Applying Evidence-based Advocacy in a Decentralized Context
In 2001, Indonesia’s administrative and financial powers of government were rapidly devolved to 550 districts, in what is now described as the “Big Bang Decentralization”. This mass decentralization included budgeting for health services and supplies. In the intervening years, district governments have struggled to identify which health issues to prioritize and the level of funds needed to achieve improved health outcomes.
In addition, the National Family Planning Board’s (BKKBN’s) role in championing the value of family planning as a health intervention diminished at the local level. Without adequate evidence and expertise, commitment and resources to promote and provide access to family planning dwindled.
So, The project (KB) must rekindle local commitment to family planning and reengage champions, expanded to all of the district, aims to increase access to quality family planning services among low- and middle-income populations, including marginalized groups and communities living in remote villages.
Fewer Women Die When Pregnancies are Planned
Family planning (KB) saves women’s lives in two ways. First, family planning helps women avoid unwanted pregnancies. Each year, 687,000 maternal deaths are averted with family planning versus the 533,000 maternal deaths that occur (red: Personal communication with Amy Tsui, Professor, Johns Hopkins School of Public Health and Director, Bill and Melinda Gates Institute for Population and Reproductive Health. Calculations based on Liu L, et al. Three methods of estimating births averted nationally by contraception. Population Studies, 2008 July; 62(2): 191-210).

As shown in the graph (Calculations for maternal mortality rate by Carie Muntifering, Doctoral Candidate, Johns Hopkins School of Public Health. Calculations based on: World Health Organization. Trends in Maternal Mortality:1990 to 2008. Estimates Developed by WHO, UNICEF, UNFPA and the World Bank, Geneva: WHO, 2007 and World Population Prospects: The 2008 Revision Population Database. United Nations, 2008. http://esa.un.org/UNPP/, accessed 13 Dec 2010.) the more couples practice family planning, the fewer women die from pregnancy-related causes (World Health Organization. Trends in Maternal Mortality:1990 to 2008. Estimates Developed by WHO, UNICEF, UNFPA and the World Bank, Geneva: WHO, 2007) Women who are not pregnant do not die from pregnancy-related causes.