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PUSKESMAS:

THE PRIMARY HEALTH CARE SYSTEM


IN INDONESIA
Introduction
Why do you have to know about
PUSKESMAS as the primary health
care system in Indonesia in relation
to the Public health and community
nutrition systems course?
References
Pedoman Kerja Puskesmas, Depkes
RI
Sistim Kesehatan Nasional
Renstra Depkes 2005-2009
Standar Pelayanan Minimal Bidang
Kesehatan
What is PUSKESMAS?
Functional health organization unit
Public health development center
Building community participation
Provide comprehensive and
integrated services to the community
under its coverage in the forms of
principal activities
PUSKESMAS coverage
Part of or the whole sub-district
(kecamatan), depending on:
Population density (~30,000)
Areas (~district head office)
Geographic (extended to have
supporting-Puskesmas/Puskesmas
Pembantu or Puskesmas Keliling)
Infrastructure (personnel and facilities)
PUSKESMAS coverage
Especially for big cities (population
1 million) = Puskesmas Pembina:
Coverage: sub-district
Population: 150,000
Referral and Coordinating several
Puskesmas Kelurahan (village-level)
Comprehensive health service

Promotion
Prevention

Cure/treatment

Rehabilitation

for all gender and age from conception


to those dying
Integrated health services
All principal health service activities:
Policlinic
Maternal and child clinic
Hygiene and sanitation program
Communicable diseases program
And others
implemented together under one
coordination and leader
Functions and roles of PUSKESMAS
in the public health system
Functions:
Public health development center
Building community participation to
promote healthy life behaviors
Provide comprehensive and integrated
health care services
Functions and roles of PUSKESMAS
in the public health system
Activities:
Stimulating the community to do self-help
activities
Informing the community to search and use the
locally available resources effectively and
efficiently
Technically assisting the community for medical
content, medical and health referral without
rising any dependency
Providing direct health services to the
community
Collaborating with other related sectors in
implementing the health programs
Functions and roles of PUSKESMAS
in the public health system
Roles:
As a technical implemental institution, it
shall have a managerial capabilities and
long-term vision to improve the quality
of health services
In planning, managing and evaluating
Using and updating related information
techniques to improve the
comprehensive and integrated health
services
Functions and roles of PUSKESMAS
in the public health system
Status:
Administration, as a technical unit of
district government office via the district
health office
Hierarchical health service, as a primary
health service facility (*)
Organization of PUSKESMAS
HEAD OF
PUSKESMAS

HEAD OF
ADMINISTRATION
UNIT

TECHNICAL UNIT SUPPORTING TECHNICAL UNIT


I-III UNIT IV-VII
Organization of PUSKESMAS

PERSONNEL JOB DESCRIPTION


Head of Leading, supervising and
Puskesmas coordinating Puskesmas
activities (structural and
functionally)
Head of Staffing, finance, facility,
Administration recording and reporting
unit
Organization of PUSKESMAS

PERSONNEL JOB DESCRIPTION


Unit I Maternal and child health,
family planning and
nutrition program activities

Unit II Prevention and treatment of


communicable diseases
(immunization,
environmental health and
laboratory)
Organization of PUSKESMAS

PERSONNEL JOB DESCRIPTION


Unit III Dental and oral health,
occupational health and
elderly

Unit IV Public health nursing, school


and sport health, mental
health, eyes health and
other specific healths
Organization of PUSKESMAS

PERSONNEL JOB DESCRIPTION


Unit V Building and developing
community health activities
and public health promotion

Unit VI Out-patient and in-patient


treatment services
Unit VII Pharmacy
Organization of PUSKESMAS
SUPPORTING JOB DESCRIPTION
UNIT
Supporting Implementing Puskesmas
Puskesmas programs to 2,500 10,000
population

Mobile Implementing Puskesmas


Puskesmas programs to remote areas
Village midwife Provide maternal and child
health service to 3,000
population
Primary Programs of PUSKESMAS
1. Maternal and child health
2. Family Planning
3. Nutrition Improvement
4. Environmental health
5. Communicable diseases eradication
6. Treatment, including emergency condition
7. Public health education/promotion
8. School health program
9. Sport health
10.Public health nursing
Primary Programs of PUSKESMAS
11. Occupational health
12. Dental and oral health
13. Mental health
14. Eyes health
15. Laboratory
16. Reporting and recording of health
information system
17. Elderly
18. Controlling traditional healer
19. And others
Referral system
Hierarchy Health service component
Households Individual or family members
Community Households of ten, Posyandu
Primary Puskesmas and its supporting
health service units, private practices, etc
facility
Primary District hospital, laboratory,
referral unit private practices, etc
Advanced Provincial hospitals, special
referral unit health facilities, etc
Referral system
Type of referral system:
Medical referral (diagnostic and treatment):
patient consultation, sending specimens and
inviting special health personnel
Health referral (promotion and prevention):
epidemiological survey and eradication of
outbreaks, food aids, investigation of food
poisoning, special aids during disaster and
displaced population/refugee, clean water
technology and laboratory
Conclusion
Why do you have to know about
PUSKESMAS as the primary health
care system in Indonesia in relation
to the Public health and community
nutrition systems course?