Preliminary Exploration of Traditional Medicine Formulas as A Basis of Effort and Support Toward Traditional Medicines Developing Use and Implementation in The Government Healthcare Program

Introduction : Develop the healthy living communities with enhance ability of community in using herbs or traditional medicine in the family health system was supported by the government regulations. Materials and Method: The study only took point 3 out of 10 points Essential Public Health Services. The point was to inform and educate the public about health, the factors that influence it, and efforts to improve it. This point was realized by collecting and selecting the formulas that have been published by the government to be summarized based on the indication of disease, quantity of herbs and water (including the parts of herb), processing of formulation and drinking rules, etc. Results: 17 Formulations of traditional medicinal herbs are valuable for the indication of diseases: arthritis, reduce blood fat /blood cholesterol, reduce blood glucose, reduce body weight, maintaining the health conditions of cancer patient, cough, diabetes mellitus, gastritis, gout, hemorrhoids, reduce high blood pressure, liver problem, nausea and vomiting, uric acid, increase urine volumes, urinary stone/kidney stone, and physical fitness. Conclusion: The formulas could be used and was introduced to the community for encouraging health literacy, empowering the community to build a family health system. Finally, the exploration of traditional medicine formulas could support the developing use and implementation of traditional medicines in the Government Healthcare Program


INTRODUCTION
Public health factor is a concern of the government; many programs have been carried out to make the public health program successful. Therefore, development in the health sector is very important, especially in villages. 1 To realize a healthy community, the government issued several regulations and government actions, among others the Healthy Living Community Program (Germas), 2 Healthy Village House (Rumah Desa Sehat/RDS), 1 and the regulations that related with Jamu and traditional herb medicine, including herbal medicine scientification, 3 and Fit with Jamu (Bude Jamu). 4 Healthy Living Community Program is directed as prioritizing efforts to increase disease prevention (preventive) and increase health promotion (promotive). 2 However, it is not ruled out about efforts to improve public health status which include disease treatment (curative) and health restoration (rehabilitative). 3 Indonesia has a wealth of medicinal plants and herbs formulation from various ethnic groups that live throughout Indonesia. Based on data from Research on Medicinal Plants and Jamu (RISTOJA) by the Indonesian Ministry of Health in 2012, 2015 and 2017, there were 32,013 traditional medicinal herbs and 2,848 plant species that had been identified as traditional medicinal plants. 5 Traditional herb medicine is called Jamu which is used based on local wisdom for generations. These empirical uses from the data is the basis for proving the safety and efficacy of the uses of Jamu formulation for generations in Indonesia. 5 Basic Health Research published in 2018 reported that many people still used herbs to control their diseases, for instance diabetes mellitus, in National scale 14,5% used traditional medicine. 6 Based on the regulations above, and for the success of the healthy community program, as well as utilizing the wealth of medicinal plants, traditional medicine formulations can be utilized, especially in efforts to increase disease prevention (preventive) and improve health promotion (promotive) in rural areas. Therefore, a study of traditional medicinal formulations was carried out which provides clarity on the weight of ingredients, formulation processing, and drinking rules.

Exploring traditional medicine formulas
The results of exploring traditional medicine formulas are as follows: The type of formulations chosen is one that has units of weight in grams.
Formulary of Indonesian traditional medicine concoction vol. 1, 1 st edition in 2011 8 showed the formulation as follows. (Table 1) Formulary of Indonesian traditional medicine concoction 1 st edition in 2011 gave the solution for several diseases among others the formula to reduce blood fat, help to relieve diabetes, and dissolve kidney stone.
Formulary of Indonesian original herbal ethnomedicine concoction 2 nd edition in 2012 9 showed the formulation as follows. (Table 2) Formulary of Indonesian original herbal ethnomedicine concoction 2 nd edition in 2012 gave the solution for several diseases among others the formula for cough and helps relieve hemorrhoids.
Formulary of Indonesian original herbal ethnomedicine concoction 3 rd edition in 2013 10 showed the formulation as follows. (Table 3) Formulary of Indonesian original herbal ethnomedicine concoction 3 rd edition in 2012 gave the solution of several diseases among others the formula to relieve liver problem, maintain the health conditions of cancer patients, and reduce high blood pressure.
Indonesian Traditional Medicinal Formulary (FROTI) in 2017 11 showed a single formulation as follows. (Table 4) Indonesian Traditional Medicinal Formulary (FROTI) in 2017 gave the solution for several diseases among others the formula for cough, gout, increased stamina, nausea and vomiting, hemorrhoids, increased urine volumes, urinary stone and diabetes mellitus. The herb is boiled with 600 ml of water until it becomes 200 ml. The decoction is taken twice a day for 8 weeks.

