DASAR PROMOSI KESEHATAN

Nurjanah
 Deklarasi Alma Ata ( 1978 )
Basic Six:

Menghasilkan strategi Promosi Kesehatan

utama dalam Kesehatan Lingkungan

pencapaian Kesehatan
Bagi Semua (Health For Pemberantasan Penyakit

All ) melalui pelayanan Kesehatan Keluarga &

Reproduksi
kesehatan dasar
(Primary Health Care). Perbaikan Gizi masyarakat

Pelayanan Kesehatan
1. Ottawa Charter, Strategi Promkes
First International Conference on Health Promotion, Ottawa, 21 November 1986

Advocating
(Advokasi)

Enabling Mediating
(Pemberdayaan) (Mediasi)
 5 pilar utama atau 5 ruang lingkup
promosi kesehatan(Ottawa Charter, 1986)
1. Kebijakan berwawasan kesehatan (Healthy public policy)

2. Lingkungan yang mendukung (Supportive environment)

3. Reorientasi pelayanan kesehatan (Reorient health service)

4. Ketrampilan individu (personnel skill)

5. Gerakan masyarakat (community action)

2. Adelaide Recommendations on Healthy
Public Policy
Second International Conference on Health Promotion, Adelaide, South Australia, 5-9 April 1988

• The recommendations of this Conference will be

realized only if governments at national, regional
and local levels take action.
• The development of healthy public policy is as
important at the local levels of government as it
is nationally.
• Governments should set explicit health goals that
emphasize health promotion
 Adelaide Recommendations
• The spirit of Alma-Ata
• Healthy public policy
• Accountability for health  impact of policy
• Action areas
Priorities:
– Supporting the health of women
– Food and nutrition
– Tobacco and alcohol
– Creating supportive environments
• Developing new health alliances
• Commitment to global public health
• Future challenges
3. Sundsvall Statement on Supportive
Environments for Health
Third International Conference on Health Promotion, Sundsvall, Sweden, 9-15 June 1991

The Conference highlighted four aspects of supportive environments:

• The social dimension, which includes the ways in which norms, customs
and social processes affect health.
• The political dimension, which requires governments to guarantee
democratic participation in decision-making and the decentralization of
responsibilities and resources
• The economic dimension, which requires a re-channelling of resources for
the achievement of Health for All and sustainable development, including
the transfer of safe and reliable technology.
• The need to recognize and use women's skills and knowledge in all sectors
- including policy-making, and the economy - in order to develop a more
positive infrastructure for supportive environments.
 4. Jakarta Declaration on
Leading Health Promotion into
the 21st Century
The Fourth International Conference on Health Promotion: New
Players for a New Era - Leading Health Promotion into the 21st
Century, meeting in Jakarta from 21 to 25 July 1997
 Deklarasi Jakarta, 1997
• Promosi kesehatan adalah investasi utama yang memberikan
dampak pada determinan kesehatan, dan memberikan
manfaat kesehatan terbesar pada masyarakat.
• Promosi kesehatan memberikan hasil positif yang berbeda
dibandingkan upaya lain dalam meningkatkan kesetaraan bagi
masyarakat dalam kesehatan. Lima prinsip Deklarasi Ottawa
merupakan kunci strategi untuk sukses.
• Promosi kesehatan perlu disosialisasikan dan harus menjadi
tangungjawab lintas sektor.
 Deklarasi Jakarta: prioritas promosi
kesehatan abad 21
• Meningkatkan tanggung jawab sosial dalam kesehatan,
• Meningkatkan investasi untuk pembangunan
kesehatan,
• Konsolidasi dan perluasan kemitraan untuk kesehatan,
• Meningkatkan kemampuan masyarakat dan
pemberdayaan individu serta menjamin tersedianya
infrastruktur promosi kesehatan.
 5. Fifth Global Conference on Health Promotion
Health Promotion: Bridging the Equity Gap,
Mexico City, June 5th, 2000
1. Recognize that the attainment of the highest possible standard of health is a positive asset for the enjoyment of life
and necessary for social and economic development and equity.
2. Acknowledge that the promotion of health and social development is a central duty and responsibility of
governments, that all sectors of society share.
3. Are mindful that, in recent years, through the sustained efforts of governments and societies working together,
there have been significant health improvements and progress in the provision of health services in many countries
of the world.
4. Realize that, despite this progress, many health problems still persist which hinder social and economic
development and must therefore be urgently addressed to further equity in the attainment of health and well being.
5. Are mindful that, at the same time, new and re-emerging diseases threaten the progress made in health.
6. Realize that it is urgent to address the social, economic and environmental determinants of health and that this
requires strengthened mechanisms of collaboration for the promotion of health across al sectors and at all levels of
society.
7. Conclude that health promotion must be a fundamental component of public policies and programmes in all
countries in the pursuit of equity and better health for all.
8. Realize that there is ample evidence that good health promotion strategies of promoting health are effective
 6. The Bangkok Charter for Health
Promotion in a globalized world,
7-11 August 2005

