Culture,

Behavior,
and Health
Yuri Nurdiantami

MK Kesehatan Global
Kesehatan Masyarakat
UPN Veteran Jakarta
 “If you wish to help a community improve its health, you must
learn to think like the people of that community. Before asking
a group of people to assume new health habits, it is wise to
ascertain the existing habits, how these habits are linked to one
another, what functions they perform, and what they mean to
those who practice them” (Paul, 1955, p. 1).
Today’s subtopic

• Basic concept from medical anthropology

• Theories of Health Behavior and Behavior Change
• Common features of Succesful Health communication and Health Promotion
Program
• Methodologies for Understanding Culture and Behavior
Basic concept from medical
anthropology

Sub-topic 1
Culture definition

“that complex whole which includes knowledge, belief, art,

morals, law, custom, and any other capabilities acquired by man
as a member of society.”
Ciri-ciri budaya

• Sharing ide dan nilai

• Dipelajari secara sosial, tidak selalu diwariskan
• Sering tidak disadari sudah tertanam pada diri seseorang
• Dapat dimodifikasi seiring dengan pengalaman sepanjang hidup à
budaya bukan merupakan sesutu yang statis
Konsep budaya dalam lingkup kesehatan

• Memandang masalah kesehatan dengan

Insider vs pendekatan kita sebagai warga di lingkungan tsb
(insider) atau sebagai orang luar (outsider)
outsider • Di tahap awal penyakit, seseorang tidak mau
dikatakan “sakit” karena secara fisik dia tidak
perspecti merasakan apapun, namun hasil lab menunjukan
sebaliknya
ves
Konsep budaya dalam lingkup kesehatan

Ethnocentrism • Memandang bahwa budaya-nya adalah yang terbaik

Holism • Melihat dalam konsep yang lebih luas suatu masalah

kesehatan (Holistik)

• derajat kapasitas seseorang dalam mendapatkan dan

Health literacy memproses serta memahami informasi kesehatan dan
mengambil keputusan tepat di bidang kesehatan
Konsep budaya dalam lingkup kesehatan

Cultural • Kemampuan sistem untuk menyediakan

perawatan bagi pasien dengan latar
compete belakang sociocultural beragam
nce
• Melihat penyebab penyakit yang
Belief system dikaitkan dengan kepercayaan/budaya
suatu daerah
 EXHIBIT 2-1 Types of Insider Cultural Explanations of Disease Causation

Ragam Body Balances

• Temperature: Hot,
cold
Supernatural
• Bewitching

penyebab
• Energy • Demons
• Blood: Loss of blood; properties of blood • Spirit
reflect
imbalance; pollution from menstrual blood •possession
Evil eye
• Dislocation: Fallen fontanel • Offending God or

penyakit
• Organs: Swollen stomach; heart; uterus; gods
liver; • Soul loss
• umbilicus; others Food
Incompatibility of horoscopes

menurut
• Properties: Hot, cold, heavy (rich),
Emotional • light
• Fright • Spoiled
• Sorro • foods

budaya
• w • Dirty foods
• Envy • Sweets
Stress Rawfoods
Weather • Combining the "wrong" foods
(incompatible
• Winds foods)
• Change of weather Sexual
Mud/clay
• Seasonal • Sex with forbidden
disbalance person
Vectors or Organisms • Overindulgence in sex

• Worms
Heredity
• Flies
• Parasit
Old Age
• es
Germs
Theories of Health Behavior
and Behavior Change
Sub-topic 2
 Health Belief
Model
people are seen as weighing perceived
susceptibility (how likely they are to get the
disease) and perceived severity
(how serious the disease is) against their
belief
Theory of Reasoned Action

• Predict an individual’s intention to engage in a behavior in a

specific time and place
• Five basic constructs precede the performance of a behavior: (1)
behavioral intent, (2) attitudes and beliefs, (3) evaluations of
behavioral outcomes, (4) subjective norms, and (5) normative
beliefs.
Diffusion of Health Innovation Model

• communication is essential for social change, and that

diffusion is the process by which an innovation is
communicated through certain channels over time among
members of a social system (Rogers, 1983; Rogers &
Shoemaker, 1972).
DIFFUSION OF INNOVATION MODEL
Early Majority
These people adopt new
Early Adopters ideas after seeing evidence Late Majority
These people are that the innovation works
The second to last segment
already aware of the
of a population to adopt
need to change and
innovative technology as it
are very comfortable
Innovators diffuses through a society.
Laggards
These people are very
willing to take risks The last to adopt a new product or
and service. They resent change and may
want to be the first to continue to rely on traditional
try the innovation products until they are no longer

'

Tee Visionaries Pragmatist Conservatives Skeptic

hies s s

POWERSLIDE
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0 WWW.POWERLIDES.CO
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 v o ·c ng
Transtheoretical
model con 1m
o ecogn
latio ·ition of in
fordor interes in change

• Model transtheoretical
mengidentifikasi 5 tahap ain c Con ·
Ongoing prac ice plation
Thinkingi about
perubahan (precontemplation
of new heal h·er changing
à maintenance). behavior
• Teori ini membantu untuk
mengembangkan strategi
yang sesuai untuk menarik
minat masyarakat di tiap
tahapnya.
Adopfng
con
ew albit
s
•aa o
Pl nniing for change

IFIGU- - 2·2 "S ages of change" r ns ·

eore icali model of
behavior change.
The Harm Reduction Model

• Teori ini awalnya digunakan pada program untuk mengurangi

ketergantungan obat/bahan kimia
• Para pecandu tidak mungkin langsung diminta untuk STOP
secara TOTAL dari mengkonsumsi narkoba, pasti dibutuhkan
waktu BERTAHAP (relapse) untuk mengurangi perlahan hingga
kemudian mampu berhenti TOTAL.
• Relapse bukan berarti kegagalan
• Membuat progres kecil dalam pengembangan positif perilaku
kesehatan akan tetap berarti.
Explanatory models

• focus on individual interactions between physician or other

staff and patients.
• Model yang dinamis dan dapat berubah tergantung kondisi
seseorang
• Fokusnya tidak hanya ”bagaimana” upaya yang dapat
dilakukan untuk mengubah budaya terkait kesehatan,
namun memperhatikan symptoms/gejala penyakit yang ada
Common Features of Successful
Health Communication and
Health Promotion Program
Sub-topic 3
Hal penting yang perlu diperhatikan dalam
kesuksesan program di masy

• Understanding and incorporating people’s insider cultural

values, beliefs, and behaviors
• A community-based approach with strong community
participation
• Recognition of gender issues
• peer group education, including use of community-based
outreach workers; and multilevel intervention
 Methodologies for
understanding culture and
behavior
Sub-topic 4
Teknik studi kualitatif

Observasi • Mengamati perilaku masyarakat dan merekamnya jika memungkinkan

• Pentliti melakukan observasi dengan mengikuti kegiatan kebudayaan atau acara di daerah tsb
Observasi partisipasi

Wawancara • Menggunakan open-ended question, dapat juga menggunakan ceklist

Focus group • Sekelompok warga diarahkan untuk berdiskusi mengenai hal tertentu

Analisis dokumen • mengevaluasi berdasarkan dokumen yang ada dan riset terbaru

Pengumpulan data sistematis • memiliki lingkup luas, bisa berupa fotografi, membuat video, dsb
Thank you!