“implementation on public health intervention for …...“implementation on public health...
TRANSCRIPT
“Implementation on Public Health Intervention for Increasing Quality of Family Health”
Trihono, Eva Sulistiowati, Suparmi, Aditia Putri
The 4th International Symposium on Health Research and
14th National Congress of Indonesian Public Health Association
Bali, 28 November 2019
Background
President’s Vision & Mission:
3 Vision & 9 Mission
Achieved through 4 programs
Health, Education, Social & Workforce
Healthy Indonesia Program
Healthy paradigm:
Healthy Indonesia Through
Family Approach (HITFA)
Strengthening Health Facilities
(Hospitals, Health Centers, etc.)
Individual health services:
National Health Insurance
Healthy Indonesia Program
Using 3 pillars:
1. Healthy paradigm community health services using family
approach (Healthy Indonesia Through Family Approach – HITFA);
cover all families in the responsibility area of Health Center
(Puskesmas) to improve family health using 12 health indicators
2. Universal Health Coverage through Jaminan Kesehatan Nasional
(National Health Insurance - NHI) individual health services the
poor people premium paid by Government.
3. Strengthening the health facilities
• HITFA use 12 health indicators, selected from main health problem
composite indicator: FHI (Family Health Index)3
Indicators of Family Health
A MCH & Nutrition:
1 Family Planning
2 Skilled birth attendance at health facilities
3 Complete Immunization for the baby
4 Exclusive Breast Feeding for the baby
5 Growth monitoring of under five
B Communicable & Non-Comunicable Disease Control:
6 TB patient treated adequately
7 Hypertension patient treated adequately
8 Severe mental disorder patient treated adequately
C Healthy lifestyle and Environmental Health:
9 Not smoking behavior
10 Clean water access for all family members
11 Good sanitarian access for all family members
12 Social health insurance for all family members
Healthy family indicated by FHI (Family Health Index): a composite index of 12 health indicators
2015
2016
20172018
2019
470 Health Centers,9 Prov, 64 Districts
2926 Health Centers,34 Prov, 514 Districts
4 Health Centers4 Prov, 4 Districts
9754 Health Centers,34 Prov, 514 Districts
5852 Health Centers,34 Prov, 514 Districts
5
Roadmap of Healthy Indonesia Through Family Approach (HITFA)
Healthy Indonesia Through Family Approach
Health Center
Family
Community Based Health Activities: Posyandu, Posbindu PTM, Posmaldes, Poskestren, UKS/M (Usia Sekolah), etc
Family FamilyFamily Family6
The Implementation of Family Approach• Health Center staff should actively do home visit to all families who live
in the responsible area
• Mainly giving health promotion, health prevention and early detection
• Collect family health data (minimal 12 indicators of family health)
collected and input to the healthy family application:
https://keluargasehat.kemkes.go.id/ directly registered at Central
Data & Information, Sec. Gen. MOH
• All Health Office (Central, Province and District) can open the
application and each Health Center has access to the raw data
• This application gives real time monitoring of the progress of Healthy
Indonesia through Family Approach (HITFA)
Proporsion of Stunting Underfive by province, 2013-2018
8
27.5
37.2
51.7
17.7
30.8
42.6
0
10
20
30
40
50
60
DK
I Jakart
a
DI Y
ogya
kart
a
Bali
Kepula
ua
n R
iau
Bangka B
elit
ung
Sula
wesi U
tara
Bante
n
Kalim
anta
n U
tara
Lam
pung
Ria
u
Papua B
ara
t
Bengkulu
Sula
wesi T
enggara
Kalim
anta
n T
imur
Sum
ate
ra B
ara
t
Jam
bi
IND
ON
ES
IA
Jaw
a B
ara
t
Jaw
a T
engah
Malu
ku U
tara
Sum
ate
ra S
ela
tan
Sum
ate
ra U
tara
Sula
wesi T
eng
ah
Goro
nta
lo
Jaw
a T
imur
Pap
ua
Kalim
an
tan S
ela
tan
Kalim
anta
n B
ara
t
Nusa T
engga
ra B
ara
t
Malu
ku
Kalim
an
tan T
eng
ah
Sula
wesi S
ela
tan
Aceh
Sula
wesi B
ara
t
Nusa T
