Journal of Maternal and Child Health (JMCH)
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Theory of Planned Behavior on Factors Affecting Tetanus Toksoid Immunization Uptake Among Pregnant Women in Boyolali, Central Java
Get PDFBackground: Tetanus is an infectious disease caused by Clostridium tetani bacteria. TT immunization in pregnant women can prevent neonatal deaths. Maternal and Neonatal Tetanus (MNT) has been among the most common life-threatening consequences of unclean deliveries and umbilical cord care practices, and are indicators of inequity in access to immunization and other maternal, newborn, and child health services. The neonatal mortality rate was still high in Boyolali Regency, Central Java. The purpose of this study was to determine the factors of TT immunization uptake among pregnant women in Boyolali, Central Java, using Theory of Planned Behavior.Subjects And Method: This was a cross-sectional study conducted in Boyolali, Central Java, from November to December 2018. A sample of 200 pregnant women from 25 community health centers was selected by simple random sampling and positioned at level 2 in a multilevel model analysis. Eight pregnant women were selected at random from each community health center. The dependent variable was TT immunization uptake. The independent variables were knowledge, education, the influence of midwife private practice, parity, income, intention, attitude, perceived behavior control, and social norm. The data on immunization uptake was obtained from the medical record. The other data were collected by questionnaire. The data were analyzed by multilevel multiple logistic regression analysis.Results: The use of TT immunization increased with better maternal knowledge (b= 1.47; 95% CI= 0.02 to 2.92; p= 0.047), high maternal education (b = 2.19; 95% CI = 0.64 to 3.75; p= 0.006), influence of midwife private practice (b= 2.07; 95% CI= 0.41 to 3.72; p= 0.014), parity ≥2 (b= 1.81; 95% CI = 0.13 to 3.5; p= 0.034), income ≥minimum regional wage (b= 1.95; 95% CI= 0.39 to 3.50; p= 0.014), strong intention (b = 1.73; 95% CI = 0.11 to 3.34; p= 0.035), positive attitude (b= 2.11; 95% CI = 0.17 to 4.05; p= 0.033), strong perceived behavior control (b= 3.84; 95% CI = 1.47 to 6.20; p <0.001), supportive social norm (b= 2.26; 95% CI= 0.29 to 4.23; p= 0.024). Community health center had a contextual effect on TT immunization uptake with ICC= 35.86%.Conclusion: The use of TT immunization increased with better maternal knowledge, high maternal education, the influence of midwife private practice, parity ≥2, income ≥minimum regional wage, strong intention, positive attitude, strong perceived behavior control, supportive social norm. The community health center has a contextual effect on TT immunization uptake.Keywords: TT immunization, knowledge, education, midwife private practice, parity, income, intention, attitude, perceived behavior control, social norm, pregnant womenCorrespondence: Tiara Yumafita, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 362A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: +6281230492658.Journal of Maternal and Child Health (2019), 4(3): 190-200https://doi.org/10.26911/thejmch.2019.04.03.0
Effect of Social Suport and Social Interaction on Anxiety Among Pregnant Women
Get PDFBackground: There is growing evidence that the antenatal period is a time of increased liability to mental disorders. The most common psychiatric illnesses during pregnancy and the postpartum period are depressive and anxiety disorder. The purpose of this study was to examine the effect of social support and social interaction on anxiety among pregnant women.Subjects and Method: A cross-sectional study was carried out in community health centers in Kutai Kartanegara, East Kalimantan, from November to December 2018. A sample of 200 pregnant women was selected by simple random sampling. The dependent variable was anxiety. The independent variables were education, parity, stress, family income, family support, social interaction, and counseling. The data were collected by questionnaire and analyzed by multiple linear regression.Results: Anxiety among pregnant women increased with stress (b= 0.33; 95% CI= 0.16 to 0.49; p= 0.001). It was decreased by high education (b= - 2.37; 95% CI= -3.93 to -0.81; p= 0.003), high income (b= -4.69; 95% CI= -7.81 to -1.57; p= 0.003), parity (b= 0.38; 95% CI= -2.98 to -0.26; p= 0.001), strong family support (b= -0.38; 95% CI= 0.52 to 0.24; p= 0.001), social interaction (b= -0.27; 95% CI= -0.42 to -0.12; p= 0.001), and conselling (b= -0.91; 95% CI= - 1.77 to -0.05; p= 0.004).Conclusion: Anxiety among pregnant women increases with stress. It is decreased by high education, high income, parity, strong family support, social interaction, and counseling.Keywords: anxiety, stress, social interaction, pregnant womenCorrespondence: Imelda Dearni Simarmata. Masters Program in Public Health, UniversitasSebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: 081227657035Journal of Maternal and Child Health (2019), 4(4): 287-293https://doi.org/10.26911/thejmch.2019.04.04.0
