RESEARCH ON GOVERNMENT PROGRAMS "HEALTHY LIVING COMMUNITY MOVEMENT" (GERMAS) IN BALI USING CRITICAL DISCOURSE ANALYSIS

On 12 November 2016, the Indonesian government launched a program to improve public health called Healthy Living Community Movement (GERMAS). GERMAS aims to raise awareness, willingness, and ability to live healthy for everyone to realize the highest degree of public health. Specifically, GERMAS's objectives are (1) increasing community participation for healthy living; (2) Increase community productivity; and (3) Reducing the burden of health care costs. According to the Governor of Bali, GERMAS activity is a step that must be implemented in an effort to provide understanding and socialization to the public about the importance of health so keep themselves healthy become living culture in society. In this research using Critical Discourse Analysis (CDA) proposed by Norman Fairclough. Norman Fairclough’s Critical Discourse Analysis using three approaches method of text analysis, discourse practice analysis, sociocultural practice analysis. The results show that government efforts to improve public health in Bali will be well received. The community considers the government's movement to adopt a healthy lifestyle in accordance with the religion of most Balinese people. In addition, considering the impact of non-infectious diseases (PTM) which is socio economically very detrimental to society will certainly get good reception for the community. The mass media design used is quite attractive and informative and it is expected that the public will get a clear picture of GERMAS.


Introduction
Health is an inseparable part of human life. Without good health, humans can not perform activities optimally and the productivity will decrease. The Government of Indonesia gives very high attention to health, considering that one of the nawacita programs of President Joko Widodo is to increase the community productivity so that the health improvement is required to implement. On 12 November 2016, the Indonesian government launched a program to improve public health called Healthy Living Community Movement (GERMAS). GERMAS aims to raise awareness, willingness, and ability to live healthy for everyone to realize the highest degree of public health. Specifically, GERMAS's objectives are (1) Increasing community participation for healthy living; (2) Increasing community productivity; and (3) Reducing the burden of health care costs. GERMAS has six main activities namely: 1) Increased physical activity.
2) Improving clean and healthy life behavior.
3) Provision of healthy food and accelerated nutrition improvement. 4) Increased prevention and early detection of disease. 5) Improving environmental quality. 6) Improved education of healthy living.
Increased physical activity performed by doing physical activity properly, correctly, regularly and measurably. Regular physical activity and become a habit will improve physical endurance and physical exercise can improve health and fitness. Improved clean and healthy life behavior as efforts to change community behavior to support improved health status. Based on the Regulation of the Minister of Health of the Republic of Indonesia Number: 2269 / MENKES / PER / XI / 2011 of 2011 concerning Guidance for the Development of Clean and Healthy Behavior, Clean and healthy life behavior (PHBS) definition is a set of behaviors practiced on the basis of consciousness as a result of learning, which makes a person, family, group or community capable of helping themselves (self-reliant) in the health field and play an active role in realizing public health. Clean and healthy life behavior covers several fields of implementation. In the field of disease prevention and environmental sanitation the behaviors that should be practiced are wash hands with soap, management of eligible drinking water and food, using clean water, using a healthy latrine, management of eligible liquid waste, eradicate the mosquito larva, not smoking indoors and others. In the field of maternal and child health and family planning the behaviors that should be practiced are asking for help on the delivery of health workers, weighing children every month, providing complete immunization to infants, becoming family planning acceptor and others. In the field of nutrition and pharmacy the behaviors that should be practiced are eat with balanced nutrition, drinking blood booster tablet during pregnancy, giving exclusive breast milk (ASI) to baby, consuming iodized salt and others. While in the field of health care behaviors that should be practiced are participate in health care insurance, actively take care of and or utilize Community Based Health Efforts (UKBM), utilize Puskesmas and other health service facilities etc. Provision of healthy food and accelerated nutritional improvement by consuming local vegetables and fruits. The purpose of this activity is to raise awareness of healthy living behavior through consuming fruits and vegetables for all levels of society. Improved prevention and early detection of disease by conducting periodic health examinations regularly to encouraging people to recognize risk of Non-communicable Diseases (PTM) such as stroke, heart disease, and diabetes behavior-related and make immediate In addition, Indonesia is having change in the diseases pattern often called epidemiological transitions marked by increased mortality and morbidity from Non-communicable Diseases (PTM) such as stroke, heart, diabetes etc. The impact of the increased incidence of PTM is the increase of health service cost that must be borne by society and government, decreasing the productivity of society, decreasing the competitiveness of the nation that ultimately affect the economic condition of the society itself.
Bali as one of tourism destination has opened GERMAS activity on 23 April 2017 by Bali Governor formally in Tabanan Regency precisely located in Alit Saputra square. The governor of Bali also invites all components of the Balinese community to continue together with local governments echoing, campaigning, and implementing the healthy lifestyle. According to the Governor of Bali, GERMAS activity is a step that must be implemented in an effort to provide understanding and socialization to the public about the importance of health so keep themselves healthy become living culture in society. The Governor of Bali said that optimal socialization and hard work of all health personnel would be able to realize the healthy and quality Bali society.

