Health Problems and Visioning the Future PH in Indonesia - Bachtiar w CV

Born in Cirebon, West JawaDokter from UNIVERSITAS INDONESIAMaster of Public Health: HARVARD-USADoctor of Science: JOHNS HOPKINS-USAPost Doc in Statistics: UNIV of MICHIGAN-USACurrent Activities:

Indonesian Public Health Association, PresidentGlobal Fund TB at FPH-UI, DirectorHealth Professions Coalition for Anti Smoking, ChairmanNational Expert Panel on TB, Health Policy SpesialistIndonesian Healthcare HIV/AIDS Roadmap development,

Head of TeamKomnas Penelitian & Pengkajian Penyakit Infeksi

(PINERE), Expert PanelIndonesian MCH-Nutrition Eval Team, Head of TeamDept of Health Policy & Administration, UI, Past Chairman;

Advice & examnine more than 150 PhD dissertationsNational Health Research Committee, Expert PanelResearch Committee in Hospital, Expert Panel

Adang Bachtiar

Visioning Public Health In Indonesia

Future Leaders’ Responsibility

[email protected]

Presented at Welcomimg Seminar for New Breed of Future PH Leaders & Knowledge Holders - FKMU.UI, 24.08.2013

Materi dapat diakses di: https://www.facebook.com/groups/iakmi.pusat/

Public Health Problemsin Indonesia

1-Healthcare services

2-Health Sector Program & Policies

3-Other Sectors Development

•Rejected, loaded.•Low empathy•Rush time incomplete exams

•Ineffective incentive system for HRH•Low capacity in logistic mgmt

•Problems in professional educ•No systematic

cont. educ

•Weak in referral system•Low acceptancy at

primary care

•Bureacratic reimburse process•Limited package•No Portability & cost-sharing•“Free curative” as vote gating for politician

•Keep revisitation•Non-holistic curatrive approach

•Reactive to illness, no empowerment•No PH spectrum

Policies and procedures

Sub-standardsHealth services

Patients & CommunityComplaints

Problem in HRH and logistics Delayed Tx

Poor provider-patient

relationship

Biz orientation

Substdcompetencies

No follow up

NGO report on HC quality, 2011

Delivery system•No programming nationally•Piloting: no eval•No standards

Delivery system•No programming nationally•Piloting: no eval•No standards

DK Modelling•Minim aliansi dr-drg-perawat utk keluarga•Sinkronisasi dg UKM(-)•Sinkr dg UKP lain(-)

DK Modelling•Minim aliansi dr-drg-perawat utk keluarga•Sinkronisasi dg UKM(-)•Sinkr dg UKP lain(-)

•Only 2% GDP vs 10% abroad (limited funds mobilization)•Curative orientation, not

support healthy life styles

•Only 2% GDP vs 10% abroad (limited funds mobilization)•Curative orientation, not

support healthy life styles

Chronic problems of “Dokter

Keluarga” system

Chronic problems of “Dokter

Keluarga” system

Partial services, only curative. No budgeting

•No vision for DK system•Conflict Professional Orgnz

•No vision for DK system•Conflict Professional Orgnz

More than 3 decadesNon existence of DK syst

Dokter Keluarga Workshop 2012

Govt Stewardship:•Up-down priority•Limited regulations•Low commitment at Local govt

Govt Stewardship:•Up-down priority•Limited regulations•Low commitment at Local govt

Alienated from healthcare systemSupply side problem

56% no ac-

cess

Time to access 1st ANC

Limited accesibility

1st ANC compliance

Mothers w/ =<12 mo. babies

w/ 12-60mos. Babies Total

n % n % n %

Yes 482 37,1 662 38,4 1144 37,9

No 816 62,9 1060 61,6 1876 62,1

DECREASING QUALITY OF MIDWIVES

1.Weighing pregnant woman2.Fundus uteri height3.Blood pressure meas.4.Iron tablets5.Tibia sign for pre-eclampsia

