KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN DIREKTORAT JENDERAL PENDIDIKAN TINGGI HEALTH PROFESSIONAL EDUCATION QUALITY (HPEQ) PROJECT (IBRD Loan No. 7737-ID) Gedung Victoria Lantai 2, Jl. Sultan Hasanuddin Kav. 47 – 51, Selatan 12160 Telp. 021 7279 1384; 021 3417 3304/05/06, Fax. 021 7279 1388 Website:www.hpeq.dikti.go.id; Email:[email protected]

Term of Reference

National Conference on Primary Health Care Education

“1st Meeting: Family Medicine as the Care-Coordinator of Primary Health Care and Its Implementation in Indonesian Higher Education Institutions”

Component 1. – Health Professional Education Quality (HPEQ Project) Sub Component 1.2 – Development of Undergraduate Medical Education and Competency Standard

Makassar, 19 November 2012

1. Background One target of component 1-HPEQ program is the development of medical curriculum and competency standard. HPEQ, actually has conducted many meetings and preparations due to those points. Moreover, it also has its responsibility towards the establishment of “next SKDI” standard for medical students. But, before we move to our further journey, lets we rethink of our existing undergraduate medical curriculum, is it still reliable for 6 years ahead? Is it well prepared? Or, do we have to do something related to the nation development, especially in facing the universal coverage (SJSN) in 2014. Looking back on the spirit of Alma Ata Declaration, 1978, entitled “The Health for All”, which is stated that the main tasks of Indonesian national health sector are to maintain and to improve health care services for every citizen in . To accomplish this, the health care system must prioritize promotion and preventive services along with disease management and rehabilitative efforts. To achieve this vision, the Indonesian national health system has some missions to carry out: (1) developing a medical system that is consistent with the national vision, (2) encouraging healthy life styles for both the individual and the community, (3) maintaining and improving individual, family and society including environmental health and the main point, (4) improving physician training and providing high quality and affordable health care regardless of the economic means of the family or community. It is a big dream, and need a systematic approach to make it real. In line with this spirit, WHO on its report in 2008 stated that the main actor of country health status is the Primary Health Care. it is also stated that there are 4 pillars in the establishment of this sector: universal coverage, medical service, good leadership and policy. From this point, the main responsibility of Medical Faculty can be “how to produce the graduate doctor who can guide Indonesian people to reach their qualified health service”. This initiative cannot be separated from interdisciplinary cooperation between education and health system perspective.

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Previously, the SKDI standard (KKI, 2006) stated that the undergraduate medical curriculum should be oriented to family medicine, but what kind of the “family medicine/family doctor oriented” they want to produce? What kind of the family doctor that they want to use in guiding the SJSN? If, the government wants to use the existing doctors, whether they are able to overcome the patient’s problem? Or do they need a special skill in primary health care level? In the other hand, still focused on problems, list of diseases and statement of “family medicine oriented curriculum”, it also lacks of the involvement of 7 areas of competencies such communication, and doctors awareness of patient as a member of their community. The education process still also focused on the teaching hospital. It is good, but may impact on the risk that graduate doctors meet many difficulties in handling patients in real cases. Green et al (2001) stated that the cases in teaching hospital are only represented 1% problems in the community. The arrangement of early exposure in primary care and community could be the best answer as the patient live in those settings.

Herewith we also want to explain the comparison of education between the primary care doctor and other specialists:

Figure 2. The Missing Puzzle in Indonesian Primary Care Doctors HPEQ Project 2012 – Component 1 Page 2

From those points, the educational aspect plays the important role in guiding the SJSN 2014. It is, of course take time but not an impossible thing to achieve. Previously, several meetings to rethink our Primary Health Care were held based on HPEQ project, from those, the consortium committee agreed to revitalize the Indonesian PHC condition as stated in the DECALARATION TOWARDS BETTER PHC WITH FAMILY DOCTORS AS THE CARE COORDINATORS (Jakarta 22 September 2012). They also had prepared its implementation in Indonesian Higher Education Institutions through educational and supporting document policies framework.

2. AIMS: 1. A national initiative towards accessible high quality primary health care with family doctors as the backbone for every citizen of Indonesia 2. To prepare of Indonesian medical faculties in implementing family medicine in their medical curriculum from undergraduate medical education to postgraduate family medicine masters and specialization 3. To build the critical mass and home-base for general practitioners and family doctors in Indonesia.

3. MEASURABLE OUTCOME

The commitment of Indonesian medical faculties in the implementation of family medicine educational approaches from undergraduate to postgraduate levels.

