How and Why did the Generasi Project Work?
Household members’ participation in other community activities increased only in Java and in treatment B areas in NTT, but not in Sulawesi. The baseline mean (column 1) and control mean (column 2) suggest the community members in NTT already spent considerably more time on semi-voluntary public labor activities than in the other two regions. Overall, Generasi had positive impacts on community efforts in all three regions, with all three regions indicating positive standardized average impacts on health activities but no impact on community efforts associated with education.
5.5 Quantities from Provider Data This section explores the changes in quantities and prices from the provider data. First, the quantities of services reported by services providers (midwives, health centers, village health post, and primary and junior secondary schools) are discussed. This is followed by the analysis of the impact on fees charged for maternal health services by health facilities, midwives, and cost of education. By analyzing prices and quantities together, we can begin to understand the incidence of Generasi benefits, as well as the degree to which Generasi shifted demand curves, supply curves, or both.
5.5.1 All Provinces The results for all provinces are shown in Table 55. The table shows quantities and fees for a variety of services provided by midwives (childbirths at private and government practice, ante-natal care, post-natal care, family planning), childbirth at Puskesmas, school enrollment and school fees, and village health post services and fees. Several results are worth noting. First, the results show a dramatic increase in all maternal and child health services offered at village health posts: the quantity of children weighed increased by 8.3 (20 percent increase); the quantity of children receiving nutritional supplements increased by 13.9 (40 percent increase); the quantity of children immunized increased by 3.1 (27 percent increase); the quantity of pregnant mothers receiving ante-natal care increased by 1.9 (42 percent increase); the quantity of pregnant mothers receiving iron pills increased by 2.3 (48 percent increase); and the quantity of children receiving Vitamin A increased by 8.8 (20 percent increase). These substantial increases do not appear to be due to record keeping—family planning services at village health post, for example, remained unchanged. The results were similar in treatments A and B. These results suggest that a major contribution of Generasi was a revitalization of the village health post system, bringing more mothers and children into the health care net. The fact that so many more mothers and children were being brought into the modern health care net may be a major reason why the Generasi program succeeded in reducing infant mortality—with such regular contact with health professionals, many at-risk children might have been saved. Second, the data from midwives suggest that there were increases in fees charged for delivery services, even though the total number of services delivered did not change substantially. Fees charged by midwives increased by Rp. 15,500 in private practice (4.6 percent), and fees charged for government delivery
Indonesia’s PNPM Generasi Program: Interim Impact Evaluation Report
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