4th ANC compliance

Mothers w/ =<12 mo. babies

w/ 12-60mos. Babies Total

n % n % n %

Yes 75 5.8 133 7.7 208 6.9

No 1223 94.2 1589 92.3 2812 93.1

Health centres limited accessibility, availability, effectivity

Difficulties in HRH

placement

Low ability in budget

advocacy

Low Financial accountability

system

Limited monev & superv

Health technology

assmt & use(-)

Inadequate HC need

assessment

Substandard health care

quality

Inadequate drug supplies and logistics

Barrier to access for poor

people

Inadequate healthcare quality

climate

(Healthcare system workshop, 2008)

Using Baldrige Framework:

Low healthcare performance (low achievement, low quality), related to:

• Low healthcare leadership at healthcentre• Limited HRH capacitation and management• Ineffective health information system at health centre• Limited community empowerment

Bachtiar et al, MCH & Nutr Midterm Ev , 2012

“UNSAFETY CHAIN”

Inadequate Capacitation of Healthcare Management System

Limited good clinical governance

Non-compliance procs.

Delayed responses

Adverse Event

Conclusion? No PH continuum spectrum: Promotive-preventive separated from

curative, and rehabilitative

Hedonistic pragmatic “profit” oriented Over-rated Sectio cessarea Low access for poor people Low access in rural areas

Healthcare quality problems

Sustainability problem

Problems in

Health Programming & Policies

Primary health care is neglected (2010 Health Facility Survey) No maintenance for health devices and appliances Limited procedures for public health and/or clinical pathway/

governance Limited local government’s budget for operational and

maintenance (big proportion for routine budget, esp ‘gaji PNS’)

HRH* supply problems, related to Unstandadized HRH production system Difficult HRH recruitment and placement & maldistributed Limited health professional performance evaluation Limited career path system

*WHO: HRH contributed to est 80% success.

MDs in district area (log)

Poor

people

Pro

port

ion

GPs Mostly in Cities

Doctors tend to open private practices in (big) cities, even in a (very) high competition. It is assumed relate to incomprehensive ability

Poor/rich district

Chronic problems in drugs’ accessibility and availability

Inadequate Health information System, i.e. non-existence Knowledge Mgmt System at health centre Data collection abilities Data analysis capacity Information uses for decision making Information uses for capacity development

Mostly it’s related to limited financing health system

PHC SUSTAINABILITY

LOCAL GOVT BUDGETING FOR HEALTH Means (7 provs)

PR.1 Public Health Programs 6.58%PR 1.1 MCH 0.70%

PR 1.2 Nutrition 0.97%PR 1.3 Immunization 0.12%

PR 1.4 TBC 0.06%PR 1.5 Malaria 0.30%

PR 1.6 HIV/AIDS 0.03%PR 1.7 Diarea 0.00%

PR 1.8 Pneumonia 0.01%PR 1.9 Dengue 0.06%

PR 1.10 Other infectious diseases 0.15%PR 1.11 Non-infectious diseases 0.03%

PR 1.12 Family Planning 0.57%PR 1.13 School Health Programs 0.07%

PR 1.14 Reproductive Health 0.01%PR 1.15 Environmental Health 1.20%

PR 1.16 Health Promotion 0.41%PR 1.17 Disaster Program 0.02%

PR 1.18 Surveillance 0.05%PR 1.19 Other Public Health Programs 1.83%

Gani, 2011

LOCAL GOVT BUDGETING FOR HEALTH Means (7 provs)

PR 2 Personal healthcare 41.23%PR 2.1 Curative visits 1.50%PR 2.2 Hospitalisation program 0.89%PR 2.3 Referral program 0.15%PR 2.4 Others for personal healthcare 38.69%

PR 3 Management and Capacity Building 52.20%PR 3.1 Administration and health management 25.29%PR 3.2 Health information system 0.28%PR 3.3 Capacity Building 0.57%PR 3.4 Infrastructures provision 15.65%PR 3.5 Monitoring and supervision 0.54%PR 3.6 Drugs and health logistics 6.90%PR 3.7 Health insurance 3.24%PR 3.8 Other Capacity Building activities 0.11%

