Samenvatting

Occasion – The Hanze University and Diponegoro University started a collaboration in 2015, focusing on community health centre ‘Pudak Payung’. It became clear that there is a need for knowledge and experience, relating to health promotion, which focuses on non-communicable diseases (NCD’s) in the community health centre. Therefore, three couples of bachelor students from the Hanze University travelled to Semarang to conduct a study and implement health education, during a two-year period. This particular research is the last part of this two-year study.
Introduction – An epidemiological transition is taking place in Indonesia. This has led to a shift in the leading causes of diseases and death and is characterized by a transition from communicable diseases to non-communicable diseases. Therefore there is need for an approach to tackle these NCD’s and health promotion is an useful tool to decrease and manage NCD’s. Health promotion can be described, according to the World Health Organisation as a wide range of interventions that are designed to benefit and protect individual people’s health and quality of life by addressing and preventing the root causes of ill health, not just focusing on treatment and cure. The Precede-Proceed method is used to design a health promotion plan.
Aim of the research – The overall aim of the two-year study is using the Precede-Proceed method, to improve the health promotion regarding NCD’s for the elderly people in the community health centre ‘Pudak Payung’. The aim for this particular research is applying phase 4, 5 and 6 of the Precede-Proceed method to provide a suitable plan of implementation for a health promotion plan and implement a part of this health promotion plan regarding NCD’s for elderly people in the community health centre ‘Pudak Payung’.
Research question – Which suitable interventions towards health promotion, can be implemented, based on the outcomes of phase 1 to 5 of the Precede-Proceed method regarding NCD’s, for the elderly people in community health centre ‘Pudak Payung’ in Semarang, Central Java, Indonesia.
Method – The data have been collected by using qualitative research methods. To answer the research question semi structural interviews and non-participant unstructured observations are used. All the collected data are used to make a plan of implementation.
Results – The results show that there are several already existing health promotion activities, such as prolanis and poksila. To give health promotion there are several chances and barriers to consider. Chances are: dedication of the staff, communication between the staff, use of social media and the use of volunteers. Barriers are: lack of money, facilities and staff, collaboration between the community health centre and other stakeholders, lack of knowledge of the staff about evidence-based practise working and knowledge of the volunteers and low participation at the organised health promotion activities. Interventions to be implemented must be focussing on lifestyle choices, like a healthier diet, lack of motivation of the patients, family support and setting up health promotion for specific diseases like dementia. Important government policies to consider are: the use of the Germas (government) program, the decentralization of many task of the government and the shift from preventive towards a more curative focus. Suitable interventions and topics for implementation are: measuring waist circumference during and arranging healthy snacks at the health promotion activities, extent health promotion talks, more use of various media to give health promotion, making the health promotion activities more attractive and use of motivational interviewing for unmotivated people.
Discussion – This research was conducted at only one community health centre, therefore the generalizability is low. Furthermore, the language barrier has to be considered. A translator was not present at all observations and there are many translations made when interviewing people. Due to limited time the plan of implementation and interventions cannot be evaluated.
Conclusion – The results of this research suggest that interventions bettering the existing health promotion activities, focusing on the most common NCD’s, who are easy and do not cost a lot of money and energy are most suitable to implement. Implemented is bettering existing health promotion activities for people with or at risk of diabetes. Interventions are adding the measurement waist circumference and training the students and volunteers to do this at existing health promotion activities, arranging healthy snack boxes at the activities and giving a supportive health promotion talk to explain these interventions.
Recommendations – More research is recommended to better the health promotion regarding NCD’s. Research about focussing not only on the elderly people, but also on the younger generations. Research about the task and education of the volunteers and research about evidence-based practise working of the staff.