INDIKATOR KESEHATAN

MASYARAKAT
Sutantri, Ph.D

8 November 2022
Health Indicators: Definition, Uses
and Attributes
Essential definitions
Health: “a state of complete physical, mental, and social well-being and
not merely the absence of disease or infirmity” (WHO, 1947)
Indicator: summary measures that capture relevant information on
different attributes and dimensions of health status and performance
of a health system
Health indicators attempt to describe and monitor a population’s
health status

Data Indicator Information

 Positive and Negative Health Indicator
Indicators are considered positive when they have a direct relationship
(association, correlation) with healthiness. The higher the indicator value,
the better the state of health of the people in the population being studied.

• i.e. Life expectancy at birth, proportion of cured TBC cases, of vaccine coverage, etc

Indicators are considered negative when they have an inverse relationship

(association, correlation) with healthiness. The higher the indicator value,
the worse is the state of health of the people in the population being
studied.
• i.e. infant mortality rate, maternal mortality rate, rate of incidence of AIDS, proportion of TBC
patients abandoning treatment.
Uses of Health Indicators
• To describe health care needs in a population, and
Description
the disease burden in specific population groups

Forecast or • To measure individual risk and prognosis, as well as

prognosis forecast of disease burdens in populations

• Facilitate an understanding of why some individuals

Explanation
in a population are healthy and others are not
System
• To provide feedback to improve decision-making in
management
various system and sectors
and QI
Evaluation • Show the results of health interventions
 Uses of Health Indicators (cont)
• Tools to support or oppose particular ideas and
Advocacy
ideologies in different context

• Provide needed information for a wide range of

Accountability
audiences and users

• Facilitate analysis and lead to a hypothesis to

Research
explain observed trends and discrepancies

• Gender-sensitive indicators measure gaps between

Measure gender
men and women resulting from differences or
gaps
inequalities in gender roles, norms, and relations.
Development and Measurement
of Health Indicators
 Incident vs Prevalent
Incidence rate Prevalence rate

• The number of new cases of a • The number of existing cases of a

disease or other health condition
divided by the population at risk
for the disease (exposed
population) in a specific place
during a specified period of time
disease or other health event
divided by the number of persons
in population at that specified
time.

Incidence is essential for analyzing the occurrence of new events in populations

and their related factors. Prevalence is essential for planning and organizing
existing resources and services as well as for obtaining additional support, when
necessary
 Types of Health Indicators
1. Morbidity Indicators

• Designed to measure the occurrence of diseases, injuries, and disabilities in

populations
• Can be expressed by measuring incidence or by measuring prevalence
• i.e. HIV Diagnosis Rate (number of new diagnosis of HIV in a population
during a specified period of time divided by the number of persons at-risk for
developing HIV during that period of time), Hypertension prevalence rate (the
number of existing cases of HT per 100,000 divided by the number of persons
in the population in a specified time)
 Types of Health Indicators
2. Mortality Indicators

• A fundamental source of demographic, geographic, and cause-of-death

information
• Used to quantify health problems and to define or monitor health priorities
and goals
• i.e. Infant mortality rate (number of deaths of children under 1 year of age
(per thousand) divided by the total number of live births in the population
during a given year), maternal mortality ratio (the number of maternal deaths
per thousand, divided by number of live births in the population in a given
year)
 DATA SOURCES FOR DEVELOPING HEALTH
INDICATORS
• Primary data sources

• Secondary data sources

• Data that was originally collected for other purposes
Advantages
Disadvantages
Main Data Sources

Health
Demographic
information
censuses
system

Routine data
Population
from health
surveys
facilities
Steps for evaluating the quality of health
indicators
Examine the integrity of the complete and valid data on which the indicator is based

Examine the consistency of the estimated indicators with regard to personal attributes (sex, age, etc)

Examine the consistency of the estimated indicators with regard to place attributes

Examine the consistency of the estimated indicator with regard to temporal attributes (is the indicator
consistent over time?)

Examine the plausibility of the magnitude of the indicator in relation to other data sources
 Indikator Program Kesehatan Masyarakat di
Indonesia

Rencana Pembangunan Rencana Strategis (Renstra)

Jangka Menengah Nasional 2020 – 2024
(RPJMN) 2020 – 2024
RPJMN 2020 – 2024
Fokus utama terkait program kesehatan masyarakat:
1. Angka kematian ibu (AKI)
2. Angka kematian bayi (AKB)
3. Angka kematian neonatal
4. Prevalensi stunting pada balita
5. Prevalensi wasting pada balita
 Angka kematian ibu (AKI)
• Kematian akibat proses yang berhubungan dengan kehamilan, persalinan, dan abortus
yang terjadi dalam kurun waktu 42 hari setelah berakhirnya kehamilan tanpa melihat
usia gestasi, dan tidak termasuk di dalamnya sebab kematian akibat kecelakaan atau
kejadian insidental.
• Target

Rumus Penghitungan Indikator:

𝐽𝑢𝑚𝑙𝑎ℎ 𝑘𝑒𝑚𝑎𝑡𝑖𝑎𝑛
100.000 𝑘𝑒𝑙𝑎ℎ𝑖𝑟𝑎𝑛 ℎ𝑖𝑑𝑢𝑝
Angka kematian bayi (AKB)
• Kematian bayi adalah bayi usia 0-11 bulan (termasuk neonatal) yang meninggal di
suatu wilayah pada kurun waktu tertentu
• Target:

Rumus Penghitungan Indikator:

