Questions/Answers
Question 1
Please provide a brief summary of the initiative including the problems/challenges it addressed and the solutions that the initiative introduced (300 words maximum)
Indonesia is currently facing an epidemiological transition in health problems, in which infectious diseases haven’t been completely resolved, while the trend of non-communicable diseases continues to increase.
According World Health Organization (WHO), Noncommunicable diseases (NCDs) is the cause of death of 40 million people per year it equals 70% worldwide mortality.
It also becomes a serious problem in Indonesia where non-communicable disease biggest cause death in Indonesia, according to data in 2014 survey Sample Registration System (SRS) minister of health republic indonesia shows 41.590 people deaths in Indonesia, 8.775 people died from stroke, 5.365 people died of heart and blood vessel disease, 2.786 people died of Diabetic Mellitus and complications, 2.204 due to hypertension and complications.
Not only the biggest cause of death, but Non comunicable disease is also the largest cost burden of national health insurance. Until January 2016, the financing of National Health Insurance for non comunicable disease reached Rp. 16.9 trillion. ways to suppress high rates of non-communicable disease and continue to increase.
Beside that, high maternal mortality and child mortality rate in Indonesia,
in 2015 maternal mortality of 307 from 100.000 births and infant mortality of 34 per 1000 Birth, the figure is still very high from the target that must be achieved from Sutainable Development Goals in 2030, where the target to be achieved is 70 per 100.000 live births and Infant mortality 12 per 1.000
Birth of Life, to suppressed mortality rate need to be implemented Birth Planning Program and Prevention Complications.
And another problem, in 2015 The Ministry of Health is implementing Nutrition Status Monitoring , which is a cross sectional study with samples from households with toddlers in Indonesia. from the monitoring found the number of short toddlers in Indonesia reached 29%, According to WHO the prevalence of short toddlers becomes a public health problem
a. What are the overall objectives of the initiative?
Please describe the overall objectives of the initiative (200 words maximum)
serious problem in Indonesia where non-communicable disease biggest cause death in Indonesia, according to data in 2014 survey Sample Registration System (SRS) minister of health republic indonesia shows 41.590 people deaths in Indonesia, 8.775 people died from stroke, 5.365 people died of heart and blood vessel disease, 2.786 people died of Diabetic Mellitus, 2.204 due to hypertension.
Until January 2016, the financing of National Health Insurance for non comunicable disease reached Rp. 16.9 trillion.
in 2015 maternal mortality of 307 from 100.000 births and infant mortality of 34 per 1000 Birth, the figure is still very high from the target that must be achieved from Sutainable Development Goals in 2030, where the target to be achieved is 70 per 100.000 live births and Infant mortality 12 per 1.000.
, in 2015 The Ministry of Health is implementing Nutrition Status Monitoring , which is a cross sectional study with toddlers in Indonesia. from the monitoring found the number of short toddlers in Indonesia reached 29%. and for resolve many problem of health must strengthen preventive programs and health promotion and the implementation of health service strengthening of the provincial government dki Jakarta especially the health department dki Jakarta formed a program “KPLDH” (ketuk pintu layani dengan hati.)
b. How does the initiative fit within the selected category?
Please describe how the initiative is linked to the criteria of the category (200 words maximum)
for resolve many problem of health must strengthen preventive programs and health promotion and the implementation of health service strengthening of the provincial government dki Jakarta especially the health department dki Jakarta formed a program “KPLDH” (ketuk pintu layani dengan hati.)
The principle of "KPLDH" program is as follows:
a. promotive (direct health education.)
b. preventive measures (health checks: blood pressure measurements, weight and height measurements, nutritional status checks, stunting screnes, antenatal care for pregnant women, are conducted to find early disease for immediate treatment.)
c. healthy paradigm (able to encourage people to be independent in guarding of health).
d. KPLDH team conduct cross-sectoral cooperation and stakeholder engagement (KPLDH team with head of sub-district, head of urban village, hamlet, neighborhood, public figure, and society.)
