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Optimizing the roles of Community Health Nursing in collaborative efforts to achieve
Sustainable Development Goals
Agus Setiawan International Conference on Healthcare Management
Bandung, 17 July 2018
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From MDGs to SDGs
2000 - 2015 2015 - 2030
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SDGs
• 17 goals
• Focuses: People, Planet, Peace, Prosperity, Partnerships (5P)
• Health: • Goal 3
• 13 Targets
• Focus: ensuring healthy life and wellbeing using a life course approach
• Highlights the importance of health promotion, disease prevention, and universal access to health care
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SDGs and Indonesia’s national development agenda
http://www.depkes.go.id/resources/download/info-terkini/rakerkesnas_gel2_2016/Paparan%20Menkes.pdf
Presidential vision and mission Sub-national vision and
mision
National development plan
MoH Strategic Plan
National budget plan
Health program implementation
Local development plan
Sub-national health strategic plan
Local budget plan
Sust
ain
able
Dev
elo
pm
ent
Go
als Su
stainab
le Develo
pm
ent G
oals
Healthy Community Movement (GERMAS)
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Healthy Community Movement (GERMAS)
• A healthy community movement/ campaign
• Promoting healthy life style
• Main objectives: • Reducing the burden of communicable and non-
communicable disease
• Preventing a declining productivity due to health related issue
• Reducing health cost
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GERMAS promoted activities
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Germas – approaches and principals
1. Multisectoral collaboration
2. Focus on community, family and individual health
3. Community empowerment
4. Health system strengthening
5. Life-course approach
6. Universal Health Coverage
7. Health Equity
Community Health Program
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Family-centered health care
• An integrated public and individual health program targeting family/ household, based on family health profile
• Community outreach program implemented at puskesmas through home visit
• Aims to improve family’s access to health care and overall health service coverage, specifically to: • improve household’s access to a
comprehensive health care • contribute to an effort to achieve Minimum
Service Standard, Universal Health Coverage, and Healthy Indonesia
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Puskesmas
Community-based health care Posyandu, PAUD, UKS, Poskestren, Upaya Kes Kerja, Posbindu NCD, etc
10
Family-centered health care
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Family-centered health care
2015
2016
2017
2018
2019
470 Puskesmas
9 Provinces
64 Districts
2926 Puskesmas
34 Provinces
514 DIstricts
4 Puskesmas
4 rovinces
4 Districts
9754 Puskesmas
34 Provinces
514 Districts
5852 Puskesmas
34 Provinces
514 Districts
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SDGs
Germas
Family-centered
health care
Potential roles for
community health
nursing
• Nationally: 49% of health workers are nurses
• Of those working in Puskesmas: • 94% working in puskesmas
at sub-district level • 93% working full-time • 82% provide child health
service • 90% provide care for adults
and older people
(Setiawan, 2017)
PROGRAMS HUMAN RESOURCES
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Forms of community health nursing supports
• Active engagement in public health program
• 1 village 1 nurse program
• Nursing centre – a collaborative program between health service providers and education institution
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Nursing Centre Model FIK UI – Puskesmas Cimanggis, Depok City
Integrated in-facility health service and community
outreach (home visit, public health education), with an
emphasize on health promotion and disease
prevention
Aims: Providing a good quality public health service through integrated education, research, and community services
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Objectives
• Providing community health nursing services, responsive to the public needs and resource availability
• Improving community’s life skill through effective community nursing engagement in health problems solution and better public health outcomes
• Generating knowledge and applying evidence-based practice for community nursing services
• Improving nurses and community health workers’ capacity
• Providing clinical practice supervision for nursing student at the community level
• Strengthening the multisectoral networking and collaboration for better public health
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Main principles
• Open collaboration and communication with health service team, local leaders, religious leaders, and community
• Promoting community active engagement (individual, family, groups, and community) through all process
• Provide advocacy for policy workers towards an optimal services
• Acknowledging each individual’s physical, mental, emotional, socio-cultural, and spritual
• Providing and bringing health service closer to the community
• Creating a healthy working environment
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Program
Health service
Research Education
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Health services
• Community health nursing service provision through in-facility services and community outreach (individual, family, and community nursing care)
• Inter-program collaboration
• Community supervision
• Developing SOP for better services
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Nursing Centre flow or services
Older people General MCH Nutrition Adult Others
Discharge Follow up Nursing Center
Hospital
Family Sub-group/ community
Individu within family
Family care
Independent group
Supporting group
Community out-reached
In-facility services
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Education activities
• Facilitate students and academician clinical practice
• Capacity building for nurses working in Puskesmas
• Develop model for community/ clinical practice supervision
• Develop SOP for community/ clinical practice supervision
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Research activities
• Baseline study
• Facilitate the research activities of FoN UI students and academician, as well as puskesmas and health office
• Facilitate students thesis/ dissertation
• Promote national/ international academic publication
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Challenges
• Inadequate policy supports
• Unavailability standard competency across all levels of service
• Lack of capacity of community nurses
• Lack of capacity in leaderships and agent of change
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Conclusion
• With an emphasize of disparities in health, community based intervention is now being one of global and national health strategy.
• Community nurses play important roles in a collaborative effort to achieve the SDGs and the National Health target.
• Collaboration between education and health service provider can bring benefits for both as well as for the community
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