engga
ra T
imur
2013 2018
Trend of under-five growth monitoring through
Integrated Health Post in the last 6 months 2007-2013
45.4
29.1
25.5
44.6
21.1
34.3
0.0
10.0
20.0
30.0
40.0
50.0
60.0
≥ 4 kali 1 – 3 kali Tidak Pernah
2007 2013
> 4 times 1 – 3 times Never
Prevalence of Hypertension based on diagnose, diagnose or treatment and measurement for >18 years, 2013 dan 2018
Gap 25.7% or 75% among
hypertension people:
They don’t know yet if they
have hypertension
2013
2018
Determinant factors of Non-Communicable Diseases
NHIHITFA
Healthy
Lifestyle
Movement
Impact of HITFA to Community Health
Correlation of HDI – PHDI - FHI
Economy
Education
Health
HDI (Human Developent Index)
Life Expectancy at birth (LE)
PHDI (Public Health Development Index): a composite index formulated by 30 main health indicators, based on National Health Survey
The correlation between HDI (Human Development Index)
2017 and PHDI (Public Health Development Index) 2018
r = 0.803
R2 = 0.645
p-value = 0.000
Correlation between Family Health Index (June 2019) and
Public Health Development Index (2018)
r = 0.648
R2 = 0.42
p-value = 0.000
Impact of HITFA to NHI (National Health Insurance)
• HITFA strengthen the community health efforts, mainly promotive &
preventive action decreasing the diseases prevalence
• HITFA strengthen the early diagnose and prompt treatment
decreasing the severity of NCD (Non-Communicable Diseases)
decreasing claim to the NHI
• HITFA facilitate the healthy lifestyle controlling the risk factors
decreasing the prevalence of the diseases decreasing budget
claim to the NHI
• HITFA improve the environment health decreasing the
communicable diseases decreasing claim to the NHI
16
Case distribution (#) Claim (IDR billion)
Case distribution & budget claim inpatient care, 2014
FHI as an advocacy tool
• We have PHDI for comparing the achievement of health development
among provinces and districts, but this index based on National Health
Survey which done every 5 years.
• HITFA composite indicator: FHI (Family Health Index)
• Based on FHI, we can rank not only among provinces and districts, but
also among sub-districts even among villages
• This rank can be made every year or if needed it’s a real time rank
• Now all District Health Offices can use FHI sub-district rank for
motivating Health Centers
• All Health Center can use FHI village rank to motivate Villages
increasing budget for health. 18
Progress of Home Visit Coverage by Provinces
65.9%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%P
apu
a
Pap
ua
Bar
at
DK
I
Kal
iman
tan
Tim
ur
NTT
Mal
uku
Sula
wes
i Uta
ra
Jaw
a B
arat
Kal
iman
tan
Ten
gah
Sum
ate
ra U
tara
Bal
i
Ban
ten
Kal
iman
tan
Bar
at
Jam
bi
Go
ron
talo
Sum
ater
a S
elat
an
Ace
h
Jaw
a Ti
mu
r
Kep
ula
uan
Ria
u
Kal
iman
tan
Uta
ra
DIY
Sula
wes
i Sel
atan
NTB
Sum
ate
ra B
arat
Mal
uku
Uta
ra
Sula
wes
i Ten
gah
Kal
iman
tan
Se
lata
n
Jaw
a Te
nga
h
Sula
wes
i Ten
ggar
a
Ban
gka
Bel
itu
ng
Ria
u
Lam
pu
ng
Ben
gku
lu
Sula
wes
i Bar
at
Ind
on
esi
a
Desember 2018 Oktober 2019
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
DESEMBER 2018 OKTOBER 2019
Progress of FHI by provinces,
Progress of FHI & 12 health indicators, National, Des 2019
24.39%
36.07%
38.14%
43.55%
50.22%
51.77%
80.72%
86.69%
87.75%
88.35%
91.60%
94.08%
17.90%
Penderita hipertensi yang berobat teratur
Penderita TB Paru yang berobat sesuai standar
Penderita gangguan jiwa berat, diobati dan tidak…
Anggota keluarga tidak ada yang merokok *)
Keluarga sudah menjadi anggota JKN
Keluarga mengikuti program KB *)
Bayi mendapatkan ASI Eksklusif
Persalinan Ibu di fasilitas pelayanan kesehatan
Pertumbuhan Balita dipantau
Keluarga memiliki akses/menggunakan jamban keluarga
Bayi mendapatkan imunisasi dasar lengkap *)
Keluarga memiliki akses/menggunakan sarana air bersih
IKS (Indeks Keluarga Sehat)
4 years HITFA Result?