Grand Total 100.00%

WTP

WDP

Disclaimer

Adverse

-200.0% 0.0% 200.0% 400.0% 600.0% 800.0% 1000.0% 1200.0% 1400.0% 1600.0% 1800.0%

-61.9%

-45.0%

1614.3%

490.0%

% Decreasing Financial Accountability2004-2007/08

WTP=Clean w/o restriciton WDP=Clean, but with some notes/restrictionDisclaimer=Couldn’t declare accountability Adverse=Non accountable

TOP REFERRED

REFERRED

1s

t

CURATIVE

5 LEVEL PREVENTIVE MEDICINE

INDIVIDUAL COUNSELLING

FAMILY COUNSELLING

HEALTH PROMOTION(COMMUNICATED SOCIETY)

COMMUNITY EMPOWERMENT

FAMILY RESILIENCE FOR HEALTHY LIFE STYLE

In Conclusion:

Non-Pyramidical “Energy” for Health

PH efforts

Personal HC

Problems in Other Sectors Related to

Health System

Limited understanding of Human Development Index Approach, i.e. MDG targets• Poverty as health risk (vice versa), limitly understood • Non synchronize sectors development to support HDI/MDG goals

Inappropriate, inadequate and delayed budget transaction implementation

Fragmented funding sources for health development

Limited budget accountability

Low priority HRH mgmt at local governments

CONCLUSION: Inefficient Health System

Misdirected & Overheated Personal Care Neglected PHC priorities

Budget orientation for

curative

Educate for curative

only

Overloaded hospital unsafe

care, anger and critics

Limited ability for healthy life

style regulations

Soc Det of Health esp.

Poverty

Unhealthy life styles

Low capacity for PHC devt

Limited budget for

PHC

Non-vitalized PHC

infrastructures

Low ability in health politics

PHC considered not for profit

only

Limited synergy of Acad-Buss-Govt for Comm

EmpowermentFailure in gatekeeping PHC system Low

understanding of community

empowerment

Low & non standardized PH profession’s competenciesModif: Bachtiar, 2011. WHO Meeting for CHW at Srilanka

Work Survey_1

Three (3) competencies are needed in job markets:• Computer literacy• Critical system thinking• Ability to serve

For first timer job seekers:• Positive energy and respect people• Output oriented• Abide to rules and implement regulations/commands

Work Survey_2

Three (3) barriers for first time job seekers:• No working experiences• Limited ability in human relation• Low professional competencies

ENOUGH COMPLAINING....

PH VISION BASED ON SITUATIONS

PH Profesionals Must Have_1

Knowledge-driven model• Adequate knowledge and skills to understand health

problems, at all levels, ie, individual and community

Problem-solving model• Adequate professional skills to solve health problems

Interactive model• Adequate softskills for implementing public health

solutions within social economic development frameworks and perspectives

Enlightenment model• A comprehensive involvement in social cultural,

poltical and economic development for the sake of people’s health

PH Profesionals Must Have_2

First Domain:Structurization of

Public Health Competencies

.

.

.

1a.M

onito

ring

Health

Sta

tus

1b.PH Diagnosis & Investigation

2a.Information,

Capacitation,

Empowerment

2b.Alliances

3a.H

ealth

Pol

icy &

Regul

atio

n3b.Rules

enforcement

4.Stdzed healthcare

5.High skilled HRH

6.Monev

practices

7.Mgmt System

8.RESEARCH

TUJUAN PENDIDIKAN NASIONAL

TERAMPILCERDAS

BERTAQWA

MIRACLEPROFIL LULUSAN KESMAS

Suplai Nakes Kesmas terampil utk kes bangsa yg blm optimal

(belum MIRACLE)

M MANAGER

I INNOVATOR

R RESEARCHER

A APPRENTICER

C COMMUNITARIAN

L LEADER

E EDUCATOR

PUBLIC HEALTH INDONESIAN NATIONAL

QUALIFICATION FRAMEWORK

CORE COMPETENCIES AND LEARNING OUTCOMES

Competency #1Ability to Understand Health Problems & SituationsAbility to define health problems and situationsDetermine usability and limitation of (existing) variety of dataIdentify data sources accurately as a relevant source of informationAbility to evaluate data integrity and comparabilityAbility to abide to principles of ethics in data collection and the use of informationAbility to establish data inference, quantitatively & qualitativelyAbility to evaluate existing data, in terms of risks and benefitsAbility to apply skills in data collection processes, and using IT based information mgmt.

