e-Journal Badan Penelitian dan Pengembangan Kesehatan / National Institute of Health Research and Development
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Gambaran Pelaksanaan Pelayanan Kesehatan Tradisional Ramuan Menggunakan Jamu Tersaintifikasi (Studi Kasus di BKTM Makassar dan Puskesmas A Karanganyar)
No full textHealth Services using jamu as the results of Saintifikasi Jamu (SJ) program is new. B2P2TOOT is the organizer of SJ training. The last Decree of National Commission for Saintifikasi Jamu (Komnas SJ) was signed in 2013 and valid for 1 year. Until now there is still no new formation of Komnas SJ. The implementation of jamu as result SJ program in health service facility is rare. Therefore description of the implementation of health services use jamu become important to be examined. This was a qualitative study using case study design. Study was conducted in the Puskesmas A Karanganyar, BKTM Makassar, and B2P2TOOT as the organizer of the SJ training. The location was selected purposively. The study was done in 2015. The factors that were examined in the form of human resources, budget, availability of herbs, and support regulations in the implementation of services. The primary data was taken by in-depth interviews. Secondary data were annual reports, decree and regulations. The respondents were all officers involved in the SJ services such as doctor, pharmacy, nurses and the management. The data had been analyzed with content analysis techniques. The main problem of implementation SJ was the need for a penal provision. Monitoring and evaluation of the program SJ had not been done intensively. SJ training was useful in the conduct of the health services using jamu, but hindered by the limited number of trained personnel, availability of budget, which ultimately affected the availability of herbs. The regulation which protects the commissioning services is urged. The regulation about Komnas SJ is also needed, therefore, the implementation of SJ program can be conducted well. Moreover, monitoring and evaluation of services using jamu program SJ and follow up is required. Research results from SJ program need to be published in order to be applied by the SJ network. Some regulations that protect SJ network is important as well so that they can do services by research based optimally.AbstrakPelayanan kesehatan jamu menggunakan hasil program Saintifikasi Jamu (SJ) merupakan hal yang masih baru. Saat ini penyelenggara pelatihan SJ adalah Balai Besar Penelitian dan Pengembangan Tanaman Obat dan Obat Tradisional (B2P2TOOT). SK Komisi Nasional Saintifikasi Jamu (Komnas SJ) terakhir adalah tahun tahun 2013 dan berlaku selama satu tahun. Hingga kini belum ada lagi pembentukan Komnas SJ, sehingga program ini terkesan jalan di tempat. Penelitian pelaksanaan pelayanan jamu hasil program SJ di fasilitas pelayanan kesehatan masih belum banyak dilakukan, bahkan data mengenai fasilitas kesehatan yang memberikan pelayanan jamu pun belum tercatat dengan baik. Oleh sebab itu perlu dikaji gambaran pelaksanaan pelayanan kesehatan menggunakan jamu. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus yang dilakukan di Puskesmas A Karanganyar dan BKTM Makassar, serta B2P2TOOT sebagai penyelenggara pelatihan program SJ. Lokasi dipilih secara purposive, yaitu penunjukan puskesmas oleh Dinkes Karanganyar, sedang BKTM karena merupakan institusi milik Kemenkes. Penelitian dilakukan pada tahun 2015. Faktor yang diteliti berupa sumber daya manusia, anggaran, ketersediaan bahan jamu, serta dukungan regulasi yang mengatur pelaksanaan pelayanan. Data diambil dengan cara wawancara mendalam kepada responden, dan data sekunder berupa laporan tahunan, SK dan peraturan yang berlaku. Responden adalah semua petugas yang terlibat dalam pelaksanaan pelayanan SJ meliputi dokter, apoteker, perawat dan bagian manajemen. Data dianalisa dengan teknik analisa konten. Masalah utama pelaksanaan program SJ adalah perlunya payung hukum penyelenggaraan program. Monitoring dan evaluasi program SJ belum intensif. Pelatihan SJ bermanfaat