e-Journal Badan Penelitian dan Pengembangan Kesehatan / National Institute of Health Research and Development
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ADEQUACY OF STRATEGIC HEALTH HEALTH CENTER IN INDONESIA (Analysis of Implementation Permenkes 75 /2014)
No full textBackground: Subjected to five of the National Medium Term Development Plan (RPJMN), the requirement for health personnel, drugs and vaccines In order to meet the needs of health workers, the health minister of Health issued Decree number 75 of 2014. The purpose of this paper is to determine the adequacy of health workers in health centers located in Indonesia. Methods: Data source of PPSDM and Media Centre of the Ministry of Health. Data up to the end of December 2013. The determination of the adequacy of strategic health workers referring health centers Permenkes No. 75 in 2014. At least four types of health personnel that must exist in health centers, namely doctors, dentists, nurses and midwives. Criteria for assessment of the adequacy of four types of health workers in health centers, namely: less, Pretty and Overload. Results: The condition of the health center there is a shortage of general practitioners in five provinces, namely West Papua (77.3%), Papua (55.9%), Southeast Sulawesi (47.5%), East Nusa Tenggara (46.7%) and Nusa Tenggara Barat (41.4%). PHC is a shortage of midwives in the province among others in DKI Jakarta (86.2%), West Papua (71.6%), Papua (70.8%), Maluku (58.6%) and East Kalimantan (51,4%). Conclusion:The placement of strategic health workers have not referring Permenkes number 75 in 2014. Recommendation: socialization Permenkes number 75 of 2014 must be implemented immediately, in order to plan the placement of health personnel refers to the Permenke
PELAKSANAAN PROGRAM JAMINAN KESEHATAN MASYARAKAT DI KALIMANTAN SELATAN (Public Health Insurance Program Implementation in South Kalimantan)
No full textBackground: The phenomenon of increase in poverty in South Kalimantan becomes a concern in an effort to reduce morbidity in poor communities. Efforts to reduce morbidity in poor communities to ensure the health needs of the poor/Underprivileged then held a health insurance program. A health insurance program is expected to lower the maternal mortality rate, infant and under five mortality rate as well as the birth rate besides the underserved of health for the poor in general. This study aims to analyze the implementation of health insurance program that can provide information and consideration in making policy in an effort to improve health care for the poor/underprivileged in South Kalimantan. Methods: This study presented a qualitative approach with descriptive exploratory that focuses the location in 5 cities in the province of South Kalimantan. The cities were chosen by geographical area category, HDI and poverty. The study was carried out in 6 months. The study instrument was questionnaire, in-depth interviews were conducted to the various informants who are competent. The field data were taken by direct observation as well as document review. Result: The results showed that the health insurance program in South Kalimantan is not optimimum in its implementation so that still needs to be evaluated. So that it could ensure the fulfillness of health needs of the poor and reduce the morbidity and mortality in poor communities. Conclusion: The implementation of health insurance program in South Kalimantan has been following the guidelines. However, it is still not optimum in case of the membership, quality of services, facilities and infrastructure, even the reporting system and organizing the health insurance program. Recommendation: Required human resources better in the implementation of such program conducted training for program managers as well as the need for SK to Tim so clear in their duties. Need more actively monitoring program for the implementation of the program can be run in line with expectations
Risiko Penggunaan ACEi Terhadap Kejadian Batuk Kering pada Pasien Hipertensi di RSUD Cengkareng dan RSUD Tarakan DKI Jakarta
