43.309.707
11.331.558
14.946.488 4.211.532
121.352.608
11.112.702
KOMITE PENANGGULANGAN KANKER NASIONAL
Soehartati Gondhowiardjo
Why We Need to Fight Cancer
The Time to Act is NOW…….
“When someone has cancer, the whole family and everyone who loves them does, too.” -Terri Clark-
•
Cancer Mortality Rate: – Higher compare to Cardiovascular and Stroke – Higher then the total mortality of TBC + Malaria + HIV/AIDS
• And the number is INCREASING……..
“Whenever you read a cancer booklet or website or whatever, they always list depression among the side effects of cancer. But, in fact, depression is not a side effect of cancer. Depression is a side effect of dying.” ― John Green, The Fault in Our Stars –
Post-2015 Agenda 4a. End preventable infant and under-5 deaths 4 Ensure Healthy Lives
4b. Increase by x% the proportion of children, adolescents, at-risk adults and older people that are fully vaccinated 4c. Decrease the MMR to no more than x per 100,000 4d. Ensure universal sexual &reproductive health and rights
4e. Reduce the burden of disease from HIV/AIDS, tuberculosis, malaria, neglected tropical diseases and priority non-communicable diseases
4
The WHO Global NCD Action Plan 2013-2020 unites governments, international partners and WHO around a common agenda
HOW ABOUT INDONESIA? Let’s analyze using the UICC five key questions: - What is Indonesia's cancer picture? - Who can help develop and implement a cancer plan? - What will be Indonesia’s plan? - How to communicate and implement the plan? - How to measure the successful of the program?
43.309.707
11.331.558
14.946.488 4.211.532
121.352.608
11.112.702
Area: 17,508 islands (6000 inhabited), 34 province Total area : 1.904.569 sq km total (fresh water: 93.000 sq km) Trend for Population Growth in Indonesia 3.257.483 sq km sea Population : 237.556.363 (2010 Census), 255,461,700 (Central Bureau Statistics 2015 est.) 4th most populous in the world
Population (million)
Growth rate (%)
Source: BPS 2014
1971
1980
POPULATION GROWTH PROJECTION • 305 MILLION in 2035 • Increase of teenager • Increase of elderly 2010
FURNERABLE GROUP
8
BURDEN OF DISESASES IN INDONESIA
FACT 1
1990
Injuries 7%
2000
2010
Communicabl e Diseases
Communicabl e Diseases Injuries
Communicabl e Diseases Injuries9%
8%
33% 43%
37% 56% 49%
58%
Non Communicable Diseases
Non Communicable Diseases
Non Communicable Diseases
SHIFT IN DISEASE BURDEN STROKE
STROKE Kecelakaan Lalin
Kecelakaan Lalin STROKE Kecelakaan Lalin
Jantung Iskemik
Jantung Iskemik
Kanker Diabetes
Diabetes
Jantung Iskemik Diabetes 10
Sumber data: Global burden of diseases
PUBLIC INFORMATION
There are around 358.000 result if you search “kanker” in google, but only 20% with trusted information
FACT 2
What is the general condition?
• A lot of miss leading information driven by “business opportunities”……….
