Clean and Healthy Behavior to Prevent Diarrhea Diseases Oleh : DR. Dr. Bagoes Wijanarko, MPH Disarikan dari Berbagai Sumber

British cholera epidemics 1831-1832: first modern outbreak in Britain 23,000 deaths helped to launch the sanitary reform movement 1848-1849: 250,000 cases and 53,000 deaths Prompted John Snow (and others) to investigate causes

The Broad Street Pump Outbreak

The London Cholera Epidemic of September 1848 – August 1849 Based on his clinical experience and review of epidemiologic characteristics of cholera, Snow formulated a theory of causation and transmission of the disease.

The London Cholera Epidemic of September 1848 – August 1849 Causal hypothesis Sewage-contaminated drinking water was a causal agent for the cholera epidemic Arguing the Miasma Theory and He proved his hypothesis

Current situation Diarrhea still become health problem Many factors related, encounter various sectors

Community behavior

Unsecured water system

House Environtment

Diarhea - typhoid fever - disentri - Helminthiasis - hepatitis A Oral-Fecal Transmission Diarhea - typhoid fever - disentri - Helminthiasis - hepatitis A

Diarrhea disesase related behavior Open defecation Water usage Others personal hygiene behavior (washing hand etc)

Factors important to adopt new behavior Complexity Compatibility Triallibility Tangibility

PUBLIC HEALTH CHALLENGE People’s health is influenced not just by, or even principally by, the availability of medical treatment but by a range of measures in outside the health sector (Lalonde, 1974)

Determinant factors of unhealthy behavior Knowledge Attitude Social norms Skill Social influence Enabling factors

HEALTH EDUCATION Is any combination of learning experiences designed to facilitate voluntary adoptions of behavior conducive to health The process of enabling people to increase control over, and to improve their health

HEALTH PROMOTION Any combination of educational, organizational, policy and regulatory support for environmental and behavioral changes conducive to health

OTTAWA CHARTER 1986 * build healthy public policy * create supportive environments * strengthen community action * develop personal skills * reorient health services

Clean & Hygienic Behaviour Individual Family Community Public space School Market (Tradisional) Hotel & Restaurant

Pengertian “… Tindakan yang dilakukan oleh Perorangan-Kelompok-Masyarakat yg sesuai dengan norma-norma kesehatan untuk memperoleh Derajat Kesehatan yang optimal, menolong dirinya sendiri dan berperan serta aktif dalam Pembangunan Kesehatan…”

INDICATORS Rumah Tangga yang memenuhi : Sembilan (9) indikator PHBS di Rumah Tangga Pertolongan persalinan oleh tenaga kesehatan Bayi diberi ASI saja sejak lahir – 6 bulan Mempunyai JPK (Jaminan Pemeliharaan Kesehatan) Ketersediaan air bersih Ketersediaan jamban Kesesuaian luas lantai dengan penghuni (9 m2/orang) Lantai rumah bukan dari tanah Cuci tangan dengan sabun Rumah bebas jentik Tiga (3) indikator gaya hidup Makan buah dan sayur setiap hari Melakukan aktifitas fisik setiap hari Tidak merokok di dalam rumah

Principle of CHB program Healthy Paradigm Pro active increasing health status Preventing Community to do Risk factors Protect people from health hazards Working together with community (participatory) Facilitating community to do healthy behavior

Strategy ADVOKASI SOCIAL SUPPORT EMPOWERMENT

STRATEGI, BENTUK & PESAN UTAMA PHBS ADVOKASI SOCIAL SUPPORT EMPOWERMENT BENTUK KEGIATAN PESAN UTAMA PEMBERDAYAAN MASY PEMBEDY. KEMITRAAN PENGEMBANGAN SDM & IPTEK PENGEMBANGAN INFRA STRUKTUR, MEDIA & SARANA TEMA  KES = HAM DAN INVESTASI. FOKUS  Ketahan Keluarga, Kepedulian Terhadap Lingkungan. Prioritas Aktivitas Fisik/Olahraga, Diet/Gizi Seimbang, No Smoking dll

Advocation

Working with community

Building the social support

Working with community

PHBS TATANAN RUMAH TANGGA

Pengertian “....Upaya untuk memberdayakan anggota RT agar tahu, mau, dan mampu mempraktikkan perilaku hidup bersih dan sehat serta berperan aktif dalam gerakan kesehatan di masyarakat ....”

Sasaran PUS Ibu Hamil & Ibu Menyusui Anak & Remaja Usila Pengasuh Anak

Indikator PHBS Tatanan RT Pertolongan Persalinan o/ Nakes Bayi diberi ASI Eksklusif Mempunyai JPKM Ketersediaan Air Bersih Ketersediaan Jamban Sehat Kesesuaian Luas lantai dgn Jumlah Penghuni Lantai Rumah bukan Tanah Tidak Merokok di dalam Rumah Melakukan Aktifitas Fisik Setiap Hari Makan Buah dan Sayur Setiap Hari

Pola Pembinaan PHBS pd Tatanan Rumah Tangga TAHAP PERSIAPAN : A. Sosialisasi & Advocacy Kesehatan B. Persiapan Sarana C. Persiapan Administrasi D. Persiapan Pelaksana

Pola Pembinaan PHBS pd Tatanan Rumah Tangga TAHAP PENGKAJIAN : A. Pengkajian Masalah Penyakit ( 10 Penyakit terbesar) B. Pengkajian Sumber Daya C. Pemetaan Wilayah D. Pengakajian Sumber Daya

Pola Pembinaan PHBS pd Tatanan Rumah Tangga TAHAP PERENCANAAN : A. Menentukan Prioritas B. Menentukan Tujuan C. Menentukan Jenis Kegiatan/Intervensi D. Jadwal Kegiatan

Pola Pembinaan PHBS pd Tatanan Rumah Tangga TAHAP PENGGERAKKAN / PELAKSANAAN : A. Advocacy B. Social Support C. Empowerment

Pola Pembinaan PHBS pd Tatanan Rumah Tangga TAHAP PEMANTAUAN & EVALUASI : A. Pemantauan B. Evaluasi

TERIMA KASIH