Competency #2Ability to develop health plan dan policy

Ability to collect, to sort and to interpret data and information related to healtjh problemsCapable to establish health policy and appropriate solution to health problemCapable in describing health policy in health improvement implications, legal and administrative frameworks, and social political impactsCapable in determining level of feasibility and expected outputs of each policy optionCapable to use new methods in health situation analysis and planningAbility to make a decisive actionsAbility to develop activity plan to implement health policyAbility to interprete and describe from policy to structures, management and programs


Competency #3Capability in establishing effective communication

Ability in communication skills either in-writings, oral or other means

Capable in asking inputs from others effectively

Capable in structuring advocacy activitiesAbility in leading and participating in (interdisciplibary) team to elaborate health issues and their solutionsCapable in aplying and using media, communication technology and networks to spread health informationAbility in deciding appropriate communication for effective solutionCapbale in presenting accurate information on demographic characteristics, statistical data, health program and sicentific products to clients


Competency #4Ability to adapt local culture

Capable to apply effective, sensitive method professionally to interact with others who have different cultural background

Capable to develop and adopt-adapt specific PH solutions that accommodate cultural differences

Ability to understand social cultural dynamics that contribute to PH problems

Ability to accept different background of health providers


Competency #5Ability to empower community

Capable to synergize community members’ interaction with different backgroundsAbility to identify social cultural background of healthcare behaviorAbility to response to wide spectrum health interests as a part of cultural varietyAbility to identify community leaders and maintain warm effective relationship with themCapable to apply group dynamics processes to improve community participationCapable to describe government roles in providing community empowered PH servicesCapable to describe private sector roles in providing community empowered PH servicesAbility to identify potential community resources for PH services


Competency #6Basic Public Health Skills Mastery

Ability to identify individual and organizational responsibility in relation to basic PH services

Ability to define, diagnose, and evaluate health status in a population, determine risk factors and other causes, and define health promotion and prevention solutions

Ability to understand historical background, structures and dynamic interactive of PH system with other system

Ability to identify and capable in applying basic research methods in PH program


Competensy #6 (cont’d)Basic Public Health Skills Mastery

Capable in applying group dynamics process for community participation

Capable in applying PH sciences and knowledge, including social behavior applied science, chronic and infectious diseases, accident and disasters

Ability to identify research limitation, the importance of accurate observation and interrelationship concept

Ability in self interest and commitment for PH services and development by using critical thinking approach


Competency #7Financial Planning & Management

Capable to develop and to present health budget and financingCapable to manage health program with limited budgetCapable to apply budget process and proceduresCapable in developing strategies for budget prioritiesCapable in monitoring financial andprogram performancesCapable in developing program proposal for financial support from external sourcesAbility in appling human interrelationship skills, motivating others, and conflict resolution in organizationAbility to negotiate many interests and establishing contract and documents in providing community based PH services


Competency #8Leadership skills and system thinking

Menciptakan kultur dari stardar etik di dalam organisasi dan komunitas

Membantu menciptakan nilai dasar dan visi bersama dan menggunakan prinsip-prinsip ini dalam petunjuk pelaksanaan

Mengidentifikasi isu internal dan eksternal yang dapat berdampak terhadap penerapan pelayanan esensial kesehatan masyarakat (mis. Rencana strategis)

Memfasilitasi kerjasama kelompok internal dan eksternal untuk menjamin partisipasi dari stakeholder kunci.


