Policy Analysis of Clean and Healthy Living Behavior in Islamic Perspective

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Policy Analysis of Clean and Healthy Living Behavior in Islamic Perspective

1Munaya Fauziah, ²Nurmalia Lusida, ³Nadilla Firda, ⁴Widya Rizki Ariandini, ⁵Suherman

1,2,3,4Faculty of Public Health, University of Muhammadiyah Jakarta

Jalan KH. Ahmad Dahlan, Cirendeu, Ciputat, South Tangerang 15419 Email: munayafauziah@umj.ac.id

ABSTRACT

Indonesia is a country with the largest Muslim population in the world. Islam is very concerned about cleanliness and health, so Indonesia should be a leading country in terms of cleanliness and health. In fact, based on the Southeast Asia Global Health Resilience Index (2019), Indonesia's health quality is ranked 4th in Southeast Asia and ranked 30th out of 193 countries in the world. The maternal mortality rate in Indonesia in 2017 was in the 3rd highest position out of 10 ASEAN countries. To improve public health status, the Ministry of Health of the Republic of Indonesia makes a policy on Guidelines for Clean and Healthy Living Behavior. This study aims to provide an understanding of Clean and Healthy Behavior from the perspective of Islam. The research method uses qualitative methods by analyzing 10 policy indicators of the Ministry of Health of the Republic of Indonesia regarding Guidelines for Clean and Healthy Living Behavior and tested for conformity with the arguments of the Qur'an and Hadith. The results showed that 10 indicators, namely childbirth assisted by health workers, exclusive breastfeeding infants, weighing toddlers every month, using clean water, washing hands with soap, using healthy latrines, eradicating mosquito larvae, consuming fruits and vegetables every day, doing activities physically every day and do not smoke in the house, has the evidence of the Qur'an and Hadith. In conclusion, 10 indicators regarding Guidelines for Guidance for Clean and Healthy Life Behavior in accordance with Islamic Sharia.

Keywords: policy analysis, behavior, clean and healthy, islamic perspective

Background

Indonesia as a country with the largest Muslim population in the world, where Islam is very concerned about cleanliness and health, should be a leading country in terms of cleanliness and health. (Peristiwo, 2019) Facts based on Index Asia's Global Health Resilience Southeast (2019) Indonesia's health quality is ranked 4th in Southeast Asia and ranked 30th out of 193 countries in the world. In Southeast Asia, Indonesia is under Thailand, Malaysia and Singapore.

(Djalante et al., 2020)

Maternal Mortality Rate (MMR) in Indonesia is still high. World Bank data for 2017 MMR in Indonesia is in the 3rd highest position out of 10 ASEAN countries. Data in 2017 there are 177 deaths per 100 thousand births in Indonesia, still far from the 2030 SDGs target, which is less than 70 deaths out of 100 thousand births. There are still deliveries that are not carried out by health workers, which is a factor that results in the high MMR in Indonesia. (WHO et al., 2019) From

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several research results, the belief factor (traditional birth attendant) is one of the factors that pregnant women do not choose health workers in the process of pregnancy and childbirth, other factors include education, economy and distance to the place of delivery. (Sialubanje et al., 2015) The factors of trust, lack of education and poverty should be resolved by involving Islamic religious scholars. Ulama have closeness with all levels of society and can explain and provide understanding from the point of view of the Islamic religion about the importance of the process of pregnancy until delivery is carried out by health workers who competent. The role of ulama involved in promoting Clean and Healthy Living Behavior is necessary and appropriate. Not only to make pregnant women and their families aware of submitting the process of pregnancy and childbirth to health workers, but also for all things related to indicators of Clean and Healthy Living Behavior. (Zaman, 2018)

The degree of health in several studies is influenced by behavioral and environmental factors. Samranah (2017) in the results of research on the Factors Affecting Health Status in Class X SMA Santri at Pondok Pesantren Ummul Mukminin Makassar, starting from the results of initial observations of gastritis which is often found in students of Ummul Mukminin Makassar, found in his research that 60 % of students are in the bad category of behavioral factors, 52.7% of students are in the bad category of environmental factors and 50.9% are in the bad category of health service factors that affect the health status of students at the Ummul Mukminin Islamic boarding school Makassar. (Samranah, 2017)

Samranah, in her research, has not tried to examine the influence of the behavioral factors of the students who are not good on health status with the religious understanding of the students regarding healthy and clean living behavior seen in the perspective of Islam. (Samranah, 2017) Yanuarti, (2018) in her writing has not been able to describe the influence of religious belief on clean and healthy living behavior. In her discussion, she wrote more about the importance of healthy and clean living behavior, while the discussion about belief or religion associated with healthy and clean living behavior was less in-depth.

