PRIMARY HEALTH CARE PROGRAM

Government effort in the prevention and control of infectious diseases nowaday uses a family approach and GERMAS (Community Movement towards being Healthy). The effort is directed at several activities including: early detection of disease, controlling risk factors, handling disease, increasing community participation, protecting people from being infected and improving the quality of public health so as not to be exposed to disease. The main priority of efforts to prevent infectious diseases is aimed at several diseases, including HIV & AIDS, tuberculosis (TB), pneumonia, hepatitis, malaria, dengue fever, influenza and bird flu, as well as neglected diseases including leprosy, frambusia, filariasis and christosomiasis. (Directorate General of Disease Prevention and Control, 2018)

In line with this, efforts to prevent and control infectious diseases have also been carried out by UPKM / CD Bethesda YAKKUM in several regions in Eastern Indonesia and the Special Region of Yogyakarta. The efforts taken include promotive, preventive, curative and rehabilitative in collaboration with the District Health Office / City and related government agencies / institutions.

Eastern part of Indonesia is still in the endemic areas of Tuberculosis (TB), Malaria, and Filariasis, with still high prevalence rate, although program interventions coming from the government and other organizations are still on place. Conditions of poverty, an unhealthy environment, poor management of handling, and malnutrition add to the high prevalence rates of these infectious disease, in addition to geographical factors. The last few years conducted by the CD Bethesda in handling TB and Malaria have been building cooperation with the district government, especially the Health Office, by encouraging and assisting village governments to allocate village budgets (ADD and Dana Desa) for P2M programs and in collaboration with Puskesmas. All that is done in stages, beginning with training the community and village government to make door-to-door visits using the SALT method (Support, Appreciation, Listening / Learning, Teamwork & Transfer). From home visits using this SALT method, the government and the team studied and obtained data on diseases (including infectious diseases) experienced by the community, in addition to potential / resource solutions, then discussed and prioritized village-funded health programs. In this point, the village government must also collaborate with Puskesmas to tackle TB and Malaria.

Another form of P2M treatment is to train village cadre teams and patients' families to become volunteer counselors to take medicine (called PMO- pengawas minum obat), because for the treatment of TB and HIV AIDS, patients must take routine medication and should not be dropped out. In addition, village cadres and families ensure that nutritional intake should not be reduced so that patient health is maintained. Therefore a nutritious local food program is also prioritized so that the health quality of infectious disease patients is maintained. We train families and health cadres how to make nutritious food using a variety of local resources, including herbal drinks to increase the stamina of infectious disease patients. Of course, education and health promotion to prevent transmission of TB and malaria continue to be carried out by villages and Puskesmas.

What about HIV AIDS? Cases of HIV & AIDS were first discovered in Indonesia in 1987 and until now still a major health problem in Indonesia, including Java and Eastern Indonesia. Some of the problems faced are the high rate of HIV transmission in the community, high rates of dropping out of ARV therapy and high cases of stigma and discrimination against people living with HIV & AIDS (PLWHA). The HIV & AIDS program conducted by UPKM / CD Bethesda YAKKUM was implemented in Belu Regency and Yogyakarta City from 2019 to 2022. The program is implemented in 3 components, namely: 1) Structural Prevention, 2) Biomedical Prevention, and 3) Behavioral Prevention, which aims to increase community participation in HIV prevention with full support from the Government.

Structural prevention is generally carried out in the context of strengthening Local Government support in the HIV & AIDS program including developing policies, advocating for increased budgeting and increasing the capacity of policy makers in implementing programs. Biomedical prevention is carried out in the context of strengthening health services, including increasing the capacity of health workers, supporting sexually transmitted infections (STI) testing and mobile HIV testing services. Behavior prevention is carried out with the aim of increasing community participation including increasing the capacity of Communities who Concerned about AIDS (WPA-  warga peduli AIDS), increasing capacity and support for PLWHA and people living with PLWHA, providing education to the general public and HIV & AIDS prevention campaigns.

 

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