Methodology
The methodology used in this research is qualitative by using Norman Fairclough Critical Discourse Analysis (CDA). The sample used in this research is an online news media that stood in Bali. The Norman Fairclough method uses three analyzes of text, discourse practice analysis, and sociocultural practice analysis.

Literature Review
The word discourse derived from the Latin discursus, which means run around here and there (derived from "dis" which mean from, in different directions and "currere" which means run) (Sobur, 2009:9). Ismail Marahimin interpreted the discourse as "the ability to forward (In discussion) in orderly and properly order", and "communication of thought, whether oral or written, officially and regularly". According to Henry Guntur Tarigan "The term of discourse is used to encompass not only in conversation, but also public speaking, writing, and formal efforts such as scientific reports and plays. Samsuri said that discourse is the language complete record about communication events, usually consists of a set of sentences that have the understanding relationship with one another. The communication can use spoken language and use written language (Sobur, 2009:10). So that discourse can interpreted as a communication event because of thought spoken and written formally or informally.
Discourse analysis looked at the language in three views, they are (1) Positivism-empirical view; (2) Constructivism view; (3) Critical view (Eriyanto, 2001:4-6). The positivism-empirical view holds that someone does not need to know the subjective meanings or values that underlie their statements, because what matters is whether the statement correctly expressed according to its syntax and semantics. Constructivism view, language no longer seen as a tool for objective reality understanding and separated from the subject as statements transmitter. Constructivism considers subjects to be central factors in discourse activities and their social relationships. The critical view corrects less sensitive constructivism view of the meaning production and reproduction process that occurs both historically and institutionally. The critical view does not focus the discourse on the right / wrong grammatical structure or interpretation process, as in the constructivism analysis but emphasizes the forces constellation occurring in the production and reproduction process. One of the figures of this critical view is Norman Fairclough.
Norman Fairclough conducts critical discourse analysis based on the big question, how to connect micro text with macro community context so that in its analysis using three approaches that is text, discourse practice, sociocultural practice (Eriyanto, 2001:286). Text is analyzed linguistically, by looking at vocabulary, semantics, and sentence order. Discourse practice is a dimension associated with the production process and text consumption. A news text has different production process. So that the resulting news text also has differences between one media with other media. This is due to differences in work patterns and habits between one media with other media. The texts consumption may differ depending on the social context of society. The texts consumption can be produced both personally and collectively. While in the text distribution, depending on the pattern and type of text and how the nature of the institution inherent in the text. Sociocultural practice is a dimension that relates to contexts outside the text. The context here can be the situation context, the broader is the institutional practice context of the media itself in relation to particular society or culture and politics.