• Lack of awareness and knowledge resulting in late diagnosis and treatment (83.4 %, 52 % patient s delay ….. misleading information?) • Estimated cancer incidence is continuously increased
Patients, and / or doctors, system delay Of cancer treatment
DATA BPJS
HIGHER COST
© Oliver Wyman
UPAYA PEMERINTAH…….. Riwayat Terbentuknya KPKN May 2014 FACTS ……
July 2014
Revitalized the idea Multisectoral for NCCP meeting between Govt – NGO – Professional to set up National Organization for Cancer control Organized by MoH
September 2014 November 2014 Setting up Strategic Plan for NCCP, guided by professional consultant
Ministry of Health Decree for NCCC
STRUKTUR ORGANISASI KOMITE PENANGGULANGAN KANKER NASIONAL Pelindung
:
1. Menteri Kesehatan 2. Wa kil Menteri Kesehatan
Pengarah
:
1. Sekretaris Jenderal 2. Di rektur Jenderal Pengendalian Penyakit dan Pe nyehatan Li ngkungan 3. Di rektur Jenderal Bina Upaya Kesehatan 4. Di rektur Je nderal Bina Kefarmasian dan Al at Kesehatan 5. Di rektur Jenderal Bina Gizi dan Kesehatan Ibu dan Anak 6. Kepa la Badan Pengembangan dan Pemberdayaan Sumber Daya Ma nusia Kesehatan 7. Ke pa la Badan Penelitian dan Pengembangan Kesehatan
Ketua
:
Prof. Dr. dr. Soehartati Gondhowiardjo, Sp.Rad (K.) Onk. Rad
Sekretaris :
1. Di rektur Penyakit Tidak Me nular 2. Di rektur Bina Upaya Kesehatan Rujukan
Anggota
:
Sekretariat :
1. Di rektur Bina Upaya Kesehatan Dasar 2. Di rektur Bina Pe layanan Penunjang Medik dan Sarana Kesehatan 3. Di rektur Bina Pe layanan Kefarmasian
10. dr. Sona r Soni Pa nigoro, Sp. B.Onk, M.Epid 11. dr. Dra ja t R Suardi, Sp. B.Onk 12. Dr. dr. Dody Ra nuhardi, Sp.PD,KHOM, FINASIM
4. Ke pa la Pusat Promosi Kesehatan 5. Kepa la Pusat Pembiayaan dan Jaminan Kesehatan 6. Kepa la Pusat Data dan Informasi 7. Ke pa la Pusat Perencanaan dan Pendayagunaan SDM Kesehatan 8. Prof. Dr.dr. Arry Ha rrya nto R, Sp.PD, KHOM 9. dr. Ari e Munandar, Sp.Onk.Rad
13. dr. Eve l i na Suzanna, Sp. PA 14. dr. El i sna Sya hrudin, Ph.D, Sp.P(K) 15. dr. Angel a Giselvania, Sp.Onk. Rad
1. Di rektorat Penyakit Tidak Menular 2. Di rektorat Bina Upaya Kesehatan Rujukan
Logical Framework Matrix High Cancer Morbidity , Mortality and COST
Uneffective Treatment, WL +/- 3 bulan … 13 h working hour
Not Optimal Treatment, > 50 %
Late Diagnosis, > 70 % CAM, > 30 % Limited Public Knowledge
Not Standardized Treatment
Less early detection, palliative, rehabilitation activity
Resources not integrated
Limited Oncology Resources
Limited Access and Number of Facility
Less Doctor Competencies in Cancer Prevention, Early Detection, TREATMENT and Rehabilitation
Limited Hospice Home Care
Not Effective HTA
Low Data Coverage and Quality
Logical Framework Matrix Decrease in cancer morbidity, mortality and COST
Health Seeking Behaviour
Cancer Treatment Based on Standard
Effective and efficient multidiscipline referral system
Regulation
Effective Healthy Lifestyle Education
National Cancer Treatment Guideline
Quantity and Quality oncology resources
Fulfillment of facilitites and distribution
Empower Hospice Home care
Empower Primary Health Care Oncology module in medical curriculum
Research and HTA unit for cancer
Effective Partnership and Advocacy national and international Establish IT system and cancer registry
Langkah Pembuatan Renstra
Multisectoral meeting between Govt – NGO – Professional to set up National Organization for Cancer control
1. 2. 3. 4. 5. 6.