dalam melaksanakan pelayanan kesehatan jamu, namun terkendala dengan terbatasnya SDM yang terlatih, tidak tersedia anggaran rutin, yang akhirnya mempengaruhi ketersediaan jamu. Regulasi yang melindungi pelaksana pelayanan juga belum ada. Perlu dipikirkan aturan tentang Komnas SJ agar pelaksanaan program SJ bisa dijalankan dengan baik. Perlu ada pembinaan dan monitoring pelaksanaan pelayanan program SJ serta tindak lanjut yang diperlukan. Hasil penelitian jamu perlu disebarluaskan sehingga dapat diaplikasikan oleh jejaring SJ. Regulasi yang diperlukan sebagai payung hukum agar jejaring SJ dapat melakukan penelitian berbasis pelayanan dengan optimal
HUBUNGAN VARIABILITAS IKLIM (CURAH HUJAN, SUHU, DAN KELEMBABAN) DENGAN KEJADIAN DIARE DI KOTA DENPASAR, PROVINSI BALI
No full textABSTRACT The variability of some climate elements could be expected to affect the increase of diarrheal diseases. This study aims to determine the relationship between variability of climate elements and the incidence of diarrhea in the city of Denpasar. The variables analyzed were the elements of the climate (rainfall, rainy days, temperature, and humidity) and the number of diarrheal cases from 2010 to 2014. The climate data and data incidence of diarrhea are from Updated Model of Surveillance System Impact of Climate Change on Health Research and Development in 2014. Data analysis was performed to generate univariable, bivariables, and multivariables data using Microsoft Excell software. The analysis showed that during the period 2010 until 2014 increased rainfall compared with the data from 2008, the highest incidence of diarrhea in Denpasar are 10,823 cases (2011). The multivariate analysis showed that there is a significant relationship between diarrhea and rainfall, rainy days, and humidity (P <0.05, r2 = 0.703; lag time 1). It can be concluded that there is a relationship between incidence of diarrhea and climate variables of 1 week earlier. There is a need to increase public awareness in maintaining environmental sanitation and hyigienic conditions during a peak of rainy and dry seasons. Keywords: Climate variability, rainfall, temperature, humidity, diarrhea ABSTRAK Terjadinya variabilitas beberapa unsur iklim, diduga dapat berhubungan dengan meningkatnya penyakit diare. Penelitian ini bertujuan untuk mengetahui hubungan variabilitas unsur-unsur iklim terhadap kejadian diare di Kota Denpasar. Variabel yang dianalisis adalah unsur-unsur iklim (curah hujan, hari hujan, suhu, dan kelembaban) dan jumlah kejadian diare dari tahun 2010 sampai dengan 2014. Data iklim maupun data kejadian diare merupakan data dasar hasil Penelitian dan Pengembangan Pemutakhiran Model/Sistem Surveilans Dampak Perubahan Iklim Terhadap Kesehatan tahun 2014. Analisis data dilakukan secara univariat, bivariat, dan multivariat, menggunakan perangkat lunak Microsoft excel. Hasil analisis menunjukkan bahwa selama kurun waktu lima tahun (2010 sampai 2014) terjadi peningkatan curah hujan dibandingkan dengan data tahun 2008, kejadian diare di Kota Denpasar paling tinggi 10.823 kasus (2011). Analisis multivariat menunjukkan bahwa terdapat hubungan yang signifikan antara diare dengan curah hujan, hari hujan, dan kelembaban (P<0,05, r2=0,703; pada lag time 1). Dapat disimpulkan bahwa ada hubungan antara kejadian diare dengan variable iklim seminggu sebelumnya. Perlu adanya upaya untuk meningkatkan kesadaran masyarakat dalam memelihara kebersihan lingkungan dan perilaku higienis terutama pada puncak musim hujan dan kemarau. Kata kunci: Variabilitas iklim, curah hujan, suhu, kelembaban, diar
DETERMINAN PERSALINAN SECTIO CAESAREA DI INDONESIA (ANALISIS LANJUT DATA RISKESDAS 2013)
