PUBLIC HEALTH

New paradigm
 BATASAN / DEFINITION
)

Public health is "the science and art of preventing

disease, prolonging life and promoting health through
the organized efforts and informed choices of society,
organizations, public and private, communities and
individuals." (1920, C.E.A. Winslow)[1]
It is concerned with threats to the overall health of a
community based on population health analysis. The
population in question can be as small as a handful of
people or as large as all the inhabitants of several
continents (for instance, in the case of a pandemic).
 Public health is typically divided into epidemiology,
biostatistics and health services. Environmental, social,
behavioral, and occupational health are other
important subfields.
AIPTKMI & IAKMI menetapkan KES-MAS meliputi
bidang ilmu, epidemiologi, biostatistik, promosi
kesehatan, kesehatan lingkungan, kesehatan &
keselamatan kerja, ilmu gizi masyarakat, administrasi &
kebijakan kesehatan dan kesehatan keluarga &
kesehatan produksi
Kombinasi dari ilmu pengetahuan, keterampilan,
moral dan etika, yang diarahkan pada upaya
pemeliharaan dan peningkatan kesehatan semua
orang, memperpanjang hidup melalui tindakan
kolektif, atau tindakan social , untuk mencegah
penyakit dan memenuhi kebutuhan menyeluruh
dalam kesehatan, dengan menggunakan srategi
pemberdayaan masyarakat untuk hidup sehat
secara mandiri
 CHARACTERISTICS OF PUBLIC HEALTH

There are 2 distinct characteristics of public

health:
1. It deals with preventive rather than curative
aspects of health
2. It deals with population-level, rather than
individual-level health issues
 SEJARAH
KESEHATAN MASYARAKAT
TERDIRI DARI 8 TAHAP PERKEMBANGAN
1. ASAL MUASAL KESEHATAN MASYARAKAT: Sanitasi dan perumahan,
Kebersihan dan keTuhanan, Penyakit dan komunitas
2. Kesehatan dan komunitas pada era Yunani (malaria, diphteri, konsep
penyakit , udara, air, tempat, hygiene, health education, kesehatan kerja,
administrasi kesehatan)
era Romawi (penyakit endemic dan epidemic, suply air dan sanitasi, iklim,
tanah dan kesehatan, kesehatan pekerja, pelayanan kesehatan)
3. Kesehatan masyarakat di era Pertengahan (500-1500 S.M)
tumbuhnya perkotaan, sanitasi urban, perlindungan konsumen, karantina,
penyakit pes, pengorganisasian kesmas, pelayanan kes, rumah sakit, panti
kesejahteraan
4. Mercantilism, Absolutism, dan Kesehatan (1500-1750): Scurvy- The
black death pada pelaut, penyakit akibat kerja, small pox, mikroskop
(Leuwenhock), Penemuan PH adm. , National Health Policy,
 SEJARAH
(lanjt)
5. Periode Pencerahan dan revolusi (1750-1830):
Population explotion, Health dan HAM, Geography of health
& disease, advice to the people, prevalence of disease
6. Industrialisasi dan Pergerakan Sanitasi (1830- 1875):
mobilisasi angkatan kerja, urban growth, statistical
enthusiasm, KIA, first step to international health org.
7. Era Bacteriological dan kelanjutannya (1875-1950):
antisepsis and asepsis, bacteriology, herbal medicine,
specific element in disease.
8. Masa kini dan lanjutan (1950 - ..) economic and social
trens, kesejahteraan ibu dan anak, kesehatan sekolah,
nutrition, kesejahteraan pekerja, penyuluhan kesehatan,
tanggung jawab pemerintah untuk peningkatan kesehatan
 Perkembangan kesehatan masyarakat sebagai
profesi global
Sebelum masehi: Hygienist, K3
Setelah masehi beberapa ratus tahun:
hygienist, K3, epidemiologist (Karantine,
vaccination), nutritionist, health educator,
demographer, administrator.
> 2010 : upaya standarisasi pendidikan profesi
sehingga dimungkinkan adanya network antar
negara
 Perkembangan (pendidikan) keilmuan kesehatan
masyarakat (global)
Abad 10 : sbg bagian pendidikan medis modern di Eropa.
Literatur dari Yunani, Romawi, dan Arab
Abad 14 : munculnya wabah bbrp peny. Menular; konsep
karantina.
Abad 17: scientific medicine dan agriculture & industrial
revolution, konsep public health berkembang
Abad 18: prevention dng vaccination (E.Jenner- smallpox vacc.)
Abad 19: Pierre Louis French founder of modern epidemiology
John Snow London U.K.
Public Health Act London U.K
Abad 20 - : W.H.O berdiri (1946), Alma Alta for P.H.C (1978),
Health for All in 2000 (1998), MDGs (2010-2015)
 Perkembangan pendidikan keilmuan
kesehatan masyarakat di Indonesia
Era 1950 sebagai bagian dari pendidikan
medis (kedokteran, kedokteran gigi)
Era 1965 sebagai bagian dari pendidikan
pascasarjana
Era 1985 sebagai pendidikan sarjana
Era 2010 sebagai biang pengembangan ilmu
di lingkup kesehatan masyarakat
 Perkembangan kesehatan masyarakat sebagai
profesi global
Sebelum masehi: Hygienist, K3
Setelah masehi beberapa ratus tahun:
hygienist, K3, epidemiologist (Karantine,
vaccination), nutritionist, health educator,
demographer, administrator.
> 2010 : upaya standarisasi pendidikan profesi
sehingga dimungkinkan adanya network antar
negara
 Perkembangan pendidikan keilmuan
kesehatan masyarakat di Indonesia
Era 1950 sebagai bagian dari pendidikan
medis (kedokteran, kedokteran gigi)
Era 1965 sebagai bagian dari pendidikan
pascasarjana
Era 1985 sebagai pendidikan sarjana
Era 2010 sebagai biang pengembangan ilmu
di lingkup kesehatan masyarakat
 PH PROFILES (INDONESIA)
M sebagai manajer pelayanan kesehatan masyarakat
I _ sebagai Inovator dalam strategi pemecahan masalah
kesehatan masyarakat
R _ sebagai Reseacher / Peneliti
A _ apprentice yaitu professional yang belajar sepanjang
hayat
C _ sebagai communitarian selalu dekat dan bersama
kelompok masyarakat binaan
L - leadership yang dapat berperan (Role player)
pemimpin yang memberi teladan baik
E - sebagai Educator bagi mereka yang membutuhkan
 CHARACTERISTICS OF PUBLIC HEALTH
There are 2 distinct characteristics of public
health:
1. It deals with preventive rather than curative
aspects of health
2. It deals with population-level, rather than
individual-level health issues
 Sistem Kesehatan Nasional &
praktisi kesehatan masyarakat
SISTEM KESEHATAN
NASIONAL