Competency #8 (cont’d)Leadership skills and system thinking

Capable to contribute to the development, implementation and monitoring standardized organization performances

Capable in applying law and regulation system and political mechanism to stimulate changes

Ability to apply theories for organizational changes and professional practices development

Capable in creating conducive environment to comply to ethical standards in organization and/or in community


2nd Domain:Public Health Professions

Involvement

4-Capacitation inHealth Knowledge

Development

1-Capacitation in Policy & Programming

3-Capacitation in“Health is

AlsoIndividual Responsibility”

2-Alliance Capacitation

Provincial Deconcentration capacities

National Guidances

Global Opportunity

Governance

Stewardship

Financial

Capacity building

Benchmarking

Standardization

StewardshipGovernance

Financial

Capacity building

Benchmarking

Standards

HRH Performance

Decentralization capacities

Health Policy Capacity

Hlth Mgtm capacity

HRD capacity

Financial capacity

HIS & Knowl mgmt

Media & nerworks

Knowl management & borderless networks

International funding

Hlth & Devt Policy CommunicationCapacities & competency devt

Modif: Bachtiar 2009

1-Capacitation in Health Policy & Programming

2-Capacitattion in Health Alliances

1-Strong allianceCivil soc &

Govt

2-HealthPriorities

3-Targets & Programs

4-SynergyAction Plam

5-Implementationwith Involvement

6-Best Practices& replications

Health Outcome

Improvement

3-Capacitation in Self Reliance

DisadvantagesAppraisals

Advantages Appraisals

Level ofParticipation

Health Problems’Articulation

ParticipationPlan

ExperiencesOf Success

SelfReliance

Modified fr: Paton, McIver, Johnston, 2007

PH Skills

Global-R

egional, Local Wisdom

4-Capacitation in Health Knowledge Mgmt

PH PROFESSION

Health Technolgy

Learning-Knowledge–Innovation

PUBLIC HEALTH KNOWLEDGE CREATION &

PRESERVATION FOR BENEFIT OF

ALL

SupplyDemand

PH organizations

PH services

Tacit&embedded knowlOpportunity & Threats

Health Outcomes

ROLE & RESPONSIBILITY OF

PH PROFESION

1.Strong Health Profession Inst.

4.Sources for Health action

2.Health professions’Mobilization

3.Knowl & SkillsDevelopment

•SOLIDITY of the Professions•Health Profession orgz existence•Continuous standardization •Accreditation•Continuing Education

•Health System Capacitation:•Health governance•Health policy capacitation•Programming & monev facilitation

•Tacit KNOWLEDGE for:•Innovation in PH Intervention•Innovation in PH-programming•Innovation in Healthy Life Styles

•‘Health is POLITICS’:•Fiscal capacitation•Resource mobilization•Embedded PH knowl•Healthy Public Policy

Adapted from Hughes-Tuohy 2003 & Hicks & Mishra 1993

Involvement of (end) Users

Health professions’ competency development

Stakeholders involvement in each step

Goals of HealthDevt

PlanningDevt

ProcessImplem &

MonevDirect

Outputs

HealthOutcomes(Indirect)

Expected benefits:-Health system capacitation

-Evidence based-Health Improvement

3rd Domain:Close Encounter With Health Users

Close Encounters’ Means & GoalA Effective knowledge production – e.g. PublicationsB Research targeting, capacity building and absorption

(i) better targeting of future research;(ii) development of research skills, personnel and overall research capacity;(iii) critical capability to utilise appropriately existing research, including that from overseas;(iv) staff development and educational benefits.

C Informing policy and product development(i) improved information bases on which to take political and executive decisions;(ii) informing product development.

D Health and health sector benefits(i) cost reduction in the delivery of existing services;(ii) quality improvements in the process of service delivery;(iii) increased effectiveness of services e.g. increased health;(iv) equity e.g. improved alloc of resources at an area level, better targeting and accessibility;(v) revenues gained from intellectual property rights.

E Broader economic benefits(i) wider economic benefits from commercial exploitation of innovations arising from R&D;(ii) economic benefits from a healthy workforce and reduction in working days lost.

Nyantri itu adalah…

• Pembentukan dan pengembangan manusia pembelajar yang diarahkan untuk menjadi anggota sekelompok masyarakat yg ingin tahu segala sesuatu dengan melakukan kegiatan pengkajian ilmiah secara orisinil untuk kebenaran yang teruji sesuai dengan metode ilmu pengetahuan

All, start from being a scholar

• Develop continuously intelectual integrity & capability to produce scientific products (5 domains)

• Systematically prevent any wrong doing of academic integrity

Responsible Scholar is..

