MINISTER OF HEALTH THE ROLE OF PSYCHOLOGIST...

transcript

MINISTER OF HEALTH

Nila F. MoeloekMinister of Health of the Republic of Indonesia

ASEAN REGIONAL UNION OF PSYCHOLOGICAL SOCIETIES CONGRESSBALI, 21 FEBRUARY 2018

THE ROLE OF PSYCHOLOGIST IN

COMMUNITY HEALTH SERVICES

IN INDONESIA

‘TACKLING PROBLEMS IN HEALTH SECTOR’

MENTERI KESEHATANREPUBLIK INDONESIA

‘Science’

began as soon as man started to ask

question’

FA MOELOEK

?Man starts to

(The approach is

through scientific

methods)‘Products’

(Science)

Differences

between human

beings and

animals

FA MOELOEK

FA MOELOEK 5

Philosophy

Love for Wisdom

(Thales)

Love for Truth

(Plato)

Indonesian Demographic Structure and Youth Potential

±64.6

million

Youths

±157 million at

productive age

Indonesia has a

population ±258 million

people1 in 4

Indonesian

people is youth

The youths of today are the main actors of social and

economic development toward 2050

Productive age

group (15-55 years)-

Non-productive –

FACT: Life Portrait of the People

In womb,

low nutrient

intake by

mother

During under-

five age,

nutrient

intake is not

balanced

During

school age,

they have

difficulties in

learning and

in making

progress

Entering

productive age,

they have

difficulties in

pursuing good

career

Poor life quality,

unhealthy lifestyles,

Developing non-

communicable

diseases at young

At old age,

developing

degenerative

diseases

Undernourished

mother

Inadequate nutrient

intake and poor diet

Non-optimal brain

development

At school, stunted

children have

difficulties in learning Poor diet which continues into

adulthood causes poor health

Low productivity

Low income

Tend to develop

non-communicable

diseases at adult

Financially incapable

Not able to provide

good nutrition for

family

Youth in Life Cycle

Brain develops rapidly

from gestation period to 5

years (golden age)

Malnutrition during

golden age has impacts

until adulthood

Normal Stunted

Development of cerebral nerve cells

Nutrition and Growth and Development

Physique of under-nourished children is reversible, but impeded brain

development, poor intellectuality, learning capacity and productivity

are irreversible.

Brain conditions of stunting

Rank 1990 2015 2040

1 Upper respiratory

tract infection

1 Stroke ?

2 Tuberculosis 2 Traffic accident ?

3 Diarrhea 3 Ischemic heart disease ?

4 Stroke 4 Cancer ?

5 Traffic accident 5 Diabetes mellitus ?

6 Birth

complications

6 Tuberculosis ?

7 Iron deficiency

anemia

7 Upper respiratory tract

infection

8 Malaria 8 Depression ?

13 Ischemic heart

disease

9 Asphyxia and birth trauma ?

16 Diabetes mellitus 10 Chronic obstructive

pulmonary disease

Source: Global burden of diseases (2010) and Health Sector Review (2014)

Our disease burden in 25 years’ time

Diabetes

Non-communicable diseases (NCDs) in Indonesia

• The 4th leading cause of death

• 2 in 100 diabetes patients age

between 25 and 34 years

• No.1 cause of death

• Cause of 4 out of 10 deaths

• 39% patients with heart diseases age <44

• 12% of children under-five years of age

are obese

• 8 in 100 children are obese

disease

Obesity

Death caused by NCDs

Mortality Rate %

Changes in behavior and

consumption which lead to high

carbohydrate and high fat intake

contribute to the high prevalence of

degenerative diseases.

Pattern of food expenditure 2016

Cigarettes 13.80

Cereals 14.02

Prepared food

and beverages

Human Development Index and components (2016)

Life expectancy rate at

Length of school stay

Average of school stay

Per capita expenditure

Adjusted (Rp/person/year)

Human Development Index

Proporsi penduduk yang hidup di bawah garis kemiskinan nasional, tahun 2011 – 2017

Source : Badan Pusat Statistik

Proportion of population living

under national poverty line

(2011-2017)(INDONESIA)

• URBANIZATION &

INDUSTRIALIZATION

• GLOBALIZATION OF

COMMERCE,

• TRANSPORTATION &

INFORMATION

• CLIMATE CHANGE

• POVERTY

• DISASTER

• VIOLENCE

• DRUGS

• HIV-AIDS

RISK FACTORS OF PSYCHOSOCIAL PROBLEMS

MINISTER OF HEALTH

• SUICIDE

• JUVENILE DELINQUENCY

• HUMAN TRAFICKING

• STREET CHILDREN

• PORNOGRAPHY ADICTION

• GAME ON LINE

ADDICTION

• DiVORCE

• BAD PARENTING etc.

