Political Commitment of Indonesian Public Health Association

to Health Development

Dr. Ede Surya Darmawan, SKM, MDM

President of IPHA 2019-2022

Goal of A State

• To establish peace and order

• To fulfill basic needs of the citizens

• To improve quality of live of its people

Tujuan NKRI Tercinta

Alinea ke-4 UUD 1945: 1. melindungi segenap bangsa Indonesia dan seluruh tumpah darah

Indonesia, 2. memajukan kesejahteraan umum, 3. mencerdaskan kehidupan bangsa, dan 4. ikut melaksanakan ketertiban dunia yang berdasarkan kemerdekaan,

perdamaian abadi dan keadilan sosial

Health is the Foundation • Character of Developed Countries:

The citizens:

– Higher income and PPP

– Highly educated

– Healthy & Longer Life Expectancy

• Human Development:

Human Development

Index (HDI)

Healthy

Education

Productivity

HEALTH DEGREE OF A NATIONS HEALTH RISK &

NEEDS TO HEALTH SERVICES

ADOLESENCE CHILDHOOD ELDERLY AGE

LOW

HIGH

PATH WAY OF LIFE EVERY CITIZEN SHOULD BE LIKE THIS

PEMBANGUNAN KESEHATAN

Meningkatkan kesadaran, kemauan, dan kemampuan

hidup sehat bagi setiap orang

agar terwujud derajat kesehatan masyarakat yang

setinggi-tingginya, sebagai investasi bagi pembangunan sumber daya manusia yang produktif secara sosial dan

ekonomis.

(Pasal 3 UU 36/2009)

TUJUAN

Upaya yang dilaksanakan oleh

semua komponen bangsa dalam rangka mencapai tujuan

kesehatan yaitu untuk meningkatkan kesadaran, kemauan, dan

kemampuan hidup sehat bagi setiap

orang agar terwujud derajat kesehatan masyarakat yang setinggi-tingginya, sebagai investasi

bagi pembangunan sumber daya manusia yang produktif secara sosial

dan ekonomis

DEFINISI

WITHOUT DEVELOPMENT HEALTH RISK &

NEEDS TO HEALTH SERVICES

ADOLESENCE CHILDHOOD ELDERLY AGE

LOW

HIGH

WITH DEVELOPMENT HEALTH RISK &

NEEDS TO HEALTH SERVICES

ADOLESENCE CHILDHOOD ELDERLY AGE

LOW

HIGH

HOW TO START?

PIRAMID OF HEALTHY LIFE

11

AIR

WATER

FOOD

CLOTHES (BEHAVIOUR)

SHELTER/HOUSING

SERVICES

TOGETHERNES: Efforts and Program to

improve pre-disposing factors

of healthy life

REDUCING: The bad impact or Diseases do to Air

Water, Food, Clothes, and

Housing

Public Health…

"... ...the science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort for the sanitation of the environment, the control of communicable infections, the education of the individual in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, and for the development of the social machinery to insure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birthright of health and longevity." (CEA Winslow, 1920)

12

1920 - 2020: 100 years of Modern Public Health

Are we healthier now?

Public Health as a System: the science and the art of :

GOAL PROCESS OBJECTIVES/ INTERMEDIATE

RESULTS

1. preventing disease,

2. prolonging life,

3. promoting physical

health and mental

health

4. and efficiency

through organized

community efforts

toward

1. a sanitary environment;

2. control of community infections;

3. education of the individual in

principles of personal hygiene;

4. organization of medical and

nursing service for the early

diagnosis and treatment of

disease;

5. development of the social

machinery

to ensure to every individual in the community a standard of living adequate for the

maintenance of health (so organizing these benefits as to enable every citizen to realize

his birthright of health and longevity) 13

Public Health a foundation of people’s welfare

PUBLIC HEALTH IS THE SCIENCE AND THE ART OF:

PROCESS OBJECTIVES/ INTERMEDIATE RESULTS GOAL

ORGANIZING

COMMUNITY’S

EFFORTS TOWARD:

1. a sanitary environment;

2. control of community infections;

3. education of the individual in

principles of personal hygiene;

4. organization of medical and

nursing service for the early

diagnosis and treatment of

disease;

5. development of the social

machinery

in order to attain:

1. preventing disease,

2. prolonging life,

3. promoting physical

health and mental

health

4. and efficiency

to ensure to every individual in the community a standard of living adequate for the

maintenance of health, so organizing these benefits as to enable every citizen to realize

his birthright of health and longevity. 14

Organizing =

Leadership

WHAT IPHA/IAKMI HAVE DONE SO FAR?