Text Analysis
The word "movement" in the Big Indonesian Dictionary means actions or movable circumstances, movements or activities. Therefore, Healthy Living Community Movement when interpreted semantically is an undertaken activity to create a healthy living community. When viewed on the website of the health department of the Republic of Indonesia said that Healthy Living Community Movement (GERMAS) is a systematic and planned action carried out jointly by all components of the nation with awareness, willingness and ability to behave healthy to improve the quality of life (MOH RI, 2016). Based on appeared news texts provide an overview of GERMAS and anyone who does Healthy Living Community Movement (GERMAS). In the news text also provides information that GERMAS is a systematic and planned action. Systematic meaning that GERMAS implemented with a certain system and a regular way. In general, the news text states that the need for GERMAS implemented by all components of society is the occurrence of changing community life patterns that have an impact on the shift pattern of disease. Changed Lifestyles due to changing times become the main cause of disease patterns from non-communicable diseases (PTM) shifted such as stroke, coronary heart disease, cancer, and diabetes. Increasing people with PTM disease leads to a decrease in community productivity that allows low contribution to development. A very clear news text description on the occurring problems due to current lack of attention to health is expected to have an impact in changing the public mindset to take more serious in health care.
The increasing statements of patients with PTM disease also supported by the Bali Provincial Health Office that states that Indonesia is currently undergoing the change in the diseases pattern often called epidemiological transitions marked by increased mortality and morbidity from noncommunicable diseases such as stroke, heart disease, diabetes, etc. The impact of the increased incidence of PTM is the increase of health service cost that must be borne by society and government, decreasing of society productivity, decreasing of state competitiveness that ultimately affect socioeconomic condition of society itself (Bali Provincial Health Office, Bali Province, 2017). Supporting statements about the rising health services cost also provided by the Governor of Bali at the official opening ceremony of Healthy Living Community Movement (GERMAS) activity in Alit Saputra Tabanan square which said that public health awareness from the beginning is needed considering the current quite expensive health cost (Balipuspanews, 2017). The governor of Bali said this is based on the experience that has happened to him so he invites people to start doing a healthy lifestyle. He also asserted. Therefore, he asserted Germas activities are steps that must be implemented in an effort to provide understanding and socialization to the public about the importance of health so that maintaining healthy self-life into the culture of society. HL Bloem (In the Ministry of Health of the Republic of Indonesia, 2016:6) indicated that the public health degree is affected by 4 factors of: behavior, environment, health care and heredity. Behavioral and environmental factors hold the role more than 75% of the public health degree condition. In the text above said that behavioral and environmental factors give a very big influence on the public health degree so that on these two factors a certain effort need to be made in improving public health degree. The Minister of Health stated that GERMAS implemented as a community promotive and preventive effort. The objectives of GERMAS are: 1) to reduce the burden of infectious diseases and non-communicable diseases, both death and disability; (2) Avoidance of declining population productivity; (3) Reducing the burden of healthcare financing due to increased illness and health expenditure (Simanjuntak, 2016).

Discourse Practices Analysis
President Joko Widodo in running his government set the program NAWACITA where GERMAS is one of the government programs run by the president Joko Widodo. GERMASsupported government programs are improving the quality of Indonesian human life and increasing people's productivity and competitiveness in international markets. As stated in the guidebook of general and specific objectives of GERMAS activities. The general objective of GERMAS is to raise awareness, willingness, and ability of the community to behave healthily in an effort to improve the quality of life. While the specific purpose of GERMAS are 1) Increase community participation for healthy living; 2) Increase community productivity; 3) Reduce the health costs burden. Socialization of this government program using media of posters, banners,   Based on the understanding of public service advertisements where the social messages displayed have the purpose to generate public awareness of the problems faced then the poster design has given the picture of benefits and importance of doing a healthy lifestyle. Health problems are an important issue today and have an impact on the decline in community productivity. Psychologically, the message addressed to the public by providing texts that are common activities carried out daily. Such as physical activity that is important to be implemented considering the many people do not have physical activity so cause health problems. The same thing also seen on the poster of fruit and vegetable consumption every day. The rapid progress today makes people choose fast food. These foods have a negative impact on public health such as Non-communicable Diseases (PTM). Consumption of foods that are low in nutrition and lack of fiber impact on the high risk of non-communicable diseases such as coronary heart disease, diabetes and so on. Giving an understanding of the effects of unhealthy foods are well illustrated in the poster design.
In mass communication, the agenda setting on the mass media is needs to implement. The agenda setting works by highlighting issues that considered less important to be important once they are publicized and accepted by public. Health issues that are important to the public shall put into consideration in designing the mass media. Based on data provided by Evidence & Analytics in National Seminar on Non-Communicable and Life Style Disease events in Jakarta that Indonesia ranks second in ASEAN for death rates from non-communicable diseases (PTM). There are 828 patients with PTM in every 100 thousand population in Indonesia (Nainggolan, 2016). Factors that cause PTM to grow in society are the unhealthy lifestyle such as high cholesterol consumption and lack of fiber and beverages including smoking, consuming alcohol, drugs, stimulants, or sedatives, lack of exercise, the type of work that many sit, competitive behavior causes stress and raises blood pressure. Unhealthy environmental factors and polluted air are also the cause of the increasing number of deaths from non-communicable diseases (PTM) (Oktora, 2011). Based on the above information then the use of agenda setting executed by the message maker is very appropriate. Issues as the key to the society problem have been broadcasted extensively by the message maker and expected to have an impact on large society.