1. Perlu strategi dan komitmen untuk menghadapi

berbagai faktor yang berpengaruh terhadap
kesehatan di dunia global, serta kebijakan dan
kemitraan untuk memberdayakan masyarakat
untuk memperbaiki kualitas kesehatan (termasuk
ketidakmerataan bidang kesehatan) menjadi fokus
pembangunan nasional dan global.
 The Bangkok Charter for Health
Promotion in a globalized world, 2005
2. Salah satu hak asasi setiap manusia adalah untuk memperoleh
kualitas kesehatan yang setinggi-tingginya. Promosi kesehatan
didasari hak asasi ini, menawarkan konsep sehat yang positif dan
inklusif yang merupakan faktor mempengaruhi kualitas hidup
kesehatan mental dan spiritual. Promosi kesehatan merupakan
fungsi inti kesehatan masyarakat, yang memberikan sumbangan
dalam mengatasi penyakit menular dan tidak menular serta
ancaman terhadap kesehatan, dan merupakan investasi efektif
untuk meningkatkan kesehatan dan pembangunan manusia serta
mengurangi ketidakmerataan/ketidaksamaan dibidang kesehatan
dan jender.
 The Bangkok Charter for Health
Promotion in a globalized world, 2005
3. Perkembangan menuju dunia yang lebih sehat
memerlukan keterlibatan politik yang kuat, peranserta
lebih luas dan advokasi yang berkesinambungan.
7. Promoting health and development: closing the
implementation gap
7th Global Conference on Health Promotion
Nairobi, 26-30 October 2009
Health promotion will be seen in this conference to be an essential, effective approach in line
with the renewal of Primary Health Care as endorsed by the Executive Board of WHO:
• To achieve the agreed international health development goals: in the health arena, the
development goals associated with the eradication of poverty include targets on addressing
specific diseases like malaria, tuberculosis, HIV/AIDS and broader issues like undernutrition,
reproductive, maternal and child health. The urgent need is for these goals to be met, and
here health promotion has specific expertise that can accelerate the progress to attainment.
• To address the emergence of noncommunicable diseases, injury, and mental disorders, a
group of conditions that are growing at epidemic rates in low and middle income countries.
They cause over 60% of the world’s mortality and lead the rankings in terms of preventable
disability. Furthermore, health systems often lack the mechanisms for sustainable funding of
health promotion, even as they buckle under the increasing costs of the growing burden of
noncommunicable conditions.
• To tackle the issue of inequities in the distribution of health by gender, social class, income
level, ethnicity, education, occupation, and other categories. Development goals should
explicitly promote an approach that fosters equity, or fairness of distribution across the
divides of social structure as part of the renaissance in the Primary Health Care movement.
 8. The 8th Global Conference on
Health Promotion,
Helskinki, Finland10-14 June 2013

• Health in All Policies (HiAP): Framework for Country

Action
• HiAP is an approach on health-related rights and
obligations. It improves accountability of policymakers for
health impacts at all levels of policy-making. It includes an
emphasis on the consequences of public policies on health
systems, determinants of health, and well-being. It also
contributes to sustainable development.
9. Shanghai Declaration on promoting health in the
2030 Agenda for Sustainable Development
21 November 2016

• We recognize that health and wellbeing are

essential to achieving sustainable
development
• We will promote health through action on all
the SDGs.
• We will make bold political choices for health
Shanghai Declaration on promoting health in the
2030 Agenda for Sustainable Development
21 November 2016

• Good governance is crucial

• Cities and communities are critical settings for
health
• Health literacy empowers and drives equity
RUANG LINGKUP PROMOSI KESEHATAN
Ilmu-ilmu yang mencakup promosi kesehatan dapat
dikelompokkan menjadi 2 bidang :
1. Ilmu perilaku; menjadi dasar dalam membentuk perilaku
manusia : psikologi, antropologi, sosiolgi
2. Ilmu-ilmu yang diperlukan untuk intervensi perilaku
(pembentukan dan perubahan perilaku) : pendidikan,
komunikasi, manajemen, kepemimpinan, dsb
Ruang lingkup Promosi Kesehatan berdasarkan aspek
pelayanan kesehatan :