Mhsw &PA

Rencana Akademi& Menuju Pasar Kerja

Rencana diri menujuSarjana & Profesi

RencanaBelajar

Individual

Mahasiswa yang berdaya Mahasiswa yang sukses

RencanaMagang &

Karir

Fasilitasi KarirBertahap

Pengemb diri& sosial (ahlak)

Rencanapembelajaran

Magang &Ekstra-

kurikuler

Capaian akademik

& perbaikan

AtmosfirPT

Aksesinformasi

Residensi& Pengemb

skills

Opsi2 pembelajaran

Mgmtkonflik

Mgmtkrisis

KomunikasiMhsw-ortu-PA

Asesmen diri

ACADEMIC INTEGRITY IS HIGH PRIORITY & SERIOUS

BUSINESS (!)

Intelectuals are nation’s

assets/ fundamental,

and within their hands the rise and

fall of of nation

DEDUCTION-INDUCTION CYCLE

• AS SCHOLAR:Disrespect to others

Irresponsible & dishonestUnproductive & laziness

Prejudice and hatredNo empathy for helping each other

WHY SERIOUS ?

• MACRO LEVEL AND LONG TERM EFFECT:

Limited understanding of nature

Instant cultures & diminisihing justice

Destruction of morality and the Nation

WHY SERIOUS ?Intelectuals are nation’s

assets/ fundamental,

and within their hands the rise and

fall of of nation

»Menerima dan/atau menggunakan pekerjaan orang lain dalam kegiatan uji-kemampuan diri sebagai calon intelektual

»Memberikan dan/atau mendorong orang lain menggunakan pekerjaan bukan miliknya dalam kegiatan PENELITIAN

It begins from tiny miny small offense

ONE BIG SERIOUS ACADEMIC DISINTEGRITY IS

PLAGIARISM

PLAGIARISM

(Latin) Plagiarius = Penculik

“Stealing and using other people’s thoughts and speechs, as it is owned” (Webster Dictionary)

THESES GUIDELINES

“Plagiat adalah kegiatan pencurian karya intelektual, baik berupa ucapan, tulisan, maupun media lain ....”

Pedomen Tesis FKMUI, 2010

Plagiarism is defined as the use of the words, ideas, diagrams, etc., of publicly available work without appropriately acknowledging the sources of these materials. This constitutes plagiarism whether it is intentional or unintentional and whether it is the work of another or of you.

An example fromThe Univ. Washington

3 TYPES PLAGIARISM

3 TYPES PLAGIARISM

FORGERY-FABRICATION

Publikasi hasil riset, padahal milik orang lain

Meminjam pekerjaan orang lain untuk mendapat “nama”

Mengkopi materi yang telah diterbitkan termasuk dari internet

Membeli makalah dari “pedagang ilmu”

FORGERY-FABRICATION

• Mengkombinasikan “sana” dan “sini” tanpa menyebutkan sumbernya

• Dan seringkali “Nggak ngerti sendiri” jadinya

“Cut-and-Paste”

• Membuat kutipan “....” tapi lupa(!) mengutip sumbernya

• Menuliskan sebagai Daftar Pustaka tetapi tidak ada hubungan dengan tulisan yg dibuat

Inappropriate Citations


Merubah alinea milik orang lain tetapi masih menggambarkan fikiran orang tersebut secara jelas, tetapi “lupa” menyebutkannya



• Kelas Kakap– Seluruh karya “dicuri”

• Kelas Teri (yang dibiarkan akan menjadi kelas kakap)– Umumnya Bab Tinjauan Pustaka– Lebih sering lagi: alinea yang dicuri

CONTOH-CONTOHCONTOH-CONTOH

CONTOH ALINEA YG DICURICONTOH ALINEA YG DICURI

Biaya pengadaan barang farmasi merupakan posisi terbesar dari biaya rutin.. dst. Burr W. Hupp (1969) menyimpulkan bahwa jika perusahaan tidak sukses dalam pengendalian persediaan, maka.. dst

– Si penulis ternyata tidak memiliki artikel Burr W Hupp (1969)

– Di dalam Daftar Pustaka tidak tercantum Burr W Hupp

CONTOH ALINEA YG DICURICONTOH ALINEA YG DICURI

• Dalam perhitungan pembiayaan rumah sakit, salah satu yang penting diperhatikan adalah biaya rutin penyediaan logistik rumah sakit, karena besarnya biaya yang harus disediakan.. Burr W. Hupp (1969) seperti dikutip oleh X (1997) menyimpulkan bahwa manajemen rumah sakit akan berhasil dengan baik, bila mampu mengendalikan pengadaan logistik.

