Kesehatan dan

Keadilan Sosial
In Nugroho, SJ

Kasus Vaksin Palsu

Mengapa kasus vaksin palsu ditampilkan dalam pembahasan
mengenai kesehatan dan keadilan sosial?

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Pertanyaan Lebih Lanjut

Apakah kesehatan selalu tergantung pada pelayanan kesehatan?
Apakah kesehatan merupakan hak warga negara?
Konsepsi keadilan sosial semacam apa yang seharusnya mewujud
dalam pelayanan kesehatan?

Hal-hal apa saja yang dapat menghambat atau

melancarkan perwujudan keadilan sosial dalam
bidang kesehatan?

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Hubungan antara kesehatan dan keadilan

sosial terkait dengan health equity.
Apa yang dimaksud dengan health equity?

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Health equaty as a development outcome

The development of society can be
judged by:
the quality of its populations health,
the fairness in distribution of health, and
the degree of protection provided from
disadvantage due to ill-health
Source: Marmot 2006 Harveian Oration

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Equity menurut World Health Organisation

Equity is the absence of avoidable or remediable differences among
groups of people, whether those groups are defined socially,
economically, demographically, or geographically.
Health inequities therefore involve more than inequality with respect
to health determinants, access to the resources needed to improve
and maintain health or health outcomes. They also entail a failure to
avoid or overcome inequalities that infringe on fairness and human
rights norms.
Source: http://www.who.int/healthsystems/topics/equity/en/

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Memahami Health Equity

Apa bedanya?

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Source:
http://www.health.state.mn.us/divs/che/creatinghealthequity.html

Source:http://www.chd.dphe.state.co.us/HealthIndicators/
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Bagaimana caranya menciptakan health equity

melalui keadilan sosial?

Assumptions

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Policies

Kesehatan dan Keadilan Sosial

Actions

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Traditional/Market Approach vs
Social Justice/Human Rights Approach
Traditional/Market Approach to Health
Underlying Assumptions

Social Justice/Human Rights Approach to Health

Alternative Assumptions

Health is a medical concept.

Health is a social concept.

Health is what you get from a health service.

Health is what you get from meeting with basic needs.

General approach: acceptance risk as a fact of life

General approach: activist perspective to creating

conditions for health

Health promotion: education of individuals about

healthy choices

Health promotion: conduct health impact assesments;

policy change

Causes of inequity: genes, bad behaviour, lifestyle,

accident

Causes of inequity: racism, class exploitation, sexism

Source: Adewale Troutman, MD, MPH, MA at the 2009 Virginia Health Equity Conference

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Traditional/Market Approach to Health

Key Features

Social Justice/Human Rights Approach to Health

Key Features

Addresses symptoms, short term, through programs and

services

Addresses root causes, long term, macro forces through

organising for social change

Promotes magic medical-bullets and technology

Promotes the meeting of basic needs

Promotes interventions delivered through health services

Promotes public works to free people from miserable living

conditions

Identifies charity and international aid as only sources of

funds for health

Identifies redistribution and economic justice as sources of

funds for health

Maintains the status quo of extreme concentrations of

wealth and power

Focuses on structural poverty and violence and tends to

blame the system

Personal responsibility and individual rights

Social responsibility to protect the common good

Tracking and monitoring: individual demographics, disease

rates

Tracking and monitoring: social conditions, investments in

neighbourhood infrastructure, processes, structures,
institutions, historical trends in exposures

Source: Adewale Troutman, MD, MPH, MA at the 2009 Virginia Health Equity Conference
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Changing the Questions

TRADITIONAL

SOCIAL JUSTICE

What interventions are necessary to address health

disparities?

What generates health inequity in the first place?

Why is there inequality?

How can we reduce inequity in the distribution of

disease and illness?

How can we eliminate inequity in the distribution of

disease and illness?

What social programs and services are necessary to

address health inequity?

What types of institutional and social change is

necessary to tackle health inequity?

How can individuals protec themselves against health

disparities?

What kind of collective action is necessary to tackle

health inequity?

How can we promote healthy behaviour?

How can we reorganise land use and transportation

policies to ensure healthy spaces and places?

Source: Adewale Troutman, MD, MPH, MA at the 2009 Virginia Health Equity Conference
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Source: http://www.globalhealthaction.net/index.php/gha/article/viewFile/19650/html/84308
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Source: http://www.ci.richmond.ca.us/2575/Health-in-All-Policies-HiAP

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To understand the issue more clearly:

Membaca JKN_Perjalanan Menuju Jaminan Kesehatan Nasional (TNP2K,
2015)
Membaca Health Financing and Universal Health Coverage (Kemenkes,
2015)
Membaca Universal healthcare coverage in Indonesia One year on (The
Economist, 2015)
Membaca The Impact of BPJS Health Implementation for the Poor and
Near Poor on the Use of Health Facility (Rolindrawan, 2015)
Menyimak video, antara lain:
https://www.youtube.com/watch?v=cdI0vzBv-tk
https://www.youtube.com/watch?v=VR1pZ2oh-7o
https://www.youtube.com/watch?v=_3d_Ax8s4sg & PPT

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Tugas
Melaporkan ke dalam 3-4 halaman tentang Laporan Smeru (2015)
dan Djoni Rolindrawan (2015)
Dikumpulkan pada 27 September 2016 di Sekretariat

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