e-Journal Badan Penelitian dan Pengembangan Kesehatan / National Institute of Health Research and Development
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Synergy of Midwives and Paraji: Finding the Plurality Side in the Maternal and Child Health Care System
No full textBackground: The government issued a Delivery social insurance program (Jampersal) to reduce the Maternal and Infant Mortality Rate (MMR and IMR). Choice of aid delivery is a midwife or paraji (TBAs) in District Cirinten, Lebak, Banten. This paper reviews the diversity in the system of Maternal and Child Health Service. Methods: descriptive study, conducted in 2012 in the village Cirinten. Conducted in-depth interviews to the midwife and paraji as well as observations of the activities of service delivery by both. Results: Coverage deliveries by health workers in Cirinten health centers was 50.4% in 2011. The concept of ‘traditional’, ‘local’ and ‘modern’ is used to describe the differences between plural MCH system in a community. Three factors related to health seeking behavior that is healing factors, psychological, and sociological. Cirinten community has a continuous historical experience in a belief system that affects the choice of TBAs (paraji). Cultural contact with the medical system affect the view of society through the traditional health care system. Conclusion: Paraji as TBAs in the remote area has a role to be a mediator between the traditional and modern MCH systems. Recomendation: Utilizing paraji to advocate the health care/MCH system to public who still believe in traditional health system through establish communications between them
Aedes Larval Habitats and Entomological Indices in 11 Regencies/Cities of South Sumatera Province
No full textDengue fever and dengue haemorrhagic fever still becomes public health problems in South Sumatera Province with all of its regencies/cities have infested with Aedes aegypti. This research aimed to determine Aedes entomological indices and its breeding habitats. The research located at 11 regencies/cities, where in every regencies/cities determined two clusters (village) based on incidence rate in the last three years. Survey of preadult mosquito was carried out inside and outside areas of 1181 houses using single larva method with modification. The survey found that the dengue vector indices for house index, breteau index, and container index were at range 22,6% - 60,6%, 26,4 – 154,1 and 8,0% - 36,2% respectively. The most dominant water holding containers found infested with pre-adults mosquito were cement tanks (33,4%), followed by buckets (18,2%) and drums (14,7%). Inside houses, larva or pupae found dominants in cement tanks (44,3%), buckets (19,5%) and drums (13,9%), while outside of the house were used containers (20,7%), followed by drums (16,7%), buckets (15,0%) and used tires (11,9%). Statistical analysis by chi-square test showed a significant relationship between infested of Aedes pre-adults with characteristic of containers (colours, volume, location found and containers). Larval survey by visiting houses should carry out routinely and integrated into dengue vector control program.Dengue fever and dengue haemorrhagic fever still becomes public health problems in Indonesia especially in South Sumatera Province with all of its regencies have infested with Aedes aegypti mosquito and dengue virus. This research aims to determine density larvae and its breeding habitats. The research located at 11 regencies/cities, where in every regencies/cities determined two clusters (village) based on incidence rate in the last three years. Larval survey was done inside and outside areas of 1181 houses using Ministry of Health standard techniques. Larvae or pupa collected were reared into adults at Entomology Laboratory Loka Litbang P2B2 Baturaja for species identification. The survey found that the dengue vector indices for house index, breteau index, and container index were at range 22,6% - 60,6%, 26,4 – 154,1 and 8,0% - 36,2% respectively. The most dominant water holding containers found infested with larvae or pupae were cement tanks (33,4%), followed by buckets (18,2%) and drums (14,7%). Inside houses, larva found dominants in cement tanks (44,3%), buckets (19,5%) and drums (13,9%), while outside of the house were used containers (20,7%), followed by drums (16,7%), buckets (15,0%) and used tires (11,9%). Statistical analysis by chi-square test showed a significant relationship between infested of larvae/pupae with characteristic of containers (colours, volume, location found and containers). Larval survey by health officer or cadre (community empowerment) should carried out frequently and integrated into dengue vector control program
Legal Analysis of the Implementation of National Health Insurance in Nganjuk
