EMERGING ROLE OF FIELD STAFF OF POPULATION/FAMILY PLANNING AGENCY: THE CASE OF INDONESIA
Dr. Pudjo Rahardjo¹

The Indonesian National Family Planning Movement has evolved from a fledgling programme in the early 1970s into what it is now - a community and social development movement.  From a pure clinical family planning (FP) approach it has now become a comprehensive family development movement.

During this time, prodded on by societal changes, its management has also grown from overseeing simple service provision to managing the complexities of new and quality services.  The era of modern management introduced information technology and changed the perspective towards reproductive health (RH) and FP programmes dramatically.

The Indonesian Reproductive Health and Family Planning Programme focusses heavily on field operations; the programme employs at present more than 35,000 field workers.  While they are the group most affected by the changes to modern management systems, it is they who also affect the management practices of the programme.

This chapter highlights this inter-relationship between programme development and management practices, on one hand, and the performance of the field personnel, on the other.

A Brief Review of the Movement's Vision and Mission:
The Setting of the Field Staff Operations

The basic references for this quick review are the original goals of the Movement when it was established in 1970: 1) the quantitative goal of lowering the total fertility rate (TFR) in 1970 by 50 percent by the turn of the century; and 2) the qualitative or normative goal to institutionalise the small, happy and prosperous family norm.  These two goals have been consistently pursued to this date, and are considered two sides of the same coin one cannot be sustained without the other.  At the moment, the vision of the National Family Planning Movement is to institutionalise people- and family-centred development to attain stable population growth by the year 2020, through the small, happy and prosperous family norm.

The Movement uses the family as the basis of programme operations.  The family is the smallest coherent unit of the society, and virtually all social interactions involve the family, for example, economic decision-making, investments for the future, education and socialisation.

Table 1 The Functions of the Family

Under the Movement, fertility rate did decline significantly, from a TFR of 5.4 in 1970 to 2.7 in 1997.  However, the programme has not yet achieved the Five-Year Plan target of TFR level of 2.56 by the end of 1998.  In the same period poverty alleviation activities began to gain momentum; within three short years, the number of non-prosperous families declined significantly, indicating that the programme was moving in the right direction.

Meanwhile, the Population Development and the Development of Prosperous Families Act of 1992 governs the vision and mission of the programme and stresses the essential element of population development in the overall context of national development.  It also defines family planning and reproductive health as consisting of four goals: 1) increasing the age at marriage; 2) promoting family planning and contraceptive use; 3) developing family resilience; and 4) enhancing family prosperity.  These broad objectives move beyond family planning.

With this development emerged additional tasks for the field workers.  However, when they were called upon to coordinate and supervise the complex set of activities within the framework of poverty alleviation.  Most of them became so engrossed in the new task that their main task of promoting FP was neglected.  This is reflected in the results of the 1997 Demographic and Health Survey (DHS), which showed an increase in fertility rates in some provinces.  This compelled the management of the Movement to take stock of the situation and carefully review their vision and mission.  The result of this review was a more focussed set of activities.

Unfortunately, achievements in overall fertility decline was not matched by the economic climate.  By mid-1997, Indonesia saw its economy rapidly deteriorated to a critical level.  With the crisis came the inherent shortages in funds, contraceptive supplies, and affected many other programme implementation issues of the Movement.

Major Strategies in Reproductive Health Orientation:
Guidance for Field Operations

Since 1980, the Indonesian National Family Planning Movement has instituted the three dimensions of programme development which are:

The Movement employs various implementation strategies.  First is the basic operational strategy, that is, the Panca Karya Strategy.  In essence, this strategy is encapsulated in the following goals:

Second, is the Catur Bhava Utama Strategy which guides the managerial aspects of the Movement and programme.  It aims to:

The Task Evolution of the Field Staff

Throughout the programme's lifespan, from the beginning in 1970 to the present, the tasks of the field staff have undergone various stages of evolution.  Table 1 shows the periods of evolution of these tasks.

