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Public Health Risk Management AGS 2023
Public Health Risk Management AGS 2023
RISIKO
KESEHATAN
MASYARAKAT
DAN
PELAYANAN
UKM
Tjahjono
Referensi public health risk
management
◼ Risk assessment:
◼ Proses sistematis untuk mengumpulkan, menilai, dan
mendokumentasikan informasi untuk menetapkan
derajatrisiko
◼ a systematic process for gathering, assessing and
documenting information to assign a level of risk
(WHO, 2012).
◼ The process of estimating the probability of
occurrenceof an undesirable event and the
magnitude of its consequencesover a specified time
period
Risk assessment
◼ Tujuan:
Memberikan dasar untuk melakukan tindaklanjut
dalam mengelola danmengurangi akibatnegative dari
risiko.
Risk assessment
(WHO, 2012)
Hazard Assessment
◼ Hazard assessment is the identification of a hazard
(or number of potential hazards) causing the event
and of the associated adverse health effects.
◼ Public health hazards can include biological, chemical,
physical and radionuclear hazards.
◼ Hazard assessment includes:
◼ identifying the hazard(s) that could be causing the event
◼ reviewing key information about the potential hazard(s) (i.e.
characterizing the hazard)
◼ ranking potential hazards when more than one is considered
a possible cause of the event (equivalent to a differential
diagnosis in clinical medicine).
Exposure Assessment
◼ Exposure assessment is the evaluation of the
exposure of individuals and populations to likely
hazards.
◼ The key output of the assessment is an estimate
of the:
◼ number of people or group known or likely to have
been exposed.
◼ number of exposed people or groups who are likely
to be susceptible (i.ecapable of getting a disease
because they not immune)
Context Assessment
◼ Context assessment is an evaluation of the
environment in which the event is taking place.
◼ This may include
◼ the physical environment such as climate, vegetation,
land use (e.gfarming, industry) and water systems
and sources as well as
◼ the health of the population (e.g. nutrition, disease
burden and previous outbreaks),
◼ infrastructure (e.g. transport links, health care and
public health infrastructure),
◼ cultural practices and beliefs
The consequences of different types
of risk:
◼ Safety issues:
◼ Fatality, injuries
◼ Health issues:
◼ Cancer and noncancer effects
◼ Public welfare issues:
◼ Aesthetics, nuisance conditions
◼ Ecological issues:
◼ Species diversity, habitat loss
◼ Financial issues:
◼ Property loss, liability
◼ Combinations of the above
Risk characterization
◼ Process of assigning the level of risk based on
risk assessment (hazard, exposure and context
assessments)
◼ If there is no mathematical output from a
quantitative model or comparison with a
guidance value, the process is based on the
expert opinion of the team.
Consequences
Probability
Risk Grading Matrix
Action
Lingkup pembahasan public health
risk management
(PHRM,…..)
◼ Residential/indoor exposures
◼ Environment/outdoor exposures
◼ Infectious/communicable diseases:
◼ ISPA,
diarrheal disease, tbc, malaria,dbd, hepatitis B, STD,
HIV/AIDS, Flu burung
◼ Non communicable diseases:
◼Diabetes, cardiovascular diseases, heart diseases, cancer
Contoh
◼ Risikoakibat cakupan program (misalnya
imunisasirendah)
◼ Risikoakibat cakupanskrininghipertensi yang
rendah
◼ Risikoakibat kurangefektifnyavaksinasiyang
dilakukan
◼ Risikoakibattracing Covid 19 tidak adekuat
◼ Paparan di lingkungan
◼ Perilaku Kesehatan
Modifikasi HVA untuk Public
Health Risk Assessment
Manajemen risiko
pelayanan UKM
Pelayanan UKM Esensial
◼ Pelayanan promosikesehatan;
◼ Pelayanan kesehatan lingkungan;
◼ Pelayanan kesehatan keluarga;
◼ Pelayanan gizi; dan
◼ Pelayanan pencegahan dan pengendalian
penyakit
Identifikasi risiko pada pelayanan
UKM – Kesehatan Keluarga
◼ Kegiatanpelayanan UKM – Kesehatan Keluarga:
◼ Kegiatan di dalam Gedung Puskesmas:
◼ PemeriksaanKehamilan
◼ Pemeriksaan Ibu Nifas
◼ PemeriksaanNeonatal
◼ Pelayananpemeriksaanbalita sehat
◼ Pelayanan Tumbuh Kembang
◼ Pelayananimunisasi
◼ Kegiatan di luar Gedung Puskesmas:
◼ PelayananPosyandu
◼ PelayananImunisasi pada bayi
◼ SimulasiDeteksi Intervensi Dini Tumbuh Kembang (SDIDTK)
CONTOH REGISTER RISIKO
N Pelayan- Risiko Kega- Probabi- Dera- Sebab Akibat Upaya Pence- Penang- Pelapor
o an watan litas jat yang gahan gung -an
Risiko telah agar jawab
Dilaku- tidak
kan terjadi
Kesehatan
Keluarga
1 Kegiatan
Posyandu
2 Imunisasi
3 SDIDTK
Ruang Area Sumber Risiko Kontro Asesmen risiko Peringk Upaya thd risiko Strateg Pemili Monitoring &
lingkup / Informa / l at (risk treatment) i k Evaluasi
lokas si Kondi Intern prioritas mitiga Risiko
i si al risiko si
Saat yang
ini ada probabilita Dampak Kesiapa Total Kontrol Pembiayaan Asesme Wakt
saat ini s n Nilai risiko risiko n ulang u
(Skor
risiko)
Take home message:
PerlunyaKerangkaKerja
terintegrasi
◼ Tujuan dan sasaran manajemen risiko kesehatan
masyarakat
◼ Identifikasi risiko dan sumber-sumber terjadinya risiko
◼ Menyusun alternatif untuk melakukan risk reduction
atau risk avoidance
◼Memilih alternatif yang paling tepat untuk melakukan
risk reduction atau risk avoidance
◼ Menyusun program-program manajemen risiko dan
penganggaran
◼ Menerapkan program-program manajemen risiko
◼ Monitoring dan evaluasi
Tujuan dan sasaran
Kriteri untuk memilih
Peraturan dan kebijakan
(theshold)
Faktor pendukung dan
Estimasi manfaat
Penghambat
Estimasi biaya
Analisis thd ruang lingkup
Batasan waktu
dan keterbatasan
Rasio manfaat/biaya