38771 Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Making Services Work for the Poor: Nine Case Studies from Indonesia Public Disclosure Authorized

INDOPOV THE WORLD BANK OFFICE JAKARTA Jakarta Stock Exchange Building Tower II/12th Fl. Jl. Jend. Sudirman Kav. 52-53 Jakarta 12910 Tel: (6221) 5299-3000 Fax: (6221) 5299-3111 Website: www.worldbank.or.id

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Printed in 2006.

This volume is a product of staff of the World Bank. The fi ndings, interpretations, and conclusions expressed herein do not necessarily refl ect the views of the Board of Executive Directors of the World Bank or the governments they represent.

The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of the World Bank concerning the legal status of any territory or the endorsement of acceptance of such boundaries. Making Services Work for the Poor : Nine Case Studies from Indonesia

Bank Dunia | The World Bank Indonesia Poverty Analysis Program (INDOPOV) Poverty Reduction and Economic Management Unit East Asia and Pacifi c Region Acknowledgements

The Making Services Work for the Poor Case Studies series was researched and written by a team led by Stefan Nachuk (EASPR). The document constitutes one part of a larger piece of analytical work designed to examine access to services for the poor in Indonesia.

This report is one output of World Bank’s Indonesia Poverty Analysis Program (INDOPOV) led by Jehan Arulpragasam and supported by the DFID Poverty Reduction Partnership Trust Fund. Case work was supported by both the World Bank (Jakarta) and the Ash Institute of Democratic Governance (Harvard University).

The Cases were written by Eleonora Suk Mei Tan, Arya B. Gaduh, Susannah Hopkins Leisher, Stefan Nachuk, Laila Kuznezov, and Janes Imanuel Ginting. Field research was undertaken by Eleonora Suk Mei Tan, Sri Budiyati, C. Clarita Kusharto (Lumajang, Pemelang, Tanah Datar); Laila Kuznezov, Janes Imanuel Ginting, Gregorius Kelik Agus Endarso, Leonardus B. Marmanto (Bandung, Jembrana, Blitar); and Arya B. Gaduh, Nunik Yunarti, Luis Fujiwara, and Maulina Cahyaningrum (Polman, Boalemo, Maros)

Special thanks to Eleonora Suk Mei Tan, Arya B. Gaduh, and Susannah Hopkins Leisher for working harder and longer than required to ensure a high quality fi nal product.

Stefan Nachuk, Menno Prasad Pradhan, Winthrop Carty (Ash Institute) provided managerial and editorial support. Susannah Hopkins Leisher provided editorial support. Juliana Wilson managed the publication process.

Making Services Work for the Poor: Nine Case Studies from Indonesia iv Table of Contents Acknowledgements iv Table of Contents v Abbreviations and Acronyms vi Case Study Synthesis 1 Introduction 3 Summary of the cases 4 Annex: Case Study Innovators and Funders 23

Case Study 1: Smaller Classes and Stronger Incentives in Tanah Datar District, West Sumatra 25

Case Study 2: Vouchers for Midwife Services in Pemalang District, Central Java 41

Case Study 3: Creating Learning Communities for Children in Polman District, West Sulawesi 59

Case Study 4: Improving Budget Transparency in Bandung, West Java 77

Case Study 5: Water Supply and Health in Lumajang District, East Java 93

Case Study 6: Health Insurance Reform in Jembrana District, Bali 113

Case Study 7: The Community Block Grant Program in Blitar City, East Java 131

Case Study 8: Participatory Planning in Maros District, South Sulawesi 149

Case Study 9: Civil Service Reform in Boalemo District, Gorontalo 165

Making Services Work for the Poor: Nine Case Studies from Indonesia v Abbreviations and Acronyms

AUSAID Australian Agency for International Development BIGS Bandung Institute of Governance Studies CBG Community Block Grant CLCC Creating Learning Communities for Children DFID Department for International Development (UK) MSWP Making Services Work for the Poor NGO non-governmental organization UNICEF United Nations Children’s Fund USAID United States Agency for International Development WSLIC-2 Second Water and Sanitation for Low-Income Communities Project

CASE STUDY SYNTHESIS

Making Services Work for the Poor: Nine Case Studies from Indonesia vi Case Study Synthesis Case Study Synthesis 2 Target projectsto ensure they benefi delivery thepoorinservice t. • providers anddonors: Findings of thefollowing from the nineMSWPcasestudiesunderscore theimportance practices”“best for service positive. innovations. thefour In caseswhere delivery thepoorwere atargetservice group, onthem wasmainly impact thefiIn ve casestudieswhere thepoor were nottargeted, thepoor were to loseoutas aslikely to benefi t from positive orreverse negative impact. innovations are implemented fldelivery exibly.In many cases, leadersdeveloped newstrategies to strengthen reducedofreforms.dissemination alsolikely theimpact canbestrongerThe casesshow thatimpact whenservice projectadjustmentsto strengthen diffi impact mid-course systems,collection making where reforms were locallyconceived, relatively cheap, andlocallyfunded. Noneofthecaseshadeff substantial newcoststo clientsare alsofacingfi nancialdiffi The fi ofallsixexternally nancialsustainability nancedcasesisindoubt,andlocally conceived reforms thatpasson fi through localorganizations andby andprocesses. working amongcivilservants, by broadening theirsupport to delivery, ensureability Leaders positive impact. builttrustby ofservice raisingawareness abouttheinadequacy conceived andfundedornot.Local leaders’ emphasizingpersonalinvolvement style, andfl exibility, key to their was were found delivery leaders, to whetherexternally bedependentonlocalratherthanexternal inservice Innovations threatened laws andregulations where are localsupporting weak orlacking. citizens, aswell asdonors, more interested ingoodgovernance. oftheinnovationsThe positive is, impact however, a boostto thepotential for fi Districts’ from nancialsustainability thestart. greater power madelocalpoliticiansand gave somelocalleadersthemeansto pay for locallyconceived reforms withouttheneedfor donors, giving external laws to andpoliciesthatdevolved thelocal level. authority The districts’ newpower over fi nanceandadministration oftheinnovationsnational-levelarrangements. studiedwould Most nothave beenpossiblewithoutthesupport andleadershipwereDecentralization delivery found for factors to success of innovative bethekey service people over 80days offi 2005. in25villagesandcitiesbetween eldwork andApril February andfocuspeople. Research group wasbasedonsemi-structured interviews discussionswithapproximately 600 provision andreached allcaseshave atotal ofatleasthalfamillion in nearly onservice madeaclearpositive impact delivery. Abouthalfthecasesfocus driveninnovations;halfwere onexternally service ledby locals. The innovations interested andothercountries useful to ideasfor donors andgovernment inIndonesia inpractical improving local ishopedthatthissynthesiswillbe ofdecentralization.It inthewake atthelocallevel inIndonesia delivery service Services Work forThe nineMaking thePoor (MSWP)casestudiessynthesized inthispaperreviewed innovations in Abstract Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: culties. Ongoingfundingisassured cases, inonlytwo cult. Inadequate information ective data ective 2 Dahl-Ostergaard, Tom Dahl-Ostergaard, etal., Lessons Learned ontheUseofPower Cooperation, inDevelopment ofChangeAnalyses andDrivers 2 More informationcan befoundatwww.worldbank.or.id. 1 provision improving service pro-poor thathave oncurrent factors outcomes, animpact key steps andpropose for andpractical ananalyticalframework for identifyandanalyze thepoorinIndonesia, delivery are objectives to summarize thestate ofbasicservice Its government’s eff The World Services Bank’sWork for Making thePoor for (MSWP)projectaimsto providethe analyticalsupport hascreatedthis shift tremendous potential for innovative delivery. localapproaches to government service and cities, of220millionpeoplewithabout440districts promote acountry change(bothpositive andnegative). In gravity for where to innovationhasthus shifted thedistricts, localgovernments now have muchmore autonomy to level. to thedistrict ofmostgovernment services decentralized thedelivery Thecenter of 2001,Indonesia January In Introduction Assist reform. intheimplementationoflocallaws andregulations supporting • Buildfl into projectrules exibility to strengthen positive or reverse negative projectimpact. • projectsincludeaneff delivery Ensure allservice • Ensure fi projects. delivery nancialsustainability for service • reform. delivery leaderswithinlocalgovernment andlocalNGOsfor service Support • projects. delivery Invest ingoodinformation disseminationmechanismsto helpbuildtrustinservice • into practice poor change. Despiteitspotential usefulness, however, theapproach hasnotyet beenwidelydisseminated orput incentives thathave andunderlying onpro- animpact blockages, aimsto identifytheopportunities, structures. It change. thatdrivesystemic the factors socio-political “Drivers ofChange” analysisfocuses onagents, institutions, and MSWP analysisbearssomerelation to the “Drivers ofChange” approach (usedby DFIDinrecent years) to understanding service delivery. service interested andothercountries to ideasfor donorsandgovernment inIndonesia inpractical improving government ishopedthatthissynthesis,replication. whichpullstogether commonalitiesamongtheninecases, It willbeuseful to thatcontributed factors orreducedandpossible ways of interms forward assessment ofinitialimpact, impact, days atthelocallevel ofdecentralization,andprovide intheearly an delivery to improve taken actions service to fiThe nineMSWPcasessynthesized inthispaperwere undertaken llsomeofthesegaps. concrete They describe how localitiesusethenew “space” delivery. provided bydecentralizationto planandimplementchangesinservice Meanwhile, extensiveliterature hasyet noneofthefairly included ananalysisof ondecentralizationinIndonesia tember 2005). 2 . orts to improve access to and quality of basic services for ofdecentralization. to improve thepoorinwake ofbasicservices orts accessto andquality 1 . ective monitoring component. monitoring ective Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine DFID: Sussex(Sep- DFID:

3 Case Study Synthesis Case Study Synthesis 4 April 2005. April local meetings. Teams spentatotal of80days inthefi eldvisitingabout25villagesandcitiesbetween and February people. The viewsofatleast100more peoplewere into incorporated fi ndingsvia research teams’ attendance at andfocusResearch group wasbasedonsemi-structured interviews discussionswithatotal ofapproximately 600 local sources; three were paidfor entirely from localsources andonlyoneentirely sources. from external half were headsandlocalNGOs. ledby innovations locals, were Most includingdistrict paidfor and bybothexternal were agencies, includingthe drivenbyexternal UNICEF,World Bank, USAID, andcentral government ministries, and Thisfi gure excludes benefi reforms, ciariesoffollow-on audiences ofBIGS’ radioshows (about250,000people)andBoalemo 5 Indicators “Welfare 2004,” BadanPusat Statistik(June 2005). 4 BPS-Susenas Panel Modul. 3 school staff CLCC (case 3) by agovernment healthproject. midwives doubledandmidwives’ coverage ofvillagesreached 95percent. Theproject was discontinued whensupplanted greatlyservices. It increased access ofthepoortoproject midwives. theproject During period, thenumberofdistrict Pemalang (case 2) thebetterandlower-performing seniorhighschoolsincreased. between students, andinequity schools improved. theotherhand, On access toseniorhighschoolswas reduced forsomechildren, mainlybelow-average went abroad underthe incentives program increased, andteachingmethodologyeducation atthebetter services exposure trips, andmore thanhalfthedistrict’s seniorhighschoolsreduced classsize. Themotivation ofschoolstaff education staff Tanah (case Datar 1) reached atotalofatleast500,000people The innovations innearlyallcases provision and onservice madeaclearpositive impact rate thanthenationalratehave of16.7percent alower(2004) poverty sustainability. coverThe ninecasesselected eightofIndonesia’s 32provinces areas. andurban Five oftheprovinces insuccess, factors provision, andreasonable easeofidentifyingandanalyzingkey improving chanceof basicservice governmental organizations (NGOs),andlocalgovernment staff The MSWPcasestudieswere chosenfrom anumberofcandidates gathered by the World Bankfrom donors, non- oftheCases Summary of between 20and29percent,of between muchhigherthanthenationalrate. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: (about 106,000 people). Some peoplecounted as“benefi(about 106,000people).Some ciaries”maynothave taken advantage of reform benefi tstowhichtheywe . CLCC (Creating Learning Communities forChildren) produced more active teachingmethodsandmore . UnderTanah Datar, 4percent ofdistrictteachersand10percent ofdistrictheadmasterswent onoverseas is aneducation project inWest active teachingandlearningmethodsstronger Sulawesi supporting was ahealthproject inCentral Java providing vouchers topoorpregnant women formidwives’ isasetofeducation reforms inWest Sumatra, includingsmallerclassesandstronger incentives for 5 . . Criteria for selection included a high possibility of for includedahighpossibility . Criteria selection 4 Half the district-level innovations Halfthedistrict-level highlighted 3 , andtheremaining rates three have poverty civil servants’ clients civil servants’ re entitled. who Using anexchange rate ofUS$1 =Rp. 10,000. 6 ofdistrictfunds; (US$360,000-$610,000) worth communities involved are very intheprocess ofproject selectionforannualallocations Rp. ofbetween 3.6and6.1billion Blitar (case 7) for manyrural poor. the poormaynolongerreceive healthcare primary from midwives andparamedics, whohadbeenthefi rstsource of care ofand satisfactionan increase withhealthservices.Stricterreferral inbothquality standards have, however, meantthat 29 to80percent duringthescheme’s fi rst year. There hasbeenalarge increase inthenumberofmidwives inthedistrictand because itcovers private aswell aspublicproviders. The percentage treatment ofsickpoorpeopleseeking increased from Jembrana (case 6) the water supplysystems. have access toproject water supply. Villagershave oflife, greater quality healthierbehavior, andasenseofownership of the targeted villagesinthedistrictvisited. 85and100percent Between ofvillagersinproject hamletsvisitedby theteam Water2 (Second forLow-Income andSanitation Communities Project) hassofar increased villagers’access towater inhalf WSLIC-2 (case 5) have beguntoreplicatecities andNGOs BIGS’ work. budgetmoreof corruption pro-poor. againstaprevious parliament,thoughtodateithasnotmadethecity Anumberof a checkontheexecutive branch, resulting inreduced allocations toquestionablebudgetitems, andhasbrought acase awareness ofbudgettransparency. abouttheimportance BIGShasempowered parliamenttostrengthen itsrole city as trained nearly100peopleincludingjournalists, politiciansandothersintheuseofinformation,raised citizens’ Institute ofGovernance budgetinformationviabooks, postersandmagazines, Studies)hasobtainedanddisseminatedcity BIGS (case 4) their own budgets. brought CLCC methodsto35percent ofdistrictschools, payforCLCC-style ofwhichaboutone-third activitiesentirely from Exam scores atproject schoolsdidnotincrease relative tonon-project schools. Formal andspontaneousreplication has involved parents andstudents, butonlyincreased schoolmanagementaccountability where headmasterswere supportive. funder, USAID, hasceased involvement inaccord withitsproject schedule. district fundingofvillageproposals isattributedtoadvocacy eff it. Women’s isstilllimited, Alarge andtheplans’impactondistrictplanningisunknown. participation increase in2004 been mixed: more peoplehave beeninvolved inplanning, butmanyothersare unaware oftheproject orpessimisticabout in19percent ofvillagesinthedistrict.Resultshave planninghasbeenundertaken budgeting. UnderMaros, participatory Maros (case 8) does notappearthepoorbenefi tsignifi cantly from the project, otherthan from fundingearmarked forslumhousing. isalocal ongovernance NGOworking inWest Java, withafocusonbudgettransparency. BIGS(Bandung isagovernance project inEastJava providing blockgrants community forvillageproposals. Blitar was inplanningand agovernance Sulawesi projectparticipation focusedoncommunity inSouth is awater WSLIC- supplyandhealthproject inEastJava participation. withanemphasisoncommunity is adistricthealthinsurance hasincreased schemeinBali.It theaccess ofthepoortohealthservices 6 they make they substantial fi nancialandin-kind contributions toprojects.It orts ofthelocal NGO champion,Forumorts Warga. Theexternal

Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine

5 Case Study Synthesis Case Study Synthesis 6 presentation ofresults. inunevenfactor results. Considerable eff The casestudieswere setsvaried. mostly doneinparallelandthusteam compositionandskill This wasaprimary study teams didnotusestandardized research particular, questions. In andfi research onpoverty nanceswasuneven. case studieswere out,andthesamplesize wassmall. carried Datawere insuffi alsooften Limitations to thecasestudies. tolodgecomplaints aboutpoorservices. have more opportunities for somestaff fi services.The removal forpoorquality neslevied ofallowances formost work-related expensescreated nancialhardship fi improvements were onlydetectableinbetterattendance. Theuseoffi nestoimprove suff performance accountability. increased It salariesofmostfull-fl edgedcivilservants by asmuch80percent, performan butcivilservant Boalemo (case 9) 2001, awave ofnational-level policiesandlaws wasintroduced thedecentralizationlaw to areality. make laying thegroundwork for adramaticprogram ofadministrative, fi nancialandpolitical decentralization.Beginning in the fallofPresident culminated Soeharto, inthe1999Law No. andRegional 22/1999onDecentralization Autonomy, policies that devolved to thelocallevel. authority Most ofthereforms studiedwould nothave ofnational-level laws beenpossiblewithout thesupport and Decentralization andleadershipwere thekey factors forsuccess ofinnovative 1. Impactofreforms incases 3,5,6,7,and8was inconclusive regarding: accountability ofschoolmanagement;villagers’he 7 Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: and districtplans, respectively. forvillageproposals over inJembrana;est inworking time, oramountofsupport impactonpoor communities; andinte and type service delivery arrangements. delivery service . However, transparency inbiddingforlower-budget projects hasimproved, andcitizens nearthecapital city is asetofgovernance reforms inGorontalo and focusedonimproving performance civilservant Several limited factors theresearch teams’ to analyze ability fi elddata.Nocontrol ort was spent after thefi wasspentafter ort eldwork to llinmissingdataandstandardizefi the Indonesia’s of1997and1998,including economicandsocialcrises cient or lacking, ered asthere were no alth; healthworkers’ inter- gration ofvillage 7 andcase ce ce villagers closelyinvolved inprojectimplementation. coverage andaccessibility, whilelocallyelected Village Implementation Teams Organizations andMaintenance keep systems under WSLIC-2. Villagers themselves decidehow many andwhere tanksto construct to putthemto ensure managementofwater supplycreated oncommunity spacefornational policy villagemanagementofwater supply headmasters andteachers to assessoneanother’s regular schoolsduring Headmaster GroupWorking meetings. The Teachers beganto generate newideastailored to localconditions, designed andalocalschoolinspector aplanfor to meetlocalneedsbetter,to adjusttheircurricula themselves. andto plan,develop andmanagetheirservices policiesgranted Curriculum andCompetency-Based educationstaff national School-BasedManagement local conditions vianewideas, newgroups, andgreater citizen participation. Decentralization’s andvillagelevels allowed extension down reforms to thesub-district to betailored to have beenpossiblewithoutthefi nancialandadministrative latitudethatdecentralizationgave to districts. (CBG) Program. Noneof thelocallyconceived reforms highlighted inthethree casestudiesmentionedabove would 2004 from bureaucratic reforms, toward whichthen went paying inpart for their innovative BlockGrant Community laying off of Rp. 2-3billion(US$200,000-300,000)from clinics, converting reorganizing governmentstructure, and thedistrict Jembrana’s leaderusedpayments from thecentralgovernment’s district insurancefirm as wellasannualsavings smaller classesandstronger incentives for teachers andheadmasters. To pay for hisnewhealthinsurancescheme, institutionsfrom 22to 8,nettingaRp.district 10billion(US$1million)annualsavings thathethen usedto pay for fi t. The leader(Bupati), for example,Tanah Datardistrict took advantageofhisnewpower bycuttingthenumberof transfers resources) about80-90percent (comprising ofdistrict whichtheywere thenableto allocate astheysaw fromsustainability thestart. locally conceived reforms withouttheneedfor external donors, givingaboostto thepotential for fi The districts’ newpower over fi poor women), theprogram wascancelledwhenanationalhealthcare program supplanted it. midwives vouchers program inPemalang for (increasedofmidwives andincreased accountability accessto services reformto inBoalemo. localapathy aboutcivilservice Finally, despite ofthe thepositive impact World Bank-funded of thecentralgovernment’s may have to recruit contributed inallowing theirown districts experiment civilservants insurance for thepoorhasthreatened Jembrana’s citizens ininsuring directly, experiments whiletheabruptending inconsistent, damagingbothlocallyconceived reforms. anddonor-driven Major achievements notwithstanding, central government’s for decentralization support hasbeensomewhat more specialized thanwe [theproject consultants]!” period, theMaintenance ashort Organizations have becomeOver bamboo, plasticpaint boxes, andwood torepair the infrastructure… systems inways thatwe hadnotconsidered. usematerialssuchas They “manageMaintenance Organizations torepair ofWSLIC-2 thewater New groupsfi civil servants. In Blitar, In leadersrealized civilservants. district a20percent increase inlocalrevenues 2002and between nd local solutionstolocal problems. After decentralization, districts becametherecipients ofsignifi decentralization,districts After cantcentral government nance andadministration gave somelocalleadersthemeansto pay for The opened enoughto enablehimto “do something” about and idealisticpersonatatime whenpoliticalspacehad notably, Most impact. BIGSwasfounded by anenergetic forproved oreven to to positive critical beimportant many of thecases,In newgroups were created that The 2004 “recentralization” ofhealth In theCLCC In casestudy, the Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine the right theright nancial

7 Case Study Synthesis Case Study Synthesis 8 a complainthasresulted inthefi offi ring ofacorrupt tothe capitalhave lodgecomplaintsnow, more opportunities andapparently doso more Atleastonce, often. such law on participatory planningwaspassedin2003, law onparticipatory to disregard them,anddisseminationofinformation aboutthemwasinadequate. Maros, where In anexpansive Because educationreforms in Tanah Datarwere upby formal notbacked signed documents, schoolstaff ofreformsThe impact isthreatened laws where andregulations localsupporting are weak orlacking. from relationship thebeginning governmentandcitizens. between to changing thetraditionaltop-down andenablestaff authority decentralization. governanceinBandungcity. Locallow-quality NGOssuchasBIGSwould have faced great politicaldiffi 0 AfteralawhasbeenpassedinIndonesia,itusuallytakes aboutayear forimplementationdecrees tobeissued. 10 planninglawwas passed, Maros was outofsimilareff one ofjust6districtsinwhichaparticipatory 9 headand7urbanvillageheads. Focus sub-district group discussionwithKepanjen Kidul 8 a new district leaderto dismantlethereformsa newdistrict whenthecurrent leaders’ ofoffi terms reforms (inbothcases, leader’s merely parliament-approved adistrict decree ratherthanadistrict law) would allow implementation decree hadbeenpassed. progressive andsanctions,was passedin2004,yet andclearimplementingarrangements asofMarch 2006,no Boalemo,changes. In Regional RegulationNo. 6/2004on Transparency inGovernance, with ofPublic Service confusionoverperpetuated roles andresponsibilities for implementing, monitoring, andpaying for themandated • “Before, allphysical projects were managedby thePublic Works netprogram,• “Intheprevious socialsafety we onlyreceived, but makesParticipation thediff sustainable impact. Tanahshow whetherthishashelpedorhurt Datar’s chances for and relevance ofthereforms inthelongrun.Further studycould ”organic” nature ofnon-legislatedchangewould increase buy-in legislation,hopingthatthe leader chosenottopasssupporting caused by thelackofalocal legalbasisforchange, Tanah Datar’s But legalizationisnottheonlyway. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: districts. participate.” munities] dotheprojects by themselves, hence want they to socommunities didnotcare.Department, [com- Now they with [Blitar],we feelownership.” 8

erence inBlitar. to develop theirorganizational andadministrative Maros, capacities. there In wasopenness Despite someproblems Despite 10 In JembranaandBlitar, In clientsfear thatminimallegalstandingfor the 9 cial. lack of passage of implementation arrangements to lackofpassageimplementationarrangements date has were specifi cally required.In Boalemo, citizens livingnear people inplanningmeetingsandhaving themspeakup inplanning—includingmore hinged onlocalparticipation improve ofvillagelife otheraspects aswell. Maros’ project empowering somecommunities, hasenabledthemto helping to ensure thewater systems’ sustainability, andby elementof wasacritical participation WSLIC-2, Citizen opportunity for localgovernment to exerciseopportunity itsnew Blitar’s headviewstheCBG program district asan parliament. againstthecity acaseofcorruption bring governance. citizens, aswell asdonors, more interested ingood Districts’ greater power madelocalpoliticiansand The newopennessemboldenedBIGSto orts supported by USAID’s supported orts “Perform” project in79 ce expire. culty culty prior to were freer stronger incentives for midwives to seekoutpoorclients. use oflocalblockgrants. Pemalang, In therulethatonlyvouchers (notcash)couldbeusedto pay midwives created over,the locallyelected authority to take Village EmpowermentInstitutions Community andbeaccountablefor, the ownership, andstrengthened chancesfor technical andfi nancialsustainability.In Blitar, alocal regulation empowered positive impact. Local leaders’ style, emphasizing personalinvolvement andfl adiff businessman whoreturned to hishomeland inhopesofmaking Jembrana’s leaderisamedicaldoctor, Blitar’s mayor aformer professor ofpublicpolicy, and Tanah Datar’s aretired to helppayreduce for thenumberofgovernment departments reform. Also, nonewere traditionalpoliticians— that theypromoted didnotbenefi tthem personally, and inmostcases required thattheyspendpoliticalcapital to also thefi staff district rstelected four headswere caseswhere district thedriversofreform—Tanah Datar, were Jembrana,BlitarandBoalemo—they enabled anewgroup ofself-motivated elections Direct champions to climb to positions ofauthority. leadership islimited by itssocialdistancefrom clients. (Maros) hashadonlylimited success. Maros doeshave alocalchampioninNGOForum Warga, but Warga’s leadershipdidplay astrong casesinwhichexternal role, thetwo Of one(Pemalang) hasendedandtheother ownership andimpactwas lost. toincrease education understanding,Datar reforms, anopportunity their leadershippowers. notincludingthenagariinTanah By command great authority. increased Decentralization hasfurther The indigenousleadersornagariofWest Sumatra traditionally even increaseimpact. An widerrange ofleaderscould further contributions. arevillagers thatthey capable required, ofmaking andsignifi cant, to provide it.Moreover, local leaderswere instrumentalinassuring of theneedforcleanwater supplyandthepotentialofproject became Leadersquickly project supporters. helpedconvince villagers involved inhamletactivitiespriortoproject implementationand project villages,WSLIC-2 villageleadershadalready beenhighly Local leadersmake thediff contribute tofi andbetterhealthforthedistrictpopulation. nancialsustainability Enforcement ofstandards andcost control have ledtoimproved quality, service andshould contract providers,health-care oneandsixmonths. includingthirteen suspensionsofbetween 2004,managershandeddown 40rebukes 2003andOctober amongthe197 October Between incorporates strictstandards formedication, fees, services,andothervariables todetercheating. Jembrana’s clear, framework. enforced regulatory The Tanah headintroduced changeinadeliberately Datardistrict roundabout way, ratherthan erence inwater supply. . These leadershadreputations for focussing onthepublicinterest: theprograms Insuccessful The Jembrana healthcare scheme

headmasters. oflocalleaders,types includingvillageheadsandschool transparency. CLCC and wereWSLIC-2 reliant onother been personallyresponsible for allBIGS’ onbudget work reforms.service BIGSwasfounded by acitizen whohas BlockGrantprogram,Community andBoalemo’s civil reforms, Jembrana’s healthinsurancescheme, Blitar’s developing andimplementing Tanah Datar’s education governmentreformersother district were responsible for conceived andfundedornot. local rather thanexternal leaders, whether externally wereInnovations delivery inservice dependent on exibility, was key to to ensure theirability erence. the potential for confl increased ict, 2, water-use regulations have reduced was strengthened.impact delivery, changesinservice support regulations were establishedto On theotherhand, where local The district leaderand The district Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine In WSLIC- In In the In

9 Case Study Synthesis Case Study Synthesis 10 positive impact. whichmay sometimeslowerfully-formed theirchancesofhigh projectswithnolocalinstitutionalbaseofsupport, such as Pemalang,WSLIC-2, CLCC, anddelivered level as to thedistrict andMaros are designed often inJakarta involvementcommunity for inprojectplanning andselection funding.conceived and fundedprojects Externally ofeducationstaff motivation andperformance designed andlocallyfundedcases—Tanah DatarandBlitar—have successful, beenfairly theformer inincreasing Do fullylocalreforms have abetter chance ofsuccess thanthosewithexternal drivers orfunders? his offi Boalemoreforms head’s areOther alsohighlydependentonthedistrict presence: staff citizen complaintsishishouse. Citizens wholive too faraway orare notaware ofhiscomingsandgoingsloseout. reforms. Boalemo’s headisineff district neithercaseisitclearthattheleaders’had not).In successorswillbeascommitted to oraseff andBIGS’his bidfor re-election, leaderpledged to step down by theendof2005(thoughasMarch 2006,he Ironically, oflocalleadersmakes theircausesvulnerable. importance thevery prove theirtechnical expertise. government. WSLIC-2’s Organizations Maintenance gainedtrustastheywere staff ontheiroffi their salaries andrequires performance, allhighoffi phone numberssocitizensoncivilservant cancallhimto report and invited citizens to comefor coff morning Many leadershadareputation for trustworthiness. headmaster wasmore successfulatintroducing reforms thananautocratic one. on CLCC ofschoolheadmasters. schoolsdependedheavily ontheleadershipstyle Amore openandparticipatory to have histravelservant allowancesreduced following theincentives reforms hehad pushed. ofimpact The extent leader’sdistrict enthusiasminopeninghishometo citizens andhis willingnessnote, to listen. hewasthefi Of rstcivil there isroom for andto move mistakes forward.” oftheBoalemoreforms Implementation wasgreatly aidedby the Blitar’s mayor taughtthat BlockGrantprogram“[t]he essenceoftheCommunity issociallearning, notperfection; andbeingpersonallyinvolved publicly,reform, inparliament, speaking indecision-making. support mustering what worked. leaderprovided theleadershipthatmadediff The Jembranadistrict through legislation whichhefeared would notbeaseff Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ce improved, butatacliniconehouraway, itdidnot. cedoors!BIGS’ for leaderiswell-known hisrefusalbylocal expected orpay to bribes take ofhisown acenterpiece reforms:ect themainnewchannelfor lodging ee eachday. Hehaspublishedhisown andhissecretaries’ mobile and improving services atsomeschools, andthelatter atincreasing andimproving services ective. BIGS’ anderror approach leaderusedatrial to fi nding Boalemo’s headremoved district thefence around hishome ed by villagersandrapidlycould Tanah Datar’s headlost district erence by championingthe attendance ataclinicnear ective ective at promoting cials to post Bothlocally and schoolswithlessmotivated headmasters, dependingon “spontaneous replication” to work. isunlikely and anadditional30schoolshave adopted, andare paying for, aversion ofCLCC ontheirown,butinpoorer schools CLCC endsisalsonotassured. UNICEFsupport after The CLCC haspaidto replicate district CLCC in70newschools, about5percenttake ofthedistrict’s development budgetto cover Funding therest ofthedistrict). to continue example, funder, isindoubtfollowingofUSAID, thedeparture theprimary thoughprojectcostsare low(itwould 1 Financial issuesare mootforPemalang, sustainability whichwas supersededby agovernment healthinsurance schemeandis 11 Financial ofallexternally fi sustainability Ongoingfundingformostreformsisindoubt. 2. by district government. by district allowanceswork hasplaced afi nancialburden onstaff are notexpensive, mainlyinvolving However, reallocation offundswithinasingle department. thereallocating of increasing, are andlocalcontributions signifi cant.Boalemo reforms, though theyhave notbeen greatly successful, represent theprogram another5to 10percent isrelatively short, ofprojectvalues. cheap, In thefundingsource is contributions have 13and22percent between contributed of theannualbudgetincash,whilelocalin-kind bureaucratic reforms have ledto a20percent 2002and2004.Communities increasebudgetbetween inthecity locally funded. Ongoing fundingisassured inonlytwo cases, where reforms were locallyconceived, relatively cheap, and and SchoolCommittees. SingaporeMalaysia, andAustralia) mustnowpassingsomeofthisonto pay headmasters, halfthecost,likely teachers staff of savings paidmostcostsofsendingschool achieved through oflocalgovernment), butthedistrict restructuring target group ofthescheme:poor. The costofeducationreforms in Tanah low (about1.5percent Datarwasfairly be renewed annually. to closethefundinggap, Notonlyisthismethod unlikely butithasbegunto exclude amajor other villagesisslatedtoendin2006. collect fees;meanwhile, forwater World supplysystemsin Banksupport some unmotivated Maintenance Organizations are notbotheringto clear thatthepreviously setamountwould notcover costs. However, also voluntarily tripledthemonthlymaintenance feewhenitbecame totheirlocality.the normalcontribution tobringWSLIC-2 Villagersthere villagewasOne soeagertogetcleanwater thatvillagersraised 3.5times constructing water supplysystems, plusmonthlyfeesformaintenance. in jeopardy. Villagers pay, butfi tional. abroad for thefitwo rst years. Schoolsthatwish to continuesending teachers andheadmasters abroad (to WSLIC-2 project villagesmustpay20percent WSLIC-2 ofthecost of Blitar’s blockgrant program hascostlessthan2percent budgeteachyear, ofthecity whilecontinued nancial sustainability andreplicability arestill nancial sustainability nanced casesisindoubt assome legitimate costsare work now nolongercovered pass onsomecoststo clientsviahealthcards thatmust headhasbeenforced funding, thedistrict on district to period. Given dependenceofthescheme theheavy source revenues declinedby 12percent inthesame health insurancescheme, whilethedistrict’s own- to 2004,duemainlyto inclusionofthenon-poorin Spending onJembranaincreased 2.5timesfrom 2003 new costs to clients alsoface fi Locally conceived reforms that passonsubstantial 11 . The fiMaros, of nancialsustainability for Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine nancial diffi nolongeropera- culties.

11 Case Study Synthesis Case Study Synthesis 12 servants to counterweight themindsetofentrenched tobureaucrats. counterweight servants Boalemo,In where thereform environment isdiffi capable young bureaucrats to positionsofgreater andinvolves authority leadersatalllevels intheprojectprocess. to headlocal healthclinicsandengagedeff Leaders amongcivilservants. builttrustby broadening theirsupport raised citizens’ ofexistingservices. awareness about theinadequacy messages over andover, managedto puttheirreforms atthetop ofthepoliticalagenda.Atsametime, they ofreforms,Jembrana, reformist leadersmadepubliccasesfor andimportance andby repeating theurgency the Leaders builttrustby raising delivery awareness ofservice abouttheinadequacy Eff 3. local offi program wasdeveloped over ofseveral aperiod years beginning withan “aspirations gathering” process to help strengths eff overofaboutfour aperiod years,approaches delivery to before improving service settlingononethatexploitsits training sessionsandworkshops, whichhelpedinculcate theneedfor reform. out,anddiscarded, BIGStried several Long lead-intimesallowed trustto grow. were allowed tobegincollecting contributions forconstruction. the Central Project ManagementUnit.Once accepted, villages and maintenance fees. Finally, actionplanswere evaluated by outsocialmappingexercisesmeetings tocarry tofi x construction action plans. Facilitators ledfocusgroup discussions andvillage in theproject thereafter were required tomake community implications ofproject involvement. Villagesstillinterested in needsassessmentsandexplainedthefi nancialandtime villageswereWSLIC-2 chosen,project facilitators ledvillagers Time ismoney, butit’s theinvestment. Once prospective worth fairly cheapprogram. refl ectedinthedistrict’s unwillingnesstoensure fundingforthis but elite, relatively local unknown NGO. Low provider buy-in is government—in favor ofexternal consultants andacommitted bypassed thekey provider district forplanningservices—the of Education. Maros alsoseemstohave from theDepartment instead;asaresult, littlebuy-in there isvery partner as primary ofEducation, Planning choosingtheDistrict Agency Department provider. withthe provider buy-in dependsonpartnering Service Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: dissemination. cials understandcitizens’ wants andneeds. tobuildtrustarehamperedby inadequate information orts Despite itseducationDespite focus, CLCC bypassed the ectively, allthewhilebuildingareputation for andexcellence. honesty Blitar’s BlockGrant Community Blitar’s withthelocalparliament. ectively mayor promoted themost CLCC required potential projectschoolsto sendtheirstaff cult, the district head has tried to build support amongnewer civil to buildsupport headhastried cult, thedistrict and SchoolCommittees to improve educationservices. through revitalized Teacher andHeadmaster GroupsWorking ofthemidwifeintegral vouchers project.CLCC part worked healthcenters an made thelocallytrusted sub-district involvement. Pemalang, them, initiallyoverlooking after BlockGrantprogram,his Community withsubstantialvillager existing localplanningprocess ( organizations andprocesses Leaders builttrustby workingthrough local against itwithingovernment, whileincreasing thecapacity math teachers. Blitar’s successhasreduced initial resistance innovationssuchas travelfunded follow-on rewards for education reform were andpromoted correct, many school- overseas were head’s convinced thatthe district goalsfor in. Anecdotal provider evidence suggestsservice buy- Tanah Datarteachers andheadmasters returning from Jembrana’s leaderappointed supporters Musrenbang . Blitar’s Mayor usesthe . In . In Tanah Datar, Blitar, and ) asthebasisfor to formalto enthusiasm for attending meetings andlowawareness oftheprojectamongclients. old thing” andfeeling andpessimistic”“hopeless abouttheprospectsfor change. Notsurprisingly, there waslow Maros clients, nobenefi incontrast,perceived virtually meetingsas tfrom theproject,seeingparticipatory “the same were discontinued, awomen’s focus group exclaimed inunison, “No, itaway!” no—don’t take clients’ has improved—when howtheywould feel asked withhealthservices iftheinsurancescheme satisfaction explanationofvillagers’ onprojectvillages—alikely impact willingness to pay regular maintenance fees. Jembrana adoption ofCLCC methodsby many schoolsisevidence. Lumajang water supplysystems have hadaclearpositive not improved, better teaching methodshave beenpopularwithstudentsandparents, for whichthespontaneous teachers studytours fundingfor to overseas take even theinitiative district after ceased. Though CLCC test results have adiff attendance canmake meetings have “people fl owingoutthrough the door, andmany sittingoutside,” reflecting theirbeliefthat astheirtrustgrew,“reduced painandtimeinlabor”; sodidtheiruseofproject midwives’ Blitarvillage services. buy-in. Pemalang mothers’ reported trustinprojectmidwives grew andneighborswhousedtheirservices asfriends Anecdotal evidence suggests client buy-in. somewhat. motivation to provide services of involvement thatlaggedbehind thoseofnon-project midwives withtheproject,thoughsalaries reduced their of offi women who should have accessed their services did nothearaboutthevoucher scheme.women whoshouldhave accessedtheir services Pemalang, midwives were sometimesunableto fi overworked lltheirinformation dissemination roles, so poor Schoolswhich missedouttended to andremote andimpact. belower-performing transparency schools. In “Stronger Incentives” to sendteachers andheadmasters overseas policy wasnotwidelydisseminated, thusreducing because ofcitizens’ lack ofawareness ofthelaw anditsprovisionsinlocalplanning. for participation The Tanah Datar intheirvillage. Maros’undertaken inpart planninghashadlimited impact groundbreaking law onparticipatory out ofthree sites visited, mostvillagersdidnoteven have arecollectionoftheplanningprocess thathadbeen planningprogram implemented inatleastsomeofthesixinitialsites—in invillageswaspoorly two participatory there.in Boalemoifmostcitizens Maros, are reforms the In even aware beingundertaken ofthecivilservice satisfi edwith the overall program, havefew access to budgets for the grant moneyspentintheirareas.It is unclear Blitar, In of thisservice. there have beenproblems ofblockgrant withtransparency spending; whilemostcitizens are scholarship was subsequentlyreallocated. thechildinquestionwas poor.because notvery knew they The heard duringscholarshipallocation, vetoing theheadmaster’s choice Bureau ofEducation decidedtodoit.Parents alsomadetheirvoices taskthatinthepastwas onlydonewhentheDistrict the school—a assisting inconstructing washbasins forstudentsandinpainting have become more engagedinschoolactivities, forexample Parents fl cials to respond to locallyvoiced needs. Pemalang midwives’ motivationto reach thepoorincreased asaresult ex theirmuscles. Since CLCC was introduced, parents erence. Tanah Datarparents took ituponthemselves to continueraisingmoneyfor Clearbenefi ts to clientsgenerally resulted inahighdegree ofclient free secondary and tertiary care, advantage sodonottake andtertiary free secondary Some poorpeopleare unaware thattheyare eligible for withvillageleadersorhealthworkers. ad hoccontacts program, leaving many to rely uponword ofmouthoron werematerials to distributed citizens thatexplainedthe ofreforms.the impact Inadequate information dissemination likely reduced In Jembrana,few ifany In written Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine

13 Case Study Synthesis Case Study Synthesis 14 problem. removal ofmostallowances for expenses, work reintroduced “specialized allowances” resolved the whichpartially reimbursement rates.reduced Boalemo’s service head, realizing district thenegative fi onstaff nancialimpact spent on “non-productive” and infrastructureprojects. Jembranaintroduced coverage services for childdelivery Monitoring including theestablishmentofIndependent Teams andlimitingtheamountoffundingthatcouldbe able to address thisissue. Annualrevisions ofBlitar’s Program Guidelinesallowed many changesinimplementation, languagewashiredfacilitators inthelocalMadura incommunicatingwithvillagers,whowas butafacilitator skilled decided to continuethevoucher schemefor oneyear. Lumajang, In languagewasinitiallyaproblem for project access oflow-income pregnant women to projectmidwives’ following thetechnical endoftheproject,and services for parliament Pemalang corruption. staff bringing acaseagainstdistrict district gearsfromwhen itshifted budget,to merely actually publicizinginformation inthe2002district aboutirregularities fi toward budgettransparency. aimin working nallyidentifyingapractical BIGSgainedalotofpositive publicity about how to achieve itsmissionofimproving governance enableditgothrough several more iterations before providers.willingness to befl fell Its exercise onthedeafearsofservice delivery to getfeedback onservice exible governmentbuiltthreeproblem, 2003and2005.BIGS’ newschoolsbetween thedistrict initialuseofa “report card” accompanied by fundingfor anincreaseclassrooms. aninitialeff inthenumberofactual In 4. Impact can Impact bestrongerwhenreformsareimplemented fl 4. sessions, workshops, books, posters, journals, thepress, andtheradio. students’ chatswiththeirparents. BIGS,whosemissionisitselfinformation dissemination,usesmany routes: training including formal methodssuchasSchoolCommittee meetingsandinformal methods suchasradioprograms and On theotherhand, CLCC reached even poorparents becauseitusedmany routes to disseminate information, but with a negative impact onaccessofthepoortobut withanegative healthcare. impact Maros signifi cantlyaltered itsinitialplans for Financial inJembranawere to address thegenesisofanewregistration shortfalls thebudgetgap scheme—useful reduced theCommittees’ motivationby choosingto pay membersonlywhenthere are problems to befi xed. villagers,WSLIC-2 allowed to setpayment schemesfor Committees, theirMaintenance have sometimes inadvertently implementation approach and its pitfalls from the start. implementation approach anditspitfalls from thestart. and locations andsetmaintenance fees, avoiding acookie-cutter 2 requires thatvillagersthemselves choosewater tanknumbers Built-in fl sustainability oftheschemeandlong-termbenefisustainability tstothepoor. benefishort-term tstothepoorare thusathreat toboth fi nancial run. However, itreduces theincentives forthepoor toregister. The This doeshelpensure access ofthepoortohealthcare intheshort is reinforced by thedistrict’s willingnesstoreimburse those providers. The willingnessofproviders evenpoornon-membersforfree toserve Jembrana’s fl very Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: exibility meanstherulesdon’t exibility have tochange. eiiiy hetn fi threatens exibility nnil sustainability. nancial WSLIC- reducing accessto educationfor some, asitwasnotinitially of impact Datar’s hadtheperverse SmallerClassespolicy strengthen positive orreverse negative impact. manyIn cases, newstrategies were developed to who thetarget group wasandhow bestto reach it. implementation refl about uncertainty district ecting and constantlychanging program rulesandinconsistent poor women throughout theprojectlife, dueto unclear were numberof provided toservices awidelyvarying fl When eiiiy os’ work. doesn’t exibility were intent onmaintainingthe exibly. Pemalang midwife to address this ort ofhis Tanah to support slumhousing whichbenefito support tsthepoor. Blitar’s increasedhealth insuranceclearly accessofthepoorto healthservices. CBGprogram requires sub-districts ofLumajang increased clearly the poordistrict villagers’ accessto water andimproved theirlivelihoods. Jembrana healthcare increased vouchers clearly accessofthepoorto midwives’ services. water supplysystemsWSLIC-2 in thefourIn caseswhere thepoorwere atarget group, onthemwas mainlypositive. impact for citizens to to donotextend remote register andpoorareas. complaints aboutcivilservants are nowinvolved inlocal-level planningfor thefi rsttime, butcoverage ispatchy.In Boalemo, increased opportunities budgetmore pro-poor. thedistrict despite itsoverall Maros, goalofmaking othervillagers, somepoorpeople, In like onbetter-off impact schools. CLCC, onpoorstudents, thoughnotpoverty-targeted, stillhadapositive than impact butitwasweaker of placesatthebetter seniorhighschools, eff Tanah Datar’s SmallerClassesandStronger policieshadtheunforeseen Incentives ofreducing impact thenumber casestudieswhereIn thepoorwere nottargeted by reforms, theywere aslikely to loseout asto benefi The pooraremorelikely tobenefi 6. diffi strengthen impact None ofthecaseshadeff Inadequate datacollectionlimitsimpact. 5. days pervillage andgiving upontheuseofvillagersasplanningfacilitators. implementationinthefi planningsoonafter participatory theprocess rst6(of20)villages, from shortening 5 to 2 between eff between itimpossibleto any gaugesuccessto makes date,linkage limited data onMaros fundingandimpact inparticular isalsoinadequate suchaswhichgrants to havedata collection quantifyprojectimpact, beenmosteff thetarget to whatextent group itimpossibletoreached. know and analysisofdatamakes wasactually Blitarproject group (poorwomen) probably reduced accessto projectmidwives for someofthepoor, butinadequate collection many ofthepoorareregistered actually inthehealthinsurancescheme. topics ashow implementationbegan).Jembranaincludesnoregularandanalysisonsuchkey after datacollection onhealthdiffi impact to strengthenisdiffi impact indicators yet appearto withoutappropriate belacking, andappropriately-measured indicators, adjustingtheproject they aretargeted. orts atlocalplanning, oftheseeff thequality orts students. Local NGO BIGShasnottailored any to work thepoor, ofitsbudgettransparency cult (project managers only began to collect healthinformationcult (projectmanagers onlybeganto inastructuredway collect fi ve years cult. assessmentof baselineinformation makes andmonitoring cult. Inadequate WSLIC-2’s datasystems,ective adjustmentsto collection project mid-course making For example, diffi ectively reducingectively poorstudents’ accessandincreasingamong inequity culties inidentifi cationandquantifi cationofthe Pemalangtarget t from improvements in service delivery if t fromimprovements delivery inservice orts, andresulting CLCC fundallocationsfromorts, thedistrict. Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine ective. Very Pemalang’s t.

15 Case Study Synthesis Case Study Synthesis 16 2 Jembrana healthinsurance was setuptoprovide allcitizens withhealthcare; thepoorwere targeted are inasmuchasthey 12 onthepoor.show whetherthisisaccompaniedbypositive impact by more Blitar, than50percent. there In isnodatato whilethere fundingbiasinsomesub-districts, isapro-poor insurance schemethatsomepoorfi asa result, membershipofthepoorinschemehasdropped nd too costly; offi district of non-poorclientsinthescheme—led byinclusion thatwould inpart or otherfactors have Jembrana,costoverruns—caused increased projectcost.In villages were notconsidered for populations, projectinclusionbecauseoflow density distancefrom projectvillages, disseminating information to theiraccessprobably them,andmonitoring reducedIn impact. somepoor WSLIC-2, Even inthesecases, however, was thepositive limited. impact BIGS Boalemo Tanah Datar Maros CLCC Blitar Jembrana WSLIC-2 Pemalang Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ensuring benefi aspectoftheprogram. tstothepoor was notthemostimportant aeTargeted Case the poor? Yes Yes + Increased fundingfor Increased slumhousing + Yes Yes + Improved quality oflife Improved quality andincreased accessto water supply + accessofthepoorto midwife Increased, thoughvarying, services + Yes Yes o*None No No - Exclusion of the poor from opportunities to Exclusion lodgecomplaintsaboutcivil ofthepoorfrom opportunities - No o- Decreased accessto seniorhighschoolfor somepoorstudents;especially in - No No + Inclusion ofthepoorinsomevillageplanning Inclusion + No No + More active teaching More active methods, greater studentandparent involvement + No 12 Exclusion ofsomepoorest hamletsinvillageplanning - Pro-poor fundingbiasinsomevillages, butimplicationsofthisfor thepoorare ? Newregistration system andscheme’s fl may have exibility reduced accessof - for Greater thepoor, accessto healthservices especiallymembersofthe + - High tank-to-household ratiosmay reduce High accessofpoorer households - Somepoorvillagesexcluded becauseofdistanceorotherconsiderations - servants remote areas, increased costsfor somepoorer schools among poorandnon-poor unknown the poor insurance scheme cials to introduce re-registration requirements for thehealth Impact onthepoor Impact In Pemalang,In diffi culties inidentifyingthepoor, Jembrana citizens, but overall sustainability. local funding, andincreases legal footing budget).Insecure inthatfundingsource istheonlythreat (thedistrict to allowed implementationto proceed. Finally, fi seemsassured nancialsustainability bytheprogram’s lowcost,fully fi nancially, implementation,as planningandduring well asthrough during the fl headhas exible way thedistrict mayor indicates politicalsustainability. isassured Socialsustainability withcommunities’ highlevel ofinvolvement staff theprogram’s growing isinstitutionallysustainable. acceptanceandsupport, The2005ofBlitar’sreelection planningprocess andwithlocalorganizations,Because ofitsintegration aswell withthepre-existing asgovernment Block Grant-funded projectshave beenmore effi contrast,Blitarappearsto besustainablefromIn allpointsofview. membersfeel Community thattechnically, increase ofthescheme. chancesofpoliticalsustainability legal basisalsoreduce sustainability. headwasreelected in2005may, thattheJembranadistrict The fact however, threaten to exclude somepoor. investment Inadequate intheadministrative andthescheme’s framework uncertain becauseoftheinclusionnon-poorclients. As aresult,part offi spendingonthehealthinsuranceschemeisincreasing to besustainable. rapidly,Jembrana isunlikely District in sustainability. changes, maintenance fee suchasensuring and fi collections ndingsubstitutes facilitators,for external willensure one year—not longenough to prove sustainability. Moreover, evidencefrom onevillageindicates thatonlymajor areas have beenoperationalfor years, amaximumoftwo systems andtwo have beenoperationalfor lessthan locals’ senseofownership ofwater supplysystems increases possibilitiesfor sustainability, thesystems inthevisited chancesofsocialsustainability. planningproject)weakens participatory WSLIC-2’s isunknown. sustainability While prospects for institutionalsustainability. Finally, limited villagerinvolvement (inwhatisostensibly avillager-focused Forum Warga cost oftheprogram, meansfi isnotassured. nancialsustainability Dependence onasinglechampion—localNGO leaves thisopento question. funds,The district’s despite thelow reluctanceto commitanddisbursenecessary and inspirational. Maros, too, data limited ofsomekey availability doesnotappearto besustainable, thoughvery isthreatenedsustainability bythefounder’s planto step down. The newleaderwillhave to beequallytalented andbyunsure fundingfor schoolswithpoorer headmasters.Department, parents BIGS’ andunsupportive Education CLCC Planning ratherthantheDistrict Agency withtheDistrict isthreatened sustainability bypartnership 7. Mostcases’ leadership, isthreatenedby problemswithpartners, sustainability and funding. —which atthevillagelevel isrelatively andhasinstitutionallimitationsofitsown, reduces unknown thanpreviouscient andhigherquality government-led projects. cials are self-fi exploring nancingmechanismswhich Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine

17 Case Study Synthesis Case Study Synthesis 18 Financial should beonefocus transparency ofinformation disseminationeff aboutbudgets,(Blitar),iscommon. Lack oftransparency even inprojectswhichhighlightcitizen participation spread theword. BIGS, whosemissionisitselfinformation dissemination,alsousesmany routes. The lesson:usemany approaches to Notably, information aboutCLCC reached even poorparents becauseitusedmany routes to disseminate information; itinnewspapers.radio ortelevision orreporting vialegaldocumentsornewsletters,writing sendinginformation vialocalleaders, andbroadcasting information on There are many optionsfor improving dissemination ofinformation, includingputtingmore oftheinformation in dissemination gotogether. eff lowbuy-inreducescycle, thepotential for eff withlocalleadersto getinformationor personalcontacts aboutpotential projectbenefi In aself-perpetuating ts. Datar, andPemalang. For instance, forced materials lackofwritten Jembranacitizens to rely uponword ofmouth target audience’s awareness of, useof, to make andability reforms. This wasthe caseinMaros, Boalemo, Tanah The casesshow thatinadequate reducedofreforms information disseminationlikely theimpact by reducing the more rapidlyto results. pro-poor information poster tested onpoorcitizens, designed orworkshops to accommodate poorcitizens, leading perhaps intoincorporated school-by-schoolimplementation.BIGScouldimplementtargeted suchasabudget activities CLCC, outreach methodstailored to theneedsofpoorer parents couldbedeliberately (ratherthanunintentionally) numbers classesinpoorer areas, reducing competitionfor placesthatmay besqueezingoutpoorer students. In more fundscouldbeprovided for teachers andclassrooms extra to accommodate studentspillover from limited- can bemadeto mitigate andstrengthen negative onthepoor. impact positive impact In Tanah Datar, for example, projectswhichdonottarget thepoor, delivery Even inongoingservice however, projectadjustments mid-course The casesdemonstrate thatthebestway to ensure thepoorbenefi tfrom reforms is to target them. 8. Looking usingMSWPfi forward: Invest ingoodinformation projects. delivery dissemination mechanismsto helpbuildtrustinservice Target to projects ensure delivery theybenefi thepoorinservice Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: lower localbuy-in.Arelationship informationective oftrustandgoodinformation disseminationcanfurther elsewhere. ective informationective dissemination(ashappenedinBoalemo),andless delivery ndings tostrengthenservice t. orts. prepared local leaders when external support ceases. prepared support localleaderswhenexternal leadershaveEnsure aplanto projectsthatuseexternal minimize dependenceonthem,andto handover to program exception” even rulethatwould experimentation, ifitconfl enabledistrict-level withnationallaw. icted thusmitigatingresistance fromwork, theestablishedorder. legalspacefor innovation, Make suchasviaa “pilot innovations withawards to for demonstrate andpublicity thedevelopment community’sneworunusual support leaders couldbenefi plansandbudgets. villageanddistrict tfromPerhaps assistanceinlinking reward successful assistance withimplementation,publicizingreforms, For impact. andmeasuring gettingfeedback, example, Maros better. delivery existingleadersinterested casestudyinnovators Most indoingservice couldbenefiSupport tfrom ofNGOsanddonors. Provide heads),andsurveys ortheAssociation leadershiptraining.ministries ofBupatis(district attendants, andinformal villageleaders.birth Search tools couldincludedirectcalls, questionnaires sentto nationalline reform, including “alternative” leaderssuchasschoolinspectors, olderteachers, SchoolCommittee heads, traditional conceived andfunded ornot.Systematically searchexternally delivery for andidentifypotential leadersinservice were leaders, whether dependentonlocalratherthanexternal delivery The casesshow thatinnovations inservice Consider lower-costalternatives: in Tanah Datar, staff aswell asinterest from localpoliticalsupport, other localities inreplicatinggarnering them. Promote reforms: relatively low-cost inexpensive reforms (suchas CLCC orBlitar)willhave abetter chance of themselves more accountableto thepublic. Funding governancereform mustrefl time. results take ect reality: Worse, ittends term to alienate thepoliticalelite by intheshort insistingthattheychangetheirbehavior andmake project-specifiBy itsnature, governance cortime-bound. reform doesnotgenerallyproduce immediate results. Provide untiedcore long-term fundingfor localgovernment andlocalNGOs thatisresults-based ratherthan revenue, andplanningfor rationalizationoflocalgovernment to reduce costs. options (andtheirpotential improving negative impact), theirfi increasing nancialplanningskills, localgovernment reformers to ensureSupport fi reforms. delivery self-fiAssist theminexploring ofservice nancialsustainability nancing following itinto donorwithdrawal aproject’s byincorporating structures. planninganddecision-making today willberewarded withbetter outcomes tomorrow. Ensure fi work nancialsustainability for donor-supported requires thatpeoplebelieve participation theirinvolvement to isintimately socialsustainability: linked sustainability The casesshow thatongoingfundingfor fi mostprojects, includingallexternally nancedprojects, isindoubt. Financial Ensure fi leaderswithinlocalgovernment reform.Support delivery andlocalNGOsfor service nancial sustainability for service delivery projects. delivery fornancial sustainability service couldhave to beensentonstudy trips centers oftrainingand Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine

