Aida, Amril, Dyas - Health and Education Inf. Panikel PDF

EVALUATION OF HEALTH AND EDUCATION INFRASTRUCTURE FOR PEOPLE EMPOWERMENT Case Study in Panikel Village, Kampung Laut, Cilacap
EXECUTIVE SUMMARY
Kampung Laut has a unique condition since it was formed by sedimentation from Citanduy and Citereup River. Poverty increased after fisheries area in Segara Anakan Lagoon exterminated by tanah timbul. Since 1976 Yayasan Sosial Bina Sejahtera (YSBS), The Foundation for bringing about Prosperity and Good Will, has conducted a poverty alleviation program with support from various donor agencies. YSBS has built a number of community-based infrastructures, includes health and education infrastructure. After road development opened access into health and education facilities, the public health and education in Kampung Laut has improved. Nevertheless, many problems still occur due to the infrastructure implementation, such as equality problems in access between male and female; between high and low social-economic level of community. This reseach is aimed to evaluate the infrastructure implementation in health and education sector that YSBS did in Panikel Village, a part of Kampung Laut sub-district. Through study of impacts, responses, and adaptation of community in Panikel, this research will focused on people empowerment program held by partnership between YSBS and government of Cilacap in order to develop Kampung Laut sub-district. The study area is in Panikel Village, with observation objects in 1 health facility, that is PKD in Bugel sub-village, and 2 education facilities, that are SDN Panikel 03 and PAUD Raudlatul Athfal which are also in Bugel. Infrastructure implementation analysis is conducted firstly by indentifying findings in physical condition, capacity, function, governance, delivery mechanism, impacts, responses, and adaptation of community and stakeholder in the area of observation, then do an analysis through problem tree, objective tree, stakeholder analysis, SWOT (strength, weakness, opportunities, threat ) analysis, and whole system design to generate alternatives of strategies recommended for the advance step of development project for health and education infrastructure in Panikel Village, Kampung Laut.
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LIST OF CONTENTS
EXECUTIVE SUMMARY ................................................................................................................... i LIST OF CONTENTS....................................................................................................................... iii LIST OF TABLES ............................................................................................................................. v LIST OF FIGURES .......................................................................................................................... vi CHAPTER I INTRODUCTION ......................................................................................................... 1 1.1. Background ................................................................................................................................ 1 1.2. Objective of Research ................................................................................................................ 2 1.3. Method....................................................................................................................................... 2 1.3.1. Data Collecting Technique............................................................................................. 2 1.3.2. Data Analysis Techniques .............................................................................................. 3 1.4. Conceptual Framework .............................................................................................................. 3 1.4.1. Conceptual Framework For Health Infrastructure ........................................................ 3 1.4.2. Conceptual Framework For Education Infrastructure .................................................. 4 CHAPTER II DESCRIPTION OF STUDY AREA................................................................................... 6 2.1. LOCATION................................................................................................................................... 6 2.1.1. Profile of Kampung Laut ................................................................................................ 6 2.1.2. Profile of Panikel ........................................................................................................... 8 2.2. INFRASTRUCTURE DEVELOPMENT BY YSBS ............................................................................. 12 2.2.1. Profile of YSBS ............................................................................................................. 12 2.2.2. Health Infrastructure................................................................................................... 13 2.2.3. Education Infrastructure ............................................................................................. 13 CHAPTER III FINDINGS AND DISCUSSION ................................................................................... 14 3.1. HEALTH INFRASTRUCTURE ....................................................................................................... 14 3.1.1. Physical Condition, Capacity, and Function ................................................................ 14 3.1.2. Governance and Delivery Mechanism ........................................................................ 15 3.1.3. Impacts, Responses, and Adaptation .......................................................................... 15 3.1.4. Analysis ........................................................................................................................ 16 3.2. EDUCATION INFRASTRUCTURE ................................................................................................ 23 3.2.1. Physical Condition, Capacity, and Function ................................................................ 23 3.2.2. Governance and Delivery Mechanism ........................................................................ 24
EVALUATION OF HEALTH AND EDUCATION INFRASTRUCTURE FOR PEOPLE EMPOWERMENT Case Study in Panikel Village, Kampung Laut, Cilacap iii
3.2.3. Impacts, Responses, and Adaptation .......................................................................... 25 3.2.4. Analysis ........................................................................................................................ 26 CHAPTER IV CONCLUSION AND RECOMMENDATION ................................................................. 34 4.1. Conclusion ................................................................................................................................ 34 4.1.1. Health .......................................................................................................................... 34 4.1.2. Education..................................................................................................................... 34 4.2. Recommendation ..................................................................................................................... 35 4.2.1. Health .......................................................................................................................... 35 4.2.2. Education..................................................................................................................... 35 REFERENCES ............................................................................................................................... 37
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LIST OF TABLES
Table 1. Panikel Population Above Age 5 According to The Highest Level of Education By Year 2010............................................................................................................................. 11
LIST OF FIGURES
Figure 1. Conceptual Framework for Health Infrastructure ................................................................... 3 Figure 2. Panikel Population According to Level of Education ............................................................... 4 Figure 3. Conceptual Framework for Education Infrastructure .............................................................. 5 Figure 4. The Administration Area of Kampung Laut Sub-District .......................................................... 6 Figure 5. Change area of Segara Anakan Lagoon.................................................................................... 7 Figure 6. Area of Study: Panikel Village .................................................................................................. 8 Figure 7. Population By Sex in Kampung Laut......................................................................................... 9 Figure 8. Livelihood of People in Panikel .............................................................................................. 10 Figure 9. Inpatient room in PKD Panikel ............................................................................................... 14 Figure 10. Problem tree for health infrastructure in Panikel................................................................ 17 Figure 11. Objective tree for health infrastructure in Panikel .............................................................. 18 Figure 12. Building condition of PAUD Raudlatul Athfal ....................................................................... 23 Figure 13. Building condition of SDN 03 Panikel ................................................................................... 23 Figure 14. Problem tree for education infrastructure in Panikel .......................................................... 27 Figure 15. Objective tree for education infrastructure in Panikel ........................................................ 28
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CHAPTER I
INTRODUCTION
1.1. Background Changes and development of Kampung Laut, Cilacap geographic condition, a phenomenon especially interesting in the development of the welfare of the community. As a result of sedimentation processes, Kampung Laut area was largely a regional waters, has now so change the various sectors in the life of society. Kampung Laut that formerly isolated now are becoming more open with it set up the access road which is initiated by the YSBS. The development of this open access road turns out to be opportunities for the development of other sectors in order to increase the welfare of its people. Education and health sectors are two crucial sectors which get the influence of road construction in Kampung Laut. However, the development in health and education infrastructure sectors is even though it has got the intervention of YSBS has not been fully able to improve the welfare of the community Kampung Laut. The issue raised in the discussion of the evaluation of the development of the health sector in particular Panikel (one village in Kampung Laut) related to gender issues, while the education sector concerning the expediency of the openness of access to education, which hasn't been able to fully perceived by everyone especially the low sosio-economic status. This writing is part of the lecture is to offer comprehensive approach MICD that discuss gender problems that occurred in the development of health infrastructure and equity problem in education infrastructure in Kampung Laut, particularly in Panikel Village, with respect to the phase-phase development, identification of the problem and strategy formulation in order to build education and health facilities that befitting for community. Why Kampung Laut? The uniqueness of the Kampung Laut geographical character made this area requires a great effort and funds to undertake infrastructure development. The complexity found in Kampung Laut becomes a challenge not easily solved.
YSBS intervention has given a big impact to the development of the community Kampung Laut since 1986 with road construction program and the program in other part, such as education and health.
Although it is open access roads, education and health facilities Kampung Laut still indicate variety of problems.
1.2. Objective of Research a. To identify physical condition, capacity, and function of health and education infrastructure. b. To identify governance and delivery mechanism of the infrastructure. c. To identify the impact of infrastructure utilization at the village level. d. To identify the responses of stakeholders at the village level. e. To identify the adaptation of local community.
1.3. Method 1.3.1. Data Collecting Technique Data required in this research include primary data and secondary data. 1. Primary Data a. Observation Primary Data obtained through field observation activities on 22-25 may 2012 in Bugel, Panikel village, Kampung Laut. b. Interview In unison with the do obeservasi field, team also conducts interviews to some of the respondents who have a connection with the object of study consisting of the YSBS, community leaders, religious leaders, and the public use of the services object of the study. 2. Secondary data Secondary Data obtained from the Kampung Laut statistical data and PODES data also the image of the Panikel village, Kampung Laut distric earned from google map.
1.3.2. Data Analysis Techniques Methods to be used: 1. Indentifying finding such as Physical Condition, Capacity, Function, Governance, Delivery Mechanism, Impacts, Responses, and Adaptation of object. 2. Then do an analysis with : a. Identify problem of infrastructure and organize the problem tree b. Formulating objective tree c. Stakeholder analysis d. SWOT (strength, weakness, opportunities, threat ) e. Whole system design
1.4. Conceptual Framework 1.4.1. Conceptual Framework For Health Infrastructure
Figure 1. Conceptual Framework for Health Infrastructure
1.4.2. Conceptual Framework For Education Infrastructure The background of conceptual framework for education infrastructure is the issue of low education level of community in Kampung Laut, that in 2006 this sub-district still get high number of illiterate people because less of getting education. The figure below shows the level of education of community in Panikel Village in 2010. Panikel Population Above Age 5 According to The Highest Level of Education By Year 2010 0% 3% Academy/ University 36% 9%
SLTA SLTP
52%
SD Not complete school/ Never attend school
Figure 2. Panikel Population According to Level of Education
The data illustrate that from total amount of population (5594 people) in Panikel, only 3572 people get education, while 2022 people are not complete their education or never attend school.
Figure 3. Conceptual Framework for Education Infrastructure
CHAPTER II
DESCRIPTION OF STUDY AREA

