OPENING THOUGHT

Adang Bachtiar MD MPH ScD

Indonesia Public Health Association

2015 Presented at FIT KE-1

ENV SUST

Natural Resources &

Ecological Devt

ECONOMIC DEVT

Industries &

Business

SOCIAL WELFARE

Social Capital devt

& Health Devt

PUBLIC HEALTH CHALLENGE POST 2015

•Overload •Minimum emphaty •Rejected for services •Unsafe procs

•Limited drug logistics capability •Unstandardized drug provision

• Less than 25% GPs pass the skills test •Weak GP forum •No hospital support

for GPs

•Hospital system alienated from health system •Neglected primary health

centre •Barely existence of

homecare services

•Reimburse procs •Quality Improvement •Local Government commitment

•HC management problems •Ineffective referrals •Ineffective prom-prev packages

• Ineffective primary health as gate-keeper •30% of population: have

illness increase from 15%

Policy Regulation

Low quality of

services

HEALTHCARE

COMPLAINTS

ON SERVICES

Inadequate

provision of

drugs esp in

primary care

Ineffective health

intervention

Minimum

interaction

provider-patient

Health

Services

Incompetence

providers

Ineffective

follow-up

•Masy menafsirkan PHW “tengkorak” sebagai keberanian dan gaya hidup

•Championship LSM sdh ada dg jejaring yg efektif tp “on-off” tbts pendanaan •NGO tandingan dari TI

•Sektoral simpang siur •Melemah krn intervensi TI

•DPR yg pro TI: UU tandingan dll •Presiden “TC home alone” •Hak asasi & pilihan indiv •Separatis non SDG •Petani tembakau sbg vote gating

•Meningkat tajam •Pemula lbh tajam •Sasaran usia produktif

•Globalisasi sbg upaya ekpansi TI •Pemisikinan petani dg mekanisasi

REGULASI

GUGUS DEPAN

TOBACCO

CONTROL

Kegagalan Risk-

Based Public

Health Policy

dalam NCD

NGO ROLES GLOBAL FRONT

IGNORANCY

EPIDEMI

TEMBAKAU

STRATEGI

“LAWAN”

GOVT ROLES

•Lobi politik yg menggurita •Multi entry consistent marketing

They do not have the resources to

do it

Dana bagi hasil pajak rokok untuk

kesehatan sangat besar di daerah

Tetapi tidak dimanfaatkan karena berbagai

sebab

Kapasitas keprofesian tak tersedia untuk

mendorong pemanfaatan yg efektif

Hypothetical Source of Failure(1)

They do not know what to do

Koalisi ABG (di daerah) for empowerment blm efektif

Peran profesi masih lemah

Tdk ada regulasi yang kuat untuk penanggulangan

merokok

Kemampuan programming lemah

Hypothetical Source of Failure(2)

They do not have the skills to do it

Legislatif sudah minta tolong expert PH tp

tak dibantu (aliansi kaukus tidak terjadi)

Kompetensi Nakes terbatas

Sinergitas multidisiplin blm optimal

Kompetensi prom-prev yang diajarkan tidak

cukup memecahkan masalah

Pendidikan kes (prom-prev) yang belum

KBK dan PBL untuk anti rokok

Hypothetical Source of Failure(3)

They do not want to do it

“Kenapa juga harus jalankan Program

prom-prev anti rokok?” (Softskills untuk

pengabdian kepada kesehatan bangsa

amat terbatas bagi nakes)

Pendidikan “jaman dulu” ditinggalkan

untuk pengabdian yang tinggi (etika

profesi kesehatan)

Hypothetical Source of Failure(4)

TRANSITIONAL(1)

1. Destructive unbalanced spatial use

2. Material sources into wasteful

consumption

3. Energy poverty, inaccesible& unfair

utilization

4. Ineffective & unsafe population mobility

1. Discerning spatial utilization

2. Efficient and empowered recycling

economy

3. Sosial justice of energy use

4. Ecological adaptive mobility

a) Healthy cities

b)Community based health initiatives

c) Village development with PH

technocrate

• DARI: • KEARAH:

TRANSITIONAL(2)

Insecure food availability related to

ecological distruction including climate

changes

5. Effective food security within healthy

biosphere

a) Risk-based management

intervention

b) Continuum of Care Strategy

c) Strengthening PHC

• DARI: • KEARAH:

TRANSITIONAL(3)