Jadi, seharusnya?Jadi, seharusnya?

• Teguran ‘terbuka’ (social punishment)

• Penilaian keprofesian

Apa hukuman pelanggaran?Apa hukuman pelanggaran?

Meneliti ulang

Skors dalam profesinya

Dipecat dari pekerjaannya

Di anulir gelar akademik yang didapat

Apa hukuman pelanggaran?Apa hukuman pelanggaran?

Expectations From The Future Leaders

Competitive AdvantagesCompetitive AdvantagesEV

IDEN

CE B

AS

ED

P

UB

LIC

HEA

LTH

CA

RE

EV

IDEN

CE B

AS

ED

P

UB

LIC

HEA

LTH

CA

RE

GLO

BA

L C

ULT

UR

AL

CO

MP

ETEN

CE

GLO

BA

L C

ULT

UR

AL

CO

MP

ETEN

CE

HR

H M

GM

T S

KIL

LS

HR

H M

GM

T S

KIL

LS

ABILITY FOR RESOURCE MOBILZATIONABILITY FOR RESOURCE MOBILZATION

COMMITMENT “HEALTH IS RIGHTS”COMMITMENT “HEALTH IS RIGHTS”

HEA

LTH

P

RO

FESS

ION

S

SY

NER

GIS

M

(ON

E H

EA

LTH

)

HEA

LTH

P

RO

FESS

ION

S

SY

NER

GIS

M

(ON

E H

EA

LTH

)

HEALTHOUTCOME

Universities;Research Centers

KNOWLEDGE SUPPLIERS

Consultants, ProfessionalPractioners,

Informal leaders

PH FACILITATORS

Govt, privates & Communities

DECISION-MAKERS

YOUR GOAL(S)

Knowledge is defined as “a justified true belief that increases an entity’s capacity for effective action” (Nonaka 1994).

Akhlakul

Kharimah

Leadership

Inter-indiv behavior

Indiv Behavior in

Orgnz

Softskills-Softskills-Softskills

Musa, Nadhoriyah As Suluk At Tandzimi min Mandhuril Islam, 1995

LEADERSHIP1

Fairness Leading “walk the talk” Visioner Honesty Responsible Intelligent/smart Orator/Communicator Knowledgable/transfering know-how

Madhi, Al Qiyadah Al Muatsiroh, 2002

LEADERSHIP2

Skillful manager Decisive Creating condusive working climate, i.e trust, warm,

peaceful, outcome focus Caring interaction, i.e to subordinates, clients etc Empowering and participation Effective-efficient

Individual behavior

Ihlas because of Allah Self evaluation & correction Honesty Optimistic Taubat Managing Knowledge Humble

Inter-individual behavior

Team work for the benefit of others (i.e., community) Amar ma’ruf nahi munkar Empathy and caring Obey to the leader Not doing ghibah Prevent from SMS attitudes (hatred/dengki)

Musa, 1995; Luth, 2001, Tasmara, 1996; 2001

Musyawarah Hard work for helping others Patience (for solving others’ problem) Continuous positive improvement High/best achievement orientation


Self control Honesty Responsible Balance between hard work & achievement, with akhirat

orientation Optimizing the works


Professional Efective and efficient Creative Managing new knowledge Teamwork Serving others with IHLAS for service excellence


From those who have much..,

much is also expected

Closing Remarks

THE POWER OF “WE”

Reflection

ACTIONDialogue

Adapted fr: Freire, P. (1995) Pedagogy of the Oppressed. New York: Continuum Publishing Co

ThankYou

.

.

.

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Health Problems and Visioning the Future PH in Indonesia - Bachtiar w CV

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