Over time the tasks of the field staff have increased from simple motivation for family planning to enhancement of family prosperity.  Thus raising the minimum qualifications of the field staff in line with the task they perform is necessary.  The tasks of the field staff can be summarised as follows:

These steps can be encapsulated in six functions of the field staff: 1) planning, 2) organising, 3) implementing, 4) maintenance, 5) recording and reporting and 6) evaluation.

Resulting from the review of the Movement's vision and mission, and considering the crisis situation the Movement is facing, one of the main tasks of the field staff is to manage the crisis situation at the field level, in terms of contraceptive supplies and in maintaining the contraceptive prevalence rate.

Organisational Arrangements of the Field Staff

The Indonesian National Family Planning Movement is one of the few government organisations which maintains its own corp of field workers.  Other agencies which have their personnel at the village level (Indonesia has a total of approximately 60,000 villages) include the Postal Services and the Ministry of Agriculture.

Today, a total of 35,000 field workers are recruited, trained and deployed at the villages.  The designation of these field workers is "functional staff" as opposed to the structural or command line category².  When the corp of FP field workers was established in 1973, their main task was to motivate potential acceptors to adopt and practice FP.  This was done very effectively by home visits and group talks held at the field workers' respective work areas, which by design, were villages where they originally came from.  With time, the role of the field workers evolved into a more managerial one, where they become the coordinators rather than implementors of their programme.  Implementation was done by related workers and village volunteer cadres.

Among these cadres are the members from the Women Family Welfare Movement, the youth organisations, and many others.  While these are cadres working under the directives of the local government leaders, that is, village heads and heads of the sub-districts (camat), the FP field workers developed their own cadre network.  These are the Pembantu Pembina Keluarga Berencana Desa (PPKBD), or the Village Family Planning Management Assistants.  Depending on the size of the village and the geographic spread, one field worker can have more than four PPKBDs working under him or her.

At the sub-district level, the field worker supervisors are responsible for the conduct of all field staff at the villages under his or her jurisdiction, and these supervisors are mostly university graduates.  As a first degree graduate, he or she is at the same academic level as the health centre physician at the sub-districts.

Recruitment of Field Staff

In the beginning the field workers were recruited on a project basis, and their tenure with the programme was for limited time only.  The reason for this was that BKKBN was, and still is, a coordinating agency, and, as such, was unable to employ its implementing staff.  Moreover, the field workers were only limited to Java and Bali Provinces.

With time the existence of the field workers as a special corp of field staff became necessary.  Appealing to the Civil Service Board and the State Ministry for Administrative Reform resulted in the national level decision to incorporate this category of staff as part of the overall structure of the Indonesian civil service.  Existing project field staff were then inducted into the civil service, and new recruits were hired.  In the meantime, as the programme expanded to cover all 27 provinces in Indonesia, field staff were stationed in all the provinces.

Recruitment and deployment are based upon the number of villages and of population within each sub-district (kecamatan).  For the densely populated sub-districts as in the provinces in Java and in some outer islands, virtually all villages have a field worker.

During the early years, the required minimum educational attainment of field workers was senior high school.  They were trained in the basic skills of IEC (information, education and communications) and in FP.  With time, as their work changed to covering village needs, additional skills were provided in their refresher training, including simple community development, reporting and recording, basic health care, and matters related to mother and child care.  Over time, their contribution to the achievements of the Movement became noticeable, and many government and non-governmental agencies began to rely on these frontline workers.

As the Movement's services became more complex, the basic educational requirement for new intakes of these field personnel was elevated to a bachelor's degree.  The minimum qualification for the fieldworkers supervisor is a master's degree in agricultural science, social science, Islamic studies, among others.  Some supervisors of this new generation have already been given scholarships to further their graduate studies in the United States, Australia and United Kingdom.

Family Registration as the Basis for Field Operations

The field workers form the backbone of field operations of the National Family Planning Movement and spearhead the programme in all aspects of implementation.

Implementation of their tasks, as already discussed, is greatly enhanced by the annual family registration, undertaken January-March each year and based on 24 indicators.  Table 3 shows these variables and the corresponding family prosperity status.  It is important to emphasise that this registration is mainly for operational purposes, in that these variables serve as intervention points to elevate and increase the prosperity status of each family.

