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2007/SOM2/LSIF2/018
A Strategy for Health Investment
Submitted by: Indonesia
Fifth Annual APEC Life Sciences Innovation Forum
Adelaide, Australia 19-20 April 2007
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DESA SIAGA : A BASIS FOR HEALTHY INDONESIA
A STRATEGY For Health Investment
VISIONSELF-SUFFICIENT
AND HEALTHYCOMMUNITY
MISSIONVALUES
STANDS FOR THE COMMUNTY
QUICK, VALIDAND RELIABLEACTION
TEAM WORK
HIGH INTEGRITY
TRANSPARENT&ACCOUNTABLE
IMPROVECOMMUNITY
HEALTH
HEALTHYINDONESIA
MOH VISION, MISSION & VALUES TO REACH THE HEALTH DEVELOPMENT VISION
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SITUATIONAL ANALYSIS
High Preventable and treatable diseases likes TBC, Malaria, DHF High cases of Maternal Bleeding, Infant
death, Malnutrition, injuries Lack of access to health service, unbalanced distribution of health personnelPoverty, low Social Cohesion
DESA SIAGA
IS A VILLAGE THAT HAVE RESOURCES, CAPABILITY AND
READINESS TO OVERCOME HEALTH PROBLEMS AND TO REACH A
HEALTHY VILLAGE
(DESA = KELURAHAN = NAGARI = VILLAGE
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OBJECTIVES OF DESA SIAGA:
• IMPROVEMENT OF COMMUNITY KNOWLEDGE AND AWARENESS ON THE IMPORTANCE OF HEALTH
• INCREASE COMMUNITY WILLINGNESS & CAPABILITIES TO SELF SUPPORT ON HEALTH RELATED MATTERS
• INCREASE ALERTNESS AND READINESS TO RISK FACTORS AND DANGERS TO HEALTH
• ENHANCE STAKEHOLDERS SUPPORT AND PARTICIPATIONTO IMPROVE COMMUNITY HEALTH
• INCREASE FAMILY CONSCIOUSNESS ON NUTRITION
• INCREASE COMMUNITY ATTITUDES FOR HEALTHY LIVING ANDHEALTHY LIFESTYLE
TARGET POPULATION OF DESA SIAGA
•INDIVIDU AND FAMILY LIVING AT THE VILLAGE: RESPONSIBLE AND CAPABLE TO POSSESS HEALTHY LIVING , CARE AND ALERT
TO OVERCOME HEALTH PROBLEMS
• COMMUNITY AND RELIGIOUS LEADERS; INFORMAL LEADERS:TO SUPPORT SOCIAL COHESION AND SOCIAL RESPONSIBILITYTOWARD HEALTH DEVELOPMENT
• FORMAL LEADERS, PRIVATE SECTORS, STAKEHOLDERS : RESPONSIBLE TOPROVIDE REGULATION, FUNDING, RESOURCES FOR HEALTH DEVELOPMENT
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CHARACTERISTICS
• Accessible of Village Health Clinic to provide basic health care
• Existence of Community SYSTEM SURVEILANCEfor disease, nutrition, environmental health, Healthy Life
styles
• Existence of Community Plan to manage and cope with crisis/ emergencies (SAFE COMMUNITY system)
• Self reliance on health financing ( develop community health insurance plan)
• Progress change of attitude toward a Healthy living andHealthy life style
INDICATORS OF SUCCESS
1. Indicator input: existence of Village community Forum (VCF); availability of Village Health Clinics (VHC) including the building, facilities and drugs; midwife and/or nurse, comm. health resources (UKBM)
