HIV/AIDS treatment funding system to support the people affected by HIV/AIDS in Surakarta, Indonesia.

People Living with HIV/AIDS (PLWHA's) quality of life (QoL) is determined by the lifetime treatment sustainability. Republic of Indonesia Minister of Health's Decree Number 328 of 2003 stated that government subsidies the PLWHA's medication and treatment, despite not covering entire medication and treatment cost. The objective of research was to analyse the cost assumed by PLWHA in accessing HIV/AIDS treatment service in Surakarta, Indonesia. The target group in this case study was PLWHAs, and related stakeholders of medical treatment in one of Public Health Centers and a Public Hospital in Surakarta; AIDS Commission of Surakarta City; Solo Plus Peer Support Group and AIDS-Care NGO selected purposively. Data collection was carried out using observation, in-depth interview, and documentation. Method and data source triangulations were used to validate data that was then analysed using Grossman's Demand for Health Capital theory. The result of research showed that the sources of HIV/AIDS treatment cost were self-income, Social Insurance Administration Organization (BPJS) fund and Local Government subsidy. Admission and physican services are given for free to PLWHA because it has been paid by BPJS Fund or has been subsidied by Local Government. Otherwise, they should pay registration cost of IDR 50,000, in Public Hospital and IDR 75,000 in Private Hospital. Physician service costs IDR 50,000-IDR 200,000. VCT Counsellor costs IDR 35,000-IDR 150,000. Non-Subsidy ARV costs IDR 687,000. 1 bottle containing 60 TB meningitis drug capsules costs IDR 145,000 for 10-20 d use and maximally IDR 210,000, while herpes drug costs IDR 295,000. CD4 examination costs IDR 126,000-IDR 297,000, RNA Viral load IDR 1,275,000-IDR 1,471,000, Haematology IDR 60,000-IRD 90,000, Cholesterol and triglyceride IDR 100,000-IDR 250,000, and SGOT/SGPT IDR 100,000-IDR 200,000. There is monthly non-medical cost the patient should spend, including transportation cost to go to health centre, and food, beverage, and newspaper cost while waiting for the service. BPJS fund and local government subsidy relieved health economic burden of PLWHAs, so that the average HIV/AIDS treatment cost in PLWHAs was relatively low, less than 10% of expense. National Insurance System including BPJS fund and local government subsidy as the answer to the integration of HIV/AIDS treatment funding management into national insurance system had provided PLWHA a funding access involving prevention, care, support, and treatment, and mitigated the effect despite less optimum.

Zoo agent's measure in applying the five freedoms principles for animal welfare.

BACKGROUND: Animal welfare should be prioritized not only for the animal's life sustainability but also for supporting the sustainability of living organism's life on the earth. However, Indonesian people have not understood it yet, thereby still treating animals arbitrarily and not appreciating either domesticated or wild animals. AIM: This research aimed to analyze the zoo agent's action in applying the five freedoms principle for animal welfare in Taman Satwa Taru Jurug (thereafter called TSTJ) or Surakarta Zoo and Gembira Loka Zoo (GLZ) of Yogyakarta Indonesia using Giddens structuration theory. MATERIALS AND METHODS: The informants in this comparative study with explorative were organizers, visitors, and stakeholders of zoos selected using purposive sampling technique. The informants consisted of 19 persons: 8 from TSTJ (Code T) and 10 from GLZ (Code G) and representatives from Natural Resource Conservation Center of Central Java (Code B). Data were collected through observation, in-depth interview, and Focus Group Discussion and Documentation. Data were analyzed using an interactive model of analysis consisting of three components: Data reduction, data display, and conclusion drawing. Data validation was carried out using method and data source triangulations. RESULTS: Food, nutrition, and nutrition level have been given consistent with the animals' habit and natural behavior. Animal keepers always maintain their self-cleanliness. GLZ has provided cages according to the technical instruction of constructing ideal cages, but the cages in TSTJ are worrying as they are not consistent with standard, rusty, and damaged, and animals have no partner. Some animals in GLZ are often sick, whereas some animals in TSTJ are dead due to poor maintenance. The iron pillars of cages restrict animal behavior in TSTJ so that they have not had freedom to behave normally yet, whereas, in GLZ, they can move freely in original habitat. The animals in the two zoos have not been free from disruption, stress, and pressure due to the passing over vehicles. CONCLUSION: There should be strategic communication, information, and education, community development, and law enforcement for the animal welfare.