19 Case Study Synthesis Case Study Synthesis 20 The casesshow that strategies canbedeveloped to strengthen positive orreverse ifprogram negative impact similar butthereforms inquestionare notbeingundertaken. information are systems variables oncontrol shouldalsoideallycollect Monitoring locations, where socio-economic design for greater eff et cetera). Onlyaccurate andwell-analyzed dataontopics relevant to program goalscanhelpto revise program to localoffi inmeetings, speaking how (speaking implementation,funding,selection, monitoring, managing), where (from more areas, urban from more rural areas), elderly, children, smallbusinessowners, localelite, etcetera) atwhatstages(proposal, are participating, planning, regular ofgroups program aboutwhattypes (women, shouldincludedatacollection monitoring thepoor, the If, for example, indevelopment onegoaloftheprogram activities,then isto increaseparticipation community asabasisforbe inadequate to andthusinadequate program demonstrate to projectimpact, serve improvements. anduseoftheindicatorsCollection isequallycrucial. As withmany projects,onBlitarappearsto datacollection (suchashigherexamscores). asoutcome to variables impact outtomay beasimportant turn be canvassed for theirown defi School Committee) variables.key nitionsof Process (suchasaparticipatory variables iscrucial.Getting theindicators right groups education, for stakeholder example?Major should What ishigh-quality course projectadjustmentsto strengthendiffi impact noneofthecaseshadeff level Indeed, ofgovernment—the district. the provincial level have beenabandoned, andhave notyet beenreplaced bylocal systems atthenewfunctional One thingthathasnotbenefi ted from decentralizationisdatacollection. Past systems thathadbeenmanagedat management staff Don’t onthebasics:investment inadministrationandmanagementcangoalongway. skimp Jembrana’s to thosewho stayed athome. eff thatreachConsider costs(the project activities more clientswithlittleornoextra “ripple eff be purchased may beavailable. to CLCC,educational excellence cutcosts. withinIndonesia In substitutes for low-cost thatcurrently materials must delay inreimbursements to providers—a delay thatcouldbeaff Build fl includeaneff projects delivery Ensure allservice Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ect”, for example, couldbestrengthened onoverseas are thatlessonslearned by studytrips ensuring passedon exibility into rulesto project strengthen positive orreverse negative impact. project are terribly overworked; anincrease instaff are overworked; terribly ectiveness. cials, attending meetings),and how (once, often regularly, atnight, cult. ective monitoringective component. numbersalonecouldhelpto resolve thethree-month ecting providerecting performance. mid- systems, datacollection ective making ect”). ect”). Tanah Datar’s “ripple a local legal environment that is supportive of service delivery reform. delivery a locallegalenvironment ofservice thatissupportive increasesactually governmentaccountability. to Designing andpassingimplementationregulations creating iskey Boalemo’s progressive law isvery transparency onpaper, butonlyitsimplementationwilldeterminewhetherit regulations. Maros’ for law example, oncitizen onthepopulation. hasnotyet participation, hadamajorimpact Passagelacking. ofprogressive locallaws may have withouttheaccompanying implementation onlyminimalimpact ofreformsThe casesshow thattheimpact isthreatened laws andregulations where are localsupporting weak or progressteachers and parents—clear toward theCLCC goalofimproving educationquality. headmaster,with anunsupportive theActive, Joyful, Eff CLCC,ultimate project aim.In componentwasnoteff thoughtheSchool-BasedManagement conditions couldbemore eff rules are fl exible. For example, dependingonlocal projectsconsistingofmodulesthatcanbeaddedorsubtracted roads. anothervillage, Organization theMaintenance household. toilets In hasplanned to for construct every village copiedthewater supplymaintenance fee oflocal system payments to for of2km collect theconstruction radio program featuring information assignments onhomework andshowcasing students’ One goodwork. WSLIC-2 teachers.for Acreative high-performing changespawned follow-on by CLCC wastheinaugurationofaschool for peerexchanges, School Committee andSchoolCommittee members to awardsas sendingsupportive Jakarta costs) are anothergoodbet. Tanah Datarreforms spawned changesatsomeschoolssuch unplannedfollow-on (increasing impact thenumberofbenefi innovationswithhighfollow-on delivery Service withoutincreasing ciaries EducationBureaufrom for to andeven theDistrict Malaysia, trips morein2005. learning appliedfor support Tanah Datareducationreforms, 150 Tanah Datarteachers in2004aloneappliedfor funding and received partial of thevoucher program whichitsupplanted. insurance tobuildonthesuccess program presents anopportunity nationalhealth Thenew are shouldseek. entitledandwhichthey awareness ofpoorpregnant towhichthey women oftheservices mayhave simplyhavingthevoucher raised booklet services; the was littleroom forfraud. Third, thevouchers were forspecifi c Second, because vouchers hadtobepresented forpayment,there women gave themstrong motivation toseekoutpoorclients. submit vouchers topoor inorder togetpaidfortheirservices healthcare.quality First, therequirement thatmidwives actually eff made itparticularly anotherchance.deserves Pemalang’s discontinued vouchers formidwives program Replicate innovations. successful delivery service Assist intheimplementation oflocallaws reform. andregulations supporting ective inincreasing poorwomen’s access to Three aspectsofthevoucher program thanarigorouslyective plannedmodel, aslongallmodulesare geared to the ective Learningonstudents,ective componentstillmadeanimpact the district visited. Eventhe district thetechnical after endofthe CLCC schoolsin now reaches 35percent nearly ofprimary roughly 30schools. Counting spontaneousadoption, schools in2004alone, andspontaneously, to another their budgets. CLCC hasspread bothformally, to 70new have alsobegunto pressure theirgovernments to publish on budgettransparency, whilecitizens from othercities BIGS’ to explore andwork trainingandinformation services organizations havesociety alreadyadvantageof taken replicated locallyare agoodbet.Atleastfour othercivil innovationsthathave already delivery been Service Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine ective inoneschool ective

21 Case Study Synthesis Case Study Synthesis 22 central government’s inembracingdecentralization. half-heartedness year later, perceived thecentralgovernment Many stopped districts thismove theexperiment. asarefl ofthe ection themselves, madegreatservants eff leader, fullofenthusiasmfor thecentralgovernment’s to begin 2003decisionto allow recruiting districts civil programs promising local-level may eff kill innovations. BoththeJembranaandPemalang delivery casesillustrate ways inwhichnationalhealth local service stillreduceof theimpact inconsistencies inimplementationofdecentralizationpolicy inIndonesia, supportive very for localleaders. isimportant framework A predictableregulatory environmentThough thenationalpolicy is, overall, fi studyand replication. nancialsustainability,further itaproject well make worth involvementon community inplanning, inadditionto itsfavorable prospectsfor technical, institutional, social, and Blitar’s positive support. impact innovationswithahighprobabilityofbeingsustainablealsomerit delivery Service level service delivery reforms.level delivery service Use MSWPresults to advocate environment for apolicy at thenational level oflocal- that issupportive Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: orts to ensure therecruitment orts process would beastransparent aspossible. A orts to ofhealthcare expandaccessto andquality fororts thepoor. Boalemo’s 3 Promised has yet World tobedisbursed. Banksupport 13 CaseAnnex: StudyInnovators andFunders .BaeoExternal/local: External: 9. Boalemo Local: 8. Maros 7. Blitar Local: 6. Jembrana External: Local: 5. WSLIC-2 4. BIGS 3. CLCC External: 2. Pemalang Local: 1. TanahDatar District head, District World Bank USAID leaders City head District Planning, andPublic Works ofHealth, Ministries World Bank, BIGS founder ofEducation UNICEF andMinistry External: ofHealth World BankandMinistry head District noao()Funder(s) Innovator(s) District Local: USAID, district External/local: communities District, Local: owned insurancecompany), clients centralandprovincial subsidies,District, P.T. (state- Askes External/local: AUSAID,World Bank, centralgovernment, villagers External/local: Ford Foundation External: UNICEF, schools district, External/local: HealthBureau centralgovernment,World district Bank, External/local: schools, SchoolCommitteesDistrict, andheadmasters Local: 13 Making Services Services Work forMaking thePoor: Nine CaseStudies from Indonesia Nine

23 Case Study Synthesis Case Study Synthesis 24 Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Case Study 1: Smaller Classes and Stronger Incentives in Tanah Datar District, West Sumatra Smaller Classes And Stronger Incentives 1

26 In Tanah Datar District, West Sumatra disadvantaged. to legalize theStronger Policy, Incentives insuffi includedinadequate disseminationofthenewpolicies,impact lackoffollow-up from study trips, thedecisionnot vision, imagination andleadershipoftheBupati, eff to ofthereforms amongschools. thepositive impact inequity Key were changesinnationalgovernment policy, the schools. There was, however, anincreased fi nancial burden onsomeschoolsandparents, andan overall increase in improved atthebetter schools, teaching andbroader skills educationaloff staff those whobenefi ted from thepolicies, andanincrease in reform mindednessofgovernment education andschool ofteachers andheadmasters, for increasedtheBupati(governor) onthepart by support student performance ofsomeEnglishteachers,and headmasters, increased changesinteaching methodologyonthepart interest in changes inattitudeandbehavior ofEnglishteachers includedincreased motivationto dobetter onthepart work schools, seniorhighschools,have(but notallprivate) aswell cutclasssizes. assomejuniorhigh andelementary Key senior highschoolsto 30students. As aresult ofthenewpolicies, over 70schoolstaff and headmasters withtrainingandstudyvisitsoverseas, andtheSmallerClassesPolicy, whichlimited classsize in theStronger Policy, Incentives are highlighted inthiscasestudy: whichrewarded Englishteachers best-performing inthisproject LiaisonGroup, asapartner Innovations Two hasserved International innovative educationpolicies at theJohnF. University, SchoolofGovernment,Harvard Kennedy incollaborationwiththeFord Foundation behavior oftheservice. and (b)accessto andquality Governanceand Innovation, ofDemocratic The Ash Institute innovationon(a)stakeholders’ delivery ofthecasestudieswasto ofservice The objective illustrate theimpact ofa for oneofninecasestudiesinsupport World Bankanalyticalproject, Services Work For“Making thePoor.” February andMarch 2005researchIn outin wascarried Tanah DatarDistrict, West Sumatraprovince, Indonesia Abstract This case was writtenby Eleonora SukMeiTan, World Bank(Indonesia).Research was based onafi eldvisitto Datar inF Tanah Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: . Access to seniorhighschooleducationdecreased for somechildren.ofeducation included Changesinquality tralia). Thiscase iscopyrighted by theauthor, Institute, theAsh andtheWorld Bankandmaynotbereproduced orreused with and MennoPradhan, alloftheWorld was provided Bank(Indonesia).Analytical Leisher andeditorialsupport by SusannahHopkins was providedWinthrop InstituteofDemocratic Carty, Governance, Ash support by: Miyat andSachiko (U.S.A.); Harvard University Pradiptateam membersincludedC.ClaritaKusharto, Paramitha Foundation (Indonesia)andSriBudiyati, SMERU Institute(Indones 1999) andM.Urquiola, IdentifyingClass Size Eff 2005. Reference was made toJ.D. andV. Angrist Lavy, UsingMaimonides’RuletoEstimatetheEff 1 Countries: Evidenceects in Developing from Rural inBolivia(November Schools 2001).Research cient numbersofclassrooms, andlimited targeting ofthepoorand ective policy implementation.Factors policy ective whichlimited positive ect of Class Size on Scholastic Achievementect ofClassSize (May onScholastic andbetter facilitiesatbettererings were sentoverseas, allpublic out theirpermission. ebruary andMarch ebruary a, Stefan Nachuk, a, Stefan Nachuk, , consultant (Aus- ia). Managerial 1

Introduction

As part of its mandate to alleviate poverty in Indonesia, the World Bank is undertaking analysis regarding “Making Services Work For the Poor.” This work aims to promote better services, especially for poor and disadvantaged people. Nine case studies from a wide range of sectors were commissioned by the World Bank to illustrate the impact of service delivery innovations on (a) stakeholders’ behavior and (b) access to and quality of the service. The Ash Institute of Democratic Governance and Innovation, at the John F. Kennedy School of Government, Harvard University, in collaboration with the Ford Foundation International Innovations Liaison Group, has served as a partner in this project as part of its research into public sector innovation and innovation’s role in fostering good government and more democratic governance. Smaller Classes And Stronger Incentives Stronger Smaller Classes And Sumatra West District, Datar Tanah In

The case studies were chosen from among the many innovative practices seen in much of Indonesian local government in recent years, through a competitive outreach process managed by the World Bank. Donors, non- governmental organizations, and local government staff were contacted and encouraged to submit proposals regarding innovative pro-poor service delivery work that they either were undertaking or knew about. Tanah Datar’s education reforms touch upon two themes central to making services more pro-poor: improved performance and accountability of local government service providers, and reform of government personnel policies. Hence its selection as one of the case studies.

The Study Site: Tanah Datar

Kabupaten Tanah Datar (Tanah Datar District) is one of the smallest of the 16 districts in West Sumatra province, Indonesia. With a population of 330,000, all from the Minangkabau ethnic group, residing in its 14 sub-districts, Tanah Datar has the highest population density in the province. In addition to their native language of Minangkabau (Arab Melayu), the overwhelming majority of the people also speak the national language, Bahasa Indonesia. As elsewhere in the province, Islam is a very important part of people’s daily lives. Unique to West Sumatra is the ethnicity-based village government system known as nagari. The nagari is a unit of people, usually of the same ethnicity, who represent the community. Cultural ties forge a strong bond between villagers and the wali nagari (nagari head); consequently, the wali nagari’s recommendations tend to be supported by local community members. Following decentralization in January 2001, the nagari began to receive more authority and started to become involved in ensuring villagers’ rights.

Tanah Datar, a primarily agricultural district, has a poverty rate of just 12 percent, well below the national average of

17 percent14. Access in the district is generally very good. All sub-districts (kecamatan) and villages can be reached by road; even sub-villages have fairly well-paved roads. Four of the 14 sub-districts, however, are relatively distant from the district town.

14 Annual national socio-economic survey (SUSENAS) data.

Making Services Work for the Poor: Nine Case Studies from Indonesia 27 Smaller Classes And Stronger Incentives 1

28 In Tanah Datar District, West Sumatra high school(SMA) school, from 89percent inschoolyear 2002/2003to 94percent in2003/2004 Education BureauData from reveals theDistrict anupward trend inthenumberofstudentsgraduating from senior assisting themto getfundingfrom theEducationBureau. if theirresources allow. Finally, localschools, informal for role insupporting example play animportant thenagari fortheir concern for education,andare education notreluctanttooreven travel further districts to neighboring funding for schools, managing schoolyear plans, schoolquality andmonitoring player SCswere ineducationthroughout Indonesia. given overadditional responsibilityfor ensuring andauthority this by greatly increasinginputinto, community andoversight of, schoolaff schools, bothreligious andsecular. The endgoalwasto improve teaching quality, andthedecree aimedto do which replaced theoldParents’ Associations (BadanPembantu Penyelenggara PendidikanorBP3)withSCsinall Accordingly,centrally-set curriculum. ofNational EducationissuedDecree No. in2002 theMinister 044/U/2002 9 Thedecree alsointroduced theEducation Council, tofacilitate inputintodistrict-leve community adistrict-levelagency 19 LawNo. 20/2003regarding 56 theNationalEducation System(SISDIKNAS);article 18 Tanah Education District Datar Bureau. 17 Education District Bureau 2004. 16 Islamicschoolscan beeitherpublicorprivate. 15 establishment ofmore representative andaccountable SchoolCommittees (SCs) The government focused policiesitdeemedcrucialto ontwo thesuccessofnationaleducationreform: reform National policy schools;andthe74,193studentstheirparentspublic andprivate teachers from otherschools, members, nagari andlocalbusinessmen),teachers andheadmasters from the608 the disseminationofeducationpolicies),SchoolCommittee theyincludeparents, members(allelected; localelite, agama, incharge ofIslamicschools),andtheOffi government staff players include intheeducationsector key Other Masriadi. under theleadershipofitsBupati(governor), Mr control governmenthastaken ofeducation thedistrict 2001decentralizationofmany services, With theJanuary The Players high schools(SMA); Islamicseniorhighschools(MA); andvocational schools publicsenior schools(MI);publicjuniorhigh(SMP);Islamic(MT); (SD); Islamicelementary Education in Tanah Datarisprovided through eightdiff The numbers Education inTanah Datar English andmathematics. Standardized nationalschool-leaving exams(UAN) are heldannuallyfor thethree educationlevels inIndonesian, Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: andLocal theOffi from EducationBureau theDistrict (dinaspendidikan), ce of Information (dinas informasi dan kommunikasi, incharge of (dinas informasice ofInformation dankommunikasi, erent types of schools: pre-schools, public elementary schools publicelementary erent ofschools:pre-schools, types 17 . The Minangkabau people are known for. peopleare known The Minangkabau 15 airs, making the SCs a potentially key the SCsapotentially key airs, making . 19 . 18 , andtherelaxing oftherigid ce of Religion (kantor (kantor Religion of ce l education policies. 16 . 1

The second policy, which has not yet been formalized, is the Competency-Based Curriculum. Under this experiment, the rigid curriculum mandated by the national government was relaxed, and individual schools were allowed to off er courses as they see fi t. For example, in Tanah Datar, the District Education Bureau began to encourage the study of Minangkabau culture, Arab Melayu (the regional language), and English. The government conducted pilot projects on CBC in selected regions starting in 2002, expanding in 2004 to the entire country.

The Innovations: Smaller Classes and Stronger Incentives

Tanah Datar has become well-known nationally and in the development community for its widespread reforms in public service provision following the 2001 implementation of decentralization. Many new education policies were Smaller Classes And Stronger Incentives Stronger Smaller Classes And Sumatra West District, Datar Tanah In promulgated, including the formation of a special high school for gifted students, the transfer of good headmasters to lower-performance schools, the introduction of a six-day work week for teachers, and funding for drop-outs from remote and poor areas to re-enter school. Two of these innovative policies are highlighted in this case study.

The Stronger Incentives Policy, implemented from 2002 to 2004, rewarded best performance of English teachers and headmasters by a trip abroad, to Australia for one week of English training or to Malaysia and Singapore for school visits. The aims of the policy were to increase teachers’ motivation to teach well, to provide teachers with examples of new teaching methods, and to convince teachers and headmasters of the need for education reform. Specifi cally, the Bupati wanted school staff to return from their trips convinced of the importance of off ering courses in English and computer skills, limiting class size to 30 students, imposing discipline, and improving teaching quality. This policy is noteworthy as international travel rewards for teachers are very unusual in Indonesia; teachers viewed the rewards as an extraordinary opportunity.

Under the Smaller Classes Policy, a limit of thirty students per senior high school (SMA) class was imposed beginning in school year 2003/2004. This policy aimed to strengthen the bond between teachers and students and to focus teachers’ attention on student performance. Previously, classes had each often contained over 40 students.

The Research Questions

This case study sought to answer three questions: 1. What impact have the two innovative policies had on the performance and behavior of teachers and headmasters? 2. What impact have the two innovative policies had on the quality of schools and access to education? 3. What impact have the two innovative policies had on the potential for continued reform, in terms of education staff behavior and willingness to take risks?

Making Services Work for the Poor: Nine Case Studies from Indonesia 29 Smaller Classes And Stronger Incentives 1

30 In Tanah Datar District, West Sumatra Hypothesis 4: studentstoaccess ofthepoorandlower-performing education. Hypothesis 3: ofteaching schools(interms which hasincreased between quality). inequality Hypothesis 2: decreased themotivationofthosewhodidnot. Hypothesis 1: The following hypotheses were tested thefi during eldwork: offi the Offi representatives, EducationBureau, members oftheDistrict four staff 35 teachers, and12parents randomly),seven (allselected headmasters, seven onewalinagari, SchoolCommittee Focus were groupoutwithabout55peopleincluding7students, carried discussionsandsemi-structured interviews been sentabroad. andhaving astaff asoneofthebestschoolsinsub-district includedbeingknown criteria withoutSMAs. a limited number ofschools;andSMASchoolselection studentsfrom sub-districts neighboring rate; included:arelatively criteria highpoverty selection OneoftheSMPs visited isIslamic. Sub-district sub-districts. schools (SMPs), public seniorhighschools(SMAs), andtwo ofwhichtwo, oneandrespectively were inremote publicjuniorhigh schools(SDs),two Selatan, andBatusanggkar). The schoolsincludedthree publicelementary The research team spentten days in Tanah (Batipuh,Batipuh Datarvisitingseven schoolsinthree sub-districts Methodology quality teaching.quality and teachers are now morethaninthepastto conceive likely andimplementtheirown innovations for higher- Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ce, andtheBupatihimself. ces of Information and Religion and the Departments ofSocial andReligionces ofInformation andtheDepartments Welfare andCommunity Welfare, theBupati’s Dueto theStronger Policy, Incentives schoolshasincreased, ofalready thequality higher-performance As aresult oftheBupati’s innovative educationpolicies, Governmenteducation staff The increased focus onstudenttest scores andlimitonstudentenrolment inSMAs have reduced The Stronger Policy hasincreased Incentives themotivationofthosewhowent abroad buthas of the sub-district EducationBureaus, staff ofthesub-district memberwhohad , headmasters , of 1

Findings

Key Events for Education Reform in Tanah Datar

Tanah Datar National wins Award for Individual schools Reformist Introduction of Decentralization Introduction of 30 Best Education initiate their own Bupati School-Based Policies pupil/class policy Policy in study tours to Elected Management Implmented and 6 day working Padang Malaysia week for teachers Province

2000 2001 2002 2003 2004 2005 Smaller Classes And Stronger Incentives Stronger Smaller Classes And Sumatra West District, Datar Tanah In

1999 Second Study 2005 Review of Introduction of Restructuring of First Study Tours and Local Competency Government Tours and Training to Government Based Bureaucracy Training to both Malaysia , Structures Curriculum Malaysia and Singapore, and Australia Australia

The two innovative policies highlighted in this case study were both personal initiatives of the Bupati20. Two themes of his leadership have been increasing the quality of public services and eradicating poverty through increasing local revenue. The Bupati sees education reform, and a subsequent increase in the local skilled labor force, as a key way to increase local revenue and thus reduce poverty. Following decentralization, the Bupati tried through discussion to convince diff erent players of the need for education reform but was not overly successful. Thus, he conceived the Stronger Incentives Policy, in hopes of convincing people by example.

Implementing the Reforms

Playing by the rules Under the Stronger Incentives Policy, rewards in the form of trips abroad were given to English teachers and headmasters. Only schools with the highest absolute scores were rewarded. To increase the total number of winners, rewards were also given to the headmaster from the highest-scoring school in each sub-district. The best English teachers from each junior and senior high school were given English training by the district, based on the headmaster’s opinion, and then tested; the best two teachers of each training were rewarded. Only teachers 45 years of age and under were, however, eligible, in an attempt to lengthen institutional memory of trip benefi ts.

The simpler Smaller Classes Policy has no rules other than the requirement that all SMA classes be limited to 30 students each. Schools which have not yet implemented the policy receive a letter of warning (surat teguran). However, most schools already have implemented it.

20 Support by the head of the District Education Bureau was necessary but the vision did not come from him.

Making Services Work for the Poor: Nine Case Studies from Indonesia 31 Smaller Classes And Stronger Incentives 1

32 In Tanah Datar District, West Sumatra To pay for theSmallerClassesPolicy, schoolfees were increased. Noothercostswere associated withthispolicy. from thedistrict. 21 Interviews withheadmastersandteachers. Interviews 21 2003/2004. 2004, In Tanah Datarreceived anaward for having thehighestnationalexamscores intheprovince inschoolyear have begunto follow suitalthoughtheyare notsorequired. Meanwhile, allpublicandsomeprivateSMAs have implemented theSmallerClassesPolicy. The better SDsandSMPs of headmasters inthedistrict. teachers andtheremainder headmasters. This represents coverage of4percent 10percent ofteachers andnearly staff years thetwo ofimplementationtheStrongerDuring Policy, Incentives eightgovernment staff Outcomes So, WhatHappened? mainly informally, by word ofmouth,onlybroad detailsofthepolicieswere communicated onpaper. and impact. Teachers insomeareas were unaware orunsure for ofthecriteria receiving rewards. Newstraveled signifiThe Stronger Policy wasnotwidelydisseminated Incentives withinthedistrict, cantlydecreasing transparency Spreading theword Australia andRp. 2millionfor to Singapore trips andMalaysia.) approximately costswere Rp. 2million(aboutUS$225).District Rp. 9million(aboutUS$1,010)perpersonfor to trips per month.Headmasters whowent to andSingapore Malaysia thattheschools’ reported share for was theirtrip budget, whileothersrequired hardship are asheadmaster headmasters salaries toaboutUS$60 contribute—a andtheschool. Someschoolscoveredevenly thedistrict splitbetween reward expensesfrom theSchoolCommittee The costofrewards for government,whileheadmaster rewards Englishteachers wasfullypaidby thedistrict were targeted improvements, atpublicsector includingeducation. institutions from 22to 8,thussaving approximately Rp. 10billion(aboutUS$1million)annually. The savings were Additional moneywasneededto pay for 2001,theBupaticutnumberofgovernment thenewpolicies. In Paying forthechanges those schoolsthatcanaff rewards were given theendofStrongerAfter Policy in2004,noperformance-based Incentives out.However, thatyear during wasaboutRp. government’strips 150million,oronly1.5percent ofthedistrict annualsavings. and Singapore, and11government staff Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: were sentto Australia andSingapore orMalaysia for exposure andtraining, trips ofwhom81percent were ord to abroad pay halfthecostsoftrips for theirstaff andheadmasters went governmentspendingfor to Australia, sodistrict 21 In thefi In rst year, 26headmasters Malaysiawent to are stilleligible for matching funds and69school 1

Changes in attitude and behavior Increased motivation to do better work on the part of English teachers and headmasters. Teachers and headmasters who went abroad for training and study trips as part of the Stronger Incentives Policy returned full of motivation and ideas to improve the quality of their teaching. Teachers returning from study trips always wrote and submitted to the Bupati a group report with follow-up observations and recommendations. These included the need for stronger discipline of teachers, students and parents, for smaller class sizes, and for improving the quality of education via provision of classes in computer skills and English, changes in teaching methodology, and an emphasis on student consultations22,23.

Changes in teaching methodology on the part of some English teachers, including those who went abroad and some who did not but associated with the trip-goers (as friends or colleagues at school, for instance). One English Incentives Stronger Smaller Classes And Sumatra West District, Datar Tanah In teacher, for example, began teaching her classes in English rather than Indonesian following her trip to Australia. She has also begun using a “student agenda” in which students record their activities in English, as well as what they have learned from them, as an aid in teaching24.

Increased interest in student performance and longer teaching hours on the part of teachers and headmasters, due to both School-Based Management and the Stronger Incentives Policy. Students now study, on average, approximately 15 hours more per week25. To demonstrate his commitment to raising student test scores, one headmaster actually signed an agreement with his School Committee stating that if the scores at his school were not above a certain level, he would resign26.

Increased support of the Bupati by those who benefi ted from policy changes. Headmasters and teachers who went abroad, in particular, returned convinced that the Bupati’s goals for education reform are correct27.

Increase in reform-mindedness of government education and school staff . While the fi rst education reforms were the initiative of the Bupati himself, currently many players in the fi eld are at work improving the content and implementation of education policy, including the District Education Bureau staff , headmasters and teachers. In fact, conversations with other Bureaus indicate that the spirit of reform has spread: improvements have already been made in the delivery of health services, for instance (see Changes in quality of education below).

22 View of key informants (SDs and SMA headmasters, Batusanggkar, SMA headmaster Batipuh, SMP teacher Batipuh, staff of District Education Bu- reau). 23 There was a question as to whether teachers and headmasters who did not go abroad would experience decreased motivation as a result. Some teachers did report a feeling of “not being treated equally” if their headmasters merited trips and they did not. Teachers from some remote schools with low awareness of the Stronger Incentives Policy may not have been motivated to improve their teaching; but neither did their motivation to maintain teaching quality decrease. 24 SMA teacher, Batipuh. 25 All schools visited by the team reported that this was the case. 26 SMA headmaster, Batusanggkar, in an interview in which the School Committee was present. 27 View of key informants (SDs and SMA headmasters, Batusanggkar, SMA headmaster Batipuh, SMP teacher Batipuh, staff of District Education Bu- reau).

Making Services Work for the Poor: Nine Case Studies from Indonesia 33 Smaller Classes And Stronger Incentives 1

34 In Tanah Datar District, West Sumatra poor students from central and district governments anddirectlyfrompoor studentsfrom someschoolshasmitigated centralanddistrict thiseff a result oftheSmallerClassesPolicy may have onasmallnumberofchildren. hadasimilarimpact Scholarshipsfor 31 Discussions withheadmasters. Discussions 31 Two feltthatitwas thatthey possiblethatmore diffi headmastersreported 30 Bureau District ofEducation. 29 Focus group Education discussion withheadmastersandDistrict Bureau staff 28 Improved at better teaching schools. skills ofeducationChanges inquality forreserved thebetter students, excluding poorandbelow-average students forchance ofwinningtrips schoolstaff andhave inorder abetter criteria, to maintainhighperformance studentsvianewselection higher-performing the sametime, beganto schoolswhere institutionalize theStronger apreference Policy wasknown Incentives for number ofclasseswasusuallynotincreased; therefore, thenumberofspotsavailable inbestSMAs decreased. At Decreased access to SMAs for somechildren. Changes inaccess toeducation increased diffi outthosepoorstudentswhocannotaff selecting inadvertently fi nal year studentsoutside regular schoolhours to boost test results) may indirectlyhave reduced accessalso, by The requirement thatstudentsatsomeSMAs spendsignifi cantlymore hoursatschool(e.g.,classes for mandatory even inremote areas, and(b)the SmallerClassesPolicy didnotapplyto them schoolsas(a)there are manyThere onaccessto juniorhighandelementary more wasnoimpact oftheseschools, SMAsthe better city wasstilllimited to thebetter students. widespread where inthecity large numberofSMAs stillensured aplacefor mostapplicants. That said, accessto The exclusion ofbelow-average studentswasmore prevalent inareas withfewer (orsometimesno)SMAs andless having more studentswillincrease theirincomes. Theonlylimitationisclassrooms. schools, includingthisone, have suffi suggestionmadeby BatipuhheadmastersandteacherstoensureOne access totheirSMAisincrease thenumberofclassrooms. of whichare lower thantheSMAs. quality parents. cannot they If aff them abetterchance tocontinue ontouniversity. Yet thecost ofsendingtheirchildren toschoolintheneighboringdistrict graduates from Batipuhusuallygototheneighboringdistrict,where oneofthebestseniorhighschoolsinprovince isloc schools have unlimitedfacilities isdoubtful. Also, access isnotguaranteed asthedemandforthese schoolsishighaswell: tofi canThey gototheneighboringdistrictandtry ndaschoolthatwillaccept them(schoolsthere donothave a cap onclas Policy. Noadditionalclasses could becreated duetotheschool’s limitedresources. Studentswhoare notaccepted intothisS registered an11percent reduction instudentenrolmentThe soleSMAinBatipuhsub-district before andafterimplementationof Reduced access to highereducation inremotearea Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: not enough data to either conclusively support orrefute theseimpressions.not enoughdatatoeitherconclusively support culty ofexamshasresultedculty inahigherrepeat rate for fi nal year students ord it,theonlyotheroptionsare tostudyatthelocal vocational schoolorgotooneoftheIslamicseniorhighschools, bo cient teacherstoaccommodate additionalclasses. Teachers beingwillingtoteachmore hoursbecause alsoreport . Thus, notonlywere there fewer spotsinSMAs, butthosespotstended to be Schoolswithhighertest scores were ableto sendtheirstaff In SMAs In where theSmaller Classes Policy wasimplemented, the cult exams resulted inhigherrepeat rates forstudents. However, there is . isunclearif ord timeatschool. to It spendextra 28 29 . . 30 . Finally, raisedschoolfees as the bestjuniorhighschool s size). Butwhetherthese ated, tostudy. Thisgives isquitehighforlocal MA haveoptions. few theSmallerClasses Most seniorhigh overseas for ect 31 . th 1 training and exposure visits; these staff returned with new ideas, many of which were put into use in the classroom. At the same time, the Smaller Classes Policy enabled teachers to focus more on individual student needs, likely increasing the quality of those students’ uptake.

Broader educational off erings and better facilities at better schools. The drive to get better students at school, raising school test scores and thus winning trips abroad, was one key motivator of the notable increase in educational off erings at better schools. Among the add-ons were additional classes to help fi nal-year students at all three levels study for the national school-leaving exams (English, math, and Indonesian); special classes for top-performing students (kelas khusus); and out-of-hours classes in key topics such as religion and computer science. One school has contracted with a private organization to provide computer training for its students. A number of schools have made the eff ort to ensure their students have access to laboratories for the natural and computer sciences and to Incentives Stronger Smaller Classes And Sumatra West District, Datar Tanah In provide one classroom per class.

Increased fi nancial burden on some schools and parents. Due to incomplete understanding of the education reforms, some schools are under the impression that they must provide services they can ill aff ord. For example, it is a policy that schools which are able provide English lessons from fi rst grade onward. Yet even poorer schools without English teachers at this level have scrambled to hire staff , to their fi nancial detriment. At the same time, some parents with children at schools with the Smaller Class Policy face higher costs as a result of both this policy and the fact that schools are making increased academic demands upon the students.

An overall increase in inequity among schools. Essentially, the good schools have gotten better while the average and worse schools have lagged behind. The national School-Based Management policy had already begun to focus the better schools’ attention on student performance, and the Stronger Incentives Policy heightened competition for better students. The better schools with higher test scores were already more likely to benefi t from the Stronger Incentives Policy. They also already had access to more government money because of their already superior performance. Having begun to implement broader educational off erings such as additional classes and subjects, and to put to use the new skills their staff had learned on trips abroad or from colleagues who had traveled, they were even more able to attract good students. After the central government inaugurated its School-Based Management initiative, schools have become more dependent on their own resources and on the fi nancial support of parents and School Committees. In a self-perpetuating cycle, good schools which attracted the top students, in part as a result of education reforms, were better able to garner fi nancial support from approving parents and Committees, not to mention government funding. Top graduates with good jobs could even contribute to their alma maters.

At the same time, the lower-performing schools tended to get less of everything—fewer of the top students, fewer trips abroad, less government money, even less chance (because of inadequate dissemination) of learning second- hand of the new ideas of teachers who had traveled abroad. The requirement that headmasters (or their schools or School Committees) contribute 50 percent of the cost of study trips further reduced the chances that lower- performing schools could benefi t from the Stronger Incentives Policy.

Making Services Work for the Poor: Nine Case Studies from Indonesia 35 Smaller Classes And Stronger Incentives 1

36 In Tanah Datar District, West Sumatra 32 District Education District Bureau. 32 The Stronger andSmaller ClassesPolicies Incentives yielded impressive benefi tsinjusta few years for teachers, Key factors oftheinnovations inthepositive impact Improving Delivery Education Service resulting the newregulations increaseafter were ofthenumberpatientsvisiting puskesmas instituted. are stillneedto great bepaidby subsidized patients. by government interest Of andwhatparts of theservice isthe theyare stillreluctantto availservices, themselves ofthem. The newbillingsystem specifi callyidentifi eswhatparts therefore relatively inexpensive. However, of aboutthequality ifpeopleare unaware costsanduncertain ofactual a newbillingsystem to ensure transparency. are highlysubsidized by Puskesmas thegovernment andare services became fi nanciallyautonomous. Theyincreased provided, their anddesignedfees as well asthenumberofservices iswillingto Subsequently, pay andthatthecommunity for services. bettersub-optimal, quality three puskesmas Two majorfi ofhealthcare ndings were (includingthepoor)considerquality services thatthecommunity to measure patients’ asurvey ofHealthconducted 2004,theDepartment In andwillingness to satisfaction pay. From education tohealthcare: thereformscontinue studies; even more have appliedto receive to travel funding from thedistrict in2005 EducationBureaufor fundingfrom to travel theDistrict andreceiving to partial for Malaysia comparative school 2004,thoughtheStronger Policy hadtechnically Incentives In ended, continuedwith150teachers applying itsspirit school late too andSchoolCommittee often, awards teachers attheirschools. for high-performing students won aprovincial Olympiad, theintroductionofsmallfi tasks for children whocome nesordisciplinary to for for peerexchanges, their trainingafter sendingmathteachers frommembers to Jakarta oneschoolto Jakarta catching on. Follow-on changesimplemented SchoolCommittee atsomeschoolshave includedsendingsupportive A rash oflocalinnovations, aswell. notonlyineducation butinotherservices report an increase of 300% in service utilization. anincrease of300%inservice report becamefullyautonomous.health centers (puskesmas) now managetheirown fiThese puskesmas nancingand hasalsoimplemented someinteresting newpolicies;in2004,anumberoflocal HealthDepartment The District patients. Of great interest istheresultingpatients. increase Of ofthenumberpatientsvisitingpuskesmas regulation afterthenew billingsystemspecifiof them.Thenew cally identifi s are subsidized oftheservice by government andwhatparts eswhatparts inexpensive. However, ifpeopleare are unaware ofservices,they stillrelucta aboutthequality ofactualcosts anduncertain billingsystemtoensuredesigned anew transparency. Puskesmas are highlysubsidized services by thegovernment andare theref services. Subsequently, three puskesmas became fi nanciallyautonomous. increased They theirfeesas well asthenumberofservi iswillingtop andthatthecommunity ofhealthcare (includingthepoor)considercommunity thequality sub-optimal, services tomeasure patients’satisfaction ofHealthconducted andwillingnesstopay. asurvey TwoIn 2004,theDepartment majorfi ndin Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: 32 . The Bupati’s newideasare s were instituted. nt toavail themselves till needtobepaidby ay for better quality ay forbetterquality ces provided, and gs were thatthe ore relatively 1 headmasters, and students, mainly from the better schools, and to a lesser degree other education stakeholders and stakeholders in other service sectors such as health. How did this happen? Of course many factors were at work, but among the key factors—those without which the policies would not have been created nor had the impact they did—are:

Changes in national government policy. Decentralization, legislated in 1999 and begun in 2001, together with the two national education reform policies (School-Based Management and Competency-Based Curriculum), paved the way for education reform at lower levels in two ways: fi rst, they loosened the political reins on the Bupati and the School Committees by transferring the bulk of the responsibility for school planning, funding and management to them; and second, by their very nature they created a climate encouraging change. Smaller Classes And Stronger Incentives Stronger Smaller Classes And Sumatra West District, Datar Tanah In

The vision, imagination, and leadership of the Bupati. It is common knowledge that remarkable leadership is often key to social change. The example of education reform in Tanah Datar is no diff erent. National government policy changes notwithstanding, it is unlikely that the Stronger Incentives and Smaller Classes Policies would even have been conceived, let alone implemented, without the Bupati’s leadership33. From his experiences abroad, the Bupati had a vision for education reform; using his creative and leadership skills, he located funding for reform by drastically downsizing local government, and proceeded to introduce changes in a deliberately round-about way (rather than through legislation which he feared would not be as eff ective).

Eff ective implementation of the reforms. Many service reforms sound good on paper but because of ineff ective or faulty implementation yield poor—or no—results. This is particularly true of incentives policies. The fact that the Tanah Datar Stronger Incentives Policy not only set out to link performance and reward more tightly, but actually succeeded in so doing, is notable. A clear result was increased motivation of teachers and headmasters who traveled abroad.

What reduced the positive impact of the innovations?

Rapid visible positive impact notwithstanding, the two policies had unexpected negative consequences— decreased access for a small but signifi cant group of school-aged children, and an increase in inequity between better and lower-performing schools. In addition, the positive impact itself was rather localized, centering on the better schools. What happened?

Inadequate dissemination of the new policies. Sources concur that there was inadequate dissemination of information about the existence of the policies and the “rules of the game”. Some schools received incomplete or inaccurate information about them, reducing their chances at winning a trip abroad or in some cases burdening them fi nancially (as when schools hired extra teachers in a misguided attempt to apply the policy on English teaching at grade one). The schools which missed out tended to be lower performers (in terms of national test scores) and

33 Bupati and head of Education Bureau.

Making Services Work for the Poor: Nine Case Studies from Indonesia 37 Smaller Classes And Stronger Incentives 1

38 In Tanah Datar District, West Sumatra classes couldbeoff classes. SMAs Most have enoughteachers; isnumberofclassrooms. thelimiting factor With more classrooms, more the SmallerClassesPolicy, asreduced classsize wasgenerallynotaccompaniedby anincrease inthe numberof Insuffi reform. forrepresents improved disseminationandimplementationofallpolicies, alostopportunity includingeducation decentralization, theyhave notbeengranted more responsibilityinproviding information to theircommunities. This issupposedto beimplemented.policy haveWhile thenagari asaresult beendelegated more ofnational authority bythecommunity, asenseoflocalownership,policy ensuring notto mentiona clearer understandingofhow that Ineff seriously. document signed bytheheadofEducationBureau isviewed asmore more formal andwillthusbetaken their dissemination;andsecond, itmay have lowered people’s awritten Indonesia, In opinionoftheirimportance. The decisionnotto legalize thereforms. Education Bureau to ensure aswell disseminationoflessonslearned asfollow-up. have notyet beenfollowed recommendations ofthetrip-goers shouldbetheresponsibilityofDistrict up. It travel abroad. addition,the Thus, hadlimited In positive ideasaboutimproving impact. teaching performance of information andenthusiasmwhichwasnotcommunicated to theircolleaguesinotherschoolswhodidnot Lack offollow-up from trips. 4 Estimateoffi eld research team. 34 25percentand perhaps to newspapers (Infokom). potential aspeopleare eagerto tellThis lastmethodhasparticular mosthave theirstories; accessto radio andCommunication itinnewspapersviatheInformation Bureauthe information onradioortelevision orreporting writing, eithervialegaldocumentsorinformal newsletters; sendinginformation andbroadcasting viathenagari; There are many optionsfor improving disseminationofinformation, including:puttingmore oftheinformation in headto headmaster andthenceteachers. Bureau headto sub-district about organically, to the andpartly pathway”“long thatmuchinformation hasto travel, Education from theDistrict changes. to attributed theBupati’sThis waspartly decisionnotto legislate hischangesbutratherto letthemcome were to have lesslikely heard, andpolicy-makers informal orheard tiesto accurately, thetrip-takers aboutthepolicy aswell,remote schoolswithoutclose schools(whichhadlesschanceofrubbingelbows withthepolicymakers); one combinedSMA/SMP years. inthe pasttwo aninitialeff solution. In be diffi Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ective useofthenagari. ective cient infrastructure (classrooms) insomeschools. cult for thoseinremote mostoftherelevant fundingcouldbethe areas—but schools—especially district ered, partially off ered, partially ort to address government builtonenewSMA, thisproblem, onenewSMP,ort thedistrict and Nagari support for a policy willautomatically for result inhigheracceptanceofthat apolicy support Nagari Teachers andheadmasters camebackfrom abroad theirtrips withagreat deal setting thereductioninclasssize. Finding thebudgetfor would construction 34 . ways: intwo fiThis limited theirimpact rst,itneedlesslycomplicated A key factor inthedecrease factor inaccessto SMAs Akey was 1

Limited targeting of the poor and disadvantaged. The poor and disadvantaged often fall through the cracks if they are not highlighted as a special target group. Tanah Datar was no exception. In this case, the disadvantaged included lower and average performing students with less chance to obtain spots at the better SMAs; poor students, who possibly were self-selected out of SMAs as a result of too-high opportunity costs for SMA attendance; and especially, students from lower and average performing schools, whose staff were not even eligible for trips abroad. Of course, identifying in advance all groups which might not benefi t, or benefi t fully, from a given policy is impossible. However, the importance to education reform of paying special attention to remote schools, poor students, and especially, students of lower and average-performing schools, could easily have been predicted, and policy measures could easily have been conceived and implemented to address the special needs of these groups. For instance, reserving some of the trips abroad for teachers of the highest performing class at lower-performing schools, or for teachers at schools registering the biggest increase in exam scores over a year, might have yielded a Incentives Stronger Smaller Classes And Sumatra West District, Datar Tanah In big impact in terms of teacher motivation at those schools.

Limited scope of the reforms. While training and study trips for English teachers and headmasters had very positive results for those staff , teachers of other subjects were not included and did not benefi t. Incentives for other staff would doubtless have strengthened the impact of the reforms.

Making it replicable

To be replicable, the reforms have to be fi nancially sustainable. The Stronger Incentives Policy was relatively expensive; because of savings from district restructuring, however, the total cost for international travel and associated costs still only amounted to less than 1.5 percent of this savings. Not every local government, however, has the freedom, nor perhaps the political will, to make what amounted in Tanah Datar to a major transfer of fi nancial resources from (now closed) district government bureaus to the education system. Financial sustainability then becomes a major issue. Generally, the more expensive a change is to institute, the less likely it will happen. A key question for education policy-makers interested in strengthening incentives as Tanah Datar did is, “How can we cut costs?” A related and no less crucial question is, “Where do we get the money for any type of incentives program?” One approach is, of course, to cut the costs of the incentives: in Tanah Datar, for example, staff could have been sent on study trips to centers of training and educational excellence within Indonesia. Another approach is to strengthen the “ripple eff ect” of the reforms by increasing the number of indirect benefi ciaries: for instance, ensuring that lessons learned on study trips are passed on to those who stayed at home.

To be replicable, the reforms have to be institutionally sustainable. While one visionary leader can push or nudge through major reforms once or twice, for long-term sustainability of a culture of reform, systemic change is necessary: institutions generally last longer than their leaders, no matter how brilliant. The number of stakeholders willing and able to take risks needs to increase, and the formal and informal rules of the game need to be altered to allow and nurture change. In Tanah Datar, it seems that this process has already begun.

Making Services Work for the Poor: Nine Case Studies from Indonesia 39 Smaller Classes And Stronger Incentives 1

40 In Tanah Datar District, West Sumatra case study shows, initial improvements in service delivery are not always orinclusive. eitherpro-poor case studyshows, delivery initialimprovements inservice interestedPolicy-makers inreplicationneedto includethistarget withequity group thedesign during phase. As this disadvantaged directlywillmagnify thisfaultwhentheyare replicated. ofequity.A note on theimportance Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Reforms whichare notdesigned to address theneedsofpoorand Case Study 2: Vouchers for Midwife Services in Pemalang District, Central Java

Vouchers For Midwife Services 2

42 In Pemalang District, Central Java andmaynotbe reproduced orreused withouttheirpermission. as byconfl stemming from icts its withthehealthcardoverlap program. project information, andanalysisofprojectdata,ineff inadequate collection Project waslimited bydiffi impact increase ofmidwives’ inquality asaresult oftrainingprovided to allmidwives services bythecentralgovernment. in1997to 32in2003. births This improvement notdueto theproject,however, islikely to an butatleastinpart implementation period, there rate wasanimprovementfrom 51per1,000live inthedistrict’s mortality maternal was quite eff fito mainfactors: two rst,the voucher enabledthepoor andsecond,to getmidwife the voucher system services, TPC pilotincreased theaccessofpoorpregnant women health care. maternal to higherquality Successwasdue midwife whichrequires funding, contract andthevoucher nodistrict system wasdiscontinued.to Overall, aPTT the with someofitsown November funding. 2004,however, In thecentralgovernment enabled TPC midwives to transfer for many government-funded midwives. The continuedthevoucher system TPC pilotendedin2003butthedistrict 2002 thegovernment tacitlyabandoneditsgoal ofmidwife by allowingrenewals privatization unlimited contract TPC midwives were onlypaiduponsubmissionofvouchers, to seekoutpoorclients. motivatingthem,inturn, In vouchers for withpre-paid specifibooklets suchasdelivery, motivatingthem to seekcare. healthservices cmaternal the midwives. Allpoorpregnant women invillageswithmidwives underthe contracted TPC pilotwere to receive ofHealthstaff level. addition,centralMinistry In province. The atthevillage wastoTPC pilotobjective healthservices strengthenofmaternal thesustainability includingPemalang ofIndonesia, inCentral pilotprojectwaslaunchedinten Java districts for (TPC) Midwives ofthe 1998,aspart WorldIn Bank-funded Project, Safe Motherhood the Targeted-Performance-Based Contracts Abstract Thiscase was writtenby Eleonora SukMeiTan, World Bank(Indonesia),basedonafi eldvisitto Pemalang districtinMarch 20 Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: provided Leisher, by Susannah Hopkins consultant (Australia). Thiscase iscopyrighted by theauthors, Institute, theAsh andt andMennoPradhan, Miyata, andSachiko Stefan Nachuk, (U.S.A.), University alloftheWorld Bank(Indonesia).Analytical anded Institute (Indonesia).Managerial, editorial, was andanalytical provided support by Winthrop InstituteofDemocrati Carty, Ash for works referenced. Research Pradipta team membersincludedC.ClaritaKusharto, Paramitha Foundation (Indonesia) andSriBud ective in holding midwives accountable for delivery of their services to thepoor. oftheirservices inholdingmidwivesective accountablefor theproject’s During delivery 1 culties inidentifyingandreaching thetarget group, insuffi thoughtthatitwasintended to assistineventualof privatization ective projectmanagement,aswellective cient dissemination of he World Bank c Governance, Harvard 05. See Bibliography05. See itorial support was itorial support iyati, SMERU 2

Introduction

The Study Site: Pemalang District

Pemalang district (kabupaten) is one of 35 districts and cities in Central Java province. The district’s population of nearly 1.3 million is all of Javanese ethnicity35. Flat terrain means all 14 sub-districts and most villages are accessible by road. Forty-eight out of the 222 villages in the district, however, are classed as “remote”, with diffi culties in transportation. The region is relatively poor with a poverty rate of almost 40 percent in some sub-districts (compared to the national rate of 17 percent); the main income source is paddy rice. The district’s illiteracy rate, 13 percent, is the same as the national rate36. The local language is the widely spoken Javanese; most elderly villagers do not speak Vouchers For Midwife Services Midwife For Vouchers Java District, Central In Pemalang Indonesian.

Maternal Health Services in Pemalang District

Maternal health services are the responsibility of the Ministry of Health via Province and District Health Bureaus (dinas kesehatan), and are available to all Indonesian women from both public and private providers. Public providers include government-paid midwives, either contracted (pegawai tidak tetap bidan di desa or BdD PTT) or appointed as civil servants (pegawai negeri sipil bidan di desa or PNS BdD) at sub-district health centers (puskesmas) and their associated village midwife stations (polindes) and health centers (puskesmas pembantu or pustu). Private providers, who work from their homes, include government-paid midwives who work for themselves after government working hours, as well as women who are solely private. A key group of private providers is the traditional birth attendants, or dukun, who are still used to assist in most village births whether a midwife delivers the child or not. In villages without subsidized midwives, dukun still deliver most babies of poor women. According to Parker and Roestam (2002), this is because their services are cheaper and more conveniently located, they are more likely to have children themselves, and they off er additional valued non-clinical services following childbirth, including cleaning the placenta, washing the baby, and providing massage for baby and sometimes mother. The dukun have no formal midwife training, are usually older women with low education levels (elementary school or lower) and usually rely on traditional methods. Since the 1990s, the government of Indonesia has asked the puskesmas to arrange small training sessions for the dukun by government midwives. In Pemalang all dukun have received this training. The dukun are, however, still not trained in how to deal with complications in delivery. With the increasing number of trained and licensed midwives, the government’s view is that the use of the dukun for deliveries should be stopped.

The current health care network in the district includes 31 doctors, 22 sub-district health centers, 49 village health centers and 161 village midwife stations with 244 midwives (115 contracted and 129 civil servants). Only a few of the 222 villages are still without a midwife37. There are about 300 dukun working in the district (at least one per

35 District Health Bureau DinKes (2004) 36 World Development Indicators Indonesia: 17 percent of women aged 15 and above and 8 percent of men aged 15 and above are illiterate. 37 District Health Bureau.

Making Services Work for the Poor: Nine Case Studies from Indonesia 43 Vouchers For Midwife Services 2

44 In Pemalang District, Central Java from thestart midwives wasanunwritten program objective budget, andstrengthenedthrough thePTT sustainability privatizing The governmentwasalready aware oftheburden thatfi nancingthenewmidwives would placeonthecentral wasoneproblem,enough midwives to butanotherwasto meetdemandinIndonesia fi ndasustainablesolution. planned to place56,000midwives nationwide 2005,ithasplacedapproximately (asofearly 50,000).Supplying BdD)Program. (pegawai Midwife Contract tidaktetapUnderthisprogram, bidandidesaorPTT thegovernment Conference. The fi Strategy oftheSafe wasthe rstprogramMotherhood launchednationallyaspart Temporary Strategy launchedaSafe 1990s, inresponse theearly Indonesia Motherhood to the1987NairobiIn Safe Motherhood increase services. accessto midwifery for aswell HealthBureau asfor thesemidwives to to regainintheirwork, maintainand theDistrict somestability indeed berenewed. thatyear presentedThe launchofanewpilotprojectfor anopportunity healthservices maternal of thesecondgroup were dueto expire in1998,though,there would wasconfusionabout whetherthecontracts midwives inPemalang washired in1994,andthesecond—agroup district of50—in1995. When thecontracts rules,were initialcontracts for withoneoptionalrenewal. athree-yearperiod Under PTT The fi rst group ofPTT clients, which made privatization following the expiration of their contracts very unlikely clients, following whichmadeprivatization very theexpirationoftheircontracts 2 Source: No. World PIC2869. BankReport 42 healthcenters. Source: headsofsub-district 41 Source: Parker andRoestam2002. 40 statisticsfrom http://devdata.worldbank.org/hnpstats/. Health,nutrition,andpoverty 39 HealthBureau Source: District (2000-2004). 38 ascompared with32intheEastAsiaIndonesia andPacifi c region intheregion.in othercountries For (2003statistics)in rate is47per1,000life births instance, theinfantmortality Despite overall improvement andchildhealthindicators maternal than remain since1997,key higherinIndonesia Reform Maternal HealthService for care childbirth-related ayear pregnant ofonepercent of allPemalang women (ormuchlessthanone-tenth deliveriesannually)to thehospital are minorrole women.healthcare: invillagematernal Hospitalsplay avery TPC midwives refer 30and50 between addition,there arevillage). In about26,000volunteer orkader, villagehealthworkers, inthedistrict. The majority life and(4)preparing adolescentsto leadahealthy reproductiveimproving offamilyplanningservices; thequality atthevillagelevel; (3) (2)strengtheninghealthservices ofmaternal thesustainability healthservices; maternal (1)improving thedemandfor ofEastand Central andutilizationofquality Java by: districts health statusinselected A Partnership andFamily thegovernment’s Approach to support strategy. The projectaimedto improve maternal 1997,the ofHealth(MOH)designedIn Project: theSafe Motherhood World BankincooperationwiththeMinistry Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: 42 . 40 . Butthenewlygraduated midwives few hadmany andattracted problems promoting theirservices 38 . 39 . 41 . 2

The pilot project, launched as a key component of the Safe Motherhood Project, was called Targeted-Performance- Based Contracts for Midwives (TPC). It was implemented from 1998 to end-2003. The main objective of the TPC pilot was to strengthen the sustainability of maternal health services at the village level43. It “was designed to be more equitable [than the existing PTT contracts system] for the BDD [midwives], …[and] more equitable for the villagers; [in addition it] would be performance-based and therefore encourage greater effi ciency.” It was intended that the TPC pilot would “save the MOH a substantial amount of money over time…as the proportion of the population who are poor continues to decline with future development… Accordingly, the TPC provides an ‘exit strategy’ for MOH’s support to the BDD [midwives], who will be assisted to become (eventually) self-sustaining private providers.” 44

The TPC pilot project consisted of three elements: contracting and training of midwives45; a demand-driven voucher system for midwives’ services; and target-based evaluation of midwives’ work. In theory, issuing pre-paid vouchers for Services Midwife For Vouchers Java District, Central In Pemalang specifi c maternal health services would ensure that people of all incomes could aff ord midwifery services. The requirement that TPC midwives submit the actual vouchers for payment gave the midwives an incentive to look for poor patients and convince them of the need for their services. Ministry of Health offi cials envisioned that through the voucher system, demand for midwife services would increase suffi ciently to permit privatization of TPC midwives’ services.

Complicating the story further, in 1997, the government had implemented Social Safety Net (SSN) Programs to reduce the negative impact of the economic crisis on the poor. One of the SSN programs, the JPS-BK (Jaring Pengaman Sosial Bidang Kesehatan, or Social Safety Net on Health), aimed to increase access to health services for lower-income families through the provision of health cards. The health card program was introduced nationwide the same year that the TPC pilot project was launched in ten districts. The health card covers not only some maternal health services (delivery, ante- and post-natal care) but many other health care services as well, in both health centers and hospitals.

Research Questions

The objective of this case study was to examine the impact of the voucher system on quality and utilization of midwife services, with a focus on utilization by the poor. Three hypotheses were tested during the fi eldwork:

1. As a result of the voucher system, utilization of TPC midwives’ services by the poor increased. 2. Specifi cally, the voucher system caused this increase in utilization because: (a) it became fi nancially possible for the poor to use TPC midwives’ services; (b) TPC midwives had a fi nancial incentive to encourage the poor to use their services; and (c) there was a greater understanding on the part of poor pregnant women of the need for, and higher quality of, TPC midwives’ services. 3. The use of targets for evaluation of TPC midwives increased their motivation, and thus the quality of their services.

43 Source: World Bank Report No. PIC2869. 44 Source: World Bank Report No. PIC2869, pp.34 and 46. 45 Training was not a part of the TPC project per se, but TPC midwives were prioritized in the new national midwife training program.