Path Analysis on the Biological and Social-Economic Determinants of Anemia in Pregnant Mothers in Bantul, Yogyakarta
Get PDFBackground: Anemia in pregnant women is one of the public health problems that is still considered as a serious problem. The most important things in handling cases of anemia in pregnant women is to pay attention to biological and socio-economic factors in pregnant women. This study aimed to determine the effect of biological and socio-economic factors on the incidence of anemia among pregnant women.Subjects and Method: This was a cross sectional study conducted in Bambanglipuro community health center, Bantul, Yogyakarta, from March to April 2019. A sample of 200 pregnant women was selected by fixed disease sampling. The dependent variable was anemia. The independent variables were age, gestational age, parity, birth spacing, education, income, adherence to iron tablet consumption, contraceptive use before pregnancy, dietary pattern, and body mass index (BMI). The data were collected by questionnaire and analyzed by path analysis.Results: The risk of anemia in pregnant women was directly and positively affected by education <Senior high school (b=1.92; 95% CI=0.67 to 3.17; p=0.003), age <20 or ≥35 years old (b=1.27; 95% CI= 0.09 to 2.46; p=0.036), parity ≥3 times (b=1.57; 95% CI= 0.42 to 2.72; p=0.007), birth spacing <2 years (b=2.58; 95% CI= 1.23 to 3.93; p<0.001), gestational age (II and III trimesters) (b=2.07; 95% CI=0.69 to 3.45; p=0.003), BMI <18.5 (b=3.21; 95% CI=1.98 to 4.44; p<0.001), and irregular iron tablet consumption (b=1.46; 95% CI=0.31 to 2.62; p=0.013). It was indirectly affected by education, history of contraceptive use, dietary pattern, and family income.Conclusion: The risk of anemia in pregnant women is directly and positively affected by education <Senior high school, age <20 or ≥35 years old, parity ≥3 times, birth spacing <2 years, gestational age (II and III trimesters), BMI <18.5, and irregular iron tablet consumption. It is indirectly affected by education, history of contraceptive use, dietary pattern, and family income.Keywords: anemia, iron tablet consumption, dietary pattern, path analysis Correspondence: Mulya Cunda Ratu Reso. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 082138095480Journal of Maternal and Child Health (2019), 4(6): 23-34https://doi.org/10.26911/thejmch.2019.04.06.03
Path Analysis on the Life-Course Biopsychosocial Determinants of Stunting in Children Under Five Years of Age in Karawang, West Java
Get PDFBackground: Studies have shown that stunted children are more likely to start school later, perform more poorly on cognitive functioning tests, and are more likely to drop out of school. In future, adults who are stunted as children earn 20% less than comparable adults who were not stunted and are 30% more likely to live in poverty and less likely to work in skilled labor. This study aimed to examine the life-course biopsychosocial determinantsof stunting in children under five years of agein Karawang, West Java, using a path analysis model.Subjects and Method: This was a case control study carried out inTunggakjati, Rengasdengklok, Kutawaluya, Pedes, and Medangasem community health centers, Karawang, West Java, from April to May 2018. A sample of 225 children under five was selected for this study by fixed disease sampling, consisting of 75 stunted children and 150 normal children. The dependent variable was stunting. The independent variables were maternal height, maternal middle upper arm circumference (MUAC), low birthweight (LBW), history of infection illness, maternal education, exclusive breastfeeding, complementary feeding, and family support. Child height was measured by infantometer or microtoice. The other variables were measured by questionnaire. The data were analyzed by path analysis run on Stata 13.Results: Stunting increased with LBW (b=1.64; 95% CI=0.69 to 2.59; p=0.001) and history of infection illness (b=1.80; 95% CI=0.94 to 2.67; p<0.001). Stunting decreased with maternal height ?150 cm (b=-1.57; 95% CI=-2.43 to -0.71; p<0.001) and appropriate complementary feeding (b=-1.80; 95% CI=-2.53 to -1.08; p<0.001). Stunting was indirectly affected by maternal MUAC, maternal education, exclusive breastfeeding, and family support.Conclusion: Stunting increases with LBW and history of infection illness, but decreases with maternal height ?150 cm and appropriate complementary feeding. Stunting is indirectly affected by maternal MUAC, maternal education, exclusive breastfeeding, and family support.Keywords: stunting, life-course, biopsychosocial, children under fiveCorrespondence
