Disease Intervention,Disease Intervention,to reach the goal of Vision to reach the goal of Vision

20202020in Indonesiain Indonesia

Farida Sirlan MD, PhDMinistry of Health,

Indonesia

Political WillPolitical Will

• Eye health has not yet high Eye health has not yet high priority priority

• Launch Vision 2020 in February Launch Vision 2020 in February 2000 by Vice President2000 by Vice President

• Vision 2020 workshop at Vision 2020 workshop at provincesprovinces

Government PolicyGovernment Policy

1.1. Healthy Indonesia 2010 throughHealthy Indonesia 2010 through• Increasing community participationIncreasing community participation• Advocacy to community leadersAdvocacy to community leaders• Training for GPs, nurses, cadres, Training for GPs, nurses, cadres,

teachersteachers• Improving facilities for PEC, SEC, TECImproving facilities for PEC, SEC, TEC

2. National strategic plan for PBL 2. National strategic plan for PBL programprogram

3. Competent based policy for eye 3. Competent based policy for eye specialistsspecialists

4. Decentralization from Jakarta to 4. Decentralization from Jakarta to ProvincesProvinces

National Health National Health SystemSystem

• Primary eye care in primary health Primary eye care in primary health centercenter

• Secondary eye care in district Secondary eye care in district hospitalhospital

• Tertiary eye care in province Tertiary eye care in province hospital/ hospital/

teaching hospitalteaching hospital

MorbidityMorbidity

• National Eye Survey 1996National Eye Survey 1996• Refraction errorRefraction error : :

22,1%22,1%• Pterygium Pterygium :: 13,9 13,9

%%• Cataract Cataract :: 7,3 7,3

%%• Conjunctivitis Conjunctivitis : : 2,0 2,0

%%• Corneal scar Corneal scar : : 1,4 %1,4 %• Glaucoma Glaucoma : : 0,4 0,4

%%

Blindness and visual Blindness and visual impairmentimpairment

• Blindness : 1.50 %Blindness : 1.50 %• Severe visual impairment : Severe visual impairment :

1.10 %1.10 %• Visual impairment : 1.80 %Visual impairment : 1.80 %

Causes of blind

• Cataract Cataract : 52 %: 52 %• Optic nerve Optic nerve : 13,4 %: 13,4 %• Refraction error Refraction error : 9,5 %: 9,5 %• Retina Retina : 8,5 %: 8,5 %• Cornea Cornea : 6,4 %: 6,4 %• Others Others : 10,2 %: 10,2 %

Professional Professional commitmentcommitment

• Increase human resourcesIncrease human resources• Increase Cataract Surgical Increase Cataract Surgical

RateRate• Increase the community Increase the community

workwork

Role of NGO’sRole of NGO’s

• Financial for promotion, training, Financial for promotion, training, screening, campaign, and screening, campaign, and consumablesconsumables

• Advocacy to government, politician, Advocacy to government, politician, businessmanbusinessman

CataractCataract

The strategy and the targetThe strategy and the targetEye care facilitiesEye care facilities

CataractCataract

The strategy and the The strategy and the targettarget

Eye care facilitiesEye care facilities

Cataract Cataract

The strategy and the targetThe strategy and the target

Eye care facilitiesEye care facilities

Children blindnessChildren blindness

Rapid survey to measures the problemRapid survey to measures the problemAdvocacy to the decision makerAdvocacy to the decision makerPromotion to communityPromotion to communityEarly detection of childhood blindEarly detection of childhood blindTraining for pediatric ophthalmology Training for pediatric ophthalmology

team team

Refraction ErrorRefraction Error

Training elementary school teachersTraining elementary school teachersScreening by trained teachers Screening by trained teachers Re-screening by hospital team Re-screening by hospital team Providing glasses, low cost or free Providing glasses, low cost or free

for the poorfor the poor

Low visionLow vision

Just started in several centersJust started in several centersTraining ophthalmologists Training ophthalmologists Work together with the school for Work together with the school for

blindblind

XerophthalmiaXerophthalmia

Rapid Survey due to monetary crisis 1998Rapid Survey due to monetary crisis 1998 Promotion through health centersPromotion through health centers Training for early detectionTraining for early detection Regular vitamin A injection and capsules Regular vitamin A injection and capsules

in HC for all children under fivein HC for all children under five Role of NGO, Helen Keller InternationalRole of NGO, Helen Keller International

GlaucomaGlaucoma

Training PEC in Health CentersTraining PEC in Health CentersStarting promotion and seminarsStarting promotion and seminarsDeveloping the glaucoma foundationDeveloping the glaucoma foundationEncouraging the glaucoma family to Encouraging the glaucoma family to

check upcheck upMulti-centers studyMulti-centers studyProviding specific treatment at TECProviding specific treatment at TEC

Diabetic RetinopathyDiabetic Retinopathy

Promotion through health centersPromotion through health centersDevelop the referral system PEC, SEC, Develop the referral system PEC, SEC,

TECTECDeveloping the diabetes foundationDeveloping the diabetes foundation Inter-discipline networkInter-discipline networkMulti-centers studyMulti-centers studyProviding specific treatment at TECProviding specific treatment at TEC

SummarySummary

To reach the goal of theTo reach the goal of the vision vision 20202020, , the disease intervention has the disease intervention has been conducted, mainly for:been conducted, mainly for:– Cataract blind, Cataract blind, – Children blind, Children blind, – Refractive errorRefractive error

HEALTHYHEALTHYINDONESIAINDONESIA

20102010