Making Services Work for the Poor: Nine Case Studies from Indonesia 45 Vouchers For Midwife Services 2

46 In Pemalang District, Central Java somewhat. All TPC projectdatafrom waslostinafi 1999andearlier HealthBureau in2000,complicatinganalysis re intheDistrict paddies.and rice Poor orjustbyfor strolling were giving through birth. familiesinterviewed chosenwiththehelpofkader thevillages poor families. wereThe voucher patientsinterviewed invited by themidwives andare motherswhousedvouchers orBadanPerencanaanKasubid, SubBidangSocial),onevillagehead, DaerahKepala ten voucher patients, andeight 7 Thiswas thetotalnumberofTPCmidwives evercontracted through the project inPemalang. 47 Because theproject involved somanyorganizations, thecentral government decidedtohire district-levelfacilitators to 46 midwives. The TPC How tpcworked ofTPC The LifeandDeath ProjectMotherhood facilitator, of whomsixare former status(PNSBdD),eightkader,TPC midwives, theSafe midwives two withcivilservant including theheadandstaff andonevillagehealthcentercenters (posyandu)were (puskesmas) visited. Aboutfi people werefty interviewed, research toolsandfocus wereThe primary group semi-structuredinterviews discussions. health Two sub-district coastal road) andvillageswitharelatively andnumberof highnumberwere selected). TPC midwives (sub-districts remote isfairly whiletheotherisnearmain district. for wereThe criteria selection location(onesub-district andAmpelgadingUjunggedevillagesinsub- Peguyangan villageinBantarBolangsub-district, Fieldwork outinMarch 2005for of11days. wascarried aperiod were visited: Three sub-districts villagesintwo Methodology such as being eligible for civil servant status following contract expiration, and being able to buy a motorbike on statusfollowing expiration,andbeingabletosuch asbeingeligible buyamotorbike forcontract civilservant allowed to choosewhere to Fourth, practice. there were rumorsofadditionalbenefi tsofbeinga TPCmidwife, the voucher project(six)than for thehealthcard program (three). Third, midwives, were TPC midwives, PTT unlike washigherforpregnant andthenumberofreimbursable healthservices maternal women was higherperservice, was there a providedTPC contract-signing bonusofRp.to low-income 500,000(~US$56),butincomefrom services three years). Second, income. Notonly (just to contracts TPC incomewasexpected behigherthanPTT initial PTT wereTPC contracts seenasdesirable for anumberofreasons. First, initial TPC contracts,atfi ve years, were longerthan renewed. would be contracts midwives, in1998whethertheirPTT hired in1995,anduncertain had previously beenPTT midwife waseligible to applyfor the TPC positions, out,allmidwives butasitturned whowere hired under TPC Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ties. Pemalang 30midwives contracted underthe District 1998. TPC pilotprojectinOctober of the District Health Bureau, eight sub-district healthcenter staff HealthBureau, oftheDistrict eightsub-district 46 the head of the Social Sub-Department of the District Planning Bureau oftheDistrict ( theheadofSocialSub-Department , eight PTT midwives, , eightPTT avoid overlapping activi- Bappeda 47 Any

2

credit.48 Finally, through the dissemination of information about the program, for which the TPC midwives were responsible, TPC midwives got the chance to promote their own services. This was especially important for the still fairly inexperienced midwives who had problems winning the trust of the villagers.

Approximately 20 of the 30 midwives contracted under TPC simply switched from PTT to TPC status in the same village. In a few cases, TPC midwives chose either villages that had never had midwives, or villages in which a PTT midwife had been working but had already left.

TPC midwives had a three-part income, including a monthly base wage for assisting in village health centers

(posyandu) a few days a month,49 fees from vouchers paid by low-income pregnant women, and private practice income. Services Midwife For Vouchers Java District, Central In Pemalang

TPC midwives’ work was evaluated by staff of the District Health Bureau against targets for the expected birth rate of the village for the voucher services and was consequently compared with the non-voucher services provided. Midwives did their own reporting each month, fi lling in simple forms and sending them to the District Health Bureau. The achievement of targets was used as one indication that poor women were receiving the services they needed; it was also intended to show the progress midwives were making in becoming fully independent private providers. Bureau staff traveled to villages to investigate cases in which targets were not met.

The vouchers. Every low-income woman in a TPC village was to receive one booklet with vouchers for the six key midwife services, including delivery, referral to the hospital in case of complications,50 ante- and post-natal care, infant care, birth control, and family health care services.51 For each pregnancy, a poor woman received a new booklet.

Each time a woman received one of these services, she paid the midwife for it with one of her vouchers. Midwives were paid a set fee for each type of voucher.52 It was hoped that the vouchers would provide a fi nancial incentive to midwives to seek out low-income pregnant women and provide services to them, as well as removing the fi nancial barrier low-income pregnant women faced in seeking midwives’ services.

Identifi cation of women to receive the voucher booklets was done mainly by the TPC midwives themselves, sometimes in cooperation with health volunteers (kader) and, in a few cases, village heads. Midwives were given a list of people who, based on criteria of the National Body for Family Coordination and Planning (BKKBN, or Badan Koordinasi Keluarga Berencana Nasional), were eligible for health cards. Criteria included having an earth (not sand)

48 Source: nine TPC midwives from two sub-districts. 49 J.C. Knowles (2000). 50 This service was only included as part of the voucher booklet in 1999. 51 In 1999, each booklet contained 29 vouchers, including one for delivery, one for emergency referral, six for ante-natal care, three for post-natal care, four for family planning, eight for infant care, and six for family health care. 52 In 1999, the voucher payments were Rp. 60,000 for delivery, Rp. 30,000 for family planning, and Rp. 5,000 each for other services.

Making Services Work for the Poor: Nine Case Studies from Indonesia 47 Vouchers For Midwife Services 2

48 In Pemalang District, Central Java continued to bereimbursed bythecentralgovernment with World Bankfunding. Bank andthecentralgovernment through 2003; 2004costsfor basewageswere whilevouchers paidby thedistrict Project Unit(DPMU) Project incomefor Monitoring alsoreceived itswork. costswere anunknown paidby the World ofRp. HealthBureau 150,000for werethe District theirrole eachpaidamonthlysalary inmonitoring. The District 53 District HealthBureau District andR.D. Menelaws(2000). Basewages andvoucher payments forthe30TPCmidwives inPemalang were 53 of thepoorto healthcare, though TPC focused andchild health andwasimplemented solelyonmaternal only and the TPC voucher project.Boththe TPC project andthehealthcard program were created to increase theaccess midwives couldprovide healthcard-reimbursablehealth card programs—intimately services— asonlyPTT linked and healthcareessentially two inPemalang: programs ongoingthatprovided thePTT healthservices maternal were contracts renewed in1998andagain20012004. PTT fact, Thus,In 1998and2004,there between were A tangledweb: thedemiseoftpc Pemalang wasover Rp. district 1.2billion (~US$134,000) for 1999to 2004; theperiod costsTPC pilotproject village headsare notinvolved inthedisseminationprocess. information aboutpregnancy, othervillages, projectsisdiscussed. health,andpro-poor however, nutrition, In the in Ampelgading, villageheadscontinueto organize monthlymeetingswithpregnant womenwhich during explain thevoucher program to her. Village headswere also sometimesinvolved indissemination. For example, became pregnant, sothemidwife drop couldinturn by thewoman’s hometo giveand heravoucher booklet wouldof thewomen drop is. by Active the kader TPC midwife’s whenalow-income woman hometo letherknow as well. Kader, status whoispregnant, becausetheyare localwomen, andwhatthesocio-economic usuallyknow themselves. Allmidwives usedthevillagehealthcenters (posyandu)asaconduitto mothers, andsomeusedkader Dissemination ofinformation aboutthe TPC pilotprojectto localwomen wasdonemainlyby themidwives (thevillagehealthcenters orposyandu),were crucialtoservices theprogram. healthcenters, whichoff that thesub-district healthcenters would runcounter to programthe (government-funded) success. sub-district Later, itbecameclear wasreasoned thatbecausethemidwivesthe projectbydesign. were It supposedto becomeprivatized, including HealthBureauAtfi (DinKes). responsibility oftheDistrict healthcenters were excluded from rst,thesub-district Dissemination. would alsohave received avoucher booklet. were thatthesamecriteria fact usedsuggeststhatin pregnantTPC villages, woman every whohadahealthcard of religion. Basedonthehealthcardmidwives thenmadetheirown criteria, eligibility listsfor voucher eligibility. The school, andbeingunableto orsendingchildren aff to elementary services fl oor,twice aday, eatingatmost having justonesetofclothes, beingunable to aff Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: 1999, Rp. 175,777,333in2000,Rp. 156,685,000in2001,Rp. 137,276,000in2002,Rp. 266,331,000in2003, andRp. 292,100,000 i Disseminationofinformation abouttheprogram to midwives, kader, andvillageheadswasthe The total costofbasewagesandvoucher reimbursements for the30 TPC midwives in ered showcase arespected for andtrusted village-level themidwives’ ord the items necessary for ord thepractice theitems necessary healthclinic ord sub-district 53 in addition, two staff inaddition,two n 2004. Rp. 178,743,600in from 2 in Java, while the health card program was national and not limited to maternal and child health. To ensure that vouchers would still be used, despite the overlap in target group of the two programs, the District Health Bureau issued a legal document (SK, or surat keputusan) that required that TPC midwife services only be paid for by voucher or cash, but not the health card.

PTT midwives, like TPC midwives, receive both a base wage and wages based on the number of poor clients they have. The payment systems for the two groups were, however, diff erent. TPC midwives were evaluated monthly by the District Health Bureau before they could receive voucher payments. They were required to submit the physical vouchers with which they had been paid, proving services had been provided and greatly reducing the opportunity for fraud. PTT midwives, on the other hand, have government-established bank accounts in which their entire estimated yearly wages are stored. Each month, they simply withdraw their base wage and claims for maternal Services Midwife For Vouchers Java District, Central In Pemalang health services provided to health card clients—though they must fi rst report to the head of the sub-district health center, whose signature is required for the withdrawal. They are not required to submit physical evidence of health card clients served. Thus, the PTT system is easier to dupe than the voucher system was.

Because the work of the TPC and PTT midwives was virtually identical, there was an expectation that wages would also be similar: an increase in the base wages and voucher or health card fees of one was expected to be followed by an increase in the base wages and voucher or health card fees of the other. In fact, TPC midwives’ base wages and voucher fees were increased twice, in 2003 and 2004, following similar increases in PTT incomes, but never reached the same level.

In 2002, tacitly abandoning the original goal of privatization of midwives’ services, the central government enacted a law allowing unlimited contract renewals for PTT midwives, but this did not extend to TPC midwives. Their contracts were due to expire at the end of 2003 with the end of the TPC pilot project. By that time, three of the TPC midwives had left the district to follow their husbands and one had received civil servant status; 26 were still practicing under the TPC pilot. Staff of the District Health Bureau were convinced that the TPC midwives were unable to become fully private practitioners. As 15 percent of district midwives were contracted under the TPC pilot project, they were also concerned about maintaining the access of low-income pregnant women in their district to midwifery services when the project ended. Hence, they decided to continue the voucher system on their own, taking the extraordinary step of funding TPC midwives’ base wages from their own resources. They were able to continue providing vouchers in TPC villages with funding from the World Bank.54 The district’s decision to continue the voucher system after the technical end of the project itself was exactly what the central government (and the World Bank as funder) had been hoping would happen.

However, the government in eff ect sabotaged the continuation of the voucher system by its decision in November 2004 to hire more PTT midwives using central government funding. The district immediately decided to discontinue the voucher system, and all 26 TPC midwives were transferred to the PTT program. Despite the clear benefi ts of

54 Staff of District Health Bureau.

Making Services Work for the Poor: Nine Case Studies from Indonesia 49 Vouchers For Midwife Services 2

50 In Pemalang District, Central Java 5 ThePKPS-BBMprogram orfuelsubsidycompensation program provided subsidiestopoorfamilies inavaricty ofareas oneoft 55 withaprogramentitles allpoorhouseholdsto freeofhealthinsurancefor basichealthservices) thepoor. Coda: moneyfor suchasinfrastructure works. otherpurposes up district central government. Discontinuingthevoucher system thuswould have onaccess, noimmediate impact yet freed to thepoor, thatthehealthcard services programknew andisfundedentirely provides by thesameno-cost the the voucher system—it increased midwives’ andreached accountability many poorpregnant women—the district cards are stillbeingusedinPemalang. government hastherefore decidedto implementtheprogram withEastIndonesia. inphases, starting Thus, health they gotjustonemonth’s notice, many includingPemalang, districts, have beenunableto meetthedeadline. The law, inthecountry. By shouldhaveGAKIN) schemeinalldistricts implementingit,butas already alldistricts started 2005,thegovernment mandated theimplementationofanewhealthinsurancefor thepoor(JPK- January In (out ofover 400nationwide) hadreplaced thePKPS-BBMprogram withtheirownhealthinsurancesystem. andinfantcare. includingmaternal theendof2004,overin allplacesitcovers By 30districts basichealthservices specifi where covered itisimplemented, amongthedistricts by thishealthinsurancevaries but ofservices c package Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: 1993 nationwide launched ) (SMS Strategy Motherhood Govt’ Health insurancefor thepoor. began to replace in2002,somedistricts thePKPS-BBMprogram (that Starting midwives hired launched. First First launched. s Safe s Safe PTT Program udrSS) (under SMS nationally of 50.000 1994 1995 district in Pemalang midwives hired PTTof 50 Second Group of Ministry of ol ak) Bank World (cooperation Motherhood Health and launched 1996 Project Project Safe Safe programs ) (SSN Net Safety Social implementing Govt begins 1997 launched in districts. 30 30 districts. otherand 9 Pemalang Pemalang midwives TPC pilot placed in project 1998 to expire Pemalang set midwives in PTTof 50 second group for contracts 3-year nationwide , SSN under ), -BK (JPS program health card launched Govt 1999 Pemalang deliveries in used for vouchers1,164 Pemalang 2000 deliveries vouchers vouchers used for for used implemented process Decentralization 706 in 2001 Pemalang deliveries vouchers vouchers used for or(P - (JPK Poor implement Insurance 565 districts districts ai ) Gakin for the the for Health in 2002 Some Some 712 vouchers deliveries in Pemalang used for renewals contract PTT unlimited allows Govt Central 2003 voucher system voucher P io ns: TPC Pilot ends District decides decides District to continue the the continue to in Pemalang Pemalang in PTT status and with its own decides to hire switches TPC switches ends voucher Central Govt midwives to midwives 2004 Pemalang money more PTT PTT more midwives: system 2005 hem ishealthcare. Pemalang in deliveries used for vouchers 654 to all districts to all ) -Gakin (JPS the Poor for Insurance Health to extend Govt decides 2005 55 The 2

Impact

Did the tpc project increase the access of the poor to tpc midwife services?

In short, yes. The number of midwives in the district more than doubled between 2001 and 2003, from 82 to 192.56

By 2004 there were 244.57 In 2003, 86 percent of Pemalang’s villages had midwives; coverage reached about 95 percent by early 2005.58 It is not surprising, then, that there was also an increase in utilization of midwives’ services. Evidence is readily available. District Health Bureau statistics show that the number of paying clients of TPC midwives increased by nearly 70 percent between 2000 and 2004 (using paid deliveries as a proxy for number of paying clients served). During that time, the number of voucher (poor) clients actually dropped by 44 percent, due mainly to changes in the number of vouchers issued. This drop masks the fact that midwife use by the poor went from almost nothing in the late 1990s to 1,164 poor women in 2000. Poor women stated that they started using midwives for the Services Midwife For Vouchers Java District, Central In Pemalang fi rst time only after TPC midwife placement in their villages. Despite the increase, however, only about 40 percent of

TPC village babies were born with TPC midwife assistance each year.59

Utilization of TPC midwives was higher than utilization of PTT midwives in villages where both types had worked, according to sub-district health clinic doctors and the TPC facilitator. PTT midwives had problems getting clients in part because of their lack of experience.

Equity in access to midwives’ services has increased because prior to the pilot, almost no poor women were using midwives, while now, many are. The ratio of non-paying to paying clients of TPC midwives, which was 46:54 in 2004, is close to the ratio of poor to non-poor in the poorest sub-districts of Pemalang, 40:60. Together with the fact that poor women have a higher birth rate than non-poor women, this suggests that the poor are equitably represented among TPC midwife clients.

However, there were huge variations in numbers of vouchers used—a decrease of 65 percent in 2001, a further decrease of 20 percent in 2002, followed by an increase of 26 percent in 2003 and a fi nal decrease of 8 percent in 2004. These variations were not driven by changes in the number of poor pregnant women in the district, but caused by unclear and constantly changing program rules and inconsistent implementation. In the fi rst few years, the District Health Bureau put no limitations on the number of vouchers that midwives could give out: well over 1,000 were issued in 2000. In 2001, however, the District Health Bureau limited the number of vouchers based on a more accurate estimate of the number of deliveries expected by poor women. This brought the number of voucher clients down to 565 (using delivery numbers as a proxy) by 2002. The establishment in 2002 of the District Program Management Unit (DPMU) further reduced the number of voucher clients as the DPMU enforced more strictly the

56 Source: Kabupaten Pemalang Dalam Angka 2003. 57 Source: District Health Bureau. 58 Team estimate based on interviews with midwives. 59 Calculation of the research team: the birth rate in Pemalang is about 2 percent, or approximately 26,000 children annually. This is roughly 117 births per village. A TPC midwife normally delivered about four babies a month in her village, or 48 a year, representing 41 percent of the estimated 117 vil- lage births annually.

Making Services Work for the Poor: Nine Case Studies from Indonesia 51 Vouchers For Midwife Services 2

52 In Pemalang District, Central Java (organized nationally by the Ministry ofHealth). (organized nationallybyThe perceived theMinistry overall increase inmidwife isrefl quality inan ected HealthBureau from situations(asuhanpersalinannormal) received theDistrict traininginhandlingemergency extra ofeachto handleemergencies. ofmidwivesliesinthecapacity andofdukun midwives theskill between TPC andPTT pregnant accessto women midwives’ stilllacked services. management wasunclearaboutthesize ofthetarget group andhowispossiblethatsomepoor bestto reach it.It noaccess—wildly flpoor women hadvirtually numbersof vouchers usedimplythattheproject uctuating increased given overall—especially thatbefore certainly ofaccessto midwife thepilot, While equity services midwives thatyear. 61 Sub-district clinic doctors still report isolated incidents of malpractice due to the inexperience of some PTT midwives. isolatedincidentsofmalpractice clinicdoctorsstill report duetotheinexperience ofsomePTT Sub-district 61 Source: staff 60 all midwives—whether TPC or not—is high,andspecifi cally, greater thanthatofthedukun. drugs. According facilitiesandthenecessary localmothersfeel to of thesecriteria, thatthequality to high-quality how longtheirrecuperation were periods following delivery. atmidwives’They alsolooked andaccess experience targets, nor was theeff didimprove projectimplementation,butthiswasnotdueto ofmidwife during theuseof The quality services motivation? What was oftargetsforevaluation theimpact onmidwives’ and quality increasing theuseof andbynon-voucherTPC midwives forholders. otherservices time inlabor.” The growth oftrustinthe aswell as services, TPC midwives assured continueduseoftheirdelivery useofmidwives’exploratory inspired that trust:somemothersreported services TPC midwives “reduced painand theirincomesto theuseofvouchers,voucher project,andlinking encouragedthemto seekoutnewclients. Initial possible for responsibilityfor themto doso. disseminationofinformation aboutthe Givingmidwives theprimary to usemidwives’placement intheirvillagesgave poorwomen theopportunity vouchers madeitfi services, nancially by thepoor. nouseofmidwifehad beennomidwifethereservices hadbeenvirtually pre-project, While midwife about Rp. 250,000,muchhigherthanthecostofadukun’s villageswhere (Rp. there 60,000-100,000).In services mostpoorpeoplecouldnotaff for theservices; with amidwife hadto spendthe timeandmoneyto travel to avillagewhere there wasamidwife andthenpay force behindtheincrease inutilizationby thepoor. Prior to thepilotproject,awoman whowanted to deliver thatmoreThe simplefact villageshadmidwives following theintroductionof TPC projectwasthedriving brought ofthetpcproject aboutincreasedaccess?What aspects targets. and consequentlysowasthenumberofvouchers, whiletheDPMU pushedmidwives more strongly to achieve targetpreviously-set onwhichnumberofvouchers 2003, thistarget issuedwasbased. birthrate wasincreased In Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: 60 These changeswere refl inanincrease ected to 712ofthenumber voucher clientsdeliveringwith TPC of District HealthBureau. ofDistrict limited toect TPC midwives. according Local to mothersassessedmidwife inpart quality ord to doso. assisted midwife byaprivate is The costofadelivery 61 diff The key erence 2

improvement in the district’s maternal mortality rate, from 51 per 1,000 live births in 1997 to 32 in 2003.62

The midwives did not fully Start of DPMU : strict Decrease in number target enforcement understand the program’s of vouchers issued objectives. The midwives Increase of target by DPMU interviewed were unsure Deliveries by TPC Midwives whether the purpose of

1200 targeting was to increase 1000 the quality of services, or 800 voucher to push midwives into 600 non-voucher Vouchers For Midwife Services Midwife For Vouchers Java District, Central In Pemalang

Utilization 400 delivering more services. 200 According to the staff of 0 2000 2001 2002 2003 2004 the District Health Bureau, Year this lowered midwives’ motivation.

What happened with the original project goal of privatizating midwives’ services?

Between 2000 and 2004, the TPC midwives’ monthly income nearly doubled from just over Rp. 1 million to nearly Rp. 2 million. During that period, the monthly base wage increased from Rp. 150,000 to Rp. 425,000 (~US$48), and income from vouchers increased marginally from Rp. 338,000 to Rp. 386,000 (~US$44). However, the main source of the increase was paying clients, whose contributions to midwives’ income increased from about Rp. 500,000 to over Rp. 1 million (~US$113) per month in that period. The data thus imply there was some progress toward achieving fi nancial self-suffi ciency.

TPC Midwife Income Sources

100% 80% Private 60% Base Wage 40% Voucher 20% 0% 2000 2001 2002 2003 2004 Year

62 Source: District Health Bureau.

Making Services Work for the Poor: Nine Case Studies from Indonesia 53 Vouchers For Midwife Services 2

54 In Pemalang District, Central Java from 72percent in2000to just46percent in2004, of istruethattheproportion happen. It TPC midwives’ clientswhowere voucher-holders dropped signifi cantly eff midwives, thus, in itbeganto renewals by allowunlimited thepoor; contract forpublic healthcare PTT services 2002,thegovernment hadalreadyBy realized themidwives thatprivatizing would decrease accessto theseessential for aswell asintheamountofbasewage. voucher services, to increases ofincomefrom in2003and2004thefees government wasdueinpart The continuedlarge portion (either through basewagesorvoucher payments) stillrepresented 42percent ofmidwives’ ahefty incomein2004. increased slightlyfrom 54percent paidby government in2000to 58percent theproportion in2004.Nevertheless, organization, theDPMU, in2002, whichpushedthenumberofvoucher clients to afi low. ve-year that Thefact local offi imprecise, theoffi andoften rates ofthetarget group couldnothave sowidely. varied Central government identifi cationofthepoorisingeneral impliesthatidentifi1164 (2000)certainly cationandquantifi cationofthetarget group was problematic, since birth should have beenissued. thatthenumberofvouchersfrom usedvaried The fact alow of565 (2002)to ahighof is stillunclearhow many poorpregnant women therewereandthushow many actually vouchers inthe district, Diffi Factors limitingvoucher impact Vouchers formidwives: lookingtothefuture health card program) andanincreased for interest poorpatientsasa result inlooking oftheproject. aninitialincreaseTPC midwives reported inmotivation(sometimeslater decreasing asaresult ofconfl with the ict addition to thoseofthe TPC midwife, however, to poorwomen hasnotgonedown. sothetotal costofchildbirth Almost allwomen, bothpoorandwell-off someeven to thatofthedukun; sayas superior theywould continuegoingto theirmidwife iftheyhadto pay. say theywantto continueusingamidwifeThe majority to deliver theirchildren becausethemidwife’s isseen quality midwives whentheyhadnotdonesobefore. There isalsoevidenceofchangesinattitudepoorpregnant women. is clear thatthebehavior ofpoorpregnantIt women haschangeddramatically—theyare now deliveringwith How didstakeholders’ behavior changeasaresultofTPC? enablingthemidwives to becomeindependentofgovernment funding. theirservices seeking wasenvisioned thattheincreasedofmidwives, quality It dueto training, would result inmore clients private 4 Usingnumberofvoucher-paid deliveries asaproxy fortotalnumberofvoucher clients;source: HealthBureau. District 64 Source: No. World PIC2869. BankReport 63 Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ect abandoning the objective of privatization. ofprivatization. abandoningtheobjective ect culties inidentifying andreaching thetarget group probably reduced access for someofthepoor. cials atfi rst went theotherdirection(overestimating thenumber)until theentranceofanew, external cial poverty estimate seemsthatinPemalang, islower rate. thantheactual It cial poverty however, (for ofthedukun , continueto post-natal pay for care) in theservices 64 and the proportion ofmidwives’ andtheproportion incomedueto paying clients 63 This didnot It 2 voucher use went up again after 2002, however, implies that the DPMU did not have its numbers right either.

While the District Health Bureau were playing the numbers game, it was largely up to the TPC midwives to actually pass vouchers on to the target group—poor pregnant women. The project design required midwives not to be in charge of distribution of vouchers to avoid confl ict of interest, but districts found this burdensome and did not comply with the design. The design of the voucher project—TPC midwives were only paid after submission of actual vouchers—worked to encourage midwives to issue as many vouchers as possible. Because the Bureau does not have a close relationship with communities, it was diffi cult for it to check whether voucher issuing was done properly. Involving kader in the process of handing out vouchers was said to increase the system’s eff ectiveness. Poor data collection, however, makes it impossible to know to what extent vouchers actually reached the target group. Services Midwife For Vouchers Java District, Central In Pemalang

Insuffi cient dissemination limited the access of some poor women to vouchers. Dissemination of information depended largely on the TPC midwives themselves, a task which they enjoyed and were glad to do, but which added much time and eff ort to their already-full days. Where they had the support of highly motivated kader, dissemination was still wide, but in other villages, where kader may not even have heard of the project, dissemination was low. In one TPC village visited, a number of lower-income women had not even heard of the voucher project. The District Health Bureau was unable to make the process more eff ective. Because it lacked a strong connection to the villages, it relied on counting the number of services TPC midwives had provided to voucher holders as a means of assessing the success of the process, but this did not provide the information necessary to accurately judge and then re- design the dissemination process for greater eff ectiveness.

Motivation of healthcare staff makes a diff erence in reaching the poor. Village A has a diligent midwife and kader who set up monthly meetings between the village head and all pregnant women. Through these meetings, information was provided about useful programs and on healthy behavior and nutrition. These meetings also helped in the identifi cation of those who were entitled to vouchers. This process of dissemination and identifi cation of the poor appeared to be very eff ective, as in this village those who are poor did receive project benefi ts. In Village B where the TPC midwife and kader were less active in providing information to villagers, targeting of the poor was less eff ective; the team spoke to many villagers who had never heard of the voucher project.

Inadequate collection and analysis of project data made mid-course project adjustments for better targeting impossible. Local District Health Bureau staff did not understand the purpose of the work for which they were responsible: collection and analysis of data about TPC midwife service utilization. Nor were they suffi ciently trained in data collection and analysis. Two of the District Health Bureau staff received one week of training in Jakarta, but this was only six months after the start of the TPC project, and the staff also state that it was not enough to do real analysis. At the same time, the central government with fi nal responsibility for ensuring project success did not request the necessary information. Collection of key data would have provided the information necessary to re-jig the project midstream for better results. For example, basic data about who is poor in a TPC village and where each of the pregnant women in that group went to deliver in a given year would have helped show whether the vouchers were reaching, and convincing, the right people. Data on maternal deaths for poor and non-poor mothers before and after the project, comparing clients of TPC and PTT midwives, would have helped to quantify the quality

Making Services Work for the Poor: Nine Case Studies from Indonesia 55 Vouchers For Midwife Services 2

56 In Pemalang District, Central Java on thepoor. babies)were7 percent withtheassistanceof ofalldistrict born TPC midwives eachyear, limited theproject’s impact had that only30of222villagesinthedistrict TPC midwives, andonlyabout40percent of TPC villagebabies(orjust The limited meantonlyasmallnumberofpoorwomen extent ofthepilotproject benefi same way. This decreased themotivationofmany TPC midwives. healthcenters butwere notpaidatthesamelevel orinthe andwere to thesub-district bothlinked same services project andthehealthcard program produced midwives, confusionamong becausetheyprovided the TPC andPTT notwithstanding, andfundingfor midwives contracted wasensured (andlater, increased). realized thatpoorpregnant women would beneedingmidwives’ for alongtimeto come, services development atthevillagelevel. 2002,thegovernment hadalreadyof strengthening ofmidwife By thesustainability services failed initsintent to move toward ofmidwives privatization becausethisconfl withitsparamountobjective icted forMidwife thepoorare services apublicgoodandhence require public funding. Using vouchers toincreaseaccess ofthepoortomidwives’ services Confl eff accurate, andthefront line—the TPC midwives—might, becauseoftheirgreater understanding, have beenmore level, would havethe implementationunitsatdistrict datacollection improved, targeting would have beenmore assigned identifibeen clearly to onepersonandhisorherclearly ed team, andhadthat team been responsive to centers were oftheproject.Hadprojectmanagement unaware aspects often Health Bureau, ofkey sothesub-district healthcenters, theyweremidwives required are directlyto theresponsibilityofsub-district theDistrict to report ofHealthsometimesconsulted Pemalang for advice, district insteadthe Ministry ofviceversa. Moreover, though thestaff fact, itself wasnotfullyaware oftheproject.In oftheobjectives such asitwas, simplydidnotrespond often to questionsandproblems posedby localdepartments. The Ministry thelifeduring oftheproject. There team, thestakeholders. wasalackofcommunicationbetween The Ministry whenitfacedproblems; moreover, to thedistrict thatcouldprovide support within theMinistry theteams changed ofHealthwasresponsible for thepilotprojectatnationallevel, thereThough theMinistry wasnosingleteam Ineff answer questionsaboutthedata),andeasyto useisalsoimportant. the dataneededto continuallyassessandstrengthen theproject), transparent (sopeoplearen’t afraidto askfor and Better training for system isnotenough;thedesign thatisuseful(e.g., datacollectors ofadatacollection collects have helpedto gaugethedemandfor, andthusperceived of,provided quality through projects. thetwo services available to thepoorthrough utilizationof midwives theproject.Datacomparing wouldof services TPC versus PTT Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ective in ensuring accurate targeting inensuring ective ofthepoor. managementfor reduced project ective problem-solving duringimplementation. opportunities between overlappingicts systems reduced midwives’ motivation. of the District Health Bureau report that HealthBureau report oftheDistrict The large the between overlap TPC The TPC pilotproject ted. ted. Clearly, thefact

2

The voucher system, if implemented well, can help midwifes’ services reach the poor better than the health card program. Three aspects of the voucher pilot project made it more eff ective than the health card program in increasing the access of the poor to midwife services. Of greatest importance was the requirement that midwives actually submit vouchers in order to get paid for their services to poor women, which gave them strong motivation to seek out poor clients. PTT midwives, paid through the health card program, are essentially pre-paid, and therefore have no fi nancial motivation to encourage the poor to use their services. Second, because vouchers had to be presented for payment, there was little room for fraud. It is reported that PTT midwives, who only needed the signature of the sub-district health clinic head for payment, often resort to fraudulent reporting to get higher wages, wasting money that should have been spent on actual services to poor women. And third, the vouchers were for specifi c services. It is possible that simply having the voucher booklet thus raised the awareness of poor pregnant women of the services to which they are entitled and which they should seek. This may have resulted in more poor Services Midwife For Vouchers Java District, Central In Pemalang voucher-holders seeking midwife care than poor non-voucher holders, despite the fact that pregnancy services are free under both the TPC pilot project and the health card program. Because of inadequate data collection on the project, however, it is impossible to know whether this last point is true.

The new national health insurance program presents an opportunity to build on the success of the voucher pilot in reaching poor pregnant women. The fi ve years of the voucher pilot project clearly increased the access of poor pregnant women to higher-quality maternal care. With the new national health insurance program, JPK-Gakin, there is an opportunity to reintroduce the use of vouchers and thereby maintain and build on pilot project success. District Health Bureau staff suggest that if vouchers were used under the national health insurance program, they could be paid directly by sub-district health clinics, which are already responsible for monitoring and payment of midwives. This would reduce the voucher-related management time and costs of the District Health Bureau. The only additional costs of reintroducing vouchers would be for production of the vouchers themselves, dissemination of information, and training and wages for data collectors, all likely payable by the district.

If vouchers were blended with the new national health insurance program, it would be crucial to avoid the pitfalls of the pilot project. The target group of poor pregnant women should be clearly defi ned, based on reasonable and widely-understood criteria, and counted in a transparent manner, ensuring that all stakeholders understand who is included and why. Annual re-counts of the target group should be institutionalized using a consistent and fair process. Responsibility for dissemination of information about the vouchers should not be the sole responsibility of the midwives but should be shared with kader and village heads. These stakeholders should be involved in monitoring to increase their knowledge of and commitment to the system. A useful, simple, eff ective and transparent monitoring plan should be designed, focused on collecting data on who should receive vouchers, who does and does not receive vouchers and why, and how the vouchers are used. Basic maternal and infant health statistics, and data on use of other maternal health service providers, should also be collected, including maternal and infant deaths. People responsible for monitoring of the voucher system should be well trained in the purpose and use of the monitoring system. Management of the voucher system should be simple and clear, based on the usual management structure and lines of communication related to health services at all levels of government. A system

Making Services Work for the Poor: Nine Case Studies from Indonesia 57 Vouchers For Midwife Services 2

58 In Pemalang District, Central Java Hariyanto, Slamet, Central Statistics Agency Bibliography The voucher system wasanexcellent beginning to increased healthcare maternal accessto quality for thepoor. of thevouchers andthereby increase motivation. should besetupto allow regular to increase meetingsamongallstakeholders theirunderstanding ofthepurpose Approach” 1997) (June World No. BankReport PIC2869, Pemalang HealthBureau, District Pemalang District, Parker, E. andA.Roestam, Menelaws, R.D., Project”Safe Motherhood 2000) (May Knowles, J.C., Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: “Consultant’s of Report Technical Assistance Provided Component to ofthe theBDDSustainability “TPC Best Management Practices BestManagement andProposed RemedialActions”“TPC (February 2000)

“Laporan Proyek Akhir Pemalang” MotherhoodKabupaten Safe “Dalam Angka”“Dalam

(Badan Pusat Pemalang” Statistik),“Kabupaten “The Bidan di Desa Program: BidandiDesa “The “Project Project: Safe Appraisal Document: Motherhood APartnership andFamily (2003) dataon Movement” Mothers “Caring A Literature andPolicy Review” (November 2002) (December 2004) (December Case Study 3: Creating Learning Communities for Children in Polman District, West Sulawesi

Creating Learning Communities For Children 3

60 In Polman District, West Sulawesi Thiscase studywas World writtenby Stefan Nachuk, Leisher, Bank(Indonesia),SusannahHopkins consultant (Australia), andAr onboard.of program mighthelptothisreluctant agency bring impact Education, ostensibly incharge oftheprogram butunenthusiasticaboutit,mustbeconvinced. Better monitoring Finally, ofimpact. sustainability to ensuring schools may bekey for institutionalsustainability, Bureau of theDistrict iscrucialfor fisupport atthepoorer nancialsustainability,school. particularly AJEL to secondary Theintroductionof CLCC 2005,andtheprogram’s endsinDecember isanopenquestion.Greater sustainability long-term community schools usingitsown funding;localinnovators have spread itto about30more schools. UNICEFfi for nancialsupport does notrefl hasexpandedCLCCAJEL. Since2001,thedistrict knowledge gainedfrom type of theto70new ect involved tools inschool,andexamsubjects,orthenational there soperhaps isamismatch AJEL between School attendance, however, improved, teaching methodsimproved, andstudentsparents bothbecamemore school have rates improved nationalexamscores ordrop-out relative non-CLCC to thoseofneighboring schools. Committee butoninformal communication(includinganinnovative schoolradioprogram) were key. Atneither and theeff changed teaching dueto methodsandincreased bothheadmaster support studentandparent participation, an autocratic headmaster andparents’ andSchoolCommittee members’ dramatically passivity. bothschools, AJEL In largely to theschool’s democratically-inclinedheadmaster, butSBM wasafailure atthepoorer schoollargely dueto which adopted CLCC onitsown. ofschoolmanagementimproved Accountability atthebetter-off Polman district, West Sulawesi province: onepoor, ruralschooltargeted byCLCC, andonebetter-off to strengthen children’s andcreative critical thinking. This casestudyexaminedCLCC’s schoolsof intwo impact especially parents’, for children’s support education,whileitsactive, joyful, eff education quality. CLCC’s school-basedmanagement(SBM)componenttargets increased community, and UNICEF, school ofEducationin1999,whichaimsto UNESCO, improve primary Department andtheIndonesian pavedDecentralization theway for theCreating Learning Communities for Children (CLCC) program designed by Abstract Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: permission. Thiscase iscopyrighted (U.S.A.). University by theauthors, Institute, theAsh andtheWorld Bank andmaynotbereproduced by MennoPrasad Pradhan Miyata andSachiko oftheWorld Bank(Indonesia)andWinthrop InstituteofDemocratic Carty, Govern Ash and Luis Fujiwara, Ford Foundation International Innovations LiaisonProgram (Brazil). Managerial, analytical, andeditorialsu B. WorldArya Gaduh, Bank(Indonesia),NunikYunarti andMaulinaCahyaningrum, consultants (Indonesia),LinaMarliani,World Ba and Menciptakan Masyarakat Yang Peduli Pendidikan UNICEF-UNESCO-Government ofIndonesia(2005).Research teammembersinc Anak, UNICEF-UNESCO-Government Participation, ManagementandCommunity throughImproving of Indonesia (2 School-Based Schools Primary Bank (Indonesia).Research was basedonafi eldvisitto Polman inMarch 2005.Reference is made toCreating Learning Communiti tools. For ofAJEL ectiveness poorparents, reliance notjustonformal communicationviatheSchool ective learning (AJEL) componentaims (AJEL) learning ective or reused withouttheir pport was providedpport , urban school , urban ya B. World Gaduh, school, due school, es forChildren: nk (Indonesia), ance, Harvard luded 000) 3

Introduction

As part of its mandate to alleviate poverty in Indonesia, the World Bank is undertaking a series of case studies to promote better services, especially for poor and disadvantaged people. The case studies were chosen from the many innovative practices seen in Indonesian local government in recent years, through a competitive outreach process managed by the World Bank. Donors, non-governmental organizations, and local government staff were contacted and encouraged to submit proposals regarding innovative pro-poor service delivery work that they either were undertaking or knew about. The Creating Learning Communities for Children (CLCC) program being implemented in Polman district, West Sulawesi, touches upon a theme that is central to making services more pro- poor: improved performance and accountability of local government service providers. Hence its selection as one Creating Learning Communities For Children For Communities Learning Creating Sulawesi West District, In Polman of the case studies.

The Study Site: Polman District

Polewali Mandar (Polman) is one of fi ve districts (kabupaten) in the recently-formed province of West Sulawesi.65 The district borders Mandar Bay where Sulawesi Island meets the Java Sea. It is the second-largest district in the province with a population of nearly 500,000, the majority of whom work in agriculture. Most residents are Muslim and belong to the Bugis-Mandar culture (indigenous to South and West Sulawesi provinces). Other residents are of Javanese and Torajan origin. The 2000 poverty rate in the district was about 26 percent, signifi cantly higher than the

2000 national rate of 19 percent.66

The study site comprised two sub-districts (kecamatan). Polewali, the district capital, is primarily urban and relatively well-off (its poverty rate in 2000 was 21 percent). Tinambung sub-district, in the southeast coastal region, is rural and rather poor (with a 2000 poverty rate of 27 percent) populated mostly by fi shermen and farmers.

Primary Education in Polman District

Primary Education in Polman District Polman district has 374 primary schools School type # Primary schools # Students # Teachers employing about 3,100 teachers and (% of total) (% of total) (% of total) serving about 53,000 pupils. As in Public non-Islamic 311 (83%) 47,811 (90%) 2,718 (87%) much of Indonesia, there are both Private non-Islamic 1 (<1%) 53 (<1%) 8 (<1%) Islamic schools (madrasah), managed Public Islamic 2 (<1%) 86 (<1%) 9 (<1%) by the Religious Aff airs Bureau, and Private Islamic 60 (16%) 5,253 (10%) 374 (12%) non-Islamic schools, managed by the Total 374 (100%) 53,203 (100%) 3,109 (100%) District Bureau of Education. In each Source: Polman District Bureau of Education 2004

65 Until end-2004, all districts in West Sulawesi were part of South Sulawesi province. 66 Central Board of Statistics 2000 data on Polewali Mamasa district which split into Polman and Mamasa districts in 2004.

Making Services Work for the Poor: Nine Case Studies from Indonesia 61 Creating Learning Communities For Children 3

62 In Polman District, West Sulawesi 7 Thedecree alsointroduced theEducation Council, tofacilitate inputintodistrict-leve community adistrict-levelagency 67 schoolquality.monitoring given overadditionalfundingfor responsibilityfor ensuring schools, andauthority managing schoolyear plans, and oversight of, schoolaff was to improve teaching quality, andthedecree aimedto dothisby greatly increasinginputinto, community and (Badan Pembantu Penyelenggara PendidikanorBP3)withSCsinallschools, bothreligious andsecular. The endgoal ofNational EducationissuedDecree No.2002 theMinister 044/U/2002whichreplaced theoldParents’ Associations and accountableSchoolCommittees Accordingly, (SCs),andtherelaxing oftherigid centrally-setcurriculum. in The governmentfocused policiesitdeemedcrucialto ontwo thesuccessofSBM:establishmentmore representative been widelydisseminated, andin2003itwaslegalized withtheNationalEducation Law (No. 20/2003). education policiesintheirschools. three nearly After years ofpilotprojectimplementation,theconceptSBM had managers would waitfor from instructions thecentralgovernment before implementingcentrally-decided responsibility for, over, andauthority planning, development andmanagementofeducation.Previously, school based management(SBM)pilotprojects inseveral districts. The essenceofSBMisthatschoolsare given greater school- inthedecentralizationofeducationbypolicy. 2000,thegovernment conducting begananexperiment In legislatedDecentralization, in1999andbegun2001, spurred achangeinthecentralgovernment’s education Genesis ofCLCC CLCC: Wherediditcome from,andwhatisit? includingthree inPolewalidistrict, in andtwo Tinambung. job itisto assessteachers intheclassroom andfacilitate solutionsto schoolproblems. There are inthe 44inspectors eachhaveand three clusters. AclusterTinambung is the responsibilityofoneschoolinspector, sub-districts whose of teachers andadmissionofnewstudents. There are roughly 60 clusters inPolman of5to 9schoolseach;Polewali The core schoolisthemodel, andhasthemostcomplete facilities, andusually, relatively greater power over hiring are organized schoolsinIndonesia inclusters,Primary eachwithone “core school” andanumberof “spillover schools”. their teachers. 90percent nearly ofthesub-districts’public andnon-Islamic, serving studentsandemploying over 80percent of representative atlarge, ofPolman As inthedistrict over 80percent district. ofthesub-districts’ schoolsare primary category, there are educationinPolewali schools. bothpublicandprivate Primary is and Tinambung sub-districts included parents, teachers, andreligious andcommunity leaders. about education maybecome SCmembers, and intheschoolsvisited, and/or theheadmaster. Parents concern andotherswithparticular orappointmentofallmembersby leaders community Association, appointment oftheremainder, asimple renaming oftheoldParents’ election ofexecutive members(head, secretary, andtreasurer) and practice are they formedinseveral ways: electionofallmembers, SC formationinpractice. ThoughSCsare supposedto beelected, in Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: player theSCsapotentially SCswere ineducationthroughout key airs, Indonesia. making 67

The secondpolicy, whichhasnotyet beenformalized, is projects on CBC in selected regions starting in 2002, in2002, regionsprojects onCBCinselected starting courses astheyseefi t. Thegovernment pilot conducted was relaxed, andindividualschoolswere allowed to off mandated bythenationalgovernment the rigid curriculum Underthisexperiment, Curriculum. the Competency-Based l education policies. er er 3 expanding in 2004 to the entire country. In 1999, the Indonesian Department of Education, UNESCO and UNICEF pioneered the Creating Learning Communities for Children (CLCC) program. The idea was to develop a model of high-quality primary education in support of the decentralization process that was about to begin. CLCC’s aim is to improve the quality of education services through improving school management accountability, strengthening parents’ participation in their children’s learning, and establishing a more active learning environment for children.68 CLCC pilot projects were fi rst implemented in 124 schools of 7 districts in 4 provinces, and by 2004, had expanded nearly twelve-fold to 1,479 primary schools in 40 districts of 9 provinces.69

The CLCC program

Offi cially, CLCC has three components: school-based management (SBM), community participation, and active, Children For Communities Learning Creating Sulawesi West District, In Polman joyful, eff ective learning (AJEL).

School-based management Though active SCs are now mandated by national law, in reality they function at varying levels of competence throughout the school system. CLCC’s school-based management (SBM) component aims to increase the involvement of communities, especially parents, in school management, especially by enabling SCs to function as they are supposed to under the law: as democratically-elected, engaged, and accountable community bodies which collaborate on and monitor the budgets, plans, and teaching activities of school staff .

The Community Participation Component. Though Under the SBM component, CLCC program funding is program documents list community participation as a separate provided for training sessions for headmasters, teachers, and component, in practice, no activities have been planned or SC members.70 Topics include school-based development funded under it. In eff ect, it has been subsumed within SBM. Indeed, community participation is integral to eff ective SBM. planning, collaborating with the community to design school budgets, and clarifying the roles of headmasters and SCs in plan implementation. First, training sessions are held at the cluster level, attended by the headmaster, one teacher and the SC head from each cluster school. In Polman, 98 headmasters (over one-fourth of all headmasters in the district) and 110 teachers (nearly 4 percent of all district primary school teachers) have attended these sessions to date. Then, workshops are given by cluster-level trainees for all teachers at their respective schools.

Schools must successfully complete training sessions and workshops in order to be eligible for CLCC funding. They are then allocated annual grants (about USD 200 per school in Polman) to pay for improved teaching materials and other items. Additional funding is provided to each cluster to support regular meetings of teachers, headmasters, and the SC.

68 Indonesian version of the CLCC program document (Menciptakan Masyarakat Yang Peduli Pendidikan Anak). 69 UNICEF-UNESCO-Government of Indonesia (2005). 70 CLCC program implementation is ongoing in Polman district as of May 2005.

Making Services Work for the Poor: Nine Case Studies from Indonesia 63 Creating Learning Communities For Children 3

64 In Polman District, West Sulawesi UNICEF was already partnering with the District Planning( Agency withtheDistrict UNICEF wasalready partnering from the same sub-districts in 2003. UNICEF support to these28schoolsisplannedto 2005. endbyDecember in2003.UNICEFsupport from thesamesub-districts in2002,expandingto 14newschools UNICEF andthetaskforce focused onatotal sub-districts of14schoolsintwo Bureau ofEducationstaffmanagement butcomposedofDistrict )began CLCC implementationattheschoollevel. for CLCCEducation, becameitspartner aswell. 2002,thedistrict’s CLCC In Taskforce Planning Agency (underDistrict Daerah 1 Former CLCC Taskforce managerinPolman. 71 andenvironmentalmother andchildhealth,nutrition, registrations. health,andaprojectto increase birth included othereducationprograms Program, suchastheEducationalDatabase Collection healthprograms on 2001UNICEFbeganCLCCIn there which ofamajorUNICEFintervention pilotprojectsinPolman aspart district The CLCC Program inPolman District monthly Teacher GuruorKKG) meetingsfor GroupKerja Working cluster (Kelompok teachers. isalsoprovidedtrainingsessionsheldatcluster schoolsand for component,support on-the-job Under theAJEL Onehundred schoolteachers trainingsessionsto ten have date. Polman attendedparticipation. AJEL primary lessonplans,make worksheets, andvisualaids, skills. andimprove question-asking The focus isonincreasing student includinghow to methodinaction, evaluateclassroom thecurriculum, activities.Sessionsdemonstrate theAJEL for teachers inabrand-newmethodologywhichteachers initiate just30percent, ratherthan100percent, of undertheActive, Joyful,The mainactivity Eff Traditional ofchildren isone-way, andanemphasisonmemorization. teaching inIndonesia withlittleparticipation Active, joyful, eff oa $11,362 $530 530 $600 1 300 $2,940 Total $630 210 Program review clusters offi sub-district 315 2 Training and for district schools School Committee Forums sub-districts 14 Groups 2 Headmaster Working TeacherGroups Working school-level training training oftrainers& dissemination, Information Grants 2002 CLCC Program Costs inPolman US$ District, Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ) on its other work, the District Planning Agency, theDistrict Bureau more of ratherthantheperhaps obviousDistrict ) onitsotherwork, tmUi ntcs Total cost Unitcost Unit Item cials ective learning 4shos42$5,768 412 schools 14 7 $474 474 $420 1 210 sub-districts 2 ective Learning (AJEL) componentistheprovision Learningective oftrainingsessions (AJEL) Bappeda orBadanPerencanaan grants. hadto cover sessions; thedistrict UNICEF onlypaidfor training However, inthe14newschools, grants intheoriginal 14schools. sessions, meetings, andannual continued to pay for training 2003,UNICEF (Rp. 109million).In USD11,500 in 2002wasnearly implementation inPolman district The total costto UNICEFofprogram Pembangunan 71 Because 3

Research Questions and Methodology

The research team sought to test six hypotheses: 1. CLCC produced more active teaching methods. 2. CLCC made school management more accountable. 3. CLCC resulted in greater parental involvement in children’s education. 4. CLCC increased children’s participation in and outside the classroom. 5. Exam scores and drop-out rates in CLCC schools have improved relative to those of neighboring non-CLCC schools. 6. CLCC methods were adopted throughout the district. Creating Learning Communities For Children For Communities Learning Creating Sulawesi West District, In Polman

The research team spent nine days in Polman district visiting two primary schools: one urban school, Sekolah Dasar Negeri or SDN 028 Pekkabata in Polewali sub-district, and one rural school, SDN 012 Karama in Tinambung sub- district. The schools were chosen because they represent very diff erent educational situations. The fi rst is relatively well-off , adopted the CLCC program on its own (in 2003), and has a very active School Committee. The second is poor, was targeted by the CLCC program directly (CLCC began there in 2002), and has a less active School Committee. SDN 028 is a “spillover school” in a cluster of nine. SDN 012 is a core school in a cluster of seven. Both are public and non-Islamic, as are 80 percent of the district’s schools.

Focus group discussions and semi-structured interviews were carried out with over 45 people including seven teachers, two headmasters, two school inspectors, eight parents, twelve School Committee members, the presenter of the radio program at SDN 012, seven members of the District Bureau of Education, two staff of the Sub-district Bureaus of Education, three CLCC Taskforce members, two ex-CLCC Taskforce managers, and one District Planning Agency staff .

Due to the short time available for fi eldwork, only two schools could be visited out of the 59 in the two sub-districts— a sample size of just 3 percent of local schools, or less than 2 percent of all district schools which have adopted CLCC to date.72 Moreover, it is uncertain how representative the two schools are. The fi ndings of this case study should therefore only be taken as suggestive of CLCC impact elsewhere; extrapolation from such a limited sample is risky.

72 The single CLCC-targeted school visited by the team represents 4 percent of CLCC-targeted schools in the district, and the single CLCC spontaneous- adopter school visited represents roughly 3 percent of such schools in the district.

Making Services Work for the Poor: Nine Case Studies from Indonesia 65 Creating Learning Communities For Children 3

66 In Polman District, West Sulawesi the Teachers’ GroupWorking (KKG). songto helphisstudents rememberwell-known mathematicalformulas. This innovationhasbeenspread widelyvia with theCLCC-provided tools, have begunto design, useandshare theirown. One teacher usesthemelodyofa The following year, promoted to headmaster, sheimmediately beganto implementCLCC inhernewschool. Her schoolteacher,A Polman primary attended aCLCC Ms. district K., trainingsessionin 2002andemerged converted. support. headmaster whowasalready soinclined, and, ironically, theschoolthatadopted CLCC onitsownwithnooutside CLCC onlyimproved signifi schoolmanagementaccountability cantlyatSDN028—the better-off ClccMakeDid Scho CLCC, headmaster meetingswere rare andirregular or K3S)to discussschoolmanagementissues, whereas to prior in Headmaster Sekolah Kepala GroupsKerja Working (Kelompok in lessdepth. With CLCC headmasters alsomeetmonthly support, the advent ofCLCC, theymetlessfrequently andcovered issues their abilities. While Teacher GroupsWorking (KKG) existed before improve andfeel theirteaching practice more confi dentabout solving. Teachers thatthesemeetingshelpthemboth reported compare teaching techniques andhelpeachotherwithproblem- teachers from allcluster schoolsattend meetingsonceamonthto fromsuccess ofAJEL. theCLCCWith fundingsupport program, to contributed the whichhaslikely big increase inmutualsupport, Teachers andheadmasters atbothschoolclusters have enjoyed a Did CLCC produce teachingmethods? moreactive CLCC Impact parents suchashomeworkassignmentsandquizzes. a schoolradio program broadcasting informationforstudentsand classrooms withAJELtools. AtSDN012,theheadmasterlaunched motivated schoolstaff implementation ofAJEL.Theanticipationpeerassessmenthas Headmaster Working onthebasisoftheir Group meetings, inpart teachers are invitedtoassesseachothers’schoolsduringregular school inspectordesignedaplanwhereby clusterheadmastersand isnotonlyteacherswhohave beeninspiredIt by AJEL.TheSDN028 The creative AJELenvironment openedthedoortoinnovations. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: tokeep theirschoolscleaneranddecorate ol Management ol Management more Acc

ountable? Yes. There wasaconsensusamongrespondents that lateness. Many teachers, encouragedby theirsuccesses recording eachchild’s atschooldiscourages timeofarrival essays, andgames. For example, theuseofapaperclock questions, aidssuchasvisualtools, andnewlearning more student emphasizinggroup interactive style work, off way teachers inboththepoorer SDN012andthebetter- CLCC uponthe hashadanimmediate andvisibleimpact SDN 028 engagewithpupils. Teachers now usea . When multipliedtogetherwe getablock’sWhen volume Length, width,andheight,together make ablock Volume ofthecube:sidestopower ofthree Volume ofthetube:basearea timesitsheight Square’s area issidetimes Triangle’s area ishalf-basetimesheight Rectangle’s area islengthtimeswidth Circle’s area ispi-Rsquared Let’s studytogetherwithallourfriends Let’s keep learning2-Dformulas Don’t getbored soquickly, let’s learnthemath Let’s allgettogetherandlearnthemath (sung tothetuneofLihatKebunku) Mathematical Formulas schoolwitha 3 fi rst step was to call a meeting of all teachers to draft the school budget plan jointly. Next, she began to build the SC. She took great care to ensure a transparent process, and the nine SC members (including eight with children or grandchildren in the school) were all democratically elected. They now play an active role in planning, budgeting, and oversight of school aff airs, meeting formally three times a year to discuss and agree with the headmaster on the school budget, evaluate student exam scores, and review expenditures. These meetings are a discipline the headmaster has imposed on herself. Ms. K. also ensures that school budgets and accountability reports (year-end reports in which she accounts for the previous year’s spending) are sent to the homes of all parents, and posts a large copy of the school budget at school—all recommended SBM tools. SC members and teachers greatly appreciate her openness and fi nd it easy to communicate with her.

At SDN 012, however, school management accountability has not improved, despite direct targeting by CLCC. Children For Communities Learning Creating Sulawesi West District, In Polman Like the SDN 028 headmaster, SDN 012’s headmaster, Mr. S., is a strong advocate of improving education quality. According to both teachers and the school inspector, he is creative and committed. However, people fi nd it diffi cult to work with him. He is seen as being stubborn and short-tempered and tends to disregard rules. At heart he does not seem to believe that SBM is important to education quality. Thus, he has done nothing to empower the SC, which consequently plays a very minor role in school aff airs. Only a few SC members have children at school, limiting parents’ ability to infl uence school aff airs via the SC. There are no regular SC meetings, and when members do meet, it is usually to respond to a fundraising request from the headmaster. The draft budget is discussed, but as one parent noted, “If only the core SC members are present for this process, it cannot be said to be transparent.”73 The head, Mr. K., sees the SC’s main role as “waiting for the report from the school about the school’s physical needs. Once there is a need, the SC moves to fi nd the funding for such needs.” The headmaster continues to control school budgets, planning, and monitoring of pupil outcomes. Twice he has misused fi nancial reports to divert CLCC funds, once to the purchase of guidebooks, and once to the construction of a sanitation system—both reasonable purchases but not in line with CLCC spending guidelines. In neither case did the headmaster consult with the SC.74

Did CLCC result in greater parental involvement in children’s education?

SDN 028 parents fl ex their muscles. Since CLCC was introduced, parents have Yes. Parents in both schools were reported assisted in constructing washbasins for students, only asking the school for to be much more involved in their children’s materials, and in painting the school—a task that in the past was only done when the District Bureau of Education decided to do it. Parents made their voices heard education than before CLCC was introduced. during scholarship allocation as well. Normally the headmaster makes scholarship However, the level of parental participation is recommendations, but both the SC and parents are consulted. In one case, parents greater in SDN 028, the better-off school with vetoed the headmaster’s recommendation because they knew the child in question was not as poor as the headmaster thought. The scholarship was reallocated. the more active SC. SDN 028 parents are more involved both directly, by helping children more with their homework, and indirectly. They participate more in SC elections, attend more school meetings, and are more likely to collect money for and

73 Source: focus group discussion and interviews with parents. 74 In neither case did people feel the headmaster was corrupt, only that he had made decisions without consulting others.

