FM UGM – “The latest global health trends, from antimicrobial resistance, includes infectious diseases antimicrobial up to cardiovascular diseases related health environment mostly are affected by the lack of knowledge in the community about the determinants of health. All those diseases even could be caused by their own health behavior. Certainly, it needs in-depth study to be formulated into government policy to reduce the Indonesian health burden,” said Dean Prof Ova Emilia while delivering her speech in a scientific forum discussing on ‘Synergy/Integrating of Biomedical, Social and Clinical Sciences to Strengthen the Application of Social Determinants of Health (SDH) in Public Health Science’ Monday (20/3) at the Faculty of Medicine UGM.
The discussion, which is organized by KIK AIPI (Indonesia Academy of Science-Medical Sciences Commission) invited seven senior lecturers from FK UGM who has expertise in public health to explicate their point of view about SDH. It is aimed at formulating a recommendation for the government. Head Department of Biostatistics, Epidemiology and Population Health Faculty, Dr. dr. Mubasysyir Hasanbasri, M.A. emphasized that World Health Organization (WHO) had a campaign about SDH to tackle the social inequality as a global movement. Nevertheless, without role from various elements of practitioner social, health, politician, the even government this campaign will not successful. “UGM as an education institution involve in many activities to advocate the government and develop the SDH handbook for the young scientist in Asian Pacific. In addition, Magister Program of Public Health Faculty of Medicine UGM includes SDH in subjects of social sciences and public health behavior,” he said.
Professor of Faculty of Medicine UGM, Prof. dr. Laksono Trisnantoro, MSc., PhD said that the scope of SDH in the health sector is drug use, health promotion, disease prevention, smoking taxes to sanitation and environmental health on the roadway. In reaching the aim of regional development by using SDH principal it needs some public policy which impacts to increase health status in society, such as sanitation, health urban planning, healthy house, economic and nutrition. “The implementation of SDH policy not only in the Ministry of Health but also institutions and professions outside health. It requires a cooperation cross-sector and profession to manage knowledge and the practitioner’s society who focusses on SDH in the area that has a medical case,” he said.
In anthropology perspective which explained by Dr. Retna Siwi Padmawati, M.A., policy making needs to consider the local wisdom in a region. For example, in Nusa Tenggara Barat (NTB), the pregnancy condition is common so that does not require antenatal care examination (ANC) which purpose to optimize the pregnant women. Pregnant women in NTB have to make sure that they are pregnant, then they will discuss it with their family before examine it to the doctor. It caused they adopt very strong kinship. “Anthropologist concerns about empiric data and field study to understand their behavior,” she said.
The expert from Department of Behavioral Health, Environment, and Social Medicine Department of Behavioral Health, Environment, and Social Medicine explicated that it needs multilevel intervention to implement tobacco control and social determinants of smoking behavior. Learning from SEATCA (Southeast Asia Tobacco Control Alliance), the intervention implement through increase the taxes on tobacco / cigarettes, cigarette advertising bans including the promotions and sponsorship, the determination of the region without a cigarette in public areas (schools, health care, children’s playground, workplace, public places, places of worship and in modes of transport general), and the inclusion of the impact of smoking on health warnings with images -50% pack of cigarettes. One of the SDH intervention programs which succeed in Yogyakarta is ‘Declaration free anti-smoke in home’ that reduce the rate percentage of husband smoking behavior by 50%, from 87% to 37% after the declaration. Other than that, the number of the husband support participation rate in motion free anti-smoke in the home increased by 30%, from 68% before the declaration to 98%, although they are still smoking outside the home.
Highlight the SDH which related to Human Immunodeficiency Virus (HIV), dr Yanri Subronto, PhD, SpPD concluded that Indonesia should work hard to prevent and control HIV and Acquired Immune Deficiency Syndrome (AIDS). It required an understanding about the characteristic of socio-demographic and determinant factor HIV infection to arrange the policy and program that suitable with the circumstance and need.
In culture aspect, The Deputy Minister of Education of Indonesia cultural affairs 2011-2014 period, Prof. Ir. Wiendu Nuryanti, M.Arch., Ph.D. elaborated solution approach at government level that policy cannot base on business but also approach the lifestyle in each individual. “The involvement of young generation is really important, and we can make them as ambassador to consummate SDH,” she said.
In the end of the discussion, The head of KIK AIPI Prof. Dr. Sjamsuhidajat, Sp.BD(K) underlined that AIPI did not have an authority to make a policy.” AIPI facilitate the scientist who has done their research to approach the government in giving a recommendation for the advancement of health in Indonesia and especially for the realization of SDH,” he said. (Mega & Sari); ( Megawangi/Translator)