Strategic Issue formulation Strategic Challenge formulation Vision – Mission Benchmark Strategic Mapping Strategic Objectives and KPIs
VISION 2019 Reducing Cancer Morbidity and Mortality in Indonesia
S
FINANCIAL Establishment of
ORGANIZATION Establishment of National Body
STRATEGIC EFFORT
Establishment of sustainable budgeting
health seeking behavior
Establishment of effective education for healthy lifestyle and
Empowering primary healthcare for early detection, palliative and rehabilitation care
Monitoring the
Effective and efficient
Implementation of cancer treatment based on national guidelines , patient safety, and quality standard
referral system for multidiscipline cancer care
Empowering hospice and
cancer awareness
home care system
I Effective partnership and advocation
REGULATION
Regulation of Complementay and Alternative Medcine
RESOURCES
Regulation for cancer prevention
with national and international bodies
AWARENESS Increased quantity and quality of human resources in Oncology
Establishment of research unit and HTA for cancer
PENDATAAN / REGISTRY Availability and implementation of IT
system and cancer registry
Fulfillment and distribution of
cancer facility as standard
Improvement of oncology
module in medical curriculum
Establishment of national cancer treatment
guidelines
Program Kerja Strategis Sasaran Strategis
1 Meningkatnya kuantitas dan kualitas sdm bidang onkologi di Indonesia
KPI
Bobot
Persentase trained personal bidang onkologi di tingkat puskesmas perkotaan (TOT)
5
Persentase rumah sakit yang memiliki tim multidisiplin onkologi
5
2 Tersedianya sistem IT dan Persentase rumah sakit registrasi kanker rujukan propinsi dan rumah sakit vertikal yang melaksanakan registrasi kanker
8
Jumlah propinsi yang melakukan registrasi kanker berbasis populasi
3
Target
Program
2015
2016
2017
2018
2019
10%
20%
30%
40%
50%
• Penyusunan sistem penanganan kanker pada Kesehatan Primer • Promosi peningkatkan keahlian nakes terhadap: kanker anak, deteksi dini, pencegahan primer, pencegahan sekunder,
10%
20%
50%
80%
Pedoman pembentukan tim onkologi rumah sakit
30%
50%
70%
80%
• Penyusunan sistem registrasi nasional • Analisa data kanker eksisting • Pengumpulan dan analisa data kanker nasional
10%
1
2
Program Kerja Strategis Sasaran Strategis
KPI
Bobot
Target 2015
3 Pemenuhan dan pemerataan fasilitas sesuai standar pelayanan kanker
Persentase rumah sakit rujukan propinsi dan rumah sakit vertikal yang memiliki fasilitas pelayanan kanker sesuai standar
2
4 Terimplementasi nya pedoman nasional penanggulangan kanker
Jumlah pedoman penanggulangan kanker
7
Tingkat kepatuhan pelaksanaan pedoman nasional di rumah sakit propinsi dan rumah sakit vertikal
6
Tingkat kepatuhan pelaksanaan pedoman nasional di puskesmas
5
Program
2016
2017
2018
2019
10%
20%
50%
80%
Penyusunan sistem untuk pengembangan pusat layanan kanker regional Peningkatan kegiatan di RS untuk: IVA dan pap smear, CBE, mammografi dan USG payudara
3
5
7
9
10
20%
30%
40%
50%
5%
10%
• •
Pedoman Penanggulangan Kanker Nasional Survey pelaksanaan pedoman
Program Kerja Strategis Sasaran Strategis
5
6
7
Kemitraan dan advokasi efektif lintas sektor dalam dan luar negeri
Terwujudnya badan penelitian dan penapisan teknologi kanker
