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 (FP) and Post-Abortion Care (PAC) services. Previously, IPAS Indonesia Foundation had provided training to service providers such as midwives, general practitioners, and obstetrician-gynecologists for PAC services from August to September 2024. Subsequently, FP 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, 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.
“In addition, they also complained about the quality of healthcare personnel services, for example, midwives, nurses, or doctors,” she added.
Generally, the feedback provided by the community at both community health centers was as follows:
- Communication style of healthcare personnel still considered less friendly towards patients
- Availability of medication for miscarriage cases and insufficient availability of contraceptives
- Lack of information regarding types of contraception and general reproductive health information
- Service waiting time still considered too long
During her accompaniment of the MUB, Serli was deeply impressed upon hearing about several mothers who struggled to give birth at healthcare facilities. This is important because there is already a local regulation prohibiting home births.
“There was a story from one mother who had to use a motorcycle taxi from home to give birth at a healthcare facility. At that time, the mother was already two centimeters dilated. This mother came from Lanu Village, where the distance from Lanu Village to Oinlasi Community Health Center is far, with difficult terrain. Upon reaching the community health center, despite all the pain she experienced, this mother still struggled to give birth there,” she recalled.
This MUB activity is conducted in seven stages. The first phase involves planning and preparation. 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 action plan related to the proposals or suggestions. These phases were conducted from March to April 2025. After that comes the implementation phase of these proposals. The final stage involves joint monitoring and reporting.
One of the residents active in the MUB meeting, Mama Odiana Nuban, stated that the topic she presented in the forum was related to contraceptive insertion services at the community health center. According to her, the services at the community health center are quite good.
[However,] regarding registration, due to common network issues, if there are many patients, service can extend until the afternoon,” she added.
For information, community health centers have implemented electronic medical records. With this system, patient registration processes must use an application that requires internet access. If the internet network condition is poor, it hinders the registration process. This is the obstacle experienced by Mama Odiana.
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 the needs of the community.
“From the Services Division, we have never conducted evaluations with the community. So far, we have only conducted evaluations with community health centers by preparing them for accreditation. This is a learning experience for us so that we can also adopt activities like this, to truly obtain more information from the community,” said Yusiani.
In the MUB forum, Yusiani also responded to the long waiting times in services. She promised to conduct an evaluation to improve these services.
“We will conduct an evaluation so that community health centers do not only assign one staff member to the polyclinic or registration counter, because currently the system requires the use of electronic medical record applications, making the process somewhat lengthy, so we will later explain to the community health centers 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.