Government Health development plan towards Healthy Indonesia 2010 - [BUKU]

Page 69 of 88 2 broad de-concentration authority or task. What is meant by the limited decentralization authority or task is the implementation of health effort that can not be handled by the society that is cross district municipal or still unable to be handled by district municipal government or that is more effective and efficient if handled by the provincial government. 5. Central Level Health Organization In order to improve the organization at the central level is always based on development in health effort and function that should be done. Development in the form of expansion or retrenchment can occur in the main operating element such as at the level of Directorate General, since the work volume and load of developmental task in health sector is increasing or conversely decreasing due to merger. Development can also occur at the element of assistant chief according to the addition of functions and efforts that have to be done especially in the managerial fields. The act number 22 1992 about health stipulates that health development is done by government and society. The society should be turned into the prime actor of health development, while government only acts as the companion. This means that only health efforts that are still unhandleable by the society requires settlement by the government. For efforts already manageable by society the government only acts as the cultivator, supervisor and facilitator. The cultivating task is done through determination of national policy standardization and regulation. Supervising task is done through licensing, accreditation and safeguarding. While facilitative task is done through guidance and control. According to the decentralization strategy, the task of implementation of health efforts that can not be tackled by the society will be done by regional government, i.e. either by the district municipal regional government or the provincial government. While for effectiveness and efficiency except regarding the management of several types of pharmaceutical inventories such as medicines, and the task of facilitating will be done by the provincial regional government. Abiding to the principle, then it can be decided that at the central level the main task of the Ministry of Health is to cultivate supervision and facilitation of health development through determination of national policy in health sector, standardization, and regulation as well as coordination of licensing, accreditation, cultivation and control. Actuation of Implementation

1. Government

The realization of healthy society is one of the tasks and responsibilities of the government, though it has not been realized yet by all the governmental apparatus. Many Page 70 of 88 of the various government’s institutions are less attentive to health efforts. Some of them even give negative contribution to health, e.g. damage to the environment and ecosystem due to agricultural and mining activities. In order to achieve optimal result in health developmental effort to actuate all governmental institutions with health concerns has become a must. Success of health development can not be relied on the Ministry of Health alone, but should be relied on all departments and or other governmental institutions. Success of health development is very much determined by the involvement of many sides in the implementation of various health efforts through cross-sectoral cooperation that is well-matched, harmonious, effective and efficient. In order to actuate stronger implementation of therefore mentioned things, it needs strong leadership in all administrative levels followed by an adequate reward system which is related to personnel’s performance, and enough infrastructures and facilities. In implementation of the imminent decentralization, it is hoped that innovation related to the above mentioned things can be improved further according to specific conditions of each region. 2. The Public Potential a. Young Generation Young generation is a development succeed generation whose cultivation is directed at among other things to handle the aspects of skill, leadership, physical fitness and creative power. In the health sector, young generation beside being the target of health efforts, it has the potential to participate in developmental efforts. What is meant by young generation is any one whose age is between 0 and 30 years. Cultivation of young generation’s potential should be done integrally among various sectors, both in planning and implementation. By observing the comprehensive and integral approach toward that group, developmental effort in various sectors that are intervention in nature in certain time is hoped to be so directed that in the end it has mutually supporting power. b. NGO non-governmental organization NGO is a strong potential and has a big role in the effort to make the society healthy. In this respect, a directed cultivation is needed, among others, to manage the aspects of participation and implementation of programs that touch the society. Now there are many NGOs in the health sector, part of them have reliable workforce and strong network to the regions. 