No full textBackground: Today, caesarean section in Indonesia have been increasing and the percentage varies among provinces.Objective: The study aimed to determine the characteristics of mothers who performed caesarean delivery as well as the risk factors that accompanied the mother during pregnancy and/or labor.Method: To explore the determinant of caesarian section operation, logistic regression analysis was done with odds ratios and 95 % confident intervals.Result: Based on the characteristics of socio-economic status, the greater chance of caesarian delivery are among mothers with highest economic level (OR: 2.55), higher education level (OR: 3.28), living in urban areas (OR: 1.46), having formal employment as private employee (OR: 1.36), and having and using health insurance (OR: 1.12) . While based on maternal health status, the greater chance of caesarian delivery are among mothers having risk factors, such as height at ≤145 cm (OR: 1.93), aged > 35 years (OR: 1,68), birth age of >42 weeks (OR: 1.97), with parity of one birth (OR: 2.49), giving birth with labor difficulties (OR: 1.21), having a history of complications during pregnancy (OR: 1.29) and complication of labor (OR: 6.63), and having complete antenatal care (K4) (OR: 1).Conclusion: Factors that encourage the occurrence of caesarean delivery are maternal characteristics, maternal and fetal health status variables with a history of complications during pregnancy, complication of labor, parity and complete antenatal care history that have a greater chance for caesarean delivery
PENGARUH PENAMBAHAN BAYAM [Amaranthus tricolor] PADA “NUGGET” KAKI NAGA LELE [Clarias gariepinus] TERHADAP KADAR ZAT BESI, PROTEIN, DAN AIR
No full textAnemia is a malnutrition is still found and is a major nutritional problem in Indonesia. According to Basic Health Research Data (Riskesdas) 2013, the prevalence of anemia in Indonesia are found in age group 5-14 years (26.4%). One way to overcome anemia is the fulfillment the food variety, one of the way is by modifying the diet made from catfish and spinach to provide high protein and iron food. The Purpose of this study was to analyze the effect of the addition of spinach to acceptance of the food, iron levels, protein content, and the water content of the food catffish nugget. This design of research is a quasi experiment with Posttest Only Control Group Design. The catfish nugget that is most acceptable by the panelists was the one with 30% (30 grams) addition of spinach. Friedman test results demonstrated the acceptability aspects of taste, color, aroma and texture has a value of ρ value ≤ α (0.05). The catfish nugget treatment with the addition 30% of spinach as much had an iron and protein content 2.33 mg and 16,34 g respectively. Anemia merupakan salah satu penyakit gangguan gizi yang masih sering ditemukan dan merupakan masalah gizi utama di Indonesia. Menurut data riskesdas tahun 2013 prevalensi anemia di Indonesia banyak ditemukan pada kelompok umur 5-14 tahun yaitu sebesar (26,4%). Salah satu cara untuk mengatasi anemia yaitu dengan pemenuhan keanekaragaman makanan, salah satunya dengan memodifikasi menu makanan yang terbuat dari lele dan bayam untuk menyediakan makanan yang tinggi protein dan zat besi.Tujuan dari penelitian ini adalah untuk menganalisis pengaruh penambahan bayam terhadap daya terima, kadar zat besi, protein, dan air pada nugget kaki naga. Desain penelitian ini adalah kuasi eksperimen dengan Posttest Only Control Group Design. Nugget kaki naga lele yang paling dapat diterima oleh panelis adalah dengan penambahan bayam sebanyak 30% (30 g), hasil uji Friedman menunjukkan daya terima aspek rasa, warna, aroma dan tekstur memiliki nilai ρ value ≤ α (0,05). Perlakuan nugget kaki naga lele yang direkomendasikan yaitu pada perlakuan nugget kaki naga lele dengan penambahan bayam sebanyak 30% atau 30 g dengan kandungan zat besi dan protein berturut-turut 2,33 mg dan 16,34 g. Anemia is a malnutrition is still found and is a major nutritional problem in Indonesia. According to Basic Health Research Data (Riskesdas) 2013, the prevalence of anemia in Indonesia are found in age group 5-14 years (26.4%). One way to overcome anemia is the fulfillment the food variety, one of the way is by modifying the diet made from catfish and spinach to provide high protein and iron food. The Purpose of this study was to analyze the effect of the addition of spinach to acceptance