Optimizing the roles of Community Health Nursing in collaborative efforts to achieve
Sustainable Development Goals
Agus Setiawan International Conference on Healthcare Management
Bandung, 17 July 2018
From MDGs to SDGs
2000 - 2015 2015 - 2030
SDGs
• 17 goals
• Focuses: People, Planet, Peace, Prosperity, Partnerships (5P)
• Health: • Goal 3
• 13 Targets
• Focus: ensuring healthy life and wellbeing using a life course approach
• Highlights the importance of health promotion, disease prevention, and universal access to health care
SDGs and Indonesia’s national development agenda
http://www.depkes.go.id/resources/download/info-terkini/rakerkesnas_gel2_2016/Paparan%20Menkes.pdf
Presidential vision and mission Sub-national vision and
mision
National development plan
MoH Strategic Plan
National budget plan
Health program implementation
Local development plan
Sub-national health strategic plan
Local budget plan
Sust
ain
able
Dev
elo
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ent
Go
als Su
stainab
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ent G
oals
Healthy Community Movement (GERMAS)
Healthy Community Movement (GERMAS)
• A healthy community movement/ campaign
• Promoting healthy life style
• Main objectives: • Reducing the burden of communicable and non-
communicable disease
• Preventing a declining productivity due to health related issue
• Reducing health cost
GERMAS promoted activities
Germas – approaches and principals
1. Multisectoral collaboration
2. Focus on community, family and individual health
3. Community empowerment
4. Health system strengthening
5. Life-course approach
6. Universal Health Coverage
7. Health Equity
Community Health Program
Family-centered health care
• An integrated public and individual health program targeting family/ household, based on family health profile
• Community outreach program implemented at puskesmas through home visit
• Aims to improve family’s access to health care and overall health service coverage, specifically to: • improve household’s access to a
comprehensive health care • contribute to an effort to achieve Minimum
Service Standard, Universal Health Coverage, and Healthy Indonesia
Puskesmas
Community-based health care Posyandu, PAUD, UKS, Poskestren, Upaya Kes Kerja, Posbindu NCD, etc
10
Family-centered health care
Family-centered health care
2015
2016
2017
2018
2019
470 Puskesmas
9 Provinces
64 Districts
2926 Puskesmas
34 Provinces
514 DIstricts
4 Puskesmas
4 rovinces
4 Districts
9754 Puskesmas
34 Provinces
514 Districts
5852 Puskesmas
34 Provinces
514 Districts
SDGs
Germas
Family-centered
health care
Potential roles for
community health
nursing
• Nationally: 49% of health workers are nurses
• Of those working in Puskesmas: • 94% working in puskesmas
at sub-district level • 93% working full-time • 82% provide child health
service • 90% provide care for adults
and older people
(Setiawan, 2017)
PROGRAMS HUMAN RESOURCES
Forms of community health nursing supports
• Active engagement in public health program
• 1 village 1 nurse program
• Nursing centre – a collaborative program between health service providers and education institution
Nursing Centre Model FIK UI – Puskesmas Cimanggis, Depok City
Integrated in-facility health service and community
outreach (home visit, public health education), with an
emphasize on health promotion and disease
prevention
Aims: Providing a good quality public health service through integrated education, research, and community services
Objectives
• Providing community health nursing services, responsive to the public needs and resource availability
• Improving community’s life skill through effective community nursing engagement in health problems solution and better public health outcomes
• Generating knowledge and applying evidence-based practice for community nursing services
• Improving nurses and community health workers’ capacity
• Providing clinical practice supervision for nursing student at the community level
• Strengthening the multisectoral networking and collaboration for better public health
Main principles
• Open collaboration and communication with health service team, local leaders, religious leaders, and community
• Promoting community active engagement (individual, family, groups, and community) through all process
• Provide advocacy for policy workers towards an optimal services
• Acknowledging each individual’s physical, mental, emotional, socio-cultural, and spritual
• Providing and bringing health service closer to the community
• Creating a healthy working environment
Program
Health service
Research Education
Health services
• Community health nursing service provision through in-facility services and community outreach (individual, family, and community nursing care)
• Inter-program collaboration
• Community supervision
• Developing SOP for better services
Nursing Centre flow or services
Older people General MCH Nutrition Adult Others
Discharge Follow up Nursing Center
Hospital
Family Sub-group/ community
Individu within family
Family care
Independent group
Supporting group
Community out-reached
In-facility services
Education activities
• Facilitate students and academician clinical practice
• Capacity building for nurses working in Puskesmas
• Develop model for community/ clinical practice supervision
• Develop SOP for community/ clinical practice supervision
Research activities
• Baseline study
• Facilitate the research activities of FoN UI students and academician, as well as puskesmas and health office
• Facilitate students thesis/ dissertation
• Promote national/ international academic publication
Challenges
• Inadequate policy supports
• Unavailability standard competency across all levels of service
• Lack of capacity of community nurses
• Lack of capacity in leaderships and agent of change
Conclusion
• With an emphasize of disparities in health, community based intervention is now being one of global and national health strategy.
• Community nurses play important roles in a collaborative effort to achieve the SDGs and the National Health target.
• Collaboration between education and health service provider can bring benefits for both as well as for the community
