Questions/Answers

The objectives of this program was to improve Clean and Healthy Behavior (PHBS), increase the number of healthy houses, and increase healthy family indicators in Makassar City, especially for 7520 vulnerable aisles / alleys in Makassar through the LONGSET (Lorong Sehat) program. The Clean and Healthy Behavior Target (PHBS) that is to be achieved was 67.50% in 2017. Data on healthy families proclaimed by the central government was Healthy data of more than 50% in 2017 while for healthy homes it increased by more than 90% in 2017. The total area of Makassar City is approximately 175.77 Km2 of land and includes 12 islands in the Makassar Strait plus an area of approximately 100 Km² with a population of 1,469,601 (based on the 2017 Central Bureau of Statistics). PHBS rate of 58.12% in 2014, for healthy homes there were 77.86% in 2014, and healthy family indicators were 45.04% in 2015. Efforts to control this achievement through the development of the LONGSET program were carried out through Health Center (Puskesmas) in the City of Makassar, Socialization, Education, Advocacy. Community participation (30% female role), besides that Social Marketing and Integrated Quality are also carried out continuously.

This program will not succeed without community participation. The community is involved in the planning stage, through a "Tudang Sipulung" where the activity is part of the Makassar City customs. In Tudang Sipulung, the community discussed issues in the aisle such as sanitation, PHBS, and healthy homes. The community is involved in the implementation of development, such as building smoking stops, hand washing facilities, and making pots. Furthermore, the community is involved in evaluating the implementation of activities so that this program can run effectively. Mobilize resources through an aisle social gathering are used for aisle development activities.

To reach the SDGs target, the Makassar City Health Office has a roadmap for controlling PHBS, Healthy Houses and Healthy Families through the Regional Medium Term Development Plan (RPJMD) of the 2014-2019 period. The morbidity rate in LONGSET declined in 2019. The government builds partnerships to jointly realize the objectives of the LONGSET. This initiative relates to the objectives of the SDGs at goal 11.1 namely Cities and sustainable settlements. If the community is involved in a participatory manner, development in the aisle is maximized, the community is more responsible and they share resources to solve problems in the aisles.

The LONGSET program implements basic health data collection through community empowerment in Makassar City. This is because more than 80% of Makassar residents live in aisle which makes it difficult for them to reach basic health data and services. By this, the LONGSET initiative empowered the community by providing training to assist Puskesmas in data collection and health services where this intervention was carried out in stages. 138 LONGSET was created in 2017. This initiative has a positive impact on the sick community groups, pregnant women, infants under five, and the elderly. The direct impact obtained through community empowerment is a rapid response to handling the health aspects of citizens through coordinating Puskesmas with residents who have attended training.

This program is implemented through: Establishment of Isle Health Cadres (KKL). The KKL is in charge of helping the surrounding community. The KKL members were chosen by the local community with the established requirements; Education, Socialization and Advocacy. Promotion of Communication, Information and Technology is distributed in all Puskesmas Sub-Puskesmas (Pustu) and KKL; Social Marketing. All Puskesmas, Pustu and KKL made posters as a means of education specifically and posted at each health service facility; Integrated Quality Assurance. KKLs were trained and controlled to keep the program sustainable.

Initially the application of LONGSET was limited to one of these aisles, but because this program succeeded in increasing the coverage of the data, it was adopted as the LONGSET program in Makassar City. The program, among others, succeeded in increasing the PHBS 67.07% coverage in 2016, Healthy Family 48% in 2016 and Healthy Houses 91.45% in 2016. The LONGSET was initially carried out in areas that were less touched by health workers. Some activities were conducted such as forming KKL to create nameplate boards and conducting quality assurance programs through regular supervision and implementing education, information and advocacy.

This LONGSET program was very successful in increasing the data coverage, it was adopted and implemented in 138 aisles and increases every year. The program has succeeded in increasing the PHBS 68.16% coverage in 2017, Healthy Family 53.11% in 2017 and Healthy Houses 91.76% in 2017. In 2016, the Ministry of Empowerment of State Civil and Bureaucratic Reforms awarded the Top 40 Public Service to LONGSET Makassar City. Around 27 cities/regencies and provinces have visited Makassar City to do benchmarking program. The program is effective to improving health data in the region, simple and easy to apply in other regions.

