PUSKESMAS:THE PRIMARY HEALTH CARE SYSTEM IN INDONESIA

Introduction

Why do you have to know about PUSKESMAS as the primary health care system in Indonesia in relation to the Public health and community nutrition systems course?

References

Pedoman Kerja Puskesmas, Depkes RI

Sistim Kesehatan Nasional Renstra Depkes 2005-2009 Standar Pelayanan Minimal Bidang

Kesehatan

What is PUSKESMAS?

Functional health organization unit Public health development center Building community participation Provide comprehensive and

integrated services to the community under its coverage in the forms of principal activities

PUSKESMAS’ coverage

Part of or the whole sub-district (kecamatan), depending on: Population density (~30,000) Areas (~district head office) Geographic (extended to have

supporting-Puskesmas/Puskesmas Pembantu or Puskesmas Keliling)

Infrastructure (personnel and facilities)

PUSKESMAS’ coverage

Especially for big cities (population ≥ 1 million) = Puskesmas Pembina: Coverage: sub-district Population: 150,000 Referral and Coordinating several

Puskesmas Kelurahan (village-level)

Comprehensive health service

Promotion Prevention

Cure/treatment Rehabilitation

for all gender and age from conception to those dying

Integrated health services

All principal health service activities: Policlinic Maternal and child clinic Hygiene and sanitation program Communicable diseases program And others

implemented together under one coordination and leader

Functions and roles of PUSKESMAS in the public health system

Functions: Public health development center Building community participation to

promote healthy life behaviors Provide comprehensive and integrated

health care services

Functions and roles of PUSKESMAS in the public health system Activities:

Stimulating the community to do self-help activities

Informing the community to search and use the locally available resources effectively and efficiently

Technically assisting the community for medical content, medical and health referral without rising any dependency

Providing direct health services to the community

Collaborating with other related sectors in implementing the health programs

Functions and roles of PUSKESMAS in the public health system

Roles: As a technical implemental institution, it

shall have a managerial capabilities and long-term vision to improve the quality of health services

In planning, managing and evaluating Using and updating related information

techniques to improve the comprehensive and integrated health services

Functions and roles of PUSKESMAS in the public health system

Status: Administration, as a technical unit of

district government office via the district health office

Hierarchical health service, as a primary health service facility (*)

Organization of PUSKESMAS

HEAD OF PUSKESMAS

TECHNICAL UNIT I-III

SUPPORTING UNIT

TECHNICAL UNIT IV-VII

HEAD OF ADMINISTRATION

UNIT

Organization of PUSKESMAS

PERSONNEL JOB DESCRIPTION

Head of Puskesmas

Leading, supervising and coordinating Puskesmas activities (structural and functionally)

Head of Administration unit

Staffing, finance, facility, recording and reporting

Organization of PUSKESMAS

PERSONNEL JOB DESCRIPTION

Unit I Maternal and child health, family planning and nutrition program activities

Unit II Prevention and treatment of communicable diseases (immunization, environmental health and laboratory)

Organization of PUSKESMAS

PERSONNEL JOB DESCRIPTION

Unit III Dental and oral health, occupational health and elderly

Unit IV Public health nursing, school and sport health, mental health, eyes’ health and other specific healths

Organization of PUSKESMAS

PERSONNEL JOB DESCRIPTION

Unit V Building and developing community health activities and public health promotion

Unit VI Out-patient and in-patient treatment services

Unit VII Pharmacy

Organization of PUSKESMAS

SUPPORTING UNIT

JOB DESCRIPTION

Supporting Puskesmas

Implementing Puskesmas programs to 2,500 – 10,000 population

Mobile Puskesmas

Implementing Puskesmas programs to remote areas

Village midwife Provide maternal and child health service to 3,000 population

Primary Programs of PUSKESMAS

1. Maternal and child health2. Family Planning3. Nutrition Improvement4. Environmental health5. Communicable diseases eradication6. Treatment, including emergency condition7. Public health education/promotion 8. School health program9. Sport health10.Public health nursing

Primary Programs of PUSKESMAS

11. Occupational health12. Dental and oral health13. Mental health14. Eyes’ health15. Laboratory16. Reporting and recording of health

information system17. Elderly18. Controlling traditional healer 19. And others

Referral system

Hierarchy Health service component

Households Individual or family members

Community Households of ten, Posyandu

Primary health service facility

Puskesmas and its supporting units, private practices, etc

Primary referral unit

District hospital, laboratory, private practices, etc

Advanced referral unit

Provincial hospitals, special health facilities, etc

Referral system Type of referral system:

Medical referral (diagnostic and treatment): patient consultation, sending specimens and inviting special health personnel

Health referral (promotion and prevention): epidemiological survey and eradication of outbreaks, food aids, investigation of food poisoning, special aids during disaster and displaced population/refugee, clean water technology and laboratory

Conclusion

Why do you have to know about PUSKESMAS as the primary health care system in Indonesia in relation to the Public health and community nutrition systems course?