2015 2016 2017 2018 2019
Design &
field try out
Implemented in
9 Prov ,64 Districts
Implemented in 514 Districts
30% Health Centers
Implemented in 514 Districts
60% Health Centers
Implemented in 514 Districts
100% Health Centers
• The impact of HITFA more clear at
Health Center
• At upper level, increase of FHI &
positive changes of family health
status in Districts level
Analysis 1:
Sept 18 – Feb 19
Analysis 2:
Sept 18 – Junie19
Trend Analysis of Family Health Status
• Analysis on family health status: the positive change if the proportion
of healthy family increase and unhealthy family decrease in provinces
or districts
• Trend analysis done to compare the family health status in 2 period:
– From September 2018 February 2019
– From September 2018 June 2019
• The result is showing the changes in 4 months (February – June 2019)
Proportion of healthy, pre-healthy and unhealthy family,
Indonesia September 2018 – February 2019
16.71%
65.78%
17.51%17.28%
65.49%
17.23%
0%
10%
20%
30%
40%
50%
60%
70%
Sehat Pra sehat Tidak sehat
Sep-18 Feb-19
Proportion of family health status
September 2018 – February 2019 by provincesProvince
September 2018 February 2019Change
Healthy Pre-Healthy Unhealthy Healthy Pre-Healthy UnhealthyBANTEN 14.0% 63.7% 22.3% 15.3% 64.1% 21.2% 2.4%
SULAWESI UTARA 18.5% 64.3% 17.2% 19.6% 65.1% 16.0% 2.2%
JAWA TIMUR 16.7% 66.9% 16.4% 18.2% 66.5% 16.0% 1.9%
KEP. RIAU 23.6% 65.8% 10.6% 25.0% 65.2% 10.2% 1.8%
BALI 33.0% 61.6% 5.5% 34.2% 61.1% 5.0% 1.7%
DI. YOGYAKARTA 28.6% 64.8% 6.6% 29.8% 64.6% 6.2% 1.6%
SUMATERA BARAT 13.2% 61.0% 25.8% 13.9% 61.1% 25.0% 1.5%
SULAWESI BARAT 14.3% 62.9% 22.8% 15.0% 63.6% 22.1% 1.4%
NTT 11.7% 66.9% 21.3% 12.4% 67.4% 20.9% 1.1%
GORONTALO 16.5% 67.2% 16.3% 16.8% 68.0% 15.7% 1.0%
ACEH 25.6% 61.9% 12.4% 26.1% 61.9% 12.1% 0.8%
KEP. BANGKA BELITUNG 19.6% 67.3% 13.1% 20.6% 66.8% 13.3% 0.8%
SUMATERA UTARA 12.9% 67.2% 20.0% 13.7% 66.2% 20.1% 0.7%
JAWA TENGAH 19.2% 66.7% 14.2% 19.5% 67.2% 13.9% 0.7%
JAWA BARAT 14.8% 66.2% 19.0% 15.4% 66.3% 18.9% 0.6%
KALIMANTAN TENGAH 16.3% 60.0% 23.7% 16.6% 60.4% 23.4% 0.6%
PAPUA BARAT 13.1% 62.5% 24.4% 13.0% 63.4% 24.0% 0.3%
SULAWESI SELATAN 20.5% 66.4% 13.1% 20.7% 66.9% 13.0% 0.3%
INDONESIA 16.7% 65.8% 17.5% 17.3% 65.8% 17.4% 0.7%
Proportion of family health status
September 2018 – February 2019 by provinces
ProvinceSeptember 2018 February 2019
ChangeHealthy Pre-Healthy Unhealthy Healthy Pre-Healthy Unhealthy
LAMPUNG 12.3% 69.6% 18.2% 12.4% 70.1% 18.3% -0.1%
DKI JAKARTA 34.1% 61.6% 4.3% 34.2% 62.2% 4.5% -0.1%
PAPUA 14.2% 66.6% 19.1% 14.6% 66.0% 19.6% -0.1%
KALIMANTAN SELATAN 17.7% 62.9% 19.4% 17.9% 62.9% 19.7% -0.2%
SULAWESI TENGAH 15.1% 65.6% 19.4% 15.1% 65.8% 19.6% -0.2%
SUMATERA SELATAN 16.7% 63.7% 19.6% 16.6% 63.6% 19.8% -0.3%
KALIMANTAN TIMUR 23.5% 63.1% 13.4% 23.3% 63.4% 13.7% -0.5%
RIAU 12.6% 65.0% 22.5% 12.5% 64.7% 22.9% -0.5%
JAMBI 13.0% 61.9% 25.1% 13.1% 60.9% 26.0% -0.8%
BENGKULU 16.3% 67.5% 16.2% 16.3% 67.2% 17.2% -1.0%
MALUKU 8.5% 60.1% 31.3% 8.4% 59.8% 32.3% -1.0%
NTB 14.5% 69.4% 16.0% 14.0% 69.7% 16.6% -1.1%
MALUKU UTARA 13.4% 67.4% 19.2% 13.2% 67.2% 20.1% -1.2%