of the food, iron levels, protein content, and the water content of the food catffish nugget. This design of research is a quasi experiment with Posttest Only Control Group Design. The catfish nugget that is most acceptable by the panelists was the one with 30% (30 grams) addition of spinach. Friedman test results demonstrated the acceptability aspects of taste, color, aroma and texture has a value of ρ value ≤ α (0.05). The catfish nugget treatment with the addition 30% of spinach as much had an iron and protein content 2.33 mg and 16,34 g respectively. Anemia merupakan salah satu penyakit gangguan gizi yang masih sering ditemukan dan merupakan masalah gizi utama di Indonesia. Menurut data riskesdas tahun 2013 prevalensi anemia di Indonesia banyak ditemukan pada kelompok umur 5-14 tahun yaitu sebesar (26,4%). Salah satu cara untuk mengatasi anemia yaitu dengan pemenuhan keanekaragaman makanan, salah satunya dengan memodifikasi menu makanan yang terbuat dari lele dan bayam untuk menyediakan makanan yang tinggi protein dan zat besi.Tujuan dari penelitian ini adalah untuk menganalisis pengaruh penambahan bayam terhadap daya terima, kadar zat besi, protein, dan air pada nugget kaki naga. Desain penelitian ini adalah kuasi eksperimen dengan Posttest Only Control Group Design. Nugget kaki naga lele yang paling dapat diterima oleh panelis adalah dengan penambahan bayam sebanyak 30% (30 g), hasil uji Friedman menunjukkan daya terima aspek rasa, warna, aroma dan tekstur memiliki nilai ρ value ≤ α (0,05). Perlakuan nugget kaki naga lele yang direkomendasikan yaitu pada perlakuan nugget kaki naga lele dengan penambahan bayam sebanyak 30% atau 30 g dengan kandungan zat besi dan protein berturut-turut 2,33 mg dan 16,34 g
HUBUNGAN ASUPAN MAKANAN, SUPLEMENTASI Fe DAN ASAM FOLAT DENGAN KADAR HEMOGLOBIN PADA IBU HAMIL RIWAYAT KURANG ENERGI KRONIS DAN ANEMIA SAAT MENYUSUI (THE RELATIONSHIP OF FOOD INTAKE, Fe AND FOLIC ACID SUPPLEMENTATION ON HEMOGLOBIN LEVEL IN PREGNANT WOMEN)
No full textPregnant women with past history of CED have a higher risk 2,76 times to suffer anemia than normal pregnant women. Fe and folic acid supplementation is one program to overcome iron deficiency anemia in the pregnant women in Boyolali but the incidence rate of anemia remains high (42,9%). This study was to analyze the relationship of food intake, Fe and folic acid supplementation on hemoglobin level in pregnant women with history of CED and anemia of breastfeeding women. This research study used analytic observation with cross sectional approach. The subject of 42 breastfeeding women with past history of CED and anemia in the third trimester of pregnancy in five public health centers in Boyolali. Data of supplementation and nutrient intake was obtained by interview. Nutritional status was determined using upper arm circumference and BMI. Hemoglobin level was measured by using cyanmethemoglobin method. Statiscally analyzed using correlation and multiple regression tests. The breastfeeding women had low food intake (<70% RDA) including macro and micro nutrients. Food intake and nutritional status in breastfeeding women negatively affected hemoglobin level in breastfeeding women (B=-0,005; p=0,040 and B=-0,134; p=0,016 respectively). Fe and folic acid supplementation in pregnant women with CED and anemia significantly influenced hemoglobin level during breastfeeding (B=0,720; p=0,016). Completed supplementation of iron-folic acid in pregnant women with CED and anemia could increase 0,720 g/dL hemoglobin levels during breastfeeding.Ibu hamil dengan kurang energi kronis (KEK) berpeluang menderita anemia 2,76 kali dari pada ibu hamil normal. Suplementasi Fe dan asam folat merupakan salah satu cara mengatasi anemia defisiensi besi tetapi angka kejadian ibu hamil di Kabupaten Boyolali dengan anemia masih tinggi (42,9%). Penelitian ini bertujuan menganalisis hubungan asupan makanan, suplementasi Fe dan asam folat dengan kadar hemoglobin pada ibu hamil riwayat KEK dan anemia saat menyusui. Jenis penelitian observasional analitik dengan