KPI Jumlah SKB dan perjanjian kerja sama kegiatan penanganan kanker lintas sektor Jumlah hasil kajian ilmiah (naskah akademik) untuk advokasi
Jumlah problem solved research yang diimplementasi kan Jumlah kajian HTA
Penyempurnaan modul Persentase institusi onkologi dalam pendidikan yang kurikulum pendidikan mengimplementasi modul onkologi
Bobot
Target 2016
4
2015 1
2
1
2
4 6
1
Program
2017 3
2018
2019 5
1
2
3
5
1
3
5
10
Penelitian kanker nasional
2 1
3 3
4 5
5 10
Pengembangan modul onkologi
Audiensi dengan kementerian terkait untuk penyusunan peraturan pemerintah Audiensi dengan DPR untuk penyusunan Undang-undang
Program Kerja Strategis Sasaran Strategis
KPI
Bobot 2015
2016 10%
Target 2017 20%
2018 30%
2019 50%
Program
8
Terwujudnya efektiktifitas edukasi dampak pola hidup sehat dan kanker
Tingkat kesadaran pola hidup sehat masyarakat dan kanker
6
9
Pemberdayaan fasilitas layanan kesehatan primer untuk diagnosa dan deteksi dini, paliatif, rehabilitasi
Persentase (jumlah) puskesmas perkotaan yang melaksanakan diagnosa dan deteksi dini Persentase (jumlah) puskesmas perkotaan yang melaksanakan paliatif dan rehabilitasi
6
10%
20%
30%
40%
50%
5
10%
20%
30%
40%
50%
• Seminar awam dan Training of Trainer • Promosi peningkatan pengetahuan masyarakat tentang: SADARI pada perempuan yang sudah menstruasi, bebas asap rokok, pola makan sehat dan tinggi serat, kanker prostat, deteksi dini • Penyusunan sistem penanganan kanker pada Kesehatan Primer • Promosi peningkatkan keahlian nakes terhadap: deteksi dini, pencegahan primer, pencegahan sekunder • Pelatihan penanganan nyeri pada pusat pelayanan primer
Program Kerja Strategis Sasaran Srategis
KPI
Bobot
Target 2015
10
Terwujudnya penanggulangan kanker sesuai standar mutu nasional dan keselamatan pasien
Persentase fasilitas pelayanan kesehatan primer yang menjalankan pelayanan sesuai standar mutu nasional Persentase fasilitas pelayanan kesehatan sekunder yang menjalankan pelayanan sesuai standar mutu nasional Persentase fasilitas pelayanan kesehatan tersier yang menjalankan pelayanan sesuai standar mutu nasional
3
Program
2016
2017
2018
2019
10%
20%
30%
50%
3
10%
20%
30%
50%
75%
3
10%
30%
50%
70%
100%
Penyusunan sistem penanganan kanker pada Kesehatan Primer Promosi peningkatkan keahlian nakes terhadap: deteksi dini, pencegahan primer, pencegahan sekunder
Program Kerja Strategis Sasaran Srategis
KPI
Bobot
Target 2015
11
Pemberdayaan sistem hospis home care
Persentase (jumlah) propinsi yang memiliki pelayanan hospis home care
4
12
Jejaring pelayanan kanker multidisiplin melalui sistem rujukan berjenjang yang tepat guna hasil guna
Persentase(Jumlah) propinsi yang sudah menjalankan sistem rujukan berjenjang
4
13
Terwujudnya health seeking behaviour
(Hasil survey) jumlah penggunaan pengobatan CAM dalam kanker
4
10%
Program
2016
2017
2018
2019
10%
20%
30%
50%
Audiensi MPI dengan Menkes mengenai : Peraturan tentang perawatan hospis, Peraturan tentang penyediaan dan penggunaan opiat sampai ke PPK II, Peraturan tentang homecare
30%
50%
70%
100%
Pengembangan sistem rujukan berjenjang bidang onkologi
10%
30%
50%
75%
Survey pasien kanker
The Roadmap of NCCC
Phase 1 (First Year)
