diah - kebijakan dan strategi napza-in english.pdf
TRANSCRIPT
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NATIONAL POLICY ON
SUBSTANCE RELATED
DISORDER IN INDONESIA
DIAH SETIA UTAMI
DIRECTORATE OF MENTAL HEALTH
INDONESIA MINISTRY OF HEALTH
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INTRODUCTION
Estimation of drug user in 2011 were 3.7 - 4.7
million (2,2% total population of 10 – 59 y.o):
27% experimental user
27% abuser
45% non injecting user
2% injecting drug user
Economy disadvantages (2008 survey):
Rp.32,4 Billion (2008) Rp.57,0 Billion (2013)
Resources: BNN
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Introduction (cont’d)
1,75%
1,99% 2,20%
0,00%
0,50%
1,00%
1,50%
2,00%
2,50%
2004 2008 2011
Prevalence of Drug Abuser
Resources: BNN
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Concept of National Strategy on
Substance Related Disorder
Prevention
Strategy
Treatment &
Rehabilitation
Strategy
To develop
Indonesian people
free from drug
abuse
• Healthy people
• Educated
people
Long term
planning
(2025)
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Policy of MOH-RI on Substance
Related Disorder
Prioritising promotion of healthy life style &
preventing behaviour problems
Integrating treatment service in existing health
facilities:
Standardized management
Sustainability program
Providing comprehensive and multi-disciplines
approach in treating drug users
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Policy of MOH-RI on Substance
Related Disorder (2)
Supporting community-based and user-based
recovery program :
To facilitate livelihood of drug user
To accommodate drug user capacity in treating their
peers
Protect human right and client’s safety:
Avoid stigmatisation & discrimination towards drug
users
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Policy of MOH-RI on Substance
Related Disorder (3)
Reducing harmful effect of injecting drug use:
9 components (drug treatment; NSP; HIV testing &
counseling; STI prevention & treatment; Condom; IEC;
Hepatiting B & C treatment & vaccination; TB
treatment)
Balancing & coordinating multi-sector approach:
Balancing three pillars approach (supply – demand –
harm reduction)
Balancing health-welfare approach and security
approach
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Policy of MOH-RI on Substance
Related Disorder (4)
8. Developing Information System:
To support evidence-based strategic planning on
substance related disorder prevention and
management
9. Legislation & Regulation
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MOH Programmes
Endorsement of National Guidelines on treatment
and rehabilitation program
Improvement of drug treatment service quality
Provision of standardised assessment system related to compulsory reporting
system & decriminalization
HIV control & management among drug users
Programmes
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Policy on Compulsory Reporting
Regulation
Compulsory reporting regulation is mandated by No.
35/2009 Narcotics Law, particularly through MOH &
MOSA
MOH has developed service system to accommodate
compulsory reporting regulation:
Develop standardised assessment & treatment plan system
Appoint several PHCs, General Hospitals, Drug Dependence
Hospital & Mental Hospitals in 33 provinces as compulsory
reporting treatment provider (IPWL)
Provide compulsory reporting budget claim
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Framework of thinking
Copulsary
registration Criminalization
Addictive Behavior is
manageable
Minimization of infection disease and
mental health problems
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Compulsory reporting system
Assesment Treatment
Plan
Treatment and
Rehabilitation
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Policy on Medical Rehabilitation
Medical Rehabilitation is a terminology in No.
35/2009 Narcotics Act referring rehabilitation
program provide by MOH
Target population of medical rehabilitation is
voluntary drug users; drug users brought by their
family or sent by criminal justice system
It covers various treatment modalities: outpatient
and inpatient approach
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Medical rehabilitation consist of...
Medical Rehabilitation Detoxification
Drug-free outpatient program
Medicated-Assisted Program
Short-term residential program
Long-term residential program
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Sumut 4
Sumbar 1 Sumsel 2
Kepri 1
Lampung1
Riau 1
DKI 18
Banten 7 Jabar 14
Jateng 6
Jatim 9
DIY 5
Bali 6
Kalbar 3
Kaltim 1
Sulsel 5
Methadone Clinic
Mei 2013: 85 clinics in 17 Provinces
Jambi 1
Data Ditjen BUK Kemenkes, 2013
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Methadone Clinic based on setting
0
5
10
15
20
25
30
35
40
45
1
26
7
1
42
5 4
RSU RSJ RSKO PKM Lapas Rutan
Data Ditjen BUK Kemenkes, 2013
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Aceh 1
Sumbar 1
Sumsel 1
DKI 2
Jabar 3
Jateng 1
Jatim 2
DIY 1 Bali 1
Kalbar 1
Kaltim 1
Sulsel 1
Residential Rehabilitation
Bengkulu 1
Banten 7
NTB 1
Kalsel 1
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Compulsary Registration Treatment
Provider (IPWL)
0
10
20
30
40
50
60
70
80
MH/DDH GeneralHospital
PHC Other medicalrehab
32
70 75
4
Series 1
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MOH Strategies on Substance Abuse
Prevention & Management
Advocacy Community
Empowerment
Improvement of Health
Professional Capacity
Strenghten Health System
Develop model of Drug Addiction
Services
Provide budget & involve private
sector
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Stakeholders in MOH on Substance Abuse Prevention
Subdit Napza
• Guidelines of IEC method for health professional; Parenting Practices;
Subdit Keswa Kel Berisiko
• Life skills education for adolescence
Dit Kes Anak
• Pedoman & Modul Penjaringan Kes Remaja (Deteksi Dini)
Dit PTM:
• Technical guidelines for smoking cessation
• Road safety due to drunk driving
Promkes:
• IEC Smoking, Substance Abuse
• Scouting: Saka Bhakti Husada
Dit PPML
• NSP for IDUs
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Stakeholders in MOH on Substance
Related Disorder Management
• Endorsement of National & Technical Guidelines related to TR; Training for Health professional; Multi-sector coordination; IPWL; Claim Budgeting
Subdit Napza:
• Strengthen & support health facilities in providing drug treatment & HIV treatment services
Dit BUKR:
• Endorsement of National & Technical Guidelines related to HIV prevention & care, including for drug user (esp IDU)
Subdit AIDS:
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