KALIMANTAN UTARA 21.3% 61.8% 16.9% 20.7% 62.5% 17.5% -1.2%
KALIMANTAN BARAT 12.8% 59.4% 27.8% 12.1% 59.4% 29.1% -2.0%
SULAWESI TENGGARA 14.1% 67.9% 18.0% 13.4% 67.4% 19.8% -2.6%
INDONESIA 16.7% 65.8% 17.5% 17.3% 65.8% 17.4% 0.7%
Progress: 18 Provinces positive, 16 provinces negative
Sumber: Aplikasi Keluarga Sehat, Juni 2019 dan Juli 2019 ; Jumlah KK sumber dari e-monev STBM
Coverage of home visit by provinces, June 2019
Indonesia: 56,88%
28Sumber: Dashboard Indikator Keluarga Sehat, Juli 2019
Indonesia 0,1818% families categorized as healthy family
Family Health Index (FHI) by provinces, June 2019
The achievement of 12 family health indicators: National
21.0%
24.2%
38.2%
44.4%
48.4%
48.4%
82.6%
88.0%
88.7%
89.3%
94.7%
95.0%
Severe mental disorder patient treated adequately
Hypertension patient treated adequately
TB patient treated adequately
Not smoking behavior for all family members
Family planning
Social Health Insurance for all family members
Exclusive breast feeding for the baby
Under-five growth mnitoring
Skilled birth attencance at health facilities
Good sanitation access for all family members
Clean water access for all family members
Complete immunization for the baby
FHI rank among Districts in NTB Province
0.094
0.117
0.12
0.134
0.166
0.172
0.172
0.183
0.245
0.254
0.147
BIMA
LOMBOK TIMUR
LOMBOK TENGAH
SUMBAWA
KOTA BIMA
DOMPU
LOMBOK BARAT
KOTA MATARAM
LOMBOK UTARA
SUMBAWA BARAT
PROV. NTB
Coverage & proportion of family health status
September 2018 – June 2019 by provinces
ProvinceCoverage home visit Healthy Pre-healthy Unhealthy
Total Rank
Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19
SULAWESI UTARA 11.72% 30.74% 18.55% 20.64% 64.27% 64.77% 17.19% 14.59% 4.69% 1
BALI 21.42% 51.30% 32.98% 35.62% 61.56% 59.81% 5.46% 4.57% 3.52% 2
DI YOGYAKARTA 20.20% 61.95% 28.59% 31.05% 64.82% 63.16% 6.59% 5.79% 3.25% 3
MALUKU 9.33% 35.83% 8.52% 10.06% 60.13% 60.28% 31.35% 29.66% 3.23% 4
BANTEN 27.02% 54.80% 14.01% 15.76% 63.65% 63.38% 22.34% 20.86% 3.23% 5
SUMATERA BARAT 36.52% 65.82% 13.24% 14.45% 61.00% 61.36% 25.76% 24.19% 2.79% 6
KEPULAUAN RIAU 18.56% 49.77% 23.64% 25.46% 65.76% 64.32% 10.60% 10.22% 2.21% 7
KALIMANTAN UTARA 27.88% 54.02% 21.30% 22.38% 61.81% 61.79% 16.89% 15.83% 2.15% 8
SUMATERA SELATAN 22.52% 55.24% 16.71% 17.61% 63.69% 63.85% 19.60% 18.54% 1.96% 9
JAWA TIMUR 24.53% 57.50% 16.68% 17.85% 66.91% 66.30% 16.42% 15.85% 1.75% 10
SULAWESI BARAT 61.17% 84.54% 14.31% 15.08% 62.90% 63.11% 22.79% 21.82% 1.74% 11
PAPUA BARAT 7.46% 16.74% 13.06% 13.29% 62.53% 63.53% 24.41% 23.18% 1.46% 12
GORONTALO 30.75% 57.60% 16.50% 16.91% 67.15% 67.70% 16.34% 15.39% 1.36% 13
SUMATERA UTARA 31.08% 54.03% 12.87% 14.07% 67.15% 65.91% 19.98% 20.02% 1.16% 14
JAWA TENGAH 29.81% 64.77% 19.16% 19.62% 66.67% 66.72% 14.16% 13.65% 0.97% 15
JAWA BARAT 17.41% 46.18% 14.84% 15.35% 66.16% 65.90% 19.00% 18.75% 0.77% 16
ACEH 25.04% 55.25% 25.61% 26.02% 61.94% 61.85% 12.44% 12.13% 0.71% 17
INDONESIA 53.93% 16.71% 17.51% 65.78% 65.45% 17.51% 17.04% 1.25%
Coverage & proportion of family health status
September 2018 – June 2019 by provinces
ProvinceCoverage home visit Healthy Pre-healthy Unhealthy
