Ailing 'Puskesmas' need treatment before they can curb outbreaks<\/p>\n
The Jakarta Post, Jakarta<\/p>\n
Prevention is better than cure, according to the popular axiom.<\/p>\n
The government, however, seems to believe the opposite as the
\nMinistry of Health is allocating just 11 percent of its budget to
\ncommunity health centers (puskesmas), while giving three times
\nthat amount to hospitals.<\/p>\n
Recent outbreaks of old diseases -- polio, dengue fever and
\nmalnutrition -- have been blamed in part on the erosion of
\npuskesmas as the vanguard of community health care, due to a lack
\nof funds following decentralization.<\/p>\n
Minister of Health Siti Fadilah Supari, speaking about the
\npolio outbreak and malnutrition cases, said many local
\nadministrations failed to provide the necessary money to keep the
\ncommunity health centers functioning healthily.<\/p>\n
The central government appears to be following suit,
\nallocating only Rp 342 billion earlier this year to assist the
\npuskesmas, while setting aside Rp 901.7 billion for hospitals,
\nwhich mainly play a curative role.<\/p>\n
In the revised 2005 state budget, Rp 698.9 billion is set
\naside for puskesmas and Rp 3.256 trillion is earmarked for
\nhospitals.<\/p>\n
This same pattern is being followed in the allocating of the
\nRp 3.7 trillion health fund for the poor from the fuel subsidy
\ncut. Only Rp 1.08 trillion of this money is being allocated for
\npublic health services at puskesmas, with the rest going to
\nhospitals. This despite the fact that in most villages across
\nIndonesia, distance is a serious barrier for people to get
\ntreatment at a hospital.<\/p>\n
\"We strongly urge the ministry to put the priority in its
\nbudget on taking preventive measures at the puskesmas level,
\ninstead of on curative measures (through hospitals),\" House of
\nRepresentatives Commission IX's health task force head, Mariani
\nAkib Baramuli, said on Tuesday.<\/p>\n
Last year, House Commission VII, which also oversees health,
\nput preventive and educational measures at the top of its list of
\nrecommendations to the health ministry.<\/p>\n
Puskesmas, a concept developed decades ago, emphasize
\npreventive and educational measures. While hospitals are
\nresponsible only for their patients, puskesmas are meant to
\nactively monitor health conditions in their respective areas,
\nwhich average more than 10,000 people.<\/p>\n
Besides serving as health centers, puskesmas also help to
\nassure local development efforts encourage the populace to
\nmaintain a healthy environment, or at least to maintain
\nconditions so they do not have a negative effect on the health of
\nthe local community.<\/p>\n
Currently, however, due to insufficient operational funds, the
\n7,277 puskesmas nationwide are not playing a preventive role.<\/p>\n
Health centers in most regions, except for Jakarta, have to
\npay money to local administrations, instead of receiving
\nassistance funds from them.<\/p>\n
A community health center head in West Java confirmed recently
\nthat the local administration, for which he works, demanded a
\nyearly fee of Rp 69 million from the center. Only about 30
\npercent of this money is returned to the health center, which is
\nbarely enough to cover its operational costs.<\/p>\n
The health center in question, located only a 30-minute drive
\nfrom Jakarta, is forced to branch out to make extra money,
\nincluding opening a telephone kiosk next to its building.<\/p>\n
Puskesmas in remote areas face more problems than a lack of
\nfunds. \"There are not enough doctors and medical workers willing
\nto work at remote puskesmas,\" the health ministry's director
\ngeneral of community health, Azrul Azwar, told The Jakarta Post
\nrecently.<\/p>\n
He said that because the government no longer made it
\ncompulsory for new doctors to serve in puskesmas, the number of
\nvolunteer doctors from Indonesia's 48 medical schools had
\nsteadily declined from an estimated 3,500 annually.<\/p>\n
\"As a result only 40 percent of puskesmas in the country are
\nled by doctors. The rest are led by mantri (male nurses) or
\nworse, district officers,\" Azrul said.<\/p>\n
He suggested that incentives be given to young doctors to
\nserve at puskesmas. In addition, the budget priorities of both
\nthe central government and local administrations is necessary.<\/p>\n
Unless these measures are taken, many doubt the government's
\nability to create a \"healthy Indonesia\" by 2010.<\/p>\n
If the puskesmas function as originally intended, fewer
\nburdens would be placed on hospitals.<\/p>\n
And why cure if you can prevent?<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/ailing-puskesmas-need-treatment-before-they-can-curb-outbreaks-1447893297", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }