“implementation on public health intervention for …...“implementation on public health...

“Implementation on Public Health Intervention for Increasing Quality of Family Health”

Trihono, Eva Sulistiowati, Suparmi, Aditia Putri

The 4th International Symposium on Health Research and

14th National Congress of Indonesian Public Health Association

Bali, 28 November 2019

Background

President’s Vision & Mission:

3 Vision & 9 Mission

Achieved through 4 programs

Health, Education, Social & Workforce

Healthy Indonesia Program

Healthy paradigm:

Healthy Indonesia Through

Family Approach (HITFA)

Strengthening Health Facilities

(Hospitals, Health Centers, etc.)

Individual health services:

National Health Insurance

Healthy Indonesia Program

Using 3 pillars:

1. Healthy paradigm community health services using family

approach (Healthy Indonesia Through Family Approach – HITFA);

cover all families in the responsibility area of Health Center

(Puskesmas) to improve family health using 12 health indicators

2. Universal Health Coverage through Jaminan Kesehatan Nasional

(National Health Insurance - NHI) individual health services the

poor people premium paid by Government.

3. Strengthening the health facilities

• HITFA use 12 health indicators, selected from main health problem

composite indicator: FHI (Family Health Index)3

Indicators of Family Health

A MCH & Nutrition:

1 Family Planning

2 Skilled birth attendance at health facilities

3 Complete Immunization for the baby

4 Exclusive Breast Feeding for the baby

5 Growth monitoring of under five

B Communicable & Non-Comunicable Disease Control:

6 TB patient treated adequately

7 Hypertension patient treated adequately

8 Severe mental disorder patient treated adequately

C Healthy lifestyle and Environmental Health:

9 Not smoking behavior

10 Clean water access for all family members

11 Good sanitarian access for all family members

12 Social health insurance for all family members

Healthy family indicated by FHI (Family Health Index): a composite index of 12 health indicators

2015

2016

20172018

2019

470 Health Centers,9 Prov, 64 Districts


4 Health Centers4 Prov, 4 Districts



5

Roadmap of Healthy Indonesia Through Family Approach (HITFA)

Healthy Indonesia Through Family Approach

Health Center

Family

Community Based Health Activities: Posyandu, Posbindu PTM, Posmaldes, Poskestren, UKS/M (Usia Sekolah), etc

Family FamilyFamily Family6

The Implementation of Family Approach• Health Center staff should actively do home visit to all families who live

in the responsible area

• Mainly giving health promotion, health prevention and early detection

• Collect family health data (minimal 12 indicators of family health)

collected and input to the healthy family application:

https://keluargasehat.kemkes.go.id/ directly registered at Central

Data & Information, Sec. Gen. MOH

• All Health Office (Central, Province and District) can open the

application and each Health Center has access to the raw data

• This application gives real time monitoring of the progress of Healthy

Indonesia through Family Approach (HITFA)

https://keluargasehat.kemkes.go.id/

Proporsion of Stunting Underfive by province, 2013-2018

8

27.5

37.2

51.7

17.7

30.8

42.6

0

10

20

30

40

50

60

DK

I Jakart

a

DI Y

ogya

kart

a

Bali

Kepula

ua

n R

iau

Bangka B

elit

ung

Sula

wesi U

tara

Bante

n

Kalim

anta

n U

tara

Lam

pung

Ria

u

Papua B

ara

t

Bengkulu

Sula

wesi T

enggara

Kalim

anta

n T

imur

Sum

ate

ra B

ara

t

Jam

bi

IND

ON

ES

IA

Jaw

a B

ara

t

Jaw

a T

engah

Malu

ku U

tara

Sum

ate

ra S

ela

tan

Sum

ate

ra U

tara

Sula

wesi T

eng

ah

Goro

nta

lo

Jaw

a T

imur

Pap

ua

Kalim

an

tan S

ela

tan

Kalim

anta

n B

ara

t

Nusa T

engga

ra B

ara

t

Malu

ku

Kalim

an

tan T

eng

ah

Sula

wesi S

ela

tan

Aceh

Sula

wesi B

ara

t

Nusa T

engga

ra T

imur

2013 2018

Trend of under-five growth monitoring through

Integrated Health Post in the last 6 months 2007-2013

45.4

29.1

25.5

44.6

21.1

34.3

0.0

10.0

20.0

30.0

40.0

50.0

60.0

≥ 4 kali 1 – 3 kali Tidak Pernah

2007 2013

> 4 times 1 – 3 times Never

Prevalence of Hypertension based on diagnose, diagnose or treatment and measurement for >18 years, 2013 dan 2018