ACHIEVEMENT OF IAKMI

1. Increase of membership and Branches

2. Improve Continuing Public Health Education

3. Broadening Networking and Collaboration

4. Actively participate in national priority program: Nusantara Sehat, Tobacco Control, Universal Health Coverage (JKN), LAM PT Kes, Quality of Health Worker

THE FUTURE CHALLENGE & PLAN OF IPHA

TRANSITIONS OF EPIDEMIOLOGY

Sumber : Double Burden of Diseases & WHO NCD Country Profiles (2014)

• Kematian akibat penyakit tidak menular semakin meningkat

• Tren ini kemungkinan akan berlanjut seiring dengan perubahan perilaku hidup (pola makan dengan gizi tidak seimbang, kurang aktifitas fisik, merokok, dll)

Penyebab Utama dari Beban Penyakit, 1990-2015

Cedera 7%

Penyakit Tidak

Menular 37%

Penyakit Menular

56%

Cedera 8%

Penyakit Tidak Menula

r 49%

Penyakit

Menular

43%

Cedera 9%

Penyakit Tidak

Menular 58%

Penyakit Menular

33%

1990 2000 2010 2015

Keterangan: Pengukuran beban penyakit dengan Disability-adjusted Life Years (DALYs) hilangnya hidup dalam tahun akibat kesakitan dan kematian prematur

Cedera 13%

Penyakit Tidak Menula

r 57%

Penyakit

Menular

30%

CHANGING OF DISEASES PATTERS

Sumber data: Global burden of diseases (2010) dan Health Sector Review (2014)

Peringkat Tahun 1990 Tahun 2010 Tahun 2015

1 ISPA 1 Stroke 1 Stroke

2 Tuberkulosis 2 Tuberkulosis 2 Kecelakaan Lalin

3 Diare 3 Kecelakaan Lalin 3 Jantung Iskemik

4 Stroke 4 Diare 4 Kanker

5 Kecelakaan Lalin 5 Jantung Iskemik 5 Diabetes Melitus

6 Komplikasi Kelahiran 6 Diabetes Melitus 6 Tuberkulosis

7 Anemia Gizi Besi 7 Low Back Pain 7 ISPA

8 Malaria 9 ISPA 8 Depresi

13 Jantung Iskemik 12 Komplikasi Kelahiran 9 Asfiksia dan Trauma Kelahiran

16 Diabetes Melitus 26 Malaria 10 Penyakit Paru Obstruksi Kronis

• Tahun 1990: penyakit menular (ISPA, TB, Diare, dll) menjadi penyebab kematian dan kesakitan terbesar

• Sejak Tahun 2010: PTM menjadi penyebab terbesar kematian dan kecacatan (stroke, kecelakaan, jantung, kanker, diabetes)

• Tanpa upaya kuat, tren peningkatan PTM ke depan masih terjadi

Evolution of Society: From Hunting to Super Smart Society

Source: Bogdan Cioruța, Univ. Tehnica Cluj-Napoca, Romania, 2019

What is the Essence of Industrial Revolution?