Making Services Work for the Poor: Nine Case Studies from Indonesia 67 Creating Learning Communities For Children 3

68 In Polman District, West Sulawesi activities. A key innovation,oftheheadmaster’s,activities. Akey hasbeenthelocalschoolradioprogram. more aboutwhatgoesonatschoolthrough letters whichare copiedto themthatrelate SCandotherschool to key contribute theirtimeandmoneytocontribute schoolinfrastructure improvement. 6 Ibid. 76 withheadmasterandparents. Source: semi-structured interview 75 6 scores for 2002and2004(sinceCLCC between allsubjects wasimplemented). However, there isnostatistical introduction ofCLCC. Specifi cally, anincrease the SDN028headmaster fromreported 6.2 to 6.7(outof10)in grade rates ineitherschoolto date. increases BothSDN012and028headmasters inexamscores didreport sincethe No. CLCC hasnot resulted inimproved examscores relative non-CLCC to neighboring schoolsorreduced drop-out schools? neighboring non-clcc rates Did pupilexam scores anddrop-out now, hischildren canpointouthismistakes. explained thatnormally, children ofhisculture would noteven (Mandar) dare to looktheirparents intheeye, but implemented. There ofanincrease are inchildren’s alsoreports outsidetheclassroom. Oneparent self-esteem the evening. SDN028,pupilabsenteeism dropped In from 10percent in2003to 4percent CLCC in2004 after was now spendmore andstudyingtogether timedoinghomework around theradio, instead ofplaying outsidein the decisionto teachers. The schoolradioprogram iscredited withachangein children’s behavior athome—they questions. Studentsare alsomore incharge ofstudygroups, choosingstudytopics themselves ratherthanleaving more instudygroups, often andinsomecasesdemandthatteachers be available for meetingsto answer extra their at home, where more theydotheirhomework andfor often SDN012,studentsnow oftime. meet longerperiods In and inquestioningtheirteachers. They are to bemore reported enthusiasticaboutlearning, notonlyatschoolbut Yes. Studentsfrom bothschoolshave becomemore andare active nowtheinitiative moreto inlearning take likely Did CLCC increasechildren’s inandoutsidetheclassroom? participation pay school fees: 70percent ofparents now pay, asopposedto 50percent before CLCC. discuss the draft budget.Parentsdiscuss thedraft to appearto upgrade have noaction schoolfacilitiesontheirown. taken role inplanningtheannualbudgetandmonitoringexpenditures: itisusuallyonlythefour core SCmemberswho However, SDN012parents remain relatively passive players inschoolmanagement.Parents play at bestamarginal ofradiosignals.interruption their children to schoolto pickuppapercopiesofquizzes thatwere to have beenbroadcast, following thetemporary radio show hasincreased theirawareness oftheirchildren’s education,andthere are caseswhenparents have taken entertainment forchildren. entertainment and quizzes, andshowcases aswell students’goodwork, asproviding cluster schools, announces homeworkassignments, delivers schoollessons SDN 012live! Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: The schoolradio program provides basicinformationon in CLCC schoolsimprove relative tothoseof The poorer SDN012parents are alsomore involved children getexcited aboutstudying, andtheyknow implemented. They are inspired byseeingtheir in theirchildren’s educationthanbefore CLCC was 75 They are alsomoreto likely 76 Parents thatthe reported 3 diff erence between CLCC and non-CLCC exam results in adjacent areas. Similarly, there is no statistical diff erence in drop-out rates between CLCC and non-CLCC schools between 2002 and 2004.77 However, CLCC is only four years old in Polman; with time, it may still have an impact on exam scores.

Were CLCC methods adopted throughout the district? CLCC has spread both formally, through expansion by district government, and informally, by word of mouth. The formal expansion of the program to 70 new schools in 13 clusters in 2004—reaching nearly 20 percent of all district primary schools—demonstrates the depth of the District Planning Agency’s support for CLCC: all expansion is funded entirely by the district. The District Bureau of Education, still primarily an implementing agency, has only lukewarm support for the CLCC program, however (see page 10).

Creating Learning Communities For Children For Communities Learning Creating Sulawesi West District, In Polman UNICEF CLCC UNICEF plans support for implemented to phase out CLCC independently by CLCC support reaches 9 SD 28 in Polman provinces Headmaster District

UNICEF CLCC UNICEF District UNICEF UNICEF supports implemented supports Education introduces introduces CLCC in 14 in SD 12 CLCC in 14 Bureau CLCC in 4 CLCC in schools in (UNICEF more schools supports C LCC provinces Polman Polman in Polman District supported ) expansion to 70 District District new schools

2000 2001 2002 2003 2004 2005

1999 2005 Decentralization Indonesian legislated by government SC legislation National Indonesian begins SBM Decentralization passed by education law government experiment begun government on SBM passed

The second method, adoption of CLCC by local innovators at non-target schools, has been one of the best, and least anticipated, impacts of CLCC. “Spontaneous” replication of the CLCC program has been led by inspectors, teachers, and others exposed to CLCC methods and successes. Following SDN 028’s successful experiment with CLCC, that school’s inspector brought CLCC to the eight other schools in SDN 028’s cluster.78 There are reports of about 30 other schools, mostly in the district capital, that have “spontaneously” adopted CLCC methods.79 The extraordinary thing about this development is that these schools have funded CLCC activities entirely from their own budgets. Counting spontaneous adopters, CLCC now reaches nearly 35 percent of district primary schools, and nearly one-third of these schools pay for CLCC activities entirely from their own school budgets.

77 Econometric analysis by the research team using the diff erence-in-diff erence model on a complete set of data for 13 out of Polman’s 15 sub-districts. Data was obtained from the District Bureau of Education. 78 Source: interview with SDN 028 school inspector. 79 Source: semi-structured interview with CLCC Taskforce manager.

Making Services Work for the Poor: Nine Case Studies from Indonesia 69 Creating Learning Communities For Children 3

70 In Polman District, West Sulawesi work without goodcooperationamongschoolmanagementpersonnel.work dependsupon Goodcooperation inturn Easy andfrank communication amongheadmaster, Committee School andschoolinspector. have beenmuchless. 012 beenforced to rely onlyontheSCto reach parents, parental involvement inchildren’s education would likely program atSDN012.For cost,theinformal route poorparents iskey. whosetimehasahighopportunity HadSDN formally viaSCmeetingsandschoolhandouts, butinformally via theirenthusiasticchildren andaninnovative radio Multiple routes to access parents. Headmaster GroupsWorking immenselyhelpful. CLCC cluster schools. Bothteachers andheadmasters fi ndthe “new generation” of Teacher Groups and Working oftheCLCCto headmasters—has beenpart program complete withregular from fundedmeetingsat thestart, Institutionalized mutualsupport. ones, atleastfor schools. thesetwo they seetheenthusiasmthatnewmethodhascreated. Clearly, tools provided by theAJEL CLCC are theright off theend,change. teachers In becauseitworks. were Bothteachers toandstudentsfrom converted AJEL thebetter- the newmethod, more reticent teachers andthemselves becameconvinced becamewillingto ofitsimportance, creative. Clearly, wasmuchsimpler. teaching preparation pre-AJEL Yet asthemore fl exible teachers went aheadwith prepare more visualorothertools learning joyfulfor to requires make students. AJEL thatteachers spendtimebeing diffi AJEL andvisiblechanges inteacher,Rapid studentandparent behavior asaresult ofAJEL. in bothschools, andSBMinone. thiscasestudy, bytheheadmaster In were thechangessupported otherwise. thechangeswhichtook hold—AJEL imagine howCLCC-promoted engagementcouldbeimplemented andcommunity changesinteaching practices Headmaster leadership. and theadoptionofnewteaching methodssuchasAJEL. responsibility for schoolplanning, fundingandmanagementto them,andcreated aclimate encouraging change implementation attheschoollevel. SBMlegislation loosenedthepoliticalreins onSCsby transferring thebulkof for throughSBM support to maintain andimprovedecentralization,inparticular during educationquality educationreformincluding oneofthecenterpiece policies, school-basedmanagement (SBM).CLCC wasdesigned Indonesia’s decentralizationreforms beginning in1999. These leddirectlyto thedecentralizationofeducation, Changes innational government policy. What madeCLCC work? Building onCLCC success Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: and the poor school now genuinely like AJEL, whileparents are oftheirchildren’s AJEL, more andthepoorschoolnow genuinelylike supportive schoolingas cult to doatfi andhadnever rst,asthey before style were used to theoldlecturing been required to There to CLCC isnoquestionthattheheadmaster iskey impact—indeed, itishard to At both schools, support for to teachersAt bothschools,thefrontline—teachers andheadmasters support Parents, CLCC’s potential championsonthehomefront, are reached notjust The CLCC program would nothave happenedhaditnotbeenfor Someteachers found SBMcannot 3 the simple ability to communicate. As a result of the SDN 012 headmaster’s inability to work together with the SC and the school inspector, the SDN 012 SC is unable to support its school actively. In contrast, the SDN 028 headmaster meets with her SC head at least once a week, and all SC members are deeply involved in the management of school aff airs. The easy and open communication that all SDN 028 school managers enjoy is key to the success of SBM there, while the autocratic style of the SDN 012 headmaster is key to the failure of SBM at his school.

What held CLCC back? The beliefs and leadership style of the headmaster. SBM depends on open debate among SC members, parents, teachers, the school inspector, and the headmaster about the school’s yearly priorities. The autocratic style of the SDN 012 headmaster—possibly stemming in part from his lack of belief in the importance of community participation—

has quashed the possibility of such debate, and left SDN 012 with a passive SC and powerless parents. Children For Communities Learning Creating Sulawesi West District, In Polman

Bypassing the District Bureau of Education. UNICEF chose the District Planning Agency as its CLCC partner because it was simpler: UNICEF already partnered with the Agency for other work in the district, and preferred to continue dealing with a single partner. UNICEF thus disburses all CLCC money to the Planning Agency. The District Planning Agency may not take on the role of implementor, so it passes the money on to the District Bureau of Education as implementing agency. But the Agency maintains a de facto management role over CLCC in two ways. First, as UNICEF partner, it is responsible for ensuring Bureau of Education compliance with UNICEF’s strict fi nancial accountability rules for CLCC. Second, though the CLCC Taskforce is nominally under the Bureau’s management, it was the Agency which recruited Bureau staff for the Taskforce, and in fact the Taskforce coordinates more with the Agency than the Bureau.

Bupati

UNICEF Dist. Planning Dist. Bureau Education Agency of Education Council

CLCC Sub -Dist. Bureaus Taskforce of Education

school headmasters School inspectors Committees

teachers parents community leaders

students

Dotted arrows indicate input relationship only. Solid arrows indicate supervisory relationship.80

80 The solid line from the District Planning Agency to the District Bureau of Education represents their relationship within the CLCC program only.

Making Services Work for the Poor: Nine Case Studies from Indonesia 71 Creating Learning Communities For Children 3

72 In Polman District, West Sulawesi to SDN 012, a school that is clearly not well-equipped to implementSBM. notwell-equipped to SDN012,aschoolthatisclearly theprocessis driving forward. To date theCLCC program suchasadditionaltraining hasnotprovided any support is higher, parents have more moneyandtimeto devote to theirchildren’s education, andachampionheadmaster Cookie cutter implementation. easierthere,stakeholders thusincreasing inschoolmanagement. thelevel ofparent participation 82 A view alsoheldby theSChead. Aview 82 UNICEFmonitoringhasnotincludeddatacollection andanalysisfornon-CLCC schools. 81 fi authority. of gures costoftheirtime, ortheirtraditionsofbehavior inrelation todecisions, becauseofthehighopportunity perhaps CLCC schools. Without adequate data, Status quo onexam scores. education—to besustainable. charged Bureau withresponsibilityfor ofEducation—theagency children’s oftheDistrict support need theactive thebestchoicefor andthroughout CLCC thecountry—was in thedistrict attheoutset;however, partner CLCC will role managerial overde facto CLCC. may bethattheAgency—UNICEF’s It for both ahostofotheractivities partner institutionally diffi CLCC, andplays onlyaminorrole andevaluation. inmonitoring hierarchicalWith itsold-style structure, itis frustrated withtheBureau’s slow paceofchange. The Bureau, meanwhile, getsnofi nancialincentive for implementing Through itsinformal relationship withthe Taskforce, force hasbeenthedriving theAgency behindCLCC expansion, quantitative improvements outcomes. instudentlearning scores CLCC remain akey indicator. for itsalready CLCC islikely weak support It ifthere are no willdiminishfurther CLCC Bureau butthepartner ofEducation,anunenthusiasticstakeholder District really needsto convince, exam has fundedsubstantialexpansionandmany otherschoolshave paidto adoptCLCC ontheirown.However, for the on examscores hashadnoapparent dampingeff so, If examscoresof thatknowledge. are aninappropriate indicator for theCLCC program. The lackofmovement exam scores—after all, gleanedfrom designed to test knowledge “old methods”—are notanaccurate refl ection hassimplynotincreased asaresultknowledge ofCLCC. ithasincreased Orperhaps from thenewmethods, but (designed tosubjects checkchildren’s ofmathematicsandlanguages)isaproblem. Perhaps knowledge children’s tools (designed to stimulate AJEL link between children’s creativity, ability, critical andlove for andexam learning) novel AJEL methodology.novel AJEL education, norinchildren’s positive response to the diff a didnotappearto make case studyfamilypoverty matter?Does poverty Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: erence inparents’ involvement intheirchildren’s cultfor theBureau to adoptnewideas. happyabouttheAgency’s The Bureau isnotparticularly 82 SDN028’s parents better-educatedandricher have communicationamongall helped make It is notablethatinthis It The key failure ofCLCCThe key to to date raiseexamscores isitsinability relative to non- CLCC, notsurprisingly, perhaps isdoingbetter intheschoolwhere localcapacity 81 itisonlypossibleto guessatthereasons. Perhaps thelackofadirect ect ontheenthusiasmofPolmanect schoolsfor CLCC—the district the headmaster accountableforschoolmanagement key demand avoice inSCmeetingsorto insistonholding there. Suchparents may belessinterested inorableto low educationlevels to contributed thefailure ofSBM hypothesizes thatSDN012parents’ and relative poverty Poor parents. andless-educated The research team research The 3

Making it replicable Cultivate the right kind of leadership. Headmaster leadership is a key factor in CLCC impact. To help ensure a positive impact, leadership training for headmasters could become part of the CLCC model. Alternatively, CLCC could target other potential leaders such as school inspectors, School Committee heads, older teachers, or District Bureau of Education staff who already have the “right” characteristics—conviction of the importance of and need for SBM, an inclusive leadership style, and the power to eff ect change or infl uence the headmaster. One criteria for CLCC expansion could be the presence of committed individuals within schools or clusters who demonstrate an “active demand” for CLCC, perhaps by attending meetings or raising initial funds on their own.

LEADERSHIP IS KEY TO THE SUCCESS OF SBM.

The SDN 028 headmaster, Ms. K., can be characterized as a driven but inclusive leader. While she had a clear vision of how and why she wanted to Children For Communities Learning Creating Sulawesi West District, In Polman implement CLCC, she moved cautiously. At every step in CLCC implementation she took care to get support from teachers, SC members, and parents. In particular, she recognized the importance of a democratically elected SC with real parent representation, organizing an election in which over 80 percent of parents participated. Notably, she left the SC meeting room when votes were cast. Parents and SC members are now deeply involved in budgeting, planning and monitoring through frequent meetings and the dissemination of budgets to all parents.

The SDN 012 headmaster, Mr. S., is a visionary but exclusionary leader. His approach to CLCC implementation has often been to do what he thinks is right without bothering to consult teachers, SC members, or parents—hindering SBM from the outset. This had the advantage of moving implementation along quickly, but has also alienated stakeholders.83 At his school, less than a third of parents participated in SC elections, which were only for the core positions of chair, secretary, treasurer, and assistant. When a majority of parents fi nally showed up for a follow-up meeting, they were asked to “approve” the SC elections. The SC then took it upon itself to appoint seventeen additional “advisory members.” As for activities, even the headmaster agrees that the SC is not very involved in planning and monitoring in his school.

According to a member of the CLCC Taskforce, urban parents like CLCC, and some urban schools have responded to this by adopting CLCC as a way to attract more high-performing students. In such a climate, less-motivated headmasters might still be successfully pressured by intent parents to implement SBM.

Focus on AJEL. In this case study, even when SBM failed, AJEL still had a dramatic impact on the behavior of teachers and students. The ultimate goal of CLCC is to improve education quality. A provocative question is how necessary SBM is to this goal. Even if successful SBM fuels stronger AJEL impact, an initial focus entirely on AJEL in schools with a low chance of SBM success would yield immediate cost savings (from SBM training activities) without reducing teaching methodology outcomes.84 Schools already interested in SBM could pursue it on their own, and poorer schools with less organized parents could push increased community involvement in school aff airs to the longer term. That said, by increasing community (and especially parental) interest in schools, SBM will likely play an important role in ensuring the fi nancial sustainability of CLCC.

Measuring success: get it right. Two things are key to measuring success, and thus being able to replicate it: getting the indicators right (which requires an unambiguous goal statement), and measuring them right. The CLCC

83 For example, one teacher appointed as school treasurer felt his position carries no weight, as the headmaster spends money without consulting him. 84 This assumes that AJEL improves education quality, which has not been proven.

Making Services Work for the Poor: Nine Case Studies from Indonesia 73 Creating Learning Communities For Children 3

74 In Polman District, West Sulawesi Cast awidenet. analyzed, fi withkey ndings feeding back into periodic“tweaking” oftheCLCC program atthecluster level. even theregion). (perhaps mustbewell Data collectors trained.country Ideally, datawillbeaccessibleandregularly comparative non-CLCC butinsocio-economically and districts, throughout schools, the clusters anddistricts hassuff data collection 5 Program inspectionteams. program Annual are monitoringisnow reviews conducted cond jointlyby districtandsub-district 85 purchase asopposedto materials infrastructure. oflearning rates,student absenteeism,teacher drop-out absenteeism, andthepercent oftheschoolbudgetdevoted to the are several alternative quantitative indicators thatcanbeusedasproxies for improved educationquality, including Are examscores thebestway to measure improvements ineducationquality? The answer, ofcourse, isno. There teachers, orexaminers. There are indicationsthatcheatingonthe national examswasaproblem inPolman district. Or,education reforms suchasAJEL. ways, thingsintheright examscantest theright butbefalsifi edbystudents, the “wrong” topics, orinthe “wrong” studentsdohave ways, asaresult outthenewknowledge failingto of bring Are examscores avalidway to notalways. measure improvements Examscantest Certainly ineducationquality? as examscores. assuccessin to educationquality outto may beasimportant turn elements suchasAJEL “outcome” elementssuch management—should becanvassed for theirown defi nitionsofeducationquality. Successineducation “process” groups—notablymajor stakeholder includingthestudentsthemselves, butalsoteachers, parents, andschool program aimsto improve education? education quality. Butwhatishigh-quality To the gettheindicators right, To measure amuch-improved indicators right, system monitoring isnecessary. asaproxy for students’class canserve ability. critical can berepresented by quantitative proxies. For example, the percentage a ofstudentswhoaskaquestionduring answered. time before thisquestioncan be to beginwith,itwilllikely besome the diffi any decrease inCLCC Given quality? Polman district—buthasthisledto schools in to 100more primary replication hasbrought CLCC Spontaneous anddistrict-ledCLCC Has replication reduced quality? Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: district Bureaus ofEducation andSCs. involve staff culties in measuring quality culties inmeasuringquality of the District Bureau oftheDistrict Education, Parliament, District PlanningofReligion,aswell ashe District Agency, andDepartment According to oneex-CLCC Taskforce manager, government’s thedistrict of70schoolsfor selection ered, butimprovement mustnotonlybeinCLCC ispossible. Datacollection schools, clusters Though higherexamscores may stillbetheultimate outcome fordecision- key responsive are teachers to students’ newideasnow? To thequalitative someextent, now,students to becritical compared withbefore wasintroduced? How AJEL possible qualitative measures ofeducationquality. For instance, howableare many schoolswithoutdemonstrablesuccessinexamscores. There are many Planning Agency,District andby headmasters, teachers, studentsandparents at CLCCIndeed, hasalready beenreplicated bothformally andinformally bythe as CLCC isnotbeing—judgedsolelyonquantitative grounds. cannotbe—and ofEducation,anessentiallyqualitative program such suchastheMinistry makers 85 With Indonesia’s decentralization, ucted by UNICEFand ads ofSub- 3

CLCC replication at random was a mistake—they should have ensured that the schools belong to the same clusters. However, the motivated SDN 028 headmaster got her CLCC start from a CLCC training she attended while a teacher in another school. The lesson: district-level training can have a major ripple eff ect, so it should be provided to as many people in as many clusters as possible.

Tailor CLCC to the community. There is some evidence that poorer, less-educated communities have less chance of success in implementing CLCC: most spontaneous replication has been in urban areas which are better-off and better-educated. However, in this case study even the poorer, less-educated community still successfully implemented AJEL as well as increasing parental involvement in children’s education. A large part of the reason had to do with the highly eff ective school radio program. It was not, then, the less-educated and poorer group of parents per se that has reduced CLCC impact at SDN 012, but the way in which those parents are approached. Children For Communities Learning Creating Sulawesi West District, In Polman Poorer, less-educated parents don’t have time to attend SC meetings, but they can listen to the radio while working at home. Parents from rural areas without a tradition of community involvement in education may not have the inclination to join the SC or attend its meetings, but in the privacy of their homes and inspired by the radio program they can still become more involved in their children’s education. The radio program was a serendipitous add-on to CLCC in SDN 012. This study points out the importance of deliberately tailoring CLCC to the socio-economic characteristics of each school community. This in turn necessitates identifi cation of potential “problem” schools before CLCC implementation in new areas. Given the extent of CLCC implementation to date, there is likely already ample data available for such an exercise.

Plan the phase-out of external support to ensure sustainability. In the case study, external funding was not necessary for CLCC replication. The 70 schools to which the district expanded the program are being supported by it, while the roughly 30 schools that have adopted CLCC on their own pay all costs out of their own budgets. At SDN 028, the enthusiastic, trusted, and eff ective headmaster was able to implement CLCC with no external funding (though her initial training was paid for by CLCC). At SDN 012, which is receiving UNICEF funding, the headmaster stated that he would continue to implement CLCC even without external support. However, the well-off SDN 028 has more fi nancial resources to spend on CLCC with monthly fees of Rp. 10,000 per family, about four times higher than SDN 012 fees. UNICEF support for CLCC in Polman is planned to end in December 2005, though there are rumors that it may be extended by one year. It is possible that SDN 012, with its poor parents and detached headmaster, will not be able to raise suffi cient funds for CLCC once UNICEF support ceases. There are several funding options, including increasing community contributions, getting more long-term fi nancial commitments from the District Bureau of Education, and identifying low-cost substitutes for CLCC materials that currently must be purchased. In any case, it is unclear what will happen when UNICEF’s support ends. Among the unanswered questions: as students pass from AJEL in primary school back to the old teaching methods in secondary school (where CLCC is not being implemented), what will happen to CLCC impact? With just seven months left as of this writing, there are still many loose ends. The right partner for sustainability—the District Bureau of Education—has not yet bought into CLCC.

Making Services Work for the Poor: Nine Case Studies from Indonesia 75 Creating Learning Communities For Children 3

76 In Polman District, West Sulawesi Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Case Study 4: Improving Budget Transparency in Bandung, West Java Improving Budget Transparency 4

78 In Bandung, West Java Thiscase studywas writtenby LailaKuznezov, consultant (USA). Research was basedonafi eldvisittoBandung, West Java, in some ofBIGS’ fraudandwaste. attempts atreducing budgetary and NGOsto usetheinformation for change. Finally, entrenched localgroups anddishonestleadersundermine budgets,that itdoesnotpublishinformation ondraft butonlyonapproved budgets,ofcitizens alsolimitstheability frequent isthatitsbudgetanalysistoo criticism complicated citizens for to understandanduse. ordinary The fact be eff target thepoor explicitly, thoughbudgetanalysis, training, andinformation disseminationarethatcould allactivities as “pollinators” to putits information to onbehalfofspecifi work c groups suchasthepoor. BIGSdoesnot In fact, not yet resulted budget.Perhaps inamore city pro-poor most importantly, BIGSdependsonotherNGOsto serve reforms created anenablingenvironment for organizations suchasBIGS.Despite BIGS’ successes, BIGS’ has work of many diff sincerity, leader, itscharismatic multi-year untiedcore funding, ofgovernment contacts,anditsuse itswidenetwork includeitsreputation factors for honesty, important organizational strengths excellence Other andweaknesses. and to BIGS’cities andby otherNGOsbecauseofBIGS.Key itsstrategy to inlinewithits bring successhasbeenitsability the needforupinother hasbeenraised, isbeingtaken budgettransparency andtheissueofbudgettransparency members thatisstillunderinvestigation. citizens’ Bandungcity ofthebudgetand awareness oftheimportance ofitsown, DPRD bringing awell-publicized somedirectaction againstsomeBandungcity caseofcorruption taken government fraudandwaste. andisbeingusedbybranch ofcity government to BIGShaseven reduce budgetary provided by BIGShasempowered orDPRDto strengthen parliament itsrole thecity asacheckontheexecutive media andstudentswithtrainingonhow to analyze eff andusebudgetinformation inadvocacy hasprovidednames andtelephone numbersfor governmentunits.citizens, all80city It politicians, NGOstaff information, publishingseveral booksaswell asanannualposter whichliststhebudgetallocationsandunitmanager inBandung,transparency West Java. To date, budget BIGShasbeensuccessfulinobtaininganddisseminatingcity Founded ofGovernanceStudies(BIGS)isanNGOdevoted in1999,theBandungInstitute to promoting budget Abstract Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: reused withouttheirpermission. Leisher,Hopkins consultant (Australia). Thiscase iscopyrighted by theauthor, Institute, theAsh and theWorld Bankandmay and Winthrop was InstituteofDemocratic Carty, Governance, Ash p Analytical andeditorial support (U.S.A.). Harvard University rial, analytical, was provided MennoPrasad andeditorial support by Stefan Nachuk, Pradhan, Miyata andSachiko oftheWorld Ba Janes ImanuelGintingoftheWorld Bank(Indonesia)andGregorius KelikAgus EndarsoofthePradipta Paramitha Foundation (Indo is madetoBiro Pusat Statistik(2000),www.kpu.go.id, www.bandung.go.id, www.bigs.or.id, andwww.antara.co.id. Research team m ectively re-designed withthepoorinmind. BIGS’ re-designed ectively citizen outreach a islimited inbothnumbersandimpact: erent channelsandformats to reach people. Finally, national-level decentralizationandaccompanying orts. Information orts. March 2005.Reference not bereproduced or rovided by Susannah embers included nesia). Manage- nk (Indonesia) ,the 4

Introduction

As part of its mandate to alleviate poverty in Indonesia, the World Bank is undertaking a series of case studies to promote better services, especially for poor and disadvantaged people. The case studies were chosen from the many innovative practices seen in Indonesian local government in recent years through a competitive outreach process managed by the World Bank. Donors, non-governmental organizations, and local government staff were contacted and encouraged to submit proposals regarding innovative pro-poor service delivery work that they either were undertaking or knew about. This case study examines a local NGO working to improve budget transparency in Bandung city, West Java. Improving Budget Transparency Budget Improving Java West In Bandung, The Study Site: Bandung City Bandung city (kota) is the capital of West Java province and the cultural center of the Sundanese ethnic group. The city, on a high plateau, is home to several well-regarded universities and institutes. It is also a manufacturing hub for textiles and garments for export, with many outlets attracting weekend shoppers from the nearby national capital; factories provide jobs for residents. Within the city limits there are also rural areas, however, and many of Bandung’s

2.5 million86 residents are small farmers. The poor comprise about 7 percent of the population.87

Budgets in Bandung There is no Indonesian equivalent to the U.S. Freedom of Information Act that would require local government to make budget information (such as proposed or approved budgets or audited expenditure information) available to the public, though a discussion on a “Kebebasan Informasi” (Freedom of Information) Law is ongoing in the National Parliament. Citizens are generally unaware of the proposed law, and local governments are unmotivated to provide information voluntarily. Personal relationships remain key to accessing government information.

In theory, public input to the budget is ensured by the relationship between the city parliament (Dewan Perwakilan Rakyat Daerah or DPRD), with locally elected representatives from the 26 sub-districts (kecamatan), and the executive branch offi ces, headed by the Mayor’s offi ce. The budget is developed by the executive branch and then submitted to the DPRD for review and legalization. Direct public participation in budget planning takes place at a series of Development Planning Meetings (musrenbang or Musyawarah Perencanaan Pembangunan) at local and district levels. However, these meetings focus more on ascertaining local leaders’ priorities than on enabling debate between the community and the government. Since the budget is not publicly released or debated, direct citizen pressure on government is limited.

The Bandung Institute of Governance Studies (BIGS) The Bandung Institute of Governance Studies (BIGS) is an independent non-governmental organization founded in

86 www.bandung.go.id. 87 Biro Pusat Statistik (2000).

Making Services Work for the Poor: Nine Case Studies from Indonesia 79 Improving Budget Transparency 4

80 In Bandung, West Java Dispenda). Interviews were withcurrent BIGSstaff alsoconducted Dispenda). Interviews DPRD members, andoffi journalists, representatives ofNGOs, recipients ofBIGStraining, membersofanorganization formed byBIGS(APAKB), participate more eff participate organizations,non-governmental governmentbodiesandthemedia,to monitor localgovernment andeventually 9 Paraphrased from www.bigs.or.id. 89 BIGShasnotyet publishedoranalyzed auditedexpenditure orvariance data,orinformationondraft budgets. 88 Methodology information. to understandandusebudgetary well asproviding educationandtrainingonthebudgetplanningprocess init,andonhow andhow to participate a provider oftools—it obtainsandpublishesdetailedapproved budgetsshowing whatmoneyisreally spenton,as and staff andthepublic, thelegislativegovernment decision-makers between andexecutive bodies, managers andbetween thathelportarget thepoor.and services BIGSwantsto remove the information“budget imbalance” between deliver onitspoliticalpromises. Analysisofthebudgetcanreveal how muchmoneyisallocated directlyto programs mechanismfor government to to implementitspolicies, understandinghow thegovernmentprimary iskey plansto aswell asgovernmentsociety staff BIGS hasamulti-faceted missionto promote andto empower goodgovernance, civil anddemocracy civilsociety has focused onbudgettransparency. Initially, butsince2002,it theorganization attempted ofbasicservices, to directlyonimproving work thedelivery Studies, of ofDevelopment 1999 by several BandungInstitute former studentsfrom theDepartment Technology. BIGS’ mission • Develop publications Develop anddisseminateresearch fi ndingsand information through seminars, • ways autonomyandstrengthen Develop toenablecommunity local socialinstitutions; • outresearch Carry andeducation ongovernance, anddemocracy; civilsociety • To achieveitsmission,BIGSshall: goodgovernance, Develop and democracy by civilsociety themedia. • autonomyandlocal community institutionalcapacity; Develop • good, Develop cleanandeffi • economic, Develop political andcultural democracy insociety; • andstrengthen civilsociety; Develop • outadvocacy basedonsoundsocialresearch; Carry • goodgovernance, Develop and democracy; civilsociety • Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: workshops, discussions, journalandbookpublishing, andthemedia. and withingovernment bodiesthemselves. The organization seesitselfnotasamonitor ofthebudgetbutas 89

isto: ectively intheplanningprocessectively whichinforms governmentspendingpriorities. cials from theplanning, water, fi offi nance, and treasury cient government institutions; themselves to holdgovernment accountable. BIGSbelieves thebudget,as 88 These “tools” are intended to enableothers, includingcitizens, other , founding members, former researchers, and Three researchers visited Bandung conducted with print andradio with print conducted were themselves. Interviews government offi BIGS’ onthepublic, impact or becausetheycouldspeakabout information abouthow BIGSworks, because theycouldprovide wereInformants either selected discussions with29informants. andfocus groupinterviews semi-structured conducting for eightdays inmid-March 2005, ces (DinasPendapatan Daerah/ cials, politicians, or 4

APAKB members now working at other NGOs or elected to the DPRD. The following hypotheses were tested during the fi eldwork: • BIGS has improved governance in Bandung City via its budget transparency work. • BIGS’ positive impact on governance has not yet extended to making the budget more pro-poor. • BIGS is having an impact on citizen involvement in the policy-making process.

BIGS’ Impact

BIGS began BIGS issued cooperation BIGS brought press release with PKS on corruption case First Ford about possible budget posters involving 2002 Foundation BIGS’ 10 corruption DPRD budget

BIGS’ first book Transparency Budget Improving Java West In Bandung, grant made to episode radio on the budget, involving the to National BIGS show on budget Soeharto’s fall “DPRD 2002 DPRD Ombudsman issues began BIGS Expenditures ,” budget Committee (ended in 2002 ) established published

1999 2000 2001 2002 2003 2004 2005

1998 2005 First budget DPRD and BIGS’ report training held First edition of other card exercise BIGS’ government implemented APAKB magazine units began to (ended June established “Bujet” make changes 2003) published to their budgets First edition of BIGS’ budget posters printed and posted ; f irst The book , annual edition of “APBD “Those Who Document” published; the book Have Just “You Better Know” published Shopped,” published

Has BIGS Improved Governance in Bandung City via its Budget Transparency Work? BIGS has been successful in obtaining and disseminating city budget information. Before BIGS put its spotlight on the budget, the practice of the city executive branch had been to provide only a budget summary to the DPRD, and no detailed budget breakdown was available to the public. Since 2002, through dogged and exacting research, BIGS has proven that it is in fact possible to obtain very detailed budget information.

BIGS disseminates budget information in several formats to a wide audience. An annual poster90 lists 80 city government units together with their budget allocations and the contact information (names and telephone numbers) for unit managers. The posters target the general public, so the information is presented in a simplifi ed

90 The 2003 poster title was “What’s Going On With Bandung City APBD 2003” (Ada Apa Dengan APBD Kota Bandung tahun 2003), which mimicked the title of a pop song that was very famous at that time, “What’s going on with you” (Ada apa denganmu). The 2004 title was “Announcement APBD 2004” (2004: Bewara APBD 2004).

Making Services Work for the Poor: Nine Case Studies from Indonesia 81 Improving Budget Transparency 4

82 In Bandung, West Java groups onthesametopics. For example, inFebruary onbudgetplanningwasattended 2005,aworkshop by DPRD members.seminars, BIGSalsoconducts roundtables,media, legislators for andworkshops andpoliticalparty special are staff to advocate onbehalfofcitizen interests. Since2004,BIGShasprovided trainingfor 94people, ofwhom55percent the compositionofAPBDbudget,andhow to analyze andusebudgetinformation andtheplanningprocess use budgetinformation eff inadvocacy BIGS provides citizens, politicians, NGOstaff throughout theprovince issues. and otherpublicpolicy The radioprograms mediaoutletsincetheyreach regular are citizens animportant 93 These shows reach an estimated audience of 35,000-40,000 listeners (phone interview withFDWBandaMARAradio Theseshows reach anestimatedaudience reporter). of35,000-40,000listeners (phoneinterview 93 FDWB, Forum” or“BandungJournalists’Discussion (Forum Wartawan Diskusi Bandung), isaforumofBandungjournalistswith 92 The InternationalBudgetProject was formedin1997toimprove toanalyze andinfl thecapacity ofcivilsociety uence gove 91 BudgetProjectin cooperationwiththeInternational from onbudgettransparency areligiousfrom arecent andareport perspective seminarrunbyincluded articles BIGS is targeted to amore audience. educated For andactivist 2005) example, themostrecent issue(January-February analysis ofthebudget,aswell asdiscussionsofissues related to theplanningandpublic consultationprocess. It BIGS’ bimonthlymagazine, Bujet (“budget” providing amore detailedandsophisticated inSundanese),containsarticles year, mainlyto government offi obtaining theinformation through itsgovernment andpoliticalcontacts. About1,000copiesare each distributed Document” budget(Anggaran APBD)withthecomplete Pendapatan city (Dokumen danBelanjaDaerahorAPBD), against several DPRDmembers(seebelow). Since2003,BIGShasalsopublishedabookeachyear entitled “APBD 1997 to 2002. Research for thisbookuncovered inthe2002DPRDbudgetandprecipitated major corruption charges BIGS’ seminalpublicationis DPRDExpenditures”“The whichanalyzed budgetdatafrom (Belanja-belanjaDewan), the information. rest are regular paperposters to distributed activists,publicoffi the3,000posters producedformat. annually since2003,halfare Of sturdy enoughto beposted outdoors, whilethe local publicaff a ten-session onalocalradiostation.BIGS’ talkshow onbudgettransparency director isstillaregular gueston BIGS doesnotrely media;ithasastrong onlyontheprint radiopresence aswell. 2001and2002itconducted In Shopped” (Mereka Yang unitactivities. BaruBelanja)(2004)withexpenditure datafor working allBandungcity Anda (Sebaiknya Tahu–Belanja Publik danBelanjaAparaturDalamAPBDtahun2003)and Who Have“Those Just BIGSpublicationsinclude Other “You Better Know—Public andApparatusExpenditures inAPBD/Local Budget2003” todistributed governmentoffi Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: strengthening democracy through themedia.Since 2002,ithascooperated withMARAradio show station onaweekly aboutcurrent institutions andoutcomes (www.internationalbudget.org). ofNGOsorsocialorganizations and30percent are studentsandotheracademics;the remainder are airs radioshows suchasthe “FDWB Talkshow,” 93 in an easy-to-understand format. inaneasy-to-understand cials, DPRD and political party members, othermonth. NGOs, anduniversities cials, every DPRDandpoliticalparty cials, academics, andNGOs. orts. , themedia,and students withtraining onhow to analyze and BIGSoff 91 on applied budget work. 1,000copiesofthemagazineare onappliedbudgetwork. ers trainingonthebudgetplanningprocess, understanding 92 appearing frequently appearing to discussbudgettransparency cials, localleaders, andotherswhowishto display rnment budgetprocesses, the missionof aff airs. 4 members, government offi cials, members of the military, and the general public. An added benefi t of the training sessions is that they present like-minded organizations and individuals with an opportunity to establish informal networks to further their budget transparency work.94

Information provided by BIGS has empowered the DPRD to strengthen its role as a check on the executive branch of city government. The executive branch is responsible for developing the APBD budget and releasing it to the DPRD, which reviews and approves it. On paper these two bodies are equally powerful, but until BIGS began to focus on budget transparency, the executive branch tightly controlled the fl ow of information, forcing the DPRD to accept budget summaries rather than detailed budgets for review and approval. DPRD members reported that since BIGS began publishing the complete APBD budget in 2003, demonstrating that the budget is both obtainable and detailed,95 they have started to debate the budget in detail,96 and have even revealed questionable budget Transparency Budget Improving Java West In Bandung, line items to the media in an eff ort to bring budget discussions into the public realm.97 In theory, with this new information they can question executive policy as refl ected in the budget, and even reject the budget itself. Some

DPRD members have begun to be proactive in requesting information, analysis, and guidance from BIGS.98

Information provided by BIGS is being used by government to reduce budgetary fraud and waste. Since BIGS has begun to publicize its close analysis of the budget and the budget itself, the government has cut or decreased its allocation to certain line items which have been criticized as unregulated or unclear, and thus susceptible to corruption. In 2005, Bappeda (the city development planning board), the DPRD, and several executive departments made a number of changes to their budgets to reduce waste and opportunities for fraud. For example, the budget for staff travelling to other cities (biaya dinas)99 was cut by 10 percent, unclear budget line items such as “coordination and harmonization” were deleted,100 and the budget for stationery and photocopying was cut.101 NGO activists, journalists and policy makers themselves report that since BIGS began to work on budget transparency, policy makers are “more careful” about budget formulation.102 According to them, this is because offi cials know that they cannot hide improprieties from BIGS. Everyone locally is aware of a case brought by BIGS to local prosecutors in 2004 charging that several DPRD members misused funds allocated to an “unregulated” line item (an item not explicitly covered by legislation or allocated to a particular department or service), and offi cials now take budget

94 Interview with Komplen, an NGO working in Bandung district. 95 BIGS only publishes approved budgets, not draft budgets being developed and debated, so the information it provides concerns the current year’s operating budget (approved the year before) or the prior years’ executed budgets. BIGS does not yet present or analyze audited expenditures. 96 Bandung Municipality DPRD member. 97 For instance, “unpredicted budget” (biaya tak terduga), “coordination costs” (biaya koordinasi), and “meals budget” (biaya makan dan minum) have been discussed (phone interview with BIGS head). 98 According to a DPRD member and former APAKB head. 99 Critics have pointed out that DPRD members’ travel often has unclear objectives, no follow-up, and is only for pleasure. 100 It is now embedded in the program budget. 101 In theory, greater budget transparency would change budget allocation from one year to the next, yet because BIGS has only focused on budget transparency since 2003, such changes would barely have had time to surface (Kabid Sosbud Bappeda Kota Bandung, or head of Bappeda’s Social Culture Unit, Bandung City). 102 The head of FPPM (National Forum for Popular Participation), one of BIGS’ founders, Deputy Director of Sawarung (Bandung Citizens’ Forum), a journalist for “Gatra” weekly magazine, and a member of Parliament.

Making Services Work for the Poor: Nine Case Studies from Indonesia 83 Improving Budget Transparency 4

84 In Bandung, West Java 0 www.antara.co.id. 103 According to FAGI, there hasbeenanincreaseeducation budgetfrom inthecity Rp. 17 billionin2003to Rp. 48 exampleofanNGOthathasusedBIGS’is theonlyknown information to advocate directlyto thegovernment. To date, theeducation-focused Independent Teacher Aspirations Forum (FAGI orForum Aspirasi GuruIndependen) process. inthepolicy more participants active as settinganexampleofhow uponthatinformation, to groups individualcitizens act andactivist willalsobecome and to advocate for for allcitizens. better performance Ultimately, BIGShopesthat by providing information aswell information aboutthebudgetto understandhow budgetallocationworks, to monitor governmentperformance, especially thosetargeted atthepoor. However, itassumesthatcitizens andcitizen groups how to willlearn use of thepoor. realizes thatfocusing It doesnothave onimproving onbudgettransparency adirectimpact services, not pro-poor, meaningthatexpenditures are notspecifi whichaddress callytargeted themainneeds to services thatareNot yet. BIGSbelieves islargelystill thatthecurrent lackofbudgettransparency to blamefor services city Pro-poor? Has BIGS’ Positive onGovernance Impact toMakingtheBudgetmore Extended andaRp.in prison 200millionfi neeach(thecaseisstillunderappeal) DPRDmembersofPadang2004 term City, West Sumatra,were charged andsentenced to withcorruption sixyears BIGS originally intended onlyto publicize theinformation. However, inaseparate casethatyear, 27ofthe1999- (amajor Rakyat including Pikiran West Java newspaper) andbroadcast ontheradio. time suchinformation hadbeenmadepubliclyavailable. BIGS’ fi ndings byseveralwere localnewspapers alsocarried issued apress release captured pointingouttheirregularity, citizens’ whichquickly attention, asthiswasthefi rst allocationsto miscellaneousitems shouldnotexceedIndonesia, ten2003BIGS percent early ofthetotal budget.In that year’s DPRDbudgethadbeenlabeled “miscellaneous” (biaya lain-lain),thoughaccording in to usualpractice basedonitsown analysis.BIGS hastaken action direct public accountability. for andtheynowalike, thegovernment believe to thatitisimportant bemore transparent inorder to increase Undoubtedly, BIGShasraisedtheprofi makers andpolicy amongactivists leoftheissuebudgettransparency allocations to unclearitems andspendingthatisperceived to benefi ratherthancitizens. tgovernment workers have helpedto increase to bemore pressure makers onpolicy “correct” informulating theirbudgets—to reduce seriously.transparency BIGS’ reputation case for beingableto obtainbudgetdataandtheexampleofcourt despite which three of the suspects had been re-elected to thecurrent DPRD.despite whichthreehadbeenre-elected ofthesuspects includingtheheadofpreviousof corruption, DPRD. As ofMarch 2005,thiscasewasstillunderinvestigation, the NationalOmbudsmanCommittee. released attorney thenamesoffour that,thedistrict After peoplesuspected attorney, DPRDto thedistrict the BandungCity andwhenthisproduced noquickresults, in2004itappealedto Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: In 2002,BIGSdiscoveredIn thatforty-fi ve percent of 103 . This inspired acaseagainst BIGSto bring 4

billion in 2005.104 It is possible that this increase is partially due to FAGI’s advocacy work on behalf of teachers and poor students, work that was inspired and supported by BIGS.

Has BIGS had an Impact on Citizen Involvement in the Policy-Making Process?

BIGS’ indirect road to a pro-poor budget. FAGI is a forum of Bandung Bandung City citizens’ awareness of the city teachers established in 2001 that aims to advocate on behalf of importance of the budget and the need for budget teachers and scrutinize education policy. One policy FAGI focuses on transparency has been raised. Journalists, politicians, relates to new student enrolment in secondary schools. Under this policy, and local leaders have all noticed that the public is only students with good grades are allowed to enter public secondary school. The problem is that public schools are generally both cheaper more aware of budgetary issues since BIGS began its and of better quality, while students with good grades are usually those work. For example, many people call or send short who have already studied in public primary schools and have attended messages to radio shows asking how can they help Transparency Budget Improving Java West In Bandung, additional courses which are too expensive for the poor. As a result, many poor students are forced to attend private junior high schools which are monitor the budget,105 asking for example, “Is there a lower-quality and more expensive. FAGI advocates a poor students’ quota budget to rebuild my local road?” or, “If our children’s for public secondary schools. school is broken down, does the government have After being trained by BIGS, FAGI’s head realized the importance of budget information to their advocacy program. Hence, since 2004, FAGI the budget to rebuild it?” Local leaders (sub-district has used BIGS’ information to advocate for a larger education budget heads or camat, as well as informal community leaders (as provided for by the Constitution). FAGI also cooperates with BIGS to such as respected activists or elders) who have educate teachers about the education budget and train them in how to fi ght corruption through a greater understanding of the budget. displayed BIGS’ budget posters also report that citizens defi nitely take notice of the posters and respond to the information by questioning them. Service providers, such as the head of the city Education Department, are also beginning to be questioned directly by citizens.

Through its activities, BIGS has not only raised public awareness of the signifi cance and function of the budget, but also of the fact that the public has a right to know the budget and how elected offi cials are spending it. As one DPRD member commented, “Citizens might never have known that the budget belongs to them; it…is known now!” 106

Journalists are making use of BIGS’ budget information to educate themselves and their audience.

According to one journalist,107 before budget information was provided by BIGS, if journalists needed it, they had only government offi cials to rely on, and rarely got what they wanted. BIGS now provides an alternate, reliable source.

The issue of budget transparency is being taken up in other cities and by other NGOs because of BIGS. Although only one organization, the education-focused FAGI, appears to be actively using BIGS’ budget information for direct sector-specifi c advocacy (see above), a number of other NGOs are taking advantage of BIGS’ services to

104 However, 2003 APBD data obtained by the research team does not coincide with this information, and the amount and nature of the increase is unclear. 105 Journalist, “Gatra” weekly magazine. 106 DPRD member. 107 “Gatra” magazine.

Making Services Work for the Poor: Nine Case Studies from Indonesia 85 Improving Budget Transparency 4

86 In Bandung, West Java begun to respond to BIGS’ information, pressuring theirgovernmentsto publishtheirbudgetsaswell. trained by BIGShasalready budget.Citizens from publishedtheSumedangcity othercitiessuchasCimahihave also posters for (alsoin anothercity, Sukabumi West Java). OnememberoftheJatinangorCitizens Forum whowas PAN orPartai AmanatNasional)hasrequested Party (theNationalMandate BIGS’ guidanceindeveloping budget advocacy organization itself.advocacy yet althoughitsmembersremain individually, active APAKB hasfailedto becomeastrong community-based Actively BudgetProcess, Participate intheBandungCity Bandung), orAliansiuntukPartisipasi AktifAnggaranKota a result ofBIGS’ creatingorganization, APAKB anactivist research.anothertack, 2003BIGStried In Allianceto (The methodology asaself-assessmenttool. Nor, ontheotherhand, didcitizens begin to pressure as for better services providers didnotseeminterestedbut localservice inresponding to theresults, orinadoptingthe Card”“Report ombudsman’s offi advice onhow to monitor budgetsandprevent andhasbeeninvited corruption to attend BIGStrainingsessions a NationalIslamicorganization whichfocuses BIGSfor hasasked onthepure implementationofIslaminIndonesia, (kabupaten Bandung),usesBIGS’(kabupaten withDPRDmembers. budgetinformation whentalking explore onbudgettransparency. andwork ofBandung anNGOfocusing Komplen, onbudgetissuesinthedistrict Key Factors inBIGS’ Success 1 Ibid., andmanytimes thehostofMara radio talkshow. 110 Journalist,“Gatra” magazine. weekly 109 andBandungdistrictare separate Bandungcity entities. 108 service providers.service conclusions whichmighthave oftheexercise increased theutility to reach conclusions abouttheperceptions users— ofpoorservice to askaboutrespondents’ incomes, itimpossibleto thusmaking (though alistwas available attheBureau ofStatistics),andneglecting such asnotselectingrespondents from amonglow-income citizens managed.they BIGSstaff key senioroffi organization, new BIGSdidnotyetvery command theattentionof provision. on service to bemore “pro-poor”. However, theexercise hadnoreal impact toprovide providers services feedbacktoservice andpushthem city Cardactivities was exercise aReport onthepublic’s perception of towork “downstream”.The earlydays:trying Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: cials, andsocould notaff ce. In 2002 it conducted a 2002itconducted ce. In Card”“Report exercise to gatherclientfeedback onmunicipalservices, Accor alsoadmittedtomethodological mistakes ding toBIGSstaff ect the services departments departments ect theservices , thiswas because asa One ofBIGS’ One fi rst on improving public services through thecreationon improving ofan publicservices to BIGS’ achieve animpact. necessary fi rst study focused follow-upaccompanied by theintense advocacy area,consistently were target andoften one policy not concentrated onresearch, studiesdidnot butitsearly focused directlyonbudget transparency. Initially, it and were inthecity not delivery improving service (1999-2001)wereactivities aimedatunderstandingand in research, analysis andpublicity. settling ononethat eff approaches to improving provision, service ultimately BIGS hasdeliberately triedout, anddiscarded, several ectively exploitsectively itsstrengths 108 Persis (Persatuan Islam), BIGS’ earliest 110

109 . 4

APAKB then… In 2003, BIGS founded APAKB as a community BIGS staff realized these eff orts were not having much impact forum advocating for and by citizens on budget issues. City on service provision. Consequently, they began to focus on residents submitted the names of over 1,000 “informal leaders” the wider issue of municipal budget allocation to services, to BIGS. These leaders agreed that APAKB should focus on monitoring city governance, especially the budget. Core and thus on budget transparency itself, in order to allow the members were chosen, three focus sectors were identifi ed, and public to see how the government sets priorities, and thus a leader was selected. APAKB also began producing a monthly enable them to advocate for their priorities. A more transparent bulletin on budget transparency, distributing it to NGOs and budget should, BIGS reasoned, facilitate a more participatory youth organizations. …and APAKB now. The bulletin is no longer produced planning process, more effi cient government spending, and because of a lack of funds, and APAKB’s only activity currently ultimately, more eff ective public services. is issuing joint press releases on education. APAKB has very limited funding, all from BIGS. APAKB’s members all have other

professional responsibilities—many lead other community BIGS is forthright about refl ecting on its mistakes and failures. Transparency Budget Improving Java West In Bandung, organizations—so they have little time to contribute to APAKB. Its ability to bring its strategy in line with its organizational strengths and weaknesses has been key to its success. Rather than trying to “be all things to all people,” BIGS staff tried several strategies, and, realizing BIGS was not good at certain activities, refocused on its core strengths, which are research and analysis in a policy area that is key to achieving “downstream” impact on the public policy process (see text box).

Because it has developed a reputation for honesty, excellence and sincerity, BIGS commands the attention of government. The non-governmental sector in Indonesia, as in many other countries, has faced increasing criticism from donors, politicians, citizens and from within the sector itself in recent years. Critics accuse NGOs of being self- serving organizations aimed at winning grant money for projects, of having a negligible impact, and even of being the tools of politicians. BIGS has successfully built its reputation within this context. First, it has demonstrated that it has strong research and analytical skills—of which perhaps the most important is its ability simply to locate detailed budget information previously assumed by most to be unavailable. By publishing the information, BIGS has proved that it is not trying to control it, but simply to push for transparency.

Second, BIGS has proved its moral integrity by refusing to accept the standard kickback arrangement that goes with most government contracts. In 2002, it won a government bid for the establishment of a local ombudsman committee. However, there was an informal agreement that the winning bidder give 11 percent of the total contract to a certain government offi cer. BIGS refused. When the government insisted, BIGS threatened to cancel the contract. In the end, BIGS was successful in retaining the contract without the kickback—but this was likely its last government contract as both sides are now wary of working with each other. BIGS is also known for rejecting large “gifts” off ered to its staff members. For example, one government offi cer attempted to off er a staff member a “holiday bonus” (THR or Lebaran) amounting to Rp. 2.5 million (USD 280), which is quite large relative to staff salaries (which run between

Rp. 800,000 and Rp. 3 million a month).111 BIGS’ leader ordered it returned.

When BIGS conducted its “Report Card” survey in 2002, high-level offi cials were not interested in participating.

111 Telephone conversation with BIGS head, May 2005.

Making Services Work for the Poor: Nine Case Studies from Indonesia 87 Improving Budget Transparency 4

88 In Bandung, West Java likelihood thatitwillcontinueto providelikelihood fl exiblefunding for BIGS coupleof years.for thenext for theFord BIGShasleft Foundation, for remains thedonor, budgettransparency apriority sothere isastrong might have tiedBIGSto astrategy thatitwould ratherdiscard. While theProgram Offi quantifi fromlearn itsmistakes,notdemandingstrict numberofpeopletrained, able which results, suchasacertain (seebelow). Notably, partnerships Fordline withlessonslearned, withrisky andto experiment hasallowed BIGSto or, conversely, to develop inaninability innewdirections. in Instead, BIGShasbeenableto re-focusitsactivities tied fundingthatmany NGOsrely onfor theircore overhead expenses, result andwhichoften eitherinmissiondrift provided BIGSwithamplefl exiblefunding. ThishasenabledBIGS to avoid andproject- thegovernment contracts andchangestrategies.activities BIGS hasreceived multi-year core funding, untiedto specifi of theresearch team). Bachelor’s degrees (notably, BIGS’ janitor hasjustfi nishedhisBachelor’s degree inLaw andhasbecomeamember staff their personalandprofessional note development, off often and which onapractical BIGS trainingsessionsinorder to improve Heallows staff theirskills. to leadBIGS’ themto leadresearch budgettrainingsessions, asking projects, andallowing juniorstaff to represent theorganization atevents, encouraging themto publish,providing oftrainers”“training to enablethem about accusations of partisanship, since it publicly invited any and all parties to cooperate with it at the start ofthe sinceitpubliclyinvited to cooperateabout accusationsofpartisanship, withitatthestart any andallparties haveposters. alike indeedquestioned BIGS’ Althoughbothalliesandskeptics independence, BIGSdoesnotworry politicalgoal,that BIGShasamore especiallysincethelogos ofbothBIGSandPKSare overt atthetop printed ofthe poster. Sucharelationship are or couldcreate inter-dependent, theimpression thattheNGOandpolitical party Sejahtera),thebudgetinformation whichassistsBIGSingathering (Partai intheannual whichisdistributed Keadilan Notably, andnotwithoutcontroversy, BIGShasdeveloped acooperative relationship PKS withonepoliticalparty, BIGS hasbeencreative andopen-mindedinforging aneff 1 Emailfrom theFord Foundation (29May2005). 113 Journalistfor“Gatra” DirectorofSawarung (BandungCitizens’ Forum). magazineandDeputy weekly 112 interest inmind. asanhonestorganization with thepublic andhasbecomewellprovince known for work, itsbudgettransparency information andeducate themselvesissues, onvarious andseminarsare well attended. BIGSisapioneerinthe Several years later, diff BIGSisgettingavery principled man,andpeople trust him.Moreover,principled heplacesagreat emphasisonstaff to thedevelopment allaccounts, oftheorganization. By theBIGSfounder andheadisregarded asanhonestand BIGS hasacharismatic andtalented leaderwhoencourages hisstaff to allowshaveof thegovernment, itsactivities whichinturn agreater impact. addto itsreputation,and radioactivities asdiditsinitiationofahigh-profi case. BIGSnow hastheattention lecourt Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: scholarship program, partly fundedby theFord scholarshipprogram, partly Foundation, for Master’s degrees andeven thecompletionof 112 It is one of a small group of Indonesian NGOs doing relatively high-quality research.publishing isoneofasmallgroup NGOsdoingrelatively Its ofIndonesian It high-quality Since 2001, BIGS has been able to partner withtheFord Since2001,BIGShasbeenableto partner Foundation whichhas erent offi reactionto itsactivities.High-level cprojects, allowing itthefreedom to choose withanunusualpartner. partnership ective to atotherfull-timejobsthatare work goodfor to grow. to development, delegatingstaff cer whochampionedfunding BIGS’ leadershiphasbeenkey er better pay. Heinitiated a cials often contact itto get contact cials often 113

to attend

4

poster initiative; only PKS was interested.114 As a consequence of including the PKS logo, some posters have been torn down in neighborhoods where other parties are strong. Yet BIGS maintains that the logo inspires other parties to work harder to win voters’ hearts, promoting healthy competition; other parties have already begun to contact BIGS to learn how to become involved in budget work. By partnering with political parties, BIGS aims to encourage them to add budget transparency to their agendas, to test its own ability to maintain its independence, and to learn new advocacy skills.115

BIGS has a wide range of government contacts to support its research, including a former BIGS staff member working with city government on budget development and several former APAKB members who have been elected to the DPRD representing various parties. Improving Budget Transparency Budget Improving Java West In Bandung,

BIGS uses many channels and formats (radio, print, training, etc.) to reach people, resulting in an impact even beyond Bandung City. Its publications and frequent appearances on radio programs help it reach a wide audience, including those in neighboring areas who are now asking their local governments for greater budget transparency. BIGS also belongs to national NGO networks that allow it to learn from others and share its own experiences throughout the country. For instance, it was the example of a fellow NGO bringing a court case in Padang which encouraged BIGS to bring its own complaint.

National-level changes paved the way for BIGS to exist and work. After the fall of Soeharto in May 1998, especially under Presidents B.J. Habibie and Abdurrahman Wahid, the government in general and parliament in particular have become more “open” to the public, creating an enabling atmosphere for organizations such as BIGS. Decentralization, beginning in 1999, has also been key; local government assumed responsibility for the provision of many services and accordingly is expected to be more accountable to its citizens at the local level. Finally, breakthroughs in corruption cases in other areas, in particular the widely publicized corruption case involving all DPRD members in Padang, have pushed BIGS to make actual use of the budget information it obtains to hold government accountable.

