Docstoc

Jakarta_mayor

Document Sample
Jakarta_mayor Powered By Docstoc
					            TB PERSPECTIVE
At North Jakarta Municipal Administration
in connection with Global Climate Change


          By. M. Effendi Anas

             File: P/Wlkt mkl Bangkok
. The accurate prediction of scientist on negative effect
   of global warming
. The occurrence of uncertain world climate
. Severe flood in Jakarta year 2004 & 2007 inundated
   50-65% of Jakarta area …> activities paralyzed


On the field of farming
. The farmers have difficulties to predict when the
   harvest season is ?
. In Indonesia year 2003, 43.000 Ha paddy field was hit
   by flood, and the drought as wide as 21.705 Ha
On the field of fishery
. The increase temperature of sea water…> coral reef
   was damaged
. The damage of coral reef ….> plankton disappears
   ….> fish food chain was disturbed …..> fish
   population was decreasing ……> the result of
   fisherman was decreasing.

North Jakarta Municipal Administration
. The increasing of temperature …>ice melted on the
   poles ….> The sea level rose ….> threaten coastal
   area ….> flood
The spread of disease
. The increasing of temperature …> incubation of mosquito
   growth shortened ….> the increasing of mosquito population
   ….> the increasing of DHF, malaria

 TBC disease
. In Indonesia …> 1 -2 sufferer per 1.000 population
. The third cause of the death after cardiovascular, upper
    respiratory system infection
. In Jakarta ….> priority program since 2001
. Tend to increase ….>year 2003 (2.589 cases), year 2004 (3.437
    cases), year 2005 (4.169 cases), year 2006 (4.653 cases).
. Climate change ….> affect to the increasing of TB …..> it was
    worsened by geographical location of north Jakarta ….> many
    slum areas, prone to flood, many people resided in unhealthy
    housing residence.
. Topography of North Jakarta ….> lower land area 0 –
    2 M from the sea level …..> as estuary 13 rivers
. Climate change
   ….> prone to flood as the sea level rises
   .…> Can increase humidity ….> the appropriate
    temperature for the growth of TB Bacteria.
   ….> prolonged dry season ..> increase air pollution
    (dust)
         ..> Bacteria grow on the dust …> prone to the
    transmission of the disease
            NORTH JAKARTA
NORTH JAKARTA BORDER
•    NORTH : KEP.SERIBU (THOUSAND ISLAND)
•    WEST : WEST JAKARTA BARAT AND TANGERANG
•    SOUTH : CENTRAL JAKARTA , EAST JAKARTA & WEST JAKARTA
•    EAST : EAST JAKARTA AND BEKASI
    THE POPULATION OF NORTH JAKARTA 2006 :
    1.173.935 PEOPLE , THE WIDTH 142.3 Km2
                                    SUB DISTRICTS :   6
                                    VILLAGES    :    31
                                    HAMLETS     : 414
                                    NEIGHBORHOODS :
                                                  4.746
                                    HOSPITALS        : 16
                                    SUB DISTRICT PHC : 6
                                    VILLAGE PHC     : 42
. Topography of North Jakarta ….> lower land area 0 –
    2 M from the sea level …..> as estuary 13 rivers
. Climate change
   ….> prone to flood as the sea level rises
   .…> Can increase humidity ….> the appropriate
    temperature for the growth of TB Bacteria.
   ….> prolonged dry season ..> increase air pollution
    (dust)
         ..> Bacteria grow on the dust …> prone to the
    transmission of the disease
. Climate change worsens the quality of environment
    …….>bacteria grow……>the case is increasing.
INDICATOR OF ENVIRONMENTAL HEALTH


 Aspects                      Result     standard

1. Permanent house            : 70.4 % : 95.0 %
2. House and occupancy rate   : 34.6 % : 5.0 %
3. House and ventilation       : 68.1 % : 95.0 %
4. House and the light          : 74.4 % : 95.0 %
5. House and plantation         : 62.3 % : 75.0 %