𝐽𝑢𝑚𝑙𝑎ℎ 𝑘𝑒𝑚𝑎𝑡𝑖𝑎𝑛 𝑏𝑎𝑦𝑖

1000 𝑘𝑒𝑙𝑎ℎ𝑖𝑟𝑎𝑛 ℎ𝑖𝑑𝑢𝑝
Angka kematian neonatal
• Kematian Neonatal adalah kematian bayi lahir hidup pada masa 0-28 hari setelah
lahir di suatu wilayah pada kurun waktu tertentu.
• Rumus:
jumlah kematian bayi (lahir hidup) yang terjadi pada masa 0−28 hari setelah lahir
1000 𝑘𝑒𝑙𝑎ℎ𝑖𝑟𝑎𝑛 ℎ𝑖𝑑𝑢𝑝

Target
Prevalensi stunting pada balita
• Balita stunting (pendek dan sangat pendek) adalah anak umur 0 sampai 59 bulan
dengan kategori status gizi berdasarkan indeks Panjang Badan menurut Umur
(PB/U) atau Tinggi Badan menurut Umur (TB/U) memiliki Z-score kurang dari -
2SD.
Rumus:

Jumlah balita stunting

jumlah balita yang diukur indeks (PB/U) atau (TB/U) X 100%

Keterangan:
PB/U: Panjang badan menurut umur
TB/U: Tinggi badan menurut umur
Prevalensi wasting pada balita
• Anak umur 0 sampai 59 bulan dengan kategori status gizi berdasarkan indeks
Berat Badan menurut Panjang Badan (BB/PB) atau Berat Badan menurut Tinggi
Badan (BB/TB) dengan Z-score kurang dari -2SD.
• Menurut Permenkes Nomor 2 Tahun 2020, balita wasting (kurus dan sangat
kurus) adalah balita gizi kurang dan gizi buruk.
• Rumus:
Jumlah balita memiliki indeks BB/PB−TB <−2SD
X 100%
Total balita yang diukur indeks BB/PB−TB
 Target Prevalensi
Stunting dan Wasting
Persentase Ibu Hamil Kurang Energi Kronik
(KEK)
• Ibu hamil dengan risiko Kurang Energi Kronis (KEK) yang ditandai
dengan ukuran Lingkar Lengan Atas (LiLA) kurang dari 23,5 cm.
Cakupan Kunjungan Antenatal
• Cakupan ibu hamil yang telah memperoleh pelayanan antenatal
sesuai dengan standar paling sedikit 4x dengan distribusi waktu 1x
pada trimester 1, 1x pada trimester ke 2, 2x pada trimester ke 3 di
suatu wilayah pada kurun waktu tertentu
Cakupan kunjungan neonatal
• Cakupan bayi baru lahir usia 0 - 28 hari yang mendapatkan pelayanan
sesuai standar paling sedikit tiga kali dengan distribusi waktu 1 kali
pada usia 6 - 48 jam, 1 kali pada usia 3 – 7 hari, dan 1 kali pada usia 8
– 28 hari setelah lahir di suatu wilayah pada kurun waktu tertentu.
 Indikator lain dalam RPJMN 2022 – 2024
Penurunan kematian ibu dan bayi
• Persentase persalinan di fasyankes
• Cakupan kunjungan antenatal
• Cakupan kunjungan neonatal
• Jumlah tenaga kesehatan yang dilatih kegawatdaruratan maternal dan neonatal
• Jumlah kabupaten/kota yang menyelenggarakan pelayanan kesehatan usia reproduksi

Percepatan dan Perbaikan Gizi Masyarakat

• Persentase bayi usia kurang dari 6 bulan mendapat ASI eksklusif
• Persentase ibu hamil Kurang Energi Kronik (KEK)
• Prevalensi wasting (kurus dan sangat kurus) pada balita
• Persentase kabupaten/kota yang melaksanakan surveilans gizi
• Persentase balita yang dipantau pertumbuhan dan perkembangannya
• Jumlah balita yang mendapatkan suplementasi gizi mikro
 Indikator lain dalam RPJMN 2022 – 2024
Pengembangan Lingkungan Sehat
• Persentase desa/kelurahan Stop Buang air besar Sembarangan (SBS)
• Jumlah kabupaten/kota sehat
• Persentase sarana air minum yang diawasi/diperiksa kualitas air minumnya sesuai standar

Penguatan Promosi Germas

• Persentase kabupaten/kota yang menerapkan kebijakan Germas
• Persentase kabupaten/kota melaksanakan pembinaan posyandu aktif
• Persentase kabupaten/kota dengan minimal 80% Posyandu Aktif
• Persentase kabupaten/kota yang menerapkan kebijakan Germas
• Jumlah pedoman/regulasi/ rekomendasi kebijakan penerapan Germas
Indikator Program Kesehatan Masyarakat dalam Renstra
2020 – 2024
• Indikator Kinerja Program Kesehatan Masyarakat
Indikator Program Kesehatan Masyarakat dalam Renstra
2020 – 2024
• Indikator Kinerja Kegiatan Pembinaan Kesehatan Keluarga
Indikator Program Kesehatan Masyarakat dalam Renstra
2020 – 2024
• Indikator Kinerja Kegiatan Pembinaan Gizi Masyarakat

• Indikator Kinerja Kegiatan Kesehatan Kerja dan Olahraga

Indikator Program Kesehatan Masyarakat dalam Renstra
2020 – 2024
• Indikator Kinerja Kegiatan Penyehatan Lingkungan
Indikator Program Kesehatan Masyarakat dalam Renstra
2020 – 2024
• Indikator Kinerja Kegiatan Promosi Kesehatan dan Pemberdayaan
Masyarakat
Indikator Program Kesehatan Masyarakat dalam Renstra
2020 – 2024
• Indikator Kinerja Kegiatan Dukungan Manajemen dan Pelaksanaan
Tugas Teknis Lainnya pada Program Kesehatan Masyarakat