Multilevel Analysis on the Contextual Effect of Posyandu on Exclusive Breastfeeding in Sleman, Yogyakarta
Get PDFBackground: There is a piece of increasing evidence that exclusive breastfeeding (EBF) up to six-month of age has important consequences on health and nutritional outcomes of children. However, studies on the contextual effect of integrated health post (posyandu) on EBF are scarce. The purpose of this study was to examine the contextual effect of posyandu on exclusive breastfeeding using multilevel analysis.Subjects and Method: A cross-sectional study was conducted in Sleman, Yogyakarta, from November to December 2018. A sample of 200 lactating mothers was selected by simple random sampling. The dependent variable was exclusive breastfeeding. The independent variables were knowledge, education, age, parity, birth spacing, employment, and family support. The data were collected by a multilevel logistic regression.Results: Exclusive breastfeeding increased with good knowledge (b= 2.66; 95% CI= 0.85 to 4.47; p= 0.004), high education (b= 2.10; 95% CI= 0.29 to 3.91; p= 0.023), maternal age 20-35 years (b= 3.35; 95% CI= 1.46 to 5.24; p<0.001), multiparous (b= 2.90; 95% CI= 0.41 to 3.39; p= 0.012), birth spacing ≥2 years (b= 2.91; 95% CI= 0.92 to 4.89; p= 0.004), unemployed mother (b= 4.53; 95% CI= 2.39 to 6.67; p<0.001), strong family support (b= 2.88; 95% CI= 1.04 to 4.72; p= 0.002). Integrated health post had substantial contextual effect on exclusive breastfeeding with ICC= 29.2%.Conclusion: Exclusive breastfeeding increases with high knowledge, high education, maternal age 20-35 years, multiparous, birth spacing, unemployed mother, strong family support. Integrated health post has the substantial contextual effect on exclusive breastfeeding.Keywords: exclusive breastfeeding, integrated health post, multilevel analysisCorrespondence: Esti Lestari. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: 082363242993.Journal of Maternal and Child Health, 2019, 4(4): 250-259https://doi.org/10.26911/thejmch.2019.04.04.0
Theory of Planned Behavior: Determinants of the Use of Modern Family Planning Method
Get PDFBackground: The use of contraception tool is one of the factors that affect fertility. It is influenced by demographic, socio-economic, legal, political and environmental factors. The use of modern family planning method can provide optimal benefits by minimizing side effects and complaints felt by the community. The aim is to analyze the determinants of the use of modern family planning method in Malinau District, North Kalimantan by using the theory of planned behavior.Subjects and Method: This was an observational analytic study with cross sectional approach conducted in 4 (four) sub-districts in Malinau District, North Kalimantan, in December 2018 to January 2019. Total 200 subjects were selected by fixed disease sampling. The dependent variable was the mothers who applied the modern family planning method. The independent variables were maternal age, parity, area of residence, level of education, family income, perception, intention, attitude, and subjective norms. The data were collected by questionnaires and analyzed with path analysis.Results: The use of modern family planning method in women is directly and positively influenced by parity ≥ 4 (b = 3.03; 95% CI = 1.23 to 4.83; p <0.001), high family income (b = 4.57; 95% CI = 2.66 to 6.47; p <0.001), positive attitude (b = 3.92; 95% CI = 1.42 to 6.42; p = 0.002), and strong intention (b = 4.84; 95% CI = 2.85 to 6.82; p <0.001). The use of modern family planning method for women is indirectly influenced by the level of education and subjective norms.Conclusions: The use of modern family planning method in women is directly and positively influenced by parity ≥ 4, high family income, positive attitude, and strong intention. The use of modern family planning methods for women is indirectly influenced by the level of education and subjective norms.Keywords: modern contraceptive methods, Theory of Planned BehaviorCorrespondence: Yuliana Agus. Masters Program In Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085343928921Journal of Maternal and Child Health (2019), 4(5): 369-379https://doi.org/10.26911/thejmch.2019.04.05.11
Contextual Effect of the Integrated Health Post on DPT3 Immunization Uptake among Infants in Wonogiri, Central Java