                                Survey .2003)
. Prevention approach ….> Host intervention - Agent
  ….> CDR …> searching of sufferer …> in Jakarta
       target up to 2006 is 70%, North Jakarta has
   reached the target
  .…> DOTS …> short term medication by inspection
   ….> Indicator is CR /cure rate
   ….> In north jakarta ….> CR 2006 was 63.9 %
    >> still under target which was 85%
   .…> DOTS evaluation (year 2006) ..> CR was 63.9 %,
       complete medication 17.5% ….> 10.4% neglected
   /DO
       ..> 7 % migrate ..> 0.9% died ..>0.2% fail
            THE DATA OF HEALTH FASILITIES IN
            NORTH JAKARTA MUNICIPAL ADM.
                                                   HEALTH FASCILITIES




                     HEALTH POST
                     INTEGRATED




                                                                                           maternity hosp.
                                                                 practitioners
                                                                                                             HO




                                                     hospitals
NO




                                                                                 midwife
     SUB DISTRICTS                                                                                                 Expl




                                                                                              Private
                                         clinics
                                                                                                             SPI




                                   PHC
                                                                                                             TA
                                                                                                              L


1    PENJARINGAN       73          7      0           4          220              7             5            4

2    PADEMANGAN        33          5      0           0          60              35             4            0

3    TG. PRIOK        132          14     1           7          222             45             4            7

4    KOJA              85          8      8           2          120             47             7            2

5    KLP. GADING       29          4      1           2          160             12             1            2

6    CILINCING        164          10     2           1          70               6             2            1

      TOTAL           516          48    12          16          852             152          23             16
. DOTS APPROACH …> supported by all Health Facilities in North
   Jakarta
  ….> Networking …> medicating and reporting on the
   same place
  .…> Internal networking …> all units from Health
   service division.
                     handle TB sufferer by DOTS
   .…> External networking …> all units from Health
   Service division
                   coordinate with Public Health Division.

. DOTS …> supported by LABORATORY…> as referral for
   recovered sufferer, fail …> Verify germ Resistance
   against drugs.
. IDEALLY …> TBC Prevention should be comprehensive
              ….> consider environmental aspect.
               …..> the theory of Biology law
                    (John Gardon) and the theory of -
                               Health Status (HL. Blum)


. Climate change …> can change strengths and
  weaknesses of environmental factors effecting the
  growth of TB bacteria …> the significant influence is the
  increasing of case prevalence
. Harmonization …> TB prevention approach by Jakarta Province
   Health Dept. / Public Health Sub Division from North Jakarta
   Municipal Administration
                                - with,
 . Infrastructural development …> physical aspect
   ..> Long term : Infrastructure; realization of BKT (East canal flood
    project), Healthy storey house (Rusunawa 1000 towers), slum area
    management , re plantation at RTH (Green space management),
    Reclamation & management of coastal area by planting mangrove
   ..> Mid term : build secondary and tertiary networking, prepare
    urban drainage system, relocate slum housing under toll road.
build Voder (water canal) & provide water pump, consistent space
    management, etc
 …> short term : residential area managemen, renovation TB
  suferrer’s house, Put TB suferrer into storey house, etc

. Climate change …> can hamper the objective of TB prevention
  program either in the environmental perspective or the approach of
  TB prevention prgram by Jakarta Province Health Dept or North
  Jakarta Municipal Administration.

. Climate change …> can hamper the achievement of MDG’S
  commitment declared by 180 countries which is reduce poverty and
  world retardation
. Climate change brings into bad effects on Health Program
. The effects on health program : …>hamper the succes of
   Communicable disease control program.
. We supprot the action of efforts to curb green house
   effect. …>reduce the use of chemical substances
   effecting the depletion of ozone layer.
. We are ready to cooperate in responding the effects of
   global warming.
   POPULATION PER SUB DISTRICT


