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Primary prevention

Here the goal is to protect healthy people from

developing a disease or experiencing an injury in the
first place. For example:
 education about good nutrition, the importance of
regular exercise, and the dangers of tobacco,
alcohol and other drugs
 education and legislation about proper seatbelt
and helmet use
 regular exams and screening tests to monitor risk
factors for illness
 immunization against infectious disease

 controlling potential hazards at home and in the

Secondary prevention
These interventions happen after an illness or
serious risk factors have already been diagnosed.
The goal is to halt or slow the progress of disease (if
possible) in its earliest stages; in the case of injury,
goals include limiting long-term disability and
preventing re-injury. For example:
 telling people to take daily, low-dose aspirin to
prevent a first or second heart attack or stroke
 recommending regular exams and screening tests
in people with known risk factors for illness
 providing suitably modified work for injured
Tertiary prevention
This focuses on helping people manage
complicated, long-term health problems such
as diabetes, heart disease, cancer and chronic
musculoskeletal pain. The goals include
preventing further physical deterioration and
maximizing quality of life. For example:
 cardiac or stroke rehabilitation programs
 chronic pain management programs
 patient support groups
A Selection A
Management support
1. Planing and
2. Organization and
Use management
3. Information
4. Human resources

A Distribution
Policy, law and regulation
Strategies to
increase access
Availability Education
Accessibility • Supply of product • Patient
• Location of and services consultating
product and • Demenad for • Social
services product and marketing
• Location of users services Management
• Business
Safe I efficacious I Cost effective I management
Quality • Financial
Medical product and services management
Acceptability Regulation
• Characteristics of • Standards
product and development
• Prices of product
services • Task shifting
and services
• Attitudes and Economic
• Ability to pay
expectations of • Insurance plan
users • Pooled
 The vast majority of health problems for most
members of the population can be treated with a
small, carefully selected number of medicines
 In practice most doctor and health professional
routinely use a small fraction of medicines produced.
Training and clinical experience chould focus on the
proper use of these few medicines
 Procurement, distribution and other supply activities
can be carried out most economically and most
efficiently for a limited list of pharmaceutical product
 Patient can be better informed about the effective use
of medicines when the number of medicines they are
confronted with is limited
 Cross-sectional, E dan D diukur bersamaan
 Case control, D ditentukan, E ditelusuri
 Cohort, E ditentukan, D diamati
 Intervensi, E diberikan, D diamati
1. Meningkatkan tranparansi / keterbukaan
dalam proses pengadaan barang/jasa
2. Meningkatkan persaingan yang sehat dalam
rangka penyediaan pelayanan publik dan
penyelenggaraan pemerintahan yang baik
3. Meningkatkan efektifitas dan efisiensi dalam
pengelolaan barang/jasa pemerintah
 Pengadaan secara elektronik atau E-
procurement adalah pengadaan Barang/Jasa
yang dilaksanakan dengan menggunakan
teknologi informasi dan transaksi elektronik
sesuai dengan ketentuan peraturan
 E-Purcashing adalah tata cara pembelian
Barang/jasa melalui E-catalogue
 Katalog Elektronik atau E-Catalogue adalah
sistem informasi elektronik yang memuat
daftar, jenis, spesifikasi teknis dan harga
barang tertentu dari berbagai penyedia
barang/jasa pemerintah
 Disusun dari FORNAS
 E-tendering adalah tata cara pemilihan
penyedia barang/jasa yang dilakukan secara
terbuka dan dapat diikuti oleh semua penyedia
barang/jasa yang terdaftar pada sistem
pengadaan secara elektronik dengan cara
menyampaikan 1 (satu) kali penawaran dalam
waktu yang ditentukan
 Uncertainty, (ketidakpastian – power relasi?)
 Asymetri of information, (informasi tidak
seimbang) consumer ignorance (ketidak
tahuan konsumen) siapa yg menguasai
 Supply induce demand (“permintaan yang
dipaksaan terhadap konsumen”)
 Externalities (dampak yg ditanggung pihak
lain/kena orang banyak)