Community Volunteers’ Care for Older Adults (Lansia) in Indonesia: The Symbolic Efficacy of Community Health Meetings (Posyandu)

https://doi.org/10.22146/jh.93198

Nathan Porath(1), Elisabeth Schröder-Butterfill(2), Hezti Insriani(3*), Ciptaningrat Larastiti(4)

(1) University of Southampton
(2) University of Southampton
(3) Independent Researcher
(4) SurveyMETER and Research Team at Care Network in Later Life in Indonesia (University of Southampton & Atma Jaya Katolik University)
(*) Corresponding Author

Abstract


Community healthcare in Indonesia relies on volunteers who engage their clients outside fixed health facilities with limited resources and formal training. These volunteers are called cadres who learn their tasks to improve community wellbeing through ongoing engagement and without prior formal skills. They are drawn from the community to serve the community. This paper is based on field research carried out with cadres through interviews and visits to integrated health meetings (posyandu lansia) held by primary healthcare centres for older adults in villages in Jakarta and Yogyakarta. The paper first discusses the recruitment requirements and incentives for being a healthcare volunteer. It suggests that both recruitment and incentives are rooted in community values of helping and doing good for the community. Volunteer cadres must have a direct normative and semiotic connection with clients, as they must be members of the community who speak the same language and understand local norms. In line with this community-centred approach, the paper then focuses on the health efficacy of posyandu by viewing them as a recurring, structured symbolic event held in the village. The argument is made that a more qualitative approach should be taken to understanding the efficacy of these meetings, drawing on research methods from the anthropology of ritual (symbolic and therapeutic) healing.

Full Text:

PDF


References

Ariani ,M. (2018). Determinants of Elderly Behavior Follow the Posyandu in the Working Area of Kebonsari Primary Healthcare Surabaya. Unnes Journal of Public Health 7(1):50-54.

Arifianto, A. (2006). Public Policy Towards the Elderly in Indonesia: Current Policy and Future Directions. SMERU Research Institute Jakarta

Ananta, A. (2012). Financing Indonesia’s Ageing Population. Southeast Asian Affairs, Vol. 2012, p.135–149.

Putri, R and Ilyas, Y. (2019) The Determinant of Outpatient Health Services Utilisation for Elderly Patients in Indonesia (Susenas 2017 Data Analysis). Journal of Indonesian Health Policy and Administration Juli, Vol. 4, No.( 2), p. 36 – 41.

Azana, D. W., Gondodiputro S. Didah (2019) Elderly’s Expectations of Services in Integrated Health Post (Posbindu): A Qualitative Study. Majalah Kedokteran Bandung, Vol. 51 No(4), , p.213–220.

Borsch-Jacobson, M. (1992). The Emotional Tie: Psychoanalysis, Mimesis and Affect. StanfordUniversity Press.

Csordas, T. J. (2002). Body/Meaning/Healing. Houndmills: Palgrave Macmillan.

Dow, J. (1986) Universal Aspects of Symbolic Healing. A Theoretical Synthesis. American Anthropologist, 88, 56–69.

Featherstone, M., and Hepworth, M. (1989). 'Ageing and old age: reflections on the postmodern lifecourse'. In B. Bytheway, T. Keil, P. Allatt, & A. Bryman (Eds.), Becoming and Being Old: Sociological Approaches to Later Life. London: Sage.

Frank, J. D. (1961). Persuasion and Healing, A Comparative Psychotherapy. New York:Schocken Books.

Gadsden, T., Stephen J., Sujarwoto, S., Kusumo, E. B., and Palagyi, A. (2021). Assessing the feasibility and acceptability of a financial versus behavioural incentive based intervention for community health workers in rural Indonesia. Pilot and Feasibility Studies, 7(132), 1-10 https://doi.org/10.1186/s40814-021-00871-7

Heywood, P., and Harahap, N. P. (2009). Health facilities at the district level in Indonesia. Australia and New Zealand Health Policy 2009. Vol.6, No.:13, 1-11. doi:10.1186/1743-8462-6-13

Jakimow, T. (2018). Volunteers’ practices of care in community development as a model for citizenship in Medan, Indonesia. Citizenship Studies, 22(2), 145–159. DOI: 10.1080/13621025.2018.1445491

Janzen, J. (1987). Therapy Management: Concept, Reality, Process. Medical Anthropology Quarterly, vol.1, No.1p.68–84.

Kirmayer, L. J. (1993). Healing and the Invention of Metaphor. The Effectiveness of Symbols Revisited. Culture, Medicine, and Psychiatry, 17, p.161–195.

Laderman, C. (1987). The Ambiguity of Symbols in the Structure of Healing. Social Science & Medicine, 24,293–301.

Laderman, C. (1991). Taming the Winds of Desire. Psychology, Medicine, and Aesthetics in Malay Shamanistic Performance. Berkeley: University of California Press.

Laderman, C., and Marina R. (Eds.). (1996). The Performance of Healing. New York: Routledge.

Law no.13/1998. Kesejahteraan Lanjut Usia.

Le´vi-Strauss, C. (1963). The effectiveness of symbols. In Structural anthropology (p. 186–205). New York: BasicBooks.

Lestari, D. M., Stephens, C., and Morison, T. (2021). Constructions of older people’s identities in Indonesian regional ageing policies: the impacts on micro and macro experiences of ageing. Ageing & Society, p.1–21. doi:10.1017/S0144686X20001907

Malik, A Putra G. Widhanarto, Vitriani A.M. (2020) Participants in the Elderly Empowerment Program Posyandu Ngudi Utomo: Study in Indonesia. Journal of Nonformal Education 6 (1) 19-28.