Question 2
The initiative should improve people’s lives, notably by enhancing the contribution of public services to the implementation of the 2030 Agenda for Sustainable Development and the realization of the SDGs
a. Please explain how the initiative improves the delivery of public services (200 words maximum)
KPLDH as agent prevention and promotion of health, will doing :
a. Home visit : KPLDH come to every resident's house perform direct health education, conduct medical check up every people, interviewing fruit and vegetable habits, inquiring about smoking, and exercise.
b. Collecting Data: 3 to 6 months of data for one hemlet, conducted in addition to individual health checks, checking the health of the home environment including source of ventilation, sunlight source, drinking water source, inspecting latrines.
c. collecting data to e-healtcare application : every KPLDH team have one internet tablets or laptop, where the results of physical examination, the disease found in every people and results of health inspection home environment entered into e-healthcare application called “e-pusekesmas”.
d. Data analysis: from the data input e-healthcare application will show the health problems that exist in the community, such as most diseases, the spread of disease.
e. Follow up : after getting health problems from the results of data collection that exist in e-healthcare application , KPLDH team held a deliberation that was attended by head of sub district, head of urban village, hamlet, neighborhood, public figure and society. KPLDH team describes the results of data collection, health problems and environmental problems to produce a joint solution of the health problems solution
Question 3
The initiative must impact positively a group or groups of the population (i.e. children, women, elderly, people with disability, etc) and address a significant issue of public service delivery within the context of a given country or region.
a. Please explain how the initiative has addressed a significant issue related to the delivery of public services (200 words maximum)
to be able to implement and strengthen all preventive programs and health promotion and the implementation of health service strengthening of the provincial government dki Jakarta especially the health department dki Jakarta formed a program “KPLDH” ( Ketuk pintu layani dengan hati)
The KPLDH team consists of 1 midwife, 1 nurse, 1 midwife. Where 1 team of KPLDH is responsible for the health of 1,250 people.
The principle of "KPLDH" program is as follows:
a. promotive (direct health education.)
b. preventive measures (health checks: blood pressure measurements, weight and height measurements, nutritional status checks, stunting screnes, antenatal care for pregnant women, are conducted to find early disease for immediate treatment.)
c. healthy paradigm (able to encourage people to be independent in guarding of health).
d. KPLDH team conduct cross-sectoral cooperation and stakeholder engagement (KPLDH team with head of sub-district, head of urban village, hamlet, neighborhood, public figure, and society.)
b. Please explain how the initiative has impacted positively a group or groups of the population within the context of your country or region (200 words maximum)
positive impact that will be felt by the community with this program is the community can get direct health services that come directly to the house,
because KPLDH wii do :
a. KPLDH team will Monitoring the health status and growth of each family member on screening through (home visit),
b.KPLDH will Provide counseling & motivation for families to always live clean and healthy life behavior (home education).
c. KPLDH will Caring for sick family members is included with complementary therapies, (medicinal plants, example: ginseng, ginger.) (home care).
d. KPLDH will How to foster environmental health including snack foods and the potential for infectious diseases and control of non-communicable diseases in special groups in society (home surveilance);
e. KPLDH will Conducting case referrals in accordance with applicable provisions and procedures as well as the level of severity including Emergency Service.
f.KPLDH will Empowering people to carefully use drugs.
and with this program will increase public knowledge to maintain the health of self, family, and environment.