Sociocultural Practices Analysis
The island of Bali, one of the parts of Indonesia, has a predominantly Hindu community. All exist aspects of life in the Balinese community is always associated with religion and culture as well as healthy lifestyle. Talk about food, In the book of Bhagavad Gita: sloka 17.7 -17.10 says that eat allowed food is that has the virtue to prolong life, purify life and give strength, health, happiness and satisfaction, has a full content of essence, fatty, nutritious and fun. While prohibited foods are foods that are too bitter, too sour, and very hot or cause the body to become very hot, too spicy, too dry and contains a lot of harsh spices favored by people with the lust. These foods cause grief, misery and disease (Gobyah, 2009). The teaching of regulating the manner and type of food consumed called as Aharalagawa. Aharalaghawa means eating rightly, according to the needs of the body. Aharalaghawa's teachings divide the food into three groups: Satwika food, Rajasika food and Tamasika food. Satwika food is a food that causes self-awareness, affection, peace, and happiness. This food group includes fruits, vegetables, beans, whole grains, milk and dairy products, and seasoning to taste. Rajasika food is a food that gives stimulation to the body and soul and should not be eaten in excess to maintain mental balance. The excess of this food will disrupt the mind becomes uneasy, panicked, and can not relax. Rajasika's food group are: Coffee, tea, softdrink, spicy spices, fermented foods and medicines. Tamasika food is a food that causes feeling lazy, sleepy, restless, and not initiative. Included in this category are meat, fish, eggs, mushrooms, alcohol, cigarettes, and stale food. In certain situations, these foods can be consumed more depending on the climate condition and the physical activity. For example, when in a place with very cold climate, where meat and a little liquor needed to increase body temperature (Yasa, 2013).
The context of clean and healthy lifestyle according to Hinduism includes two aspects, skala aspect and niskala aspect. The skala aspect is something that clear and can be implemented directly through the thinking result (cognitive) which produces emotion and behavior, then can be felt through sensing. The niskala aspect contains belief in religious teachings that affect inner tranquility through the vibrations of purity, the results can not be felt through sensations. Both are inseparable and therefore need to be considered together. Clean and healthy lifestyle based on skala and niskala aspect mentioned in Sloka Silakrama (Suhardi, 2013): Adbhir gatrani sudyanthi, manah styena sudyanthi, widyattapobhyam bhrtatma, budhir jnanena sudyati

Meaning:
The body is cleansed with water, the mind is cleansed with honesty, the soul (atman) is cleansed with knowledge, and reason (mind) is cleansed by wisdom.
The above understanding implies that skala health is achieved by cleansing the body with water. The body here not only means the body, but all parts of the human body like bathing, washing hands and feet. All conducted in order to obtain a clean and healthy body. While the soul is cleaned with honesty, science, and wisdom. So here can be concluded that the pattern of clean and healthy life according to the teachings of the Hindu religion not only has a clean and healthy body but must be balanced with a healthy soul as well. A balance between body and soul health will bring people to true happiness to achieve peace. In addition, the body also needs to be treated with a balance of motion and energy circulation (prana) to the whole body, such as sports, or in Hinduism by doing Yoga Asana and Pranayama regularly and periodically.