Factors Limiting BIGS’ Success BIGS’ work needs “pollinators”—other NGOs using its information to advocate for budget transparency for specifi c groups or sectors—to increase its impact. BIGS has not yet been very successful in recruiting other NGOs to use its budget information and skills to work on policy-focused or sector-specifi c budget transparency advocacy. The lack of pressure from citizens and uptake by sector-specifi c or poverty-focused NGOs (except FAGI) reduces the pro-poor impact of BIGS’ work.

BIGS does not target the poor explicitly. In theory, BIGS’ work analyzing and releasing budget information will provide sector-focused organizations with the tools they need to advocate for pro-poor policies. Yet this has not

114 PKS now holds more seats in the DPRD than any of the seven other parties represented. 115 Presentation at national conference on poverty alleviation and Millennium Development Goal achievement, April 2005.

Making Services Work for the Poor: Nine Case Studies from Indonesia 89 Improving Budget Transparency 4

90 In Bandung, West Java suggested thatonly50percent ofthe supposedeliminationofallocationsto unregulated reallocated items isactually only reallocations to more obscure lineitems, withnoreal inwaste reduction orfraud. Though budgetchangeshave ofBIGS’ beenmadeasaresult (at leastinpart) work, theymay represent and lessthan100percent levels literacy may alsoreduce theaccess ofthepoorto BIGS’ information. million residents, andeven radio programs onlyreach about40,000listeners. Limited access to printmedia of methodsusedto reach citizens iswide, 3,000posters ofthecity’s canreach onlyasmallproportion 2.5 BIGS’ publicizingbudget information work still doesnotreach allcitizens, especiallythepoor. eff outadvocacy carry ensure itscomplexanalysisisusedby otherorganizations citizens orprivate to reach theirown conclusions and andanalysis. BIGShasnotyetit publishestheraw developed dataratherthananopinionated away summary to thiscasestudy. during voiced by allinterviewees However, oneoffi BIGS’ budgetanalysis may betoo complicated citizens for to ordinary understandanduse. budget, BIGSdoesprotect itselffrom accusationsthatitsinformation isnotaccurate. publishingonlytheapproved to challengeandchangeit.By the government budget,ratherthanasanopportunity budgetformulation.consideration during However, Perencanaan Pembangunan), whichare ideasonlocaldevelopment annuallyto for conducted gathercommunity to inflBIGS doestry uencebudgetallocationduring to theplanningprocessdetailed informationoftheprevious whichBIGSpublishesonthe budget pertains year. citizens stilldonothave information thenecessary to comment onbudgetsbefore theyare madelaw. BIGS doesnotpublishinformation budgetsbeing developed ondraft anddebated, and sopolicy-makers localactors. the faceofpowerful wherepolitical realities citizens ofanewlydecentralizingIndonesia, are howto exercise stilllearning in theirrights damaging to thefi nancialsituationofpopular groups aligned withlocalleaders. BIGShas to contend withthe fraud andwaste. Entrenched localgroups and dishonestleadersunderminesomeofBIGS’ attempts at reducing budgetary met through advocacy.”“trickle-down off posted in poorer areas. Atrainingsessioncouldbetailored to theinterests, abilitiesandneedsofthepoor, and issued, listinginformation to abouttheten bemostrelevant government unitsfound to the poorand inasurvey to inspire upsuchtargeted themselves. themto version take oftheposter advocacy mightbe Apoverty-focused budgetsgoesto thepoorest mightbeuseful enoughto otherNGOs versusneighborhoods therichest service in BIGS’ plan,leadingmore work rapidlyto results. pro-poor For example, analysisshowing whatpercent ofcore thepoorwerehappened. If anexplicittarget ofBIGS’ specifi activities perhaps work, c to thepoormightbeincluded Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ered inaway thatisconvenient andinviting to thepoor. areto be notlikely The needsofthepoorest in particular Politicians have stepped into defend ispotentially allocationscriticized byBIGS whenthecriticism orts orts accordingly. Musrenbang Musrenbang are seen locally only as an opportunity to are seenlocallyonlyasanopportunity “approve” (Development Planning orMusyawarah Meetings cial commented thatBIGSis “truthful” because One DPRDmember While therange This criticism was This criticism The 4 to more acceptable areas, with the other 50 percent simply moved to a more disguised location. Therefore, ironically, increased budget transparency may have the adverse eff ect of driving superfl uous costs deeper into the budget, as dishonest bureaucrats get better at hiding their corruption.

Looking to the Future: How to Sustain Success Careful targeting and monitoring will be key to ensuring budget transparency really leads to improved service provision. The accountability, accessibility and motivation of actors such as legislators, politicians, and leaders varies considerably depending on the focus of their work, their constituencies, the level at which they work, and the stage(s) of law-making and budget formulation in which they are most involved—as well as on their personal characteristics. Policy advocacy NGOs like BIGS must take care to identify and usefully target the critical

people, organizations, laws and stages of the process for their cause—budget transparency. While BIGS has had Transparency Budget Improving Java West In Bandung, some success in bringing budget transparency into the public arena, it may be that better targeting will help it achieve the budget transparency “holy grail”—budget reallocation according to citizen priorities.

In particular, budget variance should be analyzed year by year to determine whether allocations to basic services have increased, allocations to line items unregulated by law have decreased, and actual expenditures in fact conform to the approved budget.

As a local NGO success story, BIGS is at risk of co-optation. Bigger organizations often like to partner with small, successful organizations such as BIGS, whether it be to help the larger organization better achieve its mission, or—more cynically—to improve the larger organization’s image, creating the impression that it has local access and support, in order to attract more funding. Whether the motivation of the prospective partner is sincere or not, BIGS risks losing its independence. The government’s recent invitation to BIGS to partner with it on a project to improve the policy-making process presents another risk. Although BIGS would have the luxury of participating in this project without government funding, the new risk is that it become too closely aligned with the current administration, and is pushed—though slightly—away from its primary mission. With its current strong leadership and assured core funding, it is doubtful BIGS will want or need to go astray, but the more success it enjoys, the more often risks, heralded as opportunities, will present themselves, including damage to the organization’s reputation, over-extending organizational capacity, mission drift, and limits to organizational independence if BIGS is not strong enough to disagree with a partner.

BIGS is a classic local NGO: started by a talented and charismatic leader able to attract skilled staff and make a diff erence. Successful local NGOs often fail to transition smoothly to a new leader. BIGS’ leader has declared his intention to step down in October 2005. Whether from within or outside the organization, the new leader will need not only talent equal to that of his or her “shadow,” but a similarly inspirational personality. Skill alone is not suffi cient for leadership of such an organization.

Making Services Work for the Poor: Nine Case Studies from Indonesia 91 Improving Budget Transparency 4

92 In Bandung, West Java Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Case Study 5: Water Supply And Health In Lumajang District, East Java

Water Supply And Health 5

94 In Lumajang District, East Java Thiscase was writtenby Eleonora SukMeiTan, World Bank(Indonesia).Research was basedonafi eldvisitto Lumajang inMarc without baselinesoreff threatened facilitators andfi by highdependenceonexternal isdiffi whileitsimpact nancialsupport, members are unmotivated becausetheyare notlocalorregularly paid. The project’s may be sustainability andinonevillage, theneedto share water sourcesinitially; iscausingconflMaintenance Organization Some ict. negativewithotherwater supplyprojects,prior experiences andlanguagediffi orinaccurately estimated andnational-level maintenance decentralization.High fees, forselection projectsupport, systems, eff ofconcrete to successincludelocalleaders’ contributing roads. factors of 2km Other water well-designed support, involvement. onevillage, for In instance, villagerscopiedtheirmaintenance fee schemeto pay for theconstruction initiative inimprovingofvillagelife otheraspects hasincreased asaresult oftheproject’s emphasisoncommunity increased ofcleanwater availability undertheproject. thanany healthactivities Villagers’ willingness the to take Healthbehavior has,data islacking. however, improved more sincetheprojectbegan,thoughlikely becauseof isimpossibleto say whethertheprojecthasbeenresponsiblecommitment. It for improved health,assupporting problems inonevillage;atleastmore, maintenance staff to pay for amore expansive system. isanopenquestion,withmanagementandmaintenance System sustainability enjoy anincreased senseofownership ofwater supplysystems; somehave even agreed to increase maintenance fees that parents have children more to timeandmoneyto classesandpaying spendontaking for instructors. Villagers increased incomeandsavings, andgreater peaceofmind. Notably, have villagesnow openedintwo kindergartens isbetter. andwater quality shortened oflife Quality hasimproved, ofreducedwater, interms timespentcollecting the tank-to-household 25and43to ratioofbetween 1isratherhigh).Distancestraveled by water have collectors percent oftargeted villagersinvillagesvisited bytheresearch team now have accessto projectwater supply (though EastJava, Lumajang where In theprojectbeganin2002,75 district, participation. and sanitation,community focusrural communities;projectactivities onimproving healthandbehavior, providing better accessto water aimsto improve oflife since2000.It thehealthstatus,andquality ofpoor implemented productivity inIndonesia ofHealth,Planning andPubliccooperation withtheMinistries Works, HomeAff The Second Water developed bythe andSanitationfor Low-IncomeWorld Communities Project Bankin (WSLIC-2), Abstract Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: the author, Institute, theAsh andtheWorld Bankandmaynotbereproduced orreused without theirpermission. was provided Leisher,editorial support by SusannahHopkins consultant (Australia). Bibliography See forworks referenced. This Governance, andMennoPradhan, Miyata, andSachiko Stefan Nachuk, (U.S.A.), Harvard University allofthe World Bank(Indonesia tute), andSriBudiyati, was SMERU provided Institute(Indonesia).Analytical andmanagerialsupport by Winthrop Ins Carty, Ash Pradiptateam membersincludedC.ClaritaKusharto, Paramitha Foundation (Indonesia), Ilmiawan Auwalin (RegionalEconomic Devel ective waterective useregulations Organizations andMaintenance (inmostcases),acareful process ofvillage ective monitoring—particularly anissuefor women, children andthepoor. monitoring—particularly ective are paidonlywhenproblems occur, reducing staff ’s culties put off airs, Education,andFinance hasbeen somevillagers, atleast case iscopyrighted by titute ofDemocratic cultto assess h and April 2005; h andApril ). Analytical and opment Insti- 5

Introduction

The Study Site: Lumajang District Lumajang is one of 38 districts (kabupaten) in East Java province and has 21 sub-districts (divided into 197 villages),

7 urban centers (kelurahan), and a population of over 1 million.116 A rural district, Lumajang has a poverty rate of 31 percent, almost double the national average of 17 percent and signifi cantly higher than the provincial average of 20 percent. More than fi fty percent of the district’s income comes from the production of rice, sugarcane, corn, vegetables and fruit. The majority of the population are Javanese and Madurese and speak their native languages on a daily basis; 60-70 percent of Madurese are unable to speak the national language of Bahasa Indonesia. The majority of the population is Muslim. Water Supply And Health Water District,In East Java Lumajang

Water Supply And Health In Lumajang Lumajang residents obtain their drinking water from four types of sources: a formal, semi-governmental institution called the District Company for Drinking Water (Perusahan Daerah Air Minum or PDAM) which pipes water directly to houses; community sources such as wells, pumps, and tanks; household and natural sources such as wells, rivers, springs and rain; and alternate sources such as independent water vendors.117 Obtaining water is especially problematic in the district’s mountainous areas, where wells must be deep and there are few springs.118 Provincial roads in East Java are excellent, though, so water vendors can reach virtually all villages.

Rural Water Supply National East Java Province District Lumajang

8% 4% 10% 6% 9% 11% 1% Formal institutions Alternative provision 55% 33% 9% Community Supply Household supply 70% 84%

Sources: The World Bank, Indonesia: Averting an Infrastructure Crisis: A Framework for Policy and Action (June 2004) and Village Potential Statistics

Province of East Java (2003).

Over 80 percent of Lumajang residents’ drinking water comes from household wells (58 percent), springs (20 percent), household pumps, and rivers.119 Supply is not too great a problem during the rainy season, though household water collectors frequently must travel about 2-5 km from home, but during the dry season, rivers and wells dry up, forcing collectors to travel greater distances. Water vendors are widely available, but at a cost ranging from Rp. 15,000 to Rp.

116 Lumajang District (2004). 117 World Bank (June 2004). 118 Lumajang District Health Bureau (2003). 119 Central Bureau of Statistics, Jakarta (2003).

Making Services Work for the Poor: Nine Case Studies from Indonesia 95 Water Supply And Health 5

96 In Lumajang District, East Java • Improving health behavior and community health services related diseases. theendof the to waterborne By healthservices Improving healthbehavior andcommunity • • Community participation to promote andeff sustainability participation Community • Providing safe, adequate, cost-eff • 124 Government of Indonesia WSLIC-2 Project Government ofIndonesiaWSLIC-2 Preparation Consultant Team (March 2000). 124 World Bank(May2000). 123 Thefi122 rst underwhich community water supplysys Sanitation for Water Supplyand (WSSLIC), Low Income Communities Project ontheincidence ofdiarrhearefl Data 121 ectsthelikelihood thatapersonhashaddiarrheainthemonthpriortodata colle InPurworejo village, thecost isRp. 15,000permonthforunlimitedwater hoursaday, afew andMeraka butinKalisemut 120 inaugurated infi ve provinces includingEastJava in2000. ofPublic ofPlanning (Bappenas),andtheMinistry Works, was ofHealth,theMinistry cooperation withtheMinistry The Second Water developed bythe andSanitationfor Low-IncomeWorld Communities Project Bankin (WSLIC-2), The Project: WSLIC-2 to 8.5out of1,000in2004. average for thoseyears, inhalf, butby 2004theincidencehadbeencutnearly from 14outof1,000peoplein2001 thandidresidents elsewherea higherincidenceofdiarrhea intheprovince, ashighthenational almosttwice residents foundprovince had thatin2001and2002,district in2003. survey The nationalSUSENASsocio-economic epidemicsforStatistics show thatdiarrhea all age groups were worse inLumajangthe thaninotherdistricts Available dataonwater-related are healthproblems incomplete andinconclusive. inthedistrict The Village Potential income ofbelow Rp. 270,000(US$30). 90,000 permonth(dependingonthevillage),thiswater istoo expensive for thepoorwhohave amonthlypercapita poor communities in under-served ruralvillagesintheprojectprovinces.poor communitiesinunder-served Project componentsinclude: andlocalpeople, andaimstoGovernment ofIndonesia, improve thehealthstatus, productivity, oflife andquality of Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: built inapproximately including46villagesinLumajang. 2,000villagesin32districts, 2006,sustainablewater inDecember andsanitationsystemsproject implementationperiod are to have been village healthvolunteers), andschoolteachers. or levels (includingmidwives andkader anddistrict atvillage,leaders, sub-district healthandsanitationworkers are ofstakeholders involvedmany types inprojectimplementation,includingvillagersandvillagehamlet are for materials suchaswashbasinconstruction provided. smallhealthandsanitationactivities methodology; health andschoolstaff healthandhygienecommunity-selected topics into schoolhealthprograms. The projectpays asmallstipendto communities andschools, includingdevelopment andproductionofMPA-PHAST andintegration materials of hygiene andsanitationtransformation (MPA-PHAST) in assessmentandparticipatory issupported participatory structed andchilddiarrheawas reduced, May2000). Bank, was implementedfrom 1993to1999(World so theaverage householdusing50litres adayfaces amonthlycost ofRp. 90,000(US$10). for implementation ofprojectactivities,aswell astrainingthemintheuseofMPA-PHAST 121

of Method ective, andeasilyaccessiblewater supplyandsanitationservices. 120 122 isfundedby IDAWSLIC-2 (the World Bank),AusAID, the ectiveness ofprojectactivities.Underthiscomponent, ectiveness 124

ction. n itisRp. 1,500per25litres, 123 tems were con-

5

Research Questions And Methodology The research team visited the fi eld for ten days in March and April 2005, travelling to fi ve villages in four sub-districts of Lumajang: Jatisari (Kedungjajang sub-district); Kalisemut and Merakan (Padang sub-district); Pakel (Gucialit sub-district); and Purworejo (Senduro sub-district). These villages were chosen because they represent a variety of experiences in project implementation: successful and less successful water supply systems, completed and ongoing construction, the challenge of negotiating shared water sources, and unexpected follow-on innovations. They also all have poverty rates higher than the district average, ranging from 37 to 45 percent.

The primary research tools were semi-structured interviews and focus group discussions in which timelines, institutional and political analysis, and transects were used. In the chosen villages, six water facilities (including tanks and pumps), two sub-district health centers (puskesmas), and two schools were visited. More than 100 people were Supply And Health Water District,In East Java Lumajang interviewed, including the head and 5 staff of the District Health Bureau, the Project Manager, 12 facilitators and consultants, 25 members of 5 diff erent Maintenance Organizations, 6 local health staff including sanitation specialists, 10 teachers, and 50 villagers. In addition, about 20 people in Merakan, Purworejo, and Kalisemut were interviewed while actually using pumps and tanks, with follow-up visits to their homes to observe household sanitation facilities. Focus group discussions were held with Kalisemut villagers at weekly project implementation meetings.

Three hypotheses were tested during the fi eldwork: • WSLIC-2 has increased villagers’ access to water, which has improved their quality of life. • WSLIC-2 has increased villagers’ feeling of ownership of water supply systems, which has increased the systems’ sustainability. • WSLIC-2-sponsored health education in schools and health care centers has improved villagers’ health and health behaviour, in part because the project involves many stakeholders.

Impact Of WSLIC-2

Key Events in the Second Water and Sanitation for Low-Income Communities Project ( WSLIC-2) in Lumajang WSLIC-2 projected to Start of Implementation end; WSLIC-2 Implementation of WSLIC-2 in to have been WSLIC-2 Implementation throughout of WSLIC-2 in 30 villages implemented in Implementation of WSLIC-2 in 24 villages 42 villages Indonesia Implementation of WSLIC-2 in 18 villages of WSLIC-2 in 3 11 villages villages

2001 2002 2003 2004 2005 2006

2000 2007 Water systems Water system Water system District Project constructed in constructed in to be Management Kalisemut and Pakel and completed in Unit formed Merakan Purworejo Jatisari

Making Services Work for the Poor: Nine Case Studies from Indonesia 97 Water Supply And Health 5

98 In Lumajang District, East Java 75 percent ofvillagersnow have accessto water through theproject. theremaining tanksorpumps.supply systems 12hamlets, bycommunity In becausetheyare nearly already served visited is30ha(inPakel village),whichwould require atravel distanceofnomore thanabout1km. asthenewwater tanksareshortened, neartheirhomes. byaprojecttankinthevillages The largest area served Even hamletsmusttravel intherainy season,thedistancethatvillagersfromfor participating water isnow greatly maintenance problems have reduced accessinMerakan. using riverwater—these householdsare slated to jointheprojectsoon,however. addition, managementand In (b)theyhadaccessto waterbelieve vendors, theprojectwould work, and(c)someofthempreferred to continue households in1.75otherhamletsofPurworejo whowere because(a)theydidn’t initiallyunwilling to participate andonehamletinPurworejo whofeel themaintenance30 householdsinKalisemut fees are too expensive, and360 128 Assuming a 30 ha rectangle of sides 0.3 km and 1 km inlength. a30harectangleand1km Assuming ofsides0.3km 128 Team calculation, assuming 400villagersinMerakan have access, and notincludingJatisariwhere construction isongoing 127 Construction isongoingin Jatisari village, thefi126 fthvillagevisited by theteam,soitisnotincludedinthisdata. Lumajang Project District Management Unit. Allproject tanksinthedistricthave about3faucets eachsocan about serve 125 Lumajang. natural sources tankshave to in24ofthe46villagestargeted community beenconstructed bytheprojectin up. seasonwhensources Now, closerto homedry inthedry pipedwater large systems connecting particularly Yes. Prior andbathing, to projectimplementation,villagershadto water walkfarto forcooking collect drinking, Villagers’Has WSLIC-2Increased management unitininfrastructure management,maintenance andrepair. Organization members are byvillagersandtrained localpeopleelected projectfacilitators, consultants, and water source isreported,Organization itistheresponsibilityofvillageMaintenance to repair it.Maintenance animals, bathing, laundry, water. anddefecation, asasource ofdrinking When aproblem withthecleanlinessofa Water hasalsoimproved hamletsnow usetheriver, quality asnovillagersfrom participating polluted bydraft pipesinsidetheirhomes,connecting cuttingtravel distanceto nil. the better-off the water supplysystems. thevillagesvisited, In Once villageshave beenaccepted for fundingby theproject,itisupto villagersto decideinwhichhamletsto build andfaraway.dirty Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: 125 Most ofthenewwater supplytanksare Most reliable, cleanandclose, replacing sources thatwere unreliable, families(234inPurworejo and30inPakel) have to eveninstalloneormore paidextra faucetsand 126 Access 5outofthe17hamletsdidnotreceive projectfundingfor water To Water? 127 The remaining 25percent include:about 3peopleatonce. . 128 Many of 5

WSLIC-2 Water Supply Coverage in Villages Visited129 Village Kalisemut Merakan Pakel Purworejo Water sources, River, vendors, Household wells, River, community Community well, pre-project community water vendors, river, tanks, vendors spring pump springs Number of community 9101732 tanks built by project Population of targeted 260 (1 out of 4 435 (2 out of 4 465 (all 3 hamlets) 1227 (all 6 hamlets) hamlets hamlets) hamlets) Percent of households in

targeted hamlets with Supply And Health Water District,In East Java Lumajang 88% ~90-95% 100% 54%130 access to project water supply Number of households per 25-28 39-43 26132 14-31133 community tank131 Year of completion 2003 2003 2004 2004

Source: Lumajang District Project Management Unit.

Has Increased Access To Water Led To Improved Quality Of Life? Yes. Improved access to water has reduced the time villagers, particularly the poor, must spend on water collection, allowing them to use that time for other things.134 Poor villagers and children in particular have benefi ted. Many mothers now have the time to cook a hot breakfast for their children, who therefore have enough strength to put in a full day at school rather than coming home early.135 Mothers also now have time to bring their children to kindergarten and assist in the classroom, leading to the opening of kindergartens in Kalisemut and Pakel.136 Evening classes for adults to fi nish elementary school have also now opened in Pakel. “Education is very important for our future generations. To set a good example to my grandchildren, I go to evening school,” mentioned one grandfather in Pakel. Some villagers use their new free time to go to the mosque; the District Project Management Unit reports more mosques have been built since project implementation began.

Some villagers have also enjoyed an increase in income or savings due to the project. Full-time Maintenance Organization members (there are about three per village) are paid for their work out of maintenance fees (the salary varies from village to village). The water systems have also allowed some villagers to develop new income

129 Not including Jatisari village where construction is ongoing. 130 Within a few months another 360 households plan to join the project, increasing the percent of participating households to almost 85%. 131 Lower number equals the ratio of participating households to tanks; higher number equals the ratio of targeted households to tanks. 132 30 households in Pakel have private connections and do not use community tanks. 133 234 households in Purworejo have private connections and do not use community tanks. 134 It is likely that women are the primary benefi ciaries of this change, though no gender-specifi c data is available. 135 Elementary school teachers in Kalisemut and Merakan. 136 Parents and members of Village Implementation Teams.

Making Services Work for the Poor: Nine Case Studies from Indonesia 99 Water Supply And Health 5 100 In Lumajang District, East Java 3 Facilitator forKalisemut. 137 pay amonthlyfee for maintenance. of ownership”. villagersintargeted Most thesystems theirlabor andmoneyto hamletscontributed and construct Yes, ifoneusesvillagers’ ofmoneyandtimeasproxies willingness contributions to make for theintangible “feeling Systems? Has WSLIC-2IncreasedVillagers’ Water Of Feeling Ownership Supply Of and four peoplewhoraisefi shinthevillage. thatrequirecottage industries areliable andconvenient source ofwater. Now, there are four orfi producersve brick generation schemes. produced Priororraisedfi bricks to projectimplementation,nooneinKalisemut sh,both family. oreven theprovince, sometimes outsidethedistrict in search withmajor potential fi ofwork, nancialgains for his no longersuff seasonthere were daysdry for whenwe looked water allnight.” familieshave Sincetheprojectbegan,participating Finally, theprojecthasgiven many villagersgreater peaceofmind. As onepersonrecalled, “Before inthe WSLIC-2, their homevillagesinresponse to thegreater ofcleanwater, availability apotential boostto thevillageeconomy. Some smallbusinessowners, suchasafemale have bread brought producer theirbusinessesbackto inKalisemut, andPakel.Kalisemut instructors’ tocontribute kindergarten in salaries, whichwasinstrumentalintheopeningofnewkindergartens percent, whichisnow available for incomeandsavings otherthings. have Higher madesomefamiliesmore ableto 3,000 now Rp. spendbetween 1,000andRp. 7,000amonthfor unlimited supply—asavings anearly ofupto 90 (US$3,600) in kind andlabour,(US$3,600) inkind demonstratingownership ofthesystems from thebeginning ofconstruction. into theirown hands.” sleeping people;itgave themtheincentive to… take matters woke up The headofPakel villageexplainedthat“WSLIC-2 isthefi“WSLIC-2 rsttimethepeoplehave beentrusted.” infrastructure,” and, “Together withthefacilitators we have created thewater system ontheeveningoffi fthofMaywithbull-races,” of [thewater system];we celebrated ofthewater thebirth arediscussion toldtheresearchhappy andproud team,“We Pride villagersinafocus group inachievement.Kalisemut Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ered from andinmany awaterfamiliesthebreadwinner shortage, hasthusbeenableto leave home 137 Villagers whopreviously purchased water atadailycostofRp. WSLIC-2 pays uptoWSLIC-2 Rp. 200millionfor a villagewater supply contributed Rp.contributed 8million(US$900)incashandRp. 32million for Eachvillagehastherefore eachvillagesystem inthisdistrict. possible, sotheprojecthaspaid maximum,Rp. 200million, only pipedwater systems—the mostexpensive type—are andlabor).BecauseofLumajang’s16 percent inkind geography, 20percentcontribute ofthetotal (4percent mustbeincashand Unitisrequired.of theManagement Villagers are required to system; for larger villageswithhigherproject costs, theconsent 5

Average monthly maintenance income and expenses, Purworejo INCOME (Rp.) Amount Sub-total An even greater burden was placed Basic monthly 3,000 2,010,000 670 contributors on Purworejo because of its large household population—fi ve times the number maintenance fee of participating households than in Additional fee for 2-4,000 468,000 234 direct connections Kalisemut. Though there is a project individual household to the house mechanism by which a large village connections Sub-total income 2,478,000 may apply for more WSLIC-2 funding, EXPENSES (Rp.) this requires a long waiting period. Maintenance 40,000 40,000 Expenses ranged Purworejo villagers did not want Water Supply And Health Water District,In East Java Lumajang From Rp. 15,000 to Rp. to wait, so they decided to pay for 205,000 monthly in the the necessary extra costs of a water past 8 months system extensive enough to serve Maintenance 100,000 100,000 them all, including more piping and Organization head more community tanks. In the end, salary Purworejo villagers each paid a one- Maintenance 100,000 100,000 time construction fee of between Rp. Organization worker 20,000 and Rp. 50,000 (depending salary on income level), totalling about Rp.

Maintenance 50,000 100,000 2 staff 29 million (US$3,200),139 or over three Organization staff and a half times more in cash than salaries required by the project. This certainly 1 Health worker 20,000 240,000 demonstrates villagers’ ownership of 5 Health volunteers 247,800 Each receives 10 the system. percent of the maintenance fees s/he Once the water supply system has collects138 been built, households begin monthly Sub-total expenses 827,800 maintenance payments. Each village MONTHLY BALANCE 1,650,200 has its own maintenance fee system, which may depend on household income, amount or type of water usage (household, agricultural or business), and/or the extent of household connections to the system. In Pakel and Kalisemut, the 100 percent payment of maintenance fees is evidence of a

138 Assuming that they systematically collect all the fees. 139 There were 870 contributors since not all hamlets agreed to the higher fees. A total of Rp. 29 million assumes one-third of the contributors paid 20,000, one-third paid 30,000, and one-third paid 50,000, but the actual breakdown is unknown.

Making Services Work for the Poor: Nine Case Studies from Indonesia 101 Water Supply And Health 5 102 In Lumajang District, East Java Organization stillhasabalanceofRp. 8monthsofoperation. 3.2millioninitsaccountafter rather thanpaying more cash,theydecidedto raise500Sengontreesoftimbertree) (atype for sale. villagersagreedtravel. thatmore Kalisemut, moneywasneededto ensure In system maintenance inthefuture, but cutthedistancewater would to collectors villagers elected have buildalarge numberoftanks—32—to to further the size ofthevillagerequired alotofpipes, sothere over to wasnoprojectmoneyleft buildthetanks, andbecause tap, Rp. 3,000for 2householdtaps, andRp. 4,000for 3householdtaps. bothbecause The increase wasnecessary increase thebasicmonthlyfee from Rp. 1,000to Rp. 3,000,withanadditionalRp. 2,000permonthfor onehousehold previously-set maintenance fees to cover Purworejo, neededcosts. In Organizations alltheMaintenance decidedto Local insomehamletsto voluntarily increase ownershipisalsoapparent inthewillingness ofprojectparticipants 4 Thisbalance ismuchlower thantheproduct of 8monthsandRp. 1,650,000(theaverage monthlynetincome, seetableabov 141 Thelow paymentrate isduetoonehamlet’s refusal topaybecause of maintenance feesthatare higherthaninitiallypro 140 OrganizationMaintenance members are onlypaidwhenthere are problems. and oneatnight,to ensure continuedsupply. There is, however, insomevillages, amajorthreat to sustainability: the source, villagershave agreed to supplywater to schedule, hamletsonanalternating two oneintheafternoon villagers raisedfees, while inPakel, where water hasbeenslowly availability decreasing asaresult oferosion near villagers have adjusted theirschemes’ managementto address problems withaviewto sustainability. Purworejo, In easily covered thecostsofneededrepairs—which inPakel have bothPurworejo notbeeninsubstantial. andPakel, In this isdueto villagers’ senseofownership fees isanopenquestion.Maintenance have mostlybeenpaidandhave of theirsystem. The systems intheotherthree villageshave agreater potential for sustainability, thoughhow much reducedlikely villagers’ senseofownership. Allthishasledto poorfi nancial and technical prospects for sustainability isdecreasing.collection Organization thattheMaintenance membersareThe fact notfrom thetargeted hamletshas in 2003,thesystem hassuff The available information impliesthatMerakan’s system isnotsustainablewithoutmajorchanges. Sinceitscompletion stakeholders. might have isalsodiffi increasedofsustainability thelikelihood systems, littlebasisfor gives assessingtheirsustainability. very The degree to whichvillagers’ senseofownership for years. lessthan two Kalisemut, timeperiod, andthelackofany technical orfiThe short nancialevaluation ofthe Purworejo andPakel,In thewater supplysystems have beenoperationalfor lessthanoneyear, and and inMerakan Systems? Water Of IncreasedTheSustainability Ownership Supply Of Has AGreaterSense sense ofownership ofthesystems, whileinPurworejo, despite apayment rate ofonly76percent, Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: additional costs ofthewater systemsinPurworejo outofmaintenance fees. whichwere paidforinpart project are soonasthey now convinced by theproject’s success elsewhere. oftheproject soare notincludedin thisrate;About 360householdsin1.75otherhamlets hadrefused topayatthestart the ered from problems withmanagement,maintenance andfi nancing.Maintenance fee cult to ascertain without in-depth interviewing of interviewing withoutin-depth cult to ascertain 141

mised by thevillagehead. 140 the Maintenance theMaintenance e) because ofthelarge y are slatedtojointhe 5

Has WSLIC-2 Health Education Improved Villagers’ Health And Health Behavior? It is impossible to say whether the project has been responsible for improved health. Health workers, sanitation workers, and doctors from sub-district health centers do report a decreased incidence of serious cases of diarrhea and skin infections in project villages, and assert that the improvement is due to both the greater availability of water for household uses and healthcare, and the increase in programs promoting healthy behaviour since WSLIC-2 began. Supporting health data is collected three times during the project’s lifespan: to provide baseline information, during a mid-term review, and one year after the project is completed. This data is gathered using MPA-PHAST, but the guidelines are not always followed,142 and thus data is not representative. District health data from sub-district health centres show a remarkable decrease of diarrhea incidence in some villages, but fl uctuations or even increases in other villages; in any case, district health data is well-known to be frequently inaccurate and does not distinguish Supply And Health Water District,In East Java Lumajang between project and non-project households.

Healthy behavior has, however, increased as a result of the project—though it seems this is more a result of increased access to clean water than of health education.143 The research team observed villagers in non-project villages collecting river water next to cows and bathers, while in project villages the proximity of cleaner water has reduced the need to rely on this polluted source. Prior to project implementation, three of the four villages relied at least partly on polluted rivers for their drinking water, but now only some villagers of 3-4 hamlets continue to collect river water. According to interviewees, the greater availability of water and time have enabled many villagers to cook a morning meal and bathe daily. Merakan sanitation workers and midwives report that midwives are pleased to have a supply of clean water to use in deliveries: “Now that clean water is available, delivery of babies happens with this water, whereas before we had to use what was available.” Teachers in the two elementary schools visited, villagers, and staff of the Maintenance Organizations in Kalisemut and Pakel report that since the water tanks were built, students come to school freshly bathed, while teachers in Merakan and Kalisemut also mention that they can regularly clean their schools with the now-abundant water. Villagers in Pakel have been particularly innovative. Though they were not willing to make separate contributions to a local health care fund, once it was decided to connect water system maintenance fees to the Rp. 1,000 health fund payments, all households agreed to pay the extra amount. The health fund allows them free consultations at the puskesmas. Villagers said, “We’re happy with the health fund because we can get free health care.”

Project health education activities being implemented in Lumajang include: • a government program begun in the 1970s to teach students and families how to bathe and use the toilet; • a “hand-washing” program (cuci tangan) which teaches children to wash their hands with soap before eating.

142 Project guidelines require that data be collected in a representative manner from villagers, disaggregated by income level and gender. However, the team observed that in some cases data was not gathered in this way. 143 The Project Appraisal Document itself included only general indicators for health behavior: “[number of] village PHAST programs carried out, number of school programs [for health] functioning, number of functioning Village Implementation Teams established,…knowledge and practice of good hygiene and health” (World Bank, May 2000, pp. 31 and 33).

Making Services Work for the Poor: Nine Case Studies from Indonesia 103 Water Supply And Health 5 104 In Lumajang District, East Java 4 Thisgoesbeyondtheproject’s village. goalofmerely increasing thenumberoflatrinesinevery 144 household bytoilet the17thofAugust for thisyear. every additional fi towardIn costs. construction nancialsupport Maintenance OrganizationPakel, the aims to buildone ofconcrete roads. of2km construction This initiative waswell received bythevillageheadwhocontributed them upontheoff of free water inexchange. According Organization, to theManagement almost100percent ofvillagershave taken Organizationthe Maintenance hasencouragedpeopleto build fences around theirgardens by off initiative themselves, Organizations usingtheMaintenance already Kalisemut, establishedthrough theproject.In other villagefacilities. They have becomelessdependentonleadershipfrom the outsideandnow sometimestake assessment skills. Through thisexperience, villagershave cometo realize thattheyhave thepower to improve The project’s involvement emphasisoncommunity hasstrengthened villagers’ planning, management,and ofwater supplysystemsThe construction isdependentlargely ontheachievements ofthevillagersthemselves. Benefi What Unexpected has hadatleastasmuchto dowiththeimprovement inhealthbehavior. to fruitionatthevillagelevel.activities However, asnoted above, thatincreased itislikely accessto cleanwater alone are alsoinvolvedand villagehealthvolunteers (kader), intheprojectandhave healtheducation helpedto bring and government healthactivities.Many otherstakeholders,suchaslocalleaders(formal andinformal), midwives stakeholders’ for have theproject; theyinturn increased support pressure inbothproject onvillagersto participate and trainingby healthfacilitators to promote bothnewandoldhealthy behavior programs hasincreased these Yes, ithasdefi nitely contributed to theimprovement. Providing healthandschoolstaff Behavior? Has TheInvolvement Many Stakeholders Of BeenKey To Improving Health ofa construction “healthy house” to increase (rumahsehat)inPakel villagers’ andschoolcleaninginMerakan • a aday” twice “bathing program for studentsandtheirfamilies; • changes in attitude and behavior as one of the key projectbenefichanges inattitudeandbehavior asoneofthekey ts. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: health andsanitationawareness. required cleansing. ritual students are now prayers; ableto goto before, mid-day theycouldnotbecausewere unableto dothe cleanliness oftheirstudentsondailyattendance records. isevidentthatstudents’ It behavior haschanged, as to use, andhealthstaff Teachers andhealthstaff er. thesame village, peoplecopiedtheirwater In schemeto system pay contribution for the have trainedteachers to checkstudentsfor Pakel, cleanliness. In teachers record the have builtwashbasins(fromorother available for material) paintbuckets thechildren ts HasTheProject Brought? 144 Project participants andtheresearch Project team participants seethese withfi nancialincentives amonth ering 5

Factors That Contributed To Success

The poor want to pay. Offi cially, the poorest do not have The project’s emphasis on villager involvement in planning, to contribute anything toward construction, though most construction, management, maintenance and fi nancing say they want to contribute just as other households do; helps ensure the water systems’ sustainability, and by project staff say this is because they want to be sure of having the same rights and ownership as other households. empowering some communities, enabled them to improve The monthly payment fees in Purworejo village range from other aspects of village life as well. Experience from previous Rp. 5,000 for the poorest households to Rp. 50,000 for the projects, notably WSSLIC, the Village Infrastructure Project, and richest households. the KDP (Kecamatan Development Project), emphasized the importance of community participation in planning, production, fi nancing and maintenance to project sustainability.145

Under WSLIC-2, villagers themselves decide how many tanks to construct and where to put them to ensure Supply And Health Water District,In East Java Lumajang accessibility. Mandatory villager contributions for construction and maintenance—set by the villagers themselves— ensure villagers literally own their water supply systems, and are more likely to understand and support the maintenance necessary for sustainability. Villager-elected Village Implementation Teams (Tim Kerja Masyarakat or TKM) (responsible for managing construction) and, subsequently, Maintenance Organizations (responsible for system management and maintenance) keep villagers closely involved in project implementation—indeed, almost all members are local villagers themselves. As a result of this intensive villager involvement, most villagers—including the poor—see the systems as being worth their money, and many have become empowered by the process. New village improvement projects such as latrines and pre-paid healthcare are additional benefi cial outcomes.

The new water supply systems were mostly well-planned and well-executed technically. Perhaps most importantly, the systems are designed to ensure that water sources do not run dry. Village Implementation Teams in collaboration with project facilitators and consultants carefully calculate the number of households or hamlets that can sustainably be served from each source and plan the system accordingly. Only in areas where water is especially plentiful are private connections an option. Another important aspect of system design is that tanks provide no space for showering. In projects where more sophisticated tanks are built, people often bathe in situ, but this requires more water than the traditional Indonesian bucket bath or mandi at home, and if water is scarce can create confl ict.146 Tank design thus gives people the incentive to take water straight home.

Leading the way in Kalisemut. Mr. L., the informal The support and involvement of local leaders, both formal Kalisemut village leader, has always been highly involved and informal, has been crucial to project support. Leaders have in organizing community activities and was a fervent helped to convince villagers of the need for clean water supply, proponent of WSLIC-2 from the beginning. Together with project facilitators, he talked to the villagers at meetings at and the potential of the project to provide it. Moreover, local his home or in the mosque, slowly increasing local support leaders have been instrumental in assuring villagers that they are to fi nance the new water system. After construction was capable of making the required total contribution of Rp. 40 million complete, he was elected by the villagers as the head of (US$4,400). In successful project villages such as Kalisemut, Pakel the new Maintenance Organization.

145 World Bank (September 1996 and May 2000) and Ministry of Home Aff airs et al. (June 2002). 146 District Health Bureau staff .

Making Services Work for the Poor: Nine Case Studies from Indonesia 105 Water Supply And Health 5 106 In Lumajang District, East Java Water useregulations reduce thepotential for confl becameproject supporters. and quickly and Purworejo, villageleadershadalready beenhighlyinvolved to projectimplementation, prior inhamletactivities Organizations, asmanifested bycontinuedmonthly maintenance contributions. up withingeniousways to solve theirproblems.” increasedThis hasinturn the villagers’ trustintheMaintenance Organizations “are more withtheinfrastructure thanwe, experienced thetrained specialists, andmanageto come the localpolitics,theiradviceandtrainingmore whichmakes eff theproject,aswell asareala personalincentive bondwithvillagers. to support They are moreto understand likely they are young, energetic peoplenewlygraduated from university. are Most from theprovince, whichgives them theinitialstagesofprojectstay andcanalways for inthevillagesduring becontacted Lumajang, advice. In Organizations are composedofthesamepeople, whichhasincreased theeff manyneeds assessmentandhealthpromotion. cases, In Village Implementation Teams andMaintenance training both Village Implementation Teams Organizations andMaintenance ontechnical issues, management, Facilitatoradvice to Community two Teams, whichare HealthBureau responsible staff (together withDistrict ) for development consultantprovide community technical technical consultant andonedistrict-based One district-based regulation (Peraturan letter listingthemembers, oranauthorization Desa) theirtasks, andtheirterms. supply system. Organizations Maintenance are independentinstitutionsthatare madeoffi (sometimes referred Organization, to asaManagement orBadanPengelola) of8-10membersto managethewater iscomplete, Organization aMaintenance thattheyare construction After thevillageelects fact paidfor theirwork. Organizations Maintenance areMost trusted andeff ofwater-relatedbeen noreports problems villages. withneighbouring seasonwhennaturalwater sources are low.Kalisemut’s thedry tanksduring As aresult, there inBulukubung have the pipesthatguidewater to Kalisemut’s tanks. Villagers from villages are neighbouring alsoallowed to use full useofthesource. return for thesevillagersagreed In freeofandaccessto to thetank, construction maintain source islocated. tankwasbuiltatthesource to Anextra villagers, provide whopreviously water to had Kertowono wherehead andprojectfacilitators thewater madeanagreement villageofKertowono withtheneighbouring for instance,completion ofthewater hamletofKalisemut, theImplementation system inBulukubung Team, village potential for intra-village confl icts.Regulationshave alsobeeneff to water for homeuse, butagricultural andbusinessusesare allowed onlyiftanksare overfl owing, reducing the Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ective, dueto theirtraining, theirlocalbackgrounds, andthe ict. Participating householdsare given unlimited access ective inreducingective inter-village confl ict. to the Prior theystate thattheMaintenance fact, ective. In ectiveness ofthetraining.ectiveness Facilitators cialwitheitheravillage 5

From each according to his or her ability. In a social mapping Villages were required to go through a lengthy process exercise, villagers list the local criteria for poor, average, and rich to obtain project support, which created understanding villagers, and then divide all village households into categories accordingly. Contribution and maintenance fees are then of and support for the project on the part of village agreed upon, with higher fees for those in higher income groups. leaders and, eventually, villagers themselves. Villages This ensures that everybody can participate in the project. The with a low availability of clean water, limited sanitation transparency of the process has increased its accuracy and facilities and a high incidence of poverty and diarrhea in villagers’ satisfaction with it. children under 5 years were eligible for project support. Local solutions to local problems. The Maintenance Villagers had to be willing to contribute to and manage Organizations “manage to repair the water systems in ways that we had not considered. They use materials such as bamboo, construction and maintenance of water supply systems in plastic paint boxes, and wood to repair the infrastructure. These order to obtain project funding.147 Once project villages had

materials are more aff ordable for them. Our opinion is that the been chosen, project facilitators involved all villagers in a Supply And Health Water District,In East Java Lumajang repairs are well done... Over a short time period, the Maintenance careful process of assessing village needs and increasing Organizations have become more specialized than we [the project consultants]!” local awareness of the need for clean water supply. Facilitators explained the fi nancial and time implications of involvement in the project to villagers in detail. Following this process, villages still interested in participating in the project were required to make community action plans (rencana kerja masyarakat) with the assistance of project facilitators, in which they described the wishes and needs of their community and how they intended to achieve their goal for water supply. Facilitators led focus group discussions and meetings (with a minimum of 40-50 villagers each) to carry out social mapping exercises to fi x construction and maintenance fees. Finally, action plans were evaluated by the Central Project Management Unit. Once accepted, villages were allowed to begin collecting contributions for construction.

Villagers’ desire to make better use of water and the positive experiences of the initial WSLIC-2 project villages have made other villages in Lumajang fertile ground for project implementation. Most people want to bathe, cook breakfast, and clean their homes and schools regularly; they do not want to use polluted water sources. The project’s success in providing clean water for households and schools in Pakel, Purworejo, Kalisemut and (to a lesser extent) Merakan has made Jatisari and other villages in the district eager to join. There is no longer a need to convince people of the project’s value.

National-level policy changes related to decentralization and the water supply and sanitation sector created an enabling environment for WSLIC-2. Decentralization, introduced in 1999 and fi rst implemented in 2001, and the evolving national Rural Water Supply and Sanitation Policy, which emphasizes (inter alia) decentralization of rural infrastructure to local levels, paved the way for village-level management of all kinds of projects, including WSLIC-2.148

147 Government of Indonesia WSLIC-2 Project Preparation Consultant Team (March 2000) and District Health Bureau. 148 World Bank (May 2000), pp. 4, 5, 124, 132.

Making Services Work for the Poor: Nine Case Studies from Indonesia 107 Water Supply And Health 5 108 In Lumajang District, East Java paid. For example, inPakel, membersare onlypaidwhenthere are problems to fi x;themonthlychecks thatthey Being localisnotenoughto ensure Organization commitment.Some Maintenance members are notregularly 149 District Project District ManagementUnit. 149 is notstrong enoughto…support…WSLIC-2. We aboutleadership.” needto learn Project staff fees, to collect andthevillagersstillhave OrganizationMaintenance trying isnot actively accessto projecttanks. leaders from thosehamlets, even withassistancefrom projectfacilitators. Despitelowmaintenance payments, the members, thoughfrom thevillage, donotlive inthetargeted hamlets, asvillagers were unableto fi ndappropriate Unmotivated Maintenance Organizations alsothreaten sustainability. eff through whichthepipesare laid, orwhichabutthe sources themselves, were notincluded, reducing theregulations’ somevillage, regulationsIn were made, butonlyby thehamlets thatusethewater systems; hamletsandvillages has greatly decreased. paragraph), resulting inlate repairs andasubsequentlackofwater, villagers’ willingness to pay maintenance fees water from Merakan’s source. Together withthelow commitmentofMerakan’s Organization Maintenance (seenext OrganizationMaintenance to anticipate andresolve theproblem, peoplefrom villagersare nearby now stealing if sources are signifi where no cantlydiminishedwith greaterregulations hadbeenmade Merakan, by the In use. near thesesources whichhadalready beenusingthemfeel threatened bythenewusersandconfl canarise ict andmostprojectvillageshavewithin villageboundaries hadto rely onsources outsidetheirborders. Households Sharing water sources poseaseriousthreat to sustainability. from thishamletwillrenew theirpayments. Organization closed off especially letdown by him. maintenance payments,Three theystopped monthsafter making theirMaintenance before anyone else, helpinghimto convince villagersintheotherhamletsofproject’s value. Therefore, theyfeel hamletwere especiallyupsetattheincreasein thisparticular becausetheyhadbeen thevillagehead’s supporters fee.substantial construction promiseThough thevillageheadhadmadesamemistaken to allhamlets, thepeople that villageforced fees upto Rp. 3,000,villagersinonehamletrefused thoughtheyalready to pay—even paida monthly fees ofjustRp. 1,000by thevillagehead. When anincrease inthenumberofwater tanks plannedfor pay for buttheyrefuse construction, becausetheyfeel Purworejo, ashamed. In villagershadinitiallybeenpromised Organization, thesehouseholdsmay maintenance stillcontribute fees andusethewater even thoughtheydidnot not contribute, theirwater continuingto from collect theriverinstead. According to theheadofMaintenance feel themaintenance fees ofKalisemut are tooAbout 30householdsinthemostdistantpart expensive, sotheydo Inaccurately estimated, increased, orrelatively highmaintenance fees are unacceptable to somevillagers. Limitations To Project Impact Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ectiveness. realize andconcedethat thatlocalmanagement iscrucialto projectsupport, theleadership “in Merakan theirpipes. thevillagers seasonstarts, OrganizationThe Maintenance hopesthatoncethedry Water sources are usuallynotconveniently located Merakan’s Organization Maintenance 149

5

perform are unpaid.150 The head of Pakel’s Maintenance Organization was assigned for a two-year period, and was very excited and proud of the water system right after construction, but now says, “I’m tired of doing this work.” Stories about paid Maintenance Organization members in other villages make him even more reluctant to continue. He wants to stop when his term is over, but is dependent on the village head to assign another leader for the Maintenance Organization.

In all WSLIC-2 villages, many people have had negative experiences with other water projects, such that some households still do not believe this project will work, so they do not participate. In Merakan, prior to WSLIC-2 implementation, water pumps were built under the KDP program. According to villagers and Bureau of Health staff , poor maintenance and incorrect use of the KDP water pump resulted in depleted water fl ow and a broken pump after six months. The villagers did not know how to repair it so they began to use river water again. Supply And Health Water District,In East Java Lumajang While the main reason for low project success in Merakan is an ineff ective Maintenance Organization, it is likely that villagers’ prior experience with KDP has compounded the problem.

About 360 families in Purworejo and 30 families in the most distant part of Kalisemut were initially reluctant to contribute to construction because they did not believe the water system would work, in part because of bad experiences with other water projects previously (other factors included the ready availability of river water and the ability of some of these families to purchase water from vendors). Thus, they did not receive project support. In recent months, however, many of these villagers have observed the project’s success in neighboring hamlets, and have begun to save for the required construction fee to extend the project to their hamlets after all.

Ineffi cient utilisation of water supply. Despite good technical design overall, the water systems could be made more effi cient, especially during rainy season. Leakage of water and overuse in schools is a common sight; excess water could be stored or used in gardens for even greater project impact.

Language diffi culties. Language initially created a problem for facilitators working in Merakan and Kalisemut, where most of the population speaks Madurese. The facilitators were new and did not know Madurese well; however, the project hired a facilitator who speaks Madurese, and eventually the other facilitators learn to cope with the language barrier, so language is no longer a problem.

Making Water And Health Services Work For The Poor The sustainability of project impact after project support ends may be threatened by high dependence on external facilitators and time-bound fi nancial bonuses for local health and school staff . Project staff are preparing for their withdrawal from the district in 2006. To ensure continued support for project activities, they intend that existing government structures such as the District Health Bureau, sub-district government, and local village heads provide advice to villagers as needed, hoping that this support will be suffi cient, and that these structures will merit the villagers’ trust.

150 It is unclear whether this is also the case in Merakan and Kalisemut. In Purworejo, Maintenance Organization staff are paid monthly whether or not there are problems.

Making Services Work for the Poor: Nine Case Studies from Indonesia 109 Water Supply And Health 5 110 In Lumajang District, East Java monitoring), groupsthese two (despite many mentionsintheProject abouttheneed for AppraisalDocument gender-sensitive Again, focused withnodatacollection onchanges inbehavior task. andwellbeingbrunt ofthewater of collection Water to supplyprojects are have well great known potential benefi ts for women andchildren, whousuallybearthe 5 E.g., World Bank(May2000),p. 20. 152 TheProject forexample, Appraisal Document, calls forregular collection of dataonwater andsanitation-related disease 151 project managementto assesstheproject’s onhealthinLumajang. impact Noadequate healthdataisthereforeevaluation ofthedatahasyet beenundertaken. available thatwould enable diffi and key segments of the population—women andchildren—impossible. Inadequate baselineinformation andmonitoring makes assessment oftheproject’s onhealth impact implementation. even thoughtheirneedfor cleanwaterof projectsupport wasjustasgreat for asthatofthoseselected project increasesfacto ownership, maintenance, andthus,Hence, afew sustainability). villagesinLumajang hadnochance over distanceslowprioritized (itisassumedthatthisipso thosewithscattered households, house-to-tank to keep each otherare preferred asaway ofreducing project costandstaff itisthatwatermuch itwillcost,andhowsystems likely willbemaintained. Thus, for example, villagescloseto villages are chosennotonlybasedonneedbutalsohow easyprojectimplementationwillbe, how Despite the project’s focus onpoorandneedyvillages, remote andpoorareas are at adisadvantage. toit topolluted revert sources. households whichcanonlybarely aff for orstressful) (friendly villagersvying between interaction thewater. competitionfor High water mightalsopush motherscouldberesting,housework; for of caring children, andthetype orpursuingincomegenerationactivities), costofthistime(children couldbeplaying,at thetanksfor studyingorhelpingwith theopportunity theirturn, competition for high,possiblyaff water atthetanksisfairly fewer than28households.the projecttechnician ideallyatankshouldserve for thedistrict, The implicationisthat it isonly14inPurworejo, butifalltargeted householdsare reached, thisnumberwillincrease to 31.According to Currently andKalisemut. 25and43inPakel, tankishigh,between The numberofhouseholdspercommunity Merakan The rather ratio hightank-to-household may have anegative onaccess. impact conclusions to bedrawn intheabsenceofbaselineinformation, indicators andregular datacollection. ruralappraisal(PRA) would, however,analyzed rapidruralappraisal(RRA)orparticipatory stillallow meaningful Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: culty gathering supporting datathaninimplementingtheproject. Datagathered isunrepresentative, supporting gathering culty andno illness or to treating the ill (World Bank, May2000, pp. Bank, 30,86-7). illness ortotreating theill(World 152 conclusions about project impact are conclusionsaboutprojectimpact hard to reach. Well-designed, well-implemented andwell- ord itto usetheirscarce fundsto purchase water, orthosewhocannotaff theamountoftimewater mustwait collectors ecting time, andvillageswithdensepopulations are 151

Facilitators appearto have greater rates andontimelost to Project ord 5

Bibliography

Central Bureau of Statistics, “Lumajang District Statistics (Kabupaten Lumajang Dalam Angka),” Lumajang District (2003). Central Bureau of Statistics, “Village Potential Statistics Province of East Java,” Jakarta (2003). Government of Indonesia WSLIC-2 Project Preparation Consultant Team, “Project Implementation Plan” (March 2000). Lumajang District, “Dalam Angka (In Figures)” (2004). Lumajang District Health Bureau (Dinas Kesehatan), “Info WSLIC 2: Lumajang Kini dan Perkembangannya” (2003). Ministry of Home Aff airs, Directorate General of Community and Village Empowerment, KDP National Secretariat Water Supply And Health Water District,In East Java Lumajang and National Management Consultants, “Final Report: Kecamatan Development Program 1998-2002” (June 2002). TKM Desa Kalisemut, “RKM Desa Kalisemut Lumajang Kecamatan Padang” (2002). TKM Desa Merakan, “RKM Desa Merakan Lumajang Kecamatan Merakan” (2002). TKM Desa Pakel, “RKM Desa Pakel Lumajang Kecamatan Gucialit” (2003). “Warta Proyek WSLIC II” (third ed.) (2004). World Bank, “Indonesia: Averting an Infrastructure Crisis: A Framework for Policy and Action” (June 2004). World Bank, “Project Appraisal Document on WSLIC-2,” Report No. 20132-IND, Jakarta (May 2000). World Bank, “Staff Appraisal Report, Republic of Indonesia, Second Village Infrastructure Project,” Report No. 15467- IND (September 13, 1996).