pendekatan cross sectional. Subjek penelitian 42 ibu menyusui dengan riwayat KEK dan anemia pada trimester III dari lima Puskesmas di Boyolali. Data suplementasi Fe dan asam folat serta asupan zat gizi diperoleh dengan wawancara. Status gizi ditentukan dengan LILA dan IMT. Kadar hemoglobin ditentukan dengan metode cyanmethemoglobin. Analisis statistik menggunakan uji korelasi dan multivariat regresi ganda. Hasil menunjukkan bahwa asupan energi, lemak, karbohidrat, zat besi dan asam folat pada ibu menyusui termasuk kategori defisit (<70% AKG). Asupan makanan dan status gizi ibu menyusui berhubungan negatif terhadap kadar hemoglobin saat menyusui (B=-0,005, p=0,040 dan B=-0,134, p=0,016). Suplementasi Fe dan asam folat pada ibu hamil riwayat KEK dan anemia berhubungan secara signifikan terhadap kadar hemoglobin saat menyusui (B=0,720, p=0,016). Dapat disimpulkan bahwa suplementasi Fe dan asam folat pada ibu hamil KEK dan anemia berpeluang menaikkan 0,720 g/dL kadar hemoglobin ibu saat menyusui
Efek Ekstrak Campuran Kulit Batang Pulai (Alstonia scholaris) dan Meniran (Phyllanthus niruri) pada Mencit Swiss Webster yang Diinfeksi Plasmodium berghei
No full textPulai and meniran is one of the medicinal plants that have been studied as a possible antimalarial drugs. This study aims to evaluate the antimalarial activity of a mixture of pulai bark and meniran extracts as antimalarial drugs. Acute toxicity tests was performed using male and female Wistar rats each 25 animals with four doses of treatment. Antimalarial test using 72 mice were divided into six dose groups: group CMC, DHP, dose mixture of 1330; 443.34; 147.78 mg/kg bw and doses of pulai groups 1330 mg /kg bw. All the mice were infected with Plasmodium berghei (D0) and given the extracts orally for 14 days. Giemsa blood stainning taken on days D1-D7 and D14 were analyzed for percentage of parasitaemia, lymphocytes, monocytes and granulocytes. Results of acute toxicity test (LD50) values obtained from extract mixture was more than 14285 mg/kg bw, are classified as non-toxic materials. The most effective dose of the test antimalarial obtained from the percentage of parasites reducing and leukocytes differential, was 147.78 mg/kg. A mixture of pulai bark and meniran extract can be considered to be used as an alternative drug in the treatment of malaria. Further research is needed to isolate and characterized the active ingredients which have the effect of antimalarial to be recommended as an antimalarial drug in the future
Assessment of Prescribing Indicators in Public and Private Primary Health Care Facilities in Java, Indonesia
No full textPrescribing indicator is an easy core indicator to evaluate drug utilization as stated in WHO guideline. Rational prescribing pattern is important to improve rational use of drugs whereas irrational prescribing pattern can lead to irrational drug use. This study aimed to assess the prescribing pattern in public and private primary healthcare facilities which were included in the National Health Insurance Program in Indonesia. This study has been conducted using the cross sectional research design, quantitative and retrospective method in four provinces in Java island (West Java, Banten, DIY and Central Java provinces) from May to July 2014. The method of retrospective data collection were collected 757 prescriptions from 26 PHCs and 900 prescriptions from 30 clinics or General Practitioners (GPs). All data in the prescribing form were analyzed manually using Microsoft Excel 2007. The average number of item in public and private facilities was 3.31 and 3.06 respectively. The percentage of generic prescribing was 93.3% and 62.0%, the percentage of drugs in accordance with the 2013 national formulary was 89.0% and 64.5%, the percentage of antibiotic per total number of encounter was 42.8% and 39.4%, while the percentage of injection per total encounter was only 0.7% and 2.2%. Paracetamol and dexamethasone were the most frequently prescribed drugs while for antibiotic group were amoxicillin, ciprofloxacin, cotrimoxazole and cefadroxil.The average number of items per encounter and antibiotic were not met the WHO standard(≤3 for average number and less than 30% for antibiotic percentage). Suitable interventions are needed to improve the prescribing practices in Indonesia
