Public Safety Center in Batang Regency, Indonesia: Study of an

Emergency Care System in a Developing Country

Siti Nurhidayah

, Wahyu Sulistiadi

1,2*

, and Al Asyary

2,3

Health Care Management, Department of Health Administration and Policy, Faculty of Public Health, Universitas

Indonesia

Department of Environmental Health, Faculty of Public Health, Faculty of Public Health, Universitas Indonesia

Department of Public Health Science, the Graduate School, Universitas Muhammadiyah Prof Dr HAMKA

Keywords: Emergency Primary Care, Disaster Primary Care, Indonesia

Abstract: Indonesia is one of the developing countries that are prone to not only disasters, including earthquakes and

tsunamis, which recently happened, but also accidents, such as traffic injuries. This study is conducted to

review and introduce the emergency care system that affects health outcomes, such as morbidity, and even

death. We evaluate the health mitigating system for health care named Public Safety Center (PSC) 119 that

was implemented in Batang Regency, Central Java Province, Indonesia. The Si Slamet PSC 119 service

innovation increased the number of emergency incident reports by 2.5 in 2015–2016, from 4.6 cases (2015)

to 6.1 cases (2016), and by 22.5 in 2016–2017, from 6.1 cases (2016) to 28.6 cases (2017). Batang Regency

is one of the districts in Indonesia that has a vision to become harmonious, energetic, competitive, religious,

quiet, and prosperous by 2022. With this integrated emergency management system, Batang’s local

government has set its position, duties, and functions in not only achieving the vision of the district but also

becoming the emergency health care for its citizens. Further development is needed to interconnect this

system to all stakeholders and foster its implementation for not only in other regions of Indonesia, but also

in other developing countries properly.

1 INTRODUCTION

Indonesia has a high risk of various natural disasters,

including earthquakes and volcanic eruptions,

because it is located in the Ring of Fire (Blair et al.,

2010; Pambudi NA et al., 2018). Indonesia is home

to four zones of active volcanoes, namely, the

Sunda, Minahasa, Halmahera, and Banda Zones

(Tupper A et al., 2004) Thus, the risk of tsunamis, as

well as other types of disasters, is significantly high

(

Indonesian Ministry of Health. Peraturan Menteri

Kesehatan Republik Indonesia Nomor 19 Tahun 2016

tentang Sistem Penanggulangan Gawat Darurat Terpadu.

Jakarta.,2016).

Indonesia’s vast area that is composed

of thousands of islands results in difficulties in

accessing other regions, differences in geographical

conditions between regions, and inadequate facilities

and medical personnel, thereby constraining the

distribution of proper health services.

Batang Regency is located between lines 6 º 51

'46" to 7 ° 11' 47" south latitude and 109 ° 40 '19 "to

110º 03' 06" east longitude on the northern coast of

Central Java (Figure 1). Batang Regency is on the

main route that connects Jakarta–Surabaya. With an

area of 78,864.16 ha, the Regency’s territory is

bordered north by the Java Sea, east by Kendal

Regency, south by Wonosobo Regency and

Banjarnegara Regency, and west by the City and

Pekalongan Regency (Batang regency Government.,

2018)

With the location of the Batang region, the

capital that boosts of economic activities is located

north of the island of Java. (Mulyono et al., 2009).

Transportation flows and high mobility in the north

coast of the Java Island (Pantura) line provide

opportunities for Batang Regency to develop quite

prospectively in the transit and transportation

services sector.

Based on the Batang Regency District

Regulation No. 7 of 2004 concerning the

Establishment of Batang District Subdistricts, the

number of subdistricts in Batang Regency that was

originally 12 increased to 15. The division of this

region was carried out by the District Government of

198

Nurhidayah, S., Sulistiadi, W. and Asyary, A.

Public Safety Center in Batang Regency, Indonesia: Study of an Emergency Care System in a Developing Country.

DOI: 10.5220/0009863301980204

In Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease (ICTROMI 2019), pages 198-204

ISBN: 978-989-758-469-5

Figure 1. The map of Batang Regency

Batang as an effort to face the challenges and problems in

the

administration, development, and services to the

community, especially at the subdistrict and village levels.

2 MATERIALS AND METHODS

This review was conducted with secondary data

collection. We examined documents that correspond

to research variables and process data found and

translated in the form of tables and/or images. The

document review includes the following:

1. Standard Operating Procedures (SOP) PSC

Service Procedures 119

2. Minister of Health Regulation No. 19 of 2016

concerning Emergency Management System

3. Presidential Instruction No. 4 of 2013

concerning Program Decade Action Safety

Road

4. Central Java Governor Regulation No. 15 of

2017 concerning Integrated Emergency

Management System (SPGDT)

This study has passed the ethical review from the

Ethic Commission of the Public Health Faculty,

Universitas Indonesia, No. 496/UN2.F10/PPM.