PENJARINGAN :      176.586 PEOPLE
PADEMANGAN :       121.839 PEOPLE
TANJUNG PRIOK :    311.440 PEOPLE
KOJA          :    221.631 PEOPLE
KLP. GADING   :    105.699 PEOPLE
CILINCING     :    236.740 PEOPLE
                  ---------------------------
North JAKARTA     1.173.935 PEOPLE
              THE NUMBER OF TB SUFERRERS BY GENDER
                         NORTH JAKARTA
                    YEAR 2003 UP TO SEPT 2007


  2007            1809            1472


  2.006                       2.639            2.014


  2.005                  2.355           1.814

  2.004               1.952       1.485


TH 2003       1.478      1.111

          0   1.000       2.000        3.000      4.000   5.000


                        MALE          FEMALE
              THE NUMBER OF TB SUFERRER IN NORTH JAKARTA
                       YEAR 2003 UP TO Sept 2007



TH 2007                   896            997                  936        15
                                                                        56


TH 2006                         1.242                1.463                       1326           92 19


TH 2005                     1.159                  1.351                  1134          37 13


TH 2004                   910             1.205                  879      63 8


TH 2003         594              1.026               523 43 6


          0         500         1.000      1.500      2.000     2.500    3.000     3.500   4.000        4.500


          BTA POS     BTA NEG           CHILDREN     RECURE     EXTRA PARU
                      CDR OF TB SUFERRERS (+ SPUTUM SMEAR)
                                 IN NORTH JAKARTA
                                     YEAR 2006

120.0

100.0
        105.6
 80.0                   92.6         87.5                                              92.0
 60.0                                       72.6
                                                                     Target 70%
 40.0

 20.0                                                  31.5
                                                                         16.5
  0.0


                                            TG PRIOK
                                     KOJA




                                                                          KLP GADING
                         CILINCING




                                                                                       JAK UTR
         PADEMANGAN




                                                       PENJARINGAN
        CDR OF PULMONARY TB SUFERRERS (+ SPUTUM SMEAR)
                      IN NORTH JAKARTA
                                   JANUARY - SEPTEMBER 2007

120.0

100.0
         102.0
 80.0

 60.0
                       79.4
                                                                       Target 70%        64.1
 40.0                                 57.6        55.7
 20.0                                                    37.1
                                                                           17.7
  0.0
                                       TG PRIOK




                                                  KOJA




                                                                            KLP GADING
                       CILINCING




                                                                                         JAK UTR
          PADEMANGAN




                                                         PENJARINGAN
CDR OF PULMONARY TB SUFERRERS (+ SPUTUM SMEAR)
              IN NORTH JAKARTA
                      YEAR 2000 UP TO SEPT 2007




                                                           92.0
                                                    91.5
         100
          90




                                             67.2




                                                                  64.1
          80
 Target 70%
          70
          60




                                      34.3
                               29.2
          50            26.9
               26.2




          40
          30
          20
          10
           0
               2000



                       2001



                               2002



                                      2003



                                             2004



                                                    2005



                                                           2006



                                                                  2007
                TH



                        TH



                                TH



                                       TH



                                              TH



                                                     TH



                                                            TH



                                                                   TH
          PULMONARY TB SUFERRERS (+ SPUTUM SMEAR) 2OO6
           EXPERIENCING CONVERSION IN NORTH JAKARTA

          100.0


                  83.8


                         80.0


                                    74.5


                                                  73.4


                                                               72.7


                                                                            70.3


                                                                                   68.1


                                                                                               68.1
Target 80%80.0




                                                                                                                            70
                                                                                                       56.8
           60.0


           40.0


           20.0




                                                                                                                 7.4
            0.0
                  KOJA


                         TG PRIOK


                                    PENJARINGAN


                                                  PADEMANGAN


                                                               KLP GADING


                                                                            YSA


                                                                                   CILINCING


                                                                                               HOPE

                                                                                                      SUKAPURA


                                                                                                                 RSU KOJA


                                                                                                                            JU
                                                                                                         RSI
                  CONVERSION OF TB (+SPUTUM SMEAR)
                         IN NORTH JAKARTA
                        YEAR 2000 UP TO 2006