Roadmap of HEALTH DEVELOPMENT

3 PILLARS HEALTHY INDONESIA

PROGRAM• MAINSTREAMING OF

HEALTH INTO DEVELOPMENT

• STRENGTHENING OF PROMOTIVE-

PREVENTIVE EFFORTS

• COMMUNITY EMPOWERMENT.

PROGRAM• EXPAND TARGETS AND BENEFITS

• FINANCING SYSTEM: INSURANCE – MUTUAL COOPERATION-BASED

• QUALITY CONTROL & COST CONTROL

• TARGETS: PBI & NON PBI

HEALTHY INDONESIA CARD

PROGRAM• INCREASE ACCESS TO HEALTH

SERVICES AT PRIMARY HEALTH FACILITIES

•OPTIMIZATION OF REFERRAL SYSTEM

• IMPROVE QUALITY WITH CONTINUUM OF CARE APPROACH AND HEALTH RISK-BASED INTERVENTION

HEALTHY FAMILY

PILLAR

1HEALTH

PARADIGM

PILLAR

2 HEALTH SERVICES

STRENGTHENING

PILLAR

3National Health Insurance

PILLAR1 HEALTH PARADIGM

PROMOTIVE PREVENTIVE

CURATIVEREHABILITATIVE

HEALTHY LIFECOMMUNITY MOVEMENT

Including the role of psychology in the community.

Presidential Instruction

No. 1 Year 2017

(Healthy Life Community Movement -GERMAS)

A well-planned and systematic action performed

collectively by all nation’s components, with

awareness, will and ability to lead a healthy life in order to

improve life quality.

HEALTH DELIVERY SYSTEM

IN INDONESIA

NATIONAL REFERRAL

HOSPITAL (1)

PROVINCE (20) & REGIONAL

HOSPITALS (110)

DISTRICT/MUNICIPAL

HOSPITALS (561)

HEALTH CENTERS (9.729)

SUB HEALTH CENTERS (1.450)

VILLAGE HEALTH POSTS (17.605)

Personal

Health

Community

Health Care

& Personal

Health Care

POSYANDU (124.249)/

POSBINDU (7.225)

psychologists

have their role in

personal health

care as well as in

community

health care,

particularly in

counseling

services,

psychotherapy,

and change of

lifestyle `

MINISTER OF HEALTH

STRATEGIC ISSUES IN MENTAL HEALTH

1. To provide protection and guarantee efforts/ mental health services based on human rights

– Integrated and sustainable manner

– Since fetal phase, children, adolescents, adults and elderly

– Promotive, preventive, curative and rehabilitative

2. To ensure the availability and affordability of resources in mental health efforts

3. Integration of mental health services at primary health care facilities and strengthening of refferal systems

4. Strengthening promotive and preventive efforts for the general public and at risk population

5. Strengthening community involvement and cross sectoral coordination in the field of mental health

MINISTER OF HEALTH

CLINICAL

PSYCHOLOGISTDOCTORS /

DENTISTS

NUTRITIONIST

PHARMACISTPUBLIC HEALTH

SPECIALISTSANITARIANBIOMEDICAL

TECHNICIAN

PHYSICAL

THERAPIST

MEDICAL

TECHNICIAN

TRADITIONAL

HEALTH

SPECIALIST

OTHER HEALTH PROFESSIONAL

CLINICAL PSYCHOLOGIST BELONGS TO ONE OF THE HEALTH PROFESSIONALS

IN INDONESIA. AT PRESENT THERE ARE 1521 CLINICAL PSYCHOLOGISTS IN THE COUNTRY.

