IPAS Indonesia Foundation, in collaboration with CIS Timor Indonesia Foundation, conducted a Feedback Mechanism (MUB) related to reproductive health services in South Central Timor Regency (TTS), East Nusa Tenggara Province. This MUB is part of the TAKENUSA project (Joint Commitment for Nusa Tenggara Women) with the aim of improving the quality of reproductive health services.
The services focused on in this MUB are related to Family Planning (KB) and Post-Abortion Care (APK). Previously, IPAS Indonesia Foundation had provided training to service providers such as midwives, general practitioners, and obstetrician-gynecologists for APK services from August to September 2024. Subsequently, KB training for midwives was conducted from December 2023 to May 2024.
This MUB is a follow-up to assess public opinion after accessing these services. The public’s input was then discussed and jointly decided upon, followed by collaborative implementation and monitoring.
In TTS Regency, the MUB was conducted in two sub-districts, namely South Amanuban and Amanatun, by inviting 27 women who had accessed services related to pregnancy, childbirth, and contraception within the last six months at two community health centers (puskesmas), namely Panite and Oinlasi.
MUB facilitator Serli Rambu Anawoli stated that topics frequently discussed in the activity included access, especially the distance from residents’ homes to health facilities, due to damaged road conditions. Additionally, some residents also discussed issues related to the availability of service equipment, such as ultrasound machines.
“Furthermore, they also complained about the quality of healthcare professionals’ services, such as midwives, nurses, or doctors,” she added.
In general, the feedback provided by the community at both puskesmas included:
- Healthcare professionals’ communication style is still considered less patient-friendly
- Insufficient availability of medication for miscarriage cases and contraceptive devices
- Lack of information regarding types of contraception and general reproductive health
- Service waiting times are still considered too long
While facilitating the MUB, Serli was particularly moved when hearing about mothers who struggled to give birth at health facilities. This is important because there is already a local regulation prohibiting home births.
This MUB activity is conducted in seven stages. The first phase is planning and preparation. This is followed by in-depth discussions and interviews with women who have accessed the services. The third stage is a presentation to convey the results of these interviews and discussions. Next is the development of a follow-up plan related to proposals or suggestions. These phases were carried out from March to April 2025. After that comes the implementation phase of the proposals. The final stage is joint monitoring and reporting.
One resident active in the MUB meeting, Mama Odiana Nuban, stated that the topic she raised in the forum was related to contraceptive insertion services at the puskesmas. According to her, the service at the puskesmas is quite good.
“However, regarding registration, due to common network issues, if there are many patients, services can extend until the afternoon,” she added.
For information, the puskesmas has implemented electronic medical records. With this system, patient registration requires an application that needs internet access. If the internet network condition is poor, it hinders the registration process. This is the obstacle Mama Odiana experienced.
Regarding the feedback presented in the MUB forum, Yusiani Nenosono, Head of Health Services Division at the TTS Regency Health Office, welcomed it positively. According to her, the matters discussed in this MUB are part of exploring community needs.
“From the Services Division, we have never conducted evaluations with the community. So far, we have only conducted evaluations with puskesmas by preparing them for accreditation. This is a learning experience for us, so we can also adopt activities like this to truly gain more information from the community,” said Yusiani.
In the MUB forum, Yusiani also responded to the considerably long waiting times for services. She promised to conduct an evaluation to improve these services.
“We will conduct an evaluation so that puskesmas do not only assign one staff member to the polyclinic or registration counter, because the current system requires using an electronic medical record application, which makes the process somewhat lengthy. Therefore, we will explain to the puskesmas to add staff in those sections,” she explained.
In this MUB process, the community is expected not only to be service users but also to actively provide input on the available services. This process opens a dialogue between the community and service providers, allowing real needs on the ground to be better identified.
It is hoped that the synergy between community input and the increased capacity of service providers will create a more effective, sustainable, and locally appropriate service system.
About the TAKENUSA Project
The TAKENUSA project was launched in 2023 with operational areas in TTS Regency, Kupang, and East Flores. This project aims to reduce the Maternal Mortality Rate in NTT through strengthening comprehensive Post-Abortion Care services. Additionally, TAKENUSA is also expected to improve contraceptive services.