No full textBackground: According to Article 22 of Law No. 32 of 2004 and the decision of the Court granting judicial review on Law No. 40 of 2004, local governments also have the authority and obligation to organize a social security system for its people, including health insurance. One of the problems faced by the local governments is in synchronizing the implementation of the local health insurance system (Jamkesda) with the National Health Insurance System (JKN). This study aimed at analyzing the synchronization of implementation of the health insurance system at central and regional levels. Methods: This study was using qualitative data analysis. The data were retrieved from literary data and the results of in-depth interviews with the parties that are considered to have in-depth knowledge related to the research topic. Results: Local Government of Nganjuk has developed social security system in health sector through the free of retribution policy in health services through the Regional Health Insurance System (SJKD). This health insurance system is operated by the District Health Insurance Agency (BPJKD) under the East Java Provincial Government. Since the implementation of JKN, Nganjuk Local Government has already begun to integrate this policy with JKN, but constrained by the scope of membership and dues obligations for the region. Conclusion: Nganjuk Government has conducted social service functions through a freeretribution in health services policy with some restrictions and along with East Java Provincial Government held SJKD. Synchronization of health insurance in Nganjuk could be begun with the process of integration of free retribution health services policy to SJKD and continue the health policy to cost sharing with the East Java Provincial Government to facilitate the process of integration to JKN. Recommendation: Nganjuk district in efforts to achieve universal health coverage is necessary to re-collecting and validating the data of jamkesmas participants, impoverished letter and the participants who can afford to pay the dues
PERKIRAAN DOSIS RADIASI YANG DITERIMA PUBLIK DI PROVINSI KEPULAUAN BANGKA BELITUNG
No full textBangka and Belitung Islands is known to have the geological potential of mineral resources, especially tin along with its accessory minerals which are distributed in almost all land and sea regions. Besides tin, tin mining activities in Bangka Belitung produces a by-product containing radioactive substances which have a risk as one of factor that can affect on the health of publics members. A major contribution of the radiation dose to the publics health comes from natural radionuclides of 226Ra, 232Th and 40K in accessory minerals of tin core. The aim of this study was to estimate the total annual radiation dose received by the cmembers of the public in Bangka-Belitung through external and internal exposure. Estimation of external dose was based on the concentration of 226Ra, 232Th and 40K in the soil and gamma exposure rate direct measurement in public houses. While the internal dose was estimated based on intake of 226Ra, 232Th and 40K by ingestion of foodstuffs that were consummed by public of Bangka - Belitung (vegetables, seeds, tubers, fruits, fishes and drinking water). Internal dose also estimated from the inhalation of radon (222Rn) and thoron (220Rn) inside the house. The annual effective external doses of outdoor and indoor ranged between 0,05 to 11,55 mSv (mean=1,17 mSv) and 0,15 to 2,10 mSv (mean=0,69 mSv) per year respectively. The annual effective internal doses by ingestion of foodstuffs and drinking water and inhalation of radon and thoron gases were 0.20 mSv, 0,76 mSv and 2,32 respectively. So that the total annual effective doses received by the member of the public in Bangka-Belitung through external and internal exposure was 5.14 mSv. In conclusion, the members of the public in Bangka – Belitung islands received higher dose of radiation than the worldwide average value for normal areas
PREVALENSI DIABETES MELITUS PADA TUBERKULOSIS DAN MASALAH TERAPI
No full textThe incidence and prevalence of diabetes mellitus (DM) is rapidly increasing across the world. DM has been known as one of the risk factors for tuberculosis (TB). DM was seen to have a negative effect on the outcome of TB treatment. This paper is a literature review based on articles about DM and TB taken from PubMed, Google, and Mendeley published ten years behind. Screening for DM in persons with TB demonstrated that DM prevalence in TB population is high. DM prevalence in TB was about 5,4 % – 44,0 %. Diabetes mellitus is a risk factor to develop active tuberculosis (OR: 1,5 – 8,9). DM impairs the immunity of the patients and therefore DM is an independent risk factor for infections such as TB. Lack control of diabetes predisposes the patient to tuberculosis. People with diabetes are more likely to fail TB treatment compared to those without diabetes. Effective management of both diseases require the same elements including early detection, providing guided standard treatment, and proper drug intak
MODEL PREDIKSI DEMAM BERDARAH DENGUE DENGAN KONDISI IKLIM DI KOTA YOGYAKARTA
No full textDengue Hemorrhagic Fever (DHF) is a disease that is an issue anualy in Indonesia. Climate is the important role to increase cases of dengue virus transmission in the environment. One of the districts with the highest dengue cases is Kota Yogyakarta. The source data of this study is used secondary data of DBD incidents derived from Health Office in Yogyakarta City and climate data from Meteorology, Climatology and Geophysics Agency (BMKG). The data were taken within eight years period starting from 2004 to 2011. The aim of study was to obtain the predictions model DBD that associated with the climatic conditions in the city of Yogyakarta. Descriptive and analytical study using Minitab 16 statistical and Excel to analyze the data. The analysis showed that the model predicted of dengue incidence in the city of Yogyakarta using three variations of climate predictor of rainfall, the rain and the temperature at the time lag 1 with correlation values 57% - 70%, while at the time of lag 2 with a correlation value among 45% - 59%. It can be concluded that the result equation can be used as a predictive model of dengue cases for the next one month. Further research is needed to generate the acurate predictive models
