Key Findings: Suami Siaga Campaign Impact Evaluation

1
Involving Husbands in Safe Motherhood The Suami
Siaga Campaign in Indonesia Ministry for Womens
Empowerment UNFPA Johns Hopkins University/Center
for Communication Programs
September 2003

2
Maternal Mortality in Indonesia

• Ratio 390-630/100,000 births
• Hemorrhage 1 cause of death
• 54 deliveries by TBAs
• In rural areas, 65 deliveries by TBAs
• Among women with little or no education, 74
  deliveries with TBAs

Source Indonesia Demographic Health Survey, 1997
3
Project Partners

• Ministry for Womens Empowerment responsible
  for Gerakan Sayang Ibu
• Johns Hopkins University/Center for Communication
  Programs
• UNFPA

Project budget 750,000 (includes salaries and
technical assistance) Duration 1998-2001
4
Intended Audience

• Primary
• Husbands, ages 15-45, low to middle SES (CDE
  economic class), living in South Sumatra, East
  Java and South Sulawesi
• Secondary
• Midwives
• Community leaders
• Families (incl. wives)

5
Project Goal

• Increase specific knowledge of the Three Delays
  that contribute to maternal mortality and promote
  attitude and behavior changes necessary to
  overcome those delays

6
Project Objectives

• Increase knowledge of danger signs
• Encourage attitude of pregnancy being special
  time
• Instill a sense of pride in husbands to be
  involved in pregnancy
• Motivate community leaders and members to develop
  transportation plans
• Increase number of midwives who discuss pregnancy
  plans with couples

7
Suami Siaga Campaign Concept

• SIAGA positively positions behaviors related
  to the Three Delays and is an abbreviation for
  
• SIAP means to be ready/prepared (accompany wife)
• ANTAR means to be transported/get a ride
• JAGA translates to guard (always be by your wife
  during and after delivery)
• SIAGA in its own word also means ALERT

8
Suami Siaga Program Components

• National PR events began in February 1999
• Television and radio spots featured dangdut
  singer Iis Dahlia (February to August 1999)
• IPC/C one-day training for midwives
• Three-part television drama Kembang untuk Nur
• Local mobilization events
• Mini grants to the community
• Tie-ins to existing activities Kembang Untuk
  Nur edited for mobile van

9
Project Monitoring and Evaluation

• Methodology
• Face to face interviews with husbands (n1,507)
  wives (n606) midwives (n93) community leaders
  (n90)
• Indicators
• Campaign exposure exposure to local activities
  message comprehension changes in attitudes and
  intention associated with exposure changes in
  perceived support from husbands, community and
  health services

10
Suami Siaga Exposure to Campaign(Unaided
recall)
Bidans
4
96
Exposed
Source JHU/CCP and TNS, 1999-2000.
Population-based Surveys among Husbands
N1,507 Wives N606 Bidans N93 Tokohs N90
11
Suami Siaga Exposure to Various Campaign
Elements
Exposure via other elements like T-shirts,
friends, neighbors, family members,
hats and mobile van was less than 10 for
husbands and wives
Source JHU/CCP and TNS, 1999-2000.
Population-based Surveys among Husbands
N1,507 Wives N606
12
Suami Siaga New Things Learned by Husbands from
the Campaign
Arrange for transport
To arrange for blood donation
How to respond to delivery complications
Do exercises
To have a trained provider at delivery
Ask neighbor to look after wife when absent
To know danger signs
Accompany wife when transported during delivery
Source JHU/CCP and TNS, 1999-2000.
Population-based Surveys among Husbands N1,507
(among respondents who claimed to learn something
new)
13
Suami Siaga Intended Behaviors of Husbands
Significant at .05 level Source JHU/CCP and
TNS, 1999-2000. Population-based Survey among
Husbands N898
14
Suami Siaga Practice of Siaga Behaviors
Suami Siaga Campaign resulted in the practice of
specific behaviors
Source JHU/CCP and TNS, 1999-2000.
Population-based Surveys among Husbands
N1,507 Wives N606
15
Suami Siaga Opportunities

• Strong political and community support
• Served as the communication component of the
  GOIs Mother Friendly Movement
• Concept adopted as the strategy for the BCI
  component of MNH program

16
Suami Siaga Lessons Learned

• Coordination at the field level
• Availability of services
• Quality of services
• Link between midwives and TBAs
• Low expectations
• Economic crisis in Indonesia