EPIDEMIOLOGI

PELAYANAN KESEHATAN

S2 KESMAS UHO 17 NOV 2017

Goals
 To develop a rational process to set priorities and
allocate very limited health resources.
Health planning:
 A process of identifying the ultimate goals and
choosing between alternative ways to achieve the
goal.

Evaluation:
The process of systematic and subjective
determination as possible, the relevance of the
effectiveness, efficiency and impact of the activity
with due regard to the agreed objectives.
STEPS :
 Measurement or analysis of disease burden
 Identify the cause of the disease
 Measurement of the effectiveness of various
interventions in the community
 Efficiency analysis within the resource use framework.
 Implementation of interventions
 Monitoring activities.
 Re-analysis of disease burden to determine whether the
problem has changed.
 The effectiveness of an intervention is
determined by a factor....

 How well the intervention works

 Ability to screen and diagnose illness
 Use of appropriate interventions
 Efficiency:
A relationship between the results achieved and the
efforts made in the form of money, resources and
stakeholders.

 Monitoring:
Continue to follow an activity to ensure that the
activity goes according to plan
 Public policy:
The sum of the decisions that make up by society.

 Health policy objectives:

Increasing health by developing people's ability to
control and improve their health.
Public Health Policy is done by:

 Improve community development.

 Developing officer skills.
 Support, mediation, help.
 Creating a supportive environment.
 Review health services.
10 Fundamental of Epidemoology
 1. Epidemiology : studies populations
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Epidemiology is the study of health and disease in

populations for the purposes of
(i) understanding disease dynamics,
(ii) controlling disease, and
(iii) promoting health.
Comparison across and within populations is the key
strategy of epidemiologic inquiry.

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 2. Populations are diverse
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 Populations (meaningful collections of people) are

diverse, heterogeneous, dynamic, and
interconnected.
 Epidemiology depends on these qualities in order
to make useful comparisons.
 Comparisons must not be confounded by
uncontrolled diversity.

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 3. Measures for studying
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populations

1) Counts of people – rates, proportions, and ratios,

e.g., birth rate, death rate, incidence, prevalence,
abortion ratio;
2) Distributions of characteristics of people, e.g.,
mean age, mean education, mean cholesterol
level;
3) Characteristics of groups or environment, e.g.,
sexual networks

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 4. Incidence
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 Fundamental concept
 Rate (incidence rate, “incidence density”) or proportion
(incidence proportion, cumulative incidence).
 Incidence rate measures the process of disease
occurrence;
 incidence proportion measures the result of a process.

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 5. Measurement
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 Observation and measurement are fundamental

to scientific advances.
 Choosing a measure – objective, conceptual
model, and availability of data (technology,
feasibility, and ethics).

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 6. Error
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 All measurement involves error.

 Science seeks to minimize error and to quantify it
as a guide to interpreting data.
 Sources of error include random error (e.g.,
variability from sampling) and systematic error
(e.g., selection bias, information bias).

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 7. Epidemiology is mass production
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 Collection, processing, management, and analysis

of epidemiologic data (medical records,
questionnaires, interviews, biological specimens,
environmental measurements) involve mass
production.
 Skillful management and quality control are key
though often unadvertised components of
epidemiology.

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 8. Health and disease are processes
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 Health and disease are complex, dynamic

processes affected by multiple, interacting
factors acting at multiple levels.
 Can be challenging to define and to measure.
 Interpretation must take this complexity into
account but not become lost in it.

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 9. Interpretation, inference, and
action
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 Interpretation takes account:

1. how data were collected
2. underlying conceptual framework.
 We are the source of our data and their spokesperson.
 Conclusions from data require inference and the weighing of
evidence.
 One of the most difficult decisions is deciding when to act.
 Action should be accompanied by monitoring.
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 10. Awareness and humility
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 Breadth of awareness and humility are

important assets.
 More factual knowledge but become a major
public health problems and failings.
 Good people can make mistakes, resist new
knowledge, take deplorable actions.
 When confronting the unfamiliar, how can we tell
fact from illusion, insight from fantasy?

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TERIMA KASIH