00.02/2018. With this ethics document, the study has

also passed the internal institution approval, which is

the formal requirement for conducting the secondary

analysis review to each of the institution document

mentioned above.

3 RESULTS AND DISCUSSIONS

Demographic

The population of Batang Regency, Central Java,

continues to increase, from 708,088 (2010) to

743,090 (2016) (7). The number of male and female

populations in the subdistrict is shown in Figure 2

and Figure 3.

Public Safety Center in Batang Regency, Indonesia: Study of an Emergency Care System in a Developing Country

199

Figure 2. Population of Batang Regency

Table 1. Male Population per Subdistrict in Batang Regency in 2010–2015(7)

District Area

Male population per subdistrict

in Batang Regency

Year

2010

Year

2011

Year

2012

Year

2013

Year

2014

Year

2015

Wonotunggal 15529 15692 15850 16002 16152 16297

Bandar 31861 32203 32520 32842 33146 33444

Blado 21270 21493 21710 21920 22124 22322

Reban 17668 17856 18037 18210 18379 18544

Onion 25533 25809 26073 26323 26567 26806

Tersono 17844 18031 18216 18389 18560 18727

Gringsing 28212 28509 28798 29073 29344 29607

Overflowing 19312 19518 19716 19906 20091 20270

Banyuputih 16346 16519 16687 16845 17003 17156

Change 24003 24256 24501 24737 24966 25191

Pecalungan 14782 14937 15091 15234 15376 15513

Write 16622 16796 16964 17129 17287 17443

Kandeman 22497 22734 22964 23185 23399 23610

Stem 59151 59752 60361 60936 61500 62054

Warungasem 22952 23192 23425 23653 23872 24087

amount 353582 357297 360913 364384 367766 371071

340000

345000

350000

355000

360000

365000

370000

375000

Tahun Tahun Tahun Tahun Tahun Tahun

2010 2011 2012 2013 2014 2015

Laki‐laki

PopulationofBatangRegency

Year2010‐2015

Laki‐laki

Perempuan

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Table 2. Female Population per Subdistrict in Batang Regency in 2010–2015(7)

District Area

Female population per subdistrict

in Batang Regency

Year

2010

Year

2011

Year

2012

Year

2013

Year

2014

Year

2015

Wonotunggal 15444 15607 15758 15910 16063 16207

Bandar 31566 31890 32199 32512 32827 33120

Blado 20939 21159 21364 21572 21779 21974

Reban 17749 17935 18109 18285 18462 18626

Onion 25258 25519 25768 26019 26271 26505

Tersono 17808 17995 18168 18345 18522 18687

Gringsing 27751 28041 28315 28589 28865 29122

Overflowing 19441 19644 19835 20028 20221 20401

Banyuputih 16496 16668 16830 16994 17158 17310

Change 24606 24863 25105 25349 25594 25822

Pecalungan 15232 15393 15542 15694 15843 15986

Write 16865 17042 17209 17376 17544 17700

Kandeman 22893 23131 23356 23583 23811 24024

Stem 59628 60253 60823 61432 62024 62578

Warungasem 22830 23069 23302 23519 23747 23957

Based on the table 1 and table 2, the population in

2010 to 2015 is the largest in Batang Regency at

19,067. (Batang Statistics Agency., 2016). This is

because most of the government and trade activities

are concentrated in the Batang region. Thus,

residents prefer to live in the region.

Vision and Mission

The mission of Batang Regency is to be harmonious,

energetic, competitive, religious, quiet, and

prosperous by 2022. The Batang District Mission

consists of the following:

1. Improve the quality of public services with

governance based on eGovernment that

supports the development of cooperation.

2. Improve the quality of human resources fully

through optimizing community empowerment

movements in various fields in an integrated

manner.

3. Increase the development of regional

economies on an ongoing basis supported by

quality infrastructure and areas based on

information and communication technology.

4. Increase security, peace, and harmony

(regional conduciveness) for the

implementation of development through the

support of the practice of religious teachings

and noble cultural values.