• Collecting available resources, self financed • Capacity building Catch the time to solve, the highest priority • Decide the highest priority in grass root ….. AWARENESS CANCER SCREENING, STANDART GUIDELINES, CANCER DATA / REGISTRY
Phase 2 (Second Year)
Phase 3 (Third to Fifth Year)
• Go Professionally Mature System • Evaluating programs • Continuous Improvement Cycle
Hasil Kegiatan
TIMELINE KPKN
November 2014
15 Des 2014
SK Menkes
Rapat Koordinasi
Nomor HK 02.02/MENKES/389/2014
Anggota KPKN dengan Struktural KemKes
Tentang KPKN
17 Nov 2014 Rapat Koordinasi Anggota KPKN dengan Dirjen BUK
27 Januari 2015
31 Januari 2015
Audiensi KPKN dengan Ketua DPD Irman Gusman
KPKN LIVE di Berita Satu
29 Januari 2015 Seminar Awam tentang Kanker Sesi I: pegawai kemkes, pegawai dinkes, LSM Sesi II: artis, public figure, pengusaha, media
Kick Off – WCD 2015, 4 Febr 2015
Hearings and seminar with parlemen, first lady n the group of ministries wife, celebrities, media, NGO, rich people in the country ets
National Movement of Prevention and Early Detection of Cancer among Women
AWARENESS
Launched by the First Lady on 21 April 2015
AWARENESS
EDUCATIONAL AND PROMOTION PRODUCT
AWARENESS
Implementation of CERDIK Behavior Check health status routine and regularly Encourage to avoid smoking and other air pollutant
Raise physical activity Daily consumption with healthy diet (low sugar, salt, dan fat), increase fruit and vegetables
Implement adequate rest Keep balance between body and mind
AWARENESS
Television / Radio Broadcast No
Programme
Date
Time
21-Jan-15
10.00 - 15.00
22-Jan-15
07.00 - 11.00
27-Jan-15
09.00 - 10.00
23-Jan-15
10.00 - 14.00
2-Feb-15
10.00 - 12.30
2-Feb-15
3 Mediakom 4 Net TV
28-Jan-15 30-Jan-15
10.00 -11.00 13.00-16.00
1-Feb-15 4-Feb-15
5 Berita satu Morning show
31-Jan-15
06.30 - 08.30
31-Jan-15
07.00 - 08.00
4-Feb-15 3-Feb-15 3-Feb-15 4-Feb-15 4-Feb-15 4-Feb-15
4-Feb-15 3-Feb-15 4-Feb-15 4-Feb-15 4-Feb-15 4-Feb-15
7.30-09.30 10.00-11.00 11.00-12.00 07.50-08.00 16.00-17.00 13.00-14.00
4-Feb-15
4-Feb-15
18.00-19.00
1 SCTV Sosok
2 DAAI Tv Dunia sehat
6 RCTI Dahsyat 7 Radio RPK 8 VOI.RRI Jak FM 9 Sonora FM 10 Berita satu Dialog siang 11 Kis FM 12 Delta FM 13 Berita satu 14 SCTV (TV) 15 Liputan6.com 16 Brosur edukasi 17 Buku mewarnai 18 Lembar Kerja siswa
Date of Air
Time of Air
Place
Person
RSCM
1-Feb-15
12.00 - 13.00
RSCM
Profile SG
SG + survivor
RSCM 11.00 - 12.00
Detail
interview dialog SOSOK Profile
PIK
dr.Rizal sp.U+ atlit
Wawancara Live
RSCM RSCM
SG Dept Radioterapi RSCM
majalah bulanan kemenkes Seputar Kanker leher rahim
Studio berita1 SG + survivor Dewi Yuliarti dr.Marlinda+ria Studio RCTI Irawan+jupe Studio dr.Evlina RSCM SG dr.Bobby
LIVE
Studio
SG+James Lumenta
LIVE
Dr.Dody HOM
Phone interview
LIVE LIVE Phone interview
Iklan layanan masyarakat Iklan layanan masyarakat 13 Video dokter bicara kanker on - going on - going on - going
AWARENESS
Television / Radio Broadcast No
Station
1
Berita 1
Talk show
World Cancer Day
4 Februari 2016
13.00 - 14.00
Prof. Dr.dr. Soehartati, Sp.Rad(K)OnkRad
2
Berita 1
Talk show
Cancer Early Detection
5 Februari 2016
13.00 - 14.00
dr. Angela Giselvania, Sp.OnkRad
3
DAAI TV
Healthy World
Pediatric Malignancy
15 Februari 2016
11.00 - 12.00