2.1. LOCATION 2.1.1. Profile of Kampung Laut Kampung Laut sub-district is a part of Cilacap Regency, Central Java. Kampung Laut subdistrict lies in Segara Anakan lagoon. It is consist of four villages, covering approximately 14,135.27 Ha or 141,3527 km2 area. The four villages are Ujung Gagak, Klaces, Ujung Alang, and Panikel. Kampung Laut lies between Latitude 1084610903E and Longitude 734747S. Kampung Laut is an area of beach and lagoon with a height of 0-3 M above sea level and tropical climates. The average temperature above 26.4C and average humidity of 48 RH and wind speed on average 7.3 knots.
Figure 4. The Administration Area of Kampung Laut Sub-District Source: BPS, 2011
Natural Condition and Changes Segara Anakan lagoon is an area that determined by the salinity levels of seawater and freshwater. From the biological side, the lagoon has a highly productive ecosystem. Fisheries communities around the lagoon have become a very prosperous. However, due to rapid sedimentation to lagoon (estimated about1 million m3 annually) from rivers reduced the wide and depth of the Segara Anakan lagoon. According to KPSKSA the water surface area of lagoon reduced from 6.540 ha in 1903 to 3.270 ha in 1984, 1.800 ha in 1992, and 600 ha in 2004. The wide of lagoon in 1976 was 4.159 ha with an average depth of 10-15 meters turned into about 600 ha in 2003 with a depth of no more than 1.5 meters.
Figure 5. Change area of Segara Anakan Lagoon Source: KPSKSA, 2009, in Thesis Sulistiono
2.1.2. Profile of Panikel a. Administration Panikel village located in the northern part of Kampung Laut sub-districts with administrative boundaries as follows. North side Southern West East : Bantarsari Village : Ujung Alang Village : Ujung Gagak Village : Brengkeng Village
The coverage area of Panikel Village is approximately 2869.871 hectares with a height of 0-1 meters above the ground surface. Panikel Village consists of five sub-villages: Bugel, Panikel, Kalenbener, Mekarsari, and Muaradua.
Figure 6. Area of Study: Panikel Village Source: PODES and Google Map
The delta formed due to rapid sedimentation in the lagoon. Manez and Lukas in (KPSKSA, 2009) stated sedimentation has been going since 1857. By local people, delta called as tanah timbul and eventually forms the land. Income of traditional fisheries decreased and the community must change to be a farmer. These situations are not easy for the community of Kampung Laut, causing a tragic period of transition. The habit and life style of fisheries cannot quickly turn into farmers.
Communities are in crisis and poverty. In fact, about the 1970 people suffer from hunger. b. Demography and Socio-economic Condition of Community In 2010 population in Kampung Laut reach out about 16.821 people with population density 118 people/ km2. Panikel Village is the most densely populated. It consists of 5728 inhabitants, with population density 155 people/ km2.
Population By Sex in Kampung Laut, Condition from Year 2003 - 2010

