(TERM OF REFERENCE) TOR
IMPLEMENTING UNIT ASSISTANCE IN BASIC SKILLS
TRAINING FOR POSYANDU CADRE
INVESTING IN NUTRITION AND EARLY YEARS (INEY) FASE II
Fiscal Year 2024
A. BACKGROUND
Legal Basis Task Function/Policy
1. Legal Basis Law Number 17 of 2003 concerning State Finance (State Gazette of the
Republic of Indonesia Year 2003 Number 47, Supplement to State Gazette of the
Republic of Indonesia Number 4286.
2. Law Number 25 of 2004 on the National Development Planning System (SPPN)
(State Gazette of the Republic of Indonesia Year 2004 Number 104, Supplement to
State Gazette of the Republic of Indonesia Number 4421).
3. Law Number 17 of 2007 concerning the National Long-Term Development Plan 2005-
2025 (State Gazette of the Republic of Indonesia 2007 Number 33, Supplement to
State Gazette of the Republic of Indonesia Number 4700).
4. Government Regulation Number 10 of 2011 concerning Procedures for Procuring
Foreign Loans and Receiving Grants (State Gazette of the Republic of Indonesia Year
2011 Number 23, Supplement to State Gazette of the Republic of Indonesia Number
5202).
5. Government Regulation Number 17/2017 on Synchronizing the National Development
Planning and Budgeting Process (State Gazette of the Republic of Indonesia 2017
Number 105, Supplement to State Gazette of the Republic of Indonesia Number
6056).
6. Presidential Regulation No. 72/2012 on the National Health System (State Gazette of
the Republic of Indonesia 2012 No. 193).
7. Presidential Regulation Number 18 of 2020 on the National Medium-Term
Development Plan for 2020-2024 (State Gazette of the Republic of Indonesia of 2020
Number 10).
8. Minister of Finance Regulation Number 224 of 2011 on Monitoring and Evaluation
Procedures for Loans and Grants to the Government (State Gazette of the Republic
of Indonesia Year 2011 Number 853), as amended by Minister of Finance Regulation
Number 180/PMK.08/2012 (State Gazette of the Republic of Indonesia Year 2012
Number 1122).
9. Regulation of the Minister of National Development Planning/Head of the National
Development Planning Agency Number 4 of 2011 on Procedures for Planning,
Submission of Proposals, Assessment, Monitoring, and Evaluation of Activities
Financed by Foreign Loans and Grants (State Gazette of the Republic of Indonesia
Year 2011 Number 761).
10. Regulation of the Minister of Home Affairs Number 54 of 2007 on Guidelines for the
Establishment of Pokjanal Posyandu and Posyandu Program.
11. Minister of Health Regulation No. 74/2015 on Health Improvement and Disease
Prevention.
12. Minister of Home Affairs Regulation Number 18/2018 on Village Community
Institutions and Customary Institutions.
13. Minister of Health Regulation Number 8 of 2019 concerning Community
Empowerment in the Health Sector;
14. Minister of Health Regulation Number 43 of 2019 concerning Community Health
Centers.
15. Minister of Health Regulation Number 25 of 2020 concerning the Organization and
Work Procedures of the Ministry of Health (State Gazette of the Republic of Indonesia
Year 2020 Number 1146).
16. Regulation of the Minister of Health Number 13 of 2022 on the Strategic Plan of the
Ministry of Health for 2020-2024 (State Gazette of the Republic of Indonesia Year
2022 Number 461).
B. GENERAL DESCRIPTION
The RPJMN 2020-2024 targets stunting Program as one of the Government's main
programs. Stunting is a condition of growth failure in children under five due to chronic
malnutrition, especially in the first 1,000 days of life (HPK). Stunting cases are targeted to
decrease in the next three years, namely in 2024 to 14%. Based on SSGI data in 2021, the
data shows 21.6%. To achieve this goal, it is necessary to intervene in feeding education and
early detection of malnutrition problems in the target mothers and toddlers who are included in
the First 1000 Days of Life period. In 2021, Presidential Regulation Number 72 of 2021
concerning the Acceleration of Stunting Program was issued which supports the achievement
of the RPJMN, by establishing specific and sensitive interventions on maternal and toddler
targets including feeding and growth monitoring.
Posyandu, a village community organization tasked with assisting the village head in
providing basic social services, plays an important role in supporting health workers to improve
access to child feeding education as well as early detection of nutritional risks. Posyandu
cadres require training and mentoring by health workers in providing services for pregnant
women and children under five at Posyandu. In 2023, there were 304,263 Posyandu recorded
in Komdat Kesmas, with 275,548 active Posyandu (82.68%). In order to provide quality basic
health services at Posyandu, it is necessary to increase the capacity of cadres as Posyandu
managers in a standardized manner. The Ministry of Health has developed a cadre capacity
building scheme with cadre data collection steps at puskesmas, implementation of basic cadre
skills training, assessment of cadre skill levels by health workers. The core material of cadre
basic skills training with the scope of maternal services, toddlers, adolescents to the elderly.
Training methods include the provision of theory as well as field practice at posyandu and
home visits.
To support the acceleration of stunting program, the Government of Indonesia decided to
reuse the World Bank's Investing in Nutrition and Early Years (INEY) Program-for-Results
(PforR) instrument during the 2022-2023 period. The implementation of PforR INEY will be
supported by an Investment Project Financing (IPF) component financed by a multi-donor
Global Financing Facility (GFF) grant. The IPF component will be used to support catalytic
investments to improve implementation capacity and strengthen implementation systems that
will provide the basis for long-term reforms and sustainable implementation capacity. In this
case, the Ministry of Health involves the Poltekkes through advocacy activities and supervision
to the field for the implementation of stunting intervention assistance at the Puskesmas and
Posyandu levels. The Poltekkes will provide assistance to Posyandu in working on child
feeding and also early detection of nutrition problems. DLI Indicator 9 emphasizes the skills of
Posyandu cadres in supporting the acceleration of stunting program. Training is conducted to
increase capacity and capability in the implementation of the program. Training for cadres
includes activities allocated by the Poltekkes. In addition, cadre training is also carried out in
stages by the Health Office and Puskesmas with the Non-Physical Special Allocation Fund in
2024.