Indication of disease
Formulation and the parts of the plant used Quantity (g) for once processing

Processing of formulation and drinking rules
Cough Thymus vulgaris (L) -herbs 20 The ingredients are boiled with 400 ml of water until it becomes 200 ml. It is then cooled, filtered and drunk all at once. It is drunk four times a day.
Glycyrrhiza glabra Linn. -roots 10 The ingredients are boiled with 600 ml of water until it becomes 200 ml. It is then cooled, filtered and drunk all at once. It is drunk once per day.
Abrus precatorius L. -leaves 5 The ingredients are boiled with 400 ml of water until it becomes 200 ml. It is then cooled, filtered and drunk all at once. It is taken three times a day.
Gout Kaempferia galanga L. -rhizome 5 The ingredients are grinded to a powder. 100 ml boiling water is added and let it stand. It is filtered and drunk while it is warm before meal. It is taken three times a day before meal.
Zingiber officinale Rosc. -rhizome 5 The ingredients are added 100 ml of boiling water and let them stand. The concoction is filtered and drunk before meal. It is taken three times a day before meal.
Melaleuca leucadendra (L) -leaves 6-10 The ingredients are boiled with 400 ml of water until it becomes 200 ml. The concoction is cooled, filtered and drunk all at once.

Increase stamina
Curcuma xanthorrhiza Roxb. -fresh rhizome 25 The ingredients are boiled with 600 ml of water until it becomes 200 ml. The concoction is cooled, filtered and drunk. It is taken twice a day one hour before meal.

Curcuma domestica Val -Fresh rhizome 15
The ingredients are boiled with 600 ml of water until it becomes 200 ml. The concoction is cooled, filtered and drunk all at once. It is taken three times a day one hour before meal.

Nausea and Vomiting
Zingiber officinale Rosc. -rhizome 1 -2 The ingredients are added 200 ml boiling water and let them stand. The concoction is filtered and drunk while warm. It is taken twice a day.

Hemorrhoids
Coleus scutellariodes (l) benth.leaves 25 The ingredients are boiled with 400 ml of water until it becomes 200 ml. The concoction is cooled, filtered and drunk all at once. It is taken once time a day.

Increase urine volumes
Orthosiphon stamineus Benth-leaves 25 The dried ingredients are boiled with 400 ml of water until it becomes 200 ml. The concoction is divided into 2 parts and taken in the morning and evening.
Imperata cylindrica L. -rhizome 100 The ingredients are boiled with 600 ml of water until it becomes 200 ml. The concoction is cooled, filtered, and drunk. It is taken three times a day.
Urinary stone Imperata cylindrica L. -rhizome 10 The dried ingredients are boiled with 400 ml of water until it becomes 200 ml. The concoction is cooled and filtered; then it is drunk while warm. It is taken three times a day.

Diabetes mellitus
Cinnamomum burmanii (Ness & Th. Nees). -bark 2 The ingredients are added into 100 ml of boiling water and let them stand. The concoction is filtered and drunk while warm. It is taken twice a day.