Gap 25.7% or 75% among

hypertension people:

They don’t know yet if they

have hypertension

2013

2018

Determinant factors of Non-Communicable Diseases

NHIHITFA

Healthy

Lifestyle

Movement

Impact of HITFA to Community Health

Correlation of HDI – PHDI - FHI

Economy

Education

Health

HDI (Human Developent Index)

Life Expectancy at birth (LE)

PHDI (Public Health Development Index): a composite index formulated by 30 main health indicators, based on National Health Survey

The correlation between HDI (Human Development Index)

2017 and PHDI (Public Health Development Index) 2018

r = 0.803

R2 = 0.645

p-value = 0.000

Correlation between Family Health Index (June 2019) and

Public Health Development Index (2018)

r = 0.648

R2 = 0.42

p-value = 0.000

Impact of HITFA to NHI (National Health Insurance)

• HITFA strengthen the community health efforts, mainly promotive &

preventive action decreasing the diseases prevalence

• HITFA strengthen the early diagnose and prompt treatment

decreasing the severity of NCD (Non-Communicable Diseases)

decreasing claim to the NHI

• HITFA facilitate the healthy lifestyle controlling the risk factors

decreasing the prevalence of the diseases decreasing budget

claim to the NHI

• HITFA improve the environment health decreasing the

communicable diseases decreasing claim to the NHI

16

Case distribution (#) Claim (IDR billion)

Case distribution & budget claim inpatient care, 2014

FHI as an advocacy tool

• We have PHDI for comparing the achievement of health development

among provinces and districts, but this index based on National Health

Survey which done every 5 years.

• HITFA composite indicator: FHI (Family Health Index)

• Based on FHI, we can rank not only among provinces and districts, but

also among sub-districts even among villages

• This rank can be made every year or if needed it’s a real time rank

• Now all District Health Offices can use FHI sub-district rank for

motivating Health Centers

• All Health Center can use FHI village rank to motivate Villages

increasing budget for health. 18

Progress of Home Visit Coverage by Provinces

65.9%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%P

apu

a

Pap

ua

Bar

at

DK

I

Kal

iman

tan

Tim

ur

NTT

Mal

uku

Sula

wes

i Uta

ra

Jaw

a B

arat

Kal

iman

tan

Ten

gah

Sum

ate

ra U

tara

Bal

i

Ban

ten

Kal

iman

tan

Bar

at

Jam

bi

Go

ron

talo

Sum

ater

a S

elat

an

Ace

h

Jaw

a Ti

mu

r

Kep

ula

uan

Ria

u

Kal

iman

tan

Uta

ra

DIY

Sula

wes

i Sel

atan

NTB

Sum

ate

ra B

arat

Mal

uku

Uta

ra

Sula

wes

i Ten

gah

Kal

iman

tan

Se

lata

n

Jaw

a Te

nga

h

Sula

wes

i Ten

ggar

a

Ban

gka

Bel

itu

ng

Ria

u

Lam

pu

ng

Ben

gku

lu

Sula

wes

i Bar

at

Ind

on

esi

a

Desember 2018 Oktober 2019

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

DESEMBER 2018 OKTOBER 2019

Progress of FHI by provinces,

Progress of FHI & 12 health indicators, National, Des 2019

24.39%

36.07%

38.14%

43.55%

50.22%

51.77%

80.72%

86.69%

87.75%

88.35%

91.60%

94.08%

17.90%

Penderita hipertensi yang berobat teratur

Penderita TB Paru yang berobat sesuai standar

Penderita gangguan jiwa berat, diobati dan tidak…

Anggota keluarga tidak ada yang merokok *)

Keluarga sudah menjadi anggota JKN

Keluarga mengikuti program KB *)

Bayi mendapatkan ASI Eksklusif

Persalinan Ibu di fasilitas pelayanan kesehatan

Pertumbuhan Balita dipantau

Keluarga memiliki akses/menggunakan jamban keluarga

Bayi mendapatkan imunisasi dasar lengkap *)

Keluarga memiliki akses/menggunakan sarana air bersih

IKS (Indeks Keluarga Sehat)

4 years HITFA Result?

