AbstractThe effective provision or utilisation of a community health service is affected by a number of cultural systems and their interaction. Possibly the system most involved but least studied, is the biomedical bureaucracy. Foster (1977) argues that most of the barriers to effective Ihealth programs lie in the bureaucracy and the assumptions of the medical profession. This study in applied anthropology arose from the Charter of Co-operation (1994) between the Minister of Health. Northern Territory and the Governor of the Province of East Nusa Tenggara in which one of the preliminary activities is the study of basic health services 1 in remote areas. Following Foster's advice I focus on the organisation structure and ethos of the Indonesian National Health System, its history, and influential components such as the biomedical system, particularly as they relate to community health.
Indonesian national health policy firmly endorses the primary health care concept. Therefore the effects of bureaucratic organisational structure and the biomedical power/knowledge nexus are compared with effective and ineffective primary health care systems in other countries. Then the formal Indonesian health policies and procedures are compared with actual observations in a health centre in rural West Timor. The differences between formal and actual practices are discussed and recommendations for change proposed.
|Date of Award||Nov 1996|