18000 16000 14000 Pop Qty 12000 10000 8000 6000 4000 2000 0 2003 2004 2005 2006 2007 2008 2009 2010 Figure 7. Population By Sex in Kampung Laut Source: Statistik Pokok Kecamatan Kampung Laut, BPS, 2010 male, 8666 female, 8155 total, 16821
People in Panikel Village is a coastal community with occupation mostly in farming and fisheries. At the early year when Panikel were still consist of water area, most of villagers live as fishermen. However, after the occurence of sedimentation from year to year, a new land formed, and agriculture sector was arising. Villagers who originally was a fishermen community think that agriculture is more profitable, so that until now people in Panikel choose agriculture as the most occupation. Many ricefield was opened after tanah timbul formed.
Livelihood of People Above 10 on Panikel Village By The End of Year 2010

agriculture mining/ excarvation 190, 16% 86, 7% 1, 0% 935, 77% industry commercial
Figure 8. Livelihood of People in Panikel Source: Statistik Pokok Kecamatan Kampung Laut, BPS, 2010
Since 1976 YSBS, an NGO work on Kampung Laut sub-district. YSBS build road and bridges from Cisumur Bugel Ciberem ; from Bugel Panikel- Karanganyar(Ujung Gagak); built irigation along the edge of roads ; built water dam and ditch so that some land becomes dry. Since then access to the Kampung Laut began to open. Even now, there are electricity and telephone facilities, information also available, economic is increasing, and there are new markets and shops. c. Education Level of Community There was generally a low level of formal education in the area. Illiteracy was high due to cost of education, transportation and lack of nearby schools. The dropout rate among elementary school student is high since parents often take their children out of school to work with the family. There are 2 elementary schools, 1 Madrasah Ibtidaiyah (the same level with elementary school), and 1 junior high school in Panikel. Accessibility of students to schools is very difficult. Students have to take boat to school or long difficult passing the bad quality of rural road. The following table shows the level of people education in Panikel. The opportunity to continue to pursue a higher education is still limited.
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Table 1. Panikel Population Above Age 5 According to The Highest Level of Education By Year 2010 Jumlah (orang) 12 145 477 2938 654 603 765 5594
Level pendidikan Akademi/ PT SLTA SLTP SD Tidak tamat SD Belum tamat SD Tidak/ belum sekolah Jumlah
Source: Statistik Pokok Kecamatan Kampung Laut, BPS, 2010
d. Healthcare Issues Kampung Laut has no sufficient public health conditions. The number of facilities and accessibility of the community in Kampung Laut to various health facilities such as hospital, health centre (Puskesmas), physician, drugstore, etc. is very low.The quality of health in the area is poor. Malaria, cholera and skin diseases are common due to lack of potable water, malnutrition and poor housing and sanitary facilities. Except for Klaces on Nusa Kambangan and Motean, the villages have no freshground water. During the wet season, rain water is collected and stored for daily use. During the dry season, freshwater is brought from Nusa Kambangan island. Geographic condition of Kampung Laut which is consist of swamps potentially trigger many health problems. Slick of water surround the settlements and high humidity cause many endemic diseases, such as malaria, DBD (dengue), and pinkeye. Bad sanitation also give effect to health problems. Many settlements have no septictank because the bad soil condition causes some difficulties for sewerage system installation. Domestic waste run directly into the river, contaminate water, then cause problems in skin disease and diarhea. Beside bad sanitation, social cultural factor bring impacts to the community health in Kampung Laut. Coastal livelihood affect community to uncontroled smoking culture.
EVALUATION OF HEALTH AND EDUCATION INFRASTRUCTURE FOR PEOPLE EMPOWERMENT Case Study in Panikel Village, Kampung Laut, Cilacap 11
Therefore, community in this area still susciptible to many respiration disease, for instance lungs inflammation and TBC. However, since the improvement in education sector and socialization by health cadres about the dangerous of smoking habit, the number of people who get respiration disease can be reducted until 2012.
2.2. INFRASTRUCTURE DEVELOPMENT BY YSBS 2.2.1. Profile of YSBS Yayasan Sosial Bina Sejahtera (YSBS) was established in 12 March 1976 by Patrick Edward Charlie Burrows, OMI, or called Father Carolus. Set from an action to help poor and homeless people, this Non-Governmental Organization legally works in social humanity sector in whole area of Cilacap. Since 1978 Yayasan Sosial Bina Sejahtera (YSBS, The Foundation for bringing about Prosperity and Good Will) conducts a poverty alleviation program with support from various donor agencies. YSBS has built a number of community-based infrastructures. E.g., approximately 487 kilometres of rural roads, bridges, dams, dykes, and irrigation canals, automatic sea gates, 26 schools (kindergarten, elementary, junior and senior high school, and an academy), six health service centres, and banks have built and run by this NGO. Kampung Laut is one of targeted area of YSBS operation. Rural road is the first and the biggest project in the area and believed give important contribution to improving the communities capacity and welfare. Rural road defined as connecting road from one village to another village or main road. In the community development program will lead community to market, economic and social facilities, or services. Since 1976, YSBS conducted labour intensive project supported by Catholic Relieve Service (CRS). The projects were Food for Work (FFW). From March 1992 onwards, the Misereor supported YSBS in its labour-intensive projects, in the form of Cash for Work (CFW). The overall aim of the project is to better the job and income situation of poor rural communities by cash-for-work program. Through the infrastructure project activities, the better transport possibilities and access to market improved. The CFW program has ended, but YSBS still use cash for work scheme to answer the rural road development need and demand from the
communities including Kampung Laut community until now. One of the intended target group of the project are poor families in a poverty region such Kampung Laut subdistrict. 2.2.2. Health Infrastructure In health sector YSBS take role in the development of medical human resources, and also in providing health education for community. The first target for public health improvement is mother and child. To support funding, YSBS involves Childfund which concerns on prosperity of children. YSBS PROGRAMS IN HEALTHCARE 1. Pemberian Makanan Tambahan (PMT) for children under five (Balita), donated by Childfund 2. Counselings about ASI eksklusif for mother 3. Publishing handbooks about ASI eksklusif for cadres in 5 villages 4. Counselings for pregnant women 5. Regularly immunization and Posyandu 6. Free circumcision (in Ujung Gagak Village) 7. Socialization for Desa siaga 8. Trainings about monitoring healthy living for cadres
2.2.3. Education Infrastructure In education sector, YSBS has built many schools in many places in Cilacap. There are 26 schools has establised by YSBS. But none in Panikel. In Panikel, YSBS take role in education improvement by holding many programs that concern on improving quality of facilities and human resources. YSBS also help children to get scholarship. Childfund Indonesia is the funder that is involved by YSBS to support school fee for poor children. YSBS PROGRAMS IN EDUCATION 1. Manajemen berbasis sekolah trainings for teachers from 5 elementary school as a pilot project of Sekolah Rumah Anak (48 teachers from 5 SD in Panikel and Ujunggagak were join) 2. Children workshop (study group and karawitan) once every 2 weeks 3. Counseling for teenagers (SMP students) about the impact of juvenile delinquency (in collaboration with Bapermas, KB, Kepolisian, Psikolog) 4. Workshop about the product of UU Perlindungan Anak dan perempuan (in collaboration with Bapermas Cilacap Region) 5. Sex education and counseling of reproduction health for teenagers
CHAPTER III
FINDINGS AND DISCUSSION