Non-comprehension ineffective,

fragmented healthcare, including alienated

hospital in synergizing health development

6. Healthy consumerism 5-level

prevention

a) Globalized innovation in prom-prev

technologies

b) Healthpreuneur including TCAM

c) Structuring hospital “without wall”

• DARI: • KEARAH:

TRANSITIONAL(4)

Learning sluggish and uneven

including education of health workers

who are incapable in solving health

problems

7. Hitech education with cultural

competencies aspect

a) Competency based learning,

including soft skills competencies

b) Use of advanced IT/IS for best

practices

• DARI: • KEARAH:

TRANSITIONAL(5)

Imbalanced economic system of "North-

South"

8. Fair competition of Low-carbon, low raw-

material economy development with

healthy biosphere consideration

a) Migration of health workers that

benefit health care system

b) Health sector investment that

stimulate affordability-accessibility-

quality and sustainability

• DARI: • KEARAH:

TRANSITIONAL(6)

Neglected social development including

family welfare

9. Inclusive caring society

a) Family and community

empowerment for health life style,

capacitating social cohesiveness

capital

b) Supported by PH professionals with

soft skill competencies of nation

character building

• DARI: • KEARAH:

TRANSITIONAL(6)

Degradation of natural and

ecological carrying capacity

10. Biodiversity growth

a) Traditional healthcare industries

including “Saintifikasi Jamu”

b) Environmental conservation for

healthy life style

c) Blue economy as health nutrition

resources

• DARI: • KEARAH:

TRANSITIONAL(7)

Explotitative international connection

11. Mutually beneficial global relationship

(The 5th Wave of Public Health

Paradigm)

a) Health sector global transaction for

heakth system benefit

b) Nation healthy life style norms and

beliefs for solution of global risk life

styles (Narcotics; alcoholism;

smoking; etc)

• DARI: • KEARAH:

THE KEYWORDS

STRONG ESTABLISHMENT OF

Public Health Ethics and Values

Core public health competencies

Core health system

End Product understanding

12 Principles of the Ethical Practice of Public Health

1. Address the fundamental causes of disease and requirements for health

2. Respect individual rights in the community

3. Ensure an opportunity for community input

4. Empowerment of marginalized

5. Seek information for effective policies and programs

6. Provide community with information

12 Principles of the Ethical Practice of Public Health

7. Act in a timely manner

8. Incorporate a variety of approaches and respect diversity

9. Enhance physical and social environment

10. Protect confidentiality

11. Ensure professional competence

12. Collaborate to build trust and effectiveness

20

NEW VISION

“To provide integrative

comprehensive holistic

care services across

the continuum for SDG Goals”

Accountability for Resources and Results

Health Interventions Affordable-Effective-Efficient-Hi Quality-Sustain

Enablers Resilient health

systems; Research and

Innovation

National Leadership and

Coordination for Quality Control

& Cost Containment

Determinants Political;

Socioeconomic; Environmental

Realizing Rights Self reliance to stay healthy &

recovery

THE STRATEGIES

22

Educating Showing paths for

healthy life styles to all people

Leading Inspire and develop

people & sectors for healthy

consumerism

Managing Use process

excellence to fulffill Health Needs &

Satisfy Community

Innovating new PH ideas and

develop capabilities to make them a

reality

Researching for rational PH decisions & new

technolgy & approaches

Apprenticing for perfection PH values and norms

Communitarian Live with; for benefit of and establish self reliance community

.

.

.

.

.

• ALLIANCE IS IMPORTANT

• Communication

• Communication

• Communication

•MEASURED ACTION

PLAN

• Continuing professional

development for PH

workers

Continuing Professional Devt (CPD)

STR-IAKMI

Renc CPD

Bekerja di bidang

Kesmas sec profesional

SKP sebagai pengalaman

CPD sepanjang

karir

MIRACLE

Karir Profesi

6-Ahli KM Pratama

7-Ahli Profesi KM Muda

8-Magister KM – AKM Madya

Jenjang KKNI - ASN

9-Doktor KM – AKM Utama

.

.

.

SDG

alliance

MIRACLE

.

.

. . .

.

Asses Develop

Manage

Professionalism

Public Health Leadesrhip

Mobilizing global-

regional-and national

resources for PH goals

within SDG frame

Synergizing PH effort, ie.,

seamless efforts of UKM

(Public health

intervention) with UKP

(Personal care)

Hatur Nuhun

Thank You