lecture 1 mkm

7/30/2019 Lecture 1 MKM

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The Rules

- Interruption at any time

- You can ask me, what you want, but

dont expect I can answer all thequestions

- Always respect if we have different

opinion- Mistakes can motivate us for more

learning


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OBJECTIVES :

- Describe of health concept

- Describe about health promotion concept- Describe the determinants factor of health

- Justify that socio-cultural influences the human

health

- Aware of the scope of health promotion anddevelop the strategies

After the end of this subject, the students will beable to :


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WHO : A STATE OF COMPLETE PHYSICAL,

MENTAL AND SOCIAL WELL BEING,AND NOT MERELY THE ABSENCE OF

DISEASE & INFIRMITY

JADI : SEHAT ITU TDK HANYA KONDISI

FISIK, JUGA MENTAL , SOSIAL. DAN

TDK SEMATA-MATA TERBATAS PDKETIADAAN PENYAKIT ATAUPUN

KELESUAN


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UNDANG-UNDANG

KESEHATAN RI( NO. 23 TH. 1992 )

KESEHATAN ADALAH KEADAAN SEJAHTERA DARIBADAN, JIWA & SOSIAL YG MEMUNGKINKAN

SETIAP ORANG HIDUP PRODUKTIF SECARASOSIAL & EKONOMIS


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Persepsi Sehat Sakit dalam 3 DimensiPENILAIAN TENTANG KONDISI KESEHATAN INDIVIDUDIBEDAKAN DALAM 8 GOLONGAN, ANTARA LAIN SBB :( NOTOATMOJO & SARWONO )

NORMALLY WELL BAIK BAIK

PESSIMISTIC BAIK BAIK

SOCIALLY ILL BAIK SAKIT

HYPOCHONDRIACOL BAIK SAKIT

MEDICALLY ILL SAKIT BAIK

MARTYR SAKIT BAIK

OPTIMISTIC SAKIT SAKIT

SERIOUSSLY ILL SAKIT SAKIT

DIMENSI SEHATTINGKAT MEDIS SOSIALSIKOLOGISBAIK

SAKIT

BAIK

SAKIT

BAIK

SAKIT

BAIK

SAKIT


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Th M d l f H lth A d l f th h t


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The Mandala of Health : A model of the human ecosystem

Family

MindBody

Spirit

Psycho-socio-economic

environment

Personalbehaviour

Physicalenvironment

Humanbiology

Lifestyle

Sickcare

system

Work

Human-made environment

Community

Biosphere

Culture


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Biosphere

Society/Nation

Culture/Subculture

Community

Family

Two person

Person

(experience & behaviour)

Nervous system

Organ/Organ system

Tissues

Cells

Organelles

Molecules

Atoms

Subatomic particles

Public Health

Epidemiologi

Biostatistic

Economics/Political Science

Sociology/Anthropology

Psychology

Biomedicine

Physics


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Social structure : The Links between personal health and social causes

culture

Social institutions

Social groups

IndividualHealth

Andillness

health

politics

Law

military

Beliefsystem

race

religion

subcultures

Stateeducation

ethnicity

gender

age

class

economy

family

Massmedia

values


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Group of factors which affect health

DiseaseAnd

disability

3. Clean water, air, housing; otherphysical environmental aspects

4. Social environment support, familystructure

2. Societal values, social norm, economicgrowth, affluence, industrialization

1. Population: size, growth,

change, migration patterns

5. Infectious agents, communicable disease6. Socioeconomic status, education level

7. Individual behaviors and lifestyle

8. Immutable factors : age, gender,ethnicity

9. Health system, service, access


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Economic factors

Intrnational ties to donors, lending institutions, global economy

Social and cultural system

Political system

Administration of agricultural and other programs

Household division of labour in agricultural and other work

Household decision-making about disposal of income inkind and cash

Household food security :