3.1. HEALTH INFRASTRUCTURE There are 2 PKD (Poliklinik Kesehatan Desa) available in Panikel Village. The area of observation is one of two PKDs, that is located in Bugel sub-village.
3.1.1.
Physical Condition, Capacity, and Function Physical condition of PKD in Panikel Village is still very minimal. To support health activities there are 1 examination room and 1 surgery room that also be an inpatient room with 2 bed and 2 baby incubators. Until now there are not other supporting facilities that support health activities. Based on the capacity 1 PKD serves 1 village, consist of 5 small villages (dusun). If viewed geographical condition and accessibility, the people where he lived much of PKD would be difficult to reach these facilities. And if there is no specific handling by the Government for additional support facilities, the people is far is not entirely enjoy this facility. Health programs on PKD Panikel are mostly specialized for baby and parents, especially women. Such as Pemberian Makanan Tambahan (PMT) for children under five (Balita), donated by Childfund Counseling about ASI exclusive for mother, Publishing handbooks about ASI exclusive for cadres in 5 villages, Counseling for pregnant women, etc . So that men get less benefit than women.
Figure 9. Inpatient room in PKD Panikel
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3.1.2.
Governance and Delivery Mechanism a. Governance Poor people in Panikel Village get help by The Government in the form JAMKESMAS as Insurance. JAMKESMAS is a social assistance program for health care for the poor and can not afford that aims to improve access and quality of health services. For administrative costs, people are charged Rp. 5000. For the Institutional arrangement, Practice midwifes are commanded under health department. Medical personnel to serve all people in the Panikel village is only 1 midwife, helped with several health cadres. A midwife have to be stand by 24 hours to help people. Medical equipments are self-provided by the midwife.
b. Delivery Mechanism For delivery mechanism aspect there are 3 problem. The problem is The coverage area is too wide while there are limited number of human resources. So that not all of the community can be served. The number of examination room, surgery room and inpatient room sufficient with the demand Jamkesmas for poor people only can be claimed in PKD, it doesnt valid for home-visit service. All this have been changes in the health field, even with a very minimal infrastructure conditions, where in 2010-2011 infant mortality and maternal at 0%.
3.1.3.
Impacts, Responses, and Adaptation a. Impacts The impact of the given health infrastructure are: Social :The existence of PKD increases prosperity, especially in the lives of
family and welfare for women and children. Economy :Due to the increased level of public health and also productivity rises Environment :PKD is supposed to participate to keep the environment, but quite the opposite is happening, PKD without IPAL is bad for the environment
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b. Responses Gender issues become a problem in health infrastructure. Because only women get more benefit from this infrastructure. and the Men were not fully served by existing programs. The challenge is How to make health facilities that exist in the Panikel Village can be beneficial for all societies, especially for male. Is now a lot opportunities to develop PKD in the Village Panikel. One is JAMKESMAS available to poor people. This program helps people in the village panikel to more easily obtain health services. There are also Partnership between midwife and dukun bayi. This system helps to reduce maternal mortality and infant. In the event of childbirth, dukun bayi must wait for the arrival of the midwife to carry out the birth process vice versa. If the system is violated, then it would be penalized. c. Adaptation Community is willing to : Use PKD services and dukun bayi has left Be health cadres Active on posyandu
3.1.4.
Analysis
a. Problem Tree Analysis Problem and Objective Tress Analysis useful for identifying the root of the problem, the core problem and the impact of the problems that arise. So be easy to make a priority problem resolution formula of health that occurred in the village of Panikel, Kampung Laut.
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Figure 10. Problem tree for health infrastructure in Panikel
In this problem tree analysis core problem is inequality in access to health facilities between men and women as central point. With the core problems as the central point, the other problems are grouped in hierarchical structure reflecting causal relationships. In this way the problem environment is graphically displayed in a Problem Tree, with causes forming the roots and the effects forming the branches.
Causes as root of the problem consist of: The involvement of Childfund that concern of the prosperity of mother and child Health facilities that available only PKD, without other facilities like pharmacy and general practical doctor Prioritizing womens health only, indicate from PKD existence with a midwife without mantri Effects forming the branches contain of: Men get less benefit than women Only child and women get benefit Low maternal mortality rate Productivity society be not maximum Health cadres only women
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b. Objective Tree Analysis Subsequently, in Objective Analysis, the Problem Tree is transformed into a set of future solutions to the problems. Each negative problem is converted into an objective by rewording it as positive future statement.
Figure 11. Objective tree for health infrastructure in Panikel
Objectives followed by the causes: The involvement of other general funder not only Childfund that concern of the prosperity of mother and child Completed the health facilities with other facilities, such as pharmacy and general practical doctor Prioritizing not only womens health but also mens health, by providing mantri
Effect logic expected on objective analysis : Equity between men and women Men also get benefit Life expectancy is high for society Productivity society be maximum Health cadres not only women but also men
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c. Stakeholder Analysis
No. 1. Stakeholder Government of Cilacap 2. Minister of Health 3. YSBS (Yayasan Bina Sejahtera) 4. Child Fund, Unicef, Misereor and other citizen organization/NGO Interests Reaching target for community welfare Holding policies in regional level Reaching targets in health Performing control over funds and activities Determining policies in health (JAMKESMAS, JAMKESDA, etc ) Having interest on getting public image Accompanying the community Bridging the community with the funder Monitoring development project Having interest on getting public image Concerning to social, environment, and humanitarian issues Provide funding Monitong and evaluating the project Institutional dedication Institutional learning Involving in research and prefeasibility studies for development project As client , target and agent of development Delivering complaints Expressing desires for development Fostering sense of belonging in order to keep the facilities developed Providing assessments Getting an increase in welfare Importance/ interest High Influence/ power High
High
High
High
High
Low
High
5. Academics
Low
Low
6.
Community of Kampung Laut, especially : Community leader WOMEN Parents who have children Elderly Local business Lower middle income group Witchdoctor
High
Low
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d. SWOT Analysis The SWOT analysis for health infrastructure (PKD) in Panikel Village is shown on the table below. Strenghts (S) 1. In 2010 and 2011 does not happen maternal mortality 2. Posyandu movement and active extension 3. Midwives and cadres who are idle Weakness (W) 1. Minimum support facilities (bed & medical equipment) 2. Minimum number of medical personnel 3. There is no other healthcare facility besides pkd 4. The lack of waste management installations. 5. Many programs devoted to women's health WO Strategy Improvement of health facilities (medical equipment, beds, treatment rooms) Develop training and midwifery courses Increasing the number of medical personnel (midwives, paramedics, village doctors, etc.) Adding to such health facilities (dispensaries, clinics, posyandu, etc.) Procurement of waste management installations.
1.
2.
3. 4.
Opportunities (O) Availability of health insurance for the poor (Jamkesmas, Jamkesda, etc.) The focus of government programs Bali Ndeso Mbangun Ndeso Partnership with midwife shaman baby PMT for Young children (dari Child Fund)
1.
2.
3.
4.
SO Strategy Improving the quality of specific services for pregnant women Ensures ease of service and bureaucracy for people who have health coverage Maintain cooperative relationships between midwives with TBAs Optimizing the government to ensure health care in panikel village
1.
2. 3.
4.
5.
Threats (T) 1. This type of epidemic disease is different and follow the seasons that occur 2. Accessibility is not optimal 3. Abnormalities of pregnancy and preterm / premature 4. Disparity between men and women in receipt of health services
TS Strategy 1. Early counseling to deal with diseases that come each season 2. Improvement of accessibility by road and river. 3. Provision of ambulance or speed boats are standby to bring patients 4. Socialization program for men, for example, counseling about the dangers of drugs, alcoholic drinks, and cigarettes
TW Strategy 1. Raising public awareness about the importance of waste management. 2. Forming system of early warning about the dangers of infectious diseases 3. Growing sense of belonging to develpod public transport