• Promosi kesehatan pada tingkat promotif

• Promosi kesehatan pada tingkat preventif
• Promosi kesehatan pada tingkat kuratif
• Promosi kesehatan pada tingkat rehabilitatif
Ruang lingkup Promosi Kesehatan berdasarkan tatanan
(tempat pelaksanaan)
• Promosi kesehatan pada tatanan keluarga (rumah
tangga)
• Promosi kesehatan pada tatanan sekolah
• Promosi kesehatan pada tempat kerja
• Promosi kesehatan di tempat-tempat umum
• Pendidikan kesehatan di institusi pelayanan
kesehatan
Siapa Sasaran Promkes ?
Individu
Keluarga
Masyarakat
LSM
Lembaga pemerintah
Institusi
 VISI = Visi Pembangunan Kesehatan
Meningkatkan kesadaran, kemauan, dan
kemampuan hidup sehat bagi setiap orang agar
terwujud derajat kesehatan masyarakat yang
setinggi-tingginya, sebagai investasi bagi
pembangunan sumber daya manusia yang
produktif secara sosial dan ekonomis.
Pasal 3 UU No. 36 tahun 2009 tentang kesehatan
 Misi Promosi Kesehatan
 Memberdayakan individu, keluarga, dan kelompok-kelompok dalam masyarakat, baik
melalui pendekatan individu dan keluarga, maupun pengorganisasian dan penggerakan
masyarakat
 Membina suasana atau lingkungan yang kondusif bagi terciptanya perilaku hidup bersih dan
sehat masyarakat
 Mengadvokasi para pengambil keputusan dan penentu kebijakan serta pihak-pihak lain yang
berkepentingan (stekeholders) dalam rangka :
– mendorong diberlakukannya kebijakan dan peraturan perudang-undangan yang
berwawasan kesehatan.
– mengintegrasikan promosi kesehatan, khususnya pemberdayaan masyarakat dalam
program-program kesehatan.
– meningkatkan kemitraan sinergis antara pemerintah pusat dan daerah serta antara
pemerintah dengan masyarakat (termasuk LSM).
 Meningkatkan investasi dalam bidang promosi kesehatan pada khususnya dan bidang
kesehatan pada umumnya.
Conclusion:

HEALTH
PROMOTION
 Tugas 2:
• Hitung 1-5 bagi kelompok
• Apa yang dimaksud strategi-strategi Promkes
(sesuai pambagian)
• Cari Penjelasan dan Contoh
• Tulis dalam 1 lembar kertas, Kumpulkan
tanggal...
 MISI = PILAR PROMOSI KESEHATAN
Pengadaan sarana olah raga
1. Kebijakan berwawasan kesehatan
(Healthy public policy) Pelatihan kader

2. Lingkungan yang mendukung Aturan tentang Ruang Terbuka hijau

(Supportive environment)
Komunitas peduli kawasan tanpa rokok
3. Reorientasi pelayanan kesehatan Penyuluhan di sekolah
(Reorient health service)
Perbaikan angkutan umum
4. Ketrampilan individu (personnel
Meningkatkan anggaran untuk promosi kesehatan
skill)
Warga peduli AIDS
5. Gerakan masyarakat (community
action) Mendorong ibu untuk K1-K4

Bank sampah
Kasus…Mengurangi Penyakit Akibat Rokok

1. Kebijakan berwawasan kesehatan (Healthy public policy)

2. Lingkungan yang mendukung (Supportive environment)

3. Reorientasi pelayanan kesehatan (Reorient health service)

4. Ketrampilan individu (personnel skill)

5. Gerakan masyarakat (community action)

 Tugas 3: (sesuai urutan)
Jelaskan upaya Promosi kesehatan dalam lima tingkat
pencegahan (Five Level of Prevention):
– Health Promotion (Promosi kesehatan)
– Specific Protection (Perlindungan khusus)
– Early Diagnosis and Prompt Treatment (Diagnosis dini
dan pengobatan segera)
– Disability Limitation (Mengurangi terjadinya kecacatan)
– Rehabilitation (pemulihan)
 Five Level of Prevention
– Health Promotion (Promosi kesehatan)
– Specific Protection (Perlindungan khusus)
– Early Diagnosis and Prompt Treatment (Diagnosis
dini dan pengobatan segera)
– Disability Limitation (Mengurangi terjadinya
kecacatan)
– Rehabilitation (pemulihan)
Five level of prevention:
A. Health Promotion (Promosi kesehatan)
B. Specific Protection (Perlindungan khusus)
C. Early Diagnosis and Prompt Treatment (Diagnosis dini dan pengobatan segera)
D. Disability Limitation (Mengurangi terjadinya kecacatan)
E. Rehabilitation (pemulihan)

1. Imunisasi B 9. Periksa tensi secara teratur C

2. Olah raga A 10. Cuci Tangan sebelum makan A
3. Memakai Alat Pelindung Diri B 11. Cek laboratorium untuk anak yang C
panas > 3 hari
4. Meningkatkan Kecukupan Gizi A 12. Minum antibiotik secara benar D
5. Periksa Kehamilan C 13. Kampanye kawasan tanpa rokok A
6. ASI Eksklusif A 14. Minum obat TB Paru secara teratur D
sampai selesai
7. Periksa Dahak C 15. Menggunakan kondom B
8. Fisioterapi pasien stroke E
See You Next Week!