Methods

The research method used is a qualitative method, by analyzing 10 indicators of fostering clean and healthy living behavior as stated in the Regulation of the Minister of Health of the Republic of Indonesia Number 2269/MENKES/PER/XI/2011 with the arguments in the Qur'an

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and Hadith. If the analyzed indicators have arguments in the Qur'an and/or Hadith, it is stated that these indicators are in accordance with Islamic teachings.

Result and Discussion

The results of the study after an analysis of 10 measurement indicators of the achievement of Clean and Healthy Life Behavior Development using the arguments of the Qur'an and Hadith, the results are as follows:

1. Indicators of delivery assisted by health workers

The childbirth is a process that is not simple. In the process of childbirth there are at least two lives that must be saved, namely the mother and the baby. During the delivery process, it is not uncommon for emergencies to arise that require special handling by competent health personnel. (WHO, 2017) Emergencies that often arise include bleeding, infection, eclampsia and dystocia. These four emergencies are generally the main causes of maternal, fetal and newborn death. (Bohren et al., 2015) The struggle of a mother giving birth normally or abnormally is very hard. In the Qur'an Surah Al Maidah (5) verse 32 explained,

ِرْيَغِب ۢاًسْفَن َلَتَق ْنَم ٗهَّنَا َلْيِءۤاَرْسِا ْ يِنَب ىٰلَع اَنْبَتَك ۛ َكِلٰذ ِلْجَا ْنِم َلَتَق اَمَّنَاَكَف ِض ْرَ ْلْا ىِف ٍداَسَف ْوَا ٍسْفَن

ِتٰنِ يَبْلاِب اَنُلُسُر ْمُهْتَءۤاَج ْدَقَل َوۗ اًعْيِمَج َساَّنلا اَيْحَا اَمَّنَاَكَف اَهاَيْحَا ْنَم َو ۗاًعْيِمَج َساَّنلا َدْعَب ْمُهْنِ م اًرْيِثَك َّنِا َّمُث

َن ْوُف ِرْسُمَل ِض ْرَ ْلْا ىِف َكِلٰذ

Meaning: That is why We ordained for the Children of Israel that whoever takes a life—unless as a punishment for murder or mischief in the land—it will be as if they killed all of humanity;

and whoever saves a life, it will be as if they saved all of humanity.1 ˹Although˺ Our messengers already came to them with clear proofs, many of them still transgressed afterwards through the land.

The period of a mother's pregnancy, giving birth and raising her child until the age of 6 years, is a very decisive human life cycle. (WHO, 2002) This period is known as the golden age or golden age and it starts from the prenatal period (conception to birth), infancy (18 months/24 months and early childhood (aged 5/6 years). In this period, parental factors will greatly determine the child's physical and psychological development.(Sartika et al., 2021) In the concept of Islam in this period, quite a lot of detail is presented in the Qur'an, including in Surah Al Mu'minun verses 12-14.

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In the process of pregnancy there is a process of physical formation and a process of life, namely when the spirit is blown by the angel Al-Arham at the age of 4 months (120 days) pregnancy. Although Allah has determined his sustenance, his death, his deeds, and his misery and happiness at the same time the spirit is breathed into the baby, at that time parents, especially mothers, are obliged to continue to care for the baby during pregnancy until delivery and then take care of it until adulthood. (WHO, 2002)

Mother's daily activities will determine the development of the baby's physical growth and mental development of the baby in the womb. Taking care of mother's health is taking care of baby's health too. Mother's diet is very decisive, eating good and halal food is highly recommended. Mothers need to get adequate nutritional input, including nutritional input from fruits and vegetables. Mothers are also advised to perform physical movements according to their gestational age, excellent physique is needed during pregnancy and also to prepare for the birth process. To ensure the health of the mother and fetus, it is necessary to have the assistance of an expert, so regular pregnancy check-ups with a midwife or doctor should always be recommended and sought for pregnant women. The spiritual health of the fetus must also be prepared. Islam teaches good practices to support the growth of the soul of the fetus. Pregnant women are encouraged to pray a lot, dhikr and read the Koran during pregnancy. According to experts, the voice and behavior of the mother will be heard, felt and learned by the baby even though it is still in the womb. Even fasting, especially voluntary fasting, is recommended for pregnant women, both for the physical health of the mother and her baby as well as for the mental development of the baby. (Suciati, 2015)

2. Indicator of giving exclusive breastfeeding

For exclusive breastfeeding Al Quran has explained it obviously in Surah Al-Baqarah (2) verse 233:

ْ لا َو ِد ْوُل ْوَمْلا ىَلَع َو ۗ َةَعاَضَّرلا َّمِتُّي ْنَا َداَرَا ْنَمِل ِنْيَلِماَك ِنْيَل ْوَح َّنُهَد َلْ ْوَا َنْع ِض ْرُي ُت ٰدِلا َو َّنُهُت َوْسِك َو َّنُهُق ْز ِر ٗهَل

َلْ ۚ اَهَعْس ُو َّلِْا ٌسْفَن ُفَّلَكُت َلْ ِۗف ْوُرْعَمْلاِب ًلْاَصِف اَداَرَا ْنِاَف ۚ َكِلٰذ ُلْثِم ِث ِرا َوْلا ىَلَع َو ٖهِدَل َوِب ٗهَّل ٌد ْوُل ْوَم َلْ َو اَهِدَل َوِبۢ ٌةَدِلا َو َّرۤاَضُت

َلََف ْمُكَد َلْ ْوَا ا ْوُع ِض ْرَتْسَت ْنَا ْمُّتْدَرَا ْنِا َوۗ اَمِهْيَلَع َحاَنُج َلََف ٍرُواَشَت َو اَمُهْن ِم ٍضاَرَت ْنَع اَنُج

ْمُتْيَتٰا اَّم ْمُتْمَّلَس اَذِا ْمُكْيَلَع َح

ٌرْي ِصَب َن ْوُلَمْعَت اَمِب َ هاللّٰ َّنَا ا ْوُمَلْعا َو َ هاللّٰ اوُقَّتا َو ِۗف ْوُرْعَمْلاِب Meaning: And mothers should breastfeed their children for two whole years, for those who want to breastfeed completely. And it is the duty of the father to provide for their maintenance and clothing in a proper manner. A person is not burdened more than he can bear. A mother

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should not suffer because of her child and neither should a father suffer because of his child.

The heirs are (obligated) like that too. If both want to wean by agreement and deliberation between them, then there is no sin on either of them. And if you want to nurse your child to someone else, then there is no sin for you to pay it in a proper way. Fear Allah and know that Allah is All-Seeing of what you do.

The verse explained that the breastfeeding period is 2 years, even if the mother is not able to breastfeed until the baby is 2 years old, it is allowed to breastfeed her baby to another mother who has an abundance of breast milk.

3. Indicator weighing toddler every month

The purpose of weighing regularly every month at the Posyandu or other health facilities is to find out if the baby/toddler is growing healthy, to identify and prevent growth disorders under five, to find out sick toddlers, complete immunizations and to receive nutrition education. This is explained in the Qur'an Surah An Nisa (4) verse 9:

ُقَيْل َو َ َّللَّٱ ۟اوُقَّتَيْلَف ْمِهْيَلَع ۟اوُفاَخ اًفٰـَع ِض ًًۭةَّي ِ رُذ ْمِهِفْلَخ ْنِم ۟اوُكَرَت ْوَل َنيِذَّلٱ َشْخَيْل َو اًديِدَس ًًۭلْ ْوَق ۟اوُلو

Meaning: Let the guardians be as concerned ˹for the orphans˺ as they would if they were to

˹die and˺ leave ˹their own˺ helpless children behind. So let them be mindful of Allah and speak equitably.

Surah An-Nisa verse 9 reminds us of the obligation to prepare a generation that is healthy, strong and has noble character. In addition to having to give breast milk to babies during 2 years and provide nutritious food intake, development Children also need to be monitored continuously to make sure they are growing and developing well. Weighing toddlers every month according to Islamic teachings. (Darojati, 2016)

4. Indicator using clean water

Clean water is a source life. Islam really needs clean water. Qur'an and Hadith explain it as follows, The conditions for a valid prayer are: ablution, ablution required to use clean and holy water. (Sulaemang et al., 2016) This is explained in the Qur'an Surah Al Maidah (5) verse 6:

ِقِفاَرَمْلٱ ىَلِإ ْمُكَيِدْيَأَو ْمُكَهوُجُو ۟اوُلِسْغٱَف ِة ٰوَلَّصلٱ ىَلِإ ْمُتْمُق اَذِإ ۟ا وُنَماَء َنيِذَّلٱ اَهُّيَأ ٰـ ََ

ي

ْمُكِسوُءُرِب ۟اوُحَسْمٱ َو

َلُج ْرَأ َو

َأ َء اَج ْوَأ ٍرَفَس ٰىَلَع ْوَأ ٰىَض ْرَّم مُتنُك نِإ َو ۚ ۟اوُرَّهَّطٱَف اًًۭبُنُج ْمُتنُك نِإ َو ۚ ِنْيَبْعَكْلٱ ىَلِإ ْمُك