No full textThe use of angiotensin converting enzyme inhibitors (ACEi) as an antihypertensive agent can cause side effects such as dry cough. The aim of this study is to evaluate risk of ACEi administration on dry cough incidence with captopril as the standard against lisinopril and ramipril in hypertensive patients at RSUD Cengkareng and RSUD Tarakan Jakarta. The design of this study is prospective cohort. The inclusion criteria were patients who received ACEi as hypertension therapy for ≤ 3 months gathered from outpatient and willing to participate as sample in this study at RSUD Cengkareng and RSUD Tarakan. Subject of this study consist of 54 patients who received captopril and 54 patients received non captopril ACEi, taken by consecutive sampling from January-July 2014. Data was collected using structured interviews and medical record. Dry cough incidence due to ACEi was evaluated using Naranjo Algorithm and analyzed using Chi Square test. Dry cough incidence was found in 19,44% of sample. No significant relationship of age, gender, ethnic, comorbidity, body mass index (BMI), dosage, and duration of use with the dry cough incidence due to the use of ACEi. There is no difference on dry cough incidence between the use of captopril, lisinopril and ramipril
Tingkat Aktivitas Sel Endokrin Penghasil Folikel Stimulating Hormon (FSH) Terkait Pemberian Pasak Bumi (Eurycoma longifolia JACK)
No full textPasak bumi is popular as an aphrodisiac. Traditionally, pasak bumi infusion is used to increase libido and duration of erection. The research was focused on: Activity level of FSH cells after three days of pasak bumi treatment. The research was carried out by evaluation using immunohistochemistry method via antibody anti FSH staining. The result of the research showed that a dosage of 18 mg/200 g body weight (bw) orally of pasak bumi maintained certain endoceine positive cells e.g. FSH production cells and were found stabile in the third days. Pasak bumi serves a stabilizer for intracellular levels of FSH in the anterior hipophysis/pituatary
Kajian Potensi Penggunaan Bioreaktor terhadap Senyawa Ajmalisin Suatu Contoh Produksi Metabolit Sekunder Tanaman Obat
No full textThe limited availability of medicinal plants as well as their limitations in cultivation as a source of medicinal compounds can lead to excessive harvesting, habitat destruction and destructive exploration. This led to the extinction of rare plants and caused the condition of natural resources worse. The purpose of this study is to elucidate the potential of bioreactor in terms of its ability to increase the active compounds of plant obtained from C. roseus, ajmalicine. The data was obtained from various references. The main references discuss about ajmalicine and bioreactor.In general, the concentration of compounds produced by cell suspension is higher than its original concentration in the plants. In study cases of ajmalicine, the compounds were produced as much as seven times more than these compounds in native plants. Other studies show that the use of different plant organs, the addition of elicitor, the weight ofinitial cells as well as aeration rate can affect the concentration of ajmalicine obtained from medium in the bioreactor. Tissue cultured plants in bioreactor can produce se- condary metabolites in a short time with high yields. However, previous optima- zation should be carried out in terms of adding elicitor, aeration rate and pH condition of the bioreactor
Tobacco Consumption by Health Insurance Participants: BPJS Risk? [Riskesdas 2013 Data Sources]
No full textBackground:Tobacco consumption can lead to the diseases that can cause death. Calculation of the experts in the Global Burden of diseases – Generating Evidence, Guiding Policy (IHME and the University of Washington), smoking is a second highest risk factor after high blood pressure (12% mortality) that results in loss of 8 years of age healthy living (8 DALY) for each individual. Tobacco atlas in 2007 referencing that Indonesia is the fourth largest tobacco-consuming country in the world after China, Russia and the United States. Indonesia has made the implementation of the National Social Security health policy in force since January 2014, an insurance that doesn’t see the participants’ risk factors because having the principle of mandatory participation. This paper would like to analyze the pattern of tobacco consumption on the health insurance participants, askes, jamsostek and jamkesmas based on Riskesdas, 2013, as a risk factor on the incidence of disease that will be borne by BPJS. Method: Bivariate analysis on Riskesdas 2013 data.Result: Jamsostek has the highest proportion of participants who consume tobacco every day as many as 26.2% of them followed by Jamkesmas (25.9%) and Askes participants (16.3%). Askes participants consume 13.6 cigarette per day, Jamsostek participants consume 12.1 stems per day and participants Jamkesmas 11.9 stems per day. Thus, if the average price of 1 stem of cigaretteis Rp 750, then the participants of Jamkesmas, Jamsostek and Askes in a month to pay as much as Rp.267.255, Rp. 273 781, and Rp. 307 412, - for cigarettes. Costs incurred by Jamkesmas participants for tobacco consumption in a month is almost 14 times the value of dues paid by the government. Rupiahs that burned into smoke and create risk factor of self and others death in Indonesia in a month in 2013 of 5.4 Trillion Rupiah in which three-quarters of amount came from Jamkesmas participants. Conclusion:The cost of tobacco consumption among smokers per day can pay the class 1 dues to 4 people’s health care. Cross-subsidies from people who are at risk and not at risk needs to be re-evaluated. Suggestion: Dues paid by the government should be examined in order not to burden the government budget