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SWOT analysis is a method of strategic planning by evaluating the external and internal factors based on existing conditions. Internal factors include the Strengths and Weaknesses, While external factors include the Opportunities and Threats Strategies formed in the health infrastructure is focused on : 1. Improved health facilities support facilities 2. Development of quality and quantity of medical personnel 3. Implementation of special programs for men's health 4. Developing Wastewater Management installation 5. Partnership between the Government and YSBS to develop Health infrastructure.
e. Whole System Design Whole System Design (WSD) consists of 4 phase, that are functional specification, conceptual design, functional design, and engineering design. This method can be used for formulating infrastructure development strategy with specific requirements and consideration into the detailed criteria of development. In this research, WSD only be done until the third phase, functional design, as the development of ideas emerged from the goal, problems, and objectives of the health infrastructure development program in Panikel for generating
recommendations. Goal Problems Generating equality in access for women and men to healthcare facilities 1. Minimum medical equipments 2. Lack of human resources 3. Healthcare programs are mostly prioritized on women and children health 4. Jamkesmas only can be claimed directly in PKD, inapplicable for home-visit service 5. Funder only concern on the prosperity of mother and child 6. Health cadres only women 1. Improving support facilities and medical equipments 2. Increasing the number of doctors and midwives to serve wider scale of service area Increasing the quality of service 3. Healthcare programs are also made for men 4. Improving the provision of Jamkesmas and Jampersal 5. More support funding from NGO that concern also to men
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Objectives
health 6. Triggering community (women and also men) to develop health cadres
Identifying 5W + H What Why Who Where When How Health facility that serves equally between men and women Besides mother and child health, men health also need more attention, especially for lungs health Men, women, and children of Panikel Village Panikel Village, serves whole area of 5 small villages 24 hours stand-by health services Providing more support facilities, such as clinics, pharmacy More human resources (doctors and midwives) to serves wider area of service Involve funder which also concern on whole human health, for men and women
WSD Formulation Functional Specification 1. Sufficient facilities for serving people in village level 2. Healthcare programs for men must be included 3. Easy access to health facilities: low cost for poor people, short travel time 4. Integrated relationship with other healthcare facilities, such as pustu (puskesmas pembantu), puskesmas, and RSUD 5. 24 hours stand-by for health service Conceptual Design Equal accessibility to health facilities between men and women Functional Design 1 PKD in every sub-village Beside PKD, pharmacy is available in the sub-village level Pharmacy located nearby the PKD Theres a public health in every sub-village for holding healthcare services, counselings, and training cadres Every PKD has minimal 1 doctor, 2 midwife, and 1 mantri Provide counseling programs for men, e.g sunatan gratis, free medical checkup
1. 2.
3. 4.
5.
6.
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3.2. EDUCATION INFRASTRUCTURE There are 4 school available in Panikel Village, that are 2 elementary school (SD), 1 Madrasah Ibtidaiyah (MI/ the same level with SD), and 1 junior high school (SMP). Early education for children (PAUD/ Pendidikan Anak Usia Dini) also has developed in this village. There are total 2 PAUD located in Bugel and Muaradua sub-village which serve 5 sub-village in Panikel. The area of observation is in 2 educational facilities: PAUD Raudlatul Athfal and SDN 03 Panikel, that are both located in Bugel sub-village.
3.2.1. Physical Condition, Capacity, and Function Bugel sub-village is the nearest sub-village to the city. Therefore, this area has developed more rapidly than other sub-villages in Panikel. Buildings for school are available with permanent structures.
Figure 12. Building condition of PAUD Raudlatul Athfal
Figure 13. Building condition of SDN 03 Panikel
According to the observation to the location of PAUD Raudlatul Athfal and SDN 03 Panikel, the findings of physical condition, capacity, and function are described in the table below.
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Description Physical Condition al
PAUD Raudlatul Athfal PAUD building is a rent house. Consist of two classes and outdoor playground. Serve 51 students in village level PAUD is off on Wednesday and Saturday
SD 03 Panikel Consist of 6 classrooms , 1 mushola , and 1 administrations room ( without library , UKS and laboratory ) The school serves 202 students Facilitate intra curricular and extracurricular activities
Capacity Function
3.2.2. Governance and Delivery Mechanism a. Governance Description Regulation PAUD Raudlatul Athfal Operational of PAUD, the financing of teachers, and curriculum development conducted cooperatively between the community and YSBS Teachers are expected from barchelor degree graduation SD 03 Panikel Educational Program for all school-age children to attend school is compulsory until 9 years (Wajar 9 tahun)
Institutional arrangement
Non formal education under Kementrian Pendidikan Nasional and Ministry of Education in Cilacap. Consist of 3 teachers. To improve quality, PAUD teachers get training programs from YSBS.
Take shelter under Departement of Education of Cilacap
Human resources
Consist of 9 teachers, 1 principal and a custodian
Funding
Monthly contributions charged to students Rp.8.000,-
Operational costs are supported by BOS, while the scholarship comes from PSM and Childfund Contributions for school development Rp.100,000 /year
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b. Delivery Mechanism Description PAUD Raudlatul Athfal The number of teacher available still not sufficient with the number of student (Standard of number of PAUD teacher, Peraturan Mendiknas RI no. 58 tahun 2009) The function of PAUD is all at once facilitate kindergarten-age student, because kindergarten is not available in Panikel. While classroom available is not meet the demand of class, according to the distribution of kindergarten level (TK A for age 3-4, TK B for age 5-6). SD 03 Panikel People does not need to pay high to get the educational facilities, because of the financial assistance of the BOS program
Efficiency
Effectivity
With minimum physical condition of facility, SDN Panikel 03 can facilitate education for school-age people in Bugel
Equity
All children in age 1-6 can get early education through PAUD
After graduate from elementary school level, the poor generally cannot attend school to the next level because of the matter of financial
3.2.3. Impacts, Responses, and Adaptation Description Impacts PAUD Raudlatul Athfal Improving people awareness to the importance of early education and personality development of children SD 03 Panikel Easier access to education for the people of the village Panikel to attend school until JUNIOR HIGH SCHOOL Decreasing the number of illiterate population Decreasing the violence to children Increasing creativity of students, in art and english Improving the quality of the curriculum to catch up the national education standards
Challenges
How to develop PAUD in order to be easily accessed from the aspect of finance and distance How to attract local people to participate in PAUD development, especially in order to support human resources as teacher How to increase the capability of local people in self-
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producing learning media for PAUD, so that it can be a new employment opportunity for villagers Opportunity Theres no kindergarten in Panikel, therefore PAUD also take the role of kindergarten
Adaptations
Emerging aspirations from community for PAUD development Several people give voluntary contribution by becoming PAUD teacher, although its only earn low salary Parents have willingness to take their children into PAUD, because the school fee is still affordable
NGO
University 3.2.4. Analysis
YSBS support funding and take effort in improving quality of teachers through training programs Dedication of KKN student
Scholarship from YSBS that connect with Childfund Many potential areas that could be used as a learning media for students. public awareness of the importance of education is increasing Students take advantages of educational facilities to study, develop skills and socialize with other students Students still have willingness to go to school although it is far from home and not easy to access because of the bad condition of road YSBS gives training to elementary school teachers as an effort to improve teacher quality Dedication of KKN students
a. Problem Tree Analysis Problem and Objective Tress Analysis useful to help us identify the root of the problem, the core problem and the impact of the problems that arise. So be easy to make a priority problem resolution formula of education that occurred in the village of Panikel, Kampung Laut.
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Figure 14. Problem tree for education infrastructure in Panikel
In this problem tree analysis, the core problem which is not all socioeconomic level could able to access higher education is set as central point. With the core problems as the central point, the other problems are grouped in hierarchical structure reflecting causal relationships. In this way the problem environment is graphically displayed in a Problem Tree, with causes forming the roots and the effects forming the branches.
