Percepatan Penanggulangan

Gangguan Penglihatan
di Indonesia
Outline
• Universal Health Coverage (UHC)
• Universal Eye Health (UEH): Global Action Plan 2014 – 2019
• Road Map Penanggulangan Gangguan Penglihatan di Indonesia
• Integrasi Program Nasional dan Program Global
• Roadmap
Health System
Health Interactions
Non-Health
Activiests/Actors Activiests /Actors
Direct Indirect
Goods: • Regulation
• Infrastructures • Education
• Equipments • Pollution Strategies
• Drugs

Health Services

Health Improvement of the population

 Health System
Political Climate
Role of the Government

Global Health Policies Local Health Policies

6 Building Blocks
• Governance
• Human Resources
• Health Financing
• Health Information
• Consumables and Technology
• Service delivery
Health System

All Organizations, people, and actions whose primary intent to

promote, restore, or maintain health.

A system producing and organizing goods (eg, infrastructures,

equipments, drugs) and services (ie, health services) to achieve the
objective of improving the health of the population. (WHO)

World Health Organisation. World Health Report 2000. Geneva: World Health Organisation, 2000.
Health System
World Health Organization (2013). "Universal eye health: a global action plan 2014-2019."
Global Action Plan 2014 - 2019
The Goal :
• Reduce Visual Impairment as a global public health problem
• Secure access to rehabilitation for visually impaired services

The Objectives :
• Generate evidence on magnitude and causes of VI and use it in advocacy;
• Develop and implement integrated national eye health policies and plans;
• Ensure multi-sectoral engagement and effective partnerships.

The Indicators are to be monitored:

• Prevalence and Causes of VI;
• Numbers of Ophthalmologists, Optometrists and Allied Ophthalmic Personnel;
• Cataract Surgical Rate  and Cataract Surgical Coverage

https://www.iapb.org/advocacy/who-action-plan
https://www.iapb.org/advocacy/who-action-plan
Eye Health System
 Proportion people aged 50 years and older The proportion of the total
35%
population of people aged 50
30%
years or older between 2000 and
25%
2030. This increases from 14% in
20% 2000 to 29% in 2030.
15%

10% The proportion is higher in

5% females. The prevalence of
0% cataract increases exponentially
2000 2005 2010 2015 2020 2025 2030
above the age of 50 years.
Total Males Females

Demographic trends in Indonesia; Hans Limburg MD PhD 2013

Roadmap Percepatan Penanggulangan
Penglihatan
Visi
Pada Tahun 2030, setiap orang di Indonesia mempunyai penglihatan
optimal dan dapat sepenuhnya mengembangkan potensi dirnya
Roadmap Percepatan Penanggulangan
Penglihatan

Tujuan Umum
“Penurunan prevalensi gangguan penglihatan dan tersedianya pelayanan rehabilitasi
yang efektif dan terjangkau bagi orang dengan gangguan penglihatan permanen”.
RAAB in Indonesia
Year Provinces Organized by
2014 Sulawesi Selatan IOA Sulawesi Selatan, Lions Club
2014 Jawa Barat IOA Jawa Barat, CBM
2014 Nusa Tenggara Barat Fred Hollow Foundation
2015 Jakarta MoH Indonesia
2015 Jawa Tengah MoH Indonesia
2015 Jawa Timur MoH Indonesia
2015 Bali MoH Indonesia
2016 Sumatera Utara MoH Indonesia
2016 Sumatera Barat MoH Indonesia
2016 Sumatera Selatan MoH Indonesia
2016 Kalimatan Selatan MoH Indonesia
2016 Sulawesi Utara MoH Indonesia
2016 Maluku MoH Indonesia
2016 Nusa Tenggara Timur MoH Indonesia
2016 Papua Barat MoH Indonesia
Situation of Visual Impairment in Indonesia
Table 1. Extrapolated magnitude of blindness in persons
  Male Female Total
  n % (95% CI) n % (95% CI) n % (95% CI)
North Sumatra 13524 1.3 (0.5 - 2.0) 22076 1.9 (1.0 - 2.7) 35601 1.6 (0.9 - 2.2)
West Sumatra 4736 1.0 (0.3 - 1.7) 8549 1.6 (0.8 - 2.5) 13281 1.4 (0.7 - 2.0)
South Sumatra 16113 2.5 (1.5 - 3.4) 29145 4.4 (3.0 - 5.7) 45253 3.4 (2.4 - 4.4)
Jakarta 7331 1.2 (0.2 - 2.2) 16135 2.6 (1.8 - 3.3) 23464 1.9 (1.3 - 2.5)
West Java 69058 2.1 (1.1 - 3.1) 111605 3.4 (2.4 - 4.4) 180666 2.8 (2.0 - 3.5)
Central Java 66774 2.1 (1.0 - 3.2) 110202 3.2 (2.4 - 4.0) 176977 2.7 (1.9 - 3.4)
East Java 193907 4.7 (2.5 - 6.9) 177687 4.1 (3.0 - 5.2) 371599 4.4 (3.1 - 5.6)
South Kalimantan 4721 1.5 (0.6 - 2.4) 7484 2.3 (1.2 - 3.3) 12205 1.9 (1.1 - 2.7)
NTB 10713 3.3 (1.9 - 4.8) 16283 4.7 (3.5 - 5.9) 27000 4.0 (3.0 - 5.1)
NTT 5577 1.4 (0.6 - 2.2) 10457 2.5 (1.5 - 3.4) 16035 2.0 (1.3 - 2.6)
Bali 58021 1.7 (0.7 - 2.6) 80012 2.2 (1.3 - 3.1) 138028 2.0 (1.1 - 2.8)
North Sulawesi 4729 1.9 (0.9 - 2.8) 3733 1.4 (0.9 - 2.0) 8461 1.7 (1.1 - 2.2)
Maluku 2391 2.0 (0.8 - 3.2) 4065 3.2 (2.2 - 4.2) 6456 2.6 (1.7 - 3.5)
West Papua 1214 2.2 (1.3 - 3.1) 1164 2.5 (1.5 - 3.5) 2379 2.3 (1.7 - 3.0)
 Blindness No of Blind
Year Provinces % Cataract
Prevalence People
2014 Sulawesi Selatan 2,6% 8.515 64,3%
2014 Jawa Barat 2,8% 180.663 71,7%
2014 Nusa Tenggara Barat 4,0% 27.000 78,1%
2015 Jakarta 1,9% 23.464 81,9%
2015 Jawa Tengah 2,7% 176.977 73,8%
2015 Jawa Timur 4,4% 371.599 81,1%
2015 Bali 2,0% 18.016 77,8%
2016 Sumatera Utara 1,7% 30.252 77,8%
2016 Sumatera Barat 1,7% 14.329 87,0%
2016 Sumatera Selatan 3,6% 37.310 85,6%
2016 Kalimatan Selatan 2,0% 9.748 87,9%
2016 Sulawesi Utara 1,7% 8.461 82,2%
2016 Maluku 2,9% 5.377 88,0%
2016 Nusa Tenggara Timur 2,0% 16.394 75,0%
2016 Papua Barat 2,4% 1.606 94,1%
 PREVALENCES OF BLINDNESS IN INDONESIA
2014-2016
Indonesia 3,0%