Peta status kerentanan Aedes aegypti (Linn.) terhadap insektisida cypermethrin dan malathion di Jawa Tengah
No full textAbstract. The increasing prevalence of Dengue Haemmorhaegic Fever (DHF) is spread through all districts in Indonesia. Dengue Haemorrhagic Fever Control such as vector control, focussing to break DHF transmission. Some research about Ae. aegypti resistance had been done in DHF endemic area in Central Java. Resistance status of Ae. aegypti against insecticide programme promoted by health government in middle and low endemic DHF in Central Java was investigated in this research. Sample collected from 100 houses selected purposively in every village, at every District there were 3 villages selected. Samples consisted of egg, larvae and adult mosquitoes of Ae. aegypti, and reared to get F1. Resistance test of Ae. aegypti done by using WHO susceptibility impregnated paper test procedure. This research showed that Ae. aegypti in all research location had been resistance to malathion 0.8% with mosquitoes mortality average between 13.80%-61.67% and almost all sample is resistance to cypermethrin 0.05% with mosquitoes mortality between 10.00%-63.33% except with sample from Banjarnegara District which has mosquitoes mortality of 84.20%. The conclusion of this research is that Ae. aegypti in all research location had been resistance to malathion. Almost all location resistant to cypermethrin except Banjarnegara District sample which has tolerance level. Keywords: resistance, Central Java, malathion, cypermethrin Abstrak. Persebaran DBD semakin meluas di semua kabupaten/kota. Pengendalian DBD terutama ditujukan untuk memutus rantai penularan, antara lain dengan pengendalian vektornya. Beberapa penelitian resistensi Aedes aegypti telah dilakukan di wilayah endemis DBD. Status resistensi Ae. aegypti terhadap insektisida yang digunakan program kesehatan di daerah endemis sedang dan rendah di Jawa Tengah merupakan hal yang akan dikaji dalam penelitian ini. Pengumpulan sampel uji dari 100 rumah per desa yang dipilih secara purposif pada tiga desa/kelurahan dengan masalah DBD pada setiap Kabupaten terpilih di Jawa Tengah. Sampel berupa larva, telur dan nyamuk dewasa yang selanjutnya dipelihara untuk memperoleh F1. Uji resistensi pada Ae. aegypti dewasa dilakukan dengan menggunakan impregnated paper dengan mengacu pada standar WHO. Hasil menunjukkan Ae. aegypti di lokasi penelitian telah resisten terhadap malathion 0,8% dengan kematian berkisar antara 13,80%-61,67%. Hampir semua telah resisten terhadap cypermethrin 0,05% dengan kisaran 10%-63,33%, kecuali sampel dari Kabupaten Banjarnegara masih toleran dengan kematian 84,20%. Sembilan kabupaten pada lokasi survei di Jawa Tengah telah resisten terhadap malathion,delapan kabupaten telah resisten cypermethrin, satu kabupaten yaitu Banjarnegara masih toleran terhadap cypermethrin. Kata Kunci: resistensi, Jawa Tengah, malathion, cypermethri
Deteksi mikrofilaria Brugia malayi pada nyamuk Mansonia spp dengan pembedahan dan metode PCR di Kabupaten Tanjung Jabung Timur
No full textAbstract. Filariasis is a public health problem in East Tanjung Jabung. Eventhough that mass treatment had been carried out since 2002, there were still villages with microfilaria rate >1%. This study aims to detect filarial worm larvae in the mosquitoes with dissections and PCR method. The mosquitoes used in this study were Mansonia spp. The number of mosquitoes that examined was 450,133 and some of Mansonia mosquitoes were checked by PCR. The result showed that microscopic dissection did not found stage 3 (L3) of filarial worm larvae in the mosquitoes. The results from PCR test showed the presence of B. malayi DNA in 8 samples of Ma. indiana. Mansonia indiana is a potential vectors for Brugia malayi filariasis in East Tanjung Jabung. PCR method is more sensitive examination in detecting microfilaria compared with dissection method. Keywords: Filariasis, Mansonia, PCR, Brugia malayi Abstrak. Filariasis di Kabupaten Tanjung Jabung Timur masih menjadi masalah kesehatan dan masih terjadi penularan. Kegiatan pengobatan massal telah dilakukan sejak tahun 2002, namun hingga tahun 