3. Female Group When viewed from social, economic and political aspects and by perceiving as well the projected changes expected in the future, special cultivation to this group can not be neglected. This matter has been not only a national concern but also an international concern as well. Page 71 of 88 In terms of planned changes, the potential of the female group is at the beginning only being concentrated on family cultivation toward a healthy, wealthy life based on the norm of family that is small, happy and wealthy. But as her position, role and responsibility have been growing broader, this group is not only tied to the family life but has also been expanded in terms of the working fields and social tasks in the society. Hence, the management of female group needs the increasing intra health sectoral coordination and between the health sector and other sectors. 4. The Health Profession The health profession occupies a strategic position in the society in thinking and implementing health sector’s developmental programs. For that reason, the function of health profession must be directed and cultivated by the government so they would appreciate the significance of the vision and mission of health rows and then participate actively in health development. Beside that they are expected to implement and co- supervise their members so that they would do their tasks according to the professional standards and do cultivation mainly in the aspect of professional ethics. 5. The Business Community It is understandable that health effort in one side can be seen as a business that yields profit, hence it draws the business community to enter it. The role of business community tends to grow greater in the future, while on the other side the government’s capacity becomes more limited, hence the government will become more selective in funding health efforts, i.e. only limited to the ‘public goods’. While health efforts of ‘private goods’ nature that are supposed to yield profit will be given to the private business community. The demand for health sector that becomes increasingly specialistic, sophisticated and practicing high quality is an opportunity for the business community to participate in health development according to economic principles without forgetting the social and ethical aspects. 6. The Informal Public Figures The informal public figures teachers, educators, scotts, religious figures, faith cultivators, etc. are a social group that can channel the public’s aspiration and they preferably can motivate the society in health development. Beside that, the informal public figures are also hoped to prepare young generation through educational institutions that grow in the society so that they will become progressive leaders. 7. The Rural Community As the developmental potential are found much in the rural area, so the implementation of rural community health development PKMD program needs improvement as an integral part of the rural development. In this context, clarity and firmness are required in the integrated cultivation implementation that covers among other things: types of cadet to be formed, the role of helper puskesmas at rural area, and the role of health and family planning section in Rural Community Tenacity Insitution LKMD in the implementation of activities that nowadays are easily found in the rural areas such as the under 5 years old cultivation post, posyandu and polindes. Page 72 of 88 Intra and Inter-Sectoral Cooperation In order to increase the intra and inter-sectoral cooperation, there are several things need attention regarding organization and motivation and public participation. To realize the cooperation, the importance of coordination, integration and synchronization of activities should be understood in terms of systemic approach and dynamic cooperation. Activity integration will be operable and developed if the coordination is clear. In order to realize a good coordination, communication between units based on transparent attitude is an absolute requirement. Intra and inter-sectoral communication system need to be improved so that it can open wider opportunity for mutual knowledge of each other’s programs and reach concensus on each role in the effort to formulate problem and its settlement effort. Arrangement of various activities should be mutually supportive and the impacts can be felt by the society as a whole. In this respect matrices on the table can give an illustration of how important is the support from various related sectors for the successful implementation of developmental programs with health concerns for the ten most favored programs see table next to this page. Table Table on Identification of Sectors Related to the Most Favored Health Programs Toward Healthy Indonesia 2010 Program’s Name Related Sectors Related Units 1. Program of Health Policy, Health Funding and Health Laws Bappenas Dept. of Internal affairs Bappeda Financial Dept. Justice Dept. Coord. Min. of Developmental Secretary general Planning bureau Public legal bureau Economic bureau Organizational bureau All directorate generals Page 73 of 88 Supervision State Apparatus Organizing Private health insurance Universities Health RD Body JPKM develop. body Health data center 2. Nutritional improvement