Food production by household

Access to food from outside households

Distribution of food within the household

Food preparation

Childcare practices

Inadequate diets of children

(frequency of feeding, meal composition, seasonal variation,weaning pratices)

Malnutrition

DiarrhoeaLower respiratorytract infection

Childmortality

Other factors

outside thismodel

Natural ecology

Settlement pattern, sanitation, water supply,

animal husbandry practices

Exposure of children to pathogens

Proximate

Tier

Intermediate

Tier

UltimateTier


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As a means of achieving Health for

All, is seen as a process of enablingpeople to increase control over andimprove their health

Ottawa Charter, (Canada, 21 nov 1986)


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Atau:

proses yang memungkinkan orang-oranguntuk mengontrol dan meningkatkankesehatannya

Dengan kata lain: Proses pemberdayaanmasyarakat untuk memelihara,

meningkatkan dan melindungi kesehatannya


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Health Promotion(Ottawa Charter, WHO 1986)

The process of enabling individual and

communities to increase control over

the determinants of healths and therebyimprove their health.

Health promotion represents a

medicating strategy between peoplechoice with social responsibility for

health to create a healthier future.


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VISI PROMKES

Masyarakat TAHU, MAU dan MAMPUmemelihara dan meningkatkan

kesehatannya


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Bahan Kuliah P 400

Misi Promosi Kesehatan

1. Advokat (advocate)

Ditujukan kepada para pengambil keputusan atau

pembuat kebijakan

2. Menjembatani (mediate)

Menjalin kemitraan dengan berbagai program dansektor yang terkait dengan kesehatan

3. Memampukan (enable)

Agar masyarakat mampu memelihara danmeningkatkan kesehatan secara mandiri


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Bahan Kuliah P 400

Strategi Promosi Kesehatan (WHO,1984)

1. Advokasi (advocacy)

Agar pembuat kebijakan mengeluarkan peraturan

yang menguntungkan kesehatan

2. Dukungan Sosial (social support)

Agar kegiatan promosi kesehatan mendapatdukungan dari tokoh masyarakat

3. Pemberdayaan Masyarakat(empowerment)

Agar masyarakat mempunyai kemampuan untukmeningkatkan kesehatannya


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Five Specific Goals for

Health Promoting Action( The Ottawa Charter,1986)

Developing healthy public policy Developing personal skills

Strengthening community action

Creating supportive environments Re-orientating health services


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Strategi Promkes (Piagam Ottawa,1986)

1. Kebijakan Berwawasan Kesehatan

2. Lingkungan yang Mendukung3. Reorientasi Pelayanan Kesehatan

4. Keterampilan Individu

5. Gerakan Masyarakat


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The Ottawa Charter for Health Promotion(WHO CPHA 1986)

DEVELOPPERSONALSKILLS

ENABLEMEDIATE

ADVOCATE

I t ti b t f t ff ti h lth


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Interactions between factors affecting health

Developpersonalskill

BUILD HEALTHYPUBLIC POLICY

EnableMediate

Advocate

Create

supportiveenvironments

Reorient

healthservice

StrengthenCommunity

action


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Sasaran Promosi Kesehatan

Sasaran Primer

Sesuai misi pemberdayaan. Misal : kepalakeluarga, ibu hamil/menyusui, anak sekolah

Sasaran Sekunder

Sesuai misi dukungan sosial. Misal: Tokohmasyarakat, tokoh adat, tokoh agama

Sasaran Tersier

Sesuai misi advokasi. Misal : Pembuat kebijakanmulai dari pusat sampai ke daerah


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SASARAN PROMKES MENURUT TATANAN

Sasaran keluarga Inst.kesehatan Tmpt.kerja sekolah Tp.umum

primer

Individu/aggt kel

yg.berisiko.