2015 2016 2017 2018 2019

Design &

field try out

Implemented in

9 Prov ,64 Districts

Implemented in 514 Districts

30% Health Centers


60% Health Centers


100% Health Centers

• The impact of HITFA more clear at

Health Center

• At upper level, increase of FHI &

positive changes of family health

status in Districts level

Analysis 1:

Sept 18 – Feb 19

Analysis 2:

Sept 18 – Junie19

Trend Analysis of Family Health Status

• Analysis on family health status: the positive change if the proportion

of healthy family increase and unhealthy family decrease in provinces

or districts

• Trend analysis done to compare the family health status in 2 period:

– From September 2018 February 2019

– From September 2018 June 2019

• The result is showing the changes in 4 months (February – June 2019)

Proportion of healthy, pre-healthy and unhealthy family,

Indonesia September 2018 – February 2019

16.71%

65.78%

17.51%17.28%

65.49%

17.23%

0%

10%

20%

30%

40%

50%

60%

70%

Sehat Pra sehat Tidak sehat

Sep-18 Feb-19

Proportion of family health status

September 2018 – February 2019 by provincesProvince

September 2018 February 2019Change

Healthy Pre-Healthy Unhealthy Healthy Pre-Healthy UnhealthyBANTEN 14.0% 63.7% 22.3% 15.3% 64.1% 21.2% 2.4%