ASESMEN PROGRAM INTERNSIP DOKTER INDONESIA DI SUMATERA BARAT TAHUN 2011
No full textABSTRACTInternsip is an apprenticeship process which needed by medical students that have had medical license toheld their ownself medical services. The first role of Program Internsip Dokter Indonesia had been heldsince February 2010. After a year program, Ministry of Health need to do an assessment for this program.This assessment held on February - March 2011 in four districts of West Sumatera Province (Pariaman,Pesisir Selatan, Lima Puluh Kota and Solok Selatan) that picked randomly. Also based onrepresentativeness of Class C class D public hospital, inpatient health center (puskesmas DTP), andoutpatient health center (puskesmas non-DTP). The results of this assessment: 1. This program had donewell in West Sumatera; 2. The aims of internsip had been achieved; 3. All interns had reached the target of400 medical cases along the program; 4. There was still some interns who couldn't reach the caseproportion target; 5. There was still some misperception about interns' status, some people still think thatthey are not a doctor yet.Keywords : internship, assessment, west sumatera, internsip dokter indonesia ABSTRAKInternsip adalah proses pemagangan yang diperlukan agar seorang mahasiswa kedokteran yang telahmemiliki ijasah dokter dapat berpraktik mandiri. Program Internsip Dokter Indonesia angkatan pertamatelah dilaksanakan di Sumatera Barat pada Bulan Pebruari 2010. Setelah 1 tahun pelaksanaan kegiataninternsip, Kementerian Kesehatan memandang perlu untuk melakukan suatu penilaian terhadap pencapaiankegiatan internsip. Asesmen dilakukan antara Bulan Februari — Maret 2011, dengan lokasi di 4 kabupatendi Sumatera Barat, yakni Pariaman, Pesisir Selatan, Lima Puluh Kota, dan Solok Selatan. Pemilihankabupaten/kota lokasi asesmen dilakukan secara random (acak) dengan mempertimbangkan keterwakilanRS Kelas C, RS Kelas D, Puskesmas rawat inap dan non rawat inap. Hasil asesmen menunjukkan bahwa:1. Pelaksanaan Program Internsip Dokter Indonesia telah berjalan dengan cukup baik di Sumatera Barat; 2.Secara umum peserta internsip telah mencapai target minimal yang ditentukan selama menjalaniinternsip; 3. Seluruh peserta telah mencapai target 400 kasus yang harus ditangani: 4. Masih ada pesertayang tidak meraih target kasus yang telah ditentukan; 5. Masih terdapat salah persepsi tentang statuspeserta internsip yang dianggap belum menjadi dokter.Kata kunci : internsip, asesmen, Sumatera Barat, internsip dokter Indonesi
KESENJANGAN ANTARA KEBUTUHAN DAN KEMAMPUAN UNTUK MENDAPATKAN PERAWATAN GIGI, RISKESDAS 2007
No full textAbstract.Analysis of gap between need and demand for dental treatment was conducted using indicatorsof Research Basic Health(RBH) 2007 e.g. need for dental treatment, perceived dental illness prevalence, utilization of dental professional services, and the ability to access dental treatment. The result of theanalysis shows that only 9% of Indonesian population who have dental problems seek for dental profesional services. This gap occurs in all age groups. Although the demand appears to increase on the higher age groups, the demand was still low (less than 13.8%). ComparingDMF-T index from NationalHousehold Health Survey(NHHS) 1995 toNHHS 2001, the promotion program showspossitive effect.However, comparingNHHS 2001 toRBH 2007 the effect is not shown. The trend ofDMF-T index on ageof 12, 15, and 18, fromNHHS 1995,NHHS 2001, andRBH 2007 showed no significant different, no difference on intercept incidence. This means that there were no protective effect.RBH 2007 showed thatthe motivation of population to restore their dental caries is very low, only 1.5 percent. A total of 75 percent of population suffers late treatment to the professional dental services so that the teeth must beextracted. NHHS 1995, NHHS 2001 and RBH 2007 showed the effects on non-functioning of earlydetection and promt treatment (Performance Treatment Index), small treatment (Required Treatment Index)and high late treatment (Missing Index)
HUBUNGAN FAKTOR SOSIAL DEMOGRAFI TERHADAP KEJADIAN TUBERKULOSIS MENURUT STRATIFIKASI JENIS KELAMIN DI JAWA TENGAH
No full textTuberculosis is closely linked to socio-demographic characteristics such as education, employment and age groups. Analysis of subset data of Riskesdas 2007 (Central Java Province) was carried out to determine the relationship between socio-demographic characteristics and pulmonary tuberculosis (TB). There were 62,827 respondents who had been classified as suspects of TB based on their perceived symptoms. A logistic regression was performed to obtain the risk factor of tuberculosis prevalence and stratified by sex group. The independent variables include age groups, level of education, employment status and residency (urban- rural). The results showed that the risk factors of TB prevalence were level of education and employment status. The risk of TB was higher among female group who did not complete primary schools (OR: 3.02%). Moreover, female group who workd was more likely to suffer from TB compared to who did not (OR: 3.03%). This paper also discusses the findings of Riskesdas 2010 and 2013 as descriptive comparisons