PKM 1 Kes Perkotaan

11

KESEHATAN PERKOTAANKESEHATAN PERKOTAAN( URBAN HEALTH )( URBAN HEALTH )

22

Definition of HealthDefinition of Health

• ““Health is a state of complete physical, Health is a state of complete physical, mental and social well-being, and not merely mental and social well-being, and not merely the absence of disease or infirmity” (WHO the absence of disease or infirmity” (WHO constitution 1948)constitution 1948)

• ““Health is a Health is a dynamicdynamic complete physical, complete physical, mental mental spiritual spiritual and social well-being, and and social well-being, and not merely the absence of disease or not merely the absence of disease or infirmity” infirmity”

(WHO, January 1988)(WHO, January 1988)

33

Masalah Kesehatan di Masalah Kesehatan di Perkotaan apa saja Perkotaan apa saja menurut Saudara ?menurut Saudara ?

1.1. ………………

2.2. ………………

3.3. …………

44

Program Kesehatan Program Kesehatan PerkotanPerkotan

di Indonesia ? di Indonesia ?

Di Depkes Di Depkes

a.a. Sudah ada Konsep kota Sehat Sudah ada Konsep kota Sehat dengan berbagai pendekatan dengan berbagai pendekatan model teori ? Sangat banyak. model teori ? Sangat banyak. Tindak lanjut ?Tindak lanjut ?

b.b. Buku- buku yang sudah Buku- buku yang sudah diterbitkan :diterbitkan :

a.a. Pengantar Kesehatan Perkotaan Pengantar Kesehatan Perkotaan ??

b.b. Pedoman Penyelenggaran Pedoman Penyelenggaran Puskesmas di Perkotaan ?Puskesmas di Perkotaan ?

c.c. Kota di Indonesia sangat Kota di Indonesia sangat beragamberagam

55

EPIDEMIOLOGIC TRANSITION EPIDEMIOLOGIC TRANSITION

CD : Communicable DiseaseNCD : Non Communicable Disease

Mortality Rate

Infections disease/CD

NCD

ID/CD Negara berkembang

Double burden ofDisease

66

Disease are grouped by period of Disease are grouped by period of disease.disease.Is it overlap among definitionof Is it overlap among definitionof chronic and acute disease?chronic and acute disease?

ColdMeaslesCholeraPneumonia

SuicideHomicideInjuryStroke

TBHIVLeprosy

CancerCVDDMHT

ChronicAcute

CD

NCD OccupationEnvironmentMental problem

77

Apa Perbedaan Kota dan Apa Perbedaan Kota dan Desa menurut Saudara ?Desa menurut Saudara ?

1.1. …………..

2.2. …………..

3.3. …………

88

URBAN Vs. RURAL (Ferdinand URBAN Vs. RURAL (Ferdinand Tonnies)Tonnies)

RURAL RURAL (Gemeinschaft)(Gemeinschaft)

URBANURBAN(Gesellschaft)(Gesellschaft)

CommunityCommunity Differences Differences

Interaction intimateInteraction intimate Formal, task Formal, task specificspecific

Cooperation Cooperation Self-interestSelf-interest

Openness Openness Privacy Privacy

Informal controlInformal control Formal controlFormal control

Less tolerance of Less tolerance of deviancedeviance

Tolerance of Tolerance of deviancedeviance

Ascribed statusAscribed status Achieved Achieved

Little changeLittle change Rapid changeRapid change

99

DEFINISI KOTA DARI BERBAGAI DEFINISI KOTA DARI BERBAGAI NEGARA DI DUNIANEGARA DI DUNIA

SANGAT BERAGAM

DASARJumlah PendudukKepadatan penduduk (jumlah/Km2)Luas WilayahMata Pencaharian Penduduk (agraris, dagang, industri, dll)Fungsi Perkembangan (pusat) industri, seni & budaya, pendidikan, rekreasi, pemerintahan, Bisnis, dll.

