Intergration of Emo-Demo session into monthly growth monitoring at Posyandu

1. The challenges and
opportunities for
implementing emo-demo
within existing
community-based health
posts (Posyandu)

2. Background
• The persistently high prevalence of under nutrition in
children aged less than five years in Indonesia is of
great concern.
• Community Based Nutrition Programs are well
established as an effective route for bringing significant
reductions in child malnutrition (WHO 2013).
• Posyandu, established in 1984, is a community-based
effort to provide basic health services including child
nutrition (growth monitoring, supplemental feeding, vitamin and
mineral supplementation and nutrition education)
• Emotion-demonstration using Behavior Center Design
theory, proven to be effective for SBCC on Hygiene
• Emo-demo modules for IYCF with SCENTS (Sederhana;
Cerita; Emosional; Nyata; Tidak terduga; Sosial) principle piloted
in Baduta Project.

3. Register
and get a
number
Waiting
Area
Weighing
Recorded in
the
Book
Interpretation of
H/W data
Weight increase/
Healthy
Counseling
LEAVE
Underweight
/ Wasting
Counseling
Given
supplementary
foods
Refer to Health Center
(Puskesmas) or Hospital
ENTER
Move
as
per
number
1 2 3 4
5 6 7 8
9 10 11 Dst.
Emo-Demo
session
Table 1
Table 2
Table 3
Table 4
Table 5
Integration Emo-Demo at Posyandu Event

4. Integration Emo-Demo
Into Health System
• East Java Provincial Government adopt
emo-demo for improving IYCF practices
into Taman Posyandu Guideline,
through:
• Series of adoption workshops with
multi-stakeholders
• Inserting and pre-testing emo-demo
modules into the guideline.
• Promoting to district/city leaders
• Providing access to fund and
technical assistance for initial
implementation

5. Integration Emo-Demo as
Teaching Materials
• 15 Universities (10 in and 5 outside
East Java) adopted emo-demo as
teaching materials, through :
• The formation of drafting team
• Introduction and workshops on Emo Demo
materials
• Development of syllabus, handouts/teaching
materials/modules (ToT)
• Testing developed materials to lecturers and
students
• ToT/Debriefing for lecturers and students
• Implementation of Emo Demo materials by
lecturers in class
• Implementation of Emo Demo materials by
lecturers/students in targeted regions

6. Discussion
At facility level,
emo-demo proved
an innovative
method of helping
cadre and midwives
to promote
nutritional behavior
change.
• However, we found that the
modules needed to be
simplified, content expanded
to other topics and timing of
topics better aligned with the
developmental stage of the
child
At health system
level, broader
governance and
capacity issues (i.e.
involving village
heads and health
centres) were key in
seeking support for
cadres and financing
related programs.
At inter-sectoral
level, enabling
universities to adopt
the module as
teaching material
should ensure
sufficient technical
support for emo-
demo activities.
Since posyandu is a
community-based,
village-level
program, cross-
sector support –
particularly from the
higher education
sector is needed

7. Conclusions
Sustainability is key in developing,
implementing and integrating successful
programs in community-based services
such as posyandu.
Attempts to scale up emo-demo
interventions must take into account policy,
planning and budgeting cycles, service
organization, staffing, continuous training,
supervision and adequate logistics at
various levels of service integration.

8. Terima Kasih