Question 4
The initiative must present an innovative idea, a distinctively new approach, or a unique policy or approach implemented in order to realize the SDGs in the context of a given country or region.
a. Please explain in which way the initiative is innovative in the context of your country or region (200 words maximum)
a. Home visit : KPLDH come to every resident's house perform direct health education, conduct medical check up every people in family register, interviewing fruit and vegetable habits, inquiring about smoking, drinking, and exercise.
b. Collecting Data: 3 to 6 months of data for one hemlet, conducted in addition to individual health checks, checking the health of the home environment including source of ventilation, sunlight source, drinking water source, inspecting latrines.
c. collecting data into e-healtcare application : every KPLDH team have one internet tablets or laptop, where the results of physical examination, the disease found in every people and results of health inspection home environment entered into e-healthcare application called “e-pusekesmas”.
d. Data analysis: from the data input e-healthcare application will show the health problems that exist in the community, such as most diseases, the spread of disease, and other environmental problems.
e. Follow up : after getting health problems from the results of data collection that exist in e-healthcare application , KPLDH team held a deliberation that was attended by head of sub district, head of urban village, hamlet, neighborhood, public figure and society. KPLDH team describes the results of data collection, health problems and environmental problems to produce a joint solution of the health problems f
Question 4b
b. Please describe if the innovation is original or if it is an adaptation from other contexts (If it is known)? (200 words maximum)
The program is original was launched on May 24, 2015 by public office of health DKI jakarta. expected KPLDH can give healthcare direct to people and citizen, and can collect accurate data, can map health problems, get priority problems, priority problem solving and improvement of various health problems in the province of DKI Jakarta.
Question 4c
c. What resources (i.e. financial, human , material or other resources, etc) were used to implement the initiative? (200 words maximum)
resource financial : financial for "KPLDH" From Regional Budget/ Anggaran Pembelanjaan Daerah (APBD) provience DKI jakarta.
resouce human : human source from proffesional health care as medical doctor, nurse, and midwife.
material :
- laptop or internet tablet for collecting data to application of e-healthcare.
- KPLDH Kit: Stetoskop, blood Tension meter, Penlight , Thermometer , Weighing and measuring instrument height , Respiratory Rate timer , Midwife kit (Antenatal care set).
- Promissory tools : Sticker KPLDH , Leaflets , Brosure .
- Drugs Basic Emergency : Analgesics , Antipyretics , ISDN , Anti Hypertension , Oralite ,Fe Tablet, Vitamin A , Antihistamine.
- Officers must wear : carry identification, Wear uniform (hats, vests, sweatshirts, sneakers).
Question 5
The initiative should be adaptable to other contexts (e.g. other cities, countries or regions). There may already be evidence that it has inspired similar innovations in other public-sector institutions within a given country, region or at the global level.
a. Has the initiative been transferred to other contexts?
Yes
yes, KPLDH program Can adaptable in other region and country,
KPLDH strategy of care approach meaning that the form of service provided covers all age groups and includes the life cycle of a human being, which is guided by:
(1) The ratio of doctors and other health workers ( nurse, midwife) to the population is 1: 1,250 people.
(2) The principal KPLDH :
a. promotive
b. preventive
c. healthy paradigm
d. regional responsibility
e. cooperation
f. family doctor
g. based domicile
h. community independence
i. equity .
Question 6
The initiative should be able to be sustained over a significant period of time.
a. Please describe whether and how the initiative is sustainable (covering the social, economic and environmental aspects) (300 words maximum)
covering social :
a. Early detection rate.
(early detection can accelerate to follow-up a health problem should be referred to health hospital or carried out by way or lifestyle changes. early detection of a disease can reduce morbidity, reduce the risk of disability to reduce the risk of death.
b. Implementation of promotive and preventive programs.
(able to encourage people to be independent in maintaining health, and increasing public knowledge about health.)
c. Screening of the child's growth.
(all children who experience nutritional and growth problems can be resolved, because the child is the future of the nation.)
covering economy :
a. KPLDH team come and give health service to every house, also to poor people.
b. if any poor people and disability KPLDH will pick him with ambulance and referring him to hospital and all for free.
enviromental aspects :
a. KPLDH give health education direct with poster, banner. ( health education given not only individual health care such as measuring blood pressure, but also environmental health such as drinking water sources, home ventilation, and latrines. )
b.from the collected data will look at the problems that exist in a region,from data KPLDH will invite stakeholders and the community to jointly create a solution of the problem.
b. Please describe whether and how the initiative is sustainable in terms of durability in time (300 words maximum)
health and evironmental problem will always be in the community. that's why a prevention and promotion program that goes straight to the people's homes will always be needed.