1010

SEJARAH KOTA DI DUNIASEJARAH KOTA DI DUNIAEVOLUTION of URBAN AREASEVOLUTION of URBAN AREAS

A.A. First Urban Revolution-First Urban Revolution-City states and Urban City states and Urban empireempire1.1. Near East Near East

Mesopotamia and Mesopotamia and Egypt (4000, and Egypt (4000, and 3.300 BC)3.300 BC)

2.2. Indus Region (India Indus Region (India and Pakistan):and Pakistan):a.a. City of Harappa and City of Harappa and

Civilization (2500 BC)Civilization (2500 BC)b.b. Mycehean and Minoan Mycehean and Minoan

Cities (2000 BC) Cities (2000 BC)

3.3. China along yellow China along yellow river (2000-1500 BC)river (2000-1500 BC)

4.4. Americas Americas (Mesoamerica about (Mesoamerica about 200 BC)200 BC)

5.5. Greece (1800 BCE)Greece (1800 BCE)

6.6. Ancient Rome (700-Ancient Rome (700-500 BCE)500 BCE)

7.7. Middle Age or Dark Middle Age or Dark Age (500 BCE – 1000 Age (500 BCE – 1000 CE)CE)

8.8. Renaissance or Renaissance or Medieval age (Roman)Medieval age (Roman)

9.9. Taurat, Injil, Al Qur’an Taurat, Injil, Al Qur’an documentdocument

1111

DEFINISI KOTA DI INDONESIA DEFINISI KOTA DI INDONESIA BERDASARKAN SK MENDAGRI RIBERDASARKAN SK MENDAGRI RI

LEVELLEVEL STATUS KOTASTATUS KOTA NAMA KEPALA NAMA KEPALA BERDASARKAN BERDASARKAN SK MENDAGRISK MENDAGRI

PusatPusat NasionalNasional Ibu kota negara Ibu kota negara (DKI Jakarta)(DKI Jakarta)

GubernurGubernur

Tingkat ITingkat I PropinsiPropinsi Ibu kota PropinsiIbu kota Propinsi Gubernur/ Gubernur/ WalikotaWalikota

Tingkat II Tingkat II

(Distric)(Distric)KabupatenKabupaten

/ Kota/ KotaKota/ KabupatenKota/ Kabupaten

(85) (325) = (85) (325) = 410410

Walikota/ BupatiWalikota/ Bupati

KecamatanKecamatan CamatCamat

DesaDesa -DesaDesa-KelurahanKelurahan

-KADES (warga)KADES (warga)-LurahLurahKOTA DESA ( BELUM JELAS )

1212

HIRARKI ISTILAH “KOTA”HIRARKI ISTILAH “KOTA”

ISTILAHISTILAH CONTOHCONTOH KRITERIAKRITERIAMega Mega metropolis/ metropolis/ global cityglobal city

New York, New York, Washington DC, Washington DC, Paris, London, Paris, London, Tokyo, Hongkong, Tokyo, Hongkong, SydneySydney

Frekuensi Frekuensi kegiatan kegiatan internasionainternasional sangat l sangat tinggitinggi

Metropolitan Metropolitan DKI Jakarta, DKI Jakarta, Bangkok, Bangkok, Singapura, Kuala Singapura, Kuala Lumpur, Hanoi, Lumpur, Hanoi, dll.dll.

Ibukota Ibukota negaranegara

““City”/ KotaCity”/ Kota -Bandung, Bandung, Surabaya, Surabaya,

DIYDIY-Depok, Depok, Tangerang, Tangerang,

Bekasi, Bogor, dll.Bekasi, Bogor, dll.

Ibu kota Ibu kota Propinsi/ Propinsi/ KotaKota

1313

SEJARAH KOTA DI DUNIASEJARAH KOTA DI DUNIAB.B. Second Urban Revolution: Second Urban Revolution:

the Rise of Modern Citiesthe Rise of Modern Cities Urbanization and Urbanization and

Industrialization Industrialization Revolution (Western Revolution (Western Europe/ North America Europe/ North America from 1760s-1800sfrom 1760s-1800s• Removing of Slum areas Removing of Slum areas

in Paris (1849) and in Paris (1849) and building replacement building replacement with extensive system of with extensive system of parksparks

• The Health of the Towns The Health of the Towns Act (1868) England Act (1868) England prescribe sanitary prescribe sanitary standards of housing standards of housing and “closing order” to and “closing order” to “unfit dwelling” “unfit dwelling”