َنِ م مُكنِ م ًٌۭدَح

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ُحَسْمٱَف اًًۭبِ يَط ا ًًۭديِعَص ۟اوُمَّمَيَتَف ًًۭء اَم ۟اوُد ِجَت ْمَلَف َء اَسِ نلٱ ُمُتْسَمٰـَل ْوَأ ِطِئ اَغْلٱ ُدي ِرُي اَم ۚ ُهْنِ م مُكيِدْيَأ َو ْمُكِهوُج ُوِب ۟او

َت ْمُكَّلَعَل ْمُكْيَلَع ۥُهَتَمْعِن َّمِتُيِل َو ْمُكَرِ هَطُيِل ُدي ِرُي نِكٰـَلَو ٍۢجَرَح ْنِ م مُكْيَلَع َلَعْجَيِل ُ َّللَّٱ َنوُرُكْش

Meaning: O believers! When you rise up for prayer, wash your faces and your hands up to the elbows, wipe your heads, and wash your feet to the ankles. And if you are in a state of ˹full˺

impurity,¹ then take a full bath. But if you are ill, on a journey, or have relieved yourselves, or have been intimate with your wives and cannot find water, then purify yourselves with clean earth by wiping your faces and hands.It is not Allah’s Will to burden you, but to purify you and complete His favour upon you, so perhaps you will be grateful.

5. Indicator of Hand washing using soap

Washing hands is part of the pillars of ablution. (Sulaemang et al., 2016) From Abi Hurairah radhiyallahuanhu, It already explained in the Quran surah Al Maidah (5) verse 6 on the discussion of water.

ِفاَرَمْلٱ ىَلِإ ْمُكَيِدْيَأ َو ْمُكَهوُج ُو ۟اوُلِسْغٱَف ِة ٰوَلَّصلٱ ىَلِإ ْمُتْمُق اَذِإ ۟ا وُنَماَء َنيِذَّلٱ اَهُّيَأ ٰـَي ىَلِإ ْمُكَلُج ْرَأ َو ْمُكِسوُءُرِب ۟اوُحَسْمٱ َو ِق

ْمُتنُك نِإ َو ۚ ِنْيَبْعَكْلٱ َمٰـَل ْوَأ ِطِئ اَغْلٱ َنِ م مُكنِ م ًٌۭدَحَأ َء اَج ْوَأ ٍرَفَس ٰىَلَع ْوَأ ٰىَض ْرَّم مُتنُك نِإ َو ۚ ۟اوُرَّهَّطٱَف اًًۭبُنُج

ْمَلَف َء اَسِ نلٱ ُمُتْس

َم ۚ ُهْنِ م مُكيِدْيَأ َو ْمُكِهوُج ُوِب ۟اوُحَسْمٱَف اًًۭبِ يَط ا ًًۭديِعَص ۟اوُمَّمَيَتَف ًًۭء اَم ۟اوُد ِجَت ُدي ِرُي نِكٰـَل َو ٍۢجَرَح ْنِ م مُكْيَلَع َلَعْجَيِل ُ َّللَّٱ ُدي ِرُي ا

َنوُرُكْشَت ْمُكَّلَعَل ْمُكْيَلَع ۥُهَتَمْعِن َّمِتُيِل َو ْمُكَرِ هَطُيِل Meaning: O believers! When you rise up for prayer, wash your faces and your hands up to the elbows, wipe your heads, and wash your feet to the ankles. And if you are in a state of

˹full˺ impurity,¹ then take a full bath. But if you are ill, on a journey, or have relieved yourselves, or have been intimate with your wives and cannot find water, then purify yourselves with clean earth by wiping your faces and hands.² It is not Allah’s Will to burden you, but to purify you and complete His favour upon you, so perhaps you will be grateful.

6. Indicator using healthy latrine

Using a healthy latrine is according to Islamic Sharia. Three Hadith can be stated here, namely:

a. Be afraid of the three places that cursed, throw dirt at the source running water, on roads and places take shelter. (Narrated by Abu Dawud and Ibn Majjah).

b. Whoever comes to latrine then cover it (HR Abu Dawud).

c. Don't be two people who are where do you sit to defecate? open her nakedness to talk, verily Allah hates the so it is. (HR Ahmad and Abu Dawud).