Causes as root of the problem consist of: Only scholarship from Childfund that available Difficulty of access and expensively transport cost Higher level school (such us SMP, SMA or SMK) located far outside the village
Effects forming the branches contain of: Less educated people The majority of community elementary school graduates Low socioeconomic groups choosing to work outside instead of continuing education The community does not have much skills (only farming skills developed) Low socio-economic groups welfare not improved significantly
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b. Objective Tree Analysis Subsequently, in Objective Analysis, the Problem Tree is transformed into a set of future solutions to the problems. Each negative problem is converted into an objective by rewording it as positive future statement.
Figure 15. Objective tree for education infrastructure in Panikel
Objectives followed by the causes: Scholarship from many resources Easy of access and cheaply cost transport Higher level school (such us SMP, SMA or SMK) available at the village
Effect logic expected on objective analysis : More educated people available The majority of community high level education graduates Low socioeconomic groups able to continuing education The community have much skills (such as skill to cultivation of sidat fish) Low socioeconomic groups welfare improved significantly
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c. Stakeholder Analysis
No. 1. Stakeholder Government of Cilacap Minister of Education and Culture 2. 3. YSBS (Yayasan Bina Sejahtera) 4. Child Fund, Unicef, Misereor and other citizen organization/NGO Interest Reaching target for community welfare Holding policies in regional level Reaching targets in education Performing control over funds and activities Determining policies in education Having interest on getting public image Accompanying the community Bridging the community with the funder Monitoring development project Having interest on getting public image Concerning to social, environment, and humanitarian issues Provide funding Monitong and evaluating the project Institutional dedication Institutional learning Involving in research and prefeasibility studies for development project As client , target and agent of development Delivering complaints Expressing desires for development Fostering sense of belonging in order to keep the facilities developed Providing assessments Getting an increase in welfare Importance/ interest High Influence/ power High
High
High
High
High
Low
High
5. Academics
Low
Low
6.
Community of Kampung Laut, especially : Community leader WOMEN Parents of students school students Local business Lower middle income group
High
Low
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d. SWOT Analysis
Strenghts (S) 1. Classroom capacity 2. Extracurricular activities (Scouts and the arts) 3. 2010-2011 graduation rate is 100% of primary school students 4. The local potential for the development of fisheries sector (Sidat) SO Strategy 1. Increased number of classrooms to accommodate students 2. Developing extracurricular activities which focus on the skills students 3. Developing 12-year study program. 4. Developing of skills in the field of fisheries
Weakness (W) 1. Minimum of support facilities (library, lab, UKS) 2. minimal amount of Lecturer 3. Low level of public education 4. There is no high school or vocational low cost WO Strategy Improved support facilities (library, lab, UKS). Procurement training to improve the quality of teachers Increasing the number of teachers (teacher) at the primary level by government programs (Honorary, teacher aides) Developing and Vocational High School in the Village Panikel TW Strategy Opportunities for marine village society, to become teachers. Give priority to local people to be able to obtain a scholarship in teacher training department Grow a sense of belonging in the society transport sector development
Opportunities (O) 1. Education was considered important by the society 2. The focus of government programs Mbali Ndeso Mbangun Ndeso 3. The role of the existence of "YSBS" as a foundation that helps provide educational assistance and to Provide scholarships
1. 2.
3.
4.
1.
2.
3. 4.
5.
Threats (T) The people with higher education levels have less awareness to re-build the village Do not have an official building and still a rent (especially PAUD) Accessibility is not optimal Many people is do not attend school and instead chose to work Lack of society skills.
1.
2. 3. 4.
TS Strategy Develop extracurricular programs that optimize the use of which educated society the provision of building official for PAUD increased accessibility to the location of the school Informal training to improve skills in the field of fisheries
1.
2.
3.
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The outline of SWOT Analysis in Educational Infrastructure in generating strategy: 1. Procurement of educational support facilities 2. Developing SMK that can be reached by the community to lower middle economic levels 3. 4. Improving the quality and quantity of Lecturer Develop the human resources to local communities as teachers
5. Empowerment society skills to utilize the potential of SDA 6. Partnership between Government, YSBS and scholarship for the development of education sector
e. Whole System Design Whole System Design (WSD) consists of 4 phase, that are functional specification, conceptual design, functional design, and engineering design. This method can be used for formulating infrastructure development strategy with specific requirements and consideration into the detailed criteria of development. In this research, WSD only be done until the third phase, functional design, as the development of ideas emerged from the goal, problems, and objectives of the education infrastructure development program in Panikel for generating recommendations. Goal, Problem, and Objective identification Goal Problems Generating equality between all socioeconomic level of society to access educational facilities 1. Minimum support facilities (no library, lab, and UKS) 2. Lack of human resources for PAUD 3. Students from low economic level are not able to continue their study to the higher level of education (SMA/ SMK and college) because of the matter of finacial 4. The function of PAUD is all at once facilitate kindergarten-age student, because kindergarten is not available in Panikel. While classroom available is not meet the demand of class, according to the distribution of kindergarten level (TK A for age 3-4, TK B for age 5-6).
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Objectives 1. Improving support facilities and educational equipments 2. Increasing the number and quality of human resources, especially for PAUD 3. Providing more scholarship for low economic level of students 4. Improve PAUD into formal early education that consider to the distribution of learning-age.
Identifying 5W + H What Why Education facilities that affordable to low economic level of community Most low economic level of community in Panikel cannot continue to the higher education because of the matter of financial Who Students from low economic level families in Panikel Village who are study in elementary school, junior high, senior high, or college. Where Panikel Village, whole 5 sub-villages When Everytime How Open access for student from low economic level family to get scholarship or support funding for higher education Scholarship sosialization and promotion in schools Registering and monitoring for low economic level students Provide information center for education and scholarship available (through internet and students database in village level)
WSD Formulation Functional Specification 1. Sufficient facilities for serving people in village level 2. Easy access to educational facilities: low cost for poor people, short travel time 3. Sufficient number of human resources in educational activities 4. Integrated to information center which provides students (school-age Conceptual Design Integrated information system for educational sector Functional Design Alternative #1: Integrated information system for educational sector in Panikel 1. Improvement of support facilities in every school (e.g library, lab, UKS, studio/ workshop) 2. Balai Desa has an information database for registering data of students from loweconomic level families, which can be shared to the donors of scholarship 3. The information center
32
inhabitants) database, scholarship, and vacancies information
organized by villagers through RT/RW 4. The scholarship information system can be built with library in every sub-village, organized by teenager cadres. Note: the concept set up from a consideration that the improvement of school facilities would increase cost. Educational facilities that affordable to low economic level of people Alternative #2: Low school fee and integrated educational facilities 1. With minimum improvement of support facilities in every school. Library, lab, and studio/ workshop are provided with integrated system between all level education in village level 2. Since a school not able to built library, 1 village has 1 integrated library which serves all level of education, and can be opened for public 3. Perpustakaan keliling can be an alternative for serving people which cannot reach the library center 4. Educational database system avaiable to support information to donor/ funder
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CHAPTER IV
CONCLUSION AND RECOMMENDATION

