DASAR PROMOSI KESEHATAN Nurjanah Deklarasi Alma Ata 1978

DASAR PROMOSI KESEHATAN Nurjanah

Deklarasi Alma Ata ( 1978 ) Basic Six: Menghasilkan strategi utama dalam pencapaian Kesehatan Bagi Semua (Health For All ) melalui pelayanan kesehatan dasar (Primary Health Care). Promosi Kesehatan Lingkungan Pemberantasan Penyakit Kesehatan Keluarga & Reproduksi Perbaikan Gizi masyarakat Pelayanan Kesehatan

1. Ottawa Charter, Strategi Promkes First International Conference on Health Promotion, Ottawa, 21 November 1986 Advocating (Advokasi) Enabling (Pemberdayaan) Mediating (Mediasi)

5 pilar utama atau 5 ruang lingkup promosi kesehatan(Ottawa Charter, 1986) 1. Kebijakan berwawasan kesehatan (Healthy public policy) 2. Lingkungan yang mendukung (Supportive environment) 3. Reorientasi pelayanan kesehatan (Reorient health service) 4. Ketrampilan individu (personnel skill) 5. Gerakan masyarakat (community action)

2. Adelaide Recommendations on Healthy Public Policy Second International Conference on Health Promotion, Adelaide, South Australia, 5 -9 April 1988 • The recommendations of this Conference will be realized only if governments at national, regional and local levels take action. • The development of healthy public policy is as important at the local levels of government as it is nationally. • Governments should set explicit health goals that emphasize health promotion

Adelaide Recommendations • • The spirit of Alma-Ata Healthy public policy Accountability for health impact of policy Action areas Priorities: – Supporting the health of women – Food and nutrition – Tobacco and alcohol – Creating supportive environments • Developing new health alliances • Commitment to global public health • Future challenges

3. Sundsvall Statement on Supportive Environments for Health Third International Conference on Health Promotion, Sundsvall, Sweden, 9 -15 June 1991 The Conference highlighted four aspects of supportive environments: • The social dimension, which includes the ways in which norms, customs and social processes affect health. • The political dimension, which requires governments to guarantee democratic participation in decision-making and the decentralization of responsibilities and resources • The economic dimension, which requires a re-channelling of resources for the achievement of Health for All and sustainable development, including the transfer of safe and reliable technology. • The need to recognize and use women's skills and knowledge in all sectors - including policy-making, and the economy - in order to develop a more positive infrastructure for supportive environments.

4. Jakarta Declaration on Leading Health Promotion into the 21 st Century The Fourth International Conference on Health Promotion: New Players for a New Era - Leading Health Promotion into the 21 st Century, meeting in Jakarta from 21 to 25 July 1997

Deklarasi Jakarta, 1997 • Promosi kesehatan adalah investasi utama yang memberikan dampak pada determinan kesehatan, dan memberikan manfaat kesehatan terbesar pada masyarakat. • Promosi kesehatan memberikan hasil positif yang berbeda dibandingkan upaya lain dalam meningkatkan kesetaraan bagi masyarakat dalam kesehatan. Lima prinsip Deklarasi Ottawa merupakan kunci strategi untuk sukses. • Promosi kesehatan perlu disosialisasikan dan harus menjadi tangungjawab lintas sektor.

Deklarasi Jakarta: prioritas promosi kesehatan abad 21 • Meningkatkan tanggung jawab sosial dalam kesehatan, • Meningkatkan investasi untuk pembangunan kesehatan, • Konsolidasi dan perluasan kemitraan untuk kesehatan, • Meningkatkan kemampuan masyarakat dan pemberdayaan individu serta menjamin tersedianya infrastruktur promosi kesehatan.

5. Fifth Global Conference on Health Promotion: Bridging the Equity Gap, Mexico City, June 5 th, 2000 1. 2. 3. 4. 5. 6. 7. 8. Recognize that the attainment of the highest possible standard of health is a positive asset for the enjoyment of life and necessary for social and economic development and equity. Acknowledge that the promotion of health and social development is a central duty and responsibility of governments, that all sectors of society share. Are mindful that, in recent years, through the sustained efforts of governments and societies working together, there have been significant health improvements and progress in the provision of health services in many countries of the world. Realize that, despite this progress, many health problems still persist which hinder social and economic development and must therefore be urgently addressed to further equity in the attainment of health and well being. Are mindful that, at the same time, new and re-emerging diseases threaten the progress made in health. Realize that it is urgent to address the social, economic and environmental determinants of health and that this requires strengthened mechanisms of collaboration for the promotion of health across al sectors and at all levels of society. Conclude that health promotion must be a fundamental component of public policies and programmes in all countries in the pursuit of equity and better health for all. Realize that there is ample evidence that good health promotion strategies of promoting health are effective

6. The Bangkok Charter for Health Promotion in a globalized world, 7 -11 August 2005 1. Perlu strategi dan komitmen untuk menghadapi berbagai faktor yang berpengaruh terhadap kesehatan di dunia global, serta kebijakan dan kemitraan untuk memberdayakan masyarakat untuk memperbaiki kualitas kesehatan (termasuk ketidakmerataan bidang kesehatan) menjadi fokus pembangunan nasional dan global.