                                         84.9
                               82.0
                     78.6




                                                   75.2
             90




                                                                                 70.0
                                                                       68.5
                                                             64.2
Target 80%   80
             70
             60
             50
             40
             30
             20
             10
              0

                   TH 2000   TH 2001   TH 2002   TH 2003   TH 2004   TH 2005   TH 2006
               RECOVERED TB SUFERRERS (+ SPUTUM SMEAR)
                          IN NORTH JAKARTA


         100.0


                    77.4




                                                                               76.3
Target 85%




                                                                 73.8
                           73.3


                                       70.0




                                                          66.7
             80.0




                                                   64.6




                                                                                                                              63.9
                                                                                            52.2
             60.0




                                                                                                          43.3
             40.0


             20.0




                                                                                                                    0.0
              0.0
                    KOJA


                           TG. PRIOK


                                       CILINCING


                                                   HOPE


                                                          YSA


                                                                 PENJARINGAN


                                                                               PADEMANGAN


                                                                                            KLP GADING

                                                                                                         SUKAPURA


                                                                                                                    RS KOJA


                                                                                                                              JAK UTR
                                                                                                            RSI
                 CR OF PULMONARY TB (+SPUTUM SMEAR)
                          IN NORTH JAKARTA
                           YEAR 2000 - 2006



Target 85%




                              72.1




                                                  70.3
                    67.2
         80




                                                                      63.9
                                                            59.7
                                        57.7
         70

         60

         50

         40
         30

         20

         10

             0

                  TH 2000   TH 2001   TH 2002   TH 2003   TH 2004   TH 2006
        TB CASES FOUND AND MEDICATED AT PUBLIC HEALTH CENTER
                         IN NORTH JAKARTA
                        YEAR 2002 - SEPT 2007




                                                                               4.653
                                                               3.594
5.000




                                               3.437




                                                                                               3.281
4.500



                               2.589
4.000
3.500
               1.888



3.000
2.500
2.000
1.500
1.000
 500
   0
          2




                           3




                                           4




                                                           5




                                                                           6




                                                                                           7
           0




                          0




                                          0




                                                          0




                                                                          0




                                                                                          0
        20




                       20




                                       20




                                                       20




                                                                       20




                                                                                       20
   R




                       R




                                       R




                                                       R




                                                                       R




                                                                                       R
   A




                      A




                                      A




                                                      A




                                                                      A




                                                                                     A
YE




                   YE




                                   YE




                                                   YE




                                                                   YE




                                                                                  YE
           EVALUATION OF TB SUFERRERS (+SPUTUM SMEAR)
                       IN NORTH JAKARTA
                            YEAR 2006

70,0


60,0     63,9

50,0


40,0


30,0


20,0

                     17,5
10,0
                                 10,4       7,0      0,9     0,2
 0,0
       RECOVERED   COMPL MED   NEGLECTED   MIGRATE   DIED   FAILED
The flow of diagnose of TB patient in hospital


                  General clinic                 Microbilology Lab.
 Patient         Specialist clinic                   Radiology
                 Emergency unit                   Patology clinic



                DOTS Unit Hospital




                                     Pharmacy
Other Health                    Medical Record
Service units
                              Promotion services

                                     Treatment
    The flow of implementation
                     Patients

          Anamnesis,PF,Sputum 3x,Ro,Lab

          TB Diagnose  Therapy Kat.I,II,III

              Follow up every 2 weeks


Control                         Control late 2 days
                                                       F
                            Hospital call supervisor   e
                                                       e
                                                       d
                                Supervisor call PHC    b
                                  On the same day      a
                                                       c
                                    House visit        k
                                 The following day
THE REFERRAL SYSTEM FOR TB PATIENTS




            coordinator               TB Supervisor
            HDL at Sub                 Sub district
              district


                                confirm
inform



             Patient, Anti TB
              drug , TB.01,
              referral letter
                 (TB.09)              Public Health
 Hospital
                                         Center
                  (TB.09)

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:42
posted:5/9/2010
language:English
pages:30