2. Indicator output: coverage at VHC, UKBM, No of emergency cases, No of HH visited and perform healthy life style
3. Indicator Process: frequency of VCF meetings , Active VHC, Active UKBM , functionalize emergency system
4. Indicator Outcome: morbidity, mental illness, maternal death, infant and under-5 death, malnutrition cases.
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VILLAGE HEALTH CLINIC(POLKESDES)
is:A Health facility built FOR and BY Community to faciltate
and serve the community to:
Improve health behaviour toward a Healthy LivingIncrease alertness and readiness to overcome risk of
disease and health problems
build up community capacity to enable to self- help on their area of health condition
Improve basic health service in conjunction with health personnel in-charged
Accelerate all support and participation from various stakeholders responsible for Community Health
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MATERNITY WARD
MATERNITY DEPOSIT
BLOODBANKING
AMBULANCE
POSYANDU
DRUG POST
MIDWIFE
VILLAGE HEALTHCLINIC
DESASIAGA
3 HC Functionsimplemented
MATERNITY HOSPITAL
COMM DEVELOPMENT
SUPERVISION & IMPROVEMENT
OF COMMUNITY RESOURCESFOR HEALTH
CENTER FORHEALTH
PROMOTION
DG OF COMM.
HEALTH
OTHER DIT.GEN
DIT.GENMED.
SERVICES
IMPROVE HEALTHCENTREQUALITY
IMPROVE QUALITY
HOSPITAL
(DEMAND)
(SUPPLY)
HEALTHYLIFESTYLES EFFORTS TO BUILD A HEALTHY
AND SELF-RELIANCE COMMUNITY
(LINK DEMAND & SUPPLY)
HEALTHYINDONESIA
STAKEHOLDERS
A HEALTHY AND SELF RELIANCE
COMMUNITY
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INVESTMENT OF HEALTH SERVICES at DESA SIAGA
Provision of drugs and health facilitiesProvision of competent health personnelPerform the referral servicesProvide health resources, guidelines and trainingsSupport , monitor and supervise health post located at Religious Group study
TARGET VILLAGE AND BUDGETIn 2006: 12.000 villages become DESA SIAGABy 2007: targeted to reach 30.000 villageBy 2008: all villages in Indonesia (70.000) transform to DESA SIAGABudget allocated for 3 year totaling Rp 7,5 trillion (=USD 675 Million)In 2007 central and local govt provide Rp 386.5 milliard (=USD 43 million)
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171,300,000.00(USD 19000)Total
6,000,000.00 6,000,000.00 Packg1MEDICINES9
2,400,000.00 200,000.00 month12OPERATIONAL COST 8
12,000,000.00 1,000,000.00 month12HONORARIUM FOR MIDWIFE7
3,000,000.00 1,500,000.00 Ps2TRAINING COMMUNITY HEALTH WORKER6
2,400,000.00 2,400,000.00 ps1TRAINING MIDWIFE5
500,000.00 500,000.00 Packg1TRAIN ING BY THE HEALTH CENTER4
10,000,000.00 10,000,000.00 Packg1MEBEULAIR, FACILITIES, EQUIPMENT3
15,000,000.00 15,000,000.00 Packg1MEDICAL DEVICES2
120,000,000.00 2,000,000.00 m260REBUILD/ RENOVATION1
TOTAL (Rp)COST/ITEM (Rp)UNITVolDESCRIPTIONNo
UNIT COST VILLAGE HEALTH CLINIC (2007)
FACTORS INVOLVED IN ACHIEVING THE RETURN OF INVESTMENT
Households assets: human (healthy, competent personnel) ,physical, financial Household behavior: risk factors, needs and expectation for servicesSocial Norms: attitude, compliance, a sense of kinship,Social Cohesion :Trust, Ties and Willingness to help othersEconomic Capital: ability to share a portion of health services and improve welfare
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COMMUNITY RESPONSIBILITIES
Strengthen Community capital through:Active participation in planning and monitoring village health developmentProvision of transportation, blood donors for emergency care and referral service, building for health post, health fundsEnhance cooperative activities through provision of small scale industry
PRIVATE/OTHER STAKEHOLDER PARTICIPATION ON HEALTH DEVELOPMENT
BUILD Corporate Social Responsibility to improve community well being through provision of funds for:Scholarships, Training and Incentive for community health workersCommunity supported activities such as: Integrated health post; medicinal garden, maternity ward, family latrine/waste disposal, cooperative activities, etc
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Political Will
Local Government should provide 70% of Funds for Village development Program including incentive for health provider and CHW/ CadresLocal Government should Instruct the village officials to be more active in monitoring and reporting the community health condition Provision of health Funds for the poor, older people without family and those in needs (disasters, calamity)
