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Research as an Instrument for Community Health Development

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Title: Research as an Instrument for Community Health Development


1
Research as an Instrument for Community Health
Development
  • By
  • Dewi Irawaty (FIK-UI)
  • Shirley M. Solberg (MUNSON)

2
Introduction
  • Indonesia has a long history of projects aimed at
    addressing the health of women and children
  • Government through primary health care centres
    (Puskesmus), child health post (Posyandu), and
    village midwives
  • NGOs through infant food supplement and family
    planning

3
Rationale for Project
  • Community health nursing needed to promote health
    and help women and children with common health
    problems at the village level
  • Also needed is the presence in the village of
    health care workers who could engage in community
    outreach and development

4
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5
Purpose of Presentation
  • Demonstrate importance of research to overall
    success of the project
  • Explore some of the challenges encountered in the
    project
  • Discuss how we addressed the challenges and what
    we attributed to our success

6
The Project
  • Title Nursing, Womens Health and Community
    Outreach in Indonesia
  • Further capacity building in the Faculty of
    Nursing at the University of Indonesia in
    community health nursing
  • Develop a comprehensive model of womens health
    and community health nursing for rural Indonesia

7
Approach to Project
  • Research orientation - participatory action
    research (PAR)
  • PAR attributes mutuality, participation, and
    systematic inquiry immediacy, relevance and
    usefulness and action, skill development, and
    learning.
  • Rasmussen, 1997, p. 254

8
Three Major Impacts
  • Effective health promotion interventions designed
  • Development of a centre for community health,
    education, research and practice (CHERP)
  • Use of research findings to effect policy among
    stakeholders in Indonesian health delivery
    sectors

9
Effective Health Promotion
  • Systematic needs assessment of villages
  • Use of a local advisory committee
  • Supervised data collection involving village
  • Worked with villages to identify areas for
    further development
  • Research preparation of junior faculty

10
Successes from Interventions
  • Childhood diarrhea reduced by 22
  • Increase in tetanus immunization for women in the
    antenatal period from 74 to 97 (first
    injection) and 51 to 80 (second injection)
  • A 42 increase in iron supplementation during
    pregnancy

11
Development of CHERP
  • Responsive to community needs and based on
    principles of health promotion
  • Supportive environment
  • Strengthened community action
  • Development of personal skills
  • Reorienting health services

12
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13
Broadening Policy
  • Systematic approach to development used to
    prepare policy paper (documented research
    findings from interventions)

14
Broadening Policy
  • Presented at a workshop with nurses from
    academic institutions, practice, and
    administration
  • Used feedback from workshop to further develop
    policy paper

15
Challenges
  • Uncertainty related to developing model that was
    a good fit with beliefs and values and best
    suited to the needs of people in the villages
  • Pressure to address acute care needs of people in
    the village
  • A need to change orientation of people in village
    towards health promotion

16
Addressing Challenges
  • Ensuring relevancy and skill development among
    students, faculty, kadres, and people living in
    the village
  • Open communication about problems and creating
    workable solutions
  • Presence in the village and engaging people there
    helped create more of a health culture

17
Contributors to Success
  • Parallel development and assistance from the
    Indonesian National Nurses Association
  • Research requirements of junior faculty in their
    MN program
  • Commitment, relationships and understanding among
    team members

18
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19
Acknowledgements
  • Indonesian team - Dr. Yani Hamid (Project
    Director 1998-2001) Dr. Junati Sahar (Project
    Director 2002-2004) Profs. Tien Gartner, Yati
    Afiyanti, Sigit Molyono, Nani. Nurhaeni, Yuni
    Astuti, and Wiwin Wiarsih.
  • Dean of Nursing (FIKUI) Dean Elly Nurachmah and
    other faculty who worked on needs assessment and
    curriculum development

20
Acknowledgements
  • Canadian team Prof Kay Matthews (team leader),
    Drs. Sandra LeFort, Donna Moralejo, Marilyn
    Porter, and Prof. Karen Webber, Ms. Shannon Muir.
  • Canadian MN students who worked with the
    Indonesian students while in Canada

21
Acknowledgements
  • University Partnerships in Cooperation and
    Development Program Tier 2 grant
  • Association of Universities and Colleges of
    Canada and The Canadian International Development
    Agency for guidance and financial support

22
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