SULAWESI UTARA 18.5% 64.3% 17.2% 19.6% 65.1% 16.0% 2.2%

JAWA TIMUR 16.7% 66.9% 16.4% 18.2% 66.5% 16.0% 1.9%

KEP. RIAU 23.6% 65.8% 10.6% 25.0% 65.2% 10.2% 1.8%

BALI 33.0% 61.6% 5.5% 34.2% 61.1% 5.0% 1.7%

DI. YOGYAKARTA 28.6% 64.8% 6.6% 29.8% 64.6% 6.2% 1.6%

SUMATERA BARAT 13.2% 61.0% 25.8% 13.9% 61.1% 25.0% 1.5%

SULAWESI BARAT 14.3% 62.9% 22.8% 15.0% 63.6% 22.1% 1.4%

NTT 11.7% 66.9% 21.3% 12.4% 67.4% 20.9% 1.1%

GORONTALO 16.5% 67.2% 16.3% 16.8% 68.0% 15.7% 1.0%

ACEH 25.6% 61.9% 12.4% 26.1% 61.9% 12.1% 0.8%

KEP. BANGKA BELITUNG 19.6% 67.3% 13.1% 20.6% 66.8% 13.3% 0.8%

SUMATERA UTARA 12.9% 67.2% 20.0% 13.7% 66.2% 20.1% 0.7%

JAWA TENGAH 19.2% 66.7% 14.2% 19.5% 67.2% 13.9% 0.7%

JAWA BARAT 14.8% 66.2% 19.0% 15.4% 66.3% 18.9% 0.6%

KALIMANTAN TENGAH 16.3% 60.0% 23.7% 16.6% 60.4% 23.4% 0.6%

PAPUA BARAT 13.1% 62.5% 24.4% 13.0% 63.4% 24.0% 0.3%

SULAWESI SELATAN 20.5% 66.4% 13.1% 20.7% 66.9% 13.0% 0.3%

INDONESIA 16.7% 65.8% 17.5% 17.3% 65.8% 17.4% 0.7%

Proportion of family health status

September 2018 – February 2019 by provinces

ProvinceSeptember 2018 February 2019

ChangeHealthy Pre-Healthy Unhealthy Healthy Pre-Healthy Unhealthy

LAMPUNG 12.3% 69.6% 18.2% 12.4% 70.1% 18.3% -0.1%

DKI JAKARTA 34.1% 61.6% 4.3% 34.2% 62.2% 4.5% -0.1%

PAPUA 14.2% 66.6% 19.1% 14.6% 66.0% 19.6% -0.1%

KALIMANTAN SELATAN 17.7% 62.9% 19.4% 17.9% 62.9% 19.7% -0.2%

SULAWESI TENGAH 15.1% 65.6% 19.4% 15.1% 65.8% 19.6% -0.2%

SUMATERA SELATAN 16.7% 63.7% 19.6% 16.6% 63.6% 19.8% -0.3%

KALIMANTAN TIMUR 23.5% 63.1% 13.4% 23.3% 63.4% 13.7% -0.5%

RIAU 12.6% 65.0% 22.5% 12.5% 64.7% 22.9% -0.5%

JAMBI 13.0% 61.9% 25.1% 13.1% 60.9% 26.0% -0.8%

BENGKULU 16.3% 67.5% 16.2% 16.3% 67.2% 17.2% -1.0%

MALUKU 8.5% 60.1% 31.3% 8.4% 59.8% 32.3% -1.0%

NTB 14.5% 69.4% 16.0% 14.0% 69.7% 16.6% -1.1%

MALUKU UTARA 13.4% 67.4% 19.2% 13.2% 67.2% 20.1% -1.2%

KALIMANTAN UTARA 21.3% 61.8% 16.9% 20.7% 62.5% 17.5% -1.2%

KALIMANTAN BARAT 12.8% 59.4% 27.8% 12.1% 59.4% 29.1% -2.0%

SULAWESI TENGGARA 14.1% 67.9% 18.0% 13.4% 67.4% 19.8% -2.6%

INDONESIA 16.7% 65.8% 17.5% 17.3% 65.8% 17.4% 0.7%

Progress: 18 Provinces positive, 16 provinces negative

Sumber: Aplikasi Keluarga Sehat, Juni 2019 dan Juli 2019 ; Jumlah KK sumber dari e-monev STBM