mis.:ibu hamil

Pasien

Pengantar/

keluarga pasien

karyawan siswa Pengunjung/

pengguna

jasa

Masyarakat

umum

skunder

Kepala keluarga

Orang tua/

mertua

Kader

TOMA

TOGA

LSM Petugas

kesehatan

Petugas

kesehatan

Kader

kesehatan

Manager

Serikat

buruh

Organisasi

profesi

Guru

Karyawan

BP3

OSIS

Pegawai

Karyawan

Manager

tersier

Kepala Keluarga

Ketua RT/RW

Kepala Desa

Pimpinan

institusi/instansi

Direktur

Pemilikperusahan

Kepala

sekolah

Yayasan

Direksi

Pemilik


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IndividualsGroupsPopulations

Focus

EducationalMotivationalOrganisationalEconomicRegulatoryTechnological

BehaviouralAdaptation

Environmental

Adaptation

BetterHealth

BetterQualityof Life

Strategies Impact Outcomes


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What health promoters need


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What health promoters need

NetworksFor support

HEALTHPROMOTER

Recognition andSupport of

Group members

Contacts

Access toresources

e.g. funding

CredibilityManagementsupport

Communitydevelopment/

group work skills

Openness andcommitment

Understanding ofself-help issues

and practice


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BAHAN DISKUSI KELOMPOK(Kelas dibagi dalam 2 kelompok,waktu

20 menit, kemudian doipresentasikan)

Diskusikan apa yang mendasariperkembangan dari upayapenyuluhan, pendidikan kesehatan,hingga promosi kesehatan!

Kegiatan apa saja yang termasuk

dalam promosi kesehatan?

Strateginya?

Harapannya?


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Case 1

A 55-year-old man is started on treatment for highblood pressure. This was detected`opportunistically` ( by chance, as part ofconsultation for another matter ) and warrants

treatment to reduce his risk of having a stroke.However, high blood pressure produces nosymptoms and will not be considered an illness bythe man unless the implications are explained. Lack

of proper explanation might cause a failure to takethe prescribed medication and a resultant higherthan necessary risk of serious illness


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Case 2

A mother is extremely worried about her young childshigh fever and vomiting, particularly as an outbreak ofmeningitis has received recent media publicity. Onexamination, her doctor is quickly able to attribute the

problem to a simple virus infection, which will resolvespontaneously in a day or two. He tell her simply to givethe child some paracetamol and fluids until the illnesshas gone. This is appropriate advice, but unless it is

accompanied by strong re-assurance and a concernedattitude, with the opportunity to consult again shouldmatters change, a major health issue, that of maternalanxiety, remains un-addressed.


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Compare and contrast between case 1 and

case 2 !

What is the main problem ?Find out the doctors definition and patients

perception of health and illness!

Give your opinion to solve the problemabove!


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Health means different things to different

people. Health is a very complex concept andexamines different ways of viewing health

In particular, the lay view ( of patient ) may bequite different from the medical view ( of

doctors ) and this is a potential source ofmuch confusion in the consultation


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It is unrealistic to expect a patient to come

with a well thought-out definition of health ora typed summary of her own health beliefs. Asprofessionals, though, we must be aware of

some of the implications of the complexitiesand differences

Definitions of health depend on individuals

health beliefs and concept of what is normal,in itself a very complex field.


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1. Health is the absence of disease

2. Health is a state of complete physical, mental,and social well-being ( World HealthOrganization definition )

3. Health designates a process of adaptation tochanging environments, to growing up andageing, to healing when damaged, to suffering,

and to the peaceful expectation of death.Health embraces the future, and thereforeincludes anguish and the inner resources tolive with it ( Ivan Illich )

Definitions of health


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Is she healthy ?

Definition 1 :

Definition 2 :

Definition 3 :

Yes

No

Possibly


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Six Clusters of Competencies forHealth Promotion Practices

(Ewles and Simnett,1995)

Managing, planning, and evaluating

Communicating Educating

Marketing and publicating

Facilitating and networking Influencing policy and practice


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Individuals

Groups

Populations

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