Sub-District Surveillance Response System Development: A Linkage Between University, Health Providers and Community to Face Global and Local Health Challenge Sunjaya DK, Herawati DMD, Sirlan F Universitas Padjadjaran - Indonesia International Conference on Sustainability Science Bangkok November 2009

Content Context and problems Sub district SRS Development Result Discussion Conclusion

Context and Problem Indonesia : islands 226 million pop HDI : 109/ 179 LE : 70.1

Under developped village Source : PHO West Java Province of West Java : 26 Districts 5683 villages Population : 43 million Poor : 26 % Jakarta Bandung District Sumedang Sub district Jatinangor

TBC MALARIA DHF Avian Flu HIV/AID S Lepra e ANTHRAX & LEPTOSPIROSIS RABIES 5 Source : West Java Province HealthOffice Burden of diseases

Environment : Physical Social Environment : Physical Social Development Behaviour Health Status : Mortality, Morbidity Health Status : Mortality, Morbidity Health System

InfantMaternal (FPB) Maternal (PHO) Number of infant and Maternal Death West Java Province Source : PHO West Java Problem of information system  missing data; missing vital statistics

Challenge : new emerging diseases local and traditional health problems disparity poverty lack of appropriate health system combination of complexity needs systemic change to protect and empower community.

Primary Health Center Primary Health Center District Govt District Govt Univ. Medical Fac. Univ. Medical Fac. Sub-district Govt. Sub-district Govt. Community Private Sectors Private Sectors Village Govt Village Govt Village midwifes Village midwifes Health cadres Health cadres Central Govt Central Govt Do they aware Do they care Do they know ? NGO

Sub-district Jatinangor Univ. Medical Fac. Univ. Medical Fac. 12 villages Pop : 81 thousand

Surveillance-response system (SRS) development in a sub-district as a pilot project  diseases & risk factors providing new approach of surveillance system involving community, local government and private health provider and link to academic society strengthen existing public health efforts Initiated by medical faculty, cooperated with Local Government & Primary Health Center (PHC)

Objectives To empower local community and advocate stakeholders facing global and local health challenge To solve community health problem by identify risk factors and other determinants of health Intervention to prevent the increasing of disease and outbreak.

Steps  Program design  Survey  Modules/ SRS guidance development  Training  ICT media development  Socialization and advocacy  Intervention

System Development Training  Cadres  Village midwifes  School teachers  Health providers : Government Private ICT development  PHC  Training  Health mapping  Web based media

Training health cadres Training and involving village midwife Training and involving teachers Professor ophtalmologist involved Training and involving government health providers

Involving private health providersInvolving chief of villages Involving chief of subdistricts Involving community

Program Design Assessment & mapping System development Risk Factors &Diseases Intervention Research Student & Lecturer research & SRS Research Role of Medical Faculty/ University

Results. A survey was accomplished to get health system baseline data. It involved lecturer, undergraduate and postgraduate students. Internet-based health mapping was developed for exposing diseases and risk factors. Modules were developed for SRS training. Training was executed for health cadres, village midwifes, school’s teachers. ICT training was carried out for PHC worker.

Primary Health Center Primary Health Center District Heath Office District Heath Office Univ. Medical Fac. Univ. Medical Fac. Sub-district Govt. Sub-district Govt. Community Health Facilities (Private) Health Facilities (Private) Village midwifes Village midwifes Health cadres Health cadres Model SRS

Authority and health provider were endorsed to joint the network. Community through trained people detects disease cases and risk factors and reports them to PHC using sms gateway, internet and or traditional media. District and sub-district authority gain information easier and at real time through internet therefore response could be done. Academic society can get information and do intervention or research needed.

Sub distrioct govt Village govt PHC Med Faculty Public internet cafe Cadres Community Health providers NGO

Cases of diarrhea reported by cadres using sms gateway

Intervention for health determinant

Discussion SRS in sub-district area is a media for every health’s stakeholders to identify community health problems and its determinants. Academic society  touch directly to the real health problem.  involving students, lecturers, researchers and  use every finding as new knowledge and manage it as well.

Through this media they can help health provider and authority in decision making to overcome health problems Linkage between community, local government, private health provider and academic society synergize efforts and responses to cope the health challenges.

Some risks factors and environmental problems were identified Need more risks factors and diseases intervention activities/ program by stakeholders Program evaluation SRS could be extend for district and West Java Province  next year program

Scaling up :  whole of the district  3 districts at north coast  involving other faculties : Agriculture, Veteriner, Antropology, Agric.Technology, etc  Integrated Food, Health and Energy Program : Funded by Ministry of Education, University, Provincial Government, District Government

Conclussion : Problems: How to raise the sustainability issues to the surface Solution: Create a system (SRS) as media to communicate between stakeholders Endorse stakeholders to participate: Local government, public and private health providers, community, cadres, teachers, academia Role of academia: mediation, advocacy, facilitation, system development, research & knowledge,

Orchestration and responsibility for human future