Coverage of home visit by provinces, June 2019

Indonesia: 56,88%

28Sumber: Dashboard Indikator Keluarga Sehat, Juli 2019

Indonesia 0,1818% families categorized as healthy family

Family Health Index (FHI) by provinces, June 2019

The achievement of 12 family health indicators: National

21.0%

24.2%

38.2%

44.4%

48.4%

48.4%

82.6%

88.0%

88.7%

89.3%

94.7%

95.0%

Severe mental disorder patient treated adequately

Hypertension patient treated adequately

TB patient treated adequately

Not smoking behavior for all family members

Family planning

Social Health Insurance for all family members

Exclusive breast feeding for the baby

Under-five growth mnitoring

Skilled birth attencance at health facilities

Good sanitation access for all family members

Clean water access for all family members

Complete immunization for the baby

FHI rank among Districts in NTB Province

0.094

0.117

0.12

0.134

0.166

0.172

0.172

0.183

0.245

0.254

0.147

BIMA

LOMBOK TIMUR

LOMBOK TENGAH

SUMBAWA

KOTA BIMA

DOMPU

LOMBOK BARAT

KOTA MATARAM

LOMBOK UTARA

SUMBAWA BARAT

PROV. NTB

Coverage & proportion of family health status

September 2018 – June 2019 by provinces

ProvinceCoverage home visit Healthy Pre-healthy Unhealthy

Total Rank

Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19

SULAWESI UTARA 11.72% 30.74% 18.55% 20.64% 64.27% 64.77% 17.19% 14.59% 4.69% 1

BALI 21.42% 51.30% 32.98% 35.62% 61.56% 59.81% 5.46% 4.57% 3.52% 2

DI YOGYAKARTA 20.20% 61.95% 28.59% 31.05% 64.82% 63.16% 6.59% 5.79% 3.25% 3

MALUKU 9.33% 35.83% 8.52% 10.06% 60.13% 60.28% 31.35% 29.66% 3.23% 4

BANTEN 27.02% 54.80% 14.01% 15.76% 63.65% 63.38% 22.34% 20.86% 3.23% 5

SUMATERA BARAT 36.52% 65.82% 13.24% 14.45% 61.00% 61.36% 25.76% 24.19% 2.79% 6

KEPULAUAN RIAU 18.56% 49.77% 23.64% 25.46% 65.76% 64.32% 10.60% 10.22% 2.21% 7

KALIMANTAN UTARA 27.88% 54.02% 21.30% 22.38% 61.81% 61.79% 16.89% 15.83% 2.15% 8

SUMATERA SELATAN 22.52% 55.24% 16.71% 17.61% 63.69% 63.85% 19.60% 18.54% 1.96% 9

JAWA TIMUR 24.53% 57.50% 16.68% 17.85% 66.91% 66.30% 16.42% 15.85% 1.75% 10

SULAWESI BARAT 61.17% 84.54% 14.31% 15.08% 62.90% 63.11% 22.79% 21.82% 1.74% 11

PAPUA BARAT 7.46% 16.74% 13.06% 13.29% 62.53% 63.53% 24.41% 23.18% 1.46% 12

GORONTALO 30.75% 57.60% 16.50% 16.91% 67.15% 67.70% 16.34% 15.39% 1.36% 13

SUMATERA UTARA 31.08% 54.03% 12.87% 14.07% 67.15% 65.91% 19.98% 20.02% 1.16% 14

JAWA TENGAH 29.81% 64.77% 19.16% 19.62% 66.67% 66.72% 14.16% 13.65% 0.97% 15

JAWA BARAT 17.41% 46.18% 14.84% 15.35% 66.16% 65.90% 19.00% 18.75% 0.77% 16

ACEH 25.04% 55.25% 25.61% 26.02% 61.94% 61.85% 12.44% 12.13% 0.71% 17

INDONESIA 53.93% 16.71% 17.51% 65.78% 65.45% 17.51% 17.04% 1.25%

Coverage & proportion of family health status

September 2018 – June 2019 by provinces

ProvinceCoverage home visit Healthy Pre-healthy Unhealthy

Total Rank

Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19

LAMPUNG 29.56% 71.59% 12.28% 12.66% 69.57% 69.51% 18.15% 17.83% 0.70% 18

SULAWESI SELATAN 36.52% 65.09% 20.52% 20.77% 66.38% 66.36% 13.10% 12.87% 0.48% 19

BANGKA BELITUNG 46.66% 70.34% 19.61% 20.63% 67.34% 65.75% 13.05% 13.62% 0.46% 20

SULAWESI TENGAH 39.59% 67.17% 15.05% 15.41% 65.56% 65.23% 19.38% 19.35% 0.39% 21

JAMBI 25.15% 58.17% 13.05% 13.58% 61.89% 60.80% 25.06% 25.61% -0.02% 22

KALIMANTAN TENGAH 22.15% 47.02% 16.27% 16.69% 60.00% 59.02% 23.73% 24.29% -0.15% 23

KALIMANTAN SELATAN 29.85% 60.89% 17.74% 18.04% 62.91% 62.10% 19.35% 19.86% -0.20% 24

DKI JAKARTA 2.17% 2.27% 34.11% 33.84% 61.57% 61.75% 4.32% 4.41% -0.36% 25

RIAU 50.74% 77.78% 12.56% 12.59% 64.98% 64.52% 22.45% 22.89% -0.40% 26

NUSA TENGGARA TIMUR 7.32% 27.84% 11.74% 11.65% 66.91% 66.62% 21.35% 21.73% -0.47% 27

KALIMANTAN TIMUR 11.70% 35.17% 23.51% 23.09% 63.07% 63.19% 13.41% 13.72% -0.73% 28

PAPUA 3.91% 14.91% 14.24% 14.41% 66.61% 65.41% 19.15% 20.18% -0.86% 29

BENGKULU 39.27% 82.60% 16.32% 16.24% 67.46% 66.68% 16.22% 17.09% -0.94% 30

MALUKU UTARA 35.15% 66.03% 13.44% 12.96% 67.36% 66.80% 19.20% 20.24% -1.52% 31

NUSA TENGGARA BARAT 25.98% 57.91% 14.52% 13.64% 69.45% 69.35% 16.03% 17.02% -1.87% 32

SULAWESI TENGGARA 22.77% 66.08% 14.14% 13.40% 67.88% 66.87% 17.98% 19.73% -2.49% 33

KALIMANTAN BARAT 18.99% 49.58% 12.80% 11.74% 59.39% 58.83% 27.81% 29.44% -2.69% 34

INDONESIA 53.93% 16.71% 17.51% 65.78% 65.45% 17.51% 17.04% 1.25%

Progress: 21 Provinces positive, 13 provinces negative

Progress of coverage and family health status change

until February 2019 and until June 2019

Jumlah (%)

