Programme : Presentation on 24
September 2003Application of ICF Framework in Morbidity and Disability Survey:
Indonesian Experience
Text version of a Powerpoint Presentation
Presented by Julianty Pradono and Soewarta Kosen, on 24 September 2003, 9:00am
Slide 1
APPLICATION OF ICF FRAMEWORK IN MORBIDITY AND DISABILITY SURVEY:
INDONESIAN EXPERIENCE
Julianty Pradono and Soewarta Kosen
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Indonesia Health Survey (Surkesnas)
An attempt to integrate all surveys which collect health data with national scope, to
support the need for optimal health information
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Indonesia Health Survey (Surkesnas) 2001 in response to
Healthy Indonesia 2010:
New visions, missions, goals, and Strategis of Nat'l Health Development
National Health Indicator Survey
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Surkesnas 2001
Components and Their Sample Sizes
(diagram)
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Surkesnas 2001
Multistage Sampling Design
(diagram)
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Team of data collection:
- 2 Medical doctor (female+male)
- 1 Laboratory technician
- 1 midwife
- Field coordinator (supervisor)
Team : 74
Time : October - December 2001
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Quality Control
Core Team (develop questionnaire)
Trainers
Data collectors
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Quality Assurance
- Questionnaires were checked by interviewers and supervisors to ensure that the data were
properly collected
- Supervisors will re-interview several respondents, observe on the spot some interviews,
physical examination, and laboratory examination
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Indonesian Experience
- Since 1986, Indonesia has conducted Community Based Morbidity and Disability Study
- National Household Health Survey in 1995 has disability component, based on ICIDH
(International Classification of Impairments, Disabilities and Handicaps), that randomly
covers 65,000 households in Indonesia.
Results have been used to estimate the National Burden of Disease.
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ICF
International Classification of Functioning, Disability and Health
- Comprehensive classification of health and health-related states associated with health
conditions
- has universal application
- Part 1: functioning and disability
- Part 2: contextual factors
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INDONESIAN DISABILITY SURVEY
- DISABILITY (based on ICF - WHO, 2001)
- Body functions (8 sections)
- Body structures (8 sections)
- Activities and Participation (8 sections)
- We did not cover: Environmental factors (determinants) and Personal factors
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Body Functions
- Mental function
- Sensory function and pain
- Voice and Speech functions
- Functions of the cardiovascular, hematological, immunological and respiratory systems
- Functions of the digestive, metabolic and endocrine systems
- Genitourinary and reproductive functions
- Neuromusculoskeletal and movement-related functions
- Functions of the skin and related structures
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Body Structures
- Structures of the nervous system
- The eye, ear and related structures
- Structures involved in voice and Speech
- Structures of the cardiovascular, immunological and respiratory systems
- Structures related to the digestive, metabolic and endocrine systems
- Structures related to the genitourinary and reproductive systems
- Structures related to movement
- Skin and related structures
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Activities and Participation
- Learning and applying knowled
- Communication
- Mobility
- Self care
- Domestic life
- Interpersonal interactions and relationships
- Major life areas
- Community, social and civic life
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Fig. 1. Prevalence of any disability (body functions or body structure or Activities
and participation) by sex and residence, Morbidity-Disability Study, NHHS 2001
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Fig.2. Prevalence of each disability (body functions, body structure, Activities and
participation) by sex,
Morbidity-Disability Study, NHHS 2001
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Fig.3. Prevalence of each body functions impairment by sex, Morbidity-Disability
Study, NHHS 2001
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Fig.4. Prevalence of each body structure impairment by sex, Morbidity-Disability
Study, NHHS 2001
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Fig.5. Prevalence of each act ivies limitation and participation restriction by sex,
Morbidity-Disability Study, NHHS 2001
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DISCUSSIONS
- ICIDH 1980 mainly dealing on people with disabilities and measure directly the condition
- ICF, by applying domain concept, includes also the healthy people as well as the
disables
- ICF Survey 2001 provides better understanding on the health and health related situation
in Indonesia
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LESSONS LEARNED
- Combining disability survey with morbidity survey (including physical examination) may
complement and support the findings; especially for body functions and body structures
- Need standardized method to assess Activity Limitation and Participation Restrictions as
well as Environmental Factors
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USES OF SURVEY RESULTS
- Information on health outcome (ICF) and information on morbidity & mortality
(ICD-10) from the 2001 National Health Survey have been combined to construct Summary
Measures of Population Health for monitoring the health of Indonesian populations and its
distribution as well as for assessing the contribution of different causes of deaths and
morbidity
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CONCLUSIONS
- The results might serve various sectors related to disability situation
- Provide common means of communication regarding health and health related states
- Establish basis to understand health & health related states, outcomes and the
determinants
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NEXT STEP
- Disseminate the ICF results to other sectors: labour, education, social affairs,
insurance, etc. and within the health sector as input for policy formulation
- To introduce & implement the World Health Survey (including ICF survey) in NHHS 2004
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Thank You
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