Improving Maternal & Newborn Health & Nutrition in Indonesia

Experienced Leader in Innovative, Scalable and Sustainable Health Programs

Futures Group and sister company GRM International have been implementing programs to improve public health and human development in Indonesia since the mid-1970s, with funding from AusAID, DFID, USAID and other donors. GRM established an official in country presence in 1995 and that presence continues today. Futures Group and GRM currently implement three projects in Indonesia, with activities at national, state, and local government area levels. Futures Group and GRM International are part of a group of international health and development companies with a joint focus on partnering with institutions, governments, and businesses worldwide to improve peoples lives. With more than 120 projects operating in more than 85 countries, and over $250 million in annual revenue, our combined group has a multisectoral focus, diverse technical offerings, and a wide geographic reach.

Program Areas
maternal and child health population and family planning sexual and reproductive
health hiv and aids infectious diseases gender poverty and equity

Futures Group and GRM Maternal and Newborn Health and Nutrition Expertise:
With DFID support in India (2012-2015), Futures Group is making family planning services available to poor, young and low parity couples using innovative public private partnership models, including social marketing, social franchising, a demand-side financing mechanism, and mobile medical units. This project will be adding 280 social franchising clinics and 18,000 social marketing outlets. Futures Group works with the government at state and district levels to create sustainable partnerships with private sector providers, within the National Rural Health Mission (NRHM) framework. In Kenya (2013 2018) under DFIDs Reproductive Health Framework, Futures Group will deliver increased family planning and maternal health services by creating and maintaining a Sector Wide Approach for family planning, and adopting a Total Market Approach to dramatically grow Kenyas family planning market and meet unmet need. The Program is also employing a Making Markets Work for the Poor (M4P) approach to increase sustainability, focusing efforts on rural women and adolescent girls, as well as employing extensive, innovative Social and Behaviour Change Communications to increase demand and reduce social barriers for family planning, and strengthening health system commodity logistics. With DFID support in South Africa (20122015), Futures Group is strengthening delivery of school health, ward primary health care, and obstetric and neonatal emergency services. The program also improves demand and accountability for health services, and uses new data and knowledge to remove barriers for uptake and access of services. The program supports regional initiatives, such as the African Union Campaign on Accelerating Reduction of Maternal Mortality in Africa (CARMMA), through strengthening district capacity to improve maternal and child health clinical governance. By April 2013, 16 of 25 districts integrated CARMMA within their health plans. We also helped organise the AU conference taking stock of CARMMA progress, attended by presidents from Nigeria and South Africa, and several government ministers. Futures Group provided technical assistance to the Innovations in Family Planning Services project (2005-2012), a collaborative effort of the Government of India and USAID to improve demand for and access to family planning and reproductive health services. We implemented and scaledup eight innovative public-private models to improve access to maternal health and family planning services. Futures formulated the state health Program Implementation Plans (PIP) for Uttar Pradesh starting in 2009. The PIP for 2010-11 supported by Futures Group was recognised as the best PIP in the country. The central government also adopted the participatory district action planning process Futures pioneered in Uttar Pradesh as a model for (NRHM) planning across the country.

Technical Services
project management research and strategic health markets and private
information sector engagement modeling and economic analysis health systems strengthening strategic consulting economics and financing program management

Futures Group GRM International Ratu Plaza Office Tower, 19th Floor JI. Jend. Sudirman Kav 9 Jakarta Pusat, 10270, Indonesia tel +62 21 720 6616 Futures Group GRM International Level 6, 444 Queen Street Brisbane Queensland 4000 GPO Box 449, Brisbane QLD 4001 tel +61 7 3025 8500 fax +61 7 3025 8555 Futures Group GRM International One Thomas Circle, NW Suite 200 Washington, DC 20005 U.S.A. tel +1.202.775.9680 fax +1.202.775.9694 www.futuresgroup.com www.grminternational.com

The AusAID-funded HIV Cooperation Program for Indonesia (HCPI) (2008-2016) is supporting Indonesia in planning, developing and implementing an effective and sustainable response to HIV. HCPI has had a massive impact on people who inject drugs in Java, HIV-positive prisoners and the general population of the Papua and West Papua provinces of Indonesia and most-at-risk populations in Bali. It in turn has a knock-on effect for the general population of Indonesia who comes across HIV-sensitive messaging or testing services in health or methadone treatment centres. The Poverty Reduction Support Facility (2011-2014), administered under the leadership of the Vice President of Indonesia with AusAID funding, supports the National Team for Accelerating Poverty Reduction to reduce poverty and the impact of shocks and stresses on the poor and vulnerable. The National Team provides directions to improve policy advice for the respective programs in contribution to the poverty reduction acceleration nationwide. Through the Australia-Indonesia Education Program (EP), AusAID Performance Oversight and Monitoring (POM) (2011-2016) monitors and evaluates the impact of AusAIDs contribution to the Government of Indonesias Education Sector Support Program. Using a range of M&E approaches and methodologies, POM generates, synthesises and analyses EP performance information and then provides evidence-based, actionable recommendations to EP management to improve program implementation and management.