• The Public Health Act The Public Health Act (1875) of England (1875) of England construction of water construction of water and sewer systemand sewer system

• In Vienna (1856) and In Vienna (1856) and in Copenhagen (1865)in Copenhagen (1865)

• 1893 Chicago’s 1893 Chicago’s World’s Columbian World’s Columbian Exposition created Exposition created aesthetic and efficient aesthetic and efficient urban environmenturban environment

• A formal grouping of A formal grouping of federal building in federal building in Washington D.C. Washington D.C. (1900), San Fransisco (1900), San Fransisco (1905) and Chicago (1905) and Chicago (1909)(1909)

1414

SEJARAH KOTA DI DUNIASEJARAH KOTA DI DUNIA

• Improvement of Improvement of water and sewer water and sewer systems and public systems and public areas; Prescribing an areas; Prescribing an air shaft to ventilate air shaft to ventilate inside rooms; Height-inside rooms; Height-restriction regulationsrestriction regulations

• First comprehensive First comprehensive zoning ordinance in zoning ordinance in New York City 1916New York City 1916

Industrialization and Industrialization and colonial expansioncolonial expansion

Composation of Composation of urban population urban population

Working and living Working and living condition in citiescondition in cities

System of citiesSystem of citiesUrban growth in Urban growth in

the 20the 20thth century century

1515

Lulus dari S1 ada kemungkinan menjadi Lulus dari S1 ada kemungkinan menjadi pejabat struktural di kemudian hari ?pejabat struktural di kemudian hari ?

Apabila Saudara ditunjuk sebagai Apabila Saudara ditunjuk sebagai pejabat di Dinkes Kota / Kab. Disuruh pejabat di Dinkes Kota / Kab. Disuruh untuk memegang Kabid / Kasi untuk memegang Kabid / Kasi Kesehatan Perkotaan apa yang Kesehatan Perkotaan apa yang Saudara Lakukan ? Saudara Lakukan ?

1616

• Jangka pendek (1 tahun)Jangka pendek (1 tahun)

• Jangka menengah (5-10 tahun)Jangka menengah (5-10 tahun)

• Jangka panjang ( > 10 tahun)Jangka panjang ( > 10 tahun)

PERENCANAANPERENCANAAN

1717

1.1. Analisa keadaan dan situasi Analisa keadaan dan situasi (potret)(potret)

2.2. Perumusan masalah secara Perumusan masalah secara spesifikspesifik

3.3. Prioritas masalahPrioritas masalah4.4. Penentuan tujuanPenentuan tujuan5.5. Penentuan alternatif pemecahanPenentuan alternatif pemecahan6.6. Prioritas pemecahan Prioritas pemecahan 7.7. Penyusunan kegiatan (POA)Penyusunan kegiatan (POA)

7 LANGKAH PERENCANAAN7 LANGKAH PERENCANAAN

1818

PRINCIPLE OF MANAGEMENTPRINCIPLE OF MANAGEMENT

Situation analysis

MonitoringControlling

Coordinating

Utilizing

Evaluating Implementing

Planning

InformationOutside

Inside

1919

THEORIES “BLUUM THEORIES “BLUUM (FACTOR/VARIABLE AFFECT OR (FACTOR/VARIABLE AFFECT OR INFLUENCE OF STATE DEGREE OF PUBLIC INFLUENCE OF STATE DEGREE OF PUBLIC HEALTH)HEALTH)

ENVIRONMENT

HEALTH BEHAVIOR

STATE DEGREE/LEVEL OF PUBLIC HEALTH

HEALTHSERVICE

GENETIC

2020

LINGKUNGANLINGKUNGAN

Fisik- Tanah- Air- Udara- Temperatur

Non Fisik- Iptek- Politik & Ideologi- Ekonomi- Sosial-Budaya

Pencemaran Lingkungan

Biologis (Infeksi) Bakteri, virus flagel/mikro- organisme, dll.

Kimia logam berat, plastik, Hg, PB, CO, CO2, peptisida, dll.Radiasi (radioaktif)

2121

GENETIK RNA dan DNA

PERILAKU KESEHATAN

POSITIF Ibadah Olah raga Makan siang dll.

