The Behaviour of Health Care Providers in Managing Diarrheal Disease in Palembang City, South Sumatera, Indonesia

Rusdi Ismail; Achirul Bakri; Muhammad Nazir; Nancy Pardede

Rusdi Ismail Diarrheal Disease Research and Training Study Group School of Medicine, Sriwijaya University, Palembang, South Sumatera, Indonesia
Achirul Bakri Diarrheal Disease Research and Training Study Group School of Medicine, Sriwijaya University, Palembang, South Sumatera, Indonesia
Muhammad Nazir Diarrheal Disease Research and Training Study Group School of Medicine, Sriwijaya University, Palembang, South Sumatera, Indonesia
Nancy Pardede Diarrheal Disease Research and Training Study Group School of Medicine, Sriwijaya University, Palembang, South Sumatera, Indonesia

Keywords: diarrheal disease; ORT; health education

Abstract

A study on knowledge, attitude and practice of health care providers in Palembang had been conducted at the end of 1989 and beginning of 1990. Four approaches were carried out: (1) by recording the help obtained by cases who consulted researchers for further help for the same diarrheal diseases (DD) episode, (2) by studying the medical records of DD cases admitted to three hospitals, (3) by studying prescriptions dispensed by three pharmacies and (4) by focus group discussions. The findings were analysed to evaluate the achievement of the Indonesian Diarrheal Diseases Control Program (CDD).

ORT, avoiding antimotility drugs and appropriated feeding have been accepted and practiced by the providers in Palembang. The target of promotion now is to support the acquisition of these behaviours to be if implemented as a routine habit of the providers and as a part of the ongoing system of health care delivery system. Specifically the danger of loperamide promotion to the policy on antimotility must be stressed.

Rapid iv rehydration and avoiding surface precipitating agents have been accepted, but are not practiced consistently yet due to practical considerations.

It seems that there is no impact at all of CDD towards the rate of antibiotic therapy in DD. Besides intensifying the campaign, enforcing group pressure, maybe we have to elaborate more the perception of health care provider as a practitioner, and conforming the strategy of the CDD campaign towards the findings.

Health education had not been practiced effectively yet. Morale and value system of the providers are important for the success of this program.

In general the medical-technic aspect of the CDD has been accepted by the providers, but there is still a lot to do in communicating them to be adopted as an effective behaviour.

References

1. SITOMORANG, K.; MOEHARIANTO; ISMAIL, R.: Hasil pengelolaan penyakit diare yang dirawat di Bagian Ilmu Kesehatan Anak Fakultas Kedokteran UNSRI/RSUP Palembang 5. dalam tahun 1979- 1980. Proceeding, PIB VII, BKGAI, Manado : BKGAI 1981.
2. DEAN, A.J.; DEAN A.G.; BURTON, A. and DICKER, R. Epi Infp, Atalanta : Center for Disease-Contro1, 1988.
3. TITI INDIJATI, S. : Kebijaksanaan Program Pemberantasan Penyakit Diare, Pertemuan Nasional P2D, Yogyakarta, 13-18 Desember
1987.
4. ANONYM : Buku Pedoman Penatalaksanaan Penderita Infeksi Saluran Pernafasan Akut (ISPA) dan Diare untuk Petugas Kesehatan. Jakarta: Ditjen PPM-PLP Departemen Kesehatan RI, 1988.
5. Cited from : LAKSMONO : Perubahan Perilaku. Ceramah Pada Penataran Managemen Pimpinan Rumah Sak it Umum. Kumpulan Makalah. Palembang : 1986.
6. SUASANTO, A.S. : Komunikasi Dalam Teori dan Praktek. Jilid 1-2 dan 3, Bandung : Binacipta, 1989.
7. JALALUDIN RAKHMAT : Psikologi Komunikasi, Bandung : Remadja Karya, 1989.
8. BHUTTA, T.I .; TAHIR, K.l. : Loperamide poisoning in children. The Lancet 335 (8685); 663 (1990).