European Journal of Molecular & Clinical Medicine

Background: The approach of economic losses due to illness and early death is an effective way to be used for advocacy and convincing all stakeholders that health is an investment. Methods: This is an observational study in the field of health economics on the magnitude of economic losses due to illness and death with the aim of providing advocacy to all health stakeholders. Results: The amount of direct costs, which consists of household expenses for transportation of IDR 749.3 million. Economic losses due to illness (YLD) IDR 26.7 billion, and YLL of IDR 243.2 billion, total economic loss due to both (DALY) is IDR 269.9 billion. Total economic losses of IDR 270.6 billion. This huge economic loss can be prevented by increasing the budget for promoting healthy behavior and expanding health insurance coverage for the community. Conclusion: Approach to economic losses due to early illness and death (DALY) as an effective advocacy way to improve the understanding of health stakeholders that interventions to reduce economic losses through increasing the health budget are an investment.

The article examine the responses of Citarum River Community , especially at Cieunteung and Linggar Villages Bandung Regency which are often exposed to floods, waste and rubbish through the perspective of "bottom up" environmental communications. The population living over the Citarum watershed is more than 15 million people, where some people depend on the river for their livelihood, so it often causes complex problems. People who live in the Citarum watershed are often victims of floods in the rainy season and drought in the dry season, as well as victims of waste pollution, both household waste and industrial waste, especially the textile industry.
The research method used is descriptive approach with qualitative data analysis technique. The results showed: there are still less responses, especially the attitudes and understanding of community of Citarum River about the condition of a healthy river (air and water); Lack of awareness and communication activities between people , formal and informal community leaders in finding the right solution; The lower participation of community and opinion leaders in seeking sustainable solution; Lack of supervision and law enforcement of the environment. Recommendation: The importance of advocacy movement, participation and assistance from and by community of the Citarum River (bottom up communication); The importance of forming groups or communities of citizens at the Citarum river area; The importance of communication and coordination is done intensively and sustainably; Local government interventions need to involve formal and informal leaders ; The importance of supervision and law enforcement seriously and professional