IDEALLY THERE SHOULD BE AROUND 40,000 OF THEM

HEALTH PROFESSIONALS

IN INDONESIAMINISTER OF HEALTH

MIDWIFE

Antenatal

Delivery,

Postnatal, and

Neonatal

Services for

infants

Services for

underfives

Services of

primary school

children

Services of junior and

senior high-school

stundents and

adolescents

• Mental health

early detection

of pregnant

mothers

• Stimulation of

fetus in the

• Mental health early

detection of

mothers after

delivering baby

• Mothers during

postnatal period

Bufas dan

lactating mothers

• Child rearing

pattern and

growth

• Early detection of

children with

growth disorders

• Monitoring of

child growth

• Early detection of

Child Mental

Health

Early detection

of school age

mental health

• Adolescence

mental health

• Counseling:

Addiction and

HV/AIDS

• Life skill of

Adolescence

• Mindfulness

• Premarital

counselling

Services of

Women of

Child Bearing

Elderly

• Early

Detection

of mental

health

elderly

• (dementia/

depressio

THE ROLE OF PSYCHOLOGIST IN

CONTINUUM OF HEALTH CARE

AND VULNERABLE GROUPS

Sustainable towards all stage of

human life

MINISTER OF HEALTH

Prevalence of Mental Emotional Problems*) Age > 15 years based on provinces, 2013

ngkulu

Kalteng

Kaltim

Sultra

onesia

Sulteng

*) Based on Self Reporting Questionnaire-20, RISKESDAS 2013

MINISTER OF HEALTH

MENTAL PROBLEMS / DISORDER

DECREASING QUALITY & PRODUCTIVITY OF HUMAN RESOURCES

• DECREASING HUMAN DEVELOPMENT INDEX

• HIGH BURDEN OF HEALTH PROBLEMS

MINISTER OF HEALTH CHANGES OF THE

BEHAVIOR OF

INDIVIDUALS,

FAMILY,

COMMUNITY

TOWARDS HIGHER

RISK OF

1. “Pasung” CasesHuman rights issue, extreme condition of unmet needs of mental health services, great impact and burden

2. Depression and AnxietyLarge prevalence, great burden, great loss of work productivity (DALYs)

3. Substance AbuseLarge prevalence, great impact and co-morbidity problems, and even mortality

4. Mental Health Problems at DisasterLarge prevalence, frequent disaster in Indonesia due to geographic condition

5. SuicideAn important issue due to mortality which actually can be prevented

5 TOP PRIORITIES OF

MENTAL HEALTH PROBLEMS IN INDONESIAMINISTER OF HEALTH

• Includes efforts to maintain and improve the health and well-being of individual psychological or community groups

PROMOTIVE

• Includes efforts to prevent or minimize the chances of any such problems or psychological disorder present either individually or in community

PREVENTIVE

• Psychological or psychotherapeutic interventions that aim to address the problems of psychological disorders or that is being experienced by individuals and community groups

CURATIVE

• Recovery efforts include again psychological functioning kilien individual or society from the problems or psychological disorders and prepare to serve back in the community

REHABILITATIVE

COVERAGE OF PSYCHOLOGICAL SERVICES

MINISTER OF HEALTH

The role of psychologist is very important

in strengthening the implementation of

promotive and preventive measures in

health development, particularly in

psychological aspects of the community

MINISTER OF HEALTH

THE ROLE OF PSYCHOLOGIST

1. To increase the psychological conditions of the individual;

2. To solve the problems or disorders of psychological/

psychiatric conditions;

2. To build an intrapsychyst dynamics of psychological, social,

and as the cause of a problem or psychological disorders;

3. To reinforce positive personality and overcoming the

personality disorder;

4. To increase the potential of the psychological ability of the

individual and of his manifestation;

5. To strengthen psychological help individuals to legal interests

MINISTER OF HEALTH

THE ROLE OF PSYCHOLOGIST

CONCLUSIONS

• Indonesia continues to improve and strengthen mental health resources, especially to provide psychologists with best possible opportunities to carry out their role.

• Indonesia integrates access to mental health services at Puskesmas and General Hospitals

MINISTER OF HEALTH

Objective ofGERMAS

Protected health

Productive

Clean environment

Decreased medical costs

WITH IMPACTS:

HEALTHY LIFE

COMMUNITY

FAMILY-BASEDAPPROACH

Toward Healthy and Sustainable Future

Freedom from fear, anxiety and depression to develop better human

resources.Each person in the world has the right to obtain the best

possible health conditions, both physically and psychologically..

NATIONALHEALTHINSURANCE(JKN)

WITH FAMILY-BASED

APPROACH (PIS-PK)

& HEALTHY LIFE

COMMUNITY

MOVEMENT

(GERMAS)

HEALTHY

INDONESIA PROGRAM

HEALTHY INDONESIA PROGRAM

IMPROVE THE LIFE QUALITY OF

INDONESIAN PEOPLE

HEALTH

PARADIGM

Health Service

Strengthening National Health Insurance

Thank you!

MINISTER OF HEALTH THE ROLE OF PSYCHOLOGIST...

Documents