Indonesian Journal of Health Administration
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LEADERSHIP TRAITS OF NURSE MANAGERS AND NURSE STAFF COMMITMENT IN THE PHILIPPINES HOSPITALS
Full text linkBackground: Effective nurse leadership significantly influences healthcare service quality. Nurse managers' leadership impacts staff nurse commitment, patient outcomes, and organizational success.
Aims: To examine nurse manager leadership traits and their relationship with staff nurse commitment in a government hospital.
Methods: Descriptive-inferential correlation research with stratified and randomized nurse managers (n = 21) and staff nurses (n = 117) as participants from five selected hospitals at Lanao del Norte. Adopted questionnaires on leadership traits and commitment were used and data were analyzed using frequency, percentage, mean, and standard deviation in SPSS v.25.
Results: The result shows that nurse manager leadership qualities are usually valid for a leader who encourages others to do what is right, gives subordinates continuing education, and is an ethical and self-confident leader. Their staff nurses believed positive components of the leadership traits of nurse managers were sometimes true. Staff nurses were generally still deciding whether they were committed to their work effectively, continuously, or normatively. Nurse managers' leadership traits are significantly related to the staff nurses' affective, continuance, and normative commitment.
Conclusion: Fostering positive leadership through education and supportive environments enhances staff nurse commitment and job satisfaction, reducing nurse turnover and improving nursing care quality.
Keywords: commitment, leadership traits, leadership qualities, nurse manager, nurse staf
ANTI-SMOKING MESSAGES VERSUS PRO-SMOKING MESSAGES AMONG INDONESIAN ADOLESCENT SMOKERS
Full text linkBackground: Anti-smoking messages (ASM) is a program designed to educate the public about the dangers of tobacco use, aiming to prevent adolescents and young people from smoking cigarettes in any form and to assist smokers in giving up their smoking habit. On the contrary, pro-smoking messages (PSM) is a marketing technique to promote tobacco products.
Aims: This study was conducted to describe the exposure to ASM and PSM among Indonesian adolescent smokers (IAS).
Methods: This study analyzed secondary data from the 2019 Global Youth Tobacco Survey (GYTS) Indonesia. The outcome variable was the respondent's smoking intensity in the last 30 days. The independent variables were the exposure to ASM and PSM in the various below-the-line media.
Results: Most IAS were male (93.