BackgroundMortality statistics from death registration systems are essential for health policy and development. Indonesia has recently mandated compulsory death registration across the entire country in December 2006. This article describes the methods and results from activities to ascertain causes of registered deaths in two pilot registration areas in Central Java during 2006-2007. The methods involved several steps, starting with adaptation of international standards for reporting causes of registered deaths for implementation in two sites, Surakarta (urban) and Pekalongan (rural). Causes for hospital deaths were certified by attending physicians. Verbal autopsies were used for home deaths. Underlying causes were coded using ICD-10. Completeness of registration was assessed in a sample of villages and urban wards by triangulating data from the health sector, the civil registration system, and an independent household survey. Finally, summary mortality indicators and cause of death rankings were developed for each site.FindingsA total of 10,038 deaths were registered in the two sites during 2006-2007; yielding annual crude death rates of 5.9 to 6.8 per 1000. Data completeness was higher in rural areas (72.5%) as compared to urban areas (52%). Adjusted life expectancies at birth were higher for both males and females in the urban population as compared to the rural population. Stroke, ischaemic heart disease and chronic respiratory disease are prominent causes in both populations. Other important causes are diabetes and cancer in urban areas; and tuberculosis and diarrhoeal diseases in rural areas.ConclusionsNon-communicable diseases cause a significant proportion of premature mortality in Central Java. Implementing cause of death reporting in conjunction with death registration appears feasible in Indonesia. Better collaboration between health and registration sectors is required to improve data quality. These are the first local mortality measures for health policy and monitoring in Indonesia. Strong demand for data from different stakeholders can stimulate further strengthening of mortality registration systems.
ABSTRACT The Healthy Indonesia Program with Family Approach (PIS-PK) is an effort to strengthen basic health that began in 2015. To get more comprehensive data and information on the implementation of PIS-PK, in 2017 the Center for Public Health Efforts to carry out a PIS-PK evaluation study in several districts/cities in Indonesia. This study uses a quantitative and qualitative approach, in one puskesmas in Labuan Bajo Regency, North Sumatra Province and Semarang City, Central Java Province. Data collection was carried out by means of in-depth interviews about the implementation of PIS-PK including input indicators (personnel, funds, tools and methods), processes (planning, implementation, supervision), and output. The results of the study show that the implementation of input indicators, such as the limited number of Puskesmas human resources in data collection and data entry, also not yet clear about the sources of funding for implementing PIS-PK. On output (results of family visits), there are differences in the results of the calculation of indicators between the results of data collection conducted by PIS-PK puskesmas officers and study results. When compared between the two puskesmas, Puskesmas H Semarang is more ready for PIS-PK than Puskesmas P in Labuan Batu Regency. It can be concluded that in the implementation of PIS-PK in both puskesmas still encountered problems, both in terms of inputs (personnel, funds, tools and methods), processes (planning, implementation, supervision), and output. As a suggestion, there needs to be more comprehensive planning in implementing PIS-PK. Keywords: PIS-PK, evaluation research, input, process, and output indicator ABSTRAK Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) merupakan program upaya penguatan kesehatan dasar yang mulai dilaksanakan pada tahun 2015. Untuk mendapatkan data dan informasi yang lebih komprehensif tentang pelaksanaan PIS-PK, pada tahun 2017 Puslitbang Upaya Kesehatan Masyarakat melakukan studi evaluasi PIS-PK di beberapa kabupaten/kota di Indonesia. Studi ini menggunakan pendekatan kuantitatif dan kualitatif, di salah satu puskesmas di Kabupaten Labuan Bajo, Provinsi Sumatera Utara dan Kota Semarang, Provinsi Jawa Tengah. Pengumpulan data dilakukan dengan cara wawancara mendalam mengenai pelaksanaan PIS PK meliputi indikator input (tenaga, dana, alat dan metode), proses (perencanaan, pelaksanaan, pengawasan), dan output. Hasil studi menunjukkan bahwa pelaksanaan untuk indikator input, seperti masih terbatasnya SDM puskesmas dalam melakukan pendataan maupun entri data, juga belum jelasnya sumber pembiayaan pelaksanaan PIS-PK. Pada output (hasil kunjungan keluarga) terdapat perbedaan hasil perhitungan indikator antara hasil pendataan yang dilakukan oleh petugas PIS-PK puskesmas dengan hasil studi. Jika dibandingkan diantara ke dua puskesmas, Puskesmas H Kota Semarang lebih siap PIS-PK daripada Puskesmas P Kabupaten Labuan Batu. Dapat disimpulkan bahwa dalam pelaksanaan PIS-PK di kedua puskesmas masih menemui permasalahan, baik dalam hal input (tenaga, dana, alat dan metode), proses (perencanaan, pelaksanaan, pengawasan), maupun output. Sebagai saran, perlu adanya perencanaan yang lebih komprehensif dalam implementasi PIS-PK. Kata kunci: PIS PK, riset evaluasi, Indikator input, proses, dan output
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