dr. Angela Giselvania, Sp.OnkRad
4
RRI
Live Interview
World Cancer Day
1 februari 2016
10.00 - 11.00
Prof. Dr.dr. Soehartati, Sp.Rad(K)OnkRad
5
SCTV
Live Live Interview
6
Programme
7
8
Radio Pelita Kasih
9 10
Theme
Date
Time
4 Februari 2016
Speaker
Liputan khusus
Cancer Awareness
Every Thursday
We Can, I Can
4 Februari 2016
10.00 - 11.01
dr. Alvita Sp.KN
CERDIK
11 Februari 2016
10.00 - 11.02
Dr. Elisna Syahruddin, PhD, Sp.P (K)
Cancer and BPJS
18 Februari 2016
10.00 - 11.03
dr. Angela Giselvania, Sp.OnkRad
Indonesia Fight Against Cancer
25 Februari 2016
10.00 - 11.04
dr. Diani Kartini, SpB (K) Onk
11
Radio Sonora Live Interview
dari KPKN + pertanyaan
4 Februari 2016
09.00 - 10.00
dr. Agus Rizal Hamid, Sp.U (K)
12
Radio Motion Phone Interview
dari KPKN + pertanyaan
4 Februari 2016
08.00
dr. Arie Munandar, Sp.OnkRad
13 14
Liputan 6
Live
Women Radio Prime time sore
ILM selama Feb akan dipasang
Liputan khusus
dari KPKN + pertanyaan
4 Februari 2016
17.00 - 18.00
dr. Evlina Suzanna, Sp.PA
15
Metro TV
Live Metro Plus Pagi
Peringatan Hari Kanker Sedunia
4 Februari 2016
10.00 - 11.00
dr. Evlina Suzanna, Sp.PA
16
TV One
Apa Kabar Indonesia
Bahaya Kanker
13 Februari 2016
07.00 - 08.00
Prof. Dr.dr. Soehartati, Sp.Rad(K)OnkRad
AWARENESS
Promotion Materials Ditribution Healthy Lifestyle and IVA No Type 1 2 3 4 5 6 7 8 9 10
Brochure
Destination
11 Provinsi telekonferense Gubernur 23 Provinsi PKK Nasional PDUI rakernas Ekspedisi Nusantara Jaya Doctor Share YKI-DKI YKI-Pusat FISIP UI Pameran Kokas Total
Healthy Lifestyle and Breast Cancer Awarenes No Type Destination 1 2 3 4 5
Brochure
Provincial and Regional Refferal Hospital in Indonesia YKI DKI YKI Pusat CISC Ministry of Health, Health Promotion Total
Qty
Time
27.500 34.500 1200 2000 2500 500 10.000 500 500 500 79.700
February 2015 February 2015 March 2015 April 2015 May 2015 May 2015 May 2015 May 2015 May 2015 May 2015
Qty
Time
30000 5000 5000 5000 5000 50000
October 2015
October 2015
AWARENESS
Promotion Materials Ditribution Distribution Atribute World Cancer Day 2016 Type No 1 2 3 4
Destination Hospital Organisation/ NGO YKI KPKN Event Total
Pocket Calender 43000 12390 6200 15000 76590
T- Shirts 1469 665 340 300 2774
Time Sticker 25100 9500 3700 10000 48300
Flyer 19000 10000 29000
Februari 2016 Februari 2016
AWARENESS
Video Distribution No 1 3
Type Educational Video
4
Video Educational Video
5
Video
6
Educational Video
Detail Fakta kanker & IVA Dokter Bicara Kanker 13 episode Pola Hidup CERDIK Hindari Kanker Journey of HOPE : Jakarta (bersama Gelang Harapan) Pengobatan Kanker
Location Istana Negara Youtube, SCTV, Berita 1, Metro TV Liputan 6 Youtube, social media, RS Besar seluruh Indonesia, videotron di DKI Jakarta Youtube Youtube, social media, RS Besar seluruh Indonesia, Videotron di DKI Jakarta ( 6 Titik di DKI Jakarta)
https://www.youtube.com/watch?v=7D4r9tJqHNo Fakta kanker 1:39 https://www.youtube.com/watch?v=1l5MT9y8usw Jingle IVA 1:05 http://video.liputan6.com/health/dokter-bicara-kanker-seluk-beluk-kankeredisi-full-2190879 Dokter Bicara Kanker @11:00 – 15:00 https://www.youtube.com/watch?v=xW8emSVko0Q Pola Hidup CERDIK Hindari Kanker
https://www.youtube.com/watch?v=GmrWIYaMFZ4 Journey of Hope : Jakarta