UPAYA UPAYA
KESEHATAN KESEHATAN
MASYARAKAT PERORANGAN

Praktisi
Kes-mas
 HOW?
A worldwide Task of Public Health
Professionals
- and an Interaction Between
Practice, Science and Education
 How is Public Health
Different From Medicine?

Public health is
population-based
Medicine is based
on the individual
 Goals
Medicine Public Health
Individual Health Population Health

Best outcome for Healthy community

individual Balance of individual
autonomy vs. limitations
on individual
Balance in allocation of
resources
Focus on prevention
 LEVEL OF PREVENTION
1. HEALTH PROMOTION
2. SPECIFIC PROTECTION
3. EARLY DIAGNOSIS AND PROMPT TREATMENT
4. DISABILITY LIMITATION
5. REHABILITATION
 HEALTH PROMOTION
IS A PROGRAM DESIGNED TO BRING ABOUT
CHANGE WITHIN PEOPLE, ORGANIZATION,
COMMUNITIES, AND THEIR ENVIRONMENT

HEALTH PROMOTION ---- change of

BEHAVIOR
 Diagnostic Tools
Medicine Public Health
Individual Health Population Health

Thermometer Demographics
Stethoscope Vital statistics
Individual data, Epidemiology
medical history
 What is Epidemiology?

The study of the distribution and

determinants of disease in
populations, to seek the causes of
both health and disease.
Epidemiologista medical detective
who links observed problems with
potential causes, to arrive at a
diagnosis and design and implement
a mitigating response.
 The Epidemiology Triangle

Host

Agent Environment
 Examples
Host Agent Environment

Human Bacteria, Virus Water, Food, Air

Human Energy Automobile

 Public Health Tools
Engineering
Host
Enforcement
Education

Agent Environment
Core Functions and
Essential Services
of Public Health
 A Public Health System Is Complex

Churches Community
Police
EMS MCOs Centers
Health Home Health
Hospitals Department
Schools Parks
Doctors Jails

Philanthropist Elected Mass Transit

Officials
CHCs Environmental
Civic Groups
Health
Fire
Tribal Health
Laboratory
Drug Employers Economic
Facilities Mental
Treatment Development
Health
 Six Obligations
1. Prevent epidemics and the spread of disease.
2. Protect against environmental hazards.
3. Prevent injuries.
4. Promote and encourage healthy behaviors.
5. Respond to disasters and assist communities in
recovery.
6. Assure the quality and accessibility of health
services.
Ten Essential Services
10 Steps of
Public Health
.
Practices
Monitor Health Status to Identify and
Solve Community Health Problems
Diagnose communitys health status.
Identify threats to health & assess needs.
Collect, analyze, and publish information on access,
utilization, costs, and outcomes of personal health
services.
Collect and analyze vital statistics and health status of
higher risk groups.
Integrate information systems with private providers
and health benefit plans.
 Diagnose and Investigate Health
Problems and Health Hazards in the
Community
Epidemiologically identify emerging health threats.
Use modern laboratory technology to conduct rapid
screening and high volume testing.
Use active surveillance programs to epidemiologically
address infectious diseases.
Maintain technical capacities to undertake
epidemiologic investigations of disease outbreaks and
to examine patterns of chronic disease and injury.
Ukuran Profesional Kesmas

Delapan Kompetensi Utama

. .

8. Memimpin dan 1b.Diagnosis &

berfikir sistim
Investigasi