Get PDFBackground: DPT3 immunization coverage is considered as one indicator of the success of immunization programs in various countries. Indonesia is one of the countries that adopted Expand Program in Immunization (EPI) in 1977 which later introduced DPT as part of routine basic immunization services for infants, although there are still infants who do not get complete DPT immunization at this time. The purpose of this study was to analyze contextual effect of the integrated health post on DPT3 immunization uptake among infants in Wonogiri, Central Java.Subjects and Method: This was an analytical observational study with a cross sectional design. It was conducted in Wonogiri community health center II, East Java, from October to December 2018. A sample of 200 infants was selected from 25 integrated health posts with simple random sampling. The dependent variable was the use of DPT3 immunization. The independent variables were maternal education, family income, religion and beliefs, family support, information exposure, attitude, subjective norm, perceived behavior control, and intention. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: The use of DPT3 immunization was influenced by maternal education (b = 2.01; 95% CI= 0.26 to 3.76; p= 0.025), family income (b= 2.56; 95% CI= 0.45 to 4.67; p= 0.017), religion and beliefs (b= 4.37; 95% CI= 1.78 to 6.96; p= 0.001), family support (b= 1.92; 95% CI= - 0.07 to 3.90; p= 0.058), exposure to information (b= 1.82; 95% CI= 0.11 to 3.54; p= 0.037), attitude (b= 1.59; 95% CI= - 0.29 to 3.47; p= 0.097), subjective norm (b= 1.66; 95% CI= - 0.17 to 3.49; p= 0.074), perceived behavior control (b= 2.50; 95 % CI= 0.57 to 4.43; p= 0.011), and intention (b= 2.93; 95% CI= 0.68 to 5.19; p= 0.011). Integrated health post had strong contextual effect on the use of DPT3 immunization with ICC= 53%.Conclusion: The use of DPT3 immunization is influenced by maternal education, family income, religion and beliefs, family support, exposure to information, attitude, subjective norm, perceived behavior control, and intention. Integrated health post has strong contextual effect on the use of DPT3 immunization.Keywords: DPT3 immunization, factors, Theory of Planned Behavior, posyandu, information exposureCorrespondence: Rizqi Inayati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Indonesia. Email: [email protected]. Mobile: +6289681682143Journal of Maternal and Child Health (2019), 4(4): 267-278https://doi.org/10.26911/thejmch.2019.04.04.0
Multilevel Analysis on Factors Affecting Measles Rubella Immunization Uptake among Toddlers in Pekanbaru, Indonesia
Get PDFBackground: Measles-Rubella (MR) immunization is a way to prevent measles and rubella, because the disease cannot be treated and the treatment given to patients is only supportive. Measles and rubella are spread in almost all provinces in Indonesia, so it needs a high and evenly coverage of at least 95% to break the chain of transmission. This study aimed to analyze the determinants of MR immunization uptake in infants.Subjects and Method: This was a cross-sectional study conducted in 25 community health posts (posyandu) in Pekanbaru, Indonesia, from April to May 2019. A sample of 200 mothers who had children aged 9-59 months was selected by stratified random sampling. The dependent variable was Rubella-Measles immunization. The independent variables were maternal education, maternal knowledge, family support, perceived susceptibility, perceived severity, perceived benefit, perceived barrier, cues to action, and self-efficacy. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression.Results: Measles-Rubella immunization uptake increased with high maternal education (b= 0.66; 95% CI= -0.07 to 1.41; p= 0.080), high maternal knowledge (b= 0.90; 95% CI= 0.14 to 1.65; p= 0.020), strong family support (b= 0.71; 95% CI= -0.05 to 1.48; p= 0.068), high perceived susceptibility (b= 1.24; 95% CI= 0.33 to 2.14; p= 0.007), high perceived severity (b= 1.19; 95% CI= 0.36 to 2.03; p= 0.005), strong perceived benefit (b= 0.93; 95% CI= 0.19 to 1.66; p= 0.013), high cues to action (b= 0.96; 95% CI= 0.19 to 1.73; p= 0.014), and high self efficacy (b= 1.45; 95% CI= 0.59 to 2.31; p= 0.001). It decreased with strong perceived barrier (b= -1.05; 95% CI= -1.81 to -0.29; p= 0.007). Posyandu had a contextual effect on Rubella-Measles immunization with ICC= 10.53%.Conclusion: Measles-Rubella immunization uptake increases with high maternal education, high maternal knowledge, strong family support, high perceived susceptibility, high perceived severity, strong perceived benefit, high cues to action, and high self efficacy. It decreases with strong perceived barrier. Posyandu has a contextual effect on Rubella-Measles immunization.Keywords: Measles, Rubella, immunization, health belief model, multilevel analysisCorrespondence: Wahyuni Rosadi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085271819193.Journal of Maternal and Child Health (2019), 4(6): 448-460https://doi.org/10.26911/thejmch.2019.04.06.06
Association Between Nutritional Status and Age at Menarche
Get PDFBackground: Menarche age is often considered for various reasons. It is one of the major indices of the female fertility which includes the period up to the menopause. More critically, menarche marks the onset of ovarian activity associated with reproduction and affects breast cancer risk. Some earlier studies reported that subjects who had menarche before 13 years of age were at a significantly higher risk of cancer cervix. Nutrition has an important bearing on age at menarche. Menarche is attained earlier by well-nourished adolescents. This study aimed to assess the relationship between menarche age and body mass index.Subjects and Method: This was a cross-sectional study conducted at Ki Hajar Dewantara Foundation Junior High School, Kota Pinang, Labuhanbatu Selatan, North Sumatera, in December 2017. A sample of 58 school girls attending Junior High School was selected for this study. The dependent variable was the menarche age. The independent variable was the body mass index (BMI). Body weight was measured by a scale. Body height was measured by micro toise. Other variables were measured by questionnaire. The data were analyzed by simple logistic regression.Results: BMI ≥ 25 was associated with an earlier menarche age (OR = 0.71; 95%CI= 0.20 to 0.85; p= 0.046).Conclusion: BMI ≥ 25 is associated with an earlier menarche age.Keywords: menarche age, body mass index, adolescentsCorrespondence: Asrika Sari. Masters Program in Public Health, Universitas Sumatera Utara, Jl. Universitas No.21, Medan 20115, North Sumatera, Indonesia, Email: [email protected]. Mobile: +6282274134348.Journal of Maternal and Child Health (2019), 4(5): 335-337https://doi.org/10.26911/thejmch.2019.04.05.0
Path Analysis on Determinants of Postpartum Bleeding at Dr. Moewardi Hospital, Central Java
Get PDFBackground: Postpartum hemorrhage is bleeding that exceeds 500 ml after the baby is born. The main causes of postpartum bleeding are uterine atony, placental retention, birth canal laceration, and blood clotting abnormalities. Predisposing factors of postpartum hemorrhage are age, parity, anemia, premature rupture of membranes, preeclampsia, prolonged labor, uterine overdistention, labor of action, history of previous bleeding, and distance of pregnancy. Postpartum hemorrhage will cause maternal death if it is not treated immediately. This study aimed to analyze the determinants of postpartum hemorrhage.Subjects and Method: This study used observational analytic with a case control approach. The study was conducted at Dr. Moewardi, Central Java, from April to May 2019. The total sample was 225 maternity mothers who were selected based on fixed disease sampling by using a ratio of 1: 2 between the case and control groups. The dependent variable was postpartum bleeding. The independent variables were age, parity, anemia, premature rupture of membranes, preeclampsia, prolonged labor, uterine overdistention, action delivery, obstetric history, uterine atony, placental retention, birth canal laceration, and pregnancy distance. Data collection techniques used secondary data medical record records which were analyzed by using path analysis.Results: Postpartum hemorrhage was directly and positively associated with atonia uterine (b= 2.46; 95% CI= 1.53 to 3.40; p<0.001), vaginal laceration (b= 1.76; 95% CI= 0.78 to 2.75; p <0.001), poor obstetric history (b= 0.93; 95% CI= 0.11 to 1.76; p= 0.026), and type of labor (b= 1.70; 95% CI= 0.94 to 2.46; p <0.001). It was indirectly affected by preeclampsia, parity, prolonged labor, premature rupture of membrane, age, anemia, uterine overdistention, birth spacing, and placental retention.Conclusion: Postpartum hemorrhage is directly and positively associated with atonia uterine, vaginal laceration, poor obstetric history, and type of labor. It is indirectly affected by preeclampsia, parity, prolonged labor, premature rupture of membrane, age, anemia, uterine overdistention, birth spacing, and placental retention.Keywords: Postpartum hemorrhage, placental retention, atonia uterine, path analysis Correspondence: Siti Nur Hidayati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 082133679586.Journal of Maternal and Child Health (2019), 4(6): 35-47https://doi.org/10.26911/thejmch.2019.04.06.0