Film About Cancer “I am Hope” LOKASI DAN PENAYANGAN Metropole XXI (Jl. Pegangsaan No.12) Wednesday, 2 March 2016 Show 1 : 2:30 PM (126 person) Show 2 : 4:45 PM (126 person) Show 3 : 7:00 PM (126 person) Friday, 4 March 2016
Show 1 : 4:45 PM (126 person) Show 2 : 5:00 PM (142 person) Thursday, 17 March 2016
Show 1: 4:45 PM (142 person)
Medsos Media cetak Radio Televisi Seminar awam Celebrities Tokoh2 negara unsur di masyarakat Ruang tunggu Di jalan (videotron) Flyer dlsb
IMPACT OF AWARENESS
Number of 30-50 Year Old Women Screened 2009 - 2014 More increase jan – april vs may – june 13 times
1,000,000 900,000
904,099
800,000 700,000
644,951
Number
600,000
575,503
500,000 400,000
338,531
300,000
291,473
200,000
172,316
100,000 2009
2010
2011
2012 Year
2013
From 36,7 million (2.45%)
2014
National and Provincial Referral Hospital
STANDARD GUIDELINES 14 national referral hospital
20 provincial referral hospital
Existing Resources
PERHOMPEDIN
PUOI
PORI
PDGKI
PERDAMI
IKABDI
POI
HBTKI
IDAI
IAPI
PABOI
HOGI
PDSKJI
PERHATI-KL
PERDATI N
PERDOS SI
Analysis and revision
Inter Sectoral Partnership
PERABOI
PDPI
Ministry of Health
Input form experts and societies
PERSPEBSI
PDSKJI
PDSRI
Reconsiliation and dan Finalisation
Implementation
YKI
CISC
YOAI
OASE
HOPE
YKAKI
STANDARD AND GUIDELINES
WORKSHOP
GUIDELINE FOR CANCER SERVICE IMPLEMENTATION in Referral System Hospital
GUIDELINE FOR MULTIDISCPLINE TEAM DEVELOPMENT
ACUAN PPK
STANDARD AND GUIDELINES PENCEGAHAN DETEKSI DINI TERAPI KANKER PALIATIF IVA n SADARI
Training of Trainers
REGISTRASI KANKER Master Trainer
WORKSHOP COURSE DESIGNERS
Master Trainer
Supervision Trainer Madya Nasional
PROVINCE TOT
Supervision Trainer Madya Provinsi
MEDICAL SYMP
Public seminar PUBLIC SYMP
For MEDICAL AND SURVIVOR / PUBLIC GROUP
Pengeluaran biaya kesehatan cenderung lebih besar menjelang akhir masa hidup: Futile treatment? Permintaan pasien?
? Pengeluaran biaya Kesehatan pada 24 Bulan Terakhir Masa Hidup (Fassbender et al 2009)
Promotion and Prevention
Screening and early detection
Primary Health Service Puskesmas, Primary Clinic
Diagnosis
Prompt Treatment
Secondary Health Service (Clinics, Hospital Type B-C-D)
Rehabilitation
Tertiary Health Service Referral Hospital (Type A)
INFORMATION AND DATA National Official Website for Cancer Program and Information
http://www.kanker.kemkes.go.id
INFORMATION AND DATA
INACARE – Indonesian Cancer Profile FILTERED BY NATIONAL ID NUMBER Hospital Visitation
Collecting data from national hospitals to get a quick glimpse about the cancer burden in all over Indonesia….. While awaiting for the real National PBCR resultc
Update 18 February 2016: Total 102.226 data from 21 hospitals in Sumatra, Java, Sulawesi
1: 3.7 11.331.558
43.309.707
1: 3.7 14.946.488 4.211.532
1: 4.3 121.352.608
1: 2.1
11.112.702
Distribution and access…………. to Radiotherapy Centers
0:~
1: 3.7
Summary 2016 Total : 30 centers 19 Cobalt, 25 Linacs (44 RT Machines) Estimated 2017 Total : Add +7 centers (Total: 37 Centers) Add +32 linacs (Total: 72 RT machines)
VISION 2019 Reducing Cancer Morbidity and Mortality in Indonesia
S
FINANCIAL
ORGANIZATION Establishment of National Body
STRATEGIC EFFORT
Establishment of sustainable budgeting
