MOH WorkshopW France

7/28/2019 MOH WorkshopW France

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Development National Policy on Healthfor Adaptation to Climate Change

in Indonesia

dr Wan Alkadri, SS , MScDirector Environmental Health

Ministry of Health Indonesia


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OUTLINE

Background Methodology for vulnerability and adaption

assessment on health and Climate Change,The Impact of climate change on healthHazardsVulnerability

Adaptive Capacity Strategy Adaptation in Indonesia


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Background


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Republic of Indonesia Population of 236.4m, 57%in villages (SCB, 2007)

17,508 islands over 3.977miles

GDP per capita US$ 3.843(UNDP,2007/8)

Human Development Indexranking 107 (UNDP 2007/8)

45.2% (105.3m) poor andvulnerable poor (WorldBank 2007)

In 2001 implemented aDecentralization policy.

In 2007 administratively;into 33 provinces, 444districts


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Climate Change now become an importantissue in Indonesia and has been

mainstreamed in National DevelopmentPlan. Ministry of Health has been developing a

National Policy on Health for Adaptation toClimate Change. With other sectors, health adaptation

strategy will be implemented in a NationalDevelopment Plan (National DevelopmentPlan 2010-2029)


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Methodology for vulnerabilityand adaption assessment onhealth and Climate Change


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CC Roadmap development method

Scientific Basis Analysis

7 regions

ClimateChangeIssues

Findings,

GIS basedinformation

Sector issues

FrameworkInstitutionalPolicy and

Program

Cross-cuttingissues


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Papua

7 REGIONSSumatera

Maluku

Nusa Tenggara

Sulawesi

Kalimantan

Jawa, Madura, Bali


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Climatechange

Directexposures(temperature,precipitation, sea levelrise, extreme events )

Environ-mental

conditions

Indirectexposures(changes in water, air,

food quality; vectorecology; ecosystems ,agriculture, industryand settlements)

Healthimpacts

Healthsystem

conditions

Social &

economicdisruption

Social conditions(upstream determinants

of health)

Modifying influence

*

*

Confalonieri, Menne et al, 2007

CLIMATE CHANGE AND HEALTH IMPACT


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Vulnerable & AdaptationFramework


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Hazard, vulnerability and riskanalysis on health sector

The analysis used time periodic as follows : baseline, compiled and analysis data from 1961

1990 (30 years) current time (1991 2008) near future (2009 2029)

and projection (2029 -2100)


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The impact of Climate Change onhealth, hazard, vulnerability and

adaptation capacity


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The impact of climate change on HealthKASUS MALARIA DI JAWA BALI THN 1989KASUS MALARIA DI JAWA BALI THN 1989 --20072007

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

Insidens Malaria0.21 0.17 0.14 0.12 0.19 0.17 0.07 0.08 0.12 0.3 0.52 0.81 0.62 0.47 0.22 0.11 0.23 0.19 0.16

1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Vector borne diseases

Hubungan antara Kasus,An. aconItus, An. maculatus dan C. hujanDesa Wadaslintang th. 2001

0

10

20

30

40

50

60

JAN PEB MAR APR MEI JUN JUL AGT SEP OKT NOP DESC-hujan

Maculatus

Aconitus

Kasus

MALARIA


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Vector borne diseases

DENGUE


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0

1000000

2000000

3000000

4000000

5000000

6000000

'81 '83 '85 '87 '89 '91 ' 93 ' 95 '9 7 '9 9 '0 1 '03 '05 '07

Sumber: Lap Subdit Diare

Water borne diseases

Diarrheal

0

50000

100000

150000

200000

250000

Jan Feb Mar apr Mei Jun Jul Ags Sep Okt Nop des

2004 2005 2006

Sumber: Lap STP. P2PL


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Hazards


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Hazards on health Increase in temperature

Rain fall variability Sea level rise

More intense extreme events Water shortage Drought Air Polution


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Change of Mean Temperature Year = 2000

Source: Susandi, 2006

oC


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oC


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oC


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Risk on water shortage in 2005


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Risk of drought in 2005


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Vulnerability


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Vulnerability

1. Poor and vulnerable poor especially in urban area2. Coastal Community (65% Population in Java Island life

in coastal area)3. Elderly and children,4. Traditional Community

5. Farmers,6. Small islands Population (17.500 islands, Indonesiaarchipelago)

7. Poor water supply, sanitation and hygiene8. Poor Health system (facility, services, and community

participation)9. Ecosystem (vector distribution and transmission)