Our Presence in Indonesia

Futures Group and GRM Offerings:

Building public, private and NGO/CSO partnerships to strengthen government health services at the national, regional and local level
Futures Groups Total Market Approach works with government, private sector, and civil society to make healthcare more accessible to those who need it most. We help the overall market expand and diversify, building on existing provider networks and varied public and private service delivery channels. In Afghanistan (2012-2014), Futures Group established the Afghan Social Marketing Organisationto work with the government to identify health priorities, with civil society to develop and deliver messages, and with the private sector to deliver quality commodities. This resulted in sales of more than 59 million health products through 5,300 outlets across the country, with more than 360,000 people trained on family planning methods, water purification and the use of oral rehydration salts. We facilitate dialogue between the public and private sectors, helping to broker relationships and develop institutional structures that support long-lasting partnerships and innovative solutions. In India (2005-2012), Futures Group worked with the government to set up a voucher scheme that would provide low-income women with a voucher to cover all costs of pregnancy at private health care facilities. In three of Indias poorest states, the vouchers have supported 44,000 antenatal care visits, 10,300 postnatal care visits and 12,500 institutional deliveries. In addition, 9,500 vouchers were used for family planning services. The approach has been embraced by state governments, especially in Uttar Pradesh where coverage has been scaled up from slums in one city to slums in 11 cities.

Analysing program costs to ensure optimal resource allocation

Through our work with the USAIDfunded Costing Task Order (20102013), we worked with policymakers and program managers to develop new tools, approaches and analyses that help to more accurately predict the cost and impact of their HIV and maternal health programs and other public health responses. By generating and disseminating realistic cost data we facilitated decision-making to inform smart investments. Through the Health Policy Project (2010-2015), we give a holistic view of health systems, including applying models on what services are needed in the future and what it will cost to scale up those programs. Futures Group established a new Efficiency and Effectiveness (E2) program to identify ways to get the greatest impact from money invested and optimise the quality and quantity of services in Kenya in 2011, and expanded to other African countries in 2012. In 2006, Indonesias National AIDS Commission (KPAN) requested assistance to develop a national costed action plan to implement the strategy. The Health Policy Initiative (2005-2010) supported KPAN to form a national costing team and to cost the plan using the Resource Needs Model (RNM), a software program that estimates resources needed and cost implications of national strategic plans. KPAN shared the draft costed action with decisionmakers. This strategic planning process helped increase the national budget allocation for HIV by US$65.7 million in four years. Provincial and district HIV budgets also increased. Futures Group works with partner countries to find solutions that support national health priorities. We have developed and use models to inform resource allocation decisions, like the Safe Motherhood, Allocate and Fam Plan Models. With these tools, we help examine the performance of current and planned programs looking at program cost, efficiencies, proven interventions and local context. For example, using the FamPlan Model, Futures Group assisted the government of Tanzania to become more realistic in the requirements and costs to meet government family planning targets.

Increasing Family Planning and Maternal Health Services in India

In 2005, Futures Group India began a five-year process under the USAID | Innovations in Family Planning Services Technical Assistance Project (ITAP) to uncover what was preventing poor women from accessing reproductive health services and determine how to reverse the troubling trend. Early on, the ITAP team met Abha, a 25-year-old pregnant woman who lived in a poor neighborhood in Agra, a city in the northern state of Uttar Pradesh. Abha discovered she would need a C-section to deliver her baby safely, but there were no affordable alternatives for a poor pregnant woman. Cost was a huge factor preventing women like Abha from accessing care. To solve the problem, ITAP piloted a voucher program in Abhas neighborhood. Their idea: give women who live below the poverty line vouchers to receive health services at private hospitals. A government agency would reimburse the hospitals for the services. The project faced considerable barriers: not only were resources an issue, but private hospitals were opposed to being reimbursed below the market rate. Using Futures Group forecasting tools, ITAP showed policymakers how they would save in the long-run by providing safe and quality reproductive health services. With policymakers convinced, the team turned to leaders at the local teaching hospitals, who were highly respected by the private hospitals. They highlighted a benefit of the program: it would increase the number of people seeking services something the hospitals were desperate for. After the program launched, Abha learned she was expecting her second child again facing delivery via C-section. This time, she obtained a voucher to give birth at a private hospital for free. With their on-the-ground relationships and local insight, ITAP made it possible for poor women like Abha to receive free, quality reproductive health care. Six years after the pilot, their program has now been taken to scale.