Market Customer Patients

Producers Healthcare Industries

• Limited,

• Variation - - • Old, • Far, • Slow • Expensive

IR-1

MORE: • Service,

• Variation + + + • New

• Closer & Faster • Cheaper

IR-4

REFOCUSING PUBLIC HEALTH existing health programs

UPAYA KESEHATAN WAJIB UPAYA KESEHATAN PENGEMBANGAN

Upaya Kesehatan Sekolah

Upaya Kesehatan Olahraga

Upaya Perawatan Kesehatan Masyarakat

Upaya Kesehatan Kerja

Upaya Kesehatan Gigi dan Mulut

Upaya Kesehatan Jiwa

Upaya Kesehatan Mata Upaya Kesehatan Usia

Lanjut

Upaya Pembinaan Pengobatan Tradisional

Upaya Kesehatan Haji

Upaya kesehatan pengembangan lain yang berdasarkan pertimbangan spedifik lokal

1. Upaya Promosi

Kesehatan 2. Upaya Kesehatan Lingkungan 3. Upaya

KIA & KB

4. Upaya Perbaikan Gizi

Masyarakat

5. Upaya Pencegahan & Pengendalian

PM

6. Upaya Pengobatan

Health Programs in Practices ???

UPAYA KESEHATAN WAJIB UPAYA KESEHATAN PENGEMBANGAN

Upaya Kesehatan Sekolah

Upaya Kesehatan Olahraga

Upaya Perawatan Kesehatan

Masyarakat

Upaya Kesehatan Kerja

Upaya Kesehatan Gigi dan Mulut

Upaya Kesehatan Jiwa

Upaya Kesehatan Mata

Upaya Kesehatan Usia Lanjut

Upaya Pembinaan Pengobatan Tradisional

Upaya Kesehatan Haji

Upaya kesehatan pengembangan lain yang berdasarkan pertimbangan

spedifik lokal

1. Upaya Promosi

Kesehatan

2. Upaya Kesehatan Lingkunga

n 3. Upaya KIA & KB 4. Upaya

Perbaikan Gizi Masyarakat

5. Upaya Pencegahan & Pengendalian

PM

6. Upaya Pengobatan

HOW TO TRANSFORM THIS:

BALANCING HEALTH SERVICES VS PUBLIC HEALTH

DEVELOPMENT PROGRAM?

Public Health Evolution

Will Public Health Evolution 4.0 Coming?

Evolution of Public Health

What is the Characteristic

Public Health Evolution 4.0??

PH (UKM) 4.0 = Keaktifan Semua Sektor + Inovasi Tiada Henti ?

UDARA

AIR

MAKANAN

PAKAIAN (perilaku)

TEMPAT TINGGAL

PELAYANAN Upaya Inovatif Semua Sektor

Dalam Menciptakan Pra

Syarat Hidup

Mengurangi Dampak Buruk dan Penyakit

Bersebab Udara, Air, Makanan, Perilaku dan

Tempat Tinggal

Lebih & Lebih: • Banyak,

• Variasi + + + • Cepat, • Dekat, • Murah

Public Health 4.0 All Sectors + Innovation

28

AIR

WATER

FOOD

CLOTHES (BEHAVIOUR)

SHELTER/HOUSING

SERVICES

ACTIVELY PARTICIPATION of

all sectors & stakeholder in

health development

REDUCING: The bad impact or Diseases do to Air

Water, Food, Clothes, and

Housing

PH Program MORE: • Service,

• Variation + + + • New

• Closer & Faster • Cheaper

Iteration and Innovation

light bulb was not invented by candle maker

ROLE & FUNCTION OF IPHA

For Organization

For Nation

For Member

The Essence of Professional Organization

ROLE & FUNCTION OF IPHA

1. IPHA for The Member: 1) Membership

2) Professionalism Development

3) Advocacy and Broadening Opportunity

2. IPHA for The Organization: 1) Legal Aspect including Business Entity

2) Strengthening Branches: Provincial and District

3. IPHA for The Nation 1) Development of Blue Print of Health Development

2) Facilitation of Health Development

3) Monitoring and Evaluation of Health Development

Advocacy of Health Development

Blue Print Indonesia

Sehat 2030

What kind of Health Development IPHA willing to achieve: • Population • Environment • Services • Program

Role of Government

Role of Non Governmental Organization

Role of University and Academic Institution

Role of Indonesian Public Health Association in Every Level

Terimakasih banyaK

Ede Surya Darmawan

081184713 edesurya@ui.ac.id