healthcare professional survey 2014 - edelman indonesia
DESCRIPTION
REDEFINING THE TRUST AND PERCEPTIONS OF INDONESIAN MIDWIVESTRANSCRIPT
“Redefining the Trust and
Perceptions of Indonesian Midwives”
HEALTHCARE PROFESSIONAL SURVEYS OVER THE YEARS
2
DEEPER ENGAGEMENT THROUGH LEVERAGING DIGITAL SHARED ASSETS
Empower your stakeholders to improve quality of engagement with HCPs by
strengthening digital presence.
421 MDs (GPs and Specialists) in 4 cities (Jakarta, Bandung, Surabaya, Medan)
2
THE RISE OF THE INTERNET AS A TRUSTED SOURCE OF INFORMATION
Emergence of online media that has in turn forced MDs to improve the way they
communicate with their patients
300 MDs (GPs and specialists) in Greater Jakarta area (Jakarta, Bogor, Depok, Tangerang, and Bekasi)
REDEFINING THE TRUST AND PERCEPTIONS OF INDONESIAN
MIDWIVES
600 midwives in 7 cities (Jakarta, Bandung, Medan, Jogjakarta, Surabaya, Makassar, Denpasar)
2010
2013
2014
WHY WE CONDUCT A HEALTHCARE PROFESSIONAL SURVEY?
• The implementation of universal health coverage as mandated by
the law Law No. 40/2004 on National Social Security (SJSN) and Law
No. 24/2011 on Social Security Providers (BPJS); massively expanding
the health market customer base, especially the basic primaryhealthcare.
• Shortage of qualified professionals is one of the greatest obstacles to
the growth of Indonesia’s healthcare sector.
• Decentralized healthcare system in Indonesia has led to varying
degrees of quality and provision of healthcare from region to region.
• Potential increase in healthcare state spending through the public
private partnership (PPP)
3
Edelman’s contribution to help better understand Indonesia’s healthcare industry
STATE OF HEALTHCARE AND MIDWIVES IN INDONESIA
In 2012, there are
359 Maternal
Mortality Ratio
per 100,000 live
birth. Emphasized
a reversal of
progress since
2007.
5
OUR GOALS ARE TO:
1. Measure midwives’ trust towards specific
channels and key institutions
2. Assess their perceptions towards specific issues
FOCUS TOPICS
6
Maternal Health
Pregnancy
Reproduction
Family Planning
Child Health
Nutrition
Exclusive Breastfeeding
HIV/AIDS PreventionPhoto: UNFPA
1
2
3
4
5
6
7
8
PROFILE OF RESPONDENTSMETHODOLOGY : FACE-TO-FACE INTERVIEW
TOTAL RESPONDENTS : 600 MIDWIVES
PERIOD : JANUARI’14 – APRIL’14
Private Clinic 57%
> 5 years 71%
Urban 61%
JKT 25%
Community Clinic 43%
2 – 5 years 29%
Rural 39%
BDG 13% SBY 15% MDN 15% JGJ 13% MKS 13% DPS8%
Working for
Years of practice
Area
Cities
*) The number of respondents was set based on relative population size in each city; the minimum number of sample size required for statistical analysis
with a 4% margin of error
**) There are currently around 200,000 midwives in Indonesia, 42% of which are in Java – Bali and 52% outside Java-Bali, the rest are in remote areas.
TOPLINE FINDINGS
The growing power of mass media, especially television and the
Internet, with midwives taking content presented at face value
Pharmaceutical and Nutrition companies are trusted institutions to help
in midwifery, not individual sales representatives
There is an ongoing concern on national nutrition, though the
topic is considered a low priority among midwives
1%
2%
3%
5%
8%
9%
9%
9%
17%
18%
21%
4%
3%
2%
4%
7%
10%
11%
10%
11%
22%
17%
5%
1%
2%
4%
7%
9%
10%
10%
13%
18%
19%
7%
2%
2%
3%
5%
9%
10%
11%
14%
15%
0%
7%
3%
8%
3%
8%
7%
12%
9%
0%
18%
0%
5%
3%
3%
3%
6%
9%
11%
11%
12%
18%
20%
5%
3%
2%
2%
3%
11%
0%
9%
13%
19%
13%
5%
1%
2%
4%
7%
9%
10%
10%
13%
18%
19%
O T H E R S
C O M P A N Y ' S W E B S I T E
N E W S P A P E R
S O C I A L M E D I A
M A G A Z I N E
P R E V I O U S L E C T U R E R
M I D W I V E S G U I D E
G O V E R N M E N T ' S G U I D E
T V
P E E R S / S E N I O R S
I N T E R N E T , N E W S P O R T A LMaternal health
Pregnancy
Child Health
Nutrition
Exclusive
Breastfeeding
Reproduction
Family Planning
HIV/AIDS
Prevention
WHERE MIDWIVES GET THEIR INFORMATION
9
Midwives in Indonesia choose peers/seniors, television, and internet/ news portal as the first go-toinformation, compared to midwives and government’s guides
Q1b. When you are looking for information to update your knowledge related to the key topics, what kind of information channels do you go to for the first time?