The Bangkok Charter for Health Promotion in a globalized world, 2005 2. Salah satu hak asasi setiap manusia adalah untuk memperoleh kualitas kesehatan yang setinggi-tingginya. Promosi kesehatan didasari hak asasi ini, menawarkan konsep sehat yang positif dan inklusif yang merupakan faktor mempengaruhi kualitas hidup kesehatan mental dan spiritual. Promosi kesehatan merupakan fungsi inti kesehatan masyarakat, yang memberikan sumbangan dalam mengatasi penyakit menular dan tidak menular serta ancaman terhadap kesehatan, dan merupakan investasi efektif untuk meningkatkan kesehatan dan pembangunan manusia serta mengurangi ketidakmerataan/ketidaksamaan dibidang kesehatan dan jender.

The Bangkok Charter for Health Promotion in a globalized world, 2005 3. Perkembangan menuju dunia yang lebih sehat memerlukan keterlibatan politik yang kuat, peranserta lebih luas dan advokasi yang berkesinambungan.

7. Promoting health and development: closing the implementation gap 7 th Global Conference on Health Promotion Nairobi, 26 -30 October 2009 Health promotion will be seen in this conference to be an essential, effective approach in line with the renewal of Primary Health Care as endorsed by the Executive Board of WHO: • To achieve the agreed international health development goals: in the health arena, the development goals associated with the eradication of poverty include targets on addressing specific diseases like malaria, tuberculosis, HIV/AIDS and broader issues like undernutrition, reproductive, maternal and child health. The urgent need is for these goals to be met, and here health promotion has specific expertise that can accelerate the progress to attainment. • To address the emergence of noncommunicable diseases, injury, and mental disorders, a group of conditions that are growing at epidemic rates in low and middle income countries. They cause over 60% of the world’s mortality and lead the rankings in terms of preventable disability. Furthermore, health systems often lack the mechanisms for sustainable funding of health promotion, even as they buckle under the increasing costs of the growing burden of noncommunicable conditions. • To tackle the issue of inequities in the distribution of health by gender, social class, income level, ethnicity, education, occupation, and other categories. Development goals should explicitly promote an approach that fosters equity, or fairness of distribution across the divides of social structure as part of the renaissance in the Primary Health Care movement.

8. The 8 th Global Conference on Health Promotion, Helskinki, Finland 10 -14 June 2013 • Health in All Policies (Hi. AP): Framework for Country Action • Hi. AP is an approach on health-related rights and obligations. It improves accountability of policymakers for health impacts at all levels of policy-making. It includes an emphasis on the consequences of public policies on health systems, determinants of health, and well-being. It also contributes to sustainable development.

9. Shanghai Declaration on promoting health in the 2030 Agenda for Sustainable Development 21 November 2016 • We recognize that health and wellbeing are essential to achieving sustainable development • We will promote health through action on all the SDGs. • We will make bold political choices for health

Shanghai Declaration on promoting health in the 2030 Agenda for Sustainable Development 21 November 2016 • Good governance is crucial • Cities and communities are critical settings for health • Health literacy empowers and drives equity

RUANG LINGKUP PROMOSI KESEHATAN Ilmu-ilmu yang mencakup promosi kesehatan dapat dikelompokkan menjadi 2 bidang : 1. Ilmu perilaku; menjadi dasar dalam membentuk perilaku manusia : psikologi, antropologi, sosiolgi 2. Ilmu-ilmu yang diperlukan untuk intervensi perilaku (pembentukan dan perubahan perilaku) : pendidikan, komunikasi, manajemen, kepemimpinan, dsb

Ruang lingkup Promosi Kesehatan berdasarkan aspek pelayanan kesehatan : • • Promosi kesehatan pada tingkat promotif Promosi kesehatan pada tingkat preventif Promosi kesehatan pada tingkat kuratif Promosi kesehatan pada tingkat rehabilitatif

Ruang lingkup Promosi Kesehatan berdasarkan tatanan (tempat pelaksanaan) • Promosi kesehatan pada tatanan keluarga (rumah tangga) • Promosi kesehatan pada tatanan sekolah • Promosi kesehatan pada tempat kerja • Promosi kesehatan di tempat-tempat umum • Pendidikan kesehatan di institusi pelayanan kesehatan

