Model of dengue haemorrhagic fever controlling policy in Indramayu Regency

Abstract

Dengue haemorrhagic fever (DHF) still becomes a problem in Indramayu regency. The occurance of DHF is linked to a number of factors, including the environment, population, health service, and vector of DHF (Aedes aegypti). The objective of this research is to establish a model of DHF controlling policy in Indramayu regency used quantitative and qualitative analysis, observational, cross sectional, Analytical Hierarchy Process, Interpretative Structural Modelling, and system approach. The location of this research is in six districts: Sindang, Indramayu, Jatibarang, Terisi, Sukagumiwang, and Tukdana. Respondents were 721 persons, consisted of 671 head of families (with random sampling), and 35 officials from government institution and 15 as experts (with purposive sampling). The results of study show that the occurance of DHF is statistically have significant relationship with (1) the health condition of household, (2) the household’s water income, (3) the household’s garbage handling, (4) the respondent’s knowledge of DHF, (5) the healthy behavior of the member of the family, (6) the household’s money income/expenditure per capita, (7) the respondent’s formal education, (8) the schedule to cleaning out the water container, and (9) the rainfall index. The main strategy to control the occurance of DHF, based on Analytical Hierarchy Process, such as the increase of healthy living environment. The key factors to control the occurance of DHF, based on prospective analysis of the Interpretative Structural Modelling outputs, id est: interprogrammer and interinstitutional cooperation at all of government administration level and supporting of environment health education. The model simulation result can give a description of the real system behavior. Of the three formulated scenarios (optimistic, moderate, and pesimistic), application of optimistic scenario is assumed as the most effective. The DHF controlling policy that need to be implementated is focused to the four factors, id est: (1) the health environment: household garbage handling, waste water, water supplies, space and building sanitation, and mosquito repellent house plant, (2) the demography: population growth; and the community knowledge, attitude, and practice; (3) the health service: cure and health education program; and (4) the vector of DHF: management of the water storage containers, Aedes aegypti eggs, larvaes, pupa, and preventive measure of the Aedes aegypti mosquitos bite. In order to implement the DHF controlling policy effectively, Indramayu government need to increase (1) the good management of the interprogrammer and interinstitutional cooperation and good management of the controlling DHF team sistematically from the regency to the district administration, (2) the supporting of technologies, funds, facilities, and standard operating procedure of health education, and (3) the service quality of the Public Health Centre.