What Community Led Health Programs should look like: Our PHE integrated CCs model

Since the start of this year Planet Indonesia’s coastal programs have expanded to an additional 321 households and approximately 1605 individuals.

In this blogpost, we’ll discuss how we establish a cornerstone of community empowerment, the human right to health.

The issues we’re dealing with are mammoth. The rural nature of our villages mean they have little to no access to consistent health services.

A shocking 89% of respondents from our survey (over 100 households) noted when they fall sick, they have no way to seek medical care due to a lack of access, financial hardships, or lack of trust in government health clinics.

Overwhelmingly this has harmful consequences for women and girls in particular. With limited family planning options and taboos surrounding maternal health, this often result in mother and infant malnutrition.

Seruat Dua’s PUMK leader Ira Maulinda and our PHE coordinator Fitria going over survey data

Baseline surveys showed that 86% of women did not know about contraceptives, and of the 14% that did, only 7% were using them regularly.

These are just SOME examples of the problems the local people have told us they face.

To respond accordingly to these community needs, the Health services provided through Conservation Cooperatives (CCs) model aims to (1) create a more hygienic and healthier environment and (2) help communities improving food security and nutrition by adopting sustainable harvesting practices.

Research has also repeatedly shown that healthy ecosystems mean healthier people. It also works the other way around too. To improve people’s health outcomes and access to primary healthcare services helps environmental conservation.

To do recognise that relationship, we have integrated our CCs model with the Population  - Health  - Environment (PHE) approach.

And because women and girls too often face greater inequalities that limit their ability to pursue the life they desire, our programs are created with a strong focus on providing women and girls with leadership and family planning opportunities.

It is through the context of those philosophies that we provide the local community members with services in healthcare, family planning, literacy, educational and savings just to name a few.

Our program strategist Demi greeting a new PUMK member before discussing what she’d like to benefit from our CCs

Given its scope, this program meets the UN sustainable development goals which includes 17 global goals and we have proof our model is working.

Currently, there are over 3000 households enrolled in our programs.

With 65% of all beneficiaries women, we have found those households are 120% more likely use contraceptives and engage in family planning decisions as a couple vs a male-dominated situation.  

In those areas we have measured a 49% decrease in deforestation loss, and within 6 months of joining our programs average household income has improved between 15-30%.

Overall, we have found our models effectively (1) improves access to healthcare and overall healthcare for women and girls and (2) acts as a catalyzer for environmental conservation.

This year we intend to expand these health programs to two indigenous villages in the Gunung Niut Nature Reserve and two coastal fishing villages in Kubu Raya, West Kalimantan.

One of our newest villages enrolled, Seruat dua is built mostly on the banks of a single river and have ownership over an incredible mangrove forest

Both of these areas average income varies from extreme poverty (less than USD $1.25 per day) to poverty (less than USD $5.00 per day), and women in both areas face extreme hardships in terms of access to healthcare and economic opportunities.

While we have our own health ambassadors, we also collaborate with several organizations to invest in better health. We work with the department of public health and local health clinics to ensure that clinics have capable staff and are stocked with basic medicine, such as pre-and post-natal and contraceptives.

Right now, we are also partnered with Blue Communities, a research coalition from the UK. This partnership is to conduct scientific research on how health interventions can drive the adoption of conservation in rural villages while improving well-being for women and girls.

Measuring the effectiveness of a PHE integrated model with Blue Communities

PhD candidate Anastasia and her supervisor Dr Karyn Morrissey from Blue Communities, a research group funded by the UK Government, arrived in Pontianak in April to conduct research on the effectiveness of PHE integrated family planning programs.

Funded by the UK Global Challenges Research Fund, the overall aim of the Blue Communities group is regarding health, well-being and livelihood capacity building of coastal communities in South-East Asia.  

The women focus group conducted on day two of our field trip with Blue Communities

We set off to accompany them to Seruat dua throughout the month of April. There they were conducting focus groups and questionnaires to explore general beliefs, attitudes and motivations regarding family planning and the environment.

The research will examine whether community led health-based interventions can (1) improve human health and consequently (2) the overall health of the coastal ecosystem.

The benefits of research like this for conservation organisations like Planet Indonesia is two-fold.

The results of this project will inform us if our programs are having the intended effect and which targets need to be approached in a different manner.

Secondly, research helps legitimise and give our programs credibility in the same way we referred to research regarding the PHE concept before implementing it in our organisation, especially if it is published in a peer-review journal.

We’re also hoping that the research will strengthen the evidence that healthy humans play a positive role in environmental conservation.

“The role of a healthy ecosystem on human health is well established, less well established is the role healthy humans play on ecosystems.” Blue Communities PhD candidate Ana said.

And all of this will be done with the voices of local community members taking center stage, meaning the science and research, like all of our work, is inclusive and community-led.