As we know that decentralization era need capable man power to acomplish local government neither do for helth. Since early 2007 until up now, there are about 100 new districts developing from about 430 districts. It means new district needs new man power that capable to govern public in that area. Basic needs such as economy, education and health are top priority local government responsibility, because their performance or success are scored from how far the progress of economy, education and health achievement in certain area. Some indicators are developed to evaluate them by minimum service standard (SPM) for district, but up now there is only health which succeeds to develop minimum service standard, others remain in progress in ministry of internal affair.
To improve programer capability in Maternal and Child Health, Ministry of Health developed planning module named District Team Problems Solving (DTPS) as improving from early edition which made by WHO. In DTPS, we don't plan health program only but also calculate budget to finance activity which is planned. DTPS takes 5 days workshop that divided into 11 sesions and needs full contribution from 5 team members from District Health Office, District Hospital, District Planning Board, District Familly Planning Board and Women Organization.
Most important thing in DTPS is not the result of planning and budgeting that has been made only , but the process. While the team processing, they interact each other to discuss main cause of maternal health problem from each sides, then they can define health issue from they side. They also learn about logical frame work how the maternal death happens, evidance based activity to solve spesific problem, indicators to measure the progress and grammar of the proposal.
The hardest is to define the main problem clearly and the impact is they can not to develop prompt activities to solve the problem effectively. Some facts above are the reason why DTPS is needed for district health office especially new district or divided district that programer turn over is so high and even some of them are incapable to do this job. Other thing that should be noticed is data validity, many they use unvalid data due to wrong definition or due to delay of reporting.
Finally i think we should conduct DTPS regularly in every district to maintain their capability of data analyzing, problem solving, planning and budgeting and up dating their knowledge of recent health policy and programs, and for central government to keep in contact to health programer and observe health development in district.
(Imran Pambudi)
