Introduction of Family Medicine Block 1

8/9/2019 Introduction of Family Medicine Block 1

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Asyhadu anlaa ilaaha illallohwa asyhadu anna Muhammadan rasuululloh

Rodliitu billahi robbaawa bil-islaami diinaawa bi Muhammadin nabiyyaw wa rosuulaa

Robbii zidni ilmaawarzuqnii fahmaa

Aamiin....


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Introduction Of Family MedicinePresent Status Of Health Care

Services In Indonesia

dr.Denny Anggoro Prakoso

Family MedicineMedical faculty UMY


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The General Objective OfThe National HealthDevelopment Program In Indonesia as Stipulated

In The National Health System

To Provide A Healthy Life For

All Indonesians


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The specific objectives of the NationalHealth Development Program in

Indonesia

To enable people to maintain their own healthand live a healthy and productive life

To promote an environment conducive to thehealth of the people

To promote good nutrition among the people

To decrease morbidity and mortality To promote a healthy and prosperous family life


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Healthcare Efforts To AchieveT

hese Objectives

The strengthening of the healthcaredelivery system as part of an overall health

development program. This is being carried out both by

government and the private sector.


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NATIONAL HEALTH STATUS

The fact that Indonesia is still a developing country,

The present condition of Indonesian healthcare remainsunsatisfactory although there have been major

improvements compared to two decades ago


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The primary cause of death in Indonesia since1995 is cardiovascular diseases that now

overtake predominant infectious diseases,reflecting the double burden faced today.

The pattern of death in Indonesia is still stronglyrelated to general poverty, low income per

capita, high rates of illiteracy and various socio-cultural factors.


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O.M.G


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According To Household Health Surveys,The 10 Leading Diseases In The Country

1. Acute respiratory tract infection

2. Diseases of skin

3. Diseases of teeth, mouth

4. Gastro-intestinal tract, other infectious diseases5. Bronchitis-asthma and other disease of respiratory

tract

6. Malaria

7. Nerve disorders

8. Cardiovascular disorders

9. Diarrhoea

10. Tuberculosis.


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PUBLIC HEALTH SERVICES

The responsiblility for dealing with public health problemin Indonesia lies with the Government

The main health body entrusted with carrying out public

health services in Indonesia is the Community HealthCenter (Puskesmas), situated at sub-district level servinga population of about 30,000-40,000. There are over7,000 such centers in the country by the year 2000.


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The Puskesmas Render

6 Basic Services

1. Health promotion

2. MCH/FP3. CDC

4. Nutrition

5. Environmental sanitation

6. Curative care and various developmentalservices according to local areas need


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PUSTU

In most instances, a doctor, with a staffingbetween 8-32,consisting of nurses, midwivesand other auxiliary personnel, heads eachPuskesmas.

In densely populated areas, there are Sub-Community Health Centers (PuskesmasPembantu) at the village level, generally headedby a senior nurse or midwife, and operatedunder the supervision of, and linked to, theCommunity Health Center.

At present, the total number of PuskesmasPembantu in Indonesia is 19,977


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PUSLING

To serve people who live in very remote areas,there are Mobile Community Health Center(Puskesmas Keliling), operated by and based at

the local Puskesmas. The staff of Puskesmas Keliling consist of one

doctor, assisted by two or three personnel,including nurses/midwives and a driver.

At present, there are about 6,024 PuskesmasKeliling serving villages within the sub-district.


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POSYANDU

To support the activities of thePuskesmas, the community health effort isorganized in the form of the IntegratedServices Post (Posyandu), located at thehamlet level.

The responsible community institution to

Posyandu is the village communityresilience committee.


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The activities of each Posyandu, assisted andsupervised by local Puskesmas staff, consist offive basic types of health services.

These are:(i) MCH Services(ii) Nutrition Services(iii) Family Planning Services(iv) Diarrhoeal Disease Control and(v) Immunization Services.