Siapa Sasaran Promkes ? Individu Keluarga Masyarakat LSM Lembaga pemerintah Institusi

VISI = Visi Pembangunan Kesehatan Meningkatkan kesadaran, kemauan, dan kemampuan hidup sehat bagi setiap orang agar terwujud derajat kesehatan masyarakat yang setinggi-tingginya, sebagai investasi bagi pembangunan sumber daya manusia yang produktif secara sosial dan ekonomis. Pasal 3 UU No. 36 tahun 2009 tentang kesehatan

Misi Promosi Kesehatan § § Memberdayakan individu, keluarga, dan kelompok-kelompok dalam masyarakat, baik melalui pendekatan individu dan keluarga, maupun pengorganisasian dan penggerakan masyarakat Membina suasana atau lingkungan yang kondusif bagi terciptanya perilaku hidup bersih dan sehat masyarakat Mengadvokasi para pengambil keputusan dan penentu kebijakan serta pihak-pihak lain yang berkepentingan (stekeholders) dalam rangka : – mendorong diberlakukannya kebijakan dan peraturan perudang-undangan yang berwawasan kesehatan. – mengintegrasikan promosi kesehatan, khususnya pemberdayaan masyarakat dalam program-program kesehatan. – meningkatkan kemitraan sinergis antara pemerintah pusat dan daerah serta antara pemerintah dengan masyarakat (termasuk LSM). Meningkatkan investasi dalam bidang promosi kesehatan pada khususnya dan bidang kesehatan pada umumnya.

Conclusion: HEALTH PROMOTION

Tugas 2: • Hitung 1 -5 bagi kelompok • Apa yang dimaksud strategi-strategi Promkes (sesuai pambagian) • Cari Penjelasan dan Contoh • Tulis dalam 1 lembar kertas, Kumpulkan tanggal. . .

MISI = PILAR PROMOSI KESEHATAN 1. Kebijakan berwawasan kesehatan (Healthy public policy) Pengadaan sarana olah raga Pelatihan kader 2. Lingkungan yang mendukung (Supportive environment) Aturan tentang Ruang Terbuka hijau 3. Reorientasi pelayanan kesehatan (Reorient health service) Penyuluhan di sekolah 4. Ketrampilan individu (personnel skill) Meningkatkan anggaran untuk promosi kesehatan 5. Gerakan masyarakat (community action) Komunitas peduli kawasan tanpa rokok Perbaikan angkutan umum Warga peduli AIDS Mendorong ibu untuk K 1 -K 4 Bank sampah

Kasus…Mengurangi Penyakit Akibat Rokok 1. Kebijakan berwawasan kesehatan (Healthy public policy) 2. Lingkungan yang mendukung (Supportive environment) 3. Reorientasi pelayanan kesehatan (Reorient health service) 4. Ketrampilan individu (personnel skill) 5. Gerakan masyarakat (community action)

Tugas 3: (sesuai urutan) Jelaskan upaya Promosi kesehatan dalam lima tingkat pencegahan (Five Level of Prevention): – Health Promotion (Promosi kesehatan) – Specific Protection (Perlindungan khusus) – Early Diagnosis and Prompt Treatment (Diagnosis dini dan pengobatan segera) – Disability Limitation (Mengurangi terjadinya kecacatan) – Rehabilitation (pemulihan)

Five Level of Prevention – Health Promotion (Promosi kesehatan) – Specific Protection (Perlindungan khusus) – Early Diagnosis and Prompt Treatment (Diagnosis dini dan pengobatan segera) – Disability Limitation (Mengurangi terjadinya kecacatan) – Rehabilitation (pemulihan)

Five level of prevention: A. Health Promotion (Promosi kesehatan) B. Specific Protection (Perlindungan khusus) C. Early Diagnosis and Prompt Treatment (Diagnosis dini dan pengobatan segera) D. Disability Limitation (Mengurangi terjadinya kecacatan) E. Rehabilitation (pemulihan) 1. Imunisasi 2. Olah raga 3. Memakai Alat Pelindung Diri B A B 4. Meningkatkan Kecukupan Gizi 5. Periksa Kehamilan 6. ASI Eksklusif A C A 7. Periksa Dahak 8. Fisioterapi pasien stroke C E 9. Periksa tensi secara teratur 10. Cuci Tangan sebelum makan 11. Cek laboratorium untuk anak yang panas > 3 hari 12. Minum antibiotik secara benar 13. Kampanye kawasan tanpa rokok 14. Minum obat TB Paru secara teratur sampai selesai 15. Menggunakan kondom C A C D A D B

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