Masalah Kesehatan Masyarakat
Aspek fisik Aspek non fisik
 Morbiditas
 Mortalitas
 Masalah peny menular
 Kekurangan gizi
 Sanitasi lingkungan
Pemecahan masalah
 Program pengobatan (kuratif)
 Mendirikan fasilitas kes.
 Mendirikan laboratorium
 Pemberantasan peny.menular
 IMUNISASI
PREVENTIF / SPECIFIC
PROTECTION
 Ignorancy (ketidaktahuan)
 Pengetahuan kesehatan
 Kesadaran dan sikap terhadap
Kesehatan
 Pengetahuan gizi
 Pengetahuan sanitasi
 dll
Pemecahan Masalah
 Meningkatkan :
pengetahuan,
 sikap
dan perilaku kesehatan
PROMOSI KESEHATAN
 Riwayat Alamiah Suatu Penyakit Pada Manusia

Perjalanan Penyakit pada Manusia

Mati
Wilayah
Sehat Wilayah Sakit
Sembuh
A B C D E

Periode Periode - Patogenesis

Pre-Patogenesis

A : Health Promotion C : Early Diagnosis and Prompt Treatment

B : Specific Protection D : Disability limitation E :Rehabilitation

KONSEP PENCEGAHAN (LEAVEL & CLARCK)

RUANG LINGKUP PENDIDIKAN / PROMOSI KESEHATAN

1. Primary prevention yaitu untuk

Promotif masyarakat resiko tinggi :ibu
Dimensi/ (kel.sehat) hamil,perokok,obesitas, anak dan lansia,
dll
aspek Preventif 2. Secondary prevention yaitu penderita
Kesehatan & kuratif penyakit chronis: asma,diabet,tbc dll
3. Tertiary prevention yaitu penderita baru
sembuh  rehabilitatif
1. Keluarga
2. Sekolah
Dimensi
3. Tempat kerja
tatanan
4. Tempat umum
5. Fasilitas pelayanan

1. Promosi kesehatan : gizi, lingk sehat

Dimensi
2. Perlindungan khusus / spesific protection : imunisasi,
tingkat fluoridasi
pelayanan 3. Diagnosa dini & pengobatan
Leavel & 4. Pembatasan cacat
Clark 5. Rehabilitasi ; gigi tiruan
PERILAKU ? Lawrence Green
(1980)

Predisposing factors
Penyuluhan Pengetahuan, sikap,
Kesehatan, kepercayaan, tradisi,
Komunikasi/ nilai dsb
infornasi

Enabling
Health Pengembangan factors/faktor
Education/ organisasi/ pendukung Health
promotion Pemberdayaan Behavior
masyarakat Ketersediaan
sarana/ fasilitas

Training Reinforcing
/pelatihan factors/factor
penguat
Sikap dan perilaku
petugas/tokoh masy,
UU
 Level of Prevention

Secondary
Primary Prevention Tertiary Prevention
Prevention

Level-1 Level-2 Level-3 Level-4 Level-5

1.Health Specific Early diagnosis Disability Rehabilitation

promotion to protection and prompt limitation and
increase treatment replacement
resistance like
against Prosthodontic
disease appliance
and implants
2.
Educational
Reinforceme
nt
Pencegahan yang dapat dilakukan pada masa
sebelum sakit dan pada masa sakit.

Leavell dan clark dalam bukunya “Preventive Medicine for the

doctor in his community” menyebutkan pencegahan penyakit
dalam 5 tingkatan. Usaha-usaha pencegahan itu adalah :
A. Masa sebelum sakit
1. Mempertinggi nilai kesehatan (Health promotion)
2. Memberikan perlindungan khusus terhadap sesuatu penyakit
(Specific protection).
B. Pada masa sakit
3. Mengenal dan mengetahui jenis pada tingkat awal,serta
mengadakan pengobatan yang tepat dan segera. (Early
diagnosis and treatment).
4. Pembatasan kecacatan dan berusaha untuk menghilangkan
gangguan kemampuan bekerja yang diakibatkan sesuatu
penyakit (Disability limitation).
5. Rehabilitasi (Rehabilitation).
Level of Prevention

Primary Prevention : Primordial prevention, Population

(mass) strategy, High risk strategy
Health Promotion Spesific Protection

Secondary Prevention
Early diagnosis and treatment

Tertiary Prevention
Disability limitation Rehabilitation
 Prevention of dental caries
Level of Primer Sekunder Tersier
Prevention
Preventive Service Health Promotion Spesific Protection Early Diagnosis Disability Limitation Rehabilitation
and Treatment
Service provided Diet planning, Appropriate use of Self examination Use of dental Use of ddental
by individual demand for fluoride. and referral, use services services
preventive Ingestion of of dental services
services, periodic
sufficient
visits to dental fluoridated water.
office Appropriate use of
fluoride
prescriptions.
Use of fluoride
dentifrice.
Oral hygiene
practices.
Service provided Dental health Community or Periodic screening Provision of dental Provision of dental
by the community education school water and referral, services. services.
programs. fluoridation, provision of dental
Promotion of school fluoride services.
research and mouth rinse, tablet
lobby efforts. and sealent
programs.
Service provided Patient education, Topical Complete Complex Removable and
by the Dental plaque control application of examination: restorative fixed
Professional program, diet flourides, fluoride prompt treatment dentistry, prosthodontics,
counseling, recall supplements and of incipient lesions, pulpotomy, root minor tooth
reinforcement, rinses, pit and preventive resin canal therapy, movements,
dental caries fissure sealent. restoration, simple extractions. impalnts.
 Prevention of periodontal disease
Level of Primer Sekunder Tersier
Prevention
Preventive Health Spesific Early Diagnosis Disability Rehabilitation
Service Promotion Protection and Treatment Limitation

Service Periodic visits of Oral hygiene Self Use of dental Use of ddental
provided by dental office, practices. examination services services
individual demand for and referral,
preventive use of dental
service. services

Service Dental heath Supervised Periodic Provition of Provition of

provided by the education school-brushing screening and dental services. dental services.
community programs. programs. referral,
Promotion of provision of
research and dental services.
lobby efforts.
Provition of oral
hygiene aids.

Service Patient Correction of Complete Deep Removable and

provided by the education, tooth examination, curettage, root fixed
Dental plaque control malalignment, scalling and planning, prosthodontics,
Professional program, recall prophylaxis curettage, splinting, minor tooth
reinforcement. corrective, periodontal movements.
restorative and surgery,
occlusal selective
 Prevention of oral cancer
Level of Primer Sekunder Tersier
Prevention
Preventive Health Spesific Early Disability Rehabilitation
Service Promotion Protection Diagnosis and Limitation
Treatment
Service Periodic visits Avoidance of Self Use of dental Use of
provided by of dental known examination services ddental
individual office, irritants. and referral, services
demand for use of dental
preventive services.
service.
Service Dental heath Periodic Provition of Provition of
provided by education screening dental dental
the programs. and referral, services. services.
community Promotion of provision of
research and dental
lobby efforts. services.
Service Patient Removal of Complete Chemothera Maxillofacial
provided by education. known irritants examination, py, radiation and
the Dental in oral cavity. biopsy, oral therapy, removable
Professional cytology, surgery. prosthodontic
complete s. Plastic
excision. surgery,