FIVE STARS DOCTOR

(WHO)
Care provider
Communicator
Manager
Community leader
Decision maker

WHO : A STATE OF COMPLETE

PHYSICAL,
MENTAL AND SOCIAL WELL
BEING,
AND NOT MERELY THE
JADI
: SEHAT
ABSENCE
OF ITU TDK HANYA KONDISI
FISIK,
DISEASE
JUGA
& INFIRMITY
MENTAL , SOSIAL.
DAN
TDK SEMATA-MATA TERBATAS

Biosphere

Society/Nation
Economics/Political Science
Culture/Subculture

Community

Sociology/Anthropology

Family
Public Health
Epidemiologi
Biostatistic

Two person

Person
(experience & behaviour)
Psychology
Nervous system

Organ/Organ system

Tissues
Biomedicine
Cells

Organelles

Molecules

Atoms

Subatomic particles

Physics

The Mandala of Health : A model of the human

ecosystem
Culture

Community
Lifestyle
Personal
behaviour

Psycho-socioeconomic
environment

Family
Spirit

Sick
care
system

Body

Mind

Human
biology

Work

Physical
environment

Human-made environment
Biosphere

Social structure : The Links between personal health and social causes
culture
Social institutions

health

Social groups

economy
class
values

family
age
Mass
media

Individual
Health
And
illness

politics
gender
Law
ethnicity
military

race
education

State
religion

subcultures

Belief
system

Group of factors which affect

health
1. Population size, growth,
change, migration patterns

9. Health system, service, access

8. Immutable factors : age, gender,

ethnicity

2. Societal values, social norm, economic

growth, affluence, industrialisation

Disease
And
disability

7. Individual behaviours and lifestyle

6. Socioeconomic status, education level

3. Clean water, air, housing; other

physical environmental aspects

4. Social environment support, family

structure

5. Infectious agents, communicable disease

Intermediate Tier

Ultimate Tier

Economic factors
Intrnational ties to donors, lending institutions, global economy
Social and cultural system
Political system
Administration of agricultural and other programs

Natural ecology

Settlement pattern, sanitation, water supply,

animal husbandry practices

Household division of labour in agricultural and other work

Household decision-making about disposal of income in
kind and cash

Household food security :

Food production by household
Access to food from outside households

Distribution of food within the household

Food preparation
Childcare practices
Exposure of children to pathogens
Inadequate diets of children
(frequency of feeding, meal composition, seasonal variation,
weaning pratices)

Proximate Tier

Malnutrition

Diarrhoea

Lower respiratory
tract infection

Child mortality
Other factors
outside this model

Family
Orientation

Nuclear Family

=
=
= Suami-Istri

Extended Family

grs keturunan

Nuclear Family
A Family which contain of father, mother, and before marriage
children.

Extended Family

More than one generation

Interactions between factors affecting family health

Family knowledge and

satisfaction with
Family type, structure
services
Family choices on
basis of need,
demand

Family culture
Health attitudes,
beliefs, values

COHESION
WELLNESS
HEALTH

Health services
accessibility,
adequacy
Primary, secondary,
tertiary prevention

Intra-family
concordance
Parental education

Distribution of economic
resources

Employment type,
satisfaction

Social
Stratification

Vertical Hierarchy

Upper Layer
Middle Layer
Lower Layer

Horizontal Hierarchy

THE RELATIONSHIP BETWEEN STRUCTURAL

AND CULTURAL DIMENSION

Structural
Dimension

Cultural
Dimension

This diagram below shows behavioral

changes sistematically
Social System
Cultural System
Personality System

INDIVIDU

Behav.