| 4. In which ways is the initiative creative and innovative?
a. Analysis of the problem
The main problem was the absence of the access for senior citizens to medical specialists to gain more information about degenerative diseases.
b. Concept Creation
RUSELA will be the one-stop promotional and preventive health center for senior citizens who are in need of the access to the specialists.
c. Academic Study
The results of problem analysis and concept creation were then discussed in a Focused Group Discussion consisting of academia and academic-related elements.
d. Bureaucratic Study
The goal was to get the full support from government authorities and non-governmental organizations.
The advocacy activities, to get official approval from local authorities, was conducted by holding official meetings with the followings:
• The City Mayor
• The Local House of Representatives
• Dr. Sardjito Public Hospital of Yogyakarta
f. Establishment Preparation
The process of the physical building establishment was done by coordinating with the officials from DBGAD.
g. Facilities and Infrastructure Setting
The process was fully supported by the Local Office of Public Health of Yogyakarta City.
h. Manpower Provision
The human resources for the initiative are the qualified and well-trained health personnel, supported by the Local Office of Public Health of Yogyakarta City.
i. Regulatory Issues
The local regulations were then issued to back-up the legal entity of the program realization.
j. Cooperation Agreement Documentation
The agreement was signed on the cooperation of civil servants delegated to the programs and the utilized access of training for the health personnel.
k. Health Personnel Training
The goal was to prepare all the health personnel to fully comprehend the pre-condition and the preferred approaches to deal with senior citizens. The process is supported by the Dr. Sardjito Public Hospital of Yogyakarta City from Internist Division, particularly from Geriatric Sub-Division.
The goal was to improve the knowledge and the awareness of community about the program’s existence and beneficial advantages.
| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
a. Academic Elements
• Faculty of Medicine of Gadjah Mada University;
• Faculty of Engineering, particularly The Architectural Engineering Major, of Gadjah Mada University
b. Governmental Elements
• Local Office of Social Affairs, Employment, and Transmigration;
• Office of Local Building and Assets
• Office of Local Tax and Financial Management
• Local Planning and Development Agency
• Local Employment Agency
• Office of Community and Women Empowerment
• Office of Local Revenue and Cooperation
• Division of Legal and Organization Adminstration
c. Non-Governmental Organization Elements
• Members Family welfare Education Program (PKK)
• Local Commission of Senior Citizens
d. Public Elements
This element is represented by the Local House of Representatives and Community Leaders
| 6. How was the strategy implemented and what resources were mobilized?
The resources include;
a. Human Resources in the planning/development process, including Bachelors of Law, Bachelors of Architecture, Specialists (Internists), Bachelors of Public Health, Bachelors of Government Science, Geriatric Sub-Specialists;
b. Human resources in service delivery process, including Geriatric Sub-Specialists, Nurses, Nutritionists, Instructors of Elderly Exercise, Administration Officers;
c. Technical Resources, including the physical building of 200 m2 width and other supporting facilities;
d. Financial Resources, including all funding from Local Budget of Yogyakarta City through DBGAD, Local Office of Public Health, and Public Health Center of Umbulharjo I.
RUSELA initiative’s mobilization is done through:
a. Budget Mobilization
b. Manpower Mobilization.
c. Supporting Facilities Mobilization
| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
a. The availability of special access for the elderly to consult affordable specialists;
b. The availability of consultation centers and promotional health efforts center for senior citizens in Yogyakarta City;
c. The straightforward and prompt access to specialists for senior citizens.
RUSELA cuts down the lengthy procedure of getting specialists (internists) service from the common 2 days of waiting to only few minutes. Senior citizens only need to come to RUSELA, register themselves, and meet the specialists.
| 8. What were the most successful outputs and why was the initiative effective?
Monitoring activities are done by conducting the followings:
a. Holding regular coordination meetings on the RUSELA operational activities;
b. Technical Mentoring to RUSELA
c. Complaint Center (UPIK) Opening through the official number of 08122780001;
d. Community Satisfaction Survey Implementation in 2014;
The result shows that more than 97% respondents are satisfied with the program.
e. USELA Progress Monitoring
It is expected that by the end of 2015, RUSELA will escalate the excellence rate to B-grade and continues to strive for A-grade in 2017.
Evaluation activities are done by conducting the followings:
a. Short-Term Evaluation in every 2 years
1. Number of Visits Escalation
2. Partnership Collaboration Evaluation
b. Mid-Term Evaluation in every 5 years
1. Community Survey on healthy life-style of the senior citizens
2. The Laboratory Attendance for Health Checking Activities by the Senior Citizen
c. Long-Term Evaluation in every 8 Years
1. The decrease in the number of degenerative diseases cases among senior citizens
2. The decrease in the rate of death caused by degenerative diseases, particularly among senior citizens.
| 9. What were the main obstacles encountered and how were they overcome?
a. Constraints in making the initiative.
1. The lack of understanding in determining the program of health promotional and preventive services for the senior citizens; the problem was solved by applying the solutions of:
• Describing the health paradigm;
• Explaining the health issues in Yogyakarta City;
• Explaining the main purpose of the initiative that is to enable the senior citizens to remain healthy and productive.
2. The limited numbers of health personnel in Yogyakarta; the problem was solved by applying the solutions of hiring technical manpower (contract-based)
b. Constraints in the implementation of RUSELA:
1. Most people are not aware of the existence of RUSELA; the problem was solved by applying the solutions of optimizing RUSELA’s existence at village level;
2. The number of visitors is less than the quota; the problem was solved by applying the solutions of opening the limited phone registration.