SITUATION OF OCCUPATIONAL HEALTH SURVEILLANCE IN INDONESIA

DIREKTORAT KESEHATAN KERJA DAN OLAHRAGA DIREKTORAT JENDERAL KESEHATAN MASYARAKAT

MINISTRY OF HEALTH REPUBLIC OF INDONESIA 2017

OUTLINE

• Function and authority of Ministry of Health

• Concerning Occupational Health Activities

• Occupational Health Legislation

• Situation of health Surveillance Procedure for Occupational Health

MINISTRY OF HEALTH

• Directorate General of Public Health that handle of health community.

• Directorate of Occupational Health and Sports

Function: • Preparing the formulation of national policies

(Norms, Standards, Procedures and Criteria) in the health sector

• 2. Monitoring and Evaluation in health

STRATEGIC STEPS MINISTRY OF HEALTH

Penerapan pendekatan continuum of care

Intervensi berbasis resiko kesehatan (health risk)

PROGRAM INDONESIA SEHAT

Pilar 1. Healthy Paradigm

Program • Promotive -

preventive as the foundation of health development

• community empowerment

• Cross-sectoral engagement

Pilar 2. Strengthtening Healthcare Facilities

Program • Main access

improvements on FKTP • Referral System

Optimization • Quality improvement

Pilar 3. National Helath Insurance

Program • Benefit • System of financing:

insurance - the mutual principle of cooperation

• Quality Control & Cost Control

• Target:beneficiaries and non beneficiaries

• “Kartu Indonesia Sehat” membership

Healthy Family

Application of the Continuum of care approach

Basic Health risk information Government

Employers

Healthcare facilities

Community workers

Healthy family Healthy

workers

A healthy paradigm will change the

mindset (mental revolution) then the

mainstream of health in every policy-

making is no exception in economic

development

Indonesian Population (Central Bureau of Statistics, Feb 2015)

WORKER 114 million • FORMAL : 39,98%

• INFORMAL (SMEs) : 60,02%

• Male : 68.2 million • Female : 41,8 million

Total Population

237,64 million

people

Working age (15 – 64 yr) : 121,87 million

Unemployee 7,4 million

WORKER

Nutrition

Reproduction

Non-

Communicable

Diseases

Communicable Diseases

TB, HIV-AIDS, Hepatitis

Occupational

diseases

Injury

WORKERS HEALTH PROBLEMS

Anemia

Abortus menstrual disorders

Hypertention DM

Cardiovascular Diseases

Access woman worker to manage

muscle skeletal disorders Mental disordes skin disorders hearing disorders, etc

absentism Dead

Accident

Breast Feeding

OCCUPATIONAL HEALTH SERVICES SYSTEM IN INDONESIA

Tertiery Healthcare (Provincial Hospital)

Secondary Healthcare (District Hospital)

Primary Healthcare (Public health centre, private clinics )

Community Empowerment

PREVENTIVE

DAN

PROMOTIVE

KURATIVE DAN

REHABILITATIVE

STRATEGY: • Community

empowerement and partnership

• Socialization and advocacy

• Strengthening health services

• Regulation • Strengthening

information system

OCCUPATIONAL HEALTH PROGRAMS IN INDONESIA

Small enterprises

•Basic Occupational Health Services through occupational health post/ Pos Upaya Kesehatan Kerja (Pos UKK)

Medium and Big Enterprises

• Healthy and Productive Women Workers Movement or Gerakan Pekerja Perempuan Sehat dan Produktif (GP2SP)

Health Facilities

• Accreditation

• Promotion of Occupational Health and Safety in Hospital and Public Health Centre or PUSKESMAS

Offices

• Health promotion

• Exercise at offices

• Provision of healthy food in canteen

Migrant workers

• Facilitating the development of policies on health services for migrant workers

• Strengthening Health Secreening Providers

• Desmigrative Program

OCCUPATIONAL HEALTH POST/

POS UKK

Health Promotion

Health Risk Identification

Health Counselling

Injury Prevention

Basic Health Examination

BASIC OCCUPATIONAL HEALTH SERVICES

-Informal sector / SMEs workers-

Pos UKK’s Cadre

Healthy and Productive Woman Workers

Movement (GP2SP) is a strategy to reduce

Indonesia health problems through women

working groups approach ;

Encouraging health knowledge through advocating and regulation strengthening

Improving accessibility and quality of workplace-based health care services

Promoting and protecting reproductive health in workplace

Improving nutritional status in women workers

Encouraging breastfeeding during work-hours.

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OCCUPATIONAL HEALTH IN

OFFICES

Exercise

STRETCHING

NUTRITION

EARLY DISEASE

DETECTION/

SCREENING

HEALTH PROMOTION

ERGONOMi,SSSAFETY,

SANITATION.

OCCUPATIONAL HEALTH IN OFFICES

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OCCUPATIONAL HEALTH PROGRAMS IN HEALTH FACILITIES

• OCCUPATIONAL HEALTH PROGRAMS FOR HEALTHCARE WORKERS Universal Health Precaution Environmental risk management Screening Health Examination

• OCCUPATIONAL HEALTH AND SAFETY AS ONE OF REQUIREMENTS TO GET ACCREDITATION

• INCREASE HEALTH WORKERS CAPACITY Occupational Disease Diagnosis Training Basic Occupational Health Training Training of Occupational health in community health centre Occupational health socialization

REPORTING OF OCCUPATIONAL DISEASE National

Level

Province Level

Provincial Health Office

District Health Office District Level

Gov . Public Health Center (PUSKESMAS)

Occupational services in work place

MINISTRY OF HEALTH

Occ Health Directorate

RE

PO

RT

ING

Occupational Health Post (Pos UKK)

RECORDING AND REPORTING FORM

Community Health Centre (Puskesmas)

Employee monthly report (LBKP) 1 District Health Office (Dinkes Kabupaten/Kota)

Employee monthly report (LBKP) 2 : Recapitulation monthly employee health report

Province Health Office (Dinkes Provinsi)

Employee monthly report LBKP 3 : Recapitulation monthly employee health report

REPORTING PERIOD ONCE A MONTH IN THE BEGINNING

No Description Amount Information

1 Sick workers served (promotive,preventive, curative and

rehabilitative)

2 Common diseases in the workers

3 Suspect Occupatioanl disease in the workers

4 Occupational disease in the workers

5 Occupational Injury case in the workers

MONTHLY EMPLOYEE HEALTH REPORT FORM

==============================================================================

Community Health Centre /District/Province :................................................ Number of Community Health Centre which report:................................................

Information : Reporting from the company's clinic, and it will record by the Community Health centre (Puskesmas), combined with the Puskesmas report. It is reporting once a month, at the beginning of the month.

OBSTACLES OF IMPLEMENTING HEALTH WORK SURVEILLANCE: Incomplete reporting and recording Data is not analyzed and rarely have feed back to the

data source Doctors and workers are less concerned about the

relation between the disease and the work environment / occupational health risks

Occupational health surveillance systems are not integrated with other health surveillance systems.

CONCLUSION

1. Occupational health is a strategic program in relation to the high number of working-age population in Indonesia.

2. Implementation of occupational health programs is expected to improve public health status

3. Occupational health surveillance is essential for the development of occupational health programs, in the prevention of occupational diseases and occupational accidents, and also improving workers health.

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