Discussion
Based on the text analysis described above, the Healthy Living Community Movement (GERMAS) as an initiative implemented by the government in overcoming the health problems faced by modern society today. According to the Minister of Health of the Republic of Indonesia that GERMAS is a promotive and preventive effort to public health problems. The general objective of GERMAS is to increase awareness, willingness, and ability to live healthy for everyone to realize the highest level of public health. When looking at the texts raised through online media, it appears that the dominant group (orthodoxa) in this case the government made efforts to invite the group of marginalized (heterodoxa) to jointly overcome the current social problems of health. The attempt to invite the heterodoxa group by the orthodoxa group is to change the unfavorable habitus that has been carried out so far. Habitus changes that occur inside ke according to Burhan Bungin (2011:91) caused by the rapid development of technology, resulting in mindset change, behavior change, material culture changes. An example of a change of mindset is a change in the social value of food served by a restaurant. The community considers that eating at fast food restaurants has a higher social value than eating at home. Whereas in terms of health, fast food provides many health problems compared with eating at home. That high social value make behavioral changes in the community. The community prefers fast food because it is considered more delicious than the food at home. The likes to eat fast food make changes in material culture such as changes in behavior when people are more likely to choose a western-style dining culture which is not necessarily appropriate to our culture. Changes in community habitus (heterodoxa group), currently causing non-communicable diseases (PTM) which increasing lately. In the news text from Bali Provincial Health Office explained about the impact of non-communicable diseases incidence increase are an increase in health service cost, decreased public productivity, declining competitiveness of the country that can ultimately affect the socio-economic conditions of society. Supporting statements from the Provincial Health Office of Bali also given by the Governor of Bali as a regional leader by providing an overview based on personal experience. Positive invitations given by the highly persuasive orthodoxa group are expected to have an effect on the heterodoxa group to change unhealthy habitus become health.
Based on Discourse Practices Analysis above, orthodoxa group thought to move the heterodoxa group through mass media seem very positive. It is possible to considering the role of the mass media as a pioneer institution of change very effectively by incorporating positive messages into a media. As Burhan Bungin says (2011:85) that the mass media acts as an institution of community enlightenment, information media and as entertainment media. When viewed from the message presented by the mass media owned by the government, seen the role of mass media has touched the problems that occur in the actual society, as an educational media that provides an overview of the benefits and the importance of implementing GERMAS. The description above has given an overview of social changes that occur in the community, where the GERMAS mass media included an easy explanation through the visual language. The mass media designs created are also quite attractive. The use of colors, text, and illustrations is quite interesting and very easily understood by the public. The text made is also simple and have solid information. The selection of mass media used is also effective. The problem is only the location to put the mass media, so that people know GERMAS and willing to do according to the media submitted message.
Based on sociocultural practices analysis, it is generally stated that Balinese people have known health for quite a long time. All of that is learned from the religions and cultures of people who are mostly Hindus. Based on the teachings of Hinduism, the guidance on healthy lifestyle has been given clearly through the holy books and slokas. This shows that the importance of health for humans has long been known and implemented by the community.

Conclusion
Based on the above explanation it can be concluded that in general the various government's movements or efforts to improve public health in Bali will be received very well. The community considers the government's movement to adopt the healthy lifestyle is in accordance with the religion of most Balinese people. In addition, considering the impact of Noncommunicable Diseases (PTM) that is very detrimental to socio-economic society, would certainly get a good reception from the public. The mass media design used to provide information about GERMAS is quite attractive and informative and it hoped that public would get the clear picture of GERMAS. The use of colors, text, and illustrations is quite interesting and easy to understand. The problem is only the location to put the mass media, so that public know GERMAS and willing to do according to the media submitted message.