Graduation Year

2012

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Public Health

Major Professor

Thomas J. Mason

Keywords

Informal Sector, Occupational Health Services, RE-AIM, Safety, Training, Worker

Abstract

Although the Ministry of Health, Indonesia, has achieved some successful occupational health interventions, published literature on such interventions in Indonesia remains scarce.

This study utilized mixed methods of qualitative and quantitative research for the years 2010 and 2011. The qualitative study covered respondents in West, Central, and East Java Provinces to gather stakeholders' perspectives on the impact, effectiveness, adoption, implementation, maintenance, and barriers of occupational health services for informal sectors in Indonesia. The quantitative portion measured the impact of occupational health training for community health officers using Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) dimensions. West Java, as a province with a center for occupational health referral services (Balai Kesehatan Kerja Masyarakat/BKKM), was compared to Central Java as a province without BKKM.

The qualitative study showed that interventions improved knowledge of and engagement in occupational health among workers and health officers. Among other improvements, occupational health training resulted in some owners of food processing home industries switching from non-food to food-based coloring. The advocacy program improved local governments' political commitment to funding the occupational health program. The BKKM played important roles in delivering occupational health in West Java Province. The quantitative study showed the efficacy variable to have the lowest p-value (p:<.0001). Meanwhile, the reach variable showed on the second lowest p-value among RE-AIM components (p: <.0190). Moreover, education (p-value: 0.0001), job type (p-value: 0.0015), and job duration (p-value: 0.0289) were considered individual variables that could have contributed to the differences in RE-AIM scores between Central and West Java.

The qualitative study confirmed that occupational health interventions in Indonesia resulted in some positive impacts related to safe and healthy work-related behaviors. The quantitative study found that West Java, a province with BKKM, had a better RE-AIM score as compared to Central Java, a province without BKKM. Some individual variables such as education, job type, and job duration could have contributed to the differences in RE-AIM scores between Central and West Java. The future direction of the occupational health-training program should consider the participants' diversity in their education, job type, and job duration.

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