Public Safety Center (PSC) 119

The Public Safety Center (PSC) 119, which was

formed based on the Presidential Instruction 4 of

2013 on Program Decade Action Safety Road, stated

that all districts/cities in Indonesia must establish a

PSC (Nasution CR,2016;Indonesian Ministry of

Health, 2016). This general emergency life support

has well-practiced on Poland in providing medical

services to patient with minor injuries as the

structure of the Hospital Emergency Ward Szwamel

K et al., 2015). In Indonesia, this system is having

special concern, particularly to potential area of

disaster (Qiantori A et al.,2012;Sangkala et al.,

2018;Amri A et al., 2016). The Health Minister

Regulation No. 19 of 2016 concerning Emergency

Management System and the Central Java Governor

Regulation No. 15 of 2017 concerning Integrated

Public Safety Center in Batang Regency, Indonesia: Study of an Emergency Care System in a Developing Country

201

Emergency Management System (SPGDT) also

stated that in the implementation of SPGDT in

Central Java Province, a PSC was formed through

119 call centers in each regency/city in the area (The

governor of central java province Peraturan daerah,

2017). The position, duties, and functions of the PSC

are as follows:

a. Position

 The PSC is a work unit that acts as a

coordination forum to provide

emergency services quickly,

accurately, and carefully for the

community.

 The PSC is open 24 hours for 7 days

continuously.

 PSC is carried out jointly with other

agencies outside the health sector that

can support the implementation of

SPGDT.

 The PSC is a major part of the pre-

SPGDT activity series of health care

facilities that function to perform

emergency services using emergency

algorithms that are in the 119 call

center application system.

b. Function

 Provide services to

victims/emergency patients and/or

reporters through a triage process

(sorting out the conditions of the

victim/emergency patient).

 Provide a first aid guide (first aid).

 Evacuate victims/emergency patients.

 Coordinate with health care facilities.

c. Task

In fulfilling its functions, the PSC carries out

the following tasks:

 Serve canal (dispatch) of the

emergency call center National

Command (National Command

Center).

 Provide emergency service by using

emergency algorithms.

 Provide ambulance service.

 Serve information about health care

facilities.

 Serve information about the

availability of beds in the hospital.

The results of the study showed that the data on the

number of emergency incident reports received by

the Si Slamet PSC 119 increased from 2015 to 2017

(Batang Health Office, 2017). The number of

consecutive events reported was 55 in 2015, 74 in

2016, and 343 in 2017 (Batang Health Office, 2017).

An overview of the number of reported emergency

cases can be seen in Figure 3.

Figure 3. The number of emergency incident reports

100

150

200

250

300

350

400

PelaporanKejadian

Tahun2015

PelaporanKejadian

Tahun2016

PelaporanKejadian

Tahun2017

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The document review conducted at the time of the

study obtained data related to the number of reports

received by the Si Slamet PSC 119 from 2015 to

May 2018. The event data received by the Si Slamet

PSC 119 from 2015 to May 2018 were used by the

researchers to differentiate the number of

occurrences before and after the Si Slamet PSC 119

with a dependent T-test. The T-test was used to

measure the difference in the number of events

before and after the Si Slamet PSC 119 because the

data obtained were numeric, the data distribution

was normal, and both groups could be paired.

Table 3. Effect of the Si Slamet PSC 119 Service

Innovation on the Number of Incident Reports in Batang

Regency in 2018(15)

Event

Report

Mean

Elementary

school

P-Value

In 2015 4,6 4.3

0.4

In 2016 6.1 3.9

In 2016 6.1 3.9 0.002

In 2017 28.6 18.5

The table 3 shows that the Si Slamet PSC 119

service innovation increased the number of

emergency incident reports by 2.5 in 2015–2016,

from 4.6 cases (2015) to 6.1 cases (2016), and by

22.5 in 2016–2017, from 6.1 cases (2016) to 28.6

cases (2017). The T-test results on the number of

reports in 2015 to 2016 obtained a p-value of 0.4,

which means that there is no significant difference in

the number of emergency incident reports between

2015 and 2016. By contrast, the T-test results on the

number of reports in 2016 to 2017 obtained a p-

value of 0.002, which means that there is a

significant difference between the number of reports

of emergency cases in 2015 to 2016.

4 CONCLUSION

The implementation of this program is in accordance

with the Presidential Instruction No. 4 of 2013,

namely, all districts/cities in Indonesia must

establish an public service center. This innovation

uses the motto “Saving life and limb”, which

involves the community, medical officers, and

ambulances in its implementation. This innovation

also involves other sectors related to the smooth

running of the PSC, such as firefighters, Indonesian

Cross Red (PMI), police, BPBD, health universities,

corporations, BPJS, and hospitals. However, this

program still does not have a memorandum of

understanding and SOP implementation procedures,

which are the complaints of the stakeholders.

Further development is needed to interconnect this

system to all stakeholders and foster its

implementation for not only in other regions of

Indonesia, but also in other developing countries

properly.

ACKNOWLEDGMENT

This study was supported by Directorate for

Research and Community Services, University of

Indonesia (DRPM-UI). We thank to several parties

which consisted of: University of Indonesia (UI),

The Batang Local Government, and University of

Muhammadiyah Prof Dr Hamka (UHAMKA).

CONFLICT OF INTEREST

The authors declare no potential conflict of interests.

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