Question 7
The initiative should have gone through a formal evaluation, showing some evidence of impact on improving people’s lives.
a. Has the initiative been formally evaluated?
Yes
If yes, please describe how the initiative was evaluated? (200 words maximum)
KPLDH program was has been running for more than two years, many people have benefited from KPLDH program, little comparison of data urban village duren sawit, jakarta :
a. people early detection of cervical cancer "IVA TEST"
before KPLDH Program implemented (2015) =33 women.
after KPLDH Program implemented (2016) =67 women.
b. hypertension detection :
before KPLDH program implemented (2015) = 208 people.
after KPLDH program implemented (2016)= 225 people.
c. tuberculosis detection :
before KPLDH program implemented (2015) = 16 people.
after KPLDH program implemented (2017) = 28 People.
from the above comparative data seen increased early detection of the disease. from early detection data will make an earlier solution so the disease will not grow to be more severe
b. Please describe the outcome of the evaluation of the impact of the initiative (200 words maximum)
a. free iva tests at all goverment public clinic in provience DKI jakarta.
b. The early detection rates of high hypertension made the movement of healthy living community. (drink, healthly food and sport based to community).
c. free treatment for TBC.
and beside that KPLDH doing :
a. Routinely KPLDH team will doing antenatal care for pregnant women, decreasing complication for women pregnant and baby to be born.
b. For women who have been sexually active and have not done early detection of cervical cancer, the KPLDH team will give "IVA test" for free in the government community health clinics.
c. For children with nutritional problems and growth, KPLDH will intervene additional nutritional feeding and will monitor the child's growth.
d. In poor and disabled people,KPLDH team will pick up patient by ambulance and refer him to hospital.
KPLDH program implemented throughout the region provience DKI jakarta dan program this will take affect the entire population our provience DKI Jakarta that as much 10 million people ( 10.37 million people).KPLDH
c. Please describe the indicators that were used (200 words maximum)
evaluated program covers 3 indicators for initiative " KPLDH" Program :
1. namely early detection rate,
2. implementation of health promotion and disease prevention program.
3. changes in Clean and Healthy Behavior.
Question 8
The initiative must demonstrate that it has engaged various actors such as from other institutions, civil society, or the private sector, when possible.
a. The 2030 Development Agenda puts emphasis on collaboration, engagement, coordination, partnerships, and inclusion. Please describe what stakeholders were engaged in designing, implementing and evaluating the initiative. Please also highlight their roles and contributions (300 words maximum)
Who were the stakeholders involved in the design of the initiative :
a. Governor of provience DKI jakarta.
b. Head of public health office provience DKI Jakarta.
c. Head division Health Service of public health office provience DKI Jakarta
d. head division human resorce of public health office provience DKI Jakarta.
Who stakeholders involved implementation :
a) Head of public health office provience DKI Jakarta.
b) Head of government health community clinics sub- district.
c) Head of government health community clinics urban village.
d) head of sub-district
Question 9
a. Please describe the key lessons learned, and any view you have on how to further improve the initiative (200 words maximum)
key lessons learned :
a. the health problem is not only the number of patients in the hospital, but the problem begins with the individual, the community and the environment in which he lives.
b. it takes a special program of promotion and prevention that directly come house to house society.
c. .health services for all residents including the poor poeople.
d. early detection to avoid further pain and disability.
e. cross-sectoral cooperation and stakeholders to get community-based solutions.
further improve the initiative :
a. it is expected that all provinces in Indonesia will have programs such as KPLDH (specifically for prevention and promotion) so that health problems can be overcome.
b. can reduce the cost of national insurance for treatment financing of disease.
c. raising public awareness about health.