Some 5-Year Results..

Project ASRI completed household surveys

in 2008 and 2012, to assess health outcomes and
attitudes on forest conservation.

Here are some of the survey results.

 Selected results for Health

1. Prevalence of Common Disease Symptoms

2. Attendant at Last Childbirth
3. Immunization of Last Child
4. Child Mortality
5. Percentage of smokers
6. Awareness of HIV
7. Good Hygiene
1. Prevalence of Common Disease Symptoms
Fever and cough may signal serious diseases, such as TB and malaria –
diseases that ASRI works to prevent. Diarrhea and weight loss may result
from preventable infectious diseases, addressed in ASRI’s patient hygiene
education efforts. Incidence in all categories is dramatically improved.

100
90
Percentage of households

2007 (n=1296)
80
2012 (n=1497)
70
60
Symptoms self-reported,
50 for the 3 months prior to
40 survey; p<0.0001 in all
30 cases.
20
10
0
Diarrhea Fever Persistent Severe
cough weight loss
 2. Attendant at Last Childbirth
ASRI’s midwife trainings, patient education, and outreach have
played a role in the shift from traditional healers to midwives.

100
90
80
Percentage of births

70 2007 (n=1302)
60 2012 (n=1358)
50
40
As reported by mother
30
20
10
0
 3. Immunization of Last Child
ASRI’s mobile clinic brings immunization services to even the most remote
villages in its service area – and the government health service has contracted
with ASRI to provide immunizations in hard-to-reach areas. The result is an
increase of 11% (complete) and 24% (any immunizations).

100
Percentage as reported by

90
80 2007 (n=1245)
70 2012 (n=1347)
mother

60
50
40
30
20
10
0
Received Any Received complete
Immunizations immunizations (p=0.002)
(p<0.0001)
 4. Child Mortality
Overall, total child mortality has declined by almost 15%, with
the most dramatic improvement in the infant mortality rate.

80
70
Deaths per 1000 births

60
50
40
30
20
10
0
Neonatal (to 1 week; Perinatal (to 1 mo.; Infant (to 1 yr; Under 5 (p=0.066)
p=0.84) p=0.39) p=0.026)

2007 (n=4002 births) 2012 (n=3230 births)

 5. Percentage of smokers
ASRI’s patient education efforts have played a role in the clear
reduction in smoking.

100
90
2007 (Men =2304;
80 Women=2320)
70
60 2012 (Men=2571;
50 Women=2415)
40
30 Based on household members
over age 10; p<0.0001 for
20 both.
10
0
Men Women
 6. Awareness of HIV
Survey results show some greater awareness of the transmission modes
of HIV, and some overall increased awareness of the existence of the
disease (including some who do not understand its transmission).

100 2007 (n=1347)

90 2012 (n=1482)
percentage of responses

80
70
60
50
40
30
20
10
0
Know how Don't Unaware of HIV
transmitted understand
transmission
 7. Good Hygiene
Access to “restroom” increased more than 20%; boiling drinking water
increased almost 25%. Defecation in river declined by 37% – a hygiene
benefit for the entire community.

100
90
percentage of responses

80
70
60 All significant at
50 p<0.0001.
40
30
20
10
0
Access to toilet Use river as toilet Boil water before
facilities drinking
2007 2012
 Selected results for Conservation

9. Valuing the National Park

10. Attitudes toward logging
11. Logging activity (households)
12. Logging activity (individuals)
13. Effect on participating loggers
14. ASRI Clinic discount
15. From red to green
16. Testimonial of a village head
 9. Valuing the National Park
ASRI’s outreach efforts have been effective in promoting appreciation of
the Gunung Palung National Park. It is also clear that most local residents
were already aware of preserving the Park for their children – almost 99%
in 2007. But only 85% think this would require protecting the Park.

100%
2007
90%
2012
80%
p<0.0001 for both
70%

60%

50%
Agree the Park is Want to keep the Agree the Park
"good" Park for their needs protection*
children *Not asked in 2007
 10. Attitudes toward logging
These questions were asked for the first time in 2012. Only 9% of
respondents consider logging acceptable – and less than 1.5%
think it is unavoidable.

100%

80%

60%

40% 2012

20%

0%
Okay to cut Okay to work Logging Logging in my
down trees as logger happens in village cannot
my village be stopped
11. Logging activity (households)
Respondents were asked whether they – or anyone in their family –
benefited from logging in Gunung Palung National Park. The 2012 results
are dramatically lower (by 68 and 70 percent).

100%

80%

60%
2007
40% 2012

20%

0%
Anyone logging in family? Do you do any logging?
 12. Logging activity (individuals)
Respondents were asked whether they had done logging in
Gunung Palung National Park in the previous year. The percentage
of active loggers declined by two-thirds – from 9% to 3%.
100

80

60

40

20

0
2008 (n=1299) 2012 (n=1497)
 13. Effect on participating loggers
Those loggers (past and present) who were aware of ASRI activities were asked
about any effect on their logging. Each of these three activities convinced more
than 80% of loggers to either stop logging or consider stopping – and the
conservation education meetings appear to be 100% effective.
25

20
Number of loggers

15

10

0
Attended ASRI Met Forest Guardian Aware of ASRI
meeting (n=9) (n=20) discount (n=11)

stopped considered stopping no effect TOTAL PARTICIPATING

 14. ASRI Clinic Discount
Only 22% of respondents were already aware of
ASRI’s health discount for non-logging villages.
When told about the discount, over 90% of people
believed their family members would stop logging
for the discount; over 80% believed their
community would stop logging.
Almost all the respondents who already knew about
the discount and had discussed it with others said
it had already decreased logging (98%).
 15. From Red to Green
Since early 2011, ASRI’s field assessment has shown
a two-thirds increase in non-logging villages –
from six to ten, out of 30 total villages served.
 16. Testimonial by a village headman
Pak Bastarin cited the impact of ASRI’s organic farming training,
speaking to a meeting of 300 people:
“Five years ago there were more than 100 people in my village
doing illegal logging, now there are less than 10.
“The effect I have seen of ASRI, is that people are working doing
organic farming. It used to be that people couldn't start
farming because they didn’t have the start up money to buy
fertilizer, but now they can just make the fertilizer themselves.
“All along the road where five years ago was just grassland there
are now organic vegetable farms and rubber trees.”
Pak Bastarin
 Summary
In the 5 years of ASRI’s operation, key health indicators have
improved , in some cases, dramatically – with greater access
to affordable, high-quality health care as well as patient
education.

The survey results also show:

• Strong local interest in preserving the forest
• Evidence that ASRI’s conservation activities are effective
• Welcome reductions in numbers of loggers

But there is still more to do to increase awareness of ASRI

programs.