Total Rank
Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19
LAMPUNG 29.56% 71.59% 12.28% 12.66% 69.57% 69.51% 18.15% 17.83% 0.70% 18
SULAWESI SELATAN 36.52% 65.09% 20.52% 20.77% 66.38% 66.36% 13.10% 12.87% 0.48% 19
BANGKA BELITUNG 46.66% 70.34% 19.61% 20.63% 67.34% 65.75% 13.05% 13.62% 0.46% 20
SULAWESI TENGAH 39.59% 67.17% 15.05% 15.41% 65.56% 65.23% 19.38% 19.35% 0.39% 21
JAMBI 25.15% 58.17% 13.05% 13.58% 61.89% 60.80% 25.06% 25.61% -0.02% 22
KALIMANTAN TENGAH 22.15% 47.02% 16.27% 16.69% 60.00% 59.02% 23.73% 24.29% -0.15% 23
KALIMANTAN SELATAN 29.85% 60.89% 17.74% 18.04% 62.91% 62.10% 19.35% 19.86% -0.20% 24
DKI JAKARTA 2.17% 2.27% 34.11% 33.84% 61.57% 61.75% 4.32% 4.41% -0.36% 25
RIAU 50.74% 77.78% 12.56% 12.59% 64.98% 64.52% 22.45% 22.89% -0.40% 26
NUSA TENGGARA TIMUR 7.32% 27.84% 11.74% 11.65% 66.91% 66.62% 21.35% 21.73% -0.47% 27
KALIMANTAN TIMUR 11.70% 35.17% 23.51% 23.09% 63.07% 63.19% 13.41% 13.72% -0.73% 28
PAPUA 3.91% 14.91% 14.24% 14.41% 66.61% 65.41% 19.15% 20.18% -0.86% 29
BENGKULU 39.27% 82.60% 16.32% 16.24% 67.46% 66.68% 16.22% 17.09% -0.94% 30
MALUKU UTARA 35.15% 66.03% 13.44% 12.96% 67.36% 66.80% 19.20% 20.24% -1.52% 31
NUSA TENGGARA BARAT 25.98% 57.91% 14.52% 13.64% 69.45% 69.35% 16.03% 17.02% -1.87% 32
SULAWESI TENGGARA 22.77% 66.08% 14.14% 13.40% 67.88% 66.87% 17.98% 19.73% -2.49% 33
KALIMANTAN BARAT 18.99% 49.58% 12.80% 11.74% 59.39% 58.83% 27.81% 29.44% -2.69% 34
INDONESIA 53.93% 16.71% 17.51% 65.78% 65.45% 17.51% 17.04% 1.25%
Progress: 21 Provinces positive, 13 provinces negative
Progress of coverage and family health status change
until February 2019 and until June 2019
Jumlah (%)
Analysis of province & district change Sept 2018 - Feb 2019
Districts with coverage of home visit >50% 54 10,5%
Districts with positive change 27 50.0%
Provinces with positive change 18 52.9%
Analysis of province & district change Sept 2018 - June 2019
Districts with coverage of home visit >50% 297 57,2%
Districts with positive change 185 62.3%
Provinces with positive change 23 67.6%
The big 15 of Districts based on the highest change: Sept 18 – Juni 19
KABUPATEN/KOTACAKUPAN SEHAT PRASEHAT TIDAK SEHAT
DELTA RANKJun-19 Sep-18 Jun-19 Sep-18 Jun-19 Sep-18 Jun-19
KEPULAUAN ANAMBAS 76.12% 15.19% 19.77% 61.66% 69.58% 23.14% 10.65% 17.07% 1
TOBA SAMOSIR 84.44% 10.27% 15.05% 61.04% 68.49% 28.69% 16.46% 17.01% 2
KOTA SURABAYA 85.14% 31.94% 39.23% 60.61% 55.45% 7.45% 5.31% 9.44% 3
HULU SUNGAI UTARA 69.96% 18.78% 23.74% 63.91% 63.00% 17.31% 13.26% 9.01% 4
MOJOKERTO 69.38% 18.06% 23.38% 68.81% 67.03% 13.13% 9.59% 8.86% 5
SANGGAU 64.45% 7.10% 9.33% 53.65% 57.94% 39.25% 32.74% 8.74% 6
SLEMAN 90.35% 27.21% 32.57% 65.54% 61.87% 7.25% 5.56% 7.05% 7
BULUNGAN 87.90% 16.06% 18.86% 60.71% 61.40% 23.23% 19.74% 6.28% 8
MUSI RAWAS 87.20% 8.14% 9.85% 58.37% 60.66% 33.49% 29.49% 5.71% 9
LAMONGAN 74.75% 21.17% 24.50% 69.07% 67.94% 9.76% 7.56% 5.53% 10
KENDAL 94.45% 16.90% 18.82% 68.06% 69.67% 15.04% 11.50% 5.46% 11
KLUNGKUNG 69.89% 42.28% 47.00% 54.18% 50.14% 3.54% 2.87% 5.39% 12
KOTA PEMATANG SIANTAR 60.51% 15.16% 17.80% 68.05% 68.10% 16.78% 14.10% 5.31% 13