ASSESMEN INTEGRITAS DALAM PROGRAM PENANGGULANGAN PENYAKIT HIV/AIDS DI KOTA MANADO
No full textIn Indonesia, there is HIV/AIDS epidemics with a prevalence of 0.2% among adults. It needs assessment on integrity to improve reliability and effectiveness the program implementation for understanding public policy, transparency, accountability, active community participation and ethics considerations of HIV/AIDS based on Government Regulation No. 75/2006. The study aimed to understand integrity of HIV/AIDS on public health institutions, and related private sectors in Manado City. It was an observational study with a cross sectional design. Data were collected by in-depth interviews to policy makers in the public sector, Head of Health Offi ces and the programmers, Provincial AIDS Committee, Province hospital, health centers, NGOs and private clinics. Standards and regulations of HIV/AIDS management activities refer to the international, national, provincial and municipal. There were transparencies but fi nancial aspects and recording reporting of cases are still un opened. The accountability and effectiveness of procedure management could not be as a whole because lacked of adequate resources, including budget availability. There were not availabity of etics based standard services. There were not policy on human resources capacity building that caused in balance the quality and quantity of staffs. The prevention and management are still lack in high-risk and vulnerable populations. There were lack of concept understanding and practical integrity of health workers on management level and health care providers. Itneeded fi nancial transparency. Monitoring and evaluation to health facilities should be regularly; there should be policies for handling public complaints, training of standards management for health workers; training concept of integrity to related sectors. The active community participation should be enhanced. ABSTRAK Di Indonesia terdapat epidemi penyakit HIV/AIDS, dengan prevalensi 0,2% orang dewasa. Perlu penilaian terhadap integritas pelaksanaan program penanggulangan HIV/AIDS untuk meningkatkan reabilitas dan efektivitas agar paham terhadap kebijakan publik, transparansi, akuntabilitas, partisipasi aktif masyarakat dan pertimbangan etik berdasar PP No. 75/2006. Penelitian ini bertujuan memahami integritas pelaksanaan program dari institusi publik bidang kesehatan dan sektor swasta terkait di Kota Manado. Jenis penelitian adalah observasional dengan desain potong lintang. Pengumpulan data dengan wawancara mendalam kepada Kepala Dinas Kesehatan, pemegang program, Komite Penanggulangan AIDS Provinsi, Rumah Sakit Provinsi, Puskesmas, LSM dan klinik swasta. Standar dan kebijakan manajemen dari kegiatan penanggulangan HIV/AIDS mengacu pada tingkat internasional, nasional, provinsi, dan kota. Terdapat transparansi namun aspek keuangan dan pencatatan pelaporan kasus masih tertutup. Tata laksana manajemen yang akuntabilitas dan efektivitas belum secara utuh karena tidak didukung oleh sumber daya yang memadai, termasuk ketersediaan dana. Belum tersedia standar pelayanan yang berbasis etik. Kebijakan tentang peningkatan kapasitas SDM belum ada mengakibatkan tidak seimbangnya kualitas dan kuantitas dari petugas. Pelaksanaan pencegahan dan penanggulangan masih kurang pada populasi risiko tinggi dan rentan. Pemahaman konsep dan integritas praktis terhadap petugas kesehatan pada tingkat manajemen dan pemberi pelayanan kesehatan masih kurang. Transparansi keuangan perlu diperjelas. Monitoring dan evaluasi ke fasilitas kesehatan perlu dilakukan secara berkala; kebijakan penanganan pengaduan masyarakat; pelatihan standar manajemen bagi petugas kesehatan; pelatihan konsep integritas kepada sektor terkait. Partisipasi aktif masyarakat perlu ditingkatkan.