4.1. Conclusion 4.1.1. Health a. Through perspective of physical condition, health infrastructure in Panikel Village is still lack of support facilities and equipments. b. Government contribution to health infrastructure development in Panikel is too low. Even the medical equipments have to be self-provided by the only midwive. YSBS has contributed in providing sanitary and holding health program for improving health of woman and children. c. Because of the funder only concern in prosperity of mother and child, the health infrastructure in Panikel Village only give advantages to women, while men are excluded. d. Health programs held in PKD have successfully decreased maternal mortality rate. e. Villagers more rely on midwive service rather than dukun bayi.
4.1.2. Education a. Education buildings are available for basic educational activities, but not yet provide support facilities, such as library, and lab for further development of education quality of people in Panikel. b. Education infrastructures in Panikel are still lack of human resources. The number of teacher for PAUD is not sufficient with the number of students. c. The benefits of education infrastructure in Panikel Village can only enjoyed by community with middle to higher social-economic level. d. The number of people in Panikel who attend higher education (SMA/SMK and college) are still low because of the matter of financial and no SMA/ SMK available in Panikel. e. Only students from middle to high economic level that are capable to continue their education to the higher level. While the middle level and below prefer to work outside the region rather than continuing education.
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4.2. Recommendation According to the findings and analysis, the recommendations for health and education infrastructure are: 4.2.1. Health a. To develop the health sector development effort is required which is holistic, encompassing the sectors other than health are especially emphasized on improving the quality of the means of transport. b. In the development of health necessary involvement of all stakeholders the related including the government, private and NGOs, academics and local community, especially men. c. Optimize completeness and service facilities, were both the quantity and quality of human resources, completeness facility, completeness equipment, and ease bureaucracy health insurance available. d. Increase number of PKD in accordance with the demand of the range of service areas. e. Increase integrated relationship with all healthcare facilities, such as pustu (puskesmas pembantu), puskesmas, and RSUD f. Promoting the community about the importance of fostering awareness in maintaining of the health environment and installing sewerage system (IPAL) in health facilities. g. In addition to the above recommendations, some programs will also favor the proposal presented in access equallity of health facilities for each gender: Jimpitan program as a substitute for health insurance Socialization program for men, for example, counseling about the dangers of drugs, alcoholic drinks, and cigarettes. Provide not only midwives, but also mantri
4.2.2. Education a. For the realization of Justice in education facilities, especially utilization of equalization for low socioeconomic groups required cooperation among all stakeholders involved. Especially in an attempt to increase the delivery of information, scholarship opportunities.
For Example: Balai Desa has an information database for registering data of students from low-economic level families, which can be shared to the donors of scholarship The information center organized by villagers through RT/RW The scholarship information system can be built with library in every subvillage, organized by teenager cadres. b. To support the growing education an unrealizable attribute on all societies need to emphasis the ease of transport, road repair, and cheaper transportation cost. c. Complete the educational facilities that have been available with a competent and qualified teacher as well as a means of supporting a complete minimal compliance with the standard. For Example: Improvement of support facilities in every school (e.g library, lab, UKS, studio/ workshop) d. Provide informal vocational education (for example training for cultivation of sidat fish in junior high school) e. The main constraint that cause the inability to access higher education (SMA and College) is the high living cost and school utilities. It would be better if SMA/ SMK also developed in Panikel. f. Provide Perpustakaan keliling
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REFERENCES
Sulistiono. 2011. Social Capital and Rural Road Development, A Case of Kampung Laut, Cilacap. Yogyakarta: Thesis Universitas Gadjah Mada. http://cilacapkab.bps.go.id/dokumen/html/stat_kecamatan/121%20Kplaut/index_121.htm http://okelife.blogspot.com/2009/12/profil-wilayah-kampunglaut.html http://regional.infogue.com/jawa_kemarau_krisis_air_bersih_terjang_cilacap_selatan http://rehab.ditptksd.go.id/index.php?module=profilsekolah&func=main&startnum=701&kd_pro=0 3&kd_kota=&nss=&nama_sekolah= http://www.cilacapkab.go.id/v2/?pilih=news&mod=yes&aksi=lihat&id=944
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EVALUATION OF HEALTH AND EDUCATION INFRASTRUCTURE FOR PEOPLE EMPOWERMENT Case Study in Panikel Village, Kampung Laut, Cilacap