KOTA TERNATE 63.95% 13.48% 15.64% 67.14% 67.88% 19.38% 16.47% 5.06% 14
SELUMA 77.35% 11.32% 13.53% 63.59% 64.20% 25.09% 22.26% 5.05% 15
Advance analysis based on individual data
• The application of HITFA using family as a analysis unit
• By get the raw data from the application, we can analyze based on
individual data
• We can search by name and by address:– TB suspect follow up by diagnostic examination if positive: treated as
soon as possible
– Hypertension who regularly not regularly taking drugs
– Hypertension who just know if they have hypertension when home visit
– Seclusion severe mental disorder
– Have no health insurance
• National Health Survey to know the prevalence
• HITFA to know by name by address the Subject
Total TB Suspects by provinces,
February 2019
0
5000
10000
15000
20000
25000
30000
INDONESIA = 156,852
(Coverage 40%)
Total hypertension based on diagnosis by provinces
February 2019
-
100,000
200,000
300,000
400,000
500,000
600,000
INDONESIA = 3,068,375
(Coverage 40%)
Total hypertension regularly taking drug by provinces
February 2019
-
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
INDONESIA = 1,864,350
(Coverage 40%)
-
100,000
200,000
300,000
400,000
500,000
600,000
Total hypertension (measurement at home visit) by
provinces February 2019
INDONESIA = 2,636,191
(Coverage 40%)
Total number seclusion of severe mental disorder by
provinces February 2019
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
INDONESIA = 22,296
(Coverage 40%)
South Kalimantan Province: Individual Analysis, Feb 2019
DISTRICTTuberculosis
Suspect
Seclusion Severe
Mental Disorder
TANAH LAUT 173 20
KOTABARU 174 15
BANJAR 308 31
BARITO KUALA 187 15
TAPIN 171 18
HULU SUNGAI SELATAN 213 29
HULU SUNGAI TENGAH 181 10
HULU SUNGAI UTARA 152 16
TABALONG 147 17
TANAH BUMBU 240 23
BALANGAN 298 14
KOTA BANJARMASIN 620 36
KOTA BANJARBARU 188 23
Result of HITFA in several Health Centers
Gabus 2 Health Center, Pati District, Central Java
Watas Marga Healh Center Rejang Lebong District,
Bengkulu Province
Tomalau Health Center, Kota Tidore Kepulauan,
North Maluku Province
Wamsisi Health Center, South Buru District
Maluku Province
Ajangale Health Center, Bone District
South Sulawesi Province
Arut Selatan Health Center, Kowabar District
Central Kalimantan Province
Conclusion
• HITFA is one of the public health intervention, using 12 simple health indicators
with family approach to improve the quality of family heath.
• HITFA is mainly health promotion, prevention and early detection of several
diseases
• HITFA is able to find the subjects who have health problems and where they are
• FHI is a composite of the 12 indictors, indicate the quality of family health, and
aggregately can be used to measure the community health in certain area
(village, sub-district, districts, province & national)
• The application of HITFA is a real time monitoring a good media for advocacy
to the local government at Province, District, Sub-district and Village level.
• HITFA is an evidence approach which is able to improve the community health
has high correlation with PHDI