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Population growth and distribution projectionin 2010


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Population growth and distribution projection

in 2020


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Adaptation to Climate

Change


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DISASTER REGIONAL CENTER

Medan

Palembang

Jakarta

Semarang

Surabaya

Denpasar

Banjarmasin Makassar Manado

Jayapura

Padang


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Hospitals Distribution in 2008


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Posyandu Distribution in 2008


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Immunization coverage rate in 2008


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National Policy, Strategy and Program

towards climate change impact on health


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Matrix as a tool to develop AdaptationStrategy

No

Regions H V R Recommendati

on foradaptation

strategy

Program and Activity Recomendation

2010-

2014

2015-

2020

2021-

2025

2025-2030

1 Sumatera

2 Jawa, Madura, Bali

3 Kalimantan

4 Sulawesi5 Kep. Nusatenggara

6 Kep. Maluku

7 Papua

Note:

H = Hazard, V = Vulnerability, R = Risk


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Basis Saintifik Rekomendasi untuk Prioritas Program


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Rekomendasi untukAlternatif Strategi

AdaptasiBahaya Kerentanan Potensi Dampak 2010 2014 2015 2019 2020 2024 2025 2029

Perubahanpola curahhujan akibatperubahanvariabilitasiklim alamiah(El-Nino [EN],La-Nina [LN]).Proyeksi ENdan LN(Sofian,2009):.

Terdapatnyapulau-pulau kecildi sebelah baratdan timur Sumatra

Banyak terdapatsistem muarasungai, lagun danrawa di pesisir timur.

40% area rawa diIndonesia

terdapat diSumatera

Informasikerentanan danrisiko di sektor kesehatan dan

adaptasiberkenaanperubahan iklimmasih minim

Terjadi perubahanekosistem di pesisir dan pedalamanMALARIA

Peningkatan curahhujan pada batasnormal akanmeningkatkan jumlah habitat baruuntuk larva yangberarti juga akanterjadi peningkatanpopulasi vector

dengan peningkatansurvival vector,vectors biting rate,pathogenisitas danincubation rate

Pembangunansadar penyakitbersumber binatang

Upayapengendalianpenyakitbersumber vektor/binatang secaraREESA (Rational,Efficient, Effective,Sustainable,Acceptable)

Penggunaanberbagai metodepemberantasanuntuk memutusrantai penularanserta keterpaduan

dengan berbagaisektor & programterkait

Komitmen PolitikDepartemenkesehatan

Advokasi danSosialisasi

Manajemen data,kajian, analisisserta penelitiantentang bahaya,kerentanan, danrisiko serta dampakperubahan iklim

terhadap malaria

Pemetaan daerahrawan malariaakibat perubahaniklim di Sumatera

Pemetaan vektor kerentananterhadapinsektisida padatingkat Kabupatendi Sumatera

Pemetaan habitatperkembangbiakan

vektor malaria diwilayah endemismalaria diSumatera

Pengembanganmodel intervensiKIE dan partisipasimasyarakattentangpengendalianmalaria

PeningkatanKapasitasPengelola Program

Penguatanmanagemen kasus

dan pengendalianvektor

PenigktanKapasitasPengelola Program

Pengendalianfaktor risikor penularan malariameliputi :pengelolaaanhabitatperkembangbiakanakibat perubahan &meningkatkankepedulian

masyarakat dalampencegahan danpengendalianmlaria .

Institutional Framework


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Institutional Framework Indonesia has ratified UNFCCs Framework with LawNo. 5 /1994

Government Regulation No. 46/2008 about National

Council on Climate Change, and Minister of Health asa member.

National Cross-sector Working Group on Climate

Change. Lead by Minister of Environment withmembers : MoForestry, MoEnergy, MoAgricultural,MoHealth, National Planning, MoPublic Works andUniversities.

National Team on Climate Change Planning, PPNMinister/BAPENAS No. 204/M.PPN/10/2008

Communication Forum for Climate Change Impact onHealth, MOH as a chairperson


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thank you

MOH WorkshopW France

Documents

Transcript of MOH WorkshopW France