked a nationwide scale-up vaccination program where PCV is scheduled into the routine child immunization Including PCV in routine child immunization However, scientific evidence has revealed that pneumonia is a preventable disease, and almost all child death from pneumonia under-age-five can be avoided if effective and timely measures are taken.
Volume 7.
Issue 1.
January Ae March 2021 program is a critical step to save more child lives and to meet the child mortality target for achieving Sustainable Development Goals (SDG.
Collaborative efforts have been made since 2017 at the district, national and global level by different stakeholders to make this happen.
prevention, from which more than 30 villages had benefited and each village received up to USD 600 funding allocated for pneumonia prevention At National Level While working together with CSO partners.
UNICEF and Clinton Health Access Institute (CHAI).
Save the ChildrenAos advocacy for GOI was focused on increased investment and full adoption of global commitments to address pneumonia into national Strengthened immunization system, improved integrated case management and promotion of health-seeking behaviors are intensely discussed through various government engagement At District level In a decentralized context such as Indonesia, national regulation and policies need to be supported with sub-national operational policies.
Save the Children works with the Civil Society Organization (CSO) coalition in Sumba Barat and Bandung districts and engages closely with district and village government officials to advocate for a strengthened health system and local resources.
Case study 1: Bandung District In Bandung, the government issued a Head of District Health Office (DHO) decree in 2019 for all primary health care centers to implement Standard Operating Procedure (SOP) for Integrated Management of Childhood Illnesses (IMCI).
Budget for OJT (On Job Trainin.
on IMCI in the year 2020 was allocated for all 62 Puskesmas (Primary Health Centre/PHC) in Bandung District funded by the District Government of Bandung through BOK (Biaya Operasional Kesehatan/Health Operational Fund suppor.
and DAU (Dana Alokasi Umum/General Allocation Fun.
At the national level, along with CSO partners and UNICEF.
Save the Children provided input to the draft National Action Plan on Pneumonia and Diarrhea, which is currently in the process to be finalized and legislated to be a ministerial decree.
On several occasions.
Save the Children also engages policymakers from various ministries in public forums to ensure policies and financial resources at the national and sub-national levels are supportive of child survival interventions to prevent children from dying from preventable diseases such as pneumonia.
Several behavioral change communication toolkits are currently being developed for caregivers and health workers at the primary health care center and cadres from a community-based integrated post (Posyand.
guidebook for village officials was also developed to help them to plan and budget for child survival intervention programs to address pneumonia.
Case study 2: Sumba Barat District Save the Children supported the development of the Sumba Barat RPJMD document (Medium Term District Development Pla.
and responded to the request for technical support from District Development Planning Agency-BAPPEDA to develop RPJMD Health Sector Technocratic design 2021 Ae 2025.
This is considered as a strategic approach, given that the technocratic design of the RPJMD document on the health sector 2021-2025 .
ith Pneumonia highlighted as one of the prioritie.
served as a reference for BAPPEDA to synchronize with the vision and mission of the new elected Head of District (BUPATI).
After synchronization, a Final RPJMD is an ultimate document that serves as a reference for related District Offices to prepare their Strategic Plan (Renstr.
In 2019, the Ministry of Health made a verbal commitment to include Pneumonia as a priority in its annual work plan, which will start in 2021.
Ministry of Village Development recently has set a target for villages to have zero pneumonia cases as its health Immunization, as well as an expansion of PCV introduction, is now part of the health system reformation plan recently announced by BAPPENAS at a provincial government forum.
At the Global Level Save the Children and partners also facilitated the participation of GOI representative on the global stage and global health agendas in the Barcelona In Sumba Barat, the village development office issued a budget allocation guidance in 2019 for villages to ensure funding allocation for pneumonia Volume 7.
Issue 1.
January Ae March 2021 Pneumonia Forum in late January 2020.
During this global event, about 350 participants from Governments/Ministry of Health.
Non-government organizations, private companies.
UN and multilateral agencies, and health experts from more than 55 countries came together to strategize more effective ways for fighting against the leading deadly but preventable disease that threatens child survivalAipneumonia (Bassat et al.
, 2.
Experts in this global forum anticipated that 9 million child deaths could be prevented from 2020 to 2030 (UNICEF.
Save the Children (SC), & Every Breath Counts (EBC), 2.
if key stakeholder come together and make joint efforts to scale up pneumonia prevention, diagnosis, and accelerate The GOI consented to the global declaration from this forum (Every Breath Counts, 2.
and declared its commitment to introduce PCV STOP Pneumonia campaign - Mobilizing support to change behavior With the spirit of fighting against pneumonia, to encourage behavioral change by caregivers and healthcare workers and raise awareness among the public.
Save the Children Indonesia also launched a STOP Pneumonia (Save the Children Indonesia, 2.
campaign nationally in 2019 to inform about the risk factors and preventive measures.
STOP is used as an acronym which in the Indonesian language stand for:
On January 29, 2020.
Suharso Monoarfa.
