A collaboration between Angsamerah and SUM II-USAID

Setting up a model of high quality and friendly sexual and reproductive health clinic in South Jakarta, October 2012 to March 2015

Goal and Achievements

The ultimate goal of the collaboration between SUM II and Angsamerah Foundation was to create a model of sexual and reproductive health care delivery in private sector, which is sustainable and replicable.

Within the first year of collaboration, Angsamerah Foundation has successfully established a “most-at-risk-population” friendly sexual and reproductive health “model clinic” in the Blok M area of South Jakarta. Klinik Yayasan Angsamerah has started its operation in the middle of July 2013. Aside of the general health care and specific care and treatment to issues related to sex, HIV and drugs, patients with HIV could also acces ART at the Klinik Yayasan.

In the second year, the clinic has been able to increase the number of clients access care in the clinic, and 40% of the patients are young people less than 25%. Started in July 2015 finally the clinic is able to provide Free HIV testing for YOUth less than 25 years old.

The Klinik Yayasan Angsamerah represents an innovative approach to health care delivery, mobilizing ideas, efforts and resources of government, the private sector and civil society to increase the access to quality health care services. This model of a public-private partnership results from a cost-sharing agreement between USAID (SUM II) and Angsamerah Foundation, financial and technical assistance from COFRA Foundation and Angsamerah Institution, and support for medical consumables and medication from local government institutions.

The Klinik Yayasan has assisted health professionals to see directly the actual model, learning its process developement and maintain the services. Adding to that, this project collaboration has engaged other health professionals to think the possibility how this can be adapted in their setting; private practice, clinic or their public health program.

The two years experience from the partnership between SUMII USAID and Angsamerah has enhanced the competency of Angsamerah Institution to design and organize trainings that help professionals to understand the concept of the provision of high quality and friendly healthcare services related to sex, HIV and drugs, with affordable prices, which can have a positive social impact as well as economically benefiting the providers, and how this concept could be adapted to different local situations.

Rational of the collaboration

Angsamerah Institution has established itself as an important player within the field of sexual and reproductive health in Indonesia and beyond. Its aim is to provide high quality, holistic, complete and one of the main pillars of a successful HIV & AIDS response is health services, which are affordable, easily accessible and non-discriminative (friendly).

Current coverage of such services in Jakarta is insufficient, resulting in suboptimal conditions for people at high risk of contracting HIV and other STIs. Health experts and community workers stress the need to add more facilities that fill the gaps of existing services and add new and alternative options.

Up until now, the private sector has not been sufficiently mobilized, in particular on the primary health care level. Driven by a strong commitment to contribute to the strengthening of the Indonesian health system in innovative ways, Angsamerah has seized the opportunity to partner with SUM II to establish a new model clinic in South Jakarta.

Service description

Klinik Yayasan Angsamerah is run by Angsamerah Foundation, which is part of the Angsamerah Institution, a private organization specialized in the provision of sexual and reproductive health services. Klinik Yayasan Angsamerah is centrally located at Jl. Panglima Polim Raya, across from Pasar Blok A, only a few minutes away from the Blok M mega shopping and entertainment area and bus terminal. The clinic is open from Monday till Saturday, with opening hours “friendly” for at-risk populations (Monday – Friday: 11 a.m – 7 p.m; Saturdays: 10 a.m – 4 p.m). Services at the clinic can be obtained incognito, that is without the need to show any identification. Patients are encouraged to make an appointment.

Klinik Yayasan Angsamerah is an outpatient clinic managed by a general practitioner. It provides general health services on a primary health care level. Special attention is given to the provision of comprehensive sexual and reproductive health services (a combination of services from prevention to treatment as prevention). Such services are often neglected by conventional providers. Services are provided to all members of society, regardless of their age, gender, sexual orientation, marital status or profession.

The clinic provides “one stop” services for HIV and STI screenings, with results being available within 20 minutes. With other words, the clinic provides the opportunity to obtain comprehensive care including counselling, testing, treatment and medical follow-up at one location and with a high level of personal continuity. This way, the transfer between two or even more institutions can be avoided, which means that patients can safe time and do not have to disclose intimate information repeatedly to new providers. Nevertheless, if patients require services beyond the primary health care level or from a specialist doctor, they will be referred to one of our partners. The clinic does also provide ARVs, with Angsamerah being a certified satellite provider for Anti-Retroviral Treatment by Sulianto Saroso Infectious Disease Hospital.

Lessons Learned

The two years experiences of the collaboration combined with other Angsamerah’s works has given valuable lessons as well led to the new opportunity of the possibility to scale up this initiative/innnovative model. This is possible, as there is a template that can be adapted, which significanly influence in reducing the cost with less time consuming, and giving higher chances to success.

The major elements for the success of replicating this initiative

1. Availaibility of assistances to health provider to develop SMART (Specific, Measurable, Attainable, Realistic, Timely)
2. It takes time about two years minimum
3. Capacity building supports to how to adapt the template; by seeing the model, trainings in the class and mentoring on the site. It is important also the suppport should not only focusing onthe  technical issues but also need to inlcude subjects about motivation, communication skills, business strategy, personal branding, and how to write a simple business plan
4. A strategic mentoring mechanism
5. Availability of minimum funding to start the business in the first one year. Availability of a small grant and/or loan with no/or small interest to the health providers will be tremendeously helpful to the health providers.

Acknowledgements

Angsamerah Foundation is immensely grateful to the many organizations and individuals whose generous support, guidance and hard work made our achievements possible.

First of all, we would like to thank the United States Agency for International Development (USAID) and its program Scaling Up For Most-At-Risk-Populations (SUM II) for their faith and trust in Angsamerah to become the collaborating partner. We greatly appreciate the funding and support through the SUM II program for making this project possible. Special thanks go to the SUM II team for their technical support and collaboration. At this point, we would also like to acknowledge the help provided by Circle Indonesia and Penabulu, which has greatly contributed to the strengthening of our organization.

We are also extremely grateful to COFRA Foundation for their generous complementary support, which came in the form of a consultant and financial resources.

Angsamerah would also like to say thank you to a number of Civil Society Organizations such as Yayasan Kapeta, Yayasan Inter Medika, Yayasan Srikandi Sejati, Yayasan Karisma, Yayasan Kusuma Buana, Yayasan LPA Karya Bhakti and Yayasan Bandungwangi for their collaboration and committment to refer patients to the new clinic.

Furthermore, Angsamerah is grateful for the endorsement from a number of government institutions, such as the Ministry of Health, the Provincial AIDS Commission of DKI Jakarta, as well as the South Jakarta branche of the AIDS Commission and their generous support with medical consumables.

Last but not least, all our accomplishments have only been possible thanks to the technical and financial backing from Angsamerah Institution and its team. Herewith, our special thanks are extended to the Angsamerah team, for their advice, persistence and hard work.

This project partnership was managed by Mr. Felix Neuenschwander

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