Table 3  Family Registration: List of Intervention Variables

It should be apparent that registration of families and determining their prosperity status using these indicators are sufficiently simple to be carried out at the grassroots level by village volunteers with the supervision of the field staff.

Evaluating the Performance of the Field Staff

Various studies have been undertaken on the ever increasing task of the field staff, by National Family Planning Coordinating Board of Indonesia (BKKBN) and the academic community.  One such study was conducted by the Demographic Institute of the University of Indonesia in Jakarta using a stratified sample of field staff from Java, Sumatra, Kalimantan and Sulawesi.  The findings of this study drew the attention of policy decision-makers at the Central Office and the Provincial BKKBN Heads.  The highlights of these study are:

Application of New Management Techniques for Field Operations

As mentioned earlier, over time the operational mode of the field staff evolved from the simple task of motivating and recruiting new acceptors into the complex management of community development.  This is effected with the application of managerial approaches, most notably those indicated below:

Routine Meetings

Over time, the National Family Planning Movement and BKKBN have developed various management system, one of which is the system of meetings.  In a standard format, routine meetings are carried out in the following order:

1)  At the village level, routine meetings are held during the first week of the month;
2)  These meetings are immediately followed by routine meetings at the sub-district level;
3)  At the district level these meetings occur during the second week of the month;
4)  At the province level they are held during the third week; and
5)  At the central level similar meetings are held in the fourth week.

At all levels, these routine meetings follow similar agenda: 1) evaluation of last month's performance; 2) implementation of the present month's activities; and 3) projection of activities for the next month.

Meetings are essentially a forum in which all stakeholders, particularly concerned community decision-makers, take part.  Community development efforts at the village and sub-district levels are useful to FP field staff; they are crucial for the successes of the Movement.  The field staff and supervisors do not really lead these meetings - allowing the respective leaders to chair yet they influence setting the stage and the substance for the meetings.  These events occur not only in the formal community development forum, but in all community activities both formal and informal, such as religious meeting, nuptial events, village lottery, sports meetings, and many others.  This is the real practice of the communicating to all segments of the local society, most essential to sustain the management process.

Reporting and Recording

Reporting and recording are at the base of the management information system (MIS).  MIS is essentially very flexible, policy-makers may prefer a large information base, or choose to have a compact and streamlined set of data.

The data is generated at the field levels by the clinics, the field workers, the posyandu and the local community groups.  This data is directly sent to the central headquarters for processing, so that it is valid, legible and ready for input into policy formulation at various levels.

In this regard the role of the field staff is highly crucial.  As field managers they are called upon to see to it that all reports from their area are collected and sent promptly to the higher levels.  They also see to it that the feedback data is justly and appropriately utilised for decision-making at their level.

Logical Framework Analysis

The latest opus in improving the management practices of increasing demands on the field staff is the application of the logical framework analysis.  With the assistance of the Country Support Team (CST) of UNFPA, BKKBN has trained all echelons I, II, III personnel from throughout the country in this planning, evaluation, monitoring and control methodology³ within six months.  This methodology is the latest addition to UNFPA's approach to proposal development and project monitoring.  Considering its versatility, BKKBN decided to adapt this methodology for its management system.  In combination with the existing methodology of strategic planning and demand fulfilment approaches, the logical framework completes the system.  The field staff are already given preliminary orientation on the application of this methodology and are achieving encouraging results.

Lessons Learnt

From this brief description of the changing and emerging role of field staff of the Indonesian National Family Planning Movement, one learns that first, with the advances made in the FP and RH programme, demands upon the field staff have also increased.  It is not sufficient to simply add to their skills and knowledge as the role is not simply enlarged.  Rather, it has undergone fundamental changes from recruitment of new acceptors and maintenance of existing acceptors, to managing the rapid tempo of community development.

Second, as in-service training is constantly required, the basic educational attainment of new field staff had to be increased.  Today the Movement cannot accept new staff with less than a basic university or masters degree.

Third, career development is most essential to prevent attrition among the field staff.  This includes overseas advanced degree course, or in-country courses with possibilities for advancement in the Movement.