Close evaluation aims to extend farmer health program, sprout more like it

For six months in 2019 the AIC’s Village Livelihood Program (VLP) trained volunteers to support improved health and agricultural outcomes in their home villages in West Sulawesi. Heads of the four participating villages have agreed that if this pilot program proves successful they will fund and support its continuation for 2020.

Evaluation and analysis of the program is nearing completion, after a process that included feedback throughout the six months and monitoring by project staff, followed by focus groups and interviews at the end of the program in October.

Feedback from the village heads has been positive, suggesting the Village Livelihood Program may continue. This would allow the volunteers to build on their deepening relationships with village health centres and with various agriculture stakeholders, further developing their own awareness as well as, of course, sewing the program’s messages more deeply into village networks and processes.

The program has been a collaboration led by The University of Sydney and Universitas Hasanuddin. The research team hopes that the successful continuation after the pilot program will provide an example and encouragement for other villages in the area to implement a similar approach.

The program

A team from the University of Sydney trained in-country experts from Hasanuddin University, Swiss Contact and the local district’s Department of Agriculture, covering specific subject knowledge and also teaching methods for sharing that knowledge. The local experts then trained the 24 volunteers (six from each village) at an intensive four-day training program, covering the basic science underpinning each topic as well as ways to engage their communities in learning.

For each village there were three health volunteers and three agriculture volunteers – all tasked with upskilling their communities and helping them to improve practices. In health this included providing better nutrition for children and mothers (child stunting is higher in West Sulawesi than other parts of Indonesia), promoting healthier regimes to reduce risks of diabetes and coronary conditions, and managing waste and infections. Agricultural volunteers promoted good agricultural practices in cocoa farming (the main income source for the community) and provided information on market opportunities, such as farming contracts.

Importantly, the health program was designed so as not to duplicate the work of the existing ‘Cadre Volunteer Network’ that focuses on maternal and child health in Indonesian villages.

Though volunteers focused on either health or agriculture, the program content and approach was guided by a ‘One Health’ model which integrates the two fields. One Health emphasises the interlinkages between the various aspects of village life, including soils, environment, human health and agricultural practices, and attempts to overcome ‘siloed’ approaches that treat each component separately. The six volunteers worked together, exchanging information and ideas in regular meetings.

Monitoring and evaluation

All contact made by a volunteers as part of the program was recorded on a smartphone app and then uploaded to a central CommCare website that could be accessed by program staff and trainers in real time. The information recorded and analysed included the type of assistance provided, whether it helped, whether further or expert opinion was sought and if the volunteers thought further training was required to address issues raised by community members.

Additional evaluation of the program included regular monitoring by AIC project staff, and focus groups with the volunteers and (separately) with stakeholders, such as health centre staff and midwives, village leaders and farmer group representatives.

The evaluation identified the need for strong support from the village head (kepala desa), and other key figures such as the village midwife. This was critical as volunteers at times experienced resistance from the community members who were often busy (especially as the pilot period covered the main cocoa harvest season) or were not receptive to change.

The fact that volunteers were all operating in their own home villages was seen a particular program design strength.

Final results and a peer-reviewed journal are in process. Once released, it is hoped these could allow the model to be applied to other rural communities, both around Indonesia and in other low- and middle-income countries.

The project team


Earlier program update: Extra support for West Sulawesi farmer health program

The preceding study: ‘Sustainability and profitability of cocoa-based farming in Sulawesi’