PUSKESMAS:

THE PRIMARY HEALTH CARE SYSTEM IN INDONESIA

Introduction 

Why do you have to know about PUSKESMAS as the primary health care system in Indonesia in relation to the Public health and community nutrition systems course?

References 

  

Pedoman Kerja Puskesmas, Depkes RI Sistim Kesehatan Nasional Renstra Depkes 2005-2009 Standar Pelayanan Minimal Bidang Kesehatan

What is PUSKESMAS?    

Functional health organization unit Public health development center Building community participation Provide comprehensive and integrated services to the community under its coverage in the forms of principal activities

PUSKESMAS’ coverage 

Part of or the whole sub-district (kecamatan), depending on:   



Population density (~30,000) Areas (~district head office) Geographic (extended to have supporting-Puskesmas/Puskesmas Pembantu or Puskesmas Keliling) Infrastructure (personnel and facilities)

PUSKESMAS’ coverage 

Especially for big cities (population ≥ 1 million) = Puskesmas Pembina:   

Coverage: sub-district Population: 150,000 Referral and Coordinating several Puskesmas Kelurahan (village-level)

Comprehensive health service Promotion  Prevention  Cure/treatment  Rehabilitation for all gender and age from conception to those dying 

Integrated health services 

All principal health service activities:     

Policlinic Maternal and child clinic Hygiene and sanitation program Communicable diseases program And others

implemented together under one coordination and leader

Functions and roles of PUSKESMAS in the public health system 

Functions:  



Public health development center Building community participation to promote healthy life behaviors Provide comprehensive and integrated health care services

Functions and roles of PUSKESMAS in the public health system 

Activities:  



 

Stimulating the community to do self-help activities Informing the community to search and use the locally available resources effectively and efficiently Technically assisting the community for medical content, medical and health referral without rising any dependency Providing direct health services to the community Collaborating with other related sectors in implementing the health programs

Functions and roles of PUSKESMAS in the public health system 

Roles: 

 

As a technical implemental institution, it shall have a managerial capabilities and long-term vision to improve the quality of health services In planning, managing and evaluating Using and updating related information techniques to improve the comprehensive and integrated health services

Functions and roles of PUSKESMAS in the public health system 

Status: 



Administration, as a technical unit of district government office via the district health office Hierarchical health service, as a primary health service facility (*)

Organization of PUSKESMAS HEAD OF PUSKESMAS

HEAD OF ADMINISTRATION UNIT

TECHNICAL UNIT I-III

SUPPORTING UNIT

TECHNICAL UNIT IV-VII

Organization of PUSKESMAS PERSONNEL

JOB DESCRIPTION

Head of Puskesmas

Leading, supervising and coordinating Puskesmas activities (structural and functionally) Staffing, finance, facility, recording and reporting

Head of Administration unit

Organization of PUSKESMAS PERSONNEL

JOB DESCRIPTION

Unit I

Maternal and child health, family planning and nutrition program activities

Unit II

Prevention and treatment of communicable diseases (immunization, environmental health and laboratory)

Organization of PUSKESMAS PERSONNEL

JOB DESCRIPTION

Unit III

Dental and oral health, occupational health and elderly

Unit IV

Public health nursing, school and sport health, mental health, eyes’ health and other specific healths

Organization of PUSKESMAS PERSONNEL

JOB DESCRIPTION

Unit V

Building and developing community health activities and public health promotion

Unit VI

Out-patient and in-patient treatment services Pharmacy

Unit VII

Organization of PUSKESMAS SUPPORTING UNIT Supporting Puskesmas

JOB DESCRIPTION

Mobile Puskesmas Village midwife

Implementing Puskesmas programs to remote areas Provide maternal and child health service to 3,000 population

Implementing Puskesmas programs to 2,500 – 10,000 population

Primary Programs of PUSKESMAS 1. Maternal and child health 2. Family Planning 3. Nutrition Improvement 4. Environmental health 5. Communicable diseases eradication 6. Treatment, including emergency condition 7. Public health education/promotion 8. School health program 9. Sport health 10.Public health nursing

Primary Programs of PUSKESMAS 11. Occupational health 12. Dental and oral health 13. Mental health 14. Eyes’ health 15. Laboratory 16. Reporting and recording of health information system 17. Elderly 18. Controlling traditional healer 19. And others

Referral system Hierarchy

Health service component

Households

Individual or family members

Community

Households of ten, Posyandu

Primary health service facility Primary referral unit Advanced referral unit

Puskesmas and its supporting units, private practices, etc District hospital, laboratory, private practices, etc Provincial hospitals, special health facilities, etc

Referral system 

Type of referral system: 



Medical referral (diagnostic and treatment): patient consultation, sending specimens and inviting special health personnel Health referral (promotion and prevention): epidemiological survey and eradication of outbreaks, food aids, investigation of food poisoning, special aids during disaster and displaced population/refugee, clean water technology and laboratory

Conclusion 

Why do you have to know about PUSKESMAS as the primary health care system in Indonesia in relation to the Public health and community nutrition systems course?