The path to improve the health and wellbeing of people with disabilities in South Sulawesi

Lead researchers from an Australia-Indonesia Centre program on improving health outcomes have outlined their findings to Indonesia’s Ministry of Health and the National Committee on Disability.

Findings from the Partnership for Australia-Indonesia Research (PAIR) program were delivered to policymakers and stakeholders using a focused policy briefing – one of seven such documents created by the AIC — as part of a series of meetings that took place in early December. The health and wellbeing team spoke with policymakers with the intent of charting a path forward.

Already, the National Commission for Disability has expressed interest in the formation of a Memorandum of Understanding with the AIC to work together on a research-based advocacy strategy.

Over the course of three years, the research project – “Improving the health and wellbeing of rural communities in South Sulawesi” – was a collaborative effort by PAIR researchers from the Universitas Airlangga, the University of Western Australia and Universitas Hasanuddin. A portion of the work focused on low levels of support for people with disabilities and increasing demand for mental health services, analysing data from three districts in South Sulawesi: Maros, Pangkep and Barru.

Through a survey of village leaders in the three districts, PAIR researchers found that most villages have between one to give PWD, with disabilities related to vision, hearing, speech, and quadriplegia. Moreover, those in the PWD community are less likely to get involved in most village activities. They have limited opportunities to participate in activities or be heard at meetings that affect them.

A second survey of Puskesmas – or primarily healthcare facility – health workers identified that there is limited funding to provide quality care and support facilities and tools for people with various forms of disabilities – such as prostheses, orthoses, and wheelchairs – to enable people with visual and hearing and physical impairment. There is also low public awareness and high stigma against PWD that continues to impact the quality and level of services.

PAIR researchers concluded that the Dana Desa program, one historically used to improve local infrastructure, was well-placed to fund initiatives that improve the quality of healthcare that those in rural communities, including PWD, pregnant women and those with mental health issues, receive. Funds could also be used to create training programs and public awareness campaigns to reduce the stigma that PWD face.

“We prioritised neglected health issues, and identified that strengthening mental healthcare and social services for people living with disability are among the most important findings,” said Dr Sudirman Nasir of Universitas Hasanuddin. “This group is already vulnerable, and becoming more vulnerable.”

Discussions at the Ministry of Health focused on the need for advocacy at both national and local levels to bolster training programs that have already been developed.

“We’ve already provided the mental healthcare guidance for primary healthcare but we do need to advocate local leaders to use Dana Desa to improve the service quality,” said the ministry’s Rahmi Purwakaningsih in discussion with PAIR researchers.

“It is important to also engage with the Ministry of Home Affairs to support our advocacy as they have stronger influence at the district level,” Rahmi continued.

This is the strength of the National Commission on Disability. With a mission to protect and fulfil the rights of PWD, it monitors, evaluates and works with stakeholders responsible for change. It also has a strong focus on education and awareness to reduce stigma and improve the quality of life and healthcare PWD can access.

Discussions at the organisation’s headquarters stressed its need for “valid and reliable research to support our advocacy at both local and national level,” according to chairperson Dr. Dante Rigmalia.

With the meeting occuring around the time of the International Day of Disabled Persons, the commission highlighted the case of Klaten, a regency with eight districts and around fifty villages that are inclusive to PWD.

“Each village has recognition, implementations, and information for disability inclusion,” said commissioner Jonna Aman Damanik, hoping more regencies and villages will soon follow suit. Jonna also stressed the need for private sector involvement and funding to further this goal.

Through these discussions, PAIR researchers better understand the types of data required by stakeholders to improve advocacy efforts.

“[The commission was] very interested in working with us to design… advocacy activities that we could then take to village leadership,” recounted Professor Anu Rammohan of the University of Western Australia, an AIC Senior Fellow. “Working with stakeholders as good as that will give us insights into exactly what their problems are, and how we can best use our research to work with them collaboratively.

“That’s what we do research for; it’s really, really rewarding to have impact,” Rammohan added.

Kevin Evans, AIC’s Indonesia Director noted that “the AIC is delighted at the interest of the commission to partner with us. We believe the kind of data driven work that our research teams have been undertaking will dovetail well to support the commission’s critical work on advocacy and support for Indonesians with disability.”

The health and wellbeing team’s efforts will continue into 2023 and also involves research into food and nutrition security and access to mental healthcare programs.