Human resources come from 46 Puskesmas of Makassar City. In the first year of implementation, LONGSET runs by using funding of other programs such as PHBS socialization. Then in 2015, this program was included in the budgeting of activities in Makassar Health Office Budget. The budget was Rp. 260,000,200 (US$ 18,572). In 2016 total budget increased and focused on LONGSET activities of Rp. 400,118,000 (US$ 28,571), in 2017 LONGSET activities were budgeted Rp. 610,517,800 (US$ 43,608), and in 2018 the budget increased by Rp 711,457,000 (US$ 50, 818). The initiative was very beneficial for the community empowering and involving women.

From 2015 to 2018, the number of healthy aisles has continued and currently has reached 138 healthy aisles. Healthy aisles are formed by Puskesmas with community participation. Furthermore, healthy aisles are managed by the community through a village government decree. To ensure the sustainability of this initiative, the city government made a mayor regulation (Perwali) to appeal to all Regional Device Organizations (OPD) at all levels including the Head of Sub-District and Village by involving cadres and communities including the role of women to play an active role in the healthy aisle activities. With this regulation, it is expected that the healthy aisles program will continue even the leader or mayor has been changed. Participation of the community, religious leaders and community leaders in a participatory manner is a special form of interaction and communication relating to the distribution of authority, responsibility and benefits to ensure the sustainability of the program. Providing rewards as a motivation for the staff responsible for Healthy Hallway is also an effective way. This award is given on National Health Day (November).

Yes

The process of implementing and controlling the LONGSET program were carried out periodically. It is believed that the success of the initiative will be largely determined by how well the implementers of the activities in the field, able to continuously carry out, develop, monitor and evaluate the programs. The supervision system was carried out very tightly where health workers in the field must continue to provide reports to the head of the work unit in the Puskesmas. Furthermore, the Health Office and other OPDs also visited directly to the field to provide an assessment of the implementation of healthy aisles.

The LONGSET Initiative uses 10 indicators of PHBS (Clean and Healthy Life Behavior) and 12 indicators of Healthy Family launched by the Ministry of Health of the Republic of Indonesia. The use of community empowerment in every aisle is very helpful in carrying out basic data collection, such as PHBS (Clean and Healthy Life Behavior), Healthy Family, Baduta Stickers (if there are toddlers under 2 years), P4K Stickers (if there are those who are pregnant), healthy home cards, larva-free stickers), infectious disease-free stickers, clean, green environment and changes in health behavior for every family member.

The LONGSET Initiative is one of the innovations in solving health problems in Makassar City. Changes in community behavior can be seen through the achievement of Clean and Healthy Behavior Data (PHBS) conducted after the launch of LONGSET of 58.12% in 2014 and after intervention to 68.16% in 2017. Data collection on healthy families proclaimed by the central government was increasing from 45.04% in 2015 to 53.11% in 2017, while Healthy Houses data from 77.86% in 2014 became 91.76% in 2017.

The LONGSET program is implemented through the collaboration of Private Companies, NGOs, Health Offices, Health center and local community participation. The private sector through its CSR funding supported capacity building for the implementation of the LONGSET program, trained every health worker, strengthened the database system, certified environmental health workers and conducted field visits. This partnership system has been running since 2015. To improve program integration, a coordination meeting with health center staff is conducted every month to evaluate the program involving the Head of the Health Office, and the Public Health Division. To increase community participation, local residents were involved in the decision-making process, including for the KKL. Local residents recommend candidates who will be trained as KKL and given training for 2 days by local NGOs. KKL are trained on how to carry out simple health data collection, good communication methods to the community, how to report data and provide education and health promotion to the surrounding community. The program taken by the Health Office makes this program very innovative and solving problems. The Healthy Auction Program LONGSET is focused on overcoming the problem of data barrier in the community by empowering the community in every aisle.

This program has shown significant results in increasing access to health services for vulnerable populations. It clearly provided a solution for handling clean, green and beautiful environments and dealing with health problems in the alleyways area. We have also developed a number of methods known as the low-cost LONGSET system using existing local resources. This system can be applied by the Auction Health Cadre and other health workers in order to provide more equitable services to the marginalized population groups. In addition, this program also demonstrates how private companies, NGOs, the Health Office and local communities can overcome health problems.