program Bappenas Public welfare Coord. Min. Dept. of internal affairs Financial Dept. Social Dept. Dept. of educ. culture Dept. of agriculture Dept. of food and holticulture Dept. of female roles ‘Binkesmas’ Dit. of Public Nutrition Dit. ‘Kesga’ family health Planning bureau Nutrition research center 3. P2M Contagious disease eradication Program including immunization Bappenas Dept. of internal affairs, PKK Dept. of finance Dept. of edu culture Dept. of information P2M Dit. Immunization ‘Binkesmas’ public health cultivation BUKP Planning bureau Contag. Disease research center Medical service Yanmed Dit. Public Participation 4. Healthy Living Behaviour and Mental Health Improvement Program Bappenas - KSKG Dept. of internal affairs Dept. of finance Dept. of information Dept. of social Dept. of religion Dept. of edu culture Public health instruction center ‘Binkesmas’ BUKP Planning bureau Dit. Mental health Program’s Name Related Sectors Related Units 5. Program of Residential areal Environment, Healthy Water and Air Bappenas Dept. of internal affairs Dept. of finance Dept. of public works Dept. of settlement Dept. of transmigration Dept. of industry trade Dept. of social Dept. of information Dept. of environ. forest cutter Dept. of agriculture Universities Environmental NGOs P2M – PLP Dit. Healthy clean water Dit. Healthy settlement Health ecology research center Public health instruction center Dit. Public participation Health laboratory center Environmental health technic clinic BTKL Planning bureau Page 74 of 88 6. Family health, Reproductive health and Family planning Program Bappenas Dept. of internal affairs Dept. of population affairs Dept. of finance Dept. of social Dept. of religion Dept. of female roles Dept. of edu culture Dept. of youth sports Universities Professional organizations: POGI, IBI, IDI, PKBI. Population affairs’ NGOs Binkesmas Kesga Yanmed Medical services Public health instruction center Planning bureau 7. Health and Occupational Health Program Bappenas Dept. of labours Dept. of industry trade Health insurance Binkesmas PSM Public health instruction center Planning bureau 8. Anti Tobacco, Alcohol and Hashish Program Bappenas Dept. of internal affairs Dept. of finance Dept. of education culture Dept. of social Dept. of information Dept. of religion Dept. of industry trade Universities Professional organizations NGOs Dept. of justice Attorney general Police dept. Public health instruction center Binkesmas Yanmed Medical services POM drug food supervision Dit. mental health Planning bureau Program’s Name Related Sectors Related Units 9. Supervision of Drugs, Dangerous Substances, Foods Beverages Program Bappenas Dept. of internal affairs Dept. of finance -- Customs office Dept. of industry trade Dept. of justice Dept. of information Attorney general Police dept. Professional organization NGOs POM ‘Binkesmas’ Yanmed medical services P2M - PLP POM clinic Puslabkes health labor. center Planning bureau Page 75 of 88 10. Accident and Injury Prevention, including Traffic Safety Program Bappenas Dept. of internal affairs Dept. of finance Dept. of transportation Dept. of educ. culture Dept. of justice Dept. of female roles Attorney general Police dept. Universities NGOs Public health instruction Yanmed Dit. mental health Binkesmas Health RD body Planning bureau Cultivation Based on the importance of integrity principle in implementation, so in order to get optimal result the cultivation effort needs to be increased for the common interest at all levels of administration. The cultivation effort is mainly toward the health manpower, so that they can work with high dedication, ethics, professionalism and nationalism. In order to implement this cultivation effort, in depth investigation and consideration are needed, as related to the fact that health manpower is a man that needs fulfillment of primary needs and self actualization. As to what is meant by cultivation in this respect is the activity of giving direction about how to implement effort according to the rules and is intended to get a unison of action in order to reach maximum effectiveness and efficiency. Supervision, Control and Evaluation Supervision Page 76 of 88 The system and implementation of developmental supervision in Indonesia includes internal supervision which includes functional supervision and adhering supervision as a part of the internal control, as well as external supervision which includes the supervision by constitutional institutions and the public supervision. Basically supervision implementation is directed to the strategic sectors, and operationally focused on activities that can provide more significant input for the Departmental Chief in the compilation of accountability regarding success failure in the implementation of organization’s mission to achieve the target and objective of Healthy Indonesia 2010. The accountability exercised by an organization individual needs a supervision audit evaluation assessment on aspects of the accountability itself from the other sides, before being reported to the one giving authority to manage the state owned resources. Supervisory Pattern and Mechanism

1. The policy that needs to be acted in the area of supervision can be differentiated