Maluku 2,6%
Sulut 1,6%
Sumut 1,6%

Sumbar 1,4% Papbar 2,3%

Sumsel 3,6%
DKI 1,9% Kalsel 1,9%
Jateng 2,7% Sulsel 2,7%
Jabar 2,8% Bali 2,0% NTT 2,0%

Jatim 4,4% NTB 4,0%

map:http://holobis.net/index.php?action=page_display&PageID=40
PREVALENCES OF CATARACT BLINDNESS IN INDONESIA
2014-2016

Maluku 1,9%
Sulut 0,7%
Sumut 0,8%

Sumbar 0,7% Papbar 1,5%

Sumsel 2,4%
DKI 1,3% Kalsel 1,0%
Jateng 1,4% Sulsel 1,8%
Jabar 1,7% Bali 1,1% NTT 1,7%

Jatim 2,9% NTB 3,1%

Indonesia 1,9%

map:http://holobis.net/index.php?action=page_display&PageID=40
 STRUCTURE OF EYE CARE
Ce
ntr
Research, Education, Difficult al
Cases
of 25 mill
Exc

g
in
ain
Tertiery
ell Eye 10 mill

Re
Difficult Cases

Tr

fe
Care
ent

r
nd

ra
l
ta
or
High Volume Cataract
Surgeries Su
pp
Secondary Eye Care 2.5 mill
Cataract Case Finding by
health Workers Primary Eye Care 30.000
Visual Impairment Case Community Structures
Findings by Key
(Key Informants/Cadres)
5000
Informants/Cadres
Pendekatan Sistem Kesehatan
Building Blocks Tujuan Indikator
Tata Kelola (Governance) Kebijakan yang Efektif Pembentukan Komda PGPK

Sumber Daya Manusia (SDM) Peningkatan Kualitas SDM Distribusi SDM mahir mata

Peningkatan Akses Layanan Komprehensif dan berkualitas Cataract Surgical Rate

Manajemen Keuangan Accountable dan Berkelanjutan Alokasi budget PGP

Alat Kesehatan dan Teknologi Cost Effective dan tepat guna Standard List IAPB

Teknologi Informasi Monitoring, pencatatan, laporan Otomatisasi sistem pelaporan

Kemitraan Peningkatan Cakupan Layanan Cakupan Layanan

Strategi
Katarak
• Meningkatkan jumlah operasi
katarak
• Kebijakan di daerah untuk
penanggulangan katarak dengan
sesuai keadaan demografi dan
prevalensi kebutaan.
• Perkuatan Sistem rujukan
Gangguan Penglihatan Lain
• Kelainan Refraksi Usia Sekolah
• Layanan komprehensif untuk
retinopati diabetik, glaukoma,
dan childhood blindness.
• Rehabilitasi penglihatan yang
komprehensif dan inklusif
Plan of Actions
1. RAAB
2. Analisa Situasi dan Rencana
Kerja
3. Pelatihan Sumber Daya
Roadmap Percepatan
Manusia Penanggulangan Gangguan
4. Sistem Rujukan dan Penglihatan
peningkatan akses layanan
kesehatan
5. Integrasi dengan BPJS
Terima Kasih