Momordica charantia (L). -fresh vegetable 100
The ingredients are mashed and 100 ml of water is added. The concoction is squeezed and filtered. It can be drunk all at once. It is taken three times a day.
Tinospora crispa (L). -stem 7.5 The dried ingredients are boiled with 300 mL of water until it becomes 150 ml. The concoction is cooled, filtered, and drunk all at once. It is taken twice a day.   12 or saintification formulary as follows. (Table 5) There are 11 types of herbal ingredients that have been scientifically proven to treat various diseases.
Saintification formulary from B2P2TOOT gave the solution of several diseases among others the formula for arthritis, hemorrhoid, liver problem, reduce body weight, urinary stone, uric acid, reduce high blood pressure, gastritis, reduce blood cholesterol, reduce blood glucose, and physical fitness.
From the references were collected above, several formulations for indication of diseases was found as follow (Table 6): the formula for reduce blood fat or blood cholesterol, help to relieve diabetes mellitus, dissolve kidney stone or urinary stone, cough, helps to relieve hemorrhoids, relieve liver problem, maintain the health conditions of cancer patients, reduce high blood pressure, gout, nausea and vomiting, increased urine volumes, arthritis, reduce body weight, uric acid, gastritis, and physical fitness.
In the methods have already explained the point number 3 can be applied in this study by aligning with government healthcare programs, namely informing and educating the public about health, the factors that influence it, and how to improve it.
Traditional medicine is widely used for the following reasons: potential for treating disease, perceiving safety, affordability, and accessibility. However, the use of traditional medicine will be dangerous or cause many risks, if ingredients, processing of formulation, and drinking rules are not standardized. 14 For the realization of the point 3 above and to reduce the risk due to non-standard use, the first step the references from the government namely some of The Formulary of Traditional Indonesian Medicinal herbs were collected which then in the second step all the formulary books were investigated via indication of diseases, formulation, composition of herbs and water, quantity (g) for once processing, processing of formulation and drinking rule. The collected data showed that the Indonesian people are familiar with using plants for body health and using the concoction such as the length/sizes of the ingredients (stem or zhizome) that were compared with the part of hand (finger and other), the number of leaves blade and until using the units of grams. As well as parts of plants, fresh or dried, processing of formulation, and drinking rules were presented.
From each book of this formulary was carried out in the study again for each formula. The formula that was quoted namely the formula that has clarity of the ingredient's utilization, especially the weight of ingredients in units of grams. The results of this study showed that several formulas can be used and was introduce to the community as presented in Tables 1 to 6.
From the results listed in table 6, it appears that there are many formulations which were used to treat non-communicable diseases. One of the government regulations is Healthy Indonesia Program with a Family Approach (PIS-DPK), the main areas of this program are Maternal Health, Child Health, Communicable Disease Control, Noncommunicable Disease (NCD) Controll. 13 Therefore the formulas that have been collected can support the Healthy Indonesia Program with a Family Approach (PIS-DPK) at which one of the main areas of this program is NCD Control. 13 Indonesia had its own tradition of traditional medicine which involves the use of herbal medicines, such as jamu. 15 The use of traditional medicine by the Indonesian people is quite high, one of which is jamu.
Those who consumed herbal medicine, who was approximately 95.60% stated that they had experienced the benefits. 16 Studies on housewives in Cicanir and Jatipamor villages showed they drank jamu to prevent and treat diseases. The percentages were Cicanir 40.79% and Jatipamor 25.86%, 17 and on fishing communities in the village of Kanci Kulon reported they used jamu to maintain health and treat disease. The number of fishermen wives who drink jamu was 89%. 18 The figure of a fisherman's wife (mother), had many important roles, one of the roles was being positioned as the manager Gout Hemorrhoids High blood pressure -reduce + + 12 Liver problem + + 13 Nausea and vomiting + 14 Uric acid + 15 Urine volumes -increase + 16 Urinary stone / kidney stone + + + 17 Physical fitness + + Based on National and Provincial Basic Health Research Studies in 2018 as well as government efforts aimed at increasing disease prevention (preventive) and improving health promotion (promotive), as well as possible efforts to improve public health status including treatment of disease (curative) and health restoration (rehabilitative), the formulas of the results of this study were useful for encouraging health literacy in the village, as well as for empowering the community to build a community health system in the village and increase community participation in the implementation of the Healthy Indonesia Program with a Family Approach, which is a Government Health Program.

CONCLUSION
The formulas as the result of the study from some The Indonesian Traditional Medicinal Formulary can support the developing use and implementation of traditional medicines in the Government Health Program.

Directorate of Research and Community Engagement of Universitas
Padjadjaran.