4. DATE AND PLACE This conference meeting will be held on: Date: 19 November 2012 Place:

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1. DETAIL SCHEDULE(S) Day 1 Monday, 19 November 2012 Time Agenda Attendants Representative of 23 Medical Faculties Representatives of AIPKI Representatives of IDI Representatives of KKI Arrival Hour and Check in Representatives of ASKES

Representatives of Certain instruction: 08.00-10.00 Indonesian Ministry of The attendants had received the draft of family Health medicine curriculum and supporting documents Representatives of All (via email/CDs) Medical Collegiums Representatives of all Nurse//Midwife//Dietician Association

Plenary Lectures Session 1: Is Family Medicine an Answer to National Health problems?

Speakers :

10.00-12.00 1. The problems Primary Health Care doctors in

Indonesia and current structure of Indonesian 1. Ministry of Health RI Health Care System 2. Consortium of Family 2. From Alma Ata to the National Initiative of Doctors Indonesia:

HPEQ-Component 1 PHC Project: Revitalization Prof. Adi Heru

of Indonesian Primary Health Care with Family Sutomo

Doctors as the Care Coordinators 3. Dr. Jack Roebiyoso

(PhD in Family 3. The ideal Future structure of Indonesian Health Medicine) Care System – Puskesmas Revitalization

Moderator:

Dr. Armyn Nurdin

16.00-18.00

Supporting document:

A booklet from Consortium of Family Doctors

about FAQs on terminology, roles and functions

of:

1. “MD” = Lulusan Dokter

2. “GP” = Dokter Praktik Umum 3. “FM” = Dokter Keluarga

12.00-14.00 Break

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Plenary Lectures Session 2: Can we approach the ideal training of Family Doctors? Speakers :

1. Grand Design of Future Ideal Medical Education 1. Dr. Isti Ilmiati Fujiati, in Indonesia: MFM (candidate of a. Educating current medical students PhD in Family with family approaches Medicine Univ. of b. Upgrading the current doctors with Philippines)

14.00-17.00 family medicine abilities 2. Collegiums of

c. The future ideal family doctors Indonesian Doctors: education KDI: Prof. Irawan 2. The Future Primary Health Care Physicians : The Yusuf Family Medicine Specialists in “General Practice”

Moderator: Dr. Mora Claramita

17.00-19.00 Break

Plenary Discussions :

Representative of 23 Reflection and recommendations from national Medical Faculties forum on these issues: Representatives of AIPKI 1. Future structure of Indonesian Health Care Representatives of IDI system Representatives of KKI 2. Upgrade the current 80.000 doctors in respond Representatives of ASKES to SJSN 2014 Representatives of 19.00-22.00 3. Training the new doctors with proper Indonesian Ministry of

postgraduate education for General Health Practitioners Representatives of All Medical Collegiums 4. Plan of Actions of every stakeholders Representatives of all Nurse//Midwife//Dietician

Association

Moderator: Prof. Gatot Lawrence

1. COMMITEE: a) Person in Charge : Direktur Belmawa sebagai Manajer Proyek b) Organizing Commitee : ▪ PIC Struktural Komponen 1 ▪ Koordinator komponen 1 ▪ Dr. Mora Claramita MHPE, PhD c) Attendants:

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Daftar Undangan:

A. Kementerian Kesehatan RI (1 Orang)

B. Ketua KDI (1 orang)

C. PDKI Pusat (2 Orang)

D. PDUI Pusat (2 Orang)

E. IDI Pusat (2 Orang)

F. AIPKI: dr. Ova Emilia

G. Ketua KKI (1 Orang)

H. Ketua MKKI (1 Orang)

I. PT Askes Pusat (1 Orang)

J. Perwakilan 8 Kolegium Spesialis (8 orang)

K. Perwakilan Asosiasi Perawat, Bidan dan Gizi (3 orang)

L. Tim FK UGM

1. Dekan - FK UGM – Jogjakarta 2. WD Kerjasama - FK UGM – Jogjakarta 3. Adi Heru Sutomo - FK UGM – Jogjakarta 4. Mora Claramita - FK UGM – Jogjakarta 5. Wahyudi Istiono - FK UGM – Jogjakarta 6. Fitriana Murriya Ekawati - FK UGM – Jogjakarta 7. Tyagita Rahardjo - FK UGM – Jogjakarta 8. Gandes Retno Rahayu - FK UGM – Jogjakarta 9. Retno Sutomo - FK UGM – Jogjakarta 10. Robikul Ihsan - FK UGM – Jogjakarta 11. I Dewa Putu Pramantara - FK UGM – Jogjakarta 12. Untung Tranggono - FK UGM - Jogjakarta 13. Bambang Suryono - FK UGM – Jogjakarta 14. Bambang Udji Joko Rianto - FK UGM - Jogjakarta 15. Mei Neni - FK UGM – Jogjakarta 16. Shinta Prawitasari - FK UGM – Jogjakarta

