1. A strategy for the improvement of diseases surveillance infrastructure in Indonesia AgungFatwanto Sunan Kalijaga

2. Content Sunan Kalijaga Background Research Strategy Improvement Strategy

3. Overview (Wikipedia, 2010) Sunan Kalijaga

4. Background (Wikipedia, 2010) Sunan Kalijaga

5. Background Sunan Kalijaga Population: 238 millions (CSB, 2010) 17,504 islands (MIA, 2004), about 6,000 of which are inhabited (IMF, 2006) Around 8,548 community health center (CHC) where 20% of them are not assigned with doctor (Republika, 4-Oct-10) 1,523 hospitals (MoH, 2010)

6. Background Sunan Kalijaga Securing public health need: A diseases surveillance infrastructure In order to detect outbreak: earlier more sensitive (highlight potential increase) accurate nation-wide with communicable result

7. Background (Sedyaningsih, 2006) Sunan Kalijaga

8. Background Sunan Kalijaga Current system (Sedyaningsih, 2006): EWORS (Early Warning Outbreak Recognition System) Developed by the National Institute of Health Research and Development (MoH) in collaboration with US NAMRU 2 Implemented in 9 cities: 13 hospitals + 2 CHC Form: paper-based data gathering + web-based electronic data entry

9. Background (Sedyaningsih, 2006) Sunan Kalijaga

10. Background (Sedyaningsih, 2006) Sunan Kalijaga

11. Background (Sedyaningsih, 2006) Sunan Kalijaga

12. Background (Sedyaningsih, 2006) Sunan Kalijaga

13. Background (Sedyaningsih, 2006) Sunan Kalijaga

14. Background (Sedyaningsih, 2006) Sunan Kalijaga

15. Background (Sedyaningsih, 2006) Sunan Kalijaga

16. Background Sunan Kalijaga Substantial Drawbacks: Timing problem: due to the use of semi-manual data entry process Coverage problem: only implemented in 9 cities (13 hospitals + 2 CHC) Dissemination problem: lack of dissemination to the responsible parties

17. Background Sunan Kalijaga Proposed project: Improving the existing diseases surveillance infrastructure Goal: Formulate a strategy to improve the diseases surveillance infrastructure for resource-limited context

18. Research Strategy Sunan Kalijaga Q1: Participatory research and design Do they suitable for the Indonesian context? Sociological theories: Culture, Polity, Economy (Habermas 81, Giddens 84, Bourdieu 86)

20. 742 spoken languages and dialects (with their own alphabet/character)

21. various religions/beliefs (6 are acknowledged by the state)

22. different level of modernityCharacters of the majority: Communal, Introvert, Responsive, Tend to be dogmatic, Religious, Mystic, Superstitious, Strong oral tradition, Hypocrite, Flexible, Friendly, Adaptive

23. Research Strategy Sunan Kalijaga Political Setting : Democratic (in progress) Unitary state (most power is concentrated in central government, limited autonomy given to district) Presidential system: with a council of ministers, who are not required to be elected members of the legislature. Division of power: executive, legislative, and judicative. Executive: central, province, district. Legislative: central (people’s representative council & regional representative council), province (provincial people’s representative council), district (district-level people’s representative council). Judicative: state court, high court, supreme court.

24. Research Strategy Sunan Kalijaga Economic Setting: Mixed economy system (played by both public and private sectors) Economic sectors (WB, 2006): - Revenue: industry (47.6%), services (37.1%), agriculture (15.3%). - Labour: agriculture (44.3%), services (36.9%), industry (18.8%). GDP per capita (IMF, 2006): US$ 2,329 GDP PPP (IMF, 2006): US$ 4,157 GDP growth (UN, 2008): 6% Very diverse level of income (big economic gap): unemployment rate (2009): 7.7%, below poverty line (WB,2006): 17.8%

26. Research Strategy Level of analysis: Infrastructure System Application Sunan Kalijaga

28. Improvement Strategy Sunan Kalijaga Q2: Does an adoption of the core concept of computer-supported collaborative work may improve the diseases surveillance system which is currently in place?

31. Organizational (Hospital, District/Provincial Health Office)

32. Group (Group of paramedics)

34. Improvement Strategy Sunan Kalijaga Q3: Does mobile-based platform a good alternative to scale-up the current infrastructure?

35. Improvement Strategy Celluler users (ATSI, 2010): 80% In 2015 it is predicted to be 107% (ATSI, 2010) Sunan Kalijaga

36. Improvement Strategy (Facebook, 2010) Sunan Kalijaga

37. Improvement Strategy (Wikipedia, 2011) Sunan Kalijaga

39. Social experiment with it (pilot project)