Making Services Work for the Poor: Nine Case Studies from Indonesia 111 Water Supply And Health 5 112 In Lumajang District, East Java Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Case Study 6: Health Insurance Reform In Jembrana District, Bali Health Insurance Reform 6 114 In Jembrana District, Bali andmaynotbereproduced orreused withouttheirpermission. This case studywas B. writtenbyWorld Arya Gaduh, Bank(Indonesia)andLailaKuznezov, Research was consultant (U.S.A.). bas basis ischallengedby a2004law centralizinghealthinsurance. Finally,are usuallyreimbursed infact by JKJ. administrationisgrossly inadequate, investment andJKJ’s legal inJKJ costs, to poornon-members asthosewhoprovide freeinclusion ofpoornon-membersalsoincreases services JKJ claimswere to non-poorclients.cost—in madefor 2004,95percent services oftheRp. 9.5billioninJKJ The informal JKJ’s inclusionofnon-poorcitizens addsgreatlybeen arapid, spendingonJKJ. unbudgetedto increaseits indistrict doesnot,however,referral to hascontributed theimprovement. JKJ appearto befi nanciallysustainable. There has thatJKJ’s enforcement islikely standards onequipment,treatment, ofstrict It medication,and and clientsatisfaction. hasalsoimproved forbothhealthcare doctors publicclinics andprivate competition between quality clients. JKJ poor familiescannotaff of thepoor, from 66percent in2004to 22percent (re-registered underthenewsystem) by 2005,sincemany May behindadrop scheme),andthisislikely inmembership per-person system (ratherthantheoldone-card-per-family poor from joining. JKJ’s attempts to becomeself-fi nancinghave focused recently onanewone-membership-card- registrationhave requirements to refuse thelegalright Meanwhile, themfree have many JKJ services. ofthe kept This increases accessofeven non-memberpoorto healthcare, themto thediscretion butsubjects ofproviders who increased for sharply poornon-members,mostpublicproviders inpractice stillprovide free care for allpoorclients. scheme. to providers theinclusion ofprivate intheJKJ Though onpaper, healthcare costshave out-of-pocket For thepoor, theincrease wasfromisdueprimarily 29to 80percent. accessofthepoorto Increased healthservices of illpeoplewhosoughttreatment inJembranamore thandoubledfrom 40percent in2003to 90percent in2004. citizenspercent were ofdistrict covered ofhealthinsurance;now, byany kind 63percent are covered. The percentage members. The schemehasimproved theaccessofbothpoorandnon-poorcitizens to healthcare. only17 Before JKJ, care isalsoprovided for poor andtertiary healthcare toMarch 2003provides all members;free free secondary primary Baliin schemebeguninJembranaDistrict, orJembranaHealthInsurance) Jembrana(JKJ The JaminanKesehatan Abstract Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: assistance was provided by SusannahLeisher, consultant (Australia). Thiscase iscopyrighted by theauthors, Institute theAsh all oftheWorld Bank(Indonesia),andWinthrop InstituteofDemocratic Carty, Governance, Ash Ana (U.S.A.). Harvard University so, consultant (Indonesia).Managerial, analytical, was provided andeditorialsupport by MennoPrasad Pradhan, Stefan Nachuk, (1999). Research teammembersincluded LailaKuznenov, JanesGinting, consultant World (U.S.A.), Bank(Indonesia)andGregorius Jembrana, Inovasi Satu Peningkatan Pelayanan Jembrana” KesehatandiKabupaten (mimeo),(2003);andADB, Policy fortheHealthS dan Pemetaan Inovasi Program Pemerintah Jembrana, (2004);I.MadeSudaarsena,”Jaminan Kabupaten Universitas Indonesia:Jakarta dence from Indonesia” Studies(2004);Eko Prasojo, in issue40:6ofTheJournalDevelopment Teguh Hasan, Kurniawan andAzwar to Jembrana forMicronutrient-Ri inMarch andtheDemand 2005.Reference “MaternalNutritionKnowledge ismadetoStevenBlock, hasincreased allmembers. increasing ord By accessto providers, toprivate re-enroll JKJ , andtheWorld Bank lytical andeditorial and LinaMarliani, KelikAgus Endar- ed onafi eldvisit ector, Manila ch Food: Evi- Identifi kasi Kesehatan 6

Introduction

As part of its mandate to alleviate poverty in Indonesia, the World Bank is undertaking a series of case studies to promote better service provision, especially for poor and disadvantaged people. The case studies were chosen from the many innovative practices seen in Indonesian local government in recent years, through a competitive outreach process managed by the World Bank. Donors, non-governmental organizations, and local government staff were contacted and encouraged to submit proposals regarding innovative service delivery work that they either were undertaking or knew about. The Jaminan Kesehatan Jembrana (JKJ) health insurance reform scheme in Jembrana District, Bali, touches upon a theme that is central to making services more pro-poor, to wit, the use of private providers to expand service coverage and improve quality by increasing competition. Hence its selection as one of Health Insurance Reform Health Insurance District,In Bali Jembrana the case studies.

The Study Site: Jembrana District The district of Jembrana in the province of Bali has a population of around 250,000 (2004). Jembrana’s annual per capita income in 2002 was Rp. 5.83 million (US$610), below the provincial average of Rp. 6.46 million (US$680). Its poverty rate was 9.0 percent in 2000, slightly higher than the provincial rate of 8.6 percent153. In both per capita income and poverty rate, Jembrana ranks fi fth of Bali’s nine districts154. There are four sub-districts (kecamatan) in Jembrana, including the capital, Negara. Most people outside the capital are farmers, raising rice, cloves, cacao, coconuts and other foodstuff s. Most of the poor are unskilled farm laborers; many work as fi shermen, tradesmen, and farmers. Some areas are hilly, and a lack of public transport means that travel from the countryside to Negara can be expensive and time-consuming.

Healthcare In Jembrana District Jembrana has 12 private clinics, 5 public clinics (pusat kesehatan masyarakat or puskesmas), 49 public village clinics (puskesmas pembantu or pustu), 2 public hospitals and 1 private hospital. The population-to-clinic ratio of 14,800:1 is quite good—half the provincial ratio—as is the population-to-hospital ratio of 84,000:1, which is two-thirds the provincial ratio (2003). There are 84 doctors (including 8 specialists and 12 dentists), 169 paramedics, and 113 midwives (2004), yielding population-to-provider ratios that are roughly in line with ratios at the provincial level (2,990:1, 1,470:1, and 2,220:1, respectively). Over 70 percent of the doctors are civil servants; however, most also have private practices. With the introduction of JKJ, private practitioners compete directly with public clinics and hospitals for primary healthcare patients.

Healthcare in Jembrana is managed by the District Bureau of Health and Social Welfare (Dinas Kesehatan dan Kesejahteraan Sosial). Puskesmas provide primary healthcare (pemberi pelayanan kesehatan I or PPK I), including preventative and basic curative care for common illnesses, health education and promotion, and reproductive

153 Central Bureau of Statistics. The district’s 2002 survey found a higher rate, 12.5 percent, but the national data are cited here to enable cross-district comparison. 154 Technically, there are 8 districts and one municipality.

Making Services Work for the Poor: Nine Case Studies from Indonesia 115 Health Insurance Reform 6 116 In Jembrana District, Bali 5 ADB(1999). 155 to otherproviders.and referring allotherservices system isimplemented, healthcare restricting for providers to whichtheyare providing licensed onlythoseservices control, payments to theproviders andthenmaking basedonsetrates. They alsoensure thatthehealthreferral fi againstasetofstandards for equipment,treatment, rsttheservice verifying andmedicationestablished for quality have medical-related diplomas. Their maintaskisto managereimbursement ofclaimsmadeby healthproviders, Body(Bapel)whichhasastaff Management ismanagedby theJKJ JKJ ofitsdesign. aspect not themostimportant hence, benefipremise ensuring thatallJembranacitizens are healthservices; entitledto quality ts to thepoorwas wassetuponthe paramedicsare noteligible.members whichwillbereimbursed atstandard JKJ rates byJKJ; care. Any generalpractitioner, to to provide contract midwifeservices ordentist,publicprivate, may sign aJKJ provider, participating andtertiary poormembersare eitherpublicorprivate; additionallyentitledto free secondary healthcare, provides includingsomedentaltreatment, allmemberswithfree from primary any in March 2003.JKJ began Body(BadanPelaksana Management orBapel)wasestablished, andimplementationofJKJ 2003, theJKJ healthinsurancescheme, afi fee-for-service dissemination ofthenewdistrict-wide In January Indonesia. rstin PreparationJembrana orHealthInsurance) Team, responsible for thedesign, pilot-testing, and The fiKesehatan (Jaminan December 2002withthe establishmentofaJKJ in rststep inthisdirectionwastaken with free basichealthcare, for aswell thepoor. asadditionalhealthcare services of healthsubsidies, anddecidedthatinstead ofsubsidizingclinicsandhospitalsdirectly, itwould provide allcitizens puskesmas. Second, clinicandhospitalutilizationrates were low. felt thisstemmedThe district from ineffi resulting insavings fallunderthemanagementofnearby from cuttingadministrative structures, sincesub-clinics whichwasunder-supplied, whiledowngrading ficlinic to ahospitalinsub-district status, ve others to sub-clinic provision surplus. the nationalaverage of40,000:1,indicatingaservice The Regentresponded by upgrading one uncovered several ineffi Regent initiated by thenewly-elected focusing andcostofhealthservices onquality survey A 2001district-initiated WhereDidItCome From,JKJ: WhatIsIt? And health services. specialist doctors and equipment are referred to tertiary healthcare, andequipmentarespecialist doctors referred orPPKIII,providers. to tertiary are referred healthcare hospitals. providers More diffi (PPKII),usuallythedistrict to secondary locations inorder torequired gainthepublicclinicexperience for aphysician’s license. Patients whorequire it government hires newlygraduated (Pegawai doctors, whoagree Tidak to intheseless-desirable work Tetap orPTT) poorer andremote ofdoctors. Hence, areas, inamutuallybenefi faceashortage often thedistrict cialarrangement, but alsoallvillageclinicsinthearea 9and14villageclinicsperpuskesmas). (between The puskesmas,especiallyin Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: 155 They are staff ciencies. First, ratiowasaround 20,000:1, half with11publicclinics, thepopulation-to-clinic ed by general practitioners andparamedics, ed bygeneralpractitioners whomanagenotonlythepuskesmas fi offourteen, ve ofwhom are or doctors cult casesrequiring cient use 6

Methodology

The fi eldwork sought to prove fi ve theses: 1. JKJ has improved access of the poor to health services. 2. JKJ has made Jembrana a more attractive place to work for all types of health professionals. 3. JKJ has intensifi ed competition for clients among health care providers. 4. JKJ has improved the quality of healthcare services and increased client satisfaction. 5. JKJ is not sustainable.

Research was conducted in two of the four sub-districts in Jembrana: Melaya and Negara. These were selected Health Insurance Reform Health Insurance District,In Bali Jembrana because they each have a public clinic which serves many poor families. In each sub-district, the team visited the lead public clinic (puskesmas) to speak with directors and staff , as well as a sub-clinic under its management, and then selected a village within the coverage area of that sub-clinic or nearby in which to conduct focus group discussions with poor citizens. Manistutu village in Melaya and Brangbang village in Negara were the chosen study sites. Manistutu was chosen because it had not been served by a doctor prior to JKJ but had two doctors at the time of the research. This village was also considered to be relatively remote (about 45 minutes’ drive from the district capital). The team also visited a banjar (hamlet) in a far corner of that village. Brangbang was selected because it has a large number of poor families, although it is not within the coverage area of the visited sub-clinic. In addition, the team randomly visited doctors holding private hours outside Negara but not necessarily in the coverage areas of the visited puskesmas.

The team used a combination of semi-structured interviews, informal interviews, and focus group discussions. In each village, separate focus group discussions were held with women and with men. The team also spoke with the head of the village and kelian adat (hamlet head), as well as midwives and doctors holding private hours in or near the area. Respondents included over 40 healthcare informants and over 70 citizen-clients. Healthcare informants included doctors, midwives, paramedics, puskesmas directors and other staff , public and private hospital directors, and local offi cials, including the Regent (the head of the district), the head of the Health and Social Welfare Bureau, and the head and staff of the JKJ Management Body. The team began and ended the week by speaking with local offi cials.

Making Services Work for the Poor: Nine Case Studies from Indonesia 117 Health Insurance Reform 6 118 In Jembrana District, Bali 5 SUSENASpeoplehave more (2003/2004).Some thanoneprovider, soannualtotalscannot betalliedinthistable; somepeop 156 advantageofproviding thepoorwith accessto providers. private membershiphastheimportant insured, JKJ Sehatalready, thoughthereby theKartu are no datato verifythis. Though many ofthepoormay thusbedouble- covers only13percent. Given that9percent ofthepopulationispoor, theimplicationisthatallpoorare covered Health insurance coverage inJembrana Improve JKJ Did JKJ Of Impact tes(nldn K)0245.6 0.2 (includingJKJ) Others (government HMO) JPKM Sehat Dana Perusahaan/kantor Astek/Jamsostek P.T. Askes targeting poor households) Sehat Kartu Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor:

2001 (health card) insurance mayactuallybecovered butdon’t by JKJ realize it. services on health Survey District (Jaminan Pemeliharaan KesehatanMasyarakat) frgvrmn mlye)889.4 8.8 (for government employees)

avlaelvlHat udshm)190.1 1.9 (a villagelevel HealthFund scheme) (government HealthCard scheme frpiaesco okr)060.8 0.6 (for workers) sector private (o rvt etrwres . 0.5 0.2 (for workers) sector private rvdr20 2004 2003 Provider Access Of Access Of 022003 2002 Dcme ) (December established Team Preparation JKJ

begun (March) implementation JKJ The Poor To HealthServices? 156 Jnay) (January established Bapel) Body ( Management JKJ (%ofthepopulation) ikpol ) sick people 29% of poor people (and of 40% sick treatment sought

. 0.1 0.0 12.7 5.8

spent billion 3.7 Rp. JKJ

spent 9.5 billion Rp.

on

treatment sought ) sick people 80% of poor people (and of 90% sick on JKJ on 042005 2004

(June) rates reduced reimbursement JKJ service insurance scheme targeting the poor), insurance schemetargeting thepoor), provider, Sehat(agovernment health Kartu population. The secondmostwidely-used halfthe Jembrana, covering nearly signifi canthealthinsuranceprovider in percent isby are farthemost covered. JKJ ofhealthinsurance;now,by any kind 63 only 17percent ofcitizens were covered healthcare providers for free. to mostprivate (aswell asallpublic) Yes, becausethepoornow have access the non-poor for to went services reimbursements of JKJ95%

Spebr) (September enacted insurance, health centralizing 2004, . 40/ Law No 66% of the poor

insured

system per-person -card- JKJ one included inJKJ services Child delivery coverage

begun ytm(May) system ( under registered the poor re- f o % 2 2 Only

le with Kartu Sehat Sehat le withKartu 2005

new Before JKJ, JKJ, Before

6

Healthcare payments by the poor, pre- and post-JKJ Pre-JKJ Theoretical What JKJ Service payment of the payment of poor members pay poor non-members Puskesmas (primary and ante-natal care) FREE Free Up to Rp. 27,000 Public hospital FREE Free Rp.10,000 Private doctor Rp. 20,000 Free Rp. 20-30,000 Midwife (ante-natal care) Rp.10,000 Free Rp.15,000 Midwife (delivery)157 Rp. 50-150,000 Free Rp. 500-600,000

By providing free health care at both private and public facilities, JKJ has increased the healthcare facility utilization Reform Health Insurance District,In Bali Jembrana rate by both poor and non-poor clients. Prior to JKJ, poor clients could only get free healthcare at the 11 public clinics (as well as local sub-clinics). Under JKJ, in addition to free care at the local sub-clinics and the remaining 5 public clinics, the poor also have access to more than 20 doctors whose practices are fully private, 2 hospitals providing secondary and tertiary care now covered by JKJ, and the private practices of more than 40 civil servant doctors who have signed individual JKJ contracts to provide additional private services after their working hours in public facilities. The increase in healthcare options has been dramatic. According to the National Socio-Economic Survey, the percentage of people in Jembrana who reported seeking treatment when they were ill more than doubled from 40 percent in 2003 (when JKJ was just starting) to 90 percent in 2004.158 For the poor, the increase was from 29 percent to 80 percent. As one male interviewee noted, “Now we can see the doctors any time for free.” A woman stated, “We can receive free family planning services frequently now from midwives.”159

On paper, healthcare costs have increased sharply for poor non-JKJ members, but most public providers still provide free care for all poor clients. Public clinics have increased their service charges for non-JKJ members from Rp. 2,500 (US$0.26) per visit before JKJ (when the poor did not have to pay) to up to Rp. 27,000 (US$2.8) for poor and non-poor non-members alike, more than ten times the pre-JKJ charge. Public hospital doctors that previously did not charge any service fee (since it was internalized in their salary) now charge non-members Rp.10,000 (US$1) for emergency room consultations. The high fees for healthcare for non-members are intended to encourage people to join the JKJ scheme. However, a list of poor households (keluarga miskin or gakin) is given to all public providers (and is available for private providers as well). Poor clients whose names are on this list will almost always get free care from public providers, whether they are JKJ members or not, and this care will almost always be reimbursed to the provider by JKJ. As the head of the Kaliakah puskesmas in Jembrana district stated, “We always provide free medication to the poor. And in general, most of them have a JKJ card or are listed in the poor household list.” Further, it is very unlikely that there are any poor people not registered in the gakin book as gakin registration is done annually and conducted carefully at the grassroots level.160 The willingness to provide free services even for

157 Child delivery services were only added to JKJ coverage in early 2005. 158 The authors’ calculation based on the 2003/2004 National Socio-Economic Survey. 159 Brangbang village interviews. 160 Head, district health offi ce.

Making Services Work for the Poor: Nine Case Studies from Indonesia 119 Health Insurance Reform 6 120 In Jembrana District, Bali registration system JKJ may actually have may actually reducedregistration theaccess ofthepoorto healthcare. system JKJ themselves upeventually aswell. Given care, theclosecorrelation ofbeinginsured underthisnew withseeking revealed fi chooseto thattheyoften enroll theirwives andchildren inJKJ rst,althoughtheyallhave plans to sign schemeorfrom eitherfrom andfamily. friends alocalmicro-credit money to enroll inJKJ, from Men poorfamilies re-registered inthisnewsystem. Each individualcard coststhesameasafamilycard. 2005,onlyabout22percent May ofpoorcitizens By hadbeen membershipcard perperson,rather thanperfamily. governmentbeganto requireneeded funds, district oneJKJ February 2005,ostensibly toIn “introduce theconceptofapremium to citizens” butmoreto raisemuch- likely use ofdiff percent ofthepoorinJembranawere insured in2004. beaccounted for by canonlypartially the The discrepancy thisclaim:according datacontradicts to thesurvey, only66 Survey butNationalSocio-Economic this arrangement, 5,000 (US$0.55)for poor households. Bodyclaimsthatallpoorhouseholdswere JKJ’s Management registered under only onemembershipcard wasrequired perfamily, costingRp. 10,000(US$1.1)for non-poorhouseholdsandRp. 164 Dentist, Bapelstaff Dentist, 164 Management Body. JKJ 163 For instance, somefamilies whohave moved intothearea temporarily donotbotherto getacard. 162 some ofthepoorwere (2003,2004). Prior insured Survey through toJKJ, otherschemes. NationalSocio-Economic 161 Bureau ofHealthandSocial Jembrana District Welfare, thepercentage increase inthenumberofgeneralpractitioners or anegative, onthenumbersofdoctors, dentists, paramedics impact and specialists. may haveJKJ madeJembrana amore attractive place for midwives to work, buthashad either anegligible, MakeDid JKJ Jembrana MoreAttractive To HealthProfessionals? percent to 95percent iftheywere insured. healthcare increasedof poorpeopleseeking from 24percent to 64percent iftheywere uninsured, butfrom 46 registration requirementsmembers ornot, andJKJ have kept many ofthemfrom joining. The degree to whichthepoorhave increased access to healthcare dependsonwhethertheyare JKJ card, theystillhaveclient doesnothave to pay. aJKJ Suchcasesrarely happen,however.” asserted, practice about hisprivate (i.e.,“I willnotreceive poorhousehold)card; patientswithonlyagakin ifthepoor topoor to poornon-membersare healthcare, atthediscretion ofproviders. meansservices talking Onedoctor in themidstofstiff non-members may bedueto publicclinics’ sense ofsocialobligationorto theirdesire to maintainagoodreputation required for JKJ membership.required for JKJ card” mustbeshown inorder to getone, andsince notallcitizens have familycards, notallcangettheIDcards a citizen mustproducecard. aJembranaidentity Though theseIDcards are free, afree, government-issued “family more to seekcare. likely However, Allcitizens ofJembranaare inJKJ. eligible to participate to applyfor membership, 2.6 times)thanfor theinsured poor(anincrease of2.0times),beinginsured adiff stillmakes Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: erent in identifyingthepoor. criteria , andheadof districthealthoffi competitionamongproviders. The informal though itdoesincrease arrangement, accessofthe 162 Moreover, membershipcards mustbepurchased andrenewed annually. JKJ Initially, 163 Even atthelow costofRp. 5,000percard, many poorfamilieshave hadto borrow ce. 161 Though theimprovement isgreater for uninsured poor(anincrease of 164

erence: insured poorare According to the The number The 6 working in Jembrana was roughly the same from 2002 to 2003 (before JKJ) and from 2003 to 2004 (after JKJ began)—however, the increase did slow slightly. The number of paramedics did not change between 2003 and 2004, stopping what had been a small decline in their numbers between 2002 and 2003. Specialist numbers also did not change between 2003 and 2004, although they had increased by a third in the year prior to JKJ. The number of dentists increased by the same absolute number after JKJ began, but by a far smaller annual percentage: 50 percent between 2003 and 2004 (after JKJ was introduced), down from a 100 percent increase between 2002 and 2003.

Change in numbers of healthcare workers, 2002-2004 % increase % increase 2002 2003 2004 2002-2003 2003-2004

General Practitioners 52 58 12% 64 10% Reform Health Insurance District,In Bali Jembrana Specialists 6 8 33% 8 0% Dentists 4 8 100% 12 50% Midwives 81 83 2% 113 36% Paramedics 171 169 -1% 169 0%

Midwife numbers, on the other hand, soared after the introduction of JKJ—at least according to the District Bureau of Health and Social Welfare. In 2003, there were 83 midwives in the district, a mere 2 percent increase over the previous year, but by 2004 the number had grown to 113—a 36 percent annual increase.165 Though strict referral regulations no longer permit them to administer primary care services which were a large part of their work prior to JKJ, JKJ reimbursements for antenatal care and child delivery services are high enough to make work in the district quite attractive for midwives.

Specialist numbers did not grow in response to JKJ because JKJ reimbursements are too low to attract them. In addition, the only workplace for specialists in Jembrana is the Negara public hospital (the only provider of secondary and tertiary healthcare services that has signed a JKJ contract), so supply is self-limiting. Paramedic numbers did not respond to JKJ because their services are not reimbursable by JKJ at all; paramedics cannot sign individual JKJ contracts as health care providers. In fact, a decrease in the number of paramedics might have been expected, as prior to JKJ, paramedics (as well as midwives) often used their primary care skills to provide general practitioner services outside offi ce hours, though in theory this was illegal. With the strict referral regulations, this is no longer possible, signifi cantly cutting paramedics’ potential income.166

Did JKJ Intensify Provider Competition For Clients? Yes. By increasing access to private providers, JKJ has increased the competition between public and private clinics for clients. Now even the poor can access private doctors registered with JKJ because services are free, whereas pre-JKJ a visit to a private doctor cost Rp. 20,000.167 The increase in the supply of doctors to the poor (all

165 The head of the district health offi ce, however, thinks the annual increase is only 7-8 midwives. 166 Some villagers still go to paramedics in an emergency, or when doctors are unavailable. 167 About 30 percent of Jembrana’s doctors are fully private.

Making Services Work for the Poor: Nine Case Studies from Indonesia 121 Health Insurance Reform 6 122 In Jembrana District, Bali morbidity rate inJembranaincreased slightlyfrommorbidity 29.17percent rate in2003to 29.49percent in2004,themorbidity quantitativeIn terms, ofhealthcare thequality for the poorseemsto have improved. yet bannedorbrought beenpermanently to court. 6 Ex-Bapelinvestigation teammembers. 168 Healthcare Improve IncreaseClient Satisfaction? And Did JKJ Of TheQuality membersmay becrowdedto out. recruit members, paying poorJKJ non-JKJ care coverage to non-poormembers, andasthehospitalcontinues andtertiary however, secondary extends ifJKJ onaccess ofthepoor,not hadanegative impact rate. thefuture, In sincethehospitalstillhasalow bed-occupancy tothey would increase alsolike thenumberofpaying clients. Sofar, thehospital’s preference for paying clientshas clients,on paying whosefees non-JKJ canbesetataprofi Other publicclinicdirectorst-maximizing level. suggest care provision and quality,hospital to improve itsmainresponse andtertiary service hasbeento focus onsecondary the villages, simplybecausethere are more providers. While to somedegree competitionhaspushedthedistrict capital, providers publicandprivate competition between forAt thedistrict clientsiseven more intense thanin puskemas’ patientnumbershave bothdecreased by athird, to just20perday. began,the concurred thatsinceJKJ puskesmas the samehoursaspustu. andKaliakah The headsoftheMelaya pustu(villageclinic)areat theManistutu decreasing rapidlysinceaprivatecliniconly100maway beganholding as thepoornow choosetheirhealthcare providers basedlargely onconvenience. For instance, patientnumbers resulted inadecrease inthenumberofclientsatlocalclinics, especiallywhere have doctors private practices, nearby hasremoved thedoctor-staff one choice:thepuskesmas.JKJ increasescosting thesame)ipsofacto poorclientswhowanted competition.Before thecare hadonly ofdoctors JKJ, many patients, ashiscare will no longerbefree. Though hecan continue hisprivate practice, heisunlikely tohave evidence, Bapelcanceled theremaining 6monthsofDr. S.’s contract. of 11otherhispatientsuncovered thesamestory. Withsuchstrong herfibelieving Dr. rststatement,issued S.asummons. Investigations claimed thatshehadactuallybeentreated by the doctor, theteam, signifi cant nancialbenefifi t fromcheating. Thoughthepatientlater Rp. 5,000/patient),theiraverage of10patientsperdayrepresented a fee(aboutRp. 8,000/patient)thanmidwivesa higherservice (about stated thatactuallythemidwifehadchecked her. Since doctorsget card signature ofoneDr. S.’s patients:itwas Dr. S.’s, butthepatient are providedusually suchservices by midwives. Ateamchecked theJKJ by Dr. S.andjust20percent by hiswife. Thiswas suspiciousbecause About 80percent hadbeenconducted offamily planningservices practice ofDr. S.andhiswife, whoisamidwife, inBrangbang village. irregularities inhisclaims, private Bapelinvestigated thehome-based measures. Anti-corruption Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: In September 2004,afternoticing InSeptember 168 suspension of their JKJ contract, althoughnoprovider contract, has suspension oftheirJKJ medications. Violators arebyupto ayear’s sanctioned about demandsfor additionalfees for non-generic initiated basedonclientcomplaints, suchascomplaints records, clients. Investigations are andinterviewing also suchasmedicalstock listsandprescription paperwork the standards byvisitingdoctors’ offi DokterIndonesia). The team ensuresIkatan adherence to Association NationalMedical (IDI,or of theIndonesian Preparation adapted bytheJKJ Team from thestandards standards were data.JKJ though there isnosupporting for standard violators, have improved quality service equipment, treatment, andmedication, andsanctions Yes. standards for islikely that It theJKJ-applied ed puskesmas’ monopolyonpoorpatients. This has Although theoverall e, reviewing ces, , 6 for the poor declined by nearly 6 percentage points in the same period, to 28.53 percent in 2004.

The qualitative data available indicate that both healthcare quality and client satisfaction have improved.

Providers list better explanations of medications, improved packaging of generic drugs, “service with a smile,”169 and shorter queues when asked to defi ne high-quality service provision. In response to the increased competition for clients, puskesmas are deliberately trying to improve service quality and client satisfaction by: • Sending mobile clinics and doctors to remote areas at least monthly (rather than just providing health education in these remote areas, as before JKJ); • Improving medicine packaging; and • Provide “full smile” reception for patients, which was never done before. Health Insurance Reform Health Insurance District,In Bali Jembrana

The focus on quality-as-client-satisfaction is mainly due to the lack of client-borne costs and stringent quality-control standards for treatments, medication and equipment, which reduce the potential for variation among providers.

Clients also feel better packaging of generic medicines is a measure of high-quality services. Before JKJ-induced competition, generic medicines were not “blister-packed” as separate doses, but—despite the medicines themselves being the same—with the nice new packaging, patients feel the medicines are now better. Patients also defi ne quality services as services that cure. According to this defi nition, health services are rated highly as patients almost always feel they are cured after visiting clinics.

Even highly reputable doctors have been investigated by A strict referral system aims to maintain quality standards Bapel. Between October 2003 and October 2004, a total of 40 but has also restricted services previously available from rebukes and suspensions were handed down among the 197 certain providers; increased numbers of providers and healthcare providers. Of them, thirteen providers170, or about 7 percent, received contract suspensions of between one and six longer working hours have maintained an adequate months. supply of healthcare services. JKJ has likely improved the quality of healthcare by implementing a strict referral system to ensure that providers only provide services in their own areas of professional expertise. For example, Bapel rejects dental care claims from general practitioners since dental care should be provided by dentists. Similarly, Bapel rejects claims for antenatal care from general practitioners that should have been handled by midwives. However, the referral system may have reduced access of the poor to healthcare by reducing health provider options; most importantly, midwives are prevented from providing primary care and paramedics are ineligible to sign up as JKJ providers; both of these providers were previously the fi rst source of care for many of the rural poor. Since JKJ began, there are many more midwives, but referral standards mean that the services they provide are restricted, shunting potential clients to the care of doctors. Only a small number of midwives continue to provide their traditional range of services. Also, together with the preference of many clients for doctors over midwives, and doctors’ fi nancial

169 Melaya Puskesmas Director and staff . 170 2004 fi gures; some providers were rebuked more than once, or both rebuked and suspended, so the total number of providers disciplined was less than 40.

Making Services Work for the Poor: Nine Case Studies from Indonesia 123 Health Insurance Reform 6 124 In Jembrana District, Bali to the district despite provisionsto thedistrict to includea measure ofcost-sharing through charging ofpremiums. increase thescheme’s healthcare willfurther andtertiary coverage for non-poormembersto includesecondary cost estimates thatthisaccounted for budget, atleast4percent ofthetotal district 171 spendingonclaimsreimbursements hadincreased 2-and-a-halftimes, to Rp.direct JKJ 9.5billion representing spending.Jembrana spentRp.lessthan2percent 2004,reported 3.7billiononJKJ, oftotal By district eachcitizenincreasing may receive. thecostofschemesincethere 2003, isnocapontheamountofservices In isincreasing rapidly.No. spending onJKJ District Sustainable? Is JKJ of clients. Yet, according to clients, thishasnotdecreasedofservices. thequality incentive to maximize thenumberofclients, doctors’ hoursare nowlongerto accommodate theincreased number health education. are atrendfor reduced. away director theactivity hasobserved from atleastonepuskesmas Indeed, providing costofspendingtimeproviding educationishigher,disincentive to clinics:theopportunity andthereceived funds own profi ts must besetaside theycontinue for anyto provide. healtheducationactivities There isthusadouble increasing,actually hasnotreceived atleastonepuskesmas any ofthismoney. Therefore, someofthepuskesmas’ preventive measures. Health Offi Atthesametime, thoughtheDistrict of thenon-remunerative whichincludespublichealtheducation campaigns andother healtheducationfunction, main benefi provides astrong ciaries, yet JKJ nancialincentive to providersfi to focusonclientcare tothedetriment Health education by thewayside? budget transfers, thanto afl aw inJKJ’s administration. However,cash shortage. may have more theshortage to delays dowithannualyear-end innational-to-provincial income.private, Public andthusdonotreceive clinicswere thecivilservant alsoreallocating resources to cover the providers’service cashfl ow, provision, whoare especiallyofdoctors andmay fully have onservice anegative impact delay were inreimbursements doctors athree-month oftheirclaims. experiencing 2005), JKJ This directlyaff Slow reimbursements to providers may aff the district. referral standardsbeenmitigated bytheconcomitantincrease haslikely andmidwives inthenumberofdoctors in to isstillmuchbetter doctors inJembrana(2,840:1)thanatthenationallevel (4,000:1).Any ofthe negative impact rate for healthspendingatthenationallevel (2.9percent oftotal spendingin2003). 7 Total Jembrana andotherexpenses, iscloser to5percent spendingonhealth,includinghealtheducation, oftotald JKJ, 175 sources expen was Rp. budget.Subtracting 982millioninnon-district puttoward 2004 JKJ thisfrom reported the2004JKJ 174 spendingforadministration, costs, Nodataisavailable management,andothernon-claims-related thoughthesewou onJKJ 173 Director, Melaya publicclinic. 172 Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: billion; theteamassumesJembrana hadtopaythisamountitself—roughly 4percent ofthedistrict’s total expenditure. spendingabove Rp. 9.5billion. total JKJ Accor ding toonedoctor, thesefactors 172

have alsodecreasedthelengthofatypic Puskesmas are themainprovider ofhealtheducationto thepoor, whoare their providerect performance. Increasing utilization of healthcare services is, ofcourse, utilizationofhealthcare Increasing services al consultation,from5-6 ce claimsthebudgetfor healtheducationis Atthetimeofresearch March (early 174 171 muchhigherthanthecomparable Moreover, theratioofpopulation minutes priort 175 The plan to increase JKJ o JKJ to2-3now.o JKJ 173 istrict expenditures. ditures yieldsaboutRp. 8.5 . The research team ld necessarily increase ects ects 6

The JKJ scheme is fi nanced by a pool of funds from diff erent sources, mainly the district’s locally-generated revenue, which comprised 80 percent of this pool in 2003 and 2004. The remainder of the funds come from central and provincial government subsidies and P.T. Askes, the state-owned insurance company, that had each, in the past, supported a diff erent part of Jembrana’s public health system. Given that other JKJ funding sources are unlikely to increase signifi cantly, any increases in JKJ spending will have to be borne by the district. Yet in 2004, Jembrana’s own- source revenue declined from Rp. 11.1 billion (2003) to Rp. 9.8 billion (USD 1 million), a drop of 12 percent, while JKJ spending increased dramatically—one reason district offi cials have become very interested in exploring options for self-funding.

As with any new program, government must either locate new sources of funding or reallocate funding from other expenditures. In the fi rst year of implementation, Rp. 3 billion in new spending on JKJ came from cutting a number Reform Health Insurance District,In Bali Jembrana of government bureaus as part of a wider restructuring eff ort, but it is unknown where the much greater 2004 JKJ funding came, or was diverted, from (district budget data for 2004 is not yet available for analysis).

As a result of JKJ’s high and rapidly increasing cost, offi cials are exploring ways of making the scheme self- fi nancing. The replacement of family with individual membership cards was the fi rst step. In addition, a card renewal fee has been initiated—essentially the same as buying a new card each year, as the cost is the same: Rp.10,000 or USD 1.1 for the non-poor, and Rp. 5,000 or 55 US cents for the poor. Even with 100 percent coverage, though, these initiatives would earn only Rp. 2.4 billion (US$250,000)—less than a third of the district’s 2004 spending on JKJ.176 Future plans to provide secondary and tertiary coverage for non-poor citizens include payments of a premium to further boost JKJ revenues.

The scheme’s very fl exibility threatens fi nancial sustainability. The willingness of providers to serve poor non-members for free if they appear on the gakin list (or even if they do not), is an informal aspect of the system that is reinforced by Bapel’s willingness to reimburse those providers. This does help ensure access of the poor to healthcare in the short run. However, it reduces the incentives for the poor to register: only 66 percent of the poor were registered with JKJ in 2004, and as of May 2005, only 22 percent (under the new one-card-per-person system). The short-term benefi ts to the poor are thus a threat to both fi nancial sustainability of the scheme and long-term benefi ts to the poor.

Inclusion of non-poor clients in the scheme adds greatly to its cost. Of the Rp. 9.5 billion in 2004 JKJ claims, 95 percent were made by non-poor citizens, most of whom could have paid for their own basic healthcare. Yet JKJ may need to court these citizens as clients who can aff ord to pay premiums as part of a future expansion of the scheme.

176 Assuming a population of 253,000 with a 12 percent poverty rate.

Making Services Work for the Poor: Nine Case Studies from Indonesia 125 Health Insurance Reform 6 126 In Jembrana District, Bali Wildly implypoorfi budgetprojections inaccurate JKJ health outcomes. essential for aneff a fi buttheyseethisasstillquite smallcomparedxed honorarium, to their work. Funding for adequate staffi salary, verifi from theircivilservant person system introduced 2005.Apart inearly cation team membersalsoget out claimverifi cationsin the fi eldand register newmembers—amonumentaltask given thenewone-card-per- positive impact; however,positive impact; oncethecurrent Regentisgone, anunsympatheticreplacement couldchange, oreven basis ofaRegentDecree. The Decree thefl gives thedistrict withthescheme to experiment exibility for maximum JKJ’s legalbasisisachallengeto itssustainability. uncertain progress toward fi to bemade. lesslikely iscertainly nancialsustainability transparency, budget projectionsmightbecomemore accurate, butwiththecurrent inaccurate fi nancial planning, claimswasreimbursed in2004,theoffi JKJ However,(US$830,000) went for non-personnelspendingsuch asJKJ. given thatRp. 9.5billion (USD1million)in Offi doubletheprojected Rp. in2004wasnearly 5.5billion. in linewithbudgetprojections,spendingonJKJ actual 179 Assuming 26 working days permonthand8hoursday. 26working Assuming Bapelverifi179 cation staff Evaluation Welfare by thedistrictHealthandSocial ManagementBody. Bureau andtheJKJ 178 stayinherhouse. amidwifeprovides If theantenatalcare, isactuallyatwo-day the“hospital stay” 177 over 500claimsaday, present, theverifi cation team consistsofonlythree memberswithnospecialtraining, each responsible for verifying Inadequate investment intheadministrative framework impact. threatens ofJKJ thesustainability measures to increasethatwouldtaking greater allowclientsto quality themto earn attract revenues. clients asaresult ofcompetitionwithotherproviders, asdecliningrevenues aviciouscycle entering prevent their motivate staff being usedfor staff reimbursements now cover fee-for-service mostcosts, aswell as such asnationalimmunizationcampaigns. JKJ practitioner’s visitisjustRp.17,000. offi evaluation by JKJ did, theprovider would beartheadditionalcost. Infact, arecent treatment are used, thecost pervisitwillnotexceed it thelimit.If ask forco-payments, butaslongapproved medications and a two-day “hospital stay”.a two-day are reimbursed uptoRp. 250,000forchilddeliveries, including reimbursed uptoRp. 27,000(US$2.8) foreachvisit,andmidwives and antenatalcare, general practitioners andmidwives are paymentstohealthcare providersJKJ Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: cially, total healthspendingin2004ofRp.13.7 Jembranareported billion(US$1.5million),ofwhichRp. 7.9billion and improve service quality inthisway. quality andimprove service potentially facelowerThe puskesmas revenues dueto fewer cials foundthecost ofanaverage general control isvitalto JKJ’s quality mechanism,whichinturn long-runsuccessinimprovingective bonuses:allfi reimbursements to directors inJembrananowve puskesmas use25percent ofJKJ 176 179 JKJ providers are notallowed JKJ to and reimbursing a fortnight’s-worth of claims within a week. In addition,staff andreimbursing In afortnight’s-worth ofclaimswithinaweek. 177

. For basichealthcare cial fi gure too low. isclearly With time, and bettergreater datacollection, the district HealthandSocial the district Welfare Bureau for programs amount offundingdirectlyfrom thecentralgovernment and paid by centralgovernment). Puskesmas stillreceive asmall are salaries still cover mostoperationalcosts(civilservant subsidies from central, governmentsto provincial ordistrict andpublichospitalsnolongerhavepuskesmas direct radically newfundingsituation. Public healthcare providers are adjustingto the nancial planning. At present, JKJ isfounded onthe ratherweak legal Atpresent, JKJ . Though 2003 spending on JKJ was Though 2003spendingonJKJ With the new JKJ scheme, With thenewJKJ must carry mustcarry ng is ng At 6 remove, JKJ. It can be argued that, given the scheme’s popularity, attempts to dismantle the system by a new Regent would face stiff popular resistance. When asked what they would think if another Regent was elected and discontinued JKJ, one women’s focus group exclaimed in unison, “No, no—don’t take it away!”

The enactment of Law No. 40/2004 on Social Security in September 2004 presented a much more serious challenge to JKJ. This law centralized the authority to provide health insurance to a central-government-appointed state- owned enterprise, P.T. Askes. Several districts with their own insurance systems have protested the law, and it is currently being contested in Indonesia’s Constitutional Court. Until the offi cial implementing regulation is issued, though, JKJ will be able to continue to function unchanged.

Success Factors Reform Health Insurance District,In Bali Jembrana JKJ gave the poor access to private as well as public healthcare providers. The poor had already had access to public doctors pre-JKJ; it is the inclusion of most private doctors and clinics in the JKJ scheme which signifi cantly increased access of the poor to healthcare. In addition, inclusion of private providers in the scheme initiated competition between public and private clinics, leading to increased quality of services for all, as seen by provider attention to client satisfaction.

Strong support and creative vision of the Regent. JKJ created major changes in health services fi nancing, placing a heavy burden on the district budget. Despite the objections of central government, the district used payments from P.T. Askes, the central government’s offi cial insurance fi rm, to support the scheme. In addition, the Regent rationalized his administration by converting clinics and reorganizing the district government structure, creating annual savings of Rp. 2-3 billion (US$200-300,000), but laying off 48 people in the Bureau of Health and Social Welfare alone. JKJ also put some civil servants, particularly the staff of public health facilities, under greater pressure with few added benefi ts. Under a diff erent leader, all these changes might have created trouble in the district parliament, but the Regent, himself a health professional, provided the strong leadership that made the diff erence by championing the reform, speaking publicly, mustering support in the parliament, being personally involved in decision-making together with personally-recruited top offi cials, and selecting remaining puskesmas directors who believe in his vision and are also capable managers.

Flexibility of design. JKJ has had great initial success in increasing the percent of the population seeking healthcare when ill. Though there are major challenges to continued positive impact, the scheme’s fl exibility has already allowed some changes in implementation, and could support more. For instance, child delivery services were fi nally included in JKJ coverage starting in early 2005; in another example, service reimbursement rates were reduced in June 2004 from Rp.10,000 to Rp.8,000 for visits to doctors, and from Rp.6,000 to Rp.4,000 for midwives,180 in an eff ort to move

180 The Rp. 27,000 reimbursement fee includes Rp. 10,000 for services and up to Rp. 17, 000 for medicine. Medicine reimbursement levels remain un- changed.

Making Services Work for the Poor: Nine Case Studies from Indonesia 127 Health Insurance Reform 6 128 In Jembrana District, Bali 8 There are confl182 ictingdataontheextenttowhichmidwifenumbers actuallyincreased. ispossiblethedecrease It inreimbursement rates ledsomeproviders tofocusonpaying non-memberclients, andtoincre 181 for someofthepoor. Even familieswhofeel theycanaff registration system, whichitselfwastoo system expensive costsfamiliesmuchmore thantheone-card-per-family Ever-stronger barriersto membership have limited JKJ’s potential onthe poor. positive impact healthcare, advantageofthebenefi andsomay nottake and tertiary secondary t. exceed theRp. 27,000reimbursement limitpervisit.Somepoorpeopleare unaware thatmembershipincludesfree scheme, andthere are continuingmisconceptionsaboutit,suchasthebeliefthatclients may have to pay ifservices via meetingsandvisitsto villagesby acampaign team. Villagers rely onvillageleadersfor information aboutthe scheme. Instead, information wasdisseminatedwas handedoutto potential membersorproviders abouttheJKJ Insuffi Limitations To JKJ The Positive Of Impact toward fi nancialsustainability andbetter population. healthforsustainability thedistrict of standards andcostcontrol have already quality, ledto improved andshouldultimately leadto service fi nancial from providerprotect thedistrict improprieties thatcouldlead to infl enforcement ated costsandlossofquality; andenforcementregulatory body, to thesuccessofJKJ. Verifi istheinstitutionalkey byBapel cationsconducted that may beprovided ofprovider, by eachtype andothervariables. management, Without adoubt,Bapel, theJKJ standards for ofmedicationthatmay strict incorporates beused, types fees thatmay becharged, ofservices types charges, charging clientsco-payments, andclaimingtreatments for whichproviders are not authorized. JKJ temptation for providers may to includeinfl cheat.Improprieties atingthenumberofclients, infl atingmedicine Clear andenforced framework. regulatory for theincrease intheirnumbersJembrana level ofreimbursement rates, andantenatal care—wereresponsible andadjustmentstolikely includechilddelivery Increased publicexpenditure onmidwives. withasmile”, (“service terms subjective increase better etc.) medicinepackaging, clientnumbers. to further treatment clinicsisfree, atmostpublicandprivate butproviders arein stillmotivatedquality to improve service providers mainlyseekto increaseofclients. thequantity Clientsare already eagerto beseenbynow doctors that carefor standards have removed members, onquality. practically whileitsrigid primary variations objective Thus, Strong incentives for providers alarge to numberofpatients. serve or Perda) whichrequires thatallows thisfl theagreement parliament, ofthedistrict exibility. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: The team did not gather data to support ordenyeitherofthesepossibilities. The teamdidnotgatherdatatosupport asan“anchor” members, forthereduction feesserving of andtocut theirfeestonon-members, thelower JKJ JKJ both toserve members, tothedetrimentof poor. theotherhand, On thefeecutmay, by reducing doctors’fi cost, hav nancialopportunity cient dissemination ofinformation hascontributed to low member numbers. 181 . It isJKJ’slaw legalbasisonaRegentDecree, (Peraturan ratherthanadistrict . It Daerah 182 The favorable conditions created by JKJ forThe favorable midwives—an adequate conditionscreated byJKJ . The JKJ-induced competition on quantity ofclientscreates competitiononquantity the The JKJ-induced ord theincreased costsmay stillnotbeableto register JKJ’s price cap has eliminated price variations variations caphaseliminated JKJ’s price price No written material material Nowritten ase theirprices fornon- feesforpayingclients. e encouraged doctors The new 6

because they lack the required identifi cation, or cannot fi nd the time to attend too-brief registration drives.183 Unintentional disincentives to puskesmas may have reduced preventive health education activities that particularly benefi t the poor. JKJ in eff ect rewards puskesmas that maximize client numbers. As health education does not yield fi nancial rewards, it may be “squeezed out” of puskesmas’ activities.

Poor fi nancial planning may have pushed JKJ offi cials to attempt self-fi nancing without adequate attention to the impact on the poor. The JKJ budget projection for 2004 was much lower than actual 2004 spending. In response to the apparent surprise of high and rapidly increasing expenditures, JKJ offi cials have begun to implement self-fi nancing mechanisms such as the one-card-per-person system that have kept the number of poor members low. Health Insurance Reform Health Insurance District,In Bali Jembrana

Because JKJ provides nearly the same benefi ts for both non-poor and poor members, it channels signifi cant public spending toward the non-poor. Though the poverty rate in Jembrana is just 9 percent, if JKJ covered all the poor, the percentage of claims for services to the poor should be well above 9 percent,184 yet in 2004 this fi gure was just 5 percent.185 The numbers imply that the JKJ scheme is not the most effi cient use of public money if the goal is free healthcare and improved health outcomes for the poor.

Making It Replicable Public clinics will have to increase revenue in order to improve quality and attract more clients. They already report that their client satisfaction eff orts are aimed at changing the perception that they are low-quality providers since they see mainly poor clients. If unable to compete for non-poor clients who can aff ord to pay, the poor may be left as the only clients at public clinics stigmatized as “low-quality”. Clinics would like to be able to provide certain secondary services in order to earn additional revenue from paying clients, but are currently not allowed to do so.

Consider the impact of the scheme on non-members, particularly the poor. Public providers continue to provide free healthcare to poor non-members, in part because of the sense of social obligation, and in part because they continue to be reimbursed by JKJ for these services. Yet because they are not members, these clients are only served at the discretion of providers, who are under no legal obligation to serve them for free; moreover, they have no recourse to Bapel’s complaint mechanism. The social ramifi cations of such a provider-client relationship are likely to be at least partly negative for these poor clients. Free care for non-members may be no favor to them, in the long run. For instance, free care for non-members increases the cost of the scheme, which may be passed on to members, including the poor. In a vicious cycle, higher costs further discourage poor non-members from joining, reducing revenue but increasing costs of the scheme.

183 Due to the management team’s resource limitations, registration was often conducted within a very short time period. 184 If JKJ does not cover the whole population, but does cover all the poor, then the poor will be disproportionately represented among JKJ members and, assuming even behavior among poor and non-poor members, the percentage of claims made for services to the poor should also be higher than their share of the district population. 185 The remainder were claims for services to the non-poor or to those insured by P.T. Askes.

Making Services Work for the Poor: Nine Case Studies from Indonesia 129 Health Insurance Reform 6 130 In Jembrana District, Bali Invest inmanagement. on JKJ’s effi and unableto propose alternative designs for thescheme, thoughthere hasbeenaninformal discussion internal centralized management),andstaff challenging decadesof after policiesdecidedby theRegent(dueto bureaucracy thenature oftheIndonesian “free” healthcare andeducation. usedto followingThe implementingdepartments, ratherthanexaminingand costs, long-term the heavy astheRegentreaps agreatpoliticalgoodwillfrom hisschemesfor dealofshort-term payment JKJ’s methods, case, suchasco-payments. however, In there waslittlepoliticalmotivationto anticipate scheme canbedesigned to anticipate andavoid these problems by, for example, theuseofdiff incorporating healthcare even workers, whenitisnotabsolutely necessary. Providers becomeineffi clients andproviders to becomelesseconomicalintheiruseand provision ofhealthcare. Clientspay more visitsto accordingly. Anticipate theover-use that comes ofservices withsubsidized healthcare, anddesignthescheme accurate and well-analyzed qualitative and/orquantitative data. onpuskesmas. Clearly, attempts to improveJKJ thescheme’s related to any performance oneofthesetopics require expenditures; fi andthelong-term funding iscomingfrom;JKJ actual health statistics;where JKJ of nancialimpact quantitative referral scheme, andofstrict requirements; ofservices; quality andsubjective from theobjective theJKJ onthepoorofexclusion impact ofparamedics theactual how midwife numbershave responded actually to JKJ; topicsapparently as:how many noregularandanalysisonsuchkey ofthepoorareregistered; datacollection actually Ensure regular data andanalysis collection to provide asoundbasisfor schemeimprovements. thebrunt. borne non-members alike,have allbeensome oftheunplanned-for eff poor are represented), disproportionately coststhatare indirectlypassedonto membersand andskyrocketing constraintsfacedbysystem. thepoor, Membership increased fees for non-members (amongwhosenumbersthe membersunderthenewone-card-per-person only22percent ofthepoorare to thenon-poor; JKJ for services diversion ofpublicfunds to disproportionate reimbursements the non-poor.risk were 2004,95percent ofJKJ In whichattempt to includeallcitizens,Non-targeted healthinsuranceschemessuchasJKJ, bothpoorandnon-poor, A healthinsurance schemethat isnotdeliberately mustaddress pro-poor theriskofbecoming anti-poor. potential gainsfrom increasing staff andstill-low membernumbers, atleastamongthepoor.investigated thattheteam isoverworked); (andknow The ofproviders whomustbe abacklog to: alaginclaimreimbursements,quality; whichmay have onservice animpact thattheyhave isunlikely timeto improveIt theirmanagementcapacity. contributed hascertainly overload The work each month,aswellresponsibilityfor asshouldering registration andre-registration ofmany thousandsofmembers. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: cacy. A typical problem schemeisthatafullysubsidized Atypical inherent system encourages inafee-for-service Atpresent, thetiny Bapelstaff ed bymedicalprofessionals specialists, were ratherthanhealthpolicy unprepared numbersandinvesting buildingfor incapacity themare high. laboriously verifi laboriously esthousandsofindividualprovider claims ects ofJKJ’s inclusiveness,ects for whichthepoorhave cient intheiruseofresources. A There is erent Case Study 7: The Community Block Grant Program In Blitar City, East Java The Community Block Grant Program 7 132 In Blitar City, East Java Thiscase was writtenby LailaKuznezov, consultant “pre- meetings called involvedCommunities are mainlythrough very inprojectselection, theannualcity-led,government-mandated villages( urban projects inthetwenty BlockGrant(CBG)The BlitarCommunity Program, implemented since2002,provides grants for development Abstract key program transparency.key players, andthelackofbudgetary which theyhave ownership. The program’s mainthreats are itsinsecure legalgrounds, of thelackofaccountability improve basedonlessonslearned, butalso becausecommunitiesare how to learning implementaprogram over communities “make mistakes” hasincreasedofsustainability, thelikelihood notonlybecausetheprogram isableto lessthan2percentbudgetannually. comprising ofthecity Notably, low-cost, itisvery The Mayor’s willingness to let appears thattheCBGProgramon thisactivity. It istechnically, institutionally, fi nanciallyandsociallysustainably. to thepoor. government, recognizing City this, mandated thatfrom 2005on,13percent ofprogram fundsbespent “number ofpoorbenefi ciaries.” Program funding for slumhousing renovation hasprovided the most directbenefi ts criterion, becauseofanew(2003)projectselection likely ofBlitar’s fundingbiasintwo pro-poor three sub-districts, generally unaware ofbudgetissues. Though targeting thepoorwasnotoriginally anexplicitgoal, there hasbeena role inmobilizingcommunities. Communitiesan important donot,however, andare inmonitoring participate (LembagaVillage EmpowermentInstitutions Pemberdayaan Community Masyarakat such astraining:from 2005on,nomore than60percent ofprogram fundsmay bespentoninfrastructure. The for governmenthasbeenencouraging infrastructure, non-tangible butcity but(initsview)more effi or US$380,000in2002to Rp. 6.14billionorUS$646,000in2004).Funded projectsrefl communities’ ect preference have rangedfrom 13to 22percent ofthetotal program budgetannually(whichitselfincreased from Rp. 3.62billion ofattendees Communities’ isencouraged—rather rare inIndonesia. participation fi contributions nancialandin-kind Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: World Bankandmaynotbereproduced orreused without theirpermission. was provided Leisher,editorial support by SusannahHopkins consultant (Australia). Thiscase iscopyrighted by theauthors, th tute ofDemocratic Governance, andStefan NachukandMennoPradhan (U.S.A.), Harvard University oftheWorld Bank(Indonesia). Agus Endarso, Pradipta Paramitha Foundation (Indonesia).Managerial, editorial, was andanalytical provided support by Winthrop Learned,” CSISEconomics Working Paper No. Series 0833(www.csis.or.id/papers/wpe083, 2004).Research teammembersincludedGre Potency“ (2000);Perdana,National Bureau Statistics, A.andMaxwell, “Village Targeting J.,“Poverty inIndonesia: Programs, (2005); Hidayat, Mayor D. S.,“Good Practices ofBlitarCBGPrograms” (presentation, 2005);http://djpkpd.go.id/data/dau/ (Fina and 2005);”Dharmawan, L.etal, Reform:Case StudiesontheLocal District “Driving Level ReformExperience inIndonesia,” Wor Government, “General Guidelines, Kecamatan BlockGrant Program 2004and2005(Pedoman UmumProgram BlockGrant Kecamatan Tahun Institutions No.dential Decree Security ofLembaga Community 49/2001”(aboutre-arrangement KetahananMasyarakat [Village Desa inMarch2005.Works andApril to Blitarcity referred toinclude:“BlitarinFigures (2004);“BlitarReg Angka)” (BlitarDalam Musrenbang Musrenbang ”, basically Musrenbang , whose purpose isto elicitcitizen, whosepurpose planning. inputinto city Blitaralso, unusually, holds kelurahan atthelocallevel. Atboth (U.S.A.) andJanesImanuelGinting, World(U.S.A.) Bank(Indonesia).Thestudyisb ) of Blitar City, East Java. Community participation is a key element. isakey ) ofBlitarCity, EastJava. participation Community Musrenbang andpre- Kelurahan Musrenbang ional GDP” (2003);“Presi-ional GDP” Problems, andLessons e Ash Institute,e Ash andthe orLPMKs), play nce Ministry website); nce Ministry cient projects ased onafi eldvisit ld Bank: Indonesia ld Bank: Carty, Ash Insti- Carty, Ash , the active , theactive Analytical and ]); Blitar City ]); BlitarCity gorius Kelik 2004 7

Introduction

The Study Site: Blitar City Blitar city (kota Blitar) is known in Indonesia as the fi nal resting place of Sukarno, the fi rst President of Indonesia, and as the location of the ancient Panataran temple. These two attractions make Blitar a popular tourist destination. The city, which includes three sub-districts (kecamatan), is only 33 km2, making it the second smallest city or district in East Java. Most of Blitar’s 123,000 citizens (2001 fi gure) are of Javanese ethnicity and work in the restaurant and hotel industries or other services industries.186 Blitar’s poverty rate is 27 percent, a bit lower than the provincial rate of 29 percent but higher than the national rate of 19 percent.187

Blitar’s Community Block Grant Program Program Block Grant Community The East Java In Blitar City, Block grant programs make available a set amount of funds for which local government submits proposals for development projects. There are many block grant programs throughout Indonesia, but they are not part of a nationwide program nor mandated by central government. They do have a common goal: to empower local government and refocus district government on district-wide planning and implementation of social services and development. Many programs have not, however, had the desired result. Problems include inadequate funds, unclear authority, a top-down approach, under-coverage of the target population, and leakage of funds.188 The Blitar Community Block Grant Program is diff erent from other such programs in Indonesia because it gives local government a great deal of authority in project decision-making, empowers existing local government as well as local representative community structures, integrates Community Block Grant (CBG) Program planning with the existing formal development planning process (Musrenbang), and emphasizes community participation.

The Blitar CBG Program, conceived and designed by the Blitar city government and implemented since 2002, provides grants for development projects in Blitar’s twenty urban villages (kelurahan). The program aims to: 1. Empower the kecamatan and kelurahan to bring services closer to the people; 2. Improve development effi ciency, eff ectiveness, transparency and accountability; 3. Create community ownership of public facilities and development projects; 4. Increase the capacity of kecamatan and kelurahan governments to meet their infrastructure needs; 5. Facilitate the development of a new, service-oriented mindset among local offi cials; 6. Increase community participation in development activities; and

7. Create employment at the kelurahan level.189

186 Blitar Regional GDP (2003). 187 Village Potency, National Bureau of Statistics (2000). Based on a population of 118,783. 188 Dharmawan (2005). 189 Paraphrased from General Guideline Block Grant Program (2005).