7. Indicator of eradicating mosquito larvae

Eradicating mosquito larvae aims to break the chain mosquito life. mosquito larvae is actually a mosquito too. Eradicating mosquito larvae or eradicating mosquitoes is it

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forbidden? by Islamic Sharia? No verses found in the Qur'an and a hadith that clearly allows kill mosquito larvae or eradicate mosquitoes. Hadith that allow kill some type of animal is,

"There are five fasiq animals that can be killed outside the forbidden land and in them: snakes, ravens, mice, black dogs and birds of prey” (HR. Muslim no. 1198). The jurists have a rule,

“Every animal that disturbing it can be killed and removed." Shaykh Ibn Baz, fatwa no. 17264 allow killing nuisance animals like him like an ant, cockroaches, mosquitoes, flies and also beast in order anticipating interference from him”

8. Indicator of consuming fruit and vegetables every day

God as the creator already provide all needs human even for all his creatures. Relating to eating

and drinking is mentioned in the Quran. It explained in Surah Al-Baqarah (2) verse 168:

ْمُكَل ٗهَّنِا ِۗن ٰطْيَّشلا ِت ٰوُطُخ ا ْوُعِبَّتَت َلْ َّوۖ اًبِ يَط ًلَٰلَح ِض ْرَ ْلْا ىِف اَّمِم ا ْوُلُك ُساَّنلا اَهُّيَا ٰي ٌّوُدَع

ٌنْيِبُّم

Meaning: O humanity! Eat from what is lawful and good on the earth and do not follow Satan’s footsteps. He is truly your sworn enemy.

9. Indicator of doing daily physical activity

Doing physical activity or exercise is important to maintain fitness and physical strength training:

The Messenger of Allah SWT said: "Whoever controls archery then leave it, then he is not our group, or he said, 'So he has do evil." (HR. Muslim). "Teach your children" swimming, archery and riding horse". (H.R Bukhari Muslim)

10. Indicator of no smoking inside the house

Decision of the Commission's Ulama Ijtima MUI fatwa throughout Indonesia in 2009 decided that smoking was "forbidden" between haram and makruh. Smoking is forbidden in public places, for children and pregnant women. Board Saudi Arabian royal fatwa, forbid smoking with a fatwa number: (4947), which reads, "Smoking is illegal. grow the raw material (tobacco) also illegal too trading it is also illegal, because smoking is dangerous which is so big", Fatwa Lajnah Daimah. The basis that is the reference of the fatwa above includes Surah Al-Baqarah (2) verse 195:

ٱ ُّب ِحُي َ هللَّٱ هنِإ ۛ ۟ا ٓوُنِسْحَأ َو ۛ ِةَكُلْههتلٱ ىَلِإ ْمُكيِدْيَأِب ۟اوُقْلُت َلَ َو ِ هللَّٱ ِليِبَس ىِف ۟اوُقِفنَأ َو َنيِنِسْحُمْل

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Meaning: And spend (your wealth) in the way of Allah, and do not drop (self) into destruction with one's own hands, and do good. Really, God love people who do good.

Conclusion

Regulation of the Minister of Health of the Republic of Indonesia Number 2269/MENKES/PER/XI/2011 concerning Guidelines for the Guidance of Clean and Healthy Living Behavior is in accordance with the rules or Sharia of the Islamic religion. 10 indicators regarding PHBS, namely childbirth assisted by health workers, exclusive breastfeeding babies, weighing toddlers every month, using clean water, washing hands with soap, using healthy latrines, eradicating mosquito larvae, consuming fruits and vegetables every day, doing physical activity every day and not smoking in the house have found strong arguments in the Qur'an and the Hadith of the Prophet Muhammad , even most of them are reflected in the behavior of Rasulullah's life every day. Indonesian Muslims have no reason not to implement government programs to continuously strive to achieve the targets of the Clean and Healthy Living Behavior program to improve the health quality of the Indonesian people, who are predominantly Muslim. Indonesian Muslims should even support and assist the government in the success of the Clean and Healthy Behavior program, so that the 2030 SDGs target is immediately achieved and Indonesia's health quality ranking is the best in Southeast Asia and even in the world.

Indonesia's health quality is still below Thailand, Singapore and Malaysia and is still ranked 30th in the world, this position is not because the majority of Indonesia's population is Muslim.

Islamic teachings related to cleanliness, health, environment and plenary behavior are very clearly informed to the adherents through the Qur'an and Hadith and even the results of the ijtihad of the scholars. The behavior and even the perception of Muslims towards a clean and healthy way of life that is still not in accordance with what is taught in Islam is what causes Indonesia's health quality to still be improved. Muslims who are supposed to be the best people on earth, should be role models, including in matters relating to cleanliness, health, environmental care and other good behavior.

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