In this regard, it is necessary to assist and analyze the implementation of basic skills
training for posyandu cadres which aims to organize the implementation of training according
to standardized materials and methods at the Provincial, District / City to Puskesmas levels.
Capacity building activities for cadres are carried out in stages, the Poltekkes team assists
cadre capacity building carried out by health centre health workers, to educate posyandu
cadres on 25 Basic Skills.
Operational Definition of Output
The output of this activity is the standardized implementation of Basic Skills Training for
Posyandu Cadres and Assessment of Cadre Skill Levels conducted by the Health Office and
Puskesmas. In addition, after the training, this activity can encourage the commitment of
relevant stakeholders to realize active Posyandu through coaching and mentoring.
C. BENEFICIARIES
The beneficiaries of this activity are:
1. Internal
• Directorate General of Public Health
• Directorate of Health Promotion and Community Empowerment
• Directorate of Nutrition and Maternal Child Health
• Central level cross-program
2. External
• Relevant ministries/agencies
• Provincial and District Health Offices
• Pokjanal and Pokja Posyandu
• Health Center
• Posyandu cadres and other health cadres
• Profession Organization (IDAI, POGI, PPNI, IBI)
• 38 Health Polytechnics of the Ministry of Health
D. STRATEGIES FOR ACHIEVING OUTCOMES
1. Implementation Method
Activities are carried out on a contractual basis
Activities consist of:
• Consultant/TA
• Qualification required:
a) Bachelor's degree in health section
b) Work experience performing assisting/supervising related to primary
health services (Puskesmas)
c) Have competence in the required field as evidenced by a diploma of
education, certificate of expertise/technical, and/or certificate of
training/course
d) Representing part of a health professional organisation that has
branches in 38 provinces and districts, preferably with members spread
to the village stage
• Setting up administration
• Coordinate with District/City Provincial Health Offices, Bappeda and other
district/village officer ( MoHA, MoV, BKKBN)
• Coordinate with LP/LS and other stakeholder who involve in the stunting
program
• Setting up data
• Implementation of Consultant/TA Activities
• Protocol/activity plan preparation and development, The training schedule
will be adjusted by the District Health Office / City / with the Puskesmas
according to their respective needs. Tools for monitoring should also be
developed by the consultant/TA
• Data collection on the implementation of basic skills training for cadres at
the provincial, city district and health center levels at least three times
during the programme period. The tool used for data collection is through a
microsite that will be filled in directly by health workers and manually
through a form that will be filled in during the activity.
• Monitoring the suitability of training implementation at the Provincial,
District/City and Health Center levels.
• Monitoring the appropriateness of the implementation of the assessment of
the skill level of cadres by puskesmas and training for cadres at least three
times during the programme period.
• Analysis of the results of training implementation and assessment of the
level of basic skills of cadres (quantitative and qualitative).
a) Quantitative: cadre skill level assessment coverage with specific
intervention coverage.
b) Qualitative: compliance of cadre assessment method, compliance of
assessment method and facilitator ability.
• Activity Reporting
The period for written activity reports is monthly and the details and format
can be referenced in the technical guidelines.
E. STAGES OF IMPLEMENTATION
o Basic skills training assistance for cadre
▪ Mapping training implementation
Objective: to collect data on Provinces/Cities/Community Health Centers that
have training funds, and mapping of training implementation plans
Activity: coordination with provincial/city health offices
▪ Monitoring and Technical Guidance on training
implementation
Objective: DHO/Provincial/City Health Office and Puskesmas are standardized in
conducting basic skills training for cadres.
Activity: Provide feedback on the training implementation plan to match the core
materials and methods in the cadre basic skills training guidelines.
▪ Monitoring and Technical Guidance on the
implementation of cadre skills assessment
Objective: The health center assesses the skill level of cadres
Activity: coordination with puskesmas. Monitoring of activities is carried out every
month, in line with the Poltekkes Technical Guidelines.
▪ The materials provided for cadres
Objective : Posyandu management that serves the life cycle, 25 basic skills of
posyandu cadres, practice in posyandu and home visits, and microtheacing
Activity : with the materials and methods specified in the cadre basic skills
training curriculum: pre-test, material (theory and assignment), field practice,
post-test in each activity.
o Mentoring of post-training
Objective: Achieves 80% in Active Posyandu and encourages stakeholders to
support Posyandu.
Activity: This assistance is also expected to find problems in each region so that
the right solution can be found and implemented.
o Analyze results on training coverage and quality
Objective: to monitor trainee coverage
Activities: monitoring participant coverage, monitoring participant training outcomes,
monitoring follow-up on training outcomes
o Activity report
Objective: to provide recommendations for the implementation of basic skills
training for cadres
Activity: analysis of training implementation results and assessment of cadres' skill
level
F. TIME OF OUTPUT ACHIEVEMENT
Analysis of the results is planned to be carried out in November, while training is ongoing
until December.
No Training Mentoring Jun Jul Agst Sep Oct Nov Dec
1 Preparation
2 Consultant/TA
Selection
3 Assistance to cadres
carrying out basic skills
training
G. COST
Total costs required for these activities are contained in the DIPA Satker Secretariat of the
Directorate General of Public Health Fiscal Year 2024 Further details of these costs are
presented separately in the attached Budget Plan (RAB).