2012 masih ditemukan adanya desa dengan Mf rate >1%. Penelitian ini bertujuan untuk mendeteksi larva cacing filaria dalam tubuh nyamuk dengan metode pembedahan dan PCR. Nyamuk yang diperiksa adalah nyamuk Mansonia spp. Jumlah nyamuk yang diperiksa sebanyak 450 ekor, 133 ekor diantaranya diperiksa secara PCR. Hasil pembedahan secara mikroskopis tidak ditemukan adanya larva cacing filaria stadium 3 (L3) dalam tubuh nyamuk.Ditemukan adanya DNA mikrofilaria B. malayi hasil pemeriksaan secara PCR pada 8 sampel nyamuk Ma. indiana. Nyamuk Ma. indiana berpotensi sebagai vektor filariasis B. malayi di Kabupaten Tanjung Jabung Timur. Metode pemeriksaan secara PCR lebih sensitif dalam mendeteksi mikrofilaria dibandingkan dengan pembedahan. Kata Kunci: Filariasis, Mansonia, PCR, Brugia malay
Variasi pengobatan malaria rumah tangga di enam provinsi endemis malaria di Indonesia
No full textAbstract. Indonesia is targeted to be free of malaria in 2030 and its success is determined by the effectiveness of treatment. Riskesdas 2013 shows the effective treatment of malaria rate as 45.5%. Nationally, only 33.7% of malaria patients received the Artemisinin-based Combination Therapy (ACTs). A further analysis to Riskesdas 2013 data was performed to describe the malaria treatment variation at household-level in six provinces in Indonesia, which are Bengkulu, Maluku, North Maluku, East Nusa Tenggara, Papua, and West Papua. Data of name, type, and sources of drugs, as well as household characteristics was analysed. Total of 287 households that meet the criteria of storing and using drugs for malaria treatment was analysed. The result shows 66 types of drugs with varied sources, including 15 antimalarial drugs (i.e. ACTs, chloroquine, and sulphadoxin-pyrimethamin). Most drugs were obtained from pharmacies and drug shops/ stalls, both in urban and rural areas. Most of the poorest households choose drugstore / stalls (46.7%) for medication. On the other hand, for the wealthier groups, pharmacy is an option to get malaria drugs (48.6%). This research reveals the persistence of resistance from anti-malarial drugs (CQ and SP) in almost all sources, including drugs from official health facilities and health workers. This diverse consumption encourages an effective monitoring, evaluation, and strengthening cross-sector participation to improve knowledge, partnership between community and private sector, and the use of information technology to enhance antimalarial drugs supply management in primary health care. An appropriate form of intervention is substantial to improve the malaria treatment coverage in Indonesia. Keywords: malaria, anti-malarial, drug variation, drug source, Indonesia Abstrak. Indonesia ditargetkan terbebas dari malaria pada tahun 2030, salah satu keberhasilannya ditentukan oleh efektifitas pengobatan. Riskesdas 2013 menunjukkan tingkat pengobatan efektif malaria sebesar 45,5%. Secara nasional, hanya 33,7% penderita malaria yang mendapatkan obat ACT. Analisis lanjut data Riskesdas 2013 dilakukan dengan tujuan untuk mengetahui gambaran variasi pengobatan malaria rumah tangga di enam provinsi di Indonesia, yaitu Bengkulu, Maluku, Maluku Utara, Nusa Tenggara Timur, Papua, dan Papua Barat. Data nama, jenis, dan sumber obat, serta karakteristik rumah tangga dianalisis bivariat. Sebanyak 287 rumah tangga yang memenuhi kriteria menyimpan dan menggunakan obat untuk pengobatan malaria yang dianalisis. Hasil menunjukkan 66 jenis obat dengan sumber yang variatif, lima belas jenis obat di antaranya merupakan obat antimalaria, (yaitu ACT, klorokuin/CQ, dan sulfadoxin-pyrimethamin/SP). Sebagian besar obat malaria diperoleh dari apotek dan toko obat/warung, baik di perkotaan dan pedesaan. Sebagian besar rumah tangga dengan status ekonomi terendah lebih banyak memilih toko obat/warung (46,7%) untuk mendapatkan obat malaria. Sebaliknya, bagi kelompok sosioekonomi teratas, apotek merupakan pilihan untuk mendapatkan obat malaria (48,6%). Penelitian mengungkapkan masih adanya rezim obat antimalaria resisten (CQ dan SP) yang beredar hampir di semua sumber, termasuk fasilitas kesehatan formal dan tenaga kesehatan. Bervariasinya obat yang dikonsumsi masyarakat dalam mengobati malaria mendorong perlunya peningkatan monitoring, evaluasi, dan penguatan partisipasi lintas-sektoral dalam meningkatkan pengetahuan masyarakat, keterlibatan masyarakat, keterlibatan sektor swasta, dan didukung dengan pemanfaatan teknologi informasi dalam manajemen suplai obat standar di layanan kesehatan primer. Bentuk intervensi yang tepat diperlukan untuk meningkatkan cakupan pengobatan malaria di Indonesia. Kata Kunci: malaria, antimalaria, variasi obat, sumber obat, Indonesi