Establishment of health seeking behavior
Establishment of effective education for healthy lifestyle and cancer awareness
Empowering primary healthcare for early detection, palliative and rehabilitation care
Monitoring the Implementation of cancer treatment based on national guidelines , patient safety, and quality standard
Effective and efficient referral system for multidiscipline cancer care
Empowering hospice and home care system
I Effective partnership and advocation with national and international bodies
REGULATION
Regulation of Complementay and Alternative Medcine
RESOURCES
Regulation for cancer prevention
AWARENESS Increased quantity and quality of human resources in Oncology
Establishment of research unit and HTA for cancer
PENDATAAN / REGISTRY Availability and implementation of IT system and cancer registry
Fulfillment and distribution of cancer facility as standard
Improvement of oncology module in medical curriculum
Establishment of national cancer treatment guidelines
The Roadmap of NCCC
Phase 1 (First Year)
• Collecting available resources • Capacity building Catch the to solve, the highest priority • Decide the highest priority in grass roottime ….. AWARENESS CANCER SCREENING, STANDART GUIDELINES, CANCER DATA / REGISTRY
Organizational workflow, and structure Phase 2 (Second Year)
Phase 3 (Third to Fifth Year)
Consolidating set up sustainable andbudgeted continuous) program Improved and completed thetoRENSTRA (countable and Receive feedback, Perfecting the products
• Go Professionally Mature System • Evaluating programs • Continuous Improvement Cycle
Globalization is COMPETITION !.
TERIMA KASIH
Distribusi geografik, Eksisting RSU Sumber Waras
RS Kanker Dharmais
1
RSPAD Gatot Subroto
4
RSUPN Dr Cipto Mangunkusumo
2
1 RSUP Fatmawati
RSU Pasar Minggu
RSUP Persahabatan
Kasus Lip, oral cavity Nasopharynx Other pharynx Oesophagus Stomach Colorectum Liver Gallbladder Pancreas Larynx Lung Melanoma of skin Kaposi sarcoma Breast Cervix uteri Corpus uteri Ovary Prostate Testis Kidney Bladder Brain, nervous system Thyroid Hodgkin lymphoma Non-Hodgkin lymphoma Multiple myeloma Leukaemia Ekstrapolasi Globocan 2012
Proporsi (GLOBOCAN) Jumlah 1.8 4.4 0.7 0.7 2 9.3 6 0.5 1.9 0.9 11.6 0.4 0 16.4 7 2.2 3.4 4.6 0.6 1.1 2.3 1.6 2.6 0.4 4.4 0.8 3.3
Indikasi RT (CCORE – Barton IMRT / SBRT (<20%=0, s/d Estimasi Load IMRT et al) Estimasi Kebutuhan 80%=0.5, >80%=1) / SBRT 287 0.78 223 1 223 700 0.85 595 1 595 111 0.78 87 1 87 111 0.8 89 0.5 45 318 0.68 216 0 0 1480 0.308 456 0 0 955 0.05 48 0.5 24 80 0.13 10 0 0 302 0.57 172 0 0 143 0.78 112 0.5 56 1846 0.76 1403 0.5 702 64 0.38 24 0 0 0 0 0 0 0 2610 0.83 2167 0 0 1114 0.8 891 0 0 350 0.35 123 0 0 541 0.35 189 40% unt DKI 4 pesawat 0 0 10 pes 732 0.6 439 1 439 96 0.49 47 0 0 7500 / 500 15 – 4 11 kekurangan …. 175 0.27 47 0 0 366 0.58 212 0.5 106 255 0.92 234 0.5 117 414 0.1 41 0 0 64 0.65 41 0.5 21 700 127 525 14469
0.65 0.38 0.04 0.514
455 48 21 7437
0.5 0 0
228 0 0 2643
Distribusi geografik, Alokasi B Koja
Cengkareng
+1
1
+1
RSPAD Gatot Subroto
Tarakan
+1 +1
RSU Sumber Waras
+1
RS Kanker Dharmais
B
4
+1 +1
RSUP Fatmawati
+1
2
1 +1
RSUPN Dr Cipto Mangunkusumo
RSUP Persahabatan
+1
B
RSU Pasar Minggu
Pasar Rebo B Budi Asih RS PON
+1