NEGATIF Merokok Narkoba Kolesterol Stress, dll.

2222

HIRARKI YANKESHIRARKI YANKESDI INDONESIADI INDONESIA

LEVELLEVEL INSTITUSIINSTITUSI

NasionalNasional RS Tipe ARS Tipe A

PropinsiPropinsi RS Tipe BRS Tipe B

Kabupaten/kotaKabupaten/kota RS Tipe C/DRS Tipe C/D

KecamatanKecamatan Puskesmas Induk & Puskesmas Induk & pembantupembantu

Perkotaan dan desaPerkotaan dan desa

MasyarakatMasyarakat Posyandu, Pos Obat Desa Posyandu, Pos Obat Desa (Bidan Desa), dll.(Bidan Desa), dll.

Keluarga, Keluarga, individuindividu

Perawatan di rumahPerawatan di rumah

2323

1.1. Health Behavior: No good behaviorHealth Behavior: No good behaviora.a. No exerciseNo exerciseb.b. Food high cholesterol and low fiber from Food high cholesterol and low fiber from

vegetable/fruitvegetable/fruitc.c. SmokingSmokingd.d. Free sexFree sexe.e. ectect

2.2. Health Service: the health service no to be equity, Health Service: the health service no to be equity, accessibility and qualityaccessibility and quality

a.a. Health centerHealth centerb.b. PCUPCUc.c. HospitalHospitald.d. Ministry of healthMinistry of healthe.e. Price of drugPrice of drugf.f. ectect

3.3. GeneticGenetic

General problem health in urban community: follow to Bluum theories (1)

2424

4.4. EnvironmentEnvironment

a.a. Physical : No safety Physical : No safety and healthyand healthy

• Water supply Water supply system (pollution)system (pollution)

• Air (pollution)Air (pollution)

• Land (limitation Land (limitation and pollution)and pollution)

• Temperature & Temperature & humudityhumudity

• Housing Housing

• BuildingBuilding

• Road injuryRoad injury

• ectect

General problem health in urban community: General problem health in urban community: follow to Bluum theories (2)follow to Bluum theories (2)

b.b. Biological & chemical: Biological & chemical: No safety and healthyNo safety and healthy

• AgentAgent• ChemicalChemical• PlantPlant• AnimalAnimal• HumanHuman

2525

d.d. Political and role no Political and role no support healty citysupport healty city

• Justice/role/lawJustice/role/law• Party/politicianParty/politician• Government policyGovernment policy

General problem health in urban General problem health in urban community: follow to Bluum theories (3)community: follow to Bluum theories (3)

c.c. Sosial economic : no Sosial economic : no accessibility, safety accessibility, safety and healthand health

• EducationEducation

• JobJob

• BusinessBusiness

• CultureCulture

• ReligionReligion

• Donor agency, Donor agency, NGO, WHONGO, WHO

• GlobalizationGlobalization

• Ect.Ect.

2626

Planning (short, medium and long times)Planning (short, medium and long times)• Vision:Vision:

Healthy City 2030Healthy City 2030

• Mission :Mission :

1.1. To maintain and improve the quality of health service in To maintain and improve the quality of health service in urban areaurban area

2.2. To maintain and improve the health behavior in urban To maintain and improve the health behavior in urban areaarea

3.3. To maintain and improve the quality environment in To maintain and improve the quality environment in urban areaurban area

4.4. To develop and research genetic factor in urban areaTo develop and research genetic factor in urban area

• Objectives :Objectives :

1.1. To improve the quality of health service in urban areaTo improve the quality of health service in urban area

2.2. To improve the health behavior in urban areaTo improve the health behavior in urban area

3.3. To maintain and improve the quality environment in To maintain and improve the quality environment in urban areaurban area

4.4. To develop and research genetic factor in urban areaTo develop and research genetic factor in urban area

2727

Buat Dokumen Perencanaan Buat Dokumen Perencanaan yang jelasyang jelas

• VisiVisi• MisiMisi• Program KegiatanProgram Kegiatan

TujuanTujuanSasaranSasaranWaktuWaktuSumberdayaSumberdaya

• Sistem Evaluasi dan Monitoring Sistem Evaluasi dan Monitoring

2828