At present, there are about 251,459 Posyanduregistered in Indonesia


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MEDICAL CARE SERVICES

The healthcare delivery system that isresponsible for medical problems inIndonesia, in general can be divided intothree categories:

(i) Primary medical care facilities

(ii) Secondary medical care

(iii) Tertiary medical care facilities


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Primary Medical Care

The primary level personal/medical care facility managedby the government is the Puskesmas assisted by thePuskesmas Pembantu and Puskesmas Keliling.

Besides the provision of medical personal care, the

Puskesmas also makes provision for public health careservices in the community medical care facilities. The primary medical care facilities managed by the

private sector vary. There are private midwivespractitioners and private medical practitioners found inalmost every part of the country.

The number of private midwives practitioners inIndonesia is estimated to be approximately 34,000.Around 20% of the private medical practitioners arespecialists, while the rest are general practitioners.


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Since most of the midwives and doctors are government

employees, their private practice is usually conducted inthe afternoon after the closing of government offices.

In some places, although it is illegal, paramedics alsohave their own private practices.

Most private medical practitioners in Indonesia operatetheir practices as a sole practice, although in the bigcities there is now an increasing trend for grouppractices that become more popular.


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Other types of primary medical care facilities managedby the private sector in Indonesia are the MCH clinic andthe polyclinic. These types of medical facilities areusually managed by midwives or nurses, although theresponsible person for these facilities is still the doctor.

Unfortunately, the actual number of private MCH clinicsand private polyclinics in Indonesia is not available.


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KITA INGIN SEHAT


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Secondary & Tertiary Medical Care

The secondary and tertiary medical carefacilities in Indonesia are located at hospitals.

There are around 1,200 hospitals registered in

the country, of which 404 hospitals aregovernment or local government hospitals.

The total number of beds available in all hospitalis 111,460, which means that for every 100,000people there are around 59.8 hospital bedsavailable


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FINANCING OF HEALTHCARE SERVICES

Health Services in Indonesia are operatedunder a fee for service system.

T

he number of people covered by healthinsurance schemes is still limited mainly tocivil servants and some private employees


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Annual health expenditure in Indonesia is still very low. Itis estimated to be around 2.5% of GNP or about US$18per capita, a level far under the WHO recommendedexpenditure level of at least 5% GNP. A big portion of

total health expenditure in Indonesia comes from thepeople, whereas the contribution of government is onlyaround 30%.

The small contribution of government are utilized for all-line subsidy that creates unfair health financing for the

poor. Most of private spending on health care is out-of-pocket, because only around 20% are protected byvarious types of prepaid care.


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Primary Health Care system

Roles in a very important position

BETTER HEALTHOUTCOMES

LOWER COST

GREATER EQUITYIN HEALTH


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Global Health Data Showed

PRIMARY HEALTHCARE

COMMUNITYHEALTH STATUS


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NATIONAL HEALTH SYSTEM DOCUMENT 2004

Primary health Care system in thefuture will be conduct by

implementing the family medicineconcept


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Why family medicine ??

1. Personal care

2. Holistic care

3. Comprehensive care

4. Emphasize on preventive medicine5. Continuing care

6. Coordinated and collllaborative care

7. Patient centered, family focused, communityoriented care

8. Quality and cost effective care


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CONCLUSION

Indonesia still faces various health problems. Toovercome these challenges, Indonesia has implemented,since 1969, a series of Five Year National Development

Programs, including the National Health Developmentprogram. Significant progress has been achieved inhealth care sector, both in public health services as wellas in medical services.

The management of the healthcare delivery system in

Indonesia is carried out both by government and theprivate sector, including some forms of public-privatemix.


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The low level of health spending, the misdirection ofgovernment subsidies, and the big portion of populationwith out-of-pocket spending indicating low proportion ofpeople protected by prepaid care, are challenges in thatneeds to be reformed gradually towards more fairness inhealth financing.

FAMILY MEDICINE CAN BE S

A SOLUTION


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Alhamdulillah

Questions are Most welcome

Documents

Introduction of Family Medicine Block 1