Analysis of province & district change Sept 2018 - Feb 2019

Districts with coverage of home visit >50% 54 10,5%

Districts with positive change 27 50.0%

Provinces with positive change 18 52.9%

Analysis of province & district change Sept 2018 - June 2019

Districts with coverage of home visit >50% 297 57,2%

Districts with positive change 185 62.3%

Provinces with positive change 23 67.6%

The big 15 of Districts based on the highest change: Sept 18 – Juni 19

KABUPATEN/KOTACAKUPAN SEHAT PRASEHAT TIDAK SEHAT

DELTA RANKJun-19 Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19

KEPULAUAN ANAMBAS 76.12% 15.19% 19.77% 61.66% 69.58% 23.14% 10.65% 17.07% 1

TOBA SAMOSIR 84.44% 10.27% 15.05% 61.04% 68.49% 28.69% 16.46% 17.01% 2

KOTA SURABAYA 85.14% 31.94% 39.23% 60.61% 55.45% 7.45% 5.31% 9.44% 3

HULU SUNGAI UTARA 69.96% 18.78% 23.74% 63.91% 63.00% 17.31% 13.26% 9.01% 4

MOJOKERTO 69.38% 18.06% 23.38% 68.81% 67.03% 13.13% 9.59% 8.86% 5

SANGGAU 64.45% 7.10% 9.33% 53.65% 57.94% 39.25% 32.74% 8.74% 6

SLEMAN 90.35% 27.21% 32.57% 65.54% 61.87% 7.25% 5.56% 7.05% 7

BULUNGAN 87.90% 16.06% 18.86% 60.71% 61.40% 23.23% 19.74% 6.28% 8

MUSI RAWAS 87.20% 8.14% 9.85% 58.37% 60.66% 33.49% 29.49% 5.71% 9

LAMONGAN 74.75% 21.17% 24.50% 69.07% 67.94% 9.76% 7.56% 5.53% 10

KENDAL 94.45% 16.90% 18.82% 68.06% 69.67% 15.04% 11.50% 5.46% 11

KLUNGKUNG 69.89% 42.28% 47.00% 54.18% 50.14% 3.54% 2.87% 5.39% 12

KOTA PEMATANG SIANTAR 60.51% 15.16% 17.80% 68.05% 68.10% 16.78% 14.10% 5.31% 13

KOTA TERNATE 63.95% 13.48% 15.64% 67.14% 67.88% 19.38% 16.47% 5.06% 14

SELUMA 77.35% 11.32% 13.53% 63.59% 64.20% 25.09% 22.26% 5.05% 15

Advance analysis based on individual data

• The application of HITFA using family as a analysis unit

• By get the raw data from the application, we can analyze based on

individual data

• We can search by name and by address:– TB suspect follow up by diagnostic examination if positive: treated as

soon as possible

– Hypertension who regularly not regularly taking drugs

– Hypertension who just know if they have hypertension when home visit

– Seclusion severe mental disorder

– Have no health insurance

• National Health Survey to know the prevalence

• HITFA to know by name by address the Subject

Total TB Suspects by provinces,

February 2019

0

5000

10000

15000

20000

25000

30000

INDONESIA = 156,852

(Coverage 40%)

Total hypertension based on diagnosis by provinces

February 2019

-

100,000

200,000

300,000

400,000

500,000

600,000

INDONESIA = 3,068,375

(Coverage 40%)

Total hypertension regularly taking drug by provinces

February 2019

-

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000


(Coverage 40%)

-

100,000

200,000

300,000

400,000

500,000

600,000

Total hypertension (measurement at home visit) by

provinces February 2019


(Coverage 40%)

Total number seclusion of severe mental disorder by

provinces February 2019

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

INDONESIA = 22,296

(Coverage 40%)

South Kalimantan Province: Individual Analysis, Feb 2019

DISTRICTTuberculosis

Suspect

Seclusion Severe

Mental Disorder

TANAH LAUT 173 20

KOTABARU 174 15

BANJAR 308 31

BARITO KUALA 187 15

TAPIN 171 18

HULU SUNGAI SELATAN 213 29

HULU SUNGAI TENGAH 181 10

HULU SUNGAI UTARA 152 16

TABALONG 147 17

TANAH BUMBU 240 23

BALANGAN 298 14

KOTA BANJARMASIN 620 36

KOTA BANJARBARU 188 23

Result of HITFA in several Health Centers

Gabus 2 Health Center, Pati District, Central Java

Watas Marga Healh Center Rejang Lebong District,

Bengkulu Province

Tomalau Health Center, Kota Tidore Kepulauan,

North Maluku Province

Wamsisi Health Center, South Buru District

Maluku Province

Ajangale Health Center, Bone District

South Sulawesi Province

Arut Selatan Health Center, Kowabar District

Central Kalimantan Province

Conclusion

• HITFA is one of the public health intervention, using 12 simple health indicators

with family approach to improve the quality of family heath.

• HITFA is mainly health promotion, prevention and early detection of several

diseases

• HITFA is able to find the subjects who have health problems and where they are

• FHI is a composite of the 12 indictors, indicate the quality of family health, and

aggregately can be used to measure the community health in certain area

(village, sub-district, districts, province & national)

• The application of HITFA is a real time monitoring a good media for advocacy

to the local government at Province, District, Sub-district and Village level.

• HITFA is an evidence approach which is able to improve the community health

has high correlation with PHDI

Terima kasihTrihono

HP: 08118894414

Email: [email protected]

Portal: kanal-kesehatan.com

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