Saturday, February 27, 2010

The increasing degree of public health (Epidemiological studies in Sleman regency, Central Java, Indonesia)

Policy:
1. Increasing community empowerment, understanding, and application of hygienic behavior and healthy.
2. Improving the quality of resources, human environment, infrastructure and health facilities.


3. Improving the quality of institutions and health services.
To achieve these goals implemented through a field of labor with the program - the program as follows:


1. Healthy behavior programs and community empowerment.
2. Nutrition Improvement Program.
3. Program health efforts.
Based on the achievement of performance indicators which consists of 40 indicators that can demonstrate the achievement of performance targets, in general it can be concluded very successful with an average achievement rate of 100% indicator. The indicators that represent the level of performance achievements are as follows:
1. Increasing role in developing cross-sectoral PHBS (Behavior Clean and Healthy Life) as many as 40 people or 100% of the target 40 people.
2. Increasing the quality of school health for 0.95% or 100% of the target of 0.95%.
3. Increased behaviors clean and healthy living in communities of 93.38% or 156.63% of the target of 60%.
4. Increasing the quality of activities Strata PHBS PHBS for more than 65% or 100% of the target PHBS> 65%
5. Increased empowerment activities posyandu cadres of 0.2% or 100% of the target 0.20%
6. Prison inmates increased knowledge about adverse drug abuse from the health point of 60% or 100% of the target of 60%.
7. Increasing public knowledge about prevention and control drug abuse by 60% or 100% of the target of 60%.
8. Children aged 0-5 years old infants weighed as much as 86.19% or 107.7% of the target of 80%.
9. Malaria morbidity in the year 2005 amounted to 0.007% or 165% of the target of 0.02%.
10. Dengue disease morbidity of 0.03% or 150% of the target of 0.06%.
11. Pes morbidity of 0% or 100% of the target of 0%.
12. Pulmonary TB cure rate of 75% or 88.24% of the target of 85%.
13. Diarrhea morbidity in all age groups of 1000 people found 16 people affected by disease or 143.75% daritarget 23/1000 population.
14. IPSA morbidity in infants less than 10% or 100% of the target less than 10%.
15. Leprosy morbidity of less than 1 / 10000 population, or 100% of the target.
16. Anthrax morbidity of 0% or 100% of the target 0%
17. Tertanggulanginya outbreaks of food poisoning, diseases and other emergencies by 90% or 100% of the target of 90%.
18. The level of pesticide exposure for 237 farmers, or 98.75% of the target of 240 farmers.
19. Infants are protected from PD3I of 15,415 or 124.65% of target infants and 12,366 pregnant women terlindungnya from PD3I of 11,314 or 83.17% of the target of 13,602 pregnant women so that the performance achievements of infants and pregnant women who terlindungnya, for 103.91%.
20. The discovery of 2 cases of AFP (acute flaced paralise) and 30 cases of measles or 100% daritarget 2 AFP cases and 30 cases of measles
21. Infectious disease epidemiology data and is not transmitted can be known quickly and accurately in hospitals and health centers as much as 52 weeks in 7 hospitals and 24 health centers, or 100% of the target of 52 weeks in 7 hospitals and 24 health centers.
22. Increasing the quality of health for vulnerable communities as much as 25 nursing or 100% of the target of 25 homes.
23.Diketahuinya problems & solving problems in the district MCH prog as much as 24 health centers, or 100% of the target 24 health centers.
24. APE assistance to as many as 48 integrated health posts yandu or 141.18% of the target yandu post 34.
25. Known problems and problem solving GSI in Kab. Sleman many as 20 people cross-sectoral or 100% of the target 20 people cross-sectoral.
26. Known problems and troubleshooting of GSI in district 4 district or 100% of the 4 target districts.
27. Known problems and problem solving SPK in Kab. Sleman as 6 BPS or 100% of the target 6 BPS.
28. Known problems and troubleshooting Polindes in Kab. Sleman many as 25 polindes or 100% of the target 25 polindes.
29. Realization of integrated aid and development with as many as 3 health centers Linsek or 75% of the target of 4 health centers.
30. KIA data availability of 24 health centers, or 100% of the target 24 health centers.
31. Team formation DTPS-MPS District in order to suppress MMR (Maternal Mortality) & AKB (Infant mortality rate) of 1-MPS DTPS team or 100% of target 1-MPS DTPS team.
32. Increased knowledge and skills of health center staff of 24 midwives PONED or 100% of the target of 24 midwives.
33. Increased knowledge and skills of health center staff about the handling of post Abortion Orphanage for 30 midwives or 100% of the target of 30 midwives.
34. Detection of causes of morbidity / mortality of mothers and infants 12 cases or 100% of the target of 12 cases.
35. Knowing the behavior and family bumil in exploiting and using the book as many as 1720 people MCH or 100% of the 1720 target.
36. KR textbook availability and family planning or as many as 300 Exp 100% of the target 300 Exp.
37. Detection of cervical cancer at an early stage for Gakin (The Poor) of 1120 gakin or 100% of the target gakin 1120.
38. Increased knowledge, skills teacher or as many as 48 teachers 100% of the target 48 teachers.
39. Increased knowledge, skills, health center staff health officials as many as 48 or 100% of the target 48 health workers.
40. KRR on increasing students' knowledge of 720 students or 100% of the target of 720 students.
The success of the performance achievements could be seen on the quality of the increasing behavior of clean and healthy living in communities of 93.38% or 156.63% of the target of 60% it was caused, among others:
a. Public awareness of the Clean Healthy lifestyle (PHBS) and conduct a clean and healthy living in the community is high.
b. The existence of counseling conducted community health workers.
c. Once every 6 months to a community survey. Later on malaria morbidity in the year 2005 amounted to 0.007% or 165% of the target of 0.02%. This success is due to include implementation of:
• Each one case of an epidemiological investigation into the shooting location of the patient with the blood supply surrounding community malaria patients.
• Medical patients.
• Early detection by making the blood supply for immigrants from malaria endemic areas and those newly arrived / returned from endemic areas (eg, soldiers returning from Aceh, Ambon).
• Medical prevention for people who will go to malaria endemic areas.
• Counseling - counseling.
• Meeting coordination village and district level for the eradication of malaria.
• Spraying the house (indoor residual spraying) endemic area (Turi and Mlati).
• Coordination of cross-border with the border area (city, Klaten, Kulonprogo, Magelang).
With these activities successfully suppressed so that the number of
case is still under the safe limit (0.02%) is 0.007%.
Dengue disease morbidity as much as 0.03% or 150% of target
0.06% of this success include the implementation:
• Guidance.
• community mobilization for the PSN (the eradication of mosquitoes nest).
• Abatisasi / sowing abate powder.
• Investigation Epidemiology / PE (field trips) at every possible case.
• Monitoring larvae regular basis by the cadres, school children, institutions, the community and schools.
• Spraying or fogging.
• Dissemination of information about dengue through leaflets, posters, banners and print media.
• Talk show through electronic media.
• Determination of the establishment of permanent procedures as follows:
o Conducting the investigation of PE, each case there is information within 1 X 24 hours.
o If the PE supports the fogging then within 3 X 24 hours conducted fogging / spraying.
10.Koordinasi o cross-border with the border area (City Yogja, Bantul).
The reduced morbidity of diarrhea in all infants of 16 per 1000 population, or 143.66% of the target of 23 per 1000 population. The success is due to:
1. Providing counseling to the community.
2. Dissemination of information through print media such as leaflets.
3. Monitoring of cases through the weekly reports of some 24 health centers and hospitals of 6.
4. Provision of latrines stimulant and other materials for the manufacture of a family privy to community groups.
5. Division kapurit to kapurisasi on drinking water sources.
6. Procedure correctly with diarrhea both in health centers, hospitals, government and private.
7. Quick response to any information with the mobilization of the number of cases of rapid movement team District (TGC).
Achievement of performance targets comprising 40 indicators showed
that the level of achievement goals in general accordance with the
targeted. These goals be achieved through major programs:
1. Healthy behaviors and community empowerment;
2. Improve nutrition;
3. Health efforts
Factors that affect community health status:
o The availability of health centers and medical clinics scattered in Sleman regency.
o Awareness of the community to take advantage of existing health facilities. Achievement of performance indicators activities (outputs) of the primary 99.4% to 100% or an average of 99.3% from the specified target with the financial support of Rp.105.682.858, 15 so that the carrying capacity of the achievement of performance targets is very significant.
The main activities that support the achievement of these goals
is as follows:
1. Management, training, establishment of school PHBS.
2. Empowerment cadre post yandu
3. Prevention and control of drug abuse
4. Handling of macro nutrients
5. Dengue disease and eradication of malaria
6. Eradication of plague, antrak, leprosy, acute respiratory infections Phenomia (ARI), tuberculosis, diarrhea
7. Handling outbreaks of disease (food poisoning and other emergencies)
8. Cholinesterase examination of pesticide spraying
9. Management and implementation of immunization
10. Observations tracking and control kipi (event follow-up post immunization) early warning of disease
11. Handling of health and disease prone rehap assistance medical disability gakin
MCH 12.Pengelolaan and guidance
Reproductive health 13.Sosialisasi
Barriers / problems:
1. Dengue disease control. In some districts an increase in DHF cases, especially
2. in District Depok, Sleman.
3. Malnutrition in balita.Upaya
Troubleshooting is done is:
1. Dengue disease control. In order to break the chain of transmission of dengue disease with the policy applied: each clinic DHF reports should conduct an epidemiological investigation (PE) in 1 X 24 hours. If the results of epidemiological investigations (PE) indicates the case became the focus of transmission potential, then within 3 X 24 hours must have been conducted focus fogging with radius of 100 - 200 m (approximately 100 houses / buildings) with PSN movement (Nest Mosquito Eradication).
2. Malnutrition in infants.
a. Providing information that is proportional to the mas media about the situation and conditions on the nutritional status of infants and policies that have been taken by the Regional Government.
b. Implementation of epidemiological investigations (PE) by the health officer if there were no reports of malnutrition and follow-up management of these cases.
c. Implementation of monitoring the nutritional status survey (PSG) in all infants in the posyandu simultaneously in February.
d. Supplementary feeding (PMT) milk for infants and pregnant women Gakin.