Making Services Work for the Poor: Nine Case Studies from Indonesia 133 The Community Block Grant Program 7 134 In Blitar City, East Java role asCBGProgram implementers. At the teams are Coordination consulted bytheCity Team to refi neprogram guidelines. (IMTs), leadersandNGOs, includingcommunity alsomonitor allprojects. Onaregular basis, these independent planning units, monitors allprojects. Newly-formed This team program determines fundingallocationsto each of Social needed—the Departments Welfare, Trade Enterprises, andAgriculture. SmallandMedium andIndustry, 9 TheLPMKswere formed by Presidential No. Decree 49/2001,whichtransformed thepreviously existingLembaga KetahananMas 191 Kecamatan andkelurahan governments are local extensionsoftheoffi 190 role TheLPMKs inthesuccessofCBGprojects. play animportant 4. TheCBGProgram issustainable. 3. TheCBGProgram benefi tspoorcommunities. 2. andeff isakey participation Community 1. The following hypotheses were tested thefi during eldwork: Research Methodology QuestionsAnd consultants, thePublic andotherparties. Works Department, levels, andRT representsmembers from thecommunities, RW leadsprojectsandcoordinates withtheplanning or Lembaga Pemberdayaan Masyarakat EmpowermentInstitution Community operational andadministrative projectsupervision. The LPMK (Village and treasurer, atthevillagelevel. provides UnitLeaders overallActivities projectsupervision are responsible for formal administration andcoordination withvillageproject teams. Planning consultantsprovide technical assistance. A treasurer, isresponsible for program implementation. This team UnitLeaders withActivities works responsible for At the provides directprogram supervision. • District/city: • District/city: Kabupaten/Kota • Sub-district: • Urban or village: RW sub-village: Urban • • Hamlet: RT or Local government levels. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: lage Community Security Institutions). Security lage Community ties. based onnationalgovernment priorities anddirectives. Incontrast, headsand RT headsare theLPMKs, directly RW representati to themove tolocal autonomyinIndonesia, bureaucrats atthislevelwere civilservants, serving andwere simplyexpectedto kelurahan kecamatan Kecamatan and RW levels, the andRW Kecamatan level, the Rukun Tetangga Monitoring Monitoring Team, includingpeoplefrom the Kelurahan , headedbythe , headedbythe 190 Kecamatan Rukun Warga Kelurahan Management Management Team, consistingofthe Kelurahan ective elementoftheCBGProgram.ective Camat Lurah Management Management Team, consistingofthe ), a directly-elected community bodyatthevillagelevel with community ), adirectly-elected kecamatan Pekerjaan Umum),the and—as Treasury Department, Daerah orBadanPerencanaPlanning Department Block GrantCoordination Team ledby the theCBGProgram, player supervise istheCity butthekey Representatives or cial bureaucracy andare responsive tohigherlevelsofgovernment. Prior At the city level,At thecity themayor andtheDPRD(Local Houseof kecamatan 191 Local regulation No. 8/2000formalized theLPMKs’ ) andincludingthePublic (Dinas Works Department -level Independent -level Independent kecamatan , coordinates strategic withcity planningand offi Dewan PerwakilanDewan Rakyat kecamatan ce’s fi and ce’s development nancial, Kecamatan kelurahan head( Monitoring Monitoring Teams head(the implement programs Camat ve oflocal communi- Pembangunan Bappeda yarakat (Vil- Desa Daerah) ) andthe Lurah (City (City ) 7

Three researchers visited Blitar for eight days in late March and early April 2005, conducting semi-structured interviews with 61 people, including the Mayor, the heads of Bappeda and the Ministry of Public Works, DPRD members, one Camat together with 7 Lurah, and one planning consultant. Five focus group discussions were held with the Lurah, RT and RW heads, kecamatan and kelurahan offi ce staff , poor families, community activists, current and former LPMK members, project benefi ciaries, and 8 members of a local NGO, FORMAK. The team also observed three public meetings including over 100 people (a joint meeting of the Independent Kecamatan Monitoring Teams, one Musrenbang and one pre-Musrenbang in Kelurahan Kepanjen Kidul).

Kelurahan Sukorejo in kecamatan Sukorejo and kelurahan Ngadirejo in kecamatan Kepanjen Kidul were selected for fi eld visits either because program implementation has been deemed successful there, or because there has been high public participation. Program Block Grant Community The East Java In Blitar City,

Findings

City government City required that government 13% of CBG Discussion Addition of a mandated that funds be spent of CBG Current Mayor elected new criterion only 60% of on slum Program Independent and began a two -year for project CBG projects infrastructure began Monitoring “aspirations gathering” Blitar CB G selection: focus on Teams process that led to the Program begun number of poor infrastructure created CBG Program beneficiaries

2001 2002 2003 2004 2005

2000 13% of 2005 Program 78% of CBG 17% of budget projects 100% of CBG focused on 22% of Program 89% of CBG contributed by projects infrastructure Program budget projects communities focused on budget contributed by focused on infrastructure contributed by communities infrastructure communities

Is Community Participation A Key And Eff ective Element Of The CBG Program? Yes. Communities are very involved in the process of project selection, though city government makes the fi nal choice. Communities in all 20 of Blitar’s kelurahan have been involved in implementation to some degree since the program began in 2002. Projects are proposed by community members and prioritized in a process linked to the annual city-led series of meetings called Musrenbang. Musrenbang, started in 1982, are held from the urban village (kelurahan) to the national level. Their purpose is to elicit citizen input into development and budget planning. In practice, however, meeting attendees are usually selected by government, rarely include the poor, and are expected simply to approve proposals as put forth by government, refl ecting the priorities of local leaders and other local elite rather than villagers. Debate between community members and government in the meetings is unusual. In sum, in most places in Indonesia, Musrenbang are not yet as participatory as was originally intended. The Musrenbang

Making Services Work for the Poor: Nine Case Studies from Indonesia 135 The Community Block Grant Program 7 136 In Blitar City, East Java through pre- costlyto implementover alargevery Blitar, area. In ofattendees localgovernment participation encouragesactive and suggested butrarely bygovernmentthroughout implemented, Indonesia becausetheyare time-consuming Blitar isalsounusualfor its “pre- andeven sometimescontestingneighborhoods proposals by otherneighborhoods. putforth signifi cantnumberofpoorpeople.up, Second,spoke proposing peopleactually development activities for their bytheresearch teamin Blitarobserved was quite diff their belief that their attendance can make adiff their beliefthatattendance canmake don’t doubtourselves; we are notafraidto askthegovernment questions.” Villagers attend CBGmeetings, refl ecting provision. As onelocalwoman toldin service researchers, “Yes, we there hasbeenachangeamongpeople—now theirneeds.governance, andseethatgovernment canserve Villagers are more abouttherole curious ofgovernment have seenprojectspassfrom proposals into reality, they are thattheycaneff learning Eff Local inputinto choice project 9 Dharmawan (June 2005). 192 The groupthe asawholechooseswhichprojects to shortlist; RW levels. RW since thefi nallistderivesfrom proposals atthepre- initiallyput forward process ensures areinputandneeds, thatallprojectsselected basedoncommunity this iterative andparticipatory Although thefi nalchoiceofprojects to fundisstillultimately made by the RT meeting 15-20 participants from each RT RT projectproposals RT Block grant announcements from eachRT 15-20participants Musrenbang Lurah Musrenbang meeting(pre- RW meeting RT proposed projects). proposals, ofwhich28were approved (27percent of Kidul, forinstance, madeatotalof106 the14RW Meeting local needs. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ective community participation hasresulted communityinnewlyempoweredective participation localcommunities. , aa Kelurahan Camat 192

Musrenbang (at (at ciiyPriiat Output Participants Activity kecamatan kelurahan In 2004inKelurahan Kepanjen Musrenbang . level) 50 participants: RW representatives, RW LPMK, 50participants: level) level) 50-60 participants: 50-60 participants: level) ) 30 participants from RT level from (representatives RT 30participants ) Musrenbang team andLPMK Bappeda leaders); of women’s andyouth organizations, religious staff , ,” essentiallya Lurah ( for theirproposals, onlyasubsetofwhichwillbebrought to thenext and At bothRW and RT headsare invitedand RT to present therationalefor theirproposals. kelurahan erence. Attendance at the initial RT and RW meetingshad erence. andRW Attendance attheinitial RT “people , decidedby kelurahan projectproposals and kelurahan erent. First, itwasattended by mostcitizens, includinga , andthen staff Camat Musrenbang Camat ; LPMK Lurah kelurahan staff and with kabupaten withkabupaten kecamatan , LPMK ( kecamatan kelurahan but at RW level. butatRW These pre- Musrenbang levels, debate isintense aspeoplefi ght Camat ) level. Atthe head)onlyfacilitates theprocess. offi and ce and in meetings at the RT and andinmeetingsattheRT Bappeda inlocal participate ectively List offundedprojects RW projectproposals RW proposals Kecamatan kelurahan at kabupaten level, atkabupaten Now thatvillagers Musrenbang level, all RW level, allRW project are 7

fl owing out through the door, and many sitting outside.”193 The response to the question of whether community members considered these projects “their own” was overwhelmingly affi rmative.

Creation of Independent Monitoring Teams has allowed higher-level community participation. In 2004, in order to address criticisms and respond to recommendations, the Mayor created Independent Monitoring Teams, eff ectively a mechanism to channel negative comments into productive recommendations, allowing activists and prominent community members to participate.

What makes Blitar CBG projects diff erent? Financial and in-kind contributions are a • “We know exactly what programs are being implemented.” proxy for community ownership and • “It is we who implement the program.” participation. About 17 percent of the 2002 Program Block Grant Community The East Java In Blitar City, • “In the previous social safety net program, we only received, but with CBG, we feel ownership. Even though we don’t always provide money, we provide CBG Program budget was contributed by decent meals and also labor.” communities, dipping in 2003 to 13 percent • “In previous [government] programs, they just came and executed the project; but rising again to 22 percent in 2004. Some we were never consulted.” communities have increased their contributions • “Before, all physical projects were managed by the Public Works Department, so communities did not care. Now they [communities] do the projects by as a way of expanding project scale to cover themselves, hence they want to participate.” 194 larger areas. In-kind contributions such as labor, meals and cigarettes for workers, donation of local materials, and even voluntary contributions of land195 are another important part of community involvement, and sometimes represent 5 to 10 percent of total project value.196

Communities pay for greater impact. In 2003, Kelurahan Kepanjen Kidul The projects funded refl ect communities’ received Rp. 18 million (US$1,900) from the CBG Program to build a 150 m long preference for infrastructure over training. domestic sewerage system. Before, there had been no sewerage in the area, hence Most CBG Program funds have been spent on people had to “dig the ground.” During implementation, 30 more households asked to be included in the project. Citizens arranged a meeting with the LPMK at infrastructure or “physical projects,” including which it was decided to extend the system by 25 meters to these new households. renovation and/or construction of government To fi nance the addition, citizens contributed an extra Rp. 2.5 million (US$260); offi ces, mosques, drainage ditches, roads, contributions varied from Rp. 10,000 or US$1 (for poor families) to Rp. 400,000 or walkways, embankments, kindergartens, US$40 (for well-off families). 197 primary schools, public toilets, cemetery gates, health clinics, security posts, meeting halls, women’s group buildings, small bridges, and housing for the poor, as well as provision of garbage bins and equipment for kindergartens, community sports, mosques and churches. Prior to the CBG program, communities stated that small infrastructure projects were seldom implemented, and when

193 Musrenbang. 194 Focus group discussion with Kepanjen Kidul Camat and 7 Lurah. 195 In some cases, villagers have contributed small strips of land along their plots to irrigation or road projects which benefi t all families in the project are. Previously there would have been a sense of resentment if the government had claimed land for projects about which the community had not been consulted. Furthermore, no coercion was reported. 196 Head of the Public Works Department. 197 Kelurahan Kepanjen Kidul interview.

Making Services Work for the Poor: Nine Case Studies from Indonesia 137 The Community Block Grant Program 7 138 In Blitar City, East Java are amore productive useofprogram fundsinthelongrunthaninfrastructure. some offi infrastructure projectsfundedrefl government’s notonlycity ects encouragementofthistrend, but(according to toward infrastructureprojects(withafew exceptions, suchashousingfor thepoor). The decreasing percentage of government hasmandated in2005,city thatnomorescreening. than60percent ofCBGProgram Starting fundsgo to projects suchasdrivertrainingandsubsidiesto purchase driver’s licenses, and traininginsewingandsilk- know.” about this;onemansuggested, would be good iftheywould postthebudgetonbuilding,“It sothatwe would they usedtheremaining fundsfor theirLPMK expensesorfor other projects. Somevillagersare beginning to think onquality, thediff to skimp andpocket LPMKs tono oneisyet accountfor asking projectexpenditures. This creates anincentive for LPMKs eitherto save or benefi tthecommunities, as well ashow to managetheoverall planningandimplementationprocess. who serve.” Allowinglocalgovernment offi for experience alearning localoffi importantly these projectsdidn’t directlybenefi tthecommunity. However,Mayor the felt that,originally, theprogram wasmost funds couldbeusedfor renovation oflocalgovernment buildings. stopped insubsequentyears,This practice since percentage decreased to 89in2003andagainto 78in2004, thefiIn rst year ofprogram implementation(2002),100percent offundedprojects focused oninfrastructure. The just comeinandbuildsomething, we didn’t why.” know done, were ofconsultative process notbasedonany atthelocallevel. kind Rather, “every nowandthentheywould 0 Focus group discussionswithpoorhouseholdsinkelurahan Sukorejo andNgadirejo. 201 Focus group discussions inSukorejo andtheMayor’s presentation ontheBlitarCBG.Posyandu rehabilitation, providing eq 200 Hidayat (2005). 199 woman respondent One inKelurahan Ngadirejo. 198 projects]. Butno[fi nancial]dataare available attheendofproject.” for sale)have increased eachyear. for householdbusinesses(suchasproduction offriedcassava chips according totheheadofwomen’s group, working CBGfunds related toeducation andsmallbusiness. aresult As oftheirinput, regardingin theMusrenbang meeting, CBGprojects particularly amongthewomen RTheads highlevelsofactivity team observed ensure women have asay, inNgadirejo thewomen do. Theresearch group.business working Althoughsimplybeingthere doesnot Women’s Empowerment UnitoftheLPMKandawomen’s small members inNgadirejo urbanvillageare women; othersleadthe Women speakup, too. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: churches, andslumhousingrenovation are categorized asnon-physical. cials) a growing realization on the part of local people and local government that activities suchastraining cials) agrowing oflocalpeopleandgovernment thatactivities realization onthepart Three LPMK outofsixRTheadsandtwo erence. SomeLPMK thediff membersadmitted keeping cials real control overhow to funds helpedthemlearn useresources to cials, to changetheirmindsetfrom whoare“those served” to “those know how muchmoneyourvillagereceivesknow [for CBG stated onerespondent; anothercommented, “Now we funding isfi nallyprovided for projectsinourownvillages,” opinions are asked,but…[w]edon’t howmuch know cost, orwhethertheLPMK spendsthefullallocation: “Our issues, suchashowunaware muchprojects ofbudgetary to theLPMKs for implementation.Local peopleare generally receiving projectfundsfromanddisbursingthem thecity budget ormonitoring. doesnotextend to the Community participation 198 199 withtheremainder ofprogram fundsdevoted 201 LPMK that membersandvillagersreported 200 The Interestingly, inthefi rst year, Camat erence, butsaidthat isresponsible for uipment formosquesand 7

Does The CBG Program Benefi t Poor Communities? Despite the fact that the poor are not a target group of the Blitar CBG Program, there has been a pro-poor funding bias in two of the three kecamatan. Over the three years of program implementation to date, per capita CBG Program funding in Kepanjen Kidul and Sananwejan kecamatan has been higher in the poorer kelurahan (see fi gures 1-3). This refl ects the fact that one of the fi ve project selection criteria is number of poor people as a percent of total benefi ciaries. 202 (There are insuffi cient data to explain why this trend is not observed in Sukorejo.) However, the available data do not show whether higher per capita spending in poorer villages has, in fact, benefi ted the poor. Some of the projects most likely to be pro-poor (targeted training for income generation activities, for example) have low per capita costs, while some of the projects least likely to be pro-poor (such as offi ce renovation) have high per capita costs, so there is not necessarily a correlation between per capita spending and benefi ts. That is, a higher per capita expenditure in poorer urban villages will not necessarily lead to a reduction in poverty there. Program Block Grant Community The East Java In Blitar City,

Figures 1-3: CBG spending and poverty, 2002-2004

1. Kecamatan Kepanjen Kidul 2. Kecamatan Sananwejan

250,000 35% 250,000 35% 30% 30% 200,000 200,000 25% 25% 150,000 150,000 20% 20% 15% 100,000 15% 100,000 10% 10% 50,000 50,000 5% 5% 0 0% 0 0% k p it l r o ng og e r n ng jo tu an do o ul p a r e a ah u e n n id b ed e g et g ir e m e nL m k n gg d je K la m G o do e n a S au B n K e s nw T a g K an R lo en a g T N p anje P B an n e p ra K e S a K K

Per capita funding % who are poor Per capita funding % who are poor

3. Kecamatan Sukorejo

250,000 30%

200,000 25% 20% 150,000 15% 100,000 10%

50,000 5%

0 0%

n r Turi Blita Tlumpu Sukorejo Pakunde Karang Sari

Per capita funding % who are poor

202 Phone interview with Kepanjen Kidul Camat.

Making Services Work for the Poor: Nine Case Studies from Indonesia 139 The Community Block Grant Program 7 140 In Blitar City, East Java adequately cover real projectexpenditures. thepre- project costssubmitted during those tasks. Communities are now alsoableto better, manageprojectbudgetsandmaterials sothatestimated with thehelpofprogram planningconsultantsand thePublic theycannow handlesomeof Works Department the LPMK andcommunitiesto solve, design, suchastheaccurate needsandconstruction calculationofmaterials Of allCBGprojects, fundingforOf slumhousingrenovation hasprovided benefi themostdirect 207 Interviews withplanningconsultant, LPMKmembers. Interviews 207 withheadofthePublic PhoneWorks interview Department. 206 with headofBappeda. (2005);interview Susilo–FORMAK Camat; FORMAKReport, andKepanjenKidul Sananwetan 205 Therecommendation was thateachkecamatan spend 10percent ofitsCBGbudgetforthispurpose. 204 Camat. and Sananwetan KepanjenKidul 203 designs, allowing communitiesto implementthemeasily. of thePublic agrees:Works thesmall-scale CBGprojects (usuallylessthanRp. 50million)have Department simple previous government-led projects,andmore withhigherprojectquality appropriate projectselection. The head Technically, communitiesfeel thatimplementationoftheCBGinfrastructure projectshasbeenmore effi Yes. Technically, institutionally, fi Is TheCbgProgram Sustainable? labor,can provide onlyunskilled jobsare stillunavailable thehigher-paid to skilled them. localemployment.if notalloftheCBGinfrastructure projectsare However, asource oftemporary asmostvillagers Guidelines, are contractors notallowed to onprojectsamountingto work lessthanRp. 50million(US$5,300),most has substantially benefi There are nodata available to demonstrate that theemployment created by CBGinfrastructure projects of each poor ofpilotprojectsinslumrenovation have, however, to require causedthecity thatRp. 200million(US$21,000) Works Department] was often broken.Now, wasoften Works we Department] are more careful asitisourownvillage.” As onewoman in Until 2005, city governmentonlyencouraged Until 2005,city or by government (throughSosnaker). Dinas intended tobeapilotproject; Blitargovernment wants toseewhetherslumrenovation ismore eff the sametime,willcontinue Sosnaker toimplementitsslumrenovation Dinas project. TheheadofBappedaexplainedthatCBGsl toFORMAK’s partly Due advocacy, theBlitargovernment hasdecidedtoearmarksomeCBGfundingforslumhousingrenovation from than through thegovernment madetheproject successful. projects, participation community and managingtheproject withateamoflocal leadersandbenefi ciaries.even FORMAKclaimsthatthougheachbenefi family ciary the sameproblems. Thus, FORMAKtooktheinitiative toraise private fundsfrom local donorstorenovate more slumhousesinPa in implementation.In2004,Pakunden kelurahan paidfortherenovation of11slumhouses. Thework was implementedby theLPMK of 52slumhouses, butaccording thisproject was tolocal ineff NGOFORMAK, Slum housingrenovation forthepoor. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: kecamatan’s Kelurahan CBGfundsbeusedonslumrenovation projectsfrom 2005on. ted thepoor. Ngadirejo explained, “Before, canalalongourpaddies[builtby thePublic theirrigation In 2003, Blitar’s Dinas Sosnaker (the Department of Employment and Social Welfare) ofEmployment andSocial In2003,Blitar’s paidfortherenovation (theDepartment Sosnaker Dinas nancially, andsocially, theBlitarCBGProgram appearsto besustainable. 204 Musrenbang Sinceprojectsare implemented locallyand, according to CBGProgram 207 Increased community ownership alsoaff community Increased kecamatan are more accurate, andthusallocated fundsare moreto likely to spend moneyonslumhousing. 206 ective because andlittlefl there was participation nocommunity exibility Althoughsometechnical problems are stilldiffi ectively implementedby communities (through CBG) ects project sustainability. project ects 204 Clearbenefi ts to the kunden, implementing ts to thepoor. received lessmoney this time, butwith um renovation is cient than 2005on.At cult for 203

7

Institutionally, the CBG Program is likely to be sustainable in part because of its integration with the formal Musrenbang process, which requires cooperation between kecamatan and kelurahan offi cials and community bodies (the LPMKs, and RW and RT heads), and avoids the creation of new and redundant institutions. In addition, the program’s success has reduced resistance against it within government, while increasing the capacity of local government offi cials to respond to locally voiced needs. When CBG discussions started in early 2001, the Mayor and other reformers were faced with the need to change the mindset of bureaucrats, as the Mayor describes it, from “that of being served, to that of those who serve.” The Mayor views the CBG Program as an opportunity for local government to exercise its new autonomy. The mindsets of offi cials at the kecamatan and kelurahan levels are beginning to change, as offi cials gain experience with managing and implementing projects which respond to needs and priorities as stated by communities themselves. CBG has served as a “pilot” to encourage local government offi cials to develop their organizational and administrative capacities in the new era of decentralization and autonomy. Program Block Grant Community The East Java In Blitar City, The organizational and technical capacity of the RW, RT, LPMK, Lurah and Camat are increasing as all parties gain experience through the program. The head of Bappeda says, “Camat can now facilitate better development planning as they lead Musrenbang in their own areas. It is better because they can now link the kecamatan’s plan with the district Renstra (Rencana Strategi or [usually fi ve-year] strategic plan)”.Camat , Lurah, LPMKs and RW and RT heads are also gaining experience in controlling funds to implement their own projects rather than spending transfers for centrally-mandated activities from the national or provincial level.

CBG Program spending, 2002-2005208 2002 Total Cbg Budget (Billion Rp.) % Community Contribution Kecamatan Sukorejo 1.03 3% Kecamatan Kepanjen Kidul 1.23 19% Kecamatan Sananwetan 1.36 27% Total 3.62 17% 2003 Kecamatan Sukorejo 1.38 4% Kecamatan Kepanjen Kidul 1.65 12% Kecamatan Sananwetan 1.87 21% Total 4.90 13% 2004 Kecamatan Sukorejo 1.62 7% Kecamatan Kepanjen Kidul 1.93 14% Kecamatan Sananwetan 2.58 38% Total 6.14 22% 2005 Kecamatan Sukorejo 1.50 209 n/a

208 General Guidelines; interview with Bappeda head; kecamatan Sukorejo. 209 Including Rp. 200 million per kecamatan for slum housing renovation; not including community contributions as they have not yet been fi xed.

Making Services Work for the Poor: Nine Case Studies from Indonesia 141 The Community Block Grant Program 7 142 In Blitar City, East Java learning.” own thatinfrastructureprojectsare notthemostproductive for useofCBGresources their isimportant “social [mainly] infrastructureprojects.” Buthefeels thatallowing communities andlocalgovernments to discover on their that communitiesare interested in ‘instant’ projects whichtheyfeel are easierto implement;that’s why theychoose moresustainability likely. The Mayor’s willingnessto letcommunities “make mistakes” implementation inproject makes program demonstrate communities’both inmoneyandkind, feeling ofownershipandcommitmentto theprogram. program, planningandimplementation,aswell to mainlyduring project cost, asincreasing contributions community The program isalsosustainablefrom asocialpointofview, involvement sinceahighlevel ofcommunity inthe about 70percent. revenue andexpenditures budget),ofwhichDAU Umum,orcentralgovernment transfers) constitute (DanaAlokasi Financially, despite annualincreases isfundedby theAPBD(district inCBGfunding. low-cost theprogram It isvery offi 215 Interview withtheMayor. Interview 215 DPRDmember. 214 2002APBDwas ofFinance Rp. 316.5billion,2003APBDRp. 344.0billion,and2004 APBDRp. 382.6 billion.Ministry (www.d 213 APBD2004. 212 DPRDSecretary. Representatives andPKBParty; ofPDIPParty 211 HeadofPublic Works Department. 210 effi energy andproviding relatively smallerprofi tmargins. The Public has Department Works “realized thatitismore these smallprojectsare lesseffi projects were unhappy. initiallyextremely As theprogram hasprogressed, however, bothgroups have realized that projects would limittheircontrol ofthoseprojects. Also, whohadpreviously contractors for won contracts these example, membersofthePublic were thatCBGfundingforWorks worried small-scaleinfrastructure Department initiallyfelt thattheprogramSome government departments wouldupontheirareas infringe ofresponsibility. For at the RW level, for theminto priorities projectproposals.” andmakes at theRW program’s participation: community “Some improvements IseeintheCBGProgram: itgatherspeople’s aspirations government offi Other irrigation. andlarge-scale market initiatives suchasacity from 2002to 2004, related bureaucratic reforms have increased localrevenues, leadingto a20percent increase intheAPBDbudget oa .0n/a 4.50 Total Kecamatan Kecamatan Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: cient for communitiesto implementthesesmallprojects,” cials nor DPRD members see the program as a major budgetary burden.cials norDPRDmembersseetheprogram asamajorbudgetary 215 there essenceoftheCBGprogram isroom is sociallearning, for andto notperfection; mistakes “The Snnea .0n/a n/a 1.50 1.50 Sananwetan Kidul Kepanjen 02TtlCgBde BlinR. %Community Contribution Total CbgBudget(BillionRp.) 2002 212 213 The CBGProgram costslessthan2percent budgetannually. ofthetotal city Sincewideryet andsincetheprogram accountsfor suchasmallamountofthebudget,neitherexecutive isshifting. ofprojecttypes The mixture The Mayor hassaid, “One bigchallengesofaris cient for uprelatively theirorganizations, greater taking timeandmanagement 210 allowingitto focus onlarger andmore strategic 211

214

cials speakapprovingly ofthe epkeu.go.id). 7 move forward.” Other government offi cials are not convinced that “social learning” is worth the potential waste of resources. According to the Sukorejo Camat, for instance, sometimes it is hard for communities to distinguish their “wants” from their “needs,” so he welcomes the new program regulation that 40 percent of program funds be spent on non-infrastructure projects. However, it is more likely that communities will accept regulations when they have had a chance to learn how the money can be spent more eff ectively, and will continue to participate in the process rather than feel resentment or become disengaged.

The only threat to the sustainability of the Blitar CBG Program seems to be its insecure legal grounds. The Program is regulated by a Surat Keputusan Walikota (Mayor’s Decision), rather than a Local Regulation/PERDA, which means that it is legally possible for a new mayor to cancel it. However, this would be a very politically risky move, given the program’s popularity. Program Block Grant Community The East Java In Blitar City,

Do The Lpmks Play An Important Role In The Success Of CBG Projects?

Local NGOs can play an important role in LPMK oversight. Anecdotal evidence suggests that the LPMKs play an The Kepanjen Kidul LPMK had a reputation for poor performance important role in mobilizing communities for and corruption. It had “marked up” many CBG projects, such participation in the program. Sub-district leaders, when as a public toilet project which cost only Rp. 7 million but was reported as Rp. 15 million. As a result, fewer toilets were pressed, judged that 45 percent of the kelurahan-level LPMKs built for the money allocated. In response, FORMAK (the Anti- are very eff ective, with the remainder average or less Corruption Forum), an NGO whose members live in Kepanjen eff ective.217 Key characteristics of eff ective LPMKs include the Kidul, mobilized the community to remove all LPMK members in the upcoming election. The NGO eff ort succeeded, and all-new ability to translate communities’ aspirations and needs into LPMK members were chosen by the communities themselves in concrete project proposals, coordinate with government 216 2004. departments to gather resources and assistance, and generate community participation. Members of eff ective LPMKs tend to be respected people, not only in terms of age, but in terms of their community roles. Members of less eff ective LPMKs, in contrast, are characterized by their passivity and self-interest. “One of the barriers to faster project implementation is the poor communication between some LPMKs and their communities,” stated one of the program’s technical consultants. However, there are no data as yet that demonstrate a link between the eff ectiveness of an LPMK and the success of the CBG projects implemented in that LPMK’s kelurahan.

Ironically, the LPMKs’ active role in the CBG Program may be to the detriment of their work in other areas. Each LPMK has 9 units covering such areas as security and order, local economic development, the environment, women’s empowerment, and community welfare. The work of many of these units may have been slowed or stopped as a result of the LPMKs’ focus on the CBG program.

216 FORMAK, head of Bappeda, head of the Public Works Department. 217 5 out of 7 LPMKs in Kecamatan Kepanjen Kidul, 2 out of 7 in Sananwetan, and 2 out of 6 in Sukorejo.

Making Services Work for the Poor: Nine Case Studies from Indonesia 143 The Community Block Grant Program 7 144 In Blitar City, East Java structures suchastheLPMK to implementtheprogram, localbureaucrats atthe program. to solicitpeople’simportant input. development community Thus, theenvironment for wasripe aparticipatory andpre- the caseelsewhere inIndonesia, implemented, alltheLPMKs byballot,ratherthanappointed inBlitarhadbeenselected from above asissometimes foundationreformers leadingto built apro-participation theCBGProgram. The vision,leadership, and andbeliefinparticipation “social learning” oftheMayor andakey group of strengthening to inandcontribute the program, programparticipate further sustainability. requirement that13percent ofCBGfundsbespent on slumhousingrenovation, increasewillingness to community changessuchastheintroduction ofindependent Other responsiblewas likely for biasofprogram thepro-poor funding, and as suchcanbeconsidered animprovement. numberofpoorpeoplewhobenefiselection: t. (whichwassuggested ata Thisnewcriterion forum oftheLPMK) and funding. The program’s fl representatives community are howtoand locally-elected collaborate. alsolearning 218 Interview with City Mayor, withCity Camat. Interview headofBappeda, andKepanjenKidul 218 hasincreased. capacity and managerial strategically andintegrate local-level into higher-level planning(suchasthe forproviding localgovernment (especiallyatthe opportunities Program to exercise asanexcellent newlygranted wasenvisioned opportunity from localautonomy, thestart Program implementation hasbeenintegrated withthe project volume ifcostshadbeenunderestimated. fromcostsofimplementation,withdiscrepancies theactual leadingtobudget estimatesreduced areto vary likely project community-developed earlier, stages. andselection Otherwise, theprojectnomination,prioritization, during available among regularmembers. community Planning consultants’ assistancemay alsobemore eff agrees withtheneedfor are them;somepeopleare abouttheircost,andothersfeel already concerned theirskills decided uponandmoneyallocated), theirinvolvement hasbeenassociated with “mistakes,” andnoteveryone Yet to projectshave since planning consultantscomeinjustprior theimplementationphase(whichisafter been forhelpful inassistingthemwithproposal estimates ofbudget,laborandmaterialrequirements. design, particularly thatplanningconsultantshaveassist withtheCBGProgram. beenvery membersacknowledge community Most implementation andincreasing theirtechnical capacity. Program planningconsultants have beenfairlyeff Success Factors Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: The annualrevision ofProgram Guidelinesallowed for theaddition,in2003,ofanewcriterion project exible designhasallowed improvements toimplementation, bemadeinproject monitoring 218 SincetheMayor recognized thevalueofusingexistingcommunity-based Musrenbang were already beingheld, government felt becausecity itwas kecamatan inassistingcommunitiesective withproject Musrenbang The city governmentpays forThe city planningconsultantsto kecamatan -level teams monitoring in2004,andthe2005 process andthelocalLPMKs. and kelurahan Renstra Before theCBGProgram wasever kecamatan ). Indeed, localadministrative). Indeed, levels) how to to learn think and kelurahan ective ective if used The CBG levels 7

In 1999 a group of fi ve high-level Blitar offi cials together with four city legislators began working together to develop a fi ve-year strategic plan (Renstra) for the city to take advantage of newly granted local autonomy. The following year, a former professor of public administration was elected mayor and took offi ce determined to implement the plan. Reforms such as the promotion of bright young government employees to the position of Camat were undertaken at once. Between 2000 and 2002, an “aspirations gathering” (jaring asmara) process was carried out by the Mayor and others through which newly-elected local government offi cials worked to understand local wants and needs. In 2001, discussions began about the creation of a block grant program to empower local government and communities, in line with the nationwide eff ort to fund small community projects. The program, intended as a pilot, was initiated and developed by Blitar city government without international or NGO assistance, in contrast to the block grant programs of many other districts in Indonesia.219 The Community Block Grant Program Block Grant Community The East Java In Blitar City,

The Mayor was very aware of the many hurdles that the CBG Program would have to overcome: bureaucrats unused to taking the initiative and to a bottom-up approach; low community trust in government; low capacity of the Camat to manage CBG projects; the potential for tension between government departments; and the possibility that community proposals would tend more toward “wants” than “needs.” His ability to see these hurdles as a normal and indeed useful learning process strengthened the program’s participatory approach. The Mayor viewed the CBG program not only as a direct benefi t to communities– the “public reason” for the program–but also as the most eff ective way to allow local bureaucrats to gain experience exercising a new mindset as public servants, rather than entitled offi cials, in the spirit of the era of decentralization and increased local autonomy in Indonesia.

Decentralization and national-level support and funding for local government autonomy laid the groundwork necessary for a community participation-focused program such as CBG. DAU transfers from the central government have largely paid for the CBG Program.

Limiting Factors The success of the program’s community participation depends on community cohesion, which tends to be weaker in more urbanized areas. Sukorejo is the most urbanized of Blitar’s sub-districts; many of its workers are traders, civil servants, or in the service industry. Communities there are also quite heterogeneous. These two factors may work against community cohesiveness, and hence participation.220 Indeed, Sukorejo had the lowest percentage of community contributions to the program of all three kecamatan.

Neither the LPMKs nor the Independent Monitoring Teams are accountable. The LPMKs’ role as project implementers compromises their position as project monitors. This dual role has drawn some criticism, in particular from the newly created Independent Monitoring Teams. LPMKs are seen as unlikely to be objective in monitoring since they are part of the program implementation structure; meanwhile, there is no formal mechanism for monitoring and evaluating the LPMKs themselves, leaving open opportunities for corruption. Even though communities in

219 Interview with City Mayor; Blitar City’s Government Bureaucratic Reform Book (2004). 220 Sukorejo Camat.

Making Services Work for the Poor: Nine Case Studies from Indonesia 145 The Community Block Grant Program 7 146 In Blitar City, East Java are onlydonethrough negotiationsatthe However,with themoften. aboutwhichprojectswill befundedbecausefi villagersare still uncertain nalallocations heads aswell asLPMK asthe membersfunction “voice” ofcitizens intheirarea, are accountableto them,andmeet teamandRT members, Monitoring andcurrent andformerIndependent LPMKisassumedthatRW members. It heads, NGOand andRW level) members suchasRT whichare bythemore community attended active primarily project selection islargely limitedproject selection to proposing projects. Prioritization occursathigher-level meetings( Limited community understandingaboutfi at theprojectsite.” meeting, alocalmanpulledasideresearcher andwhispered, would begoodiftheycoulddisplay thebudget “It interest acommunity inexaminingprojectbudgets.reported However, thismay bechanging; onecommunity after despite theirgeneralinterest non-existent LPMK inmonitoring spending.is virtually Neither LPMKs norvillagers offi and community leaders,and community the government listens to them,butthere ofconfl isarisk ofinterest.Inviting ict NGOs by localNGOsmay improve andaccountability. transparency Many teams independent monitoring draw from NGOs Incorporate localNGOsinto program monitoring to helpensure accountability andtransparency. Making ItReplicable Lack ofbudgettransparency reduces ownership project be asource level. ofcontention atthecommunity for approved projectsenduphigher, theusualgovernment reactionisto reduce thescaleofprojects, whichcan budgetestimates arecommunity unrealistically low. When budgetcalculationsmadeby theplanningconsultants projects. thisphaseisthatfrequently Oneoftheconsequencestheirabsenceduring in nominatingandprioritizing The role oftheplanningconsultantsisto provide technical assistanceinimplementation,sotheydonotparticipate The exclusion ofplanningconsultants from planningsometimesleadsto project clasheswithcommunities. increase thecredibilityofIMT recommendations. business. reduces ofboththeteams andtheLPMKs, theaccountability This further althoughatthesametimemay scale projectsand, asaresult oftheCBGProgram’s implementation,may have emphasisoncommunity lostsome LPMK heads, andNGOstaff contractors orprivate Bappeda Independent Teams are alsoregularly consulted by onLPMKssanctions ifcorruption-related problems are found. theirfiThey canonlyreport ndings to the Monitoring The Independent Teams created to strengthen program to donothave monitoring impose theauthority also notyet demandingLPMK inaccountingfor transparency fundsreceived andspentonproject costs. casesareextreme ableto remove LPMK orevaluationisever members, fed noreport backto them.Communities are Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ces, disseminated. theyare notposted sites atwork orotherwise Villagers’ aboutbudgetinformation knowledge actually dowithteam fi actually ndings isnotclear.MonitoringIndependent Many Team membersare former Camat nal project choice. project nal and whohadpreviously received governmentfunding for small- Bappeda Bappeda for guidelinerevisions. However, whatthe . Althoughprojectbudgetsare available atthe level. As mentionedearlier, role thecommunity in Monitoring Monitoring Camat Camat kelurahan Camat . The and

7 to take on the role of independent monitors outside the program hierarchy might help to ensure they are fully able to report instances of corruption and research community opinion in a less-biased way.

Ensure that key players are playing the most eff ective roles possible in program implementation. There is much disagreement about the eff ectiveness of the roles of various actors, in particular the LPMK, the Independent Monitoring Teams, and the planning consultants. Much debate concerns the roles of the LPMKs, RW and RT in monitoring and implementation. LPMKs do most implementation; however, some believe that RW and RT teams would be more appropriate in a project implementation role, further strengthening local capacity and improving the effi ciency of implementation. In this vision, the LPMKs would monitor the RW and RT project teams. In some instances this is already occurring, but in

2005 LMPKs were still implementing most projects, with little accountability to the community, local kelurahan or Program Block Grant Community The East Java In Blitar City, kecamatan offi cials, or IMTs.

The Independent Monitoring Teams focus on the LPMKs, but are powerless to issue sanctions if misdeeds are uncovered. Formalizing IMT oversight of the LPMKs through addition of an audit function, for example, would provide a mechanism for accountability and transparency.

Finally, some communities would like planning consultants to be brought in at the planning stage, but program management fears this would be too expensive. Government should re-examine the roles of the key players and especially communities’ expectations of each.

Data collection must be done regularly and carefully to maximize the positive impact of adjustments to program design. As with many projects, data collection on the CBG Program appears to be inadequate to demonstrate project impact, and thus inadequate to serve as a sound basis for program improvements. If, for example, one goal of the program is to increase community participation in development activities, then regular program monitoring should include data collection about what types of groups (women, the poor, the elderly, children, small business owners, local elite, et cetera) are participating, at what stages (proposal, planning, selection, implementation, funding, monitoring, managing), where (from more urban areas, from more rural areas), how (speaking in meetings, speaking to local offi cials, attending meetings), and how often (once, regularly, at night, et cetera). Only accurate and well-analyzed data on topics relevant to program goals will be successful in revising program design for greater eff ectiveness.

Making Services Work for the Poor: Nine Case Studies from Indonesia 147 The Community Block Grant Program 7 148 In Blitar City, East Java Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Case Study 8: Participatory Planning In Maros District, South Sulawesi Participatory Planning 8 150 In Maros District, South Sulawesi planning. chances for ofparticipatory socialsustainability limitations reduce thechancesofinstitutionalsustainability. Finally, limited villagerinvolvement inPDPPmay reduce PDPP implementationhasdependedheavily ontheinvolvement ofthemainlocalchampion,Forum Warga, whose of dataandlimited fi but nancialcommitmentsfrom thedistrict, fi nancialhardship doesnotappear tobeafactor. annual planning, though. The fi dueboth to lack Maros planningin isuncertain, ofparticipatory nancialsustainability Forum Warga ofPDPPvillageheadsare thatabouttwo-thirds usingthe5-year plansasabasisfor asserts village-level planningandbudgeting. howmany villageplansarebeingusedindistrict actually isunknown to getfunding. It plansandbudgets, andcontinueto lobbygovernment ondistrict offi impact no villageproposals hadever beenfunded. Despiteminorsuccesses, then,villagersare stillpessimisticabouttheir though inonevillagePDPPwasconfirmed to have helpedsecure funding two proposalsfor where, to PDPP, prior is impossibleto say whetherthere oramountofvillagebudgetallocations over hasbeenachangeintype time, requests. However, byForum thiswasdueto advocacy Warga ratherthanto PDPPitself. Dueto thelackof data,it of villageproposals to (calculated 67percent byRp. amount),butintheendmore oftotal thandoubleditssupport ensure thatvillageplansinfl just38percent planned to support In 2004,thedistrict budgetallocation. uencedistrict eff was nil. hasincreased, Even invillageswhere women’s participation hasstillbeenlimited, despite participation processes. However, villagesvisited intwo by theteam, villagerawareness ofandinvolvement inthePDPPprocess of thesevillages, thenewplanningprocess hasindeedinvolved more peoplethandidthetraditionalplanning just 20ofMaros’ 5-year villageplansunderPDPP. villages(only19percent) have completed participatory some In planninginMaros. As of thisreport, ofthewriting successfully lobbiedfor passageofalaw requiring participatory Program 2003,they inplanning. (PDPP)aimedatincreasing In Development villagerparticipation ofParticipatory Perform’s SouthSulawesi province. inMaros district, 2002,Forum In localpartner Warga andPerform staff planningfor investment multi-year plans. district Forumparticipatory Warga, organization, was alocalcivilsociety with governmentsinIndonesia Regionalprojectto assist80district Management) (Performance-Orientated From 2001to 2005,theUnited(USAID)implemented Development for States thePerform Agency International Abstract Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: to thecontrary. Andnowhereorts are villagersinvolved inbudgeting. of PDPPwasto Oneoftheobjectives reproduced orreused withouttheirpermission. Democratic Governance, Thiscase iscopyrighted (U.S.A.). Harvard University by theauthors, Institute, theAsh andtheWorld B Managerial, analytical, was provided andeditorialsupport by MennoPrasad Pradhan, World Bank(Indonesia),andWinthrop Carty, Project document);PDPPHandbook(Perform Project document);andLocal Governance Fact (Perform Project Sheet:Maros Regency do Ian, Perform Lessons Learned Study, 2005);Ten Culpin Planning, (January Jakarta andT StepsforImplementingPDPPinDistricts ingrum, consultants (Indonesia),andLuis Fujiwara, Ford Foundation InternationalInnovations LiaisonProgram (Brazil). Sources a fi eldvisittoMaros inMarch 2005.ResearchArya Gaduh, teammembersincluded B. World Bank(Indonesia),Nunik and M Yunarti This case was writtenby Stefan NachukoftheWorld Leisher, Bank(Indonesia)andSusannahHopkins consultant (Australia). Rese cials directlyasthemosteff ank andmaynotbe usedincludeGreen, arch was based on aulina Cahyan- Ash Instituteof Ash owns (Perform ective ective way begana cument). 8

Introduction

As part of its mandate to alleviate poverty in Indonesia, the World Bank is undertaking analysis regarding “Making Services Work For the Poor.” This work aims to promote better services, especially for poor and disadvantaged people. The case studies were chosen through a competitive outreach process managed by the World Bank from among the many innovative practices seen in much of Indonesian local government in recent years. Donors, non- governmental organizations, and local government staff were contacted and encouraged to submit proposals regarding innovative pro-poor service delivery work that they either were undertaking or knew about. Maros’ reforms in promoting citizen participation in planning touch upon a key theme central to making services more pro-poor: enhanced client power. Participatory Planning District,In Maros South Sulawesi

The Study Site: Maros District In 2001, Maros district had a population of 278,300, living in 14 sub-districts. Located in the western part of South Sulawesi province, Maros is about 30 kilometers north of the provincial capital, Makassar. The district’s 2004 poverty rate was just under 21 percent, higher than the 2004 national rate of nearly 17 percent. Agriculture is the main economic activity. There are many ethnic groups in Maros, but the Buginese and Makasarese comprise the majority.

The Perform Project And Forum Warga From 2001 to 2005, the United States Agency for International Development (USAID) implemented the “Perform” (Performance-Orientated Regional Management) project to use “participatory planning to assist 80 local [district] governments in the creation of multi-year investment programs.” One of these districts was Maros.

Perform project strategies: At the local level, the Perform project focused on 1. Improving the quality of local fi scal policies by providing technical providing villages, districts, and civil society assistance to the Ministry of Finance; 2. Improving the quality of local administrative policies by providing organization partners with technical assistance technical assistance to the Ministry of Home Aff airs; and (mainly training and facilitation) in participatory 3. Improving the quality of local planning policies. planning methods for the preparation of medium- term investment plans linked to district budgets. Before providing assistance, Perform required interested local governments to commit to fully involving stakeholders in the planning process and to allocating suffi cient funds for project implementation.

Forum Warga (FWSM, or Salewangang Maros in the local language, meaning “prosperous Maros”) was Perform’s local partner in Maros.221 Forum Warga is a consortium of NGOs, citizens, and local informal leaders. Its vision is to make Maros a “prosperous community” through greater community participation by: 1. Institutionalizing citizen participation in policy-making;

221 Forum Warga members state that they founded their group independently. However, Perform staff played a key role in helping the group develop by, for example, helping them organize meetings and work with district government offi cials.

Making Services Work for the Poor: Nine Case Studies from Indonesia 151 Participatory Planning 8 152 In Maros District, South Sulawesi (APBD, orAnggaranPendapatan danBelanjaDaerah). plan andbudgetsendsitto DPRD, ofthenewyear’s where budget itisdiscussedandlegalized aspart district annual planningmeetings, andby The fi plans attheir wereve-year to beused by villagesasabasisuponwhich to produce annualplans, bysub-districts offi theseplansto forwarding sub-district • productionoffi villagedevelopment plans;and ve-year • facilitators would theorganization withvillagersto work ofvillagemeetingsinwhich leadersanddistrict • thecreation plans; ofsub-village • • data collection; the projectwere to beresponsible for: andvillagefacilitators inplanning. trainedby Partisipatif orPDPP)aimedatincreasingDistrict villagerparticipation 2002,Perform andForumIn Warga beganaProgram (Program Development ofParticipatory DasarPembangunan 226 Law No. 13/2003 on Community Participatory-Based Regional Development Planning. LawNo. RegionalDevelopment Participatory-Based 13/2003onCommunity 226 ofForum PDPPmanagerinBappedaandGeneral Secretary Warga. 225 PDPPmanager, Bappeda. 224 leader. ofasub-district Secretary 223 Forum Warga membersandGeneral Secretary. 222 donationsfrom members. community well asbyin-kind Forum Warga byfi issupported nancialdonationsfromtwo-thirds ofthedistrict’s organizations as 55civilsociety Encouraging theexecutive andlegislative citizen’s bodiesto take voices into account. 3. Helping to ensure theapproval planningandbudgeting; ofvillageproposals district during 2. kerja); sustainability; potential to increase villagers’ sustainability; kerja); incomes;andurgency. score eachagainstfimeeting participants jobcreation (lapangan opportunities; ofmarket availability ve criteria: meeting. theproposals After district are assessedfor fi budget, proposals andthe current district twithlineministry of Maros’ produces 20-25projectproposals, so280-350proposals mustbeconsidered each 14sub-districts during 0 Public law/policy. disseminationofthenew 10. Passage ofthelawby DPRD. 9. Consideration comments ofcommunity by districtparliament(DPRD). 8. Formal complaints by citizens. 7. Final formulation. policy/law 6. Government feedback tocommunities. 5. responses Community tothelaw. 4. 3. Community organization. Exposingcommunities tothedraft laws. 2. Publicizing draft lawsandplans. 1. The Law’s tenstepstoparticipation. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Pembangunan Daerah identify and prioritize theirneeds; identify andprioritize ), and the District Parliament), andtheDistrict (DPRDor Bappeda during itsannualplanningmeetingsto during inform fund allocation. Planningces, Board theDistrict ( 225

222

planning, lobbied for passageofalaw onparticipatory 2003,ForumIn Warga andPerform staff Partisipasi Masyarakat/Perencanaan Pembangunan (Perencanaan PlanningDevelopment (P2DBPM/P2BM) Regional Participatory-Based Community for thelaw have notyet beenpassed. Underthelaw, Dewan PerwakilanDewan Rakyat 226 though implementation arrangements thoughimplementationarrangements 224 Finally, Pembangunan Daerah Bappeda Bappeda ). orBadanPerencanaan drafts adevelopment drafts successfully Berbasis Berbasis 223 Each 8

Berbasis Masyarakat) is now the required mechanism for development planning in Maros, though it complements rather than replaces previous planning mechanisms. The new law requires citizen involvement in short-, medium-, and long-term planning at village, sub-district, and district levels, in annual district budget creation, and in the formulation of policies in many areas including health, education, and the environment. The law also further requires full transparency and gives citizens the right to complain.

Research Questions And Methodology The fi eldwork tested three hypotheses: • The new law and the Program of Participatory Development (PDPP) have increased citizens’ involvement in planning and budgeting.

• The new law and the Program of Participatory Development (PDPP) have not made district budgets or plans Participatory Planning District,In Maros South Sulawesi more refl ective of citizen priorities. • The impact of the new law and the Program of Participatory Development (PDPP) is unsustainable.

The research team spent 10 days visiting the district town, Maros, and 3 sub-districts: Mandai, Maros Baru, and Lau. In Mandai, the team visited Pattontongan and Hasanuddin villages; in Maros Baru, Mattirotasi village; and in Lau, Soreang village. PDPP has not yet been implemented in Soreang, but the other three villages visited were part of the fi rst phase of PDPP. Focus group discussions and semi-structured interviews were carried out with 92 people, including 6 Forum Warga members, 2 Bappeda members, 3 DPRD members, 2 Perform staff , 1 sub-district head, 3 sub-district staff members, 3 village heads, 37 villages elites, and 35 villagers.

Findings

Maros government allocates Rp . 100 m illion to Forum Warga fund planning in advocacy more an additional 20 Maros People’s than doubles villages Representative Citizen Participatory district’s Council formed consultations planning law financial USAID Perform to impeach on a drafted and support for project in previous Bupati participatory passed by village Maros ended Implementation of planning law DPRD proposals decentralization begun law nationwide

1999 2000 2001 2002 2003 2004 2005

1998 2005 Forum Warga USAID and Perform Participatory village Participatory “Perform” staff begin the plans completed in 6 village plans project initiated PDPP villages completed nationwide in 14 First Mattirotasi more villages village proposal funded by district Election of new Maros Bupati

Making Services Work for the Poor: Nine Case Studies from Indonesia 153 Participatory Planning 8 154 In Maros District, South Sulawesi these villages in particular, it is likely that PDPP has increased participation inplanning.these villagesinparticular, thatPDPPhasincreased itislikely participation meetings. In planning process; villageheadsthemselves theproposals hadbeenwriting to submitto sub-district Some PDPP villages had not even been holding old-style Some PDPPvillageshadnoteven beenholdingold-style 2 Villagerinterviews. 227 had been),andthevillagefacilitator hadmoved away. ofPDPP,Village elites hadnomemory buttook adimview didn’t intheirvillage2003(thoughaccording whetherPDPPplanninghadbeenconducted to Perform, it know For few example, villagerswere inHasanuddinvillage, very even aware ofPDPP. The (new)villageheadandhisstaff However, intwo villagesvisited, villagerawareness ofandinvolvement inthenewplanningprocess was nil. Source: Mattirotasi villagers. with,theprocess ofdiscussionin,andthelevel ofsatisfaction wereconsensus wasthatboththequality high. more confiOthers recalled thatmoreupinPDPPplanningmeetings. out. peoplespoke dentaboutspeaking The not onlyaware init.Onevillagerstated thatcitizens ofthePDPPplanningprocess are buthadparticipated now thandidtheoldplanningpractices.time for participation someofthesetwenty villages,In thenewplanningprocess hasinvolved more peopleandprovided more Planning( Agency to theDistrict villages, andonly20percent oftheRp.for 100millioncommitted by thisprocess thedistrict hasyet beendisbursed as aresult offi planninghas yet beendoneinthese20 In theevent, nanciallimitations. notrainingorparticipatory to hadaplanto anadditional40villagesin2005,later expandPDPPactivities scaleddown todistrict 20villages facilitated planningin14more 2005(postponedfrom villagesinearly 2004becauseofbudgetlimitations). The With Perform’s assistance, sixvillageplanswere governmentfundedand completed in2003,andthedistrict Twenty ofMaros’ 103villages—just19percent—have villageplansunderPDPP. completed participatory Have The TheNewLawAnd Increased Citizens’ Involvement Budgeting? InPlanningAnd Output Facilitators Discussants Proposal makers Time required Number ofparticipants Type ofparticipants Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Village head District andvillage facilitators District Smallgroups 2days Facilitated process encouragesallparticipants Five-Year Village Mid-Term Plan 30-50people Annual Village Plan Development Village head Elites, menandwomen,young poorandrich, speak elites Only Individuals 2 hours 5-20 people elites Mostly Bappeda Old process ( Musrenbang ). P rogram Of rogram Of musbangdes tingkat desa) tingkat musbangdes P or For example, inMattirotasi village, mostvillagerswere articipatory articipatory to speakup and old, informal leaders meetings prior to theintroductionofnew meetingsprior PDPP process ( D evelopment partisipatif) musrenbang (PDPP) desa 227

8 of the utility of their participation in even the old-style planning meetings (musbangdes), explaining that they were never given enough time to consult with villagers beforehand. Many perceived meetings to be “the same old thing” in which they would make proposals, but nothing would happen afterwards. One informal leader said, “I only have a 10 percent desire to come to this [year’s] meeting, as I’m afraid it will be a repetition of last year.”

In Pattontongan village, villagers and village leaders were also unaware of PDPP, though according to Perform, it had been implemented there as well. Here, villagers reported informal involvement in planning, however; they engage in informal discussions about their development problems, and then submit their ideas to the head of the neighborhood, who presents them at the musbangdes.

Even in villages where overall participation has increased, women’s participation has still been limited. Participatory Planning District,In Maros South Sulawesi PDPP required 30 percent female attendance at planning meetings. Female participation during the meetings was also reported to be somewhat forced; facilitators questioned women directly to ensure that they spoke up. While the attendance quota was usually met on the fi rst of the two days of planning, the Forum Warga head estimates that only about half of those women showed up on the second day, citing their household work demands.

PDPP villagers are still not involved in budgeting. Either directly or indirectly, the research team found no evidence that the already limited villager involvement in planning extends to budget allocation at the district level.

Have The New Law And The Program Of Participatory Development (PDPP) Made District Budgets Or Plans More Refl ective Of Citizen Priorities? There was a large increase in planned district funding for 2004 village proposals. It is debatable to what degree this was the result of the new law and the PDPP, however. The direct cause of the increase was Forum Warga’s advocacy, but one of the Perform project aims includes successful advocacy by local groups for improved district budget processes.

At fi rst, the district government agreed to fund just 38 percent of 2004 village proposals (calculated by Rp. amount). Forum Warga was very disappointed, and held a meeting with some DPRD and Bappeda members to discuss the situation, pointing out that some approved expenditures, such as car purchases for civil servants, were inappropriate, while support for legitimate development activities was insuffi cient. After three meetings, the number of village proposals funded was dramatically increased, to 67 percent (about Rp. 133 million) of the total request, representing

70 percent of the district’s entire annual development budget for both villages and district departments.228 At the same time, according to the Perform website, district proposals to buy vehicles, discretionary allocations for the Bupati (district head), and support for professional organizations were cut. Given the power of the departments, this was seen as a substantial accomplishment.229

228 Article by local Perform manager in Berita Perencanaan Partisipatif (“Participatory Planning News”). 229 Estimates from head of economic and development sector in Bappeda (actual budget document was unavailable to the team) and the RAPBD (draft budget or Rancangan Anggaran Pendapatan dan Belanja Daerah that is formalized as the APBD).

Making Services Work for the Poor: Nine Case Studies from Indonesia 155 Participatory Planning 8 156 In Maros District, South Sulawesi Bupati andtheheadof remains low.proposals fundedby thedistrict actually Villagers said that lobbying government offi 231 Interviews withMattirotasi villagers. Interviews 231 230 Mattirotasi Village Mid-term Plan2003-2007 oftoilets in2005. construction The villagerequested toilets justfundedpublic for eachhouseholdbutthedistrict • ofpaved construction roads in2004. The villagerequested fundingfor1,500 min3hamlets, butthedistrict • proposals have beingamended): (after tovillage leaderstated PDPP, thatprior villageproposals hadnever beenfunded, whereas oftheir sincethen,two MattirotasiIn village,fundingfor afew PDPPclearlyhelpedinobtainingsomedistrict villageproposals. though. refute thisassertion, Bappeda Bappeda of villagebudgetallocations over time. Due to the lackofdata, itisimpossibleto say whetherthere oramount hasbeenachangeinthetype its greatest feeling Mattirotasi villagersstilldescribe impact, andpessimistic”“hopeless to lobby government directlyasthemosteff plansandbudgets,Despite somesuccesses, and continue villagersare ondistrict stillpessimisticabout theirimpact ear o oa od 700,000,000 - - - 105,000,000 - - - - Bawalangi ofconcreteConstruction road to from Kanjitonang Repairs for localroad ofbridge Construction ofasphaltroadConstruction inslum oftoiletsConstruction for eachhousehold ofcleanwaterConstruction tubs Training for chipsproduction shrimp Revolving funds Bawalangi ofconcreteConstruction road to from Kanjitonang Completion ofvillagehead’s offi channel ofirrigation Extension Mangrove plantation activities Analysis ofcommunity Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: toilets. school. funded just150minonehamlet—the onewithanelementary Accor northePerform managerwere orlower ableto levels supplyany to budgetdataatdistrict substantiate or hasnotrewarded withsignifi theirplanning work cantlydiff ding tothevillagehead, thisandotheritemsinthetabledonothave costsbecause villagerswereunabletoest Bappeda ciiis20 06Cost (Rp.) 2006 2005 Activities e- ce has been the key to achievingsomeoftheirgoals, hasbeenthekey suchasbuildingavillageoffi ective wayective to thevillagewhere getfunding. PDPPhasapparently In had The biggest single concern identifiThe biggestsingleconcern Mattirotasi edby villagerswasthat erent and/orbiggerdevelopment grants. Neither 231 asthenumberofvillage imate them. cerssuchasthe 750,000,000 40,000,000 750,000,000 230 The ce 8

and village road.232 For example, they felt that funding for a road project was only forthcoming because they were able to directly request it from the Bupati during one of his monitoring visits.233 The head of Hasanuddin village has also sent proposals directly to the Bupati, as well as attempting to get the support of a relative of the Padangala hamlet head’s wife who is a member of the DPRD.234 Tellingly, Padangala hamlet has received funding for street lights, school renovation and path upgrading.235 Many villagers noted that “having a friend in the local parliament or planning agency” is the best way to get results.

