Beban Penyakit Nasional Karena Tuberkulosis Paru

Besarnya masalah TB di negara berkembang termasuk Indonesia sangat besar dan memerlukan penanggulangan yang sungguh-sungguh. Masalahnya menjadi lebih unik karena penyakit ini terutama mengenai penduduk usia produktif (15-59 tahun) yang merupakan tulang punggung keluarga dan masyarakat.Tersedianya teknologi diagnostik dan obat anti tuberkulosis yang ampuh, tidak menjamin efektivitas program pemberantasan, karena banyaknya kendala yang dihadapi.Untuk Indonesia pemberantasan Tuberkulosis merupakan salah satu prioritas utama karena tingkat kesakitan dan kematian yang tinggi serta dampak ekonomi negatif yang ditanggung oleh keluarga, masyarakat dan negara

Analysis of Potential Health and Economic Impact Oflarge Avian Influenza Epidemics in Indonesia

The analysis of potential health and economic impacts from large epidemics on avian flu in Indonesia had been conducted using several sources including data from health, agriculture, tourism and transportation sectors. This analysis aimed to socialize the understanding on negative impacts and the size of burden if a large epidemic happened in lndonesia. It was estimated 43.2 million people will suffer from avian flu with a total deaths in the first two weeks at about 525.000 persons and 605.000 cases need hospitalized in the first 2 (two) months of epidemics. The cost needed for case managements reach 539.9 million US Dollars. In agriculture sector, the direct lost because of disease or stumping out of poultry reached 97.2 million US Dollars and the preventing cost using vaccines for poultry is 74.7 million US Dollars. In tourism sector. the losses reached 8.6 million Dollars and in transportation sector reached 1.7 milliard US Dollars just in the first two months. The negative impact will increase if the epidemic was in a long duration or the virus type is more virulent. So the government and community efforts to do promotion and preventive activities including preventing the virus transmission in poultry, to protect if the epidemic starts and to decrease the negative impacts for community health is important to manage the situation

Dampak Kesehatan dan Ekonomi Perilaku Merokok Dl Indonesia

Indonesia is the fifth largest country in the world for tobacco consumption. Objective of the study is to estimate the health and economic impact of smoking behavior in 2005. Data used include National Socio economic Survey 2004, National Health Survey 2004, Population Projection for 2005, Medical expenditures of diseases related to tobacco collected from central government hospitals in Jakarta and the Indonesian Abridged Life Table. Global Burden of Disease method is used to estimate the disease burden. The results show that in 2005, about 399,800 people died due to diseases related to tobaccoor about 26% of total deaths (1,539,288). About 3, 846,373 DALYs (productive years) were lost due to premature mortality and 1,502,900 DALYs were lost due to morbidity and disability. The macro-economic loss due to tobacco was estimated in the amount of 44 Trillion Rupiahs and total medical expenditure due to tobacco was estimated in the amount of 2 Trillion rupiahs. Average cigarette consumption per person per day was 11 sticks or 330 sticks per month. Total budget spent in one month was Rp. 165,000 or equal to 20 days of income, based on Regional Minimum Wages (in Jakarta) of Rp. 8, 000 per person per day. It is concluded that smoking behavior produces negative health and economic impact at macro level aswell as at individual level. Therefore Cost-effective policies to control tobacco as suggested in the Framework Convention of Tobacco Control can reduce the negative impact of smoking behavior

Survei Kematian Neonatal (Studi Autopsi Verbal) di Kabupaten Cirebon, 2004

In its attempt to realize the intervention program to saving newborn babies with asphyxia, the Ministry of Health will initiate to train midwives in the village in order to that they know how to operate resuscitation equipment to save neonatal baby with asphyxia. The intervention program his dubbed successful if the mortality proportion due if asphyxia decreased to half as targeted. The survey was conducted in the rural area of Cirebon district. The sample was 200 neonatal death babies, calculated using the hypothesis test with different proportion; p1 0.3 (30% neonatal death cause of asphyxia, according household health survey 2001), p2 0.15, α 0.05, β 0.2, (l-β) 0.8. Neonatal dead cases happened within 12 months prior to the survey were identified by rural midwives out of their personal records. The death cases were followed up by interviewing the mother of the neonatal baby concerning its birth, illness or disorder histories before death. The diagnosis of the diseases were based on the International Classification of Diseases 10 and Wigglesworth classification, determined in union by NIHRD researchers and neonatologists. The neonatal mortality rate was 13 out of 1,000 live births. The major cause of early neonatal mortality was respiration disorder mainly caused by birth asphyxia (45%), of which 90 percent could be intervened by doing resuscitation (for babies weighed more than 1.000 gram). The second and third order of the mortality causes was infection (22%) and congenital disorders (11%) respectively. The major cause of late neonatal mortality was infection (56%), followed by low birth weight and prematurely born, as well as neonatal jaundice (14 percent each), and congenital disorder comes in the third place. The option to handle asphyxia with the early neonatal babies is the right effort to decrease the neonatal mortality rate. And to achieve the utmost result, it is necessary that the rural midwives maintain their standard performance (in terms of quantity and quality) in their basic midwifery services, i.e. providing pregnancy health care and detecting as early as possible maternal diseases/complication. Besides, there must be continuous monitoring and adequate guidance from the counselor team from referral hospital