Power of mass
media for
midwives
WHERE MIDWIVES GO TO VERIFY INFORMATION
Q1c. What is your most trusted source to verify information concerning these key topics? (open ended)
A large percentage of midwives surveyed do not verify information and accept the first go-to source
of information
RESPONSE TO CERTAIN COMMUNITY ISSUESMajority of midwives agree that people lack understanding towards “disadvantages of
early marriage” and “HIV/AIDS transmission”
25%
30%
32%
41%
52%
53%
64%
65%
11%
13%
18%
18%
18%
22%
17%
17%
64%
57%
51%
40%
30%
24%
20%
18%
People put less priority to rely on professional healthcare
providers during labor/childbirth
People do not see the importance of periodical medical
check-up during pregnancy
People do not realize the importance of giving a complete
vaccination to infants and toddlers
People do not realize the importance of using
contraception as part of family planning
People do not see the importance of exclusive
breastfeeding for babies until 1 year old
People are less concerned with family nutrition fulfillment
People do not understand properly how HIV/AIDS is being
transmitted
People do not realize the disadvantages of early/young
marriage
Agree Indifferent Disagree
Q2c. I will read several statements. Please indicate how much do you agree/disagree to the statement. (5 point scale, 1=strongly disagree, 5=strongly disagree)
ISSUES THAT MATTER
12
42%
37%
42%
38%
38%
52%
51%
49%
Diseases during
pregnancy
Diseases
Nutrition problem
Side effect
Mother preference
Malnutrition
Transmission & increasing
prevalence
Inability to conceive
25%
30%
32%
41%
52%
53%
64%
65%
People put less priority to rely on
professional healthcare providers
during labor/childbirth
People do not see the importance
of periodical medical check-up
during pregnancy
People do not realize the
importance of giving a complete
vaccination to infants and toddlers
People do not realize the
importance of using contraception
device as part of family planning
People do not see the importance
of exclusive breastfeeding for
babies until 1 year old
People are less concerned with
family nutrition fulfillment
People do not understand properly
on how HIV/AIDS being transmitted
People do not realize the
disadvantages of early/young
marriage REPRODUCTION
HIV/AIDS
NUTRITION
EXCL. BREASTFEED
FAMILY PLANNING
CHILD HEALTH
PREGNANCY
MATERNAL HEALTH
Agree with the statement Biggest issue with the topic…
Q2c. I will read several statements. Please indicate how much do you agree/disagree to the statement. (5 point scale, 1=strongly disagree, 5=strongly disagree)
Q2a. To your knowledge, what are the biggest issue with the biggest impact within the key topics (highest findings only)
Q1a. Looking at these key topics related to midwifery, which one is the most important based on your opinion
• Prompted answers came from responses to a given list and indicate all that the midwife agreed with
• Unprompted answers add up to 100%: single most important
VIEWS ON 8 KEY TOPICS
79
91
92
96
62
79
83
86
61
67
85
92
94
10
6
5
3
13
10
6
8
16
12
7
4
3
11
3
4
2
25
11
11
6
24
21
9
5
3
BPJS
BKKBN
Ministry of Health
Doctor
Radio
Magazine/Newspaper
Internet
TV
NGO
Insurance Company
FMCG Company
Nutrition Company
Pharma Company
Trust Indiferent Distrust
MIDWIVES’ TRUST IN INSTITUTIONS TO HELP THEM DO THEIR JOBSThe midwives surveyed showed significant trust in pharmaceutical and nutrition companies. On par
with Ministry of Health (MoH), doctors’, NGOs are the least trustedM
ED
IAIN
DU
STR
YG
OV
TN
GO
IND
IV
Q3. How much trust do you place on these institutions in helping you doing your job as midwife (9 point scale, 1=do not trust at all, 9=highly trust)
Note: no specific company names were mentioned, only examples of product as illustration
TYPE OF NEGATIVE CASES MIDWIVES HAVE HEARD ABOUT MOSTMalpractice cases involving doctors resonates the most, with dr. Ayu’s malpractice case mentioned by
more than half (53%) of respondents.