McGuire, M. B. (1983). Words of Power. Personal Empowerment an Healing.

Culture, Medicine, and Psychiatry, 7, p.221–240.

Moerman, D. E. (1979). Anthropology of symbolic healing. Current Anthropology, 20, 59–80.

Moerman, D. E. (2002). Meaning, medicine and the placebo effect. Cambridge: University Press.

Naimoli, J. F., Frymus, D. E., Wuliji, T., Franco, L. M.,and Newsome, M. H. (2014). A community health worker ‘logic model’: towards a theory of enhanced performance in low- and middle-income countries. Hum Resource Health, 12(1), p.56.

Newell, K. W. (1975). Health by the People. Geneva: World Health Organisation.

Nurvidya, A. E., Braun L. K., and Hogervorst, E. (2012). Three Pillars of Active Ageing in Indonesia. Asian Population Studies. DOI:10.1080/17441730.2012.680334

Perry, B. H., Zulliger, R., & Rogers, M. M. (2014). Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness. Annu. Rev. Public Health, vol. 35, p.399–421.

Porath, N. (2011). Creating Medicine on a Swing. The Effectiveness of Mirroring, Mimetic Sensoriality, and Embodiment to Facilitate Childbirth among the Sakais of Riau (Sumatra). Journal of the Royal Anthropological Institute, 17, p.811–828.

Pratono, . A., and Maharani, A. (2018). Long-Term Care in Indonesia: The Role of Integrated Service Post for Elderly. Journal of Aging and Health, Vol. 30(10), p.1556–1573.

Rochester, C., Payne, A., and Howlett, S. (2010). Volunteering and Society in the 21st Century. Palgrave Mcmillan.

Schaaf, M., Warthin, C., Freedman, L., et al. (2020). The community health worker as service extender, cultural broker and social change agent: a critical interpretive synthesis of roles, intent and accountability. BMJ Global Health 2020, 5, 1-13 Article e002296. doi:10.1136/ bmjgh-2020-00229

Schneider, H., Okello, D., and Lehmann, U. (2016). The global pendulum swing towards community health workers in low- and middle-income countries: a scoping review of trends, geographical distribution and programmatic orientations, 2005 to 2014. Human Resources for Health, 14, p.65.

Schröder-Butterfill, E., Porath, N., Handajani Y. S., et al. (2023). Vulnerable, Heroic … or Invisible? Representations Versus Realities of Later Life in Indonesia. Progress in Development Studies, 23(4), p.408–426.

Scott, K., Beckham, W. S. , Gross, M., , Pariyo, R., George, Krishna, D. C., Giorgio and Perry, B. H. (2018). What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers. Human Resources for Health, 16(39), p.1–17.

Setiawan, E., Poedjibudjo, J., and Tondok, M. (2017). The health-care needs among older persons in an Indonesian urban setting. Asian J Pharm Clin Res, Vol 10 Issue (7),p. 233–238.

Shelley, K., Afdhila, N., and Rohde, J. (2017). Indonesia’s Community Health Workers (Cadres) in Case Studies of Large-Scale Community Health Worker Programs: Examples from Afghanistan, Bangladesh, Brazil, Ethiopia, Niger, India, Indonesia, Iran, Nepal, Pakistan, Rwanda, Zambia, and Zimbabwe. USAID, MCHIP.

Simbolon, P., & Simbolon, N. (2018). Association between Social-Cultural and the Utilization of Elderly Integrated Health Services (Posyandu Lansia) in Hamparan Perak Health Center Unnes. Journal of Public Health, 7 (1).

Soebekti, R. (1979). ‘Relationship between Traditional Healing and Modern Medicine in the Context of Health Centre and Primary Health Care’. In R. Kusamanto, & W. M. Setyenogoro.(Eds.), Traditional healing practices;Proceedings,ASEAN Mental Health Teaching Seminar on Traditional Healing, Jakarta Indonesia, Jakarta: Directorate of Mental Health,

Standing, H. A., Mushtaque, R., Chowdhury. (2008). Producing effective knowledge agents in a pluralistic environment: What future for community health workers?. Social Science & Medicine, 66,p. 2096–2107.

Sumini, Sukamdi, Pangaribowo, E. H., Keban, Y. T., and & Darwin, M. (2022). Elderly Care: A Study on Community Care Services in Sleman, DIY, Indonesia. Journal of Ageing Research, | https://doi.org/10.1155/2020/3983290

Rahardjo, T. B. W., Hartono, T., Dewi, V. P., Hogervorst, E., & Arifin, E. N. (2009). Facing the Geriatric Wave in Indonesia: Financial Conditions and Social Support. Ed. Evi Nurvidya Arifin and Aris Ananta 2009 Older persons in Southeast Asia: an emerging asset. Singapore: ISEAS Publishing,

World Health Organization. Regional Office for Europe. (‎1978)‎. Declaration of Alma-Ata. World Health Organization. Regional Office for Europe. https://apps.who.int/iris/handle/10665/347879



DOI: https://doi.org/10.22146/jh.93198

Article Metrics

Abstract views : 1444 | views : 544

Refbacks

  • There are currently no refbacks.




Copyright (c) 2024 Humaniora

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.