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17. Mahar Agusno - FK UGM – Jogjakarta 18. Ismail Suryopranoto - FK UGM – Jogjakarta 19. Nur Azid M - FK UGM - Jogjakarta 20. Siti Nur Asiah - Sekretariat – Jogjakarta 21. Sardjiono - Sekretariat – Jogjakarta

M. Tim FK UNS

22. Dekan - FK UNS - 23. Arsita - FK UNS – Surakarta 24. Putu Suriasa - FK UNS – Surakarta

N. Tim FK UNHAS

25. Dekan - FK UNHAS – Makassar 26. Armyn Nurdin - FK UNHAS – Makassar 27. Gatot Lawrence - FK UNHAS – Makassar 28. Tahir Abdullah - FK UNHAS – Makassar

O. Tim FK UNDIP

29. Dekan - FK UNDIP – 30. Anies - FK UNDIP – Semarang

P. Tim FK UNAIR

31. Dekan - FK UNAIR – 32. Tim Kedokteran Keluarga - FK UNAIR – Surabaya

Q. Tim FK UI

33. Dekan - FK UI – Jakarta 34. Dhanasari Vidiawati - FK UI – Jakarta

R. Tim FK UNTAN

35. Sugito Wonodirekso - FK UNTAN –

S. Tim FK USU

36. Dekan - FK USU –

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37. Isti Ilmiati Fujiati - FK USU – Medan

T. Tim FK UNMUL

38. Lukas Daniel - FK UNMUL – 39. Tim Kedokteran Keluarga - FK UNMUL – Samarinda

U. Tim FK UNAND

40. Dekan - FK UNAND – 41. Rahmatina B. Herman - FK UNAND – Padang

V. FK UMY

42. Dekan - FK UMY – Jogjakarta 43. Denny Prakosa - FK UMY – Jogjakarta

W. FK UMJ

44. Pitut - FK UMJ – Jakarta 45. Oktarina - FK UMJ – Jakarta

X. FK UB

46. Dekan - FK UB – 47. Jack Roebijoso - FK UB – Malang 48. Nuretha HP - FK UB – Malang 49. Alidha Nur R - FK UB – Malang

Y. Tim FK UKDW

50. Slamet Sunarno Hardjosuwarno - FK UKDW – Jogjakarta

Z. Tim FK UNPAD

51. Dekan - FK UNPAD – 52. Nita Arisanti - FK UNPAD – Bandung

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AA. Tim FK UDAYANA

53. Dekan - FK UDAYANA – 54. Made Dharmadi - FK UDAYANA – Denpasar

BB. Tim FK UNDANA

55. Dekan - FK UNDANA – Kupang 56. Nicholas Edwin - FK UNDANA – Kupang

CC. Tim FK UII 57. Dekan - FK UII – Jogjakarta 58. Taufik Nuryahya - FK UII – Jogjakarta

DD. FK UNSYIAH 59. Dekan - FK UNSYIAH – 60. Tim Kedokteran Keluarga - FK UNSYIAH – Banda Aceh

EE. FK UNCEN 61. Dekan - FK UNCEN – Papua 62. Tim Kedokteran Keluarga - FK UNCEN – Papua

FF. FK UNRI 63. Dekan - FK UNRI – Riau 64. Tim Kedokteran Keluarga - FK UNRI – Riau

GG. FK UNSRAT 65. Dekan - FK UNSRAT – 66. Tim Kedokteran Keluarga - FK UNSRAT – Manado

HH. FK UNLAM 67. Dekan - FK UNLAM – Kalimantan Selatan 68. Tim Kedokteran Keluarga - FK UNLAM – Kalimantan Selatan

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II. FK UIN Syarif Hidayatullah 69. Dekan - FK UIN Syarif Hidayatullah - Jakarta 70. Tim Kedokteran Keluarga - FK UIN Syarif Hidayatullah – Jakarta

JJ. FK UKRIDA 71. Dekan - FK UKRIDA – Jakarta 72. dr. Andry - FK UKRIDA – Jakarta

KK. LSM SHEEP Indonesia

73. Andreas Subiyakto - LSM SHEEP Indonesia – Jogjakarta

74. Timotius Aprianto - LSM SHEEP Indonesia – Jogjakarta

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