Studies of doctor–patient communication generally advocate a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. We investigated factors underlying the use of a one-way consultation style by doctors in a Southeast Asian setting. We conducted a qualitative study based on principles of grounded theory. Twenty residents and specialists and 20 patients of a low or high educational level were interviewed in internal medicine outpatient clinics of an Indonesian teaching hospital and two affiliated hospitals. During 26 weeks we engaged in an iterative interview and coding process to identify emergent factors. Patients were generally dissatisfied with doctors’ communication style. The doctors indicated that they did not deliberately use a one-way style. Communication style appeared to be associated with characteristics of Southeast Asian culture, the health care setting and medical education. Doctor–patient communication appeared to be affected by cultural characteristics which fell into two broad categories representing key features of Southeast Asian culture, “social distance” and “closeness of relationships”, and to characteristics categorized as “specific clinical context”. Consideration of these characteristics could be helpful in promoting the use of a partnership communication style.
A Community service program (PkM) carried out by the Department of Anthropology, Faculty of Cultural Sciences, Gadjah Mada University in 2018 took place in Pucung Hamlet, Wukirsari Village, Bantul, which aims to develop Pedukuhan Pucung as a tourism village through participatory methods. In the implementation of this PkM, the participatory method that is introduced is the PRA (participatory rural appraisal) that researchers could act as facilitators and could directly facilitate citizens to recognize and utilize participatory methods to develop a CAP (Community Action Plan) which would later become a tourist village development plan. At the end of the implementation of this program, the CAP has successfully compiled the development of a Pucung tourism village based on local culture and it was also agreed to create a tourism village development organization and to select several local facilitators. Further, the PkM team will still provide assistance to the sustainability and implementation of the CAP of the Pucung Tourism Village.--------------------------------------------------Kegiatan program pengabdian kepada masyarakat (PkM) yang dilakukan oleh Departemen Antropologi, Fakultas Ilmu Budaya, Universitas Gadjah Mada pada tahun 2018 ini mengambil lokasi di Pedukuhan Pucung, Desa Wukirsari, Bantul, yang terkait dengan pengembangan Pucung sebagai desa wisata secara partisipatoris. Dalam pelaksanaan PkM ini, metode partisipatoris yang dikenalkan adalah metode PRA sehingga peneliti dapat bertindak sebagai fasilitator dan langsung dapat memfasilitasi warga dalam mengenal dan memanfaatkan metode partisipatoris untuk menyusun CAP (Community Action Plan), yang nantinya akan menjadi program pengembangan desa wisata. Pada akhir pelaksanaan program ini telah berhasil disusun CAP pengembangan Desa Wisata Pucung yang berbasis budaya lokal dan juga disepakati untuk membentuk kepengurusan organisasi pengembangan desa wisata dan pemilihan beberapa fasilitator lokal. Dalam pengembangan selanjutnya, tim PkM masih akan melakukan pendampingan terhadap keberlanjutan dan pelaksanaan CAP pengembangan Desa Wisata Pucung.
BackgroundIndonesia is among those countries committed to malaria eradication, with a continuously decreasing incidence of malaria. However, at district level the situation is different. This study presents a case of malaria resurgence Kokap Subdistrict of the Kulon Progo District in Yogyakarta Province, Java after five years of low endemicity. This study also aims to describe the community perceptions and health services delivery situation that contribute to this case.MethodsAll malaria cases (2007–2011) in Kulon Progo District were stratified to annual parasite incidence (API). Two-hundred and twenty-six cases during an outbreak (May 2011 to April 2012) were geocoded by household addresses using a geographic information system (GIS) technique and clusters were identified by SaTScan software analysis (Arc GIS 10.1). Purposive random sampling was conducted on respondents living inside the clusters to identify community perceptions and behaviour related to malaria. Interviews were conducted with malaria health officers to understand the challenges of malaria surveillance and control.ResultsAfter experiencing three consecutive years with API less than 1 per thousand, malaria in Kokap subdistrict increased almost ten times higher than API in the district level and five times higher than national API. Malaria cases were found in all five villages in 2012. One primary and two secondary malaria clusters in Hargotirto and Kalirejo villages were identified during the 2011–2012 outbreak. Most of the respondents were positively aware with malaria signs and activities of health workers to prevent malaria, although some social economic activities could not be hindered. Return transmigrants or migrant workers entering to their villages, reduced numbers of village malaria workers and a surge in malaria cases in the neighbouring district contributed to the resurgence.ConclusionCommunity perception, awareness and participation could constitute a solid foundation for malaria elimination in Kokap. However, decreasing number of village malaria workers and ineffective communication between primary health centres (PHCs) within boundary areas with similar malaria problems needs attention. Decentralization policy was allegedly the reason for the less integrated malaria control between districts, especially in the cross border areas. Malaria resurgence needs attention particularly when it occurs in an area that is entering the elimination phase.
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