Trial of Medical Certificate of Cause of Death (Smpk) to Improve the Quality of Recording and Reporting Hospitals Mortality Data in Jakarta, Year 2007

Statistik kematian sangat penting untuk memberikan informasi dasar tentang kesehatan masyarakat. Di Indonesia, pencatatan dan pelaporan penyebab kematian masih merupakan masalah, disebabkan antara lain belum adanya standardisasi pelaporan kejadian kematian di rumah sakit (RS) dan di rumah. Pada tahun 2005, Badan Litbangkes berkolaborasi dengan WHO dan SPH, University of Queensland mengembangkan Sertifikat Medis Penyebab Kematian(SMPK) untuk Provinsi DKI Jakarta berdasarkan ICD-10. Penggunaan SMPK oleh rumah sakit ditetapkan dengan Surat Keputusan Kepala Dinas Kesehatan Propinsi DKI Jakarta No. 3942/2006. Uji coba dilakukan dengan melatih dokter mengenai konsep underlying cause of death (UCOD) untuk mengisi SMPK, dan memeriksa setiap SMPK dari pasien rawat inap yang meninggal di RS Saint Carolus dan Pasar Rebo sepanjang tahun 2007. Pemeriksaan terhadap jumlah kelengkapan, dan keakuratan pengisian SMPK oleh dokter dilakukan oleh peneliti Badan Litbangkes. Hasil menunjukkan bahwa tanggapan dokter mengisi SMPK di Saint Carolus lebih baik daripada di Pasar Rebo (791 vs 321 SMPK). Dikedua RS kira-kira90 persen keterangan tentang selang waktu sakit sampai meninggal tidak diisi. Beberapa hal yang tidak akurat seperti mode of dying yaitu respiratory failure (J96.9), cardiac arrest (146. 9), dan pneumonia unspecified (J18) dicatat sebagai penyebab kematian. Untuk meningkatkan kualitas pencatatan penyebab kematian, semua dokter harus diberikan pelatihan penyegaran, dan diinformasikan mengenai hal-hal yang tidak akurat yang harus dihindari sebagai UCOD sesuai konsepICD-10. Perekam medis juga harus dilatih khusus untuk pengkodean dan penentuan UCOD final dengan menggunakan Medical Mortality Data System. Kata kunci: Uji Coba, Sertifikat Medis Penyebab Kematia

Mortality in Central Java: results from the indonesian mortality registration system strengthening project

Background. Mortality statistics from death registration systems are essential for health policy and development. Indonesia has recently mandated compulsory death registration across the entire country in December 2006. This article describes the methods and results from activities to ascertain causes of registered deaths in two pilot registration areas in Central Java during 2006-2007. The methods involved several steps, starting with adaptation of international standards for reporting causes of registered deaths for implementation in two sites, Surakarta (urban) and Pekalongan (rural). Causes for hospital deaths were certified by attending physicians. Verbal autopsies were used for home deaths. Underlying causes were coded using ICD-10. Completeness of registration was assessed in a sample of villages and urban wards by triangulating data from the health sector, the civil registration system, and an independent household survey. Finally, summary mortality indicators and cause of death rankings were developed for each site. Findings. A total of 10,038 deaths were registered in the two sites during 2006-2007; yielding annual crude death rates of 5.9 to 6.8 per 1000. Data completeness was higher in rural areas (72.5%) as compared to urban areas (52%). Adjusted life expectancies at birth were higher for both males and females in the urban population as compared to the rural population. Stroke, ischaemic heart disease and chronic respiratory disease are prominent causes in both populations. Other important causes are diabetes and cancer in urban areas; and tuberculosis and diarrhoeal diseases in rural areas. Conclusions. Non-communicable diseases cause a significant proportion of premature mortality in Central Java. Implementing cause of death reporting in conjunction with death registration appears feasible in Indonesia. Better collaboration between health and registration sectors is required to improve data quality. These are the first local mortality measures for health policy and monitoring in Indonesia. Strong demand for data from different stakeholders can stimulate further strengthening of mortality registration systems