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Jakarta Post

Quality education is (also) a health policy

As the nation welcomes a new leader, the future of Indonesian health policy has become a hotly debated topic among medical professionals and the public alike

Adhitya S Ramadianto (The Jakarta Post)
Jakarta
Thu, October 9, 2014

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Quality education is (also) a health policy

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s the nation welcomes a new leader, the future of Indonesian health policy has become a hotly debated topic among medical professionals and the public alike. The upcoming administration will have to tackle numerous obstacles to implement the promised universal healthcare coverage to improve the health of Indonesians. However, the incoming government must not lose sight of the bigger picture on health.

So far, most of the conversations about health policies have been constrained to the provision of medical care: how to develop adequate facilities, allocate resources, deploy medical professionals and certainly how to finance the whole operation. While they are real problems facing our healthcare system right now, our policymakers must also take into account other determinants that have a real and measurable impact on health. These include socioeconomic environment, physical environment and individual characteristics and behaviors.

For example, experiencing unbearable psychological stress at work may lead to troublesome physical symptoms. A lack of open green spaces means children spend more time indoors, deprived of healthy physical activities. Smokers feel free to puff in public spaces thanks to weak law enforcement. Neglecting to manage these determinants will put a heavy burden on even the most developed healthcare system, let alone our fledgling system.

One important determinant of health is education. Research findings show that better education brings better health outcomes. More years of schooling translates into a lower mortality rate, better physical health conditions and higher life
expectancy.

Education exerts its effects through many channels: the better educated are less likely to engage in unhealthy behavior, are more likely to adopt preventive healthcare and to utilize available healthcare more optimally. In short, educated people have better health literacy, or '€œthe capacity to obtain, process and understand basic health information and the services needed to make appropriate health decisions,'€ a study report stated.

Furthermore, those with higher education land better-paid jobs '€” and income still plays a huge role in one'€™s health status.

Implementing a high-quality education system, therefore, is a requirement to achieve the goals of '€œIndonesia Sehat'€ (Healthy Indonesia). Sadly, recent examples show the inadequacy of our schools in educating the masses, especially in health literacy.

Quack healers are still attracting clients all over the country, including those selling dubious '€œnatural remedies'€, even though there is simply no physiological or pharmacological basis for the therapy. People are spending exorbitant amounts of money to pay for a placebo effect at best, or even worse, potentially harmful treatments.

Indonesian children are being increasingly victimized by the anti-vaccination movement that has sprung up in recent years, an unwelcome import from misguided Western cultures as well as conspiracy-loving religious extremists. These '€œanti-vaxxers'€ rely on pseudo-science and mass hysteria, instead of sound medical evidence affirming the safety and benefits of immunization.

Two examples of their malicious handiwork are the 2005 polio outbreak in Sukabumi, West Java, and the 2011 diphtheria outbreak in East Java; not to mention the steady rise of previously-rare vaccine-preventable diseases.

The use of long-term contraception methods, such as the intrauterine device (IUD), praised for its effectiveness and convenience, is hampered by myths about its side effects. Many women still reject the IUD in fear of exaggerated risk of uterine damage or the baseless rumor that it causes congenital defects in the baby should it fail in preventing pregnancy. Couple this trend with the fact that less-educated women tend to have more children and we still have a long way to go in reducing the maternal mortality rate that disproportionately affects those with a high number of children.

Thus, investing in quality education and health literacy is as pressing an issue as building hospitals and training new physicians. Education is more than a job requirement; it serves a higher purpose as the key to leading a fruitful life by opening up precious opportunities. By providing quality education, we are giving our next generations an opportunity to grow up and live healthily.

Additionally, educated people make empowered patients who realize that their health is their responsibility and are ready to collaborate with the medical system to achieve good health. Patient and community empowerment to maintain one'€™s own health is vital because physicians and other health professionals can only influence the health of their patients up to a certain degree.

As health itself depends on various factors, there are many parts of the curriculum that can contribute to improving health literacy. The education system should properly equip students with critical thinking skills so that they will be able to navigate the flood of information in the digital era. Successful science education, like biology and chemistry, will build a strong foundation of health knowledge. Reading is crucial, as many health information sources are written.

Oral language skills are as influential to allow people to describe their health condition more accurately to the doctor, a starting point to better care. Basic math will always come in handy, whether to calculate one'€™s body mass index or to take the correct drug dosage. Finally, students must develop analytical thinking to select relevant information and apply it in health-related decision making.

A chain is only as strong as its weakest link; building the medical system alone will not suffice in achieving Indonesia Sehat. An understanding of the close connection between education and health should serve as yet another wake-up call for stakeholders to evaluate, and to redesign if necessary, the national education system.

The fresh air president-elect Joko '€œJokowi'€™ Widodo brought to politics should also make its way into our education policies. The government must not hesitate to overhaul our school system and curricula, and give the national education system a fresh start. Nevertheless, these changes must be carefully thought through with sufficient time, unlike the last decade'€™s rushed curriculum changes that have become more like knee-jerk reflex reactions instead of deliberately planned actions.

If the government is serious about improving the health of the nation, the quality of our education must also take center stage, considering that its success or failure will affect the health of generations of Indonesians to come.

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The writer graduated from the faculty of medicine of the University of Indonesia and is a former executive committee member of Asian Medical Students'€™ Association International.

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