IndonesiaAos Minister for National Development Planning, said in his keynote address at the Forum.
AuIt gives me great pleasure today to announce that the Government of Indonesia is committed to proceeding with the special mechanism for PCV procurement through the Gavi Advance Market Commitment.
Ay It is noteworthy that by introducing PCV into its national routine immunization program, more than four million (GAVI, 2.
children in Indonesia will be protected against pneumococcal disease every year.
S for ASI eksklusif or exclusive breastfeeding for six months.
continued with complementary feeding up to two years of age.
T for Tuntaskan Imunisasi or ensure routine O for Obati or bring a sick child to the health facility for proper treatment.
P for Pastikan asupan gizi dan CTPS, or ensure adequate nutrition, ensure clean air, and handwash with soap.
AuSTOP PneumoniaAy campaign organized public mobilization events through community engagement activities, seminars, public dialogue, radio talk show and social media channels to reach not just local communities but also the public at large.
Most of the events engaged prominent figures and influencers such as the provincial and district first ladies, celebrity.
Indonesia Pediatrician Associations (IDAI) representative and youth.
All of the events were linked with important global momentums to amplify the messages, such as World Immunization Week.
World Breastfeeding Week and Global Handwashing Day, and World Pneumonia day.
As of June 2020, the campaign has reached 11 million listeners through nationwide radio talk shows in 22 provinces, 6,032 views on social media channels, and 119,930 web users and 193,488 page views.
On September 16, 2020, the Ministry of Health in Indonesia signed an agreement with UNICEF on the procurement of affordable vaccine and drug.
Thanks to the continuous efforts of advocacy and campaign of addressing the childhood pneumonia problem.
Save the Children Indonesia is considered as one of the most important contributors in making this breakthrough happen.
This agreement will help to scale up PCV into the national immunization program, signifying the continued commitment of GOI to protect infant and young children against Having PCV as part of the nationwide routine child immunization program, this partnership will allow Indonesia to purchase the PCV at levels far below the current market price, and when scaled nationally, this can prevent close to 10,000 child deaths each year, leading to further child mortality reduction in Indonesia (UNICEF, 2020.
Save the Children has been working with global development partners and local partners in Indonesia to support the GOI ending preventable childhood pneumonia deaths by addressing the most critical gaps in pneumonia prevention, protection and Recognizing that AuStop PneumoniaAy wonAot happen without influencing policies at all levels, since 2017.
Save the Children has been implementing robust advocacy and campaign.
Volume 7.
Issue 1.
January Ae March 2021 GAVI.
Indonesia to protect four million children a Retrieved https://w.
news/media-room/indonesiaprotect-four-million-children -year-against-pneumonia International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health (JHSPH).
Pneumonia and diarrhoea progress report Retrieved from https://w.
edu/ivac/wpcontent/ uploads/2020/11/IVAC_PDPR_2020.
Madhi.
Levine.
Hajjeh.
Mansoor.
, &
Cherian.
Vaccines to prevent pneumonia and improve child survival.
Bulletin of the World Health Organization, https://doi.
org/10.
2471/BLT.
Save the Children Indonesia.
Stop Pneumonia.
Retrieved from http://stoppneumonia.
UNICEF.
One child dies of pneumonia every 39 seconds, agencies warn [Press releas.
Retrieved from https://w.
org/press-releases/one-childdies-pneumonia-every-39-seconds-agencies-warn UNICEF.
Ministry of Health and UNICEF sign an agreement to procure affordable vaccines and drugs.
Retrieved https://w.
org/indonesia/pressreleases/ministry-health-and-unicef-sign-agreementprocure-affordable-vaccines-and-drugs UNICEF.
Rights to breathe: Addressing Retrieved https://w.
org/ indonesia/stories/pneumonialombok UNICEF.
Six surprising facts about childhood pneumonia: Everything you need to know about Retrieved https://w.
org/indonesia/stories/6-suprisingfacts-about-childhood-pneumonia UNICEF.
Save the Children (SC), & Every Breath Counts (EBC).
Every child's right to survive: An agenda to end pneumonia deaths.
Retrieved from https://data.
org/resources/every-childs-right-to-survive-anagenda-to-end-pneumonia-deaths/ While government programs and commitments to end pneumonia seem promising, joint efforts by all stakeholders need to be continued and strengthened to ensure that childhood pneumonia is not forgotten despite the current COVID-19 pandemic situation.
Declaration of Conflicting Interest The authors declare no conflict of interest.
Funding Save the Children UK and Save the Children Hong Kong, in support of Save the ChildrenAos Pneumonia Centenary Commitment, provided necessary funding.
Author Biographies Tata Sudrajat is Deputy of Program Impact and Policy.
Save the Children Indonesia.
Wahdini Hakim is Health Nutrition Lead.
Save the Children Indonesia.
Taskin Rahman is Senior Regional Advocacy & Campaign Manager.
Save the Children Asia Region.
Rashed Shah is Child Health Advisor.
Save the Children USA.
References