13%
20%
40%
51%
62%
82%
Malfunction of medical devices
Contaminated medicine
Contaminated beverage
Contaminated food
Contaminated milk
Doctor's malpractice
81%
cannot recall
the brand
name(s)
Q10abc. Have you ever heard of these type of cases? Which sources did you hear it for the first time? Who/what did you verify it with?
TV is the main
driver of
popularity. 91%
heard of it the
first time from TV
and 80% used
TV to verify the
story
TRUSTED SPOKESPERSONWhile pharmaceutical and nutrition companies are trusted, as institutions, their sales representatives
and company executives are the lowest on the trust scale. Spokespersons with medical background are
preferred
19%
33%
35%
37%
43%
53%
63%
85%
90%
90%
11%
7%
6%
3%
7%
9%
4%
1%
1%
1%
70%
60%
60%
60%
50%
39%
34%
14%
10%
10%
NGO Representative
Village Head (Lurah)
Company Executive
Sales Representative
Mayor
Religious Leader
Consumer
MoH Representative
IBI Representative
Academician/Doctor
Trust Indifferent Distrust
Q9. Among these individuals, who do you think is the trusted spokesperson to deliver information/message (4 points scale, 1=do not trust at all, 4=highly trusted)
1 IBI : Ikatan Bidan Indonesia (Indonesian Midwives Associations
2 MoH : Ministry of Health
1
2
TRUST TOWARDS CERTAIN MEDIAThe Internet and TV have had a huge influence over the midwives surveyed
35%
42%
45%
47%
59%
9%
2%
3%
1%
4%
56%
56%
53%
52%
37%
Radio
Newspaper
Magazine
TV
Internet
Trust Indifferent Distrust
Q9. Among these media sources, what do you think is the trusted channel to deliver information/message (4 points scale, 1=do not trust at all, 4=highly trusted)
Ma
tern
al
He
alth
Pre
gn
an
cy
Re
pro
du
ctio
n
Fa
mily
P
lan
nin
g
Ch
ild
He
alth
Nu
tritio
n
Ex
clu
siv
eB
rea
stfe
ed
ing
HIV
/AID
S
Pre
ve
ntio
n
TV 53% 52% 49% 55% 54% 52% 54% 58%
Medical Doctors (MD) 60% 56% 60% 32% 61% 56% 38% 65%
Midwives Guide 33% 37% 28% 37% 25% 19% 39% 6%
Internet 25% 23% 27% 22% 24% 23% 21% 24%
Magazine 16% 17% 15% 14% 16% 18% 18% 8%
Government Guide 8% 6% 8% 17% 9% 8% 10% 20%
TRUSTED SOURCE MIDWIVES USE TO CONVINCE PATIENTSAmong respondents, TV and Medical Doctors are the most trusted sources to convince their patients.
Q12a. What is your main source to convince patients in the key topics? (multiple response)
Majority of midwives
are available in rural
areas which limits their
access to internet
HCPS BEHAVIOUR: REFER PATIENTS TO ONLINE AND PEERS
19
Results from Healthcare Professionals Survey 2013
2
7
21
32
38
3
7
20
31
39
2
6
23
32
37
Broadcast media
Print media
Books/journal
Health professional
Internet/web/
blog/forum
Specialist
GP
Total
Q5: Which of the following sources of information do you recommend to your patients MOST if they want to find information on health or medical issues? Which one do you recommend as
the SECOND? Which is the THIRD? Base Total = 421; GP = 279, SP = 142
Our 2013 Healthcare Professional Survey
found that healthcare practitioners’ use of
the Internet to convince patients is the
exact opposite of midwives
MOVING FORWARD
Mass media, especially television and internet, are important and effective means to communicate with midwives
• Health institutions to monitor data accuracy,
• Perform rapid response to mis-interpreted message
• Provide direct and tactical interpretation to message
Tripartite collaboration, leveraging trust in pharmaceutical institutions
and authoritative role of government and doctors is the way forward• Private health institutions to build capacity of the Ministry of Health and doctors
• Ministry of Health to build capacity of other health institution in performing a campaign
THANK YOU