It is unknown how many village plans are actually being used in district planning and budgeting. The Mattirotasi village head, for one, is certain that his village’s plan is being used by the district, as he has visited the district and seen that they actually have the plan and use it. On the other hand, in Hasanuddin nobody in the village could even locate the new mid-term plan that had supposedly been produced. In Pattontongan, a village facilitator Participatory Planning District,In Maros South Sulawesi did have a semi-completed fi ve-year plan, but was unsure what to do with it. He reports asking the local Perform managers about it, but until now he hasn’t had a clear answer.236

According to a Bappeda staff member who is also the local PDPP manager, Bappeda has all 20 completed village mid-term plans, yet the local Perform manager has borrowed them all and was either unwilling or unable to show them to the research team.

Despite the apparent lack of impact at district level, Forum Warga leaders state that about two-thirds of PDPP village heads are using the 5-year village plans as a basis for village-level annual planning. The Mattirotasi village head was the only one who was able to confi rm this, however.237 Forum Warga also claims that it ensures village plans are submitted to the musrenbang (Development Planning Meeting) at sub-district level,238 but there was no evidence to show that village plans are being used at this level.

Is The Impact Of The New Law And The Program Of Participatory Development (Pdpp) Unsustainable? The fi nancial sustainability of participatory planning is uncertain, due both to lack of data and to limited fi nancial commitments from the district, but fi nancial hardship does not appear to be a factor. The primary funder (USAID) has left; while the remaining funder (the district government) has continued to fund the PDPP process, its actual support has been much less than its promised support for the last two years. In 2004, it initially planned to dedicate Rp. 250 million (about US$25,000) to participatory planning in 14 villages, but cut this to Rp. 50 million. In the end, even this sum was not disbursed until 2005, due to budget shortages in 2004. In 2005, it allocated

232 Hasanudin village. 233 Interviews with Matterotasi villagers. 234 Informal interview with Hasanuddin village head. 235 Interviews with community in the poorest hamlet in Hasanuddin village. 236 According to the General Secretary of Forum Warga. 237 PDPP manager/Bappeda staff . 238 Forum Warga.

Making Services Work for the Poor: Nine Case Studies from Indonesia 157 Participatory Planning 8 158 In Maros District, South Sulawesi PDPP Funding planningintheremaining 63villages. stated commitment to fundingparticipatory 20villages, buttoRp. date 100millionto hasdisbursedjust20percent afurther ofthissum. There hasbeenno sustainability: inMattirotasi, for example, thevillageheadwas noteven awaresustainability: thatthere hadbeen villagefacilitators. Warga staff ) were used. Admittedly, usingvillagersasfacilitators eff may nothave been very villages, novillagefacilitators were trained orused;instead, trainers(includingForum Perform managersanddistrict from planningprocess eachvillage, inthesevillages. were However, to have ledtheparticipatory 14 inthenext 20 peopletrainedfacilitators for thefi rst6villages to beincludedinPDPP. Village facilitators, including3leaders trained 20trainers:10from localgovernment and10fromorganizations, civilsociety includingForum Warga. These Limited villagerinvolvement inPDPPmay reduce chances for socialsustainability. remaining 63villagesisuncertain. Yet there isnoobvious alternative to theForum’s leadership. fi nancial resourcesto maintainthislevel soitsability ofinvolvement and technical skills, to the ifPDPPisextended planninginall20villages. However, hasalsohelpedfacilitate level. participatory well asthedistrict It ithaslimited and budgets, byhaving staff to ensure tries plans planning. thatvillageplansareusedinforming district actually It in promoting participatory Warga, whoselimitations reduce thechances ofinstitutionalsustainability. PDPP implementation hasdependedheavily ontheinvolvement ofthemainlocalchampion, Forum throughout thedistrict. oftheslow paceofPDPPimplementation budget, though,implyingthatbudgetlimitationsmay notbeattheheart more atanaverage costpervillageofRp.10 million. This represents lessthan5percent ofMaros’ 2005development from thisfithough. Extrapolating gure, the Rp. remaining 63villagescouldbeexpected to costabout 630million the remaining 63villagesdiffi to accurately calculate thecostofimplementingPDPPto estimates date,ofthecostimplementationin making The team wasunableto obtainany fi nancialdatafrom for its2004PDPPspending.Perform Without this, itisimpossible Source: PDPPmanager/Bappedastaff 3 EstimateofPDPPmanagerbasedonagreed cost-sharing thedistrict (20percent) between andPerform (80percent); nosupp 239 (US$10,000) Rp. 100million p 0mlin(S500 Rp. 200million(US$20,000) Rp. 50million(US$5,000) Rp. 50 million (US$5,000) No data available, though it is known that Nodataavailable, thoughitisknown Rp. 50million(US$5,000) Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: available. ititbde Perform budget budget District present involved atandactively as inplanningmeetingsateachtechnical department cult. AtleastRp. 400millionhasbeen spentorcommitted for theprocess in40villages, . odt lne 20 Nodate planned 0 Perform paidsomeprojectcoststhisyear 239 2005 January-February i-036 Mid-2003 The Forum active hasbeenvery implemented When When ective inbuildingsocial ective Perform staff orting budgetdata orting Number of Villages initially 14 8

When it was explained to him what the responsibilities of the village facilitators were, he concluded that he must have been one of them! But he could not recall having attended any related training. Village facilitators were never paid for their work, in contrast to district and Forum Warga facilitators, perhaps further reducing their buy-in to the program. (According to Bappeda, this was because most were already village leaders whose job responsibilities included facilitation of village meetings.) Moreover, Forum Warga—essentially the local leader of PDPP—is, despite its championing of villagers’ causes, isolated from the villagers by its elite status. Though it has formal links with NGOs in many villages, it does not have a strong local base of support. Many villagers have never even heard of it. Perhaps as a result, villagers have not taken ownership of the participatory planning process.

Key Factors In The Positive Impact Of Participatory Planning

It is still early days for the participatory planning process, so perhaps it is not surprising that its positive impact has Participatory Planning District,In Maros South Sulawesi so far been rather limited. First, more villagers are now involved in annual planning at the village level than before, and they reportedly are more confi dent about being involved; second, in some villages, the 5-year plan produced by the process is actually being used as a basis for annual village planning, and is being brought to the sub-district musrenbang in hopes of infl uencing higher-level planning. The increase in 2004 funding for village proposals is arguably another result, albeit indirect, of PDPP.

Political changes at district and national level. After the economic and social crises of 1997 and 1998, the incumbent Bupati was impeached and ultimately imprisoned for corruption, the fi rst time that citizens had exerted such power in Maros’ recent history. This was in line with changes that were happening all over the country. The struggle to unseat the Bupati led to the formation of the Maros Representative Council, a grassroots citizens’ groups, and gave citizens a hint of their potential to shape district events.

Meanwhile, at the national level a sweeping decentralization law was passed that suddenly vested each of the approximately 420 districts and towns in the country with greater control over planning and budgeting.240 Local politicians, citizens, and foreign donors began taking a much greater interest in promoting good governance and participatory processes at the local level. The law, implemented in 2001, set the stage for the entrance of the Perform project and the formation of Forum Warga the following year.

240 Law 22/1999 on Decentralization and Regional Autonomy established the framework for Indonesia’s decentralization process, while Law 25/1999 clarifi ed the fi scal relationships among central and local governments.

Making Services Work for the Poor: Nine Case Studies from Indonesia 159 Participatory Planning 8 160 In Maros District, South Sulawesi The Perform project. getting atleastsomegovernmentto fundingfor keep theprocess eachyear. citizens. low pervillagecostsofimplementingPDPPhaveThe likely probably alsohelpedto enablePDPPsupporters relationship beginning governmentand between toopenness from changing thetraditionaltop-down thevery groups engagedindiscussionswith civilsociety actively andPerform staff political resistance. localgovernment offi thatkey The fact roles andultimately passingthelaw. indrafting Legal reform would nothave beenpossiblehadthere beenstrong many others,withForum especiallythoselinked implications ofinstitutionalizingparticipation, Warga, played active ofForumsupportive Warga andPerform projectstaff staff responsible for reviewing, prioritizing,andallocatingdevelopment funds, includingallvillageproposals. The receptiveness oflocalgovernment staff reformers inDPRD. for thelaw andleadershipoftheBupatiother inMaros becauseoftheconsultative process andthesupport successful, ademonstrationthatpassageofthelaw isindeedasignifi cantachievement. Conditions wereright support for theformation ofForumsupport Warga, withtheForum role played government on inworking akey anddistrict 4 There was anominallybottom-up planningmechanisminplace nationwideformanyyears previously, mostvil butinreality 243 Perencanaan Pembangunan Masyarakat Berbasis Partisipasi P2BM. 242 withDPRDmemberand ChairofGovernance Commission. Interview 241 Planning (P2DBM/P2BM) Based RegionalDevelopment Participatory Regulation Number13onCommunity the law, andthree drafts, theteamfi nalized theproposed law. DPRDapproved Regional planningandaseminaronthedesignof and 2003,includingaworkshop onparticipatory four rounds ofpopularconsultation amonggovernment, andcitizens 2002 between NGOs and 60%fromtodraft NGOs) inplanning. legislationtorequire After citizen participation The meetingresulted inaproposal tocreate ateamof15people(40%from thegovernment withtheirconstituents.greater popularity enabling themtorespond more eff initiative, could recognizing actuallywork intheirfavor, thatenhanced participation by processes. Reformistelementswithinthedistrictgovernment welcomedparticipatory this willing toattendbecause understoodthatmanydonorswould they beginrequiring discuss how inplanning. topromote greater Government citizen participation staff Perform staff coincided withaperiodofpolitical fermentledby local students. university InMay2002, legislation. The process participatory ofdrafting Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Formulation Management Locally). and Development Pedoman Penyusunan Perencanaan dan Pengendalian Pembangunan diDaerah, or HomeAff plans themselves, rarely andonlyvery were villageproposals approved NegeriNo.9 andfunded(KeputusanMenteriDalam tahun19 were involved andhave intheinitialmeetingsthatledtobeenquite passageofthelaw onparticipation, andlocal studentsorganized ameetingwith local to leadersandNGOs 242 in2003. Perform projectstaff ectively tocitizen demands, andintheprocess build 241 were key facilitators and supporters oftheplanningprocess. were facilitators andsupporters key They provided Perform’s inauguration inthedistrict to “changing therulesofgame.” . While someDPRDmemberswere aboutthe concerned cials—theBupati,DPRDmembers, and were in early 2002aboutthenewlaw indicates inearly desirable nornecessary processes hadbeenneither participatory major changefrom thepastwhen that asserts matters”—a“participation commitment to participation. The law staff involved government,NGO, andPerform andpassingthelaw—whichdrafting planning. Passage ofalaw onparticipatory districts, yetdistricts, inonlysixhasitbeen legislation intheother79program has attempted to promote similar provided alegalbasisfor PDPP. Perform airs Ministry Decree No. Decree 9/1982,GuideofPlanning airs Ministry —oiie spot o and for support —mobilized The collaborative process of Bappeda istheorganization 243 Bappeda . The law also lage headsdrafted Bappeda 82 tentang —were —were

8 passage of the law on participation, and supported village-level planning via funding and facilitation. The project’s specifi c requirements about including more people in planning meetings and encouraging them to speak up were also important.

Forum Warga’s genuine commitment to, and ability to lead, participatory planning. The Forum provided a legitimate, local organizational home for participatory planning advocates to rally around. Its ability to make a diff erence for PDPP was likely due in part to its government contacts and organizational support from the Perform project.

The leadership of some sub-district and village heads. A few active sub-district (camat) and village (lurah) leaders have helped bring participatory planning to life. Of the villages visited by the team, this was only the Participatory Planning District,In Maros South Sulawesi case in Mattirotasi, but Forum Warga asserts that over two-thirds of PDPP village heads now understand and use participatory planning methods. They play a key role in ensuring that villagers understand their rights under the new law, that local planning processes are undertaken on schedule and to a high quality, and that villagers understand the subsequent process of prioritization and budget allocation at district and sub-district levels. In the opinion of Forum Warga’s secretary general, the Mattirotasi village head, for example, ”really understands how to get community participation.” He has close relationships with many members of the Forum, and a background as a district activist. In 1998, he joined other activists to form the Majelis Amanat Rakyat Maros or Maros People’s Representative Council which impeached Maros’ previous Bupati.

Villagers and village leaders’ continued use of personal lobbying as a way of obtaining district support for village proposals.

What Reduced The Positive Impact Of The Innovations? Limited involvement of villagers in PDPP. Perform and Forum Warga facilitators met with leaders of all 20 PDPP villages to ensure an appropriate cross-section of villagers be invited to two-day planning meetings. However, there was no follow-up; it was left to village leaders to issue invitations to and publicize meetings. In Mattirotasi village over 50 people attended. Their degree of representativeness of the village population is unknown, though interviewees stated that all stakeholders had been involved.244 Preparatory sub-village meetings were required by PDPP rules, but in at least one village (Pattontongan), villagers claimed that there had been no such meeting in the poorest of the 4 sub-villages, which reduced their ability to prepare their proposals and thinking. The village facilitator, however, contends that sub-village meetings were conducted in all 4 sub-villages. Strategies to increase women’s involvement were ineff ective in part because they failed to take into account women’s work responsibilities and consequent availability for meeting.

244 In Hasanudin village, no reliable information is available because the village facilitator moved out of the village, there is a new village head, and villagers did not have a clear recollection of the process. In Pattontongan village, locals reported that the planning process has not yet been com- pleted.

Making Services Work for the Poor: Nine Case Studies from Indonesia 161 Participatory Planning 8 162 In Maros District, South Sulawesi days. to process, budgetlimitations,a leisurely 14villages, theprocess 5-day dueinpart butinthenext took just2 A truncated planningprocess insomevillages. awareness oftheForum orwhatitdoes. Meanwhile, Forum Warga hasbroad butshallow roots amongMaros’ citizens. localcitizens Most have alimited and closeassociates suchastheMattirotasi villageleader, planning. there isnolocalchampionfor participatory Dependence on onelocalchampion. 246 Interview withgeneral ofForum secretary Interview Warga. 246 Forum Warga facilitated theprocess inthenext 14,duringwhichtimePerform was windingupitswork inMaros. 245 the program’s relative merit. years. The district’s inconstantfi planning to date wrangling impliesinternal over for participatory nancialsupport costs for expandingthe program to newvillages, meanthatthetotal willrise, costofthiswork notfall, inthecoming expensive, costsassociated recurring withtrainingfacilitatorsvery villageprogress, andmonitoring plusincreased PDPP). Further, there isnoplanfor fi long-term planning. nancialsustainability Whileitisnot,initself,for participatory reallocated from theagreed budget(thismay explainthedrasticreductionindistrict’s 2004fi for nancialsupport fileadership. Hefrequently extra-budgetary makes nancialcommitments to villages, sothatmoneyhas to be Weak from thegovernment support for PDPP. potential for localsupport. and comparative eff planningmeetings)andoutcomes (fundingfor villageprojects). (joining The existence theiractions links between The lackofmeasurable improvements inbudgetallocations for PDPPvillages. one Indeed, rather weak. facilitator”“village wasunaware oftraininghehadsupposedlyreceived. Only insixvillageswere attempts madeto usevillagefacilitators, andeven inthesevillages, villagerinvolvement was many limitations which have likely been key to problems with funding participatory planning andputtingthe tomany problems limitations whichhave beenkey withfundingparticipatory likely Limitations ofthelaw. aplan together.implement aneedsassessmentanddraft consultants trained by Perform. assistancethe process from ontheirown, orseekfurther 3: Year Year 2: document; 1: Year timetableforPDPPimplementation: Perform Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: 246 Most participants agreed process for wastoo to brief thatanintensive eff thecommunity participants two-day Most Local plan; stakeholders beginroll-over Local stakeholders prepare multi-year planning Local governments assumedabletocontinue ofa ectiveness “shadow process”—informalthe undermined further lobbying—has likely The Participatory Planning Law wasasignifiThe Participatory Maros. cantachievement in However, ithas areWhile many stakeholders involved inPDPP, otherthanForum Warga In thefi In rst6villages, PDPPwas implemented asintended, in out of103villages, planningin6 Maros having facilitatedleft actively participatory to results.ending wastimeboundratherthanlinked Perform Poorly-planned endingofPerform’s support. funding. thenecessary ensuring cadre ofindividualswhowould continuetheprocess, or The previous Bupati is known forThe previous hisratherpoorfi Bupatiisknown nancial 245 withoutleaving behindeitherasolid Villagers have seenfew orno The project’s ectively ectively

8 resultant plans to use in district-level planning and budgeting. For instance, the law does not clarify: • implementation arrangements at the sub-district and village levels; • how participatory planning will be funded;

• what constitutes “participation”; 247 • the roles and responsibilities of diff erent levels of government for implementation; and • how village plans and district budgeting shall be linked.

Nor does it include provisions for a citizen’s complaints commission or sanctions for government staff who do not work in a participatory manner.248 (Both were dropped just prior to fi nalization of the law.)

Lack of an implementation decree for the law. The implementation decree is almost complete, and it is hoped that Participatory Planning District,In Maros South Sulawesi it will soon be legalized. It is expected that the decree would clarify much of the confusion surrounding participatory planning, as it would clarify responsibilities and help ensure accountability.

Local political changes. It is likely that the election of a new Bupati and the replacement of Bappeda’s head in late 2005 were one cause of the slow disbursal of funds committed to participatory planning in the next 20 villages and also delayed implementation of the implementation decree for the participatory law.249

Citizens’ weak understanding of their rights and obligations under the new law. Most local citizens are unaware of the new law, and even fewer were able to cite its specifi c provisions regarding their participation in planning, further reducing their “demand” for participatory “services”.

Very limited available data on PDPP spending, funding for village proposals, and production and use of village plans. The lack of adequate data on these key topics means it is impossible to accurately gauge the success of PDPP to date, making it diffi cult to plan for eff ective implementation in the future.

Making It Sustainable And Replicable Consider instituting a local “block grant” system. Such a system, which provides a pre-set amount of funding for local development proposals, could off er a direct, immediate, and powerful incentive for villagers to invest in developing high-quality medium-term plans.

Widely disseminate information on citizens’ rights and obligations regarding participatory planning. Citizens are less likely to eff ectively participate in planning exercises if they are unaware that the law supports them in this. Currently, many citizens still believe that planning remains the responsibility of their leaders.

247 It merely states that “participation is a form of active societal involvement, directly and indirectly responsibly providing input for all policy formula- tion and enactment, and for all governance activities, so they can be more accommodative, transparent and accountable.” 248 DPRD Chair on Governance. 249 PDPP manager/Bappeda staff and Secretary General of Forum Warga.

Making Services Work for the Poor: Nine Case Studies from Indonesia 163 Participatory Planning 8 164 In Maros District, South Sulawesi planning district-wide. yet play therole to whichitaspires, inbudgeting and thatoforganizing andfacilitatinggenuinecitizen participation planning. citizens Most onlyhave avagueawarenesspromoting ofForum participatory Warga atpresent, soitcannot organizationsCivil society suchasForum Warga musthave deepsupport infl factor. butisstillanimportant uenceofpoliticalparties, and budgets. Provide to government support offi better outcomes tomorrow. requires thatpeoplebelieve participation theirinvolvement today willberewardedto socialsustainability: with structureto helpensure theirrealization.planning anddecision-making Financial isintimately linked sustainability despite Perform’s stated intent to ensure both.Suchfundamentalgoalsneedto into beincorporated aproject’s planningwasnotinstitutionalized orfithat participatory Maros, nancially secure bythetime departed Perform Outside agents suchastheUSAIDPerform shouldemploy project results-based programming. potential to eff work plans, yet becauseoftheir grounding andpolitics, invillagesociety theseare thefacilitators withthegreatest to helpvillagesproduce high-quality facilitators usedsofarhave trainingandsupport notreceived thenecessary level.exercises, theywillnotbeusedatthedistrict thenitisalmostcertain There isevidencethatthefew village Invest facilitators. village-level heavily intraining andsupporting Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: Technical isnot,ofcourse, suffi support ectively atthevillagelevel.ectively ces (inthiscase, cient to address the “egos” andthe departments ofthedistrict Bappeda ) to improve to linkvillageplans theirability If poor-quality plansresult from village poor-quality If to function eff to function asagents ectively It isclear It Case Study 9: Civil Service Reform In Boalemo District, Gorontalo Civil Service Reform 9 166 In Boalemo District, Gorontalo Thiscase studywas B. writtenbyWorld Arya Gaduh, Bank(Indonesia).Research was basedonafiApril eldvisittoBoalemoin fi nancialcommitmentsfrom theILGR project. weak civilsociety, avery andunfulfithe marginalizationofdistrict, ofcitizens livingindistantandpoorparts lled decisionto removethe short-sighted “operational allowances”), ontheBupatiasanindividual, over-dependence fi ofsalary reform (thedearth quality,system ofthemonitoring nes for salary theimpracticality for service nes, and fi havefactors conspired to limitthereforms’ ootnoteseff off been mainlydueto theBupati’s commitmentandleadership, andto thefi nancialpromises and technical support atleastoncesucha complainthasresulted fact, inthe fi In often. offi ring ofcorrupt as citizens livingnearthecapitalnow to have lodgecomplaints, more andapparently opportunities dosomore money beingspentinthedistrict. The reforms more seemtoaccountable havethepublic, madecivilservants that are usuallydoneby non-localfi project ofallconstruction rms, and whichlikely represent asubstantialportion in increasing ofprocurement, thetransparency butonlyfor smallerprojects. Collusion remains inthelarger projects fi ofthosewhomtheyare supposed to beinspecting. nancialsupport The reforms appear to have been successful offi ontheperformance expenses—has hadanegative impact eldstaff reported. Moreover, onereform—the removal ofso-called “operational allowances”, usedmainlyto pay for fi eldtrip quality, becausequality-related for violationsare likely beingneitherinvestigated poorservice a civilservant nor attendance, butthedatato prove thiswere notavailable to theresearch tem. Nofi nehas yet beenleviedon to date. ifnarrowlyThere defi may have performance beenanimprovement incivilservant ofstaff nedin terms increasing them),together withfi discipline. nes to improve civilservant Thesuccessofthe reforms hasbeenlimited competitive biddingfor procurement, (signifi for andtheintroductionofanewsystem ofsalaries civilservants cantly reform. service The mainreforms regulation have ontransparency, includedpassageofadistrict theintroductionof inGorontalo province, hasledaprocessSince 2002,theBupati(Regent)ofBoalemodistrict ofcivil Indonesia, Abstract Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ered bythe World Bank-funded for Initiatives Local GovernanceReform (ILGR) Project. Ontheotherhand, many is copyrighted by theauthor, Institute, theAsh andtheWorld Bankandmay notbereproduced orreused withouttheirpermissio wasGovernance, Editorialandanalytical provided Leisher, support by (U.S.A.). Susannah Hopkins Harvard University consultant was providedsupport by Stefan Nachuk andMennoPrasad Pradhan oftheWorld Bank(Indonesia)andWinthrop Institute Carty, Ash B. World Gaduh, Bank(Indonesia),andNunikYunarti andMaulinaCahyaningrum, consultants (Indonesia).Managerial, analytical, to CombatingCorruptioninIndonesia: Enhancing 1 Acc ountability and Development, World andDevelopment, teammembersinclud Bank(2004).Research ountability toectiveness date, designed includingpoorly incentives , someofwhommustnow rely onthe cials. The successofreforms has 2005. Reference ismade (Australia). Thiscase n. of Democratic and editorial ed Arya ed Arya

9

Introduction

As part of its mandate to alleviate poverty in Indonesia, the World Bank is undertaking a series of case studies to promote better services, especially for poor and disadvantaged people. The case studies were chosen through a competitive outreach process managed by the World Bank from the many innovative practices seen in Indonesian local government in recent years. Donors, non-governmental organizations, and local government staff were contacted and encouraged to submit proposals regarding innovative pro-poor service delivery work that they either were undertaking or knew about. The reforms being implemented in Boalemo district, Gorontalo, touch upon a theme that is central to making services more pro-poor: reforming the civil service. Hence its selection as one of the case studies. Civil Service Reform In Boalemo District, Gorontalo The Study Site: Boalemo District Boalemo district was established in October 1999, following the central government’s decision to decentralize, and the new district government was formed in 2000. Immediately thereafter, a costly dispute over the location of the new capital forced the district to build government facilities in two cities. The dispute was settled at the end of 2002 by splitting Boalemo into two new districts, Boalemo and Pohuwato. The population of the new Boalemo district was 106,440 in 2003.250

By any standard, people in Boalemo are poor. A 2000 poverty assessment by the Central Body of Statistics (Badan Pusat Statistik or BPS) put its poverty rate at 39 percent, much higher than the national average of 19 percent. In 2003, its Gross Domestic Product (GDP) was Rp. 280 billion (US$29.5 million) or just Rp. 2.6 million (US$276) per capita. The district depends on agriculture and fi sheries: in 2003, three-quarters of its labor force worked in these sectors, contributing just over one-third of the district’s GDP.

Boalemo is culturally homogeneous; most citizens are of Gorontalo origin and many, especially older people, do not speak Bahasa Indonesia. Ninety-six percent are Muslim. Religion plays an important part in daily life, as refl ected in the district’s motto, Boalemo Bertasbih, which literally means “Boalemo with the prayer beads.”251

The Civil Service In Boalemo Two types of civil servants work in Boalemo. Full-fl edged civil servants (pegawai negeri) receive their base salary from the central government, and only the central government may fi re them. Districts are able to assign their jobs, however. In 2004, Boalemo employed 1,320 full-fl edged civil servants.252

250 Boalemo Dalam Angka 2003 [Boalemo in Numbers 2003], Central Board of Statistics (2004). 251 “Bertasbih” Stands for Beriman, Takwa, Sehat, Bersih, Indah, Harmonis; that is Faithful, Devohed, Healthy, Clean, Charming, in Harmony. .252 Interview with District Finance Bureau staff member.

Making Services Work for the Poor: Nine Case Studies from Indonesia 167 Civil Service Reform 9 168 In Boalemo District, Gorontalo The three main foci of civil service reformThe three mainfoci inBoalemoare below. ofcivilservice described Reform Focus #1:Improving Transparency reforms infi andinundertaking and publicparticipation nancialmanagementandprocurement. governments inimproving (specifi transparency cally, accountability regulation ontransparency), issuingadistrict includingBoalemo. inIndonesia, (kabupaten) initiated in22districts district The projectgoalwasto support Meanwhile, 2002,the inOctober World Bank-funded for“Initiatives Local GovernanceReform (ILGR) Project” was From reforms governmentintroducedinorder asetofcivilservice to 2002to achieve 2004,thedistrict thismission. government’s wasformed. ofthedistrict Governance reform missionsince2000when thedistrict hasbeenpart TheReforms Genesis Of The Reforms 5 ILGR Project Appraisal Document. 255 Hondascannot fi ll 254 “structural” are positions:they generally, forinstance, workers, teachers, and eldstaff fi Full-fl253 privileges edgedcivilservant can includea “structural” allowance, allowances forawifeandchild, andmonthly 2004. relying heavily onhondas. According to astaff 7. The formulation of public service standards.7. Theformulationofpublicservice 6. Periodic meetingswiththelegislative body. 5. Regionaldevelopment. 4. .Computerization ofgovernment administration. 3. Thedevelopmentofagovernment thatisneed-based. 2. Theimplementationofasystemrewards andpunishments. civilservice. 1. Provision ofahigh-quality Mission: the public. implement, andcontrol allgovernment activitiesinorder toserve Vision: Boalemo’s Vision andMissiononGovernance The District InspectorateThe Offi District head reports to theBupati. head reports fiit mainlyconducts nancialaudits. The regional practice, development plan.In government andimplementingthe is responsible for thedistrict monitoring (Badan Pengawas Daerahor Bawasda) Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: bureau heads. 254

Independence ingovernance: toplan,formulate, theability ce

member of the District Finance memberoftheDistrict Bureau, there were 1,476hondasin ensured thatthepubliccancomplaindirectly to theDistrict addition,hehas complaints directlyto him.In andmake mornings tradition: thepublicwasinvited to visithimathomeintheearly public easyaccessto him. year hebegana The next “morning coff ordered theremoval ofthefence surrounding hishometo allow the Following heador in2001,theBupati(district hiselection “Regent”) District-contracted employees ( District-contracted get neither the salary nor the privileges northeprivileges get neitherthesalary civil servants for Boalemo. hasbeen civil servants Hence, thedistrict offull-flthese employees, thishasmeantashortage edged 2003 decisionto maintainazero-percent growth rate for was drasticallycut. Together withthecentralgovernment’s available to newdistricts ineachofthetwo work servants 2002 splitofBoalemo, the numberoffull-fl edgedcivil whichcanhire and fithe district, re thematwill. With the Hondas’issues suchasmarriage). ispaidby entire salary same rigid centralrules(whicheven governpersonal however,civil servants; theyare alsonotboundby the rather thanmanagers, schoolprincipals, or honor daerah orhonda rice rations. 255

253 offull-fl edged ee” ) 9

Inspectorate Offi ce. In 2003, ILGR project implementation began in Boalemo. ILGR facilitators worked with the district government and civil society to draft a Regional Regulation (Peraturan Daerah or Perda) to strengthen the legal basis for government transparency.256 At the end of 2004, Regional Regulation No. 6/2004 on “Transparency of Public

Service in Governance” was enacted by the district parliament. It is to become operational in January 2006.257 On paper, the regulation is very progressive. It clearly requires public agencies to provide most types of information— except those related to police and national defense intelligence and the protection of intellectual property rights and competition—to anyone who asks for it. The regulation also states clearly which agency (the Transparency Commission) is responsible for implementation, as well as describing administrative and criminal sanctions for those who disobey it.

Following enactment of this groundbreaking legislation, the Bupati has continued to undertake other eff orts to Civil Service Reform In Boalemo District, Gorontalo increase transparency. In 2005, he insisted that all high offi cials begin posting their offi cial salaries on their doors. He requires all bureaus to publicize their progress in achieving the year’s target for own-source revenue, for both transparency and accountability purposes. He has also published his own and his secretaries’ mobile phone numbers, so citizens can either call him directly or send him text messages to report on civil servants’ performance.

Reform Focus #2: Reducing Corruption In Procurement Government procurement is one of the main sources of fi nancial “leakage” throughout Indonesia.258 With sole- sourcing as opposed to competitive bidding long the government’s method of choice, procurement has often been used to reward politicians’ cronies with government projects. District governments argue that sole-sourcing is not all bad: it can nurture the growth of local businesses, particularly in the construction sector. With the 2003 introduction of Presidential Decree No. 80/2003 on competitive bidding, however, most government purchases of goods and services must now go through a competitive bidding process. Neither district governments nor local businessmen are fans of the new requirement.

In 2004, despite protests from many local businessmen and politicians, the Bupati introduced competitive procurement to Boalemo—with a few twists. He made use of religion to try to restrain members of the Procurement

256 See http://www.p2tpd.or.id. 257 Operationalizing any regulation requires an implementing decree, which usually takes about a year to issue. Regional Regulation No. 6/2004 was issued at the end of 2004. 258 World Bank (2004).

Making Services Work for the Poor: Nine Case Studies from Indonesia 169 Civil Service Reform 9 170 In Boalemo District, Gorontalo than theusualdaily)roll-calls. implement thefi nes, theBupatiintroduced system amonitoring to sign(rather which hourly requires civilservants quality. littleemphasisisputonservice to behavior; percentage for violationspertain To eachviolation.Most help the new TOKD, to beleviedwhenever any often violationsiscommitted. The fi nes reduce the TOKD byaprescribed (ranging from Rp. 450,000to Rp. 800,000dependingonqualifi cations). TheBupatiincludedasystem of fi neswith seetablebelow). For amountdependsonthecivilservant’s rank; exact hondas, the TOKD becametheentire salary initiated itsuse, thereby increasing ofmostfull-fl thesalaries by asmuch80percent (the edged civilservants daerahor (tunjangan operasionalkinerja TOKD). Prior to thereforms, the TOKD wasnotusedinBoalemo. The Bupati full-flIn Boalemo, salaries. thisallowanceoperational iscalleda regional edgedcivilservant performance projects thatare prone andadvisestheBupationmeasures to corruption, to prevent corruption. givesof theLegallegaladviceaboutcontractors, monitors theProcurement Department) Committee, monitors staff bidders’ technical documentsanddisbursesproject budgets. The Legal Advocacy Team (includingtheheadand and representativesSecretary from relevant technical bureaus andtheFinancial Bureau) verifi of estheaccuracy he beganmicro-managing theprocurement process teams. viatwo The Verifi cation Team (includingtheDistrict (narrowly defi nedasgooddiscipline). 2004,theBupatibeganto implementasystem ofrewardIn performance andpunishmentto improve civilservice Reform Focus Incentives #3: Restructuring To Improve Performance Committee from allcommittee membersare corruption: nowsworninapublicreligious ceremony. 6 “Good discipline” isusuallytaken tomeancoming toandleavingtheoffi 261 No. BupatiDecree 65/2003. 260 TheProcurement259 Committee from isanadhocbody ofcivilservants aproject’s (usuallyagovernment implementingagency Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ous civil service ceremonies,ous civilservice instructions. andfollowing supervisor tion forthosewhocorrupt theprocess. the procurement periodtoselectthecontractor fortheproject. Apparently, thetextforswearing-in ceremony includesthr of the District Attorney’s oftheDistrict offi .Fi omk prpit eot.5-10 5.00 4.00 10.00 10.00 0.625 20.00 10. ViolateCentral Gov. RegulationNo. 30/1980 aboutcivilservants. 9. Fail tomake appropriate reports. 8. Fail (forexample, policy aboutreligious dress, supervisor toobey exercise, orlectures). notattendarequired7. Do meetingorotherevent. publicservice. 6. Neverperform provision forpoorservice by thepublic. 5. Arereported 4. Areabsentwithoutexplanation. 3. Leave theoffi lateattheoffi 2. Arrive hourlyroll1. Miss call withoutexplanation. eery 1.25 ce early. e 1.25 ce. iltosFine (%ofTOKD) Violations ce, theChiefofPolice, theheadandstaff 261 The reward provide to hechosewastheallowance top thatmostdistricts up 257 ce ontime, breaks taking withintheallowed timelimit,attendingthevari- 30-100 of the District Inspectorate, andthehead Inspectorate, oftheDistrict 260 bureau), setupduring

eats ofdivinedamna- 259 In addition, In 9

Full-fl edged civil servant salaries, post-reform (Rp.) 262 central government portion, 2003 district portion, 2004 non-operational TOKD as % of central base salary TOKD allowance government portion minimum maximum minimum maximum Rank 1 575,000 879,000 0 350,000 40% 61% Rank 2 726,000 1,186,000 0 450,000 38% 62% Rank 3 905,000 1,463,000 263 650,000 44%264 72% Rank 4 1,069,000 1,800,000 210-2,500,000 1-3,500,000 78%265 81% Source: Bupati Decree No. 55/2004 Civil Service Reform In Boalemo District, Gorontalo The Bupati also removed most “operational Summary of civil service reforms in Boalemo Transparency allowances,” which, depending on which bureaus • Improved access to the Bupati and District Inspectorate Offi ce the civil servants are in, can constitute a major • Passage of district regulation on transparency percentage of the full-fl edged civil servant salary. • Posting of staff salaries and phone numbers and bureaus’ progress in achieving goals The allowances, for travel, project-related work, and Procurement participation in committees,266 are prone to misuse, • Introduction of competitive bidding, with religious swearing-in and create a “pecking order” among bureaus, with ceremony for Procurement Committee and micro-management of procurement via Verifi cation and Legal Advocacy Teams the most project-intensive bureau having the highest Incentives operational allowances. The Bupati intended the • Introduction of TOKD with fi nes and monitoring, thereby greatly TOKD to substitute for the operational allowances, increasing civil servant salaries • Removal of most “operational allowances” removing both the potential for abuse and the “pecking order”.267

262 Decree of the Regent of Boalemo No. 55A/2004 and Regulation of the Government No. 11/2003 on civil servant salaries. 263 Rank 3 staff occasionally receive non-operational allowances as well. 264 Not including the non-operational allowance. 265 Assuming minimum salary earners receive the smallest TOKD and maximum salary earners receive the largest TOKD. 266 Civil servants often infl ated claims for these allowances, particularly at the end of the fi scal year, when bureaus attempt to fully spend their budg- ets. 267 There was an increase in the salary of all civil servants when this reform was implemented, to address the loss of “operational allowances”, but the size of the increase is not known.

Making Services Work for the Poor: Nine Case Studies from Indonesia 171 Civil Service Reform 9 172 In Boalemo District, Gorontalo Have The Civil Service Reforms Improved CivilServants? Have TheCivilService ThePerformance Of TheReforms Of Impact ofgovernance reformsnapshot ofthestory inBoalemo. andhenceshould beconsidered ofthiscomplexandelusive subject, a merestudy barely scratches thesurface ofgovernancereforms The impact ishard ofthesubject. to because ofthesensitivity measure,This case inpart had to rely onlocalgovernment staff team memberswould have becauseofthelanguagebarrier: Citizensof parliament. were inpart notinterviewed focus group discussionswere representing conducted, onewith14CSOactivists 8CSOs, andonewith12members whohadwon andacontractor several development projectsinBoalemo. addition,two In Tilamuta sub-districts, level offi BureauInspectorate, ofPublic Agency,Works, lower- Bureau CivilService ofHealth,andLegal District Department), were withhigh-level conducted offi interviews The research team spentsixdays in days capital)andtwo inGorontalo City.Tilamuta (thedistrict Semi-structured reforms more accountableto havethepublic. Thecivil service madecivilservants 3. reforms have Thecivil service increased inprocurement. transparency 2. reforms have Thecivil service ofcivilservants. improved theperformance 1. The research examinedthefollowing three hypotheses: Methodology Hypotheses And Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: cials, ILGR facilitators, organization several (CSO) civilsociety activists,thestaff 1999 established Boalemo district district 2000 formed government district Boalemo Regent elected Boalemo Current asinterpreters, responses. possiblyskewing 2001 nationwide begun project ILGR cials (the Bupati and the heads of the District Planning Agency, cials (theBupatiandtheheadsofDistrict District districts and Pohuwato into Boalemo Boalemo split 2002 begun coffee” tradition “morning Regent’s government by central numbers set servant fledged civil full- for growth rate Zero-percent bidding issued competitive decree on government Central 2003 Boalemo begun in implementation project ILGR begun servants civil of full-fledged of recruitment decentralization experiment on government Central enacted transparency on Boalemo law 042005 2004 out in Boalemo carried reforms Incentives Boalemo introduced to bidding Competitive ofhealthclinicsinDulupiand ended servants civil of full-fledged of recruitment decentralization experiment on government Central required officials Boalemo high of salaries of Posting 2005 9

There may have been an improvement in “civil servant performance”, if narrowly defi ned in terms of staff attendance. A head of the District Development Planning Agency (Badan Perencanaan Pembangunan Daerah or Bappeda) suggested that the new TOKD fi nes reduce absenteeism, and further noted that he has observed less absenteeism and “more enthusiasm” among hondas than among his agency’s full-fl edged civil servants. The head of the Public Health Centers (Pusat Kesehatan Masyarakat or puskesmas) in the district capital of Tilamuta also noticed this impact.

On the other hand, the head of the Public Works Bureau feels that workload fl uctuations have had a greater impact on absenteeism than the TOKD fi nes. The research team was unable to obtain attendance records to support any of these claims. Civil Service Reform In Boalemo District, Gorontalo

TOKD violations related to service quality No TOKD fi ne has ever been imposed for poor service quality. #5: Reported for poor service provision by the public. According to a staff member at the District Finance Bureau responsible #6: Never perform public service. for subtracting fi nes from regular TOKD payments, almost all fi nes #9: Fail to make appropriate reports. have been imposed for the simplest violations, such as those related to attendance. This suggests that either quality-related violations have never occurred or that they have never been noted. Since the team found that complaints about civil servants are regularly made, whether to the Bupati, the District Inspectorate or the parliament, it is more likely that civil servants’ quality-related violations are simply not being noted.

Incentives reform places a fi nancial burden on The removal of “operational allowances” has created problems staff . The head of the Public Works Bureau must go for staff who legitimately spend most of their time in the fi eld. to the province 4 to 5 times a month, bringing 4 to 5 By de-linking salary top-ups to project- and fi eld-related activities, staff members each time. Prior to the reforms, a travel allowance covered his trip expenses. Now, however, the Bupati did succeed in reducing fi nancial “leaks”. However, this has only gasoline is reimbursed (from project budgets), had a negative impact on fi eld staff performance. The head of the and he often must personally pay for staff meals, an Public Works Bureau complained that he must now personally expense that usually exceeds his TOKD. supplement the cost of staff meals during fi eldtrips, as the TOKD has proved insuffi cient. He pointed out that without the “operational allowances”, project inspectors conducting fi eld inspections must now often depend on fi nancial support from the contractors they are supposed to be inspecting, with clear negative implications for accountability. Similarly, health clinic staff complained that they must now personally pay for gasoline during fi eld visits to villages. The Bupati has responded to these unforeseen consequences by permitting “specialized allowances” for both project inspectors and health clinics—in eff ect a partial reversion to the system of “operational allowances”.

Making Services Work for the Poor: Nine Case Studies from Indonesia 173 Civil Service Reform 9 174 In Boalemo District, Gorontalo 269 Data fromFinance District Data Bureau andBappeda(2004). 269 projects are thosethatcan “Smaller” bemanagedby local (Boalemo)contractors. projects are thosethatmustbe “Larger” 268 Public? Have TheCivilService projects. The reforms appearto have beensuccessful inincreasing thetransparency ofprocurement for smaller Reforms IncreasedTransparencyHave TheCivilService InProcurement? projects likely representsprojects likely asubstantialamountofmoney. wasalmostdoublethatofsmaller,contractors locally-managedprojects. Hence, inlarger theongoingcorruption local contractors, whotend to onthesmallerprojects;butvalueofprojectsmanagedby work larger, non-local Fifty-six percent ofthetotal numberofprojects managedby theBoalemoPublic Works Bureau in2004were won by competitive process for canstillbecontracted provincially- and centrally-fundedprojects. offi Procurement Committee to dividelarge government projectscontinue. “Commission fees” usuallypaidto high agreements much.Covert amongthelarger fi very larger contracts rms, withgovernment offi firms suggested thattheintroductionofcompetitive procurement hasnotchangedtheprocess ofbidding for For larger contracts,however, collusionremains. informant sector Aprivate from oneofthelarger construction bids rejected, but,according to theBureau head, theywere satisfi edwithhisexplanations. 2004 procurements were completed. Somethree orfour to bidderscameforward complainabouthaving hadtheir respected thenewprocess: complaintsoraccusationsoffoul noserious play were the madeinthemassmediaafter According to theBupatiandPublic Works Bureau head, most,ifnotall, ofthefirms involved appeared to have lossesnow becausetheyhaveeven incurring underestimated projectcosts. fees” received from contractors, dueto theirnow thinprofi tmargins. are thatsomelocalcontractors He reported regarded asoneofthemainnestscorruption—statedthatcompetitive procurement hasreduced the “commission the district,districtwas abletofi re themimmediately. Bupati. Since all10offi more levies. TheInspectorate theincidentto reported offi department demonstrate fraud—including thefact thatsome minor the Inspectorate offi After itwas confi hadnotbeenadded, rmedthatthelevies hadbeenaddedtodistrictrevenue. money whether thelevy offi from bureau.levies thetransportation TheInspectorate complaints from somecitizens aboutsuspicioustransport Citizen power inaction. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: cials have generallynotchanged. Moreover, fi level viathenew atthedistrict rms thatdonotlandcontracts ce checkedFinance withtheDistrict Bureau tosee contractors. Projects withbudgetslessthanRp. 50million(US$5,300) are, however, exempt from thecompetitive bidding requir 268

A highoffi cials hadprintedbogusreceipts tocollect ce evidence gatheredto thenecessary cials involved hadbeencontracted by In2004,theInspectorate received cial atthePublic Works Bureau—the bureau responsible for infrastructureprojectsandoften Reforms MadeCivilServants use these opportunities to complainaboutoffi use theseopportunities agree membersandcivilsociety parliament thatcitizens actually parliamentary andinspectorate offi parliamentary complain directlyto him.Similaropeningsare available atthe Bupati’s willingness to openuphishomehasallowed citizens to a complainthasresulted inthefi offi ring ofcorrupt complaints, andapparently dosomore Atleastonce, often. such Citizens to livingnearthecapitalhave lodge more opportunities 269 MoreAcc e. oenet offi Government ces. ountable To The cials, andwiththe cials and public and cials handledby provincial ement. cials. The cials. cials, 9

services,270 and there is a general impression that complaints are often addressed eff ectively. Complainants have ranged from a teacher disagreeing with cuts to her salary, to a community reporting money siphoned from village grants by village leaders.

Lessons From The Reforms

What Made The Reforms Possible? The Bupati’s commitment and leadership. Implementation of the reforms was greatly aided by the Bupati’s personal involvement in them, especially his enthusiasm in opening his home to citizens and his willingness to listen. Of note, he was the fi rst civil servant to have his travel allowances reduced following the allowance reforms.

The Bupati’s skill at managing challenges to the often controversial reforms has also been key; he has frequently Civil Service Reform In Boalemo District, Gorontalo used broad support from below to address resistance at the top. His success in pushing forward the implementation of the TOKD-with-fi nes system, despite some resistance from the parliament and some high-level bureaucrats, partly came from the support of civil servants at all levels (as most civil servant salaries were increased by the reform).

Budgetary incentives and technical support for reform from the ILGR project. The ILGR project, implemented in Boalemo beginning in 2002, came with a promise of investment loans or grants to fi nance the district’s poverty reduction strategy and several conditions for disbursement: • Enactment of a district Regulation on Transparency (a “Freedom of Information” Act); • Implementation of transparent district fi nancial management practices in accordance with World Bank guidelines; • Implementation of a transparent procurement process in accordance with the Presidential Decree No. 80/2003; and • Creation of a Poverty Reduction Strategy Paper (PRSP). The as-yet unfulfi lled promise of investment funds was a strong additional impetus to reform.

The national decree on procurement reform. This decree provided a useful hook on which to hang the “hat” of procurement reform at the district level; it was used by both the Bupati and ILGR facilitators to push reform in the face of dissent.

The use of signifi cant fi nancial incentives to improve civil servant performance. For hondas whose entire salary is made up of the TOKD, the threat of fi nes was apparently eff ective, as fi nes could constitute a signifi cant proportion of the salary.

Easily understood, quantifi ed and monitored violations. Five of the ten TOKD violations relate to staff attendance, a variable that is easy to understand and monitor.

270 Interviews with the Bupati, Inspectorate, and District Parliament.

Making Services Work for the Poor: Nine Case Studies from Indonesia 175 Civil Service Reform 9 176 In Boalemo District, Gorontalo impacts—negative impacts that most likely couldhave thatmost likely beenpredicted byaff impacts impacts—negative Poorly designed “allowances reform”. system ahassle, butstaff sign-ups becauseitsstaff roll-call was notimplementinghourly himself wasnotinattendance whentheteam arrived, andhadto becalledfrom hishometo meetthem. The clinic offi Neither theInspectorate capital, anoffi revealeddistrict abreakdown ofthissystem thefarther onattendance.had apositive impact Buttheresearch team’s visitto apublicclinicinDulupi,anhouraway from the out frequent inspections. The threat ofpenaltiesisthuscredible inthoseoffi centers, for example, are located closeto theoffi ad hoc style ofsomethereforms.ad hocstyle government’s response to complaintsfrom fi eldstaff manner. appearsthereformof thereform. was designed It neithersystematically norinaparticipatory The been eff many high-level bureaucrats, hasbeenpatchy monitoring andinadequate. particular, In hasonly monitoring crucial, monitoring butwithinsuffi which makes ofthemonitoringThe system impracticality for TOKD violations. areas. improvements toperformance non-quality reforms inBoalemoessentiallylimited performance issuesfrom quality the civil servant delivery exclusion ofservice alone measure, butitispossiblethrough careful topic. toindicators work identifymeaningful for thisimportant The isnoteasyto defi delivery three quality, relate andthenonly loosely. toofservice service istrue thatquality It ne, let of The dearth TOKD violations quality. for service about suchpractices. canaff nolocalcontractors virtually offi easyto colludewithhighdistrict itfairly potential bidders, making equipment. projects becauseofthehighcostnecessary Thus, any large projectwillhave onlyahandfulof The inherently smallernumberofbiddersfor larger projects. What HasLimited TheReforms? ThePositive Of Impact more accepted for smallerprojects, butlessnaturallysusceptibleto corruption. potential bidders, themore diffi than larger projects, sothere are inherently more potential biddersfor smallerprojects. The larger thepoolof The inherently larger numberofbiddersfor smallerprojects. Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ective closetoective thecapital. The offi were notfi nedbecausethese TOKD violationshadnotbeen reported. ce northeBupatihadever suddenvisitsto conducted thisclinic. The clinicdirector cult for themto colludefor unfairprofi ts. Hence, competitive biddingisnotonly ord to bidfor theseprojects, there areto becomplaintsinthedistrict unlikely Removalofthe “operational allowances” hadnegative aswell aspositive ces of cient staff cient ces of the Bupati and the Inspectorate, whichcantherefore cesoftheBupatiandInspectorate, carry Bappeda —reinstating some allowances—only continuesthesomewhat —reinstating someallowances—only Half the TOKD violationsrelate solelyto attendance; only , thePublic Works Bureau, andthe Tilamuta public health to carry out this task, and only lackluster support from support andonlylackluster outthistask, to carry , whospendmostoftheirtimeinthefi eld, found the Notmany contractors, localornot,candolarger Many more fi smaller rms are able to undertake ce isfrom theBupati’s andtheInspectorate’s. cials to set goodprices. Moreover, given that The system ifviolators onlyworks are caught, ces andthefi nessystem hasapparently ected ected staff before theimplementation 9

Overdependence on one person—the Bupati himself. Many citizen complaints are channeled directly through the Bupati, which means people must physically travel to his home for meetings at which complaints may be lodged. Uncertainty regarding the timing of meetings, however, creates a barrier to the reporting of poor public service. Moreover, meetings can be cancelled at the Bupati’s convenience. At the time of this research, one such meeting was cancelled because the Bupati had just returned from fi eld inspections. The uncertainty about meetings would likely aff ect some people’s willingness to come and complain. Other reforms are also highly dependent on the Bupati himself, for example monitoring of TOKD violations. A clinic near the Bupati’s offi ce saw positive changes in attendance as a result of frequent monitoring, but a clinic one hour away did not. An ILGR facilitator stated that during the Bupati’s recent one-month leave, there was a lessened sense of urgency in maintaining discipline, particularly among the bureaus close to the Bupati’s offi ce, resulting in a negative impact on civil servant attendance. Civil Service Reform In Boalemo District, Gorontalo

Lack of political incentive to deal with ongoing corruption in larger projects. The likely corruption in procurement for larger projects rarely involves local fi rms, perhaps one reason there has been no local reporting about the issue. At the same time, there are rumors that the Bupati might actually get cuts from larger projects.

Financial incentives for better performance were less eff ective for full-fl edged civil servants than for hondas. The diff erence was likely due to the fact that the portion of the salary subject to fi nes—the TOKD—is only part of the full-fl edged servant’s salary, but comprises the whole of a honda’s salary.

The barrier of distance for citizens, especially the poorest, who want to report poor service. Since all offi ces at which citizens can complain are located in Tilamuta, the district capital, citizens outside the capital do not have equal opportunity to register complaints. This limits the potential for improving civil servant accountability. Poorer areas are especially at risk, including Paguyaman Pantai, the district’s poorest sub-district, more than an hour’s drive from the capital across a diffi cult mountainous area with poor-quality roads, and Dulupi, the second poorest sub- district, a forty-fi ve-minute drive away. It is diffi cult, if not impossible, for poor people in these two sub-districts to fi nd the time and transportation money to go to the capital to complain. On occasion, the Bupati, Inspectorate or members of Parliament visit these areas to get feedback, but these visits do not happen often.

Weak civil society. Greater transparency in the district was supposed to have provided more room for civil society organizations (CSOs) to demand better services and less corruption. CSOs have not, however, been eff ective in capitalizing on the improved transparency. On the contrary, the reputation of district CSOs has been tainted by an incident in which many were brought to court for their alleged involvement in misappropriating poverty-reduction funds.

Unfulfi lled fi nancial commitments. The government of Boalemo has fulfi lled all the requirements for ILGR funding and is now entitled to receive disbursements directly. In anticipation of this funding, from 2002 to 2004 the district spent about Rp.150 million (US$15,800) from its own budget to support the reforms—yet it is still waiting for ILGR funds. At one point, the parliament almost refused to endorse the district law on transparency due to the continued

Making Services Work for the Poor: Nine Case Studies from Indonesia 177 Civil Service Reform 9 178 In Boalemo District, Gorontalo in loans in each of the subsequent two years.in loanseachofthesubsequenttwo ] (so technically andthesameamount thecentralgovernment willbeborrowing themoneyratherthandistrict), for three years beginning in2006,withBoalemoslated to receive agrant ofRp. 4.5billion(US$474,000)thefi rst year regarding clearanceofthemoney. The current agreement isthatthepromised ILGR fundswillbedisbursedyearly strong stance. aparticularly taking ministersThird, (who hassinceleft) there have beendelays from theBankside the centralgovernment level, there wasconfl conceptoftaking aboutthe very Bankloans, ict World withoneofthe on theestablishmentofregulations required to borrow to from allowdistricts foreign donorsdirectly. Second, at offunds. non-arrival There were three problems thathave causedthedelays: fi rst,thecentralgovernment dithered can complementcompetitive procurement to helpfi ghtcorruption. them withinformation regarding grants theyare supposedto receive) law combinedwiththenewtransparency quality. Publicservice (lettingcommunitiesmonitor projectimplementation by expenditure providing tracking users, thusplacingpressure offi service ondistrict an independentorganization suchasaCSOsurvey further. quality improve For civilservice example, theestablishmentof “report cards” couldallow quality for service limits theeff complaints,long asitisnottoo costlyto citizens report docomeforward. However, withinthebureaus collegial loyalty Create quality. monitoring ofcivilservice mechanismsfor third-party increasewhether itwillactually governmentaccountability. thelawImplement ontransparency. Moving TheReforms Forward delay ofthe promised funds. 271 Interview withanILGR Interview facilitator. 271 approach problem: isto poverty. reduce thedistrict’s primary organizations canuseful,society ondonorprojects. butmightcreate Another anunsustainabledependency apparent reason].” many CSOactivistsjuststickaround theseoffi or parliamentoffi many CSOactivistshangingaround regional government of anILGR “Inotherdistricts, Ihave facilitator: neverseenso and theparliament.Thisiswell-captured by thecomments of arelationship withtheregion’s power centers—the Bupati shaken by money.” Moreover, appeartohave toocozy CSOs convictiona veteran[of CSOactivists]can activist:“The be do notseemabletomaintaintheirindependence. To quote andpoliticsinBoalemo.Civil society Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: ectiveness of internal mechanisms in monitoring performance; hence, theneedfor monitors to performance; mechanismsinmonitoring external ofinternal ectiveness ces, except whenthere are real needs. Here, 271 Similarly, theBupatiadmitted receiving for criticism pushingthereforms despite the CSOs inBoalemo CSOs e [o no [for ces Onpaper, progressive, thelaw isvery butitsimplementationwilldetermine reducing inthedistrict. poverty thegrowthNurture by ofanindependent civilsociety on local political leaders. Direct support from donors toon localpoliticalleaders. civil Directsupport themselves. Thus, thesuccessofreforms dependsmainly orpoliticians to or sector theprivate becomecivilservants Hence, are young activists tempted to changetheirallegiance cannot operate alone. work onincomefrom theiradvocacy andindependentcivilsociety.active CSOsinBoalemo Most governance reform thatappearsto bemissinginBoalemoisan The district’s suggeststhat,as experience A critical ingredient Acritical for ces to improve 9

Speed up reforms by removing inconsistency in central government support for decentralization. In 2003, the central government decided to begin letting districts recruit their own full-fl edged civil servants. Boalemo’s Bupati, full of enthusiasm for this move, made great eff orts to ensure the recruitment process would be as transparent as possible. He drafted members of the police and the public attorney’s offi ce to monitor exams. He insisted that exams be evaluated transparently: a person would shout out the answers and the monitors would review the candidates’ answers and fi nal scores publicly. Most considered the process fair. Unfortunately, after only one year, the central government stopped the experiment. Many districts perceived this move as a refl ection of the central government’s half-heartedness in embracing decentralization. The episode illustrates a problem faced by many districts embarking on civil service reforms: sometimes reforms have had to be rolled back because of the decisions (or, more often, the indecisions) of the central government. A predictable regulatory framework is important for reform. Civil Service Reform In Boalemo District, Gorontalo

Take the long view. By its nature, governance reform does not produce immediate results. Worse, in the short term, it tends to alienate the political elite by insisting that they change their behavior and make themselves more accountable to the public. Results take time.

Making Services Work for the Poor: Nine Case Studies from Indonesia 179 Civil Service Reform 9 180 In Boalemo District, Gorontalo Nine CaseStudies from Indonesia Nine Services Work forMaking thePoor: