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"This study aims to analyze: (1) the financial independence and commitment of health services in the region; (2) the potential for growth in supporting health services in the region; and (3) the relationship pattern between financial independence and regional potential for growth to achieve the goal of fulfilling health service commitments in the region. This research is explanatory research using a quantitative approach. The results show that: (1) the average level of financial independence of regencies/cities in South Sulawesi Province fall under the high category and relatively independent in terms of source and allocation of regional budgets; (2) the average growth of all regencies/cities in South Sulawesi Province shows positive figures which implies that the prospect of their economic growth has accelerated along with several problems in each regency/city; (3) some regencies/cities with large APBD do not have an increased allocation of resources for health expenditure. On the contrary, some regencies/cities that fall under the category of low budget and financial independence have a better commitment to health service and expenditure. In addition, almost all regencies/cities categorized as having good potential for growth ended up having low performance in health expenditure. The local government has carried out fiscal decentralization, which is defined as the freedom for regions in carrying out policies related to budget politics in the region. Notwithstanding the preceding, the role of the central government is still greatly expected to advocate for the improvement of health expenditure quality."

"Indonesia currently adopts a new decentralization policy. In the past, central government had been the major role of regional and cities development. With the new policy, central government has transferred its role in developing cities and regions to the local governments. This policy adopts two complimentary laws. Law No.22/1999, which is basically the devolution policy, has been accompanied by Law No.25/1999, which basically is the fiscal decentralization policy. Both laws reflect that decentralization policy in Indonesia has adopted the concept of "money follows functions".Before the implementation of decentralization policy, the government of cities had been benefited from many facilities built by central government on the city area. With the decentralization policy, it is expected that a reduced role of central government will have a significant impact on the growth of cities in Indonesia. The policy has three major fiscal instruments; a block grant funding, a specific grant and revenue sharing. The block grant funding is considered as the most important instruments of fiscal decentralization in Indonesia. About 80 percent of financial transfer from central to local governments will be in the block grant type of transfer. In the past, the use of transfers was determined by central government specifically. Therefore, the role of block grant was very minimal. With the new fiscal decentralization scheme, the benefits of cities from central government investments are expected to decrease. Therefore, there is a question to what extend the cities will be sustainable in the decentralization era.This paper attempts to answer the impacts of current fiscal decentralization policy on the growth of the cities. The first objective of the paper is to evaluate the current intergovernmental tranfers and their impact to cities revenues. Secondly, by utilizing a regional macroeconometric model, this paper also elaborates the implication of the transfers to the city growth and interregional disparity in Indonesia."

"ABSTRAKPola konsumsi vegetarian menunjukkan peningkatan popularitas yang signifikan. Indonesia Vegetarian Society mencatat peningkatan pesat jumlah anggotanya dari 5.000 orang (1998) menjadi 500.000 (2010). Ibu vegetarian dikuatirkan memiliki status gizi prahamil yang lebih rendah dan berisiko memiliki outcome kehamilan yang rendah yaitu status gizi bayi lahir dan cadangan lemak ibu untuk menyusui rendah. Studi ini bertujuan menganalisis pengaruh vegetarian dan nonvegetarian terhadap status gizi ibu, durasi ASI predominan, dan pertumbuhan bayi selama periode 0-6 bulan. Studi dengan desain kohort longitudinal dilakukan di lima kota di Indonesia (Jakarta, Surabaya, Pontianak, Palembang dan Pekanbaru) dengan populasi vegetarian usia subur terbanyak. Sejumlah 85 ibu-bayi berhasil diikuti selama 6 bulan postpartum.. Berdasarkan data 24 HR food recall, ibu vegetarian secara bermakna mengkonsumsi energi, protein, dan lemak lebih rendah namun karbohidrat lebih tinggi dibandingkan ibu nonvegetarian. Dalam hal zat gizi mikro, ibu vegetarian mengkonsumsi vitamin B12 dan Zn lebih rendah secara signifikan dibandingkan ibu nonvegetarian. Konsumsi saat laktasi pada kedua kelompok signifikan lebih rendah daripada konsumsinya saat hamil. Hasil penelitian menunjukkan bahwa vegetarian tidak mempengaruhi durasi ASI predominan. Konsumsi energi ibu laktasi mempengaruhi durasi ASI predominan pada kelompok nonvegetarian. Secara keseluruhan tidak ada perbedaan IMT postpartum kedua kelompok selama 6 bulan (p value=0,306), tetapi setelah dikontrol durasi ASI predominan (24 minggu) ada perbedaan bermakna (p value=0,047) pada penurunan BB ibu postpartum. Pada kelompok vegetarian faktor yang paling mempengaruhi IMT ibu postpartum adalah IMT postpartum 0 bulan (bulan ke-1 dan ke-2) dan IMT prahamil (bulan ke-3 hingga ke-6), sedangkan pada kelompok nonvegetarian adalah IMT postpartum 0 bulan (bulan ke-1 hingga ke-5) dan durasi ASI predominan (bulan ke-6). Pertumbuhan BB bayi ibu vegetarian lebih tinggi dari nonvegetarian secara bermakna (p value=0,009), tetapi kedua kelompok memiliki PB yang tidak berbeda (p value=0,235). Setelah dikontrol durasi ASI predominan (24 minggu) tidak ada perbedaan pertumbuhan BB dan PB bayi pada kedua kelompok, namun weight loss ibu vegetarian lebih besar (p value=0,047). Faktor yang paling mempengaruhi BB bayi kelompok vegetarian adalah jenis kelamin bayi (bulan ke-1 sampai ke-6), dan pada kelompok nonvegetarian adalah BBL bayi (bulan ke-1 dan ke-2), jenis kelamin (bulan ke-3), dan IMT ibu postpartum 0 bulan (bulan ke-4 hingga ke-6). Faktor yang paling mempengaruhi pertumbuhan PB bayi kelompok vegetarian adalah jenis kelamin bayi (bulan ke-1 hingga bulan ke-5) dan PBL (bulan ke-6), pada kelompok nonvegetarian adalah PBL (bulan ke-1 hingga ke-4) dan jenis kelamin bayi (bulan ke-5 dan ke-6).Hasil penelitian ini mendukung kebijakan pemberian ASI eksklusif 6 bulan, baik pada vegetarian dan nonvegetarian, dengan didukung program gizi dan konsumsi yang cukup pada periode laktasi. Penting menyebarluaskan informasi konsumsi energi dan zat gizi yang cukup pada masa laktasi serta peran aktif pemerintah untuk melakukan suplementasi energi dan zat gizi bagi ibu laktasi. Ibu vegetarian juga perlu mengkonsumsi suplemen zat gizi mikro seperti vitamin B12 dan Zn pada saat laktasi.

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ABSTRACT

Numbers of vegetarian has increased significantly in recent years. Indonesia Vegetarian Society recorded an increase of its member from 5000 in 1998 to 500000 in 2010. Vegetarian mothers were known to have lower pre-pregnancy nutritional status and posing a greater risk to have lower pregnancy outcomes including lower nutrional status of infant at birth and lower maternal fat stores for lactation. This study aimed at analyzing the effect of vegetarian diet on maternal nutritional status, duration of predominant breastfeeding, and infant growth in the period of 0-6 months postpartum. This study is a longitudinal cohort design and conducted in five cities in Indonesia (Jakarta, Surabaya, Pontianak, Palembang and Pekanbaru) with high population of vegetarian childbearing age women. A number of 85 mother-infant pairs consisted of 42 vegetarian and 43 non-vegetarian were followed until 6 month postpartum period. Based on 24 HR food recall, vegetarian mothers consumed lower intakes of energy, protein, and fat but higher intake of carbohydrate. Vegetarian mothers had significant lower intakes of vitamin B12 and zinc. In both groups, nutrient intakes during lactation were significantly lower than intakes during pregnancy. This study shows that vegetarian diet had no influence on predominant breastfeeding duration, but among non-vegetarian mothers, energy intakes during lactation did affect duration of pre-dominant breastfeeding. Overall, no difference was found for 6 months postpartum BMI between the two groups (p value=0.306). However, after controlled by predominant breastfeeding of 24 weeks, significant difference was found for weight loss during postpartum period (p value=0.047). Among vegetarian mothers, the most influencing factor affecting maternal postpartum BMI was 0 month postpartum BMI (affecting BMI 1- and 2-month postpartum), and pre-pregnancy BMI (affecting BMI 3-month postpartum BMI onward). Among non-vegetarian mothers, the most influencing factor affecting maternal postpartum BMI was 0 month postpartum BMI (affecting BMI 1- to 5-month postpartum) and duration of predominant breastfeeding (affecting BMI 6-month postpartum). Weight growth of infants of vegetarian mothers was higher than that of non-vegetarian mothers (p value=0.009), but no difference was found for infant length growth (p value=0.235). After controlled by predominant breastfeeding of 24 weeks, the difference on infant growth were disappeared. However vegetarian mothers had significantly greater weight loss (p value=0.047). Among vegetarian mothers, the most influencing factor affecting infant weight was infant?s sex (affecting infant weight at month 1 to 6 after birth) while among non-vegetarian mothers was infant birthweight (affecting infant weight at month 1 and 2 after birth), infant?s sex (affecting infant weight at month 3 after birth), and maternal 0 month postpartum BMI (affecting infant weight at month 4 to 6 after birth). The most influencing factor affecting infant length among vegetarian mothers was infant?s sex (affecting infant length at month 1 to 5 after birth) and length at birth (affecting infant length at month 6 after birth), while among non-vegetarian mothers the most influencing factor was infant length at birth (affecting infant length at 1 to 4 after birth) and infant?s sex (affecting infant length at 5 and 6 month after birth.

Results of this study supports 6 months exclusive breastfeeding policy for both vegetarian and non-vegetarian, but necessitates nutrition and food consumption related programs during lactation period. It is important to spread information on the importance of adequate energy and nutrient intakes during lactation. Government should take an active role toward supplementation program for lactating mothers. Vegetarian mothers are to balance their diet during lactation period by taking micro-nutrient supplementation such as vitamin B12 and zi"