lecture 1 mkm
TRANSCRIPT
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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