1.4. Conceptual Framework 1.4.1. Conceptual Framework For Health Infrastructure

Figure 1. Conceptual Framework for Health Infrastructure

SD Not complete school/ Never attend school

Figure 2. Panikel Population According to Level of Education

Figure 3. Conceptual Framework for Education Infrastructure

DESCRIPTION OF STUDY AREA

Population By Sex in Kampung Laut, Condition from Year 2003 - 2010

Livelihood of People Above 10 on Panikel Village By The End of Year 2010

Source: Statistik Pokok Kecamatan Kampung Laut, BPS, 2010

FINDINGS AND DISCUSSION

Figure 9. Inpatient room in PKD Panikel

Figure 10. Problem tree for health infrastructure in Panikel

Figure 11. Objective tree for health infrastructure in Panikel

Figure 12. Building condition of PAUD Raudlatul Athfal

Figure 13. Building condition of SDN 03 Panikel

Description Physical Condition al

Take shelter under Departement of Education of Cilacap

Consist of 9 teachers, 1 principal and a custodian

Monthly contributions charged to students Rp.8.000,-

University 3.2.4. Analysis

Figure 14. Problem tree for education infrastructure in Panikel

Figure 15. Objective tree for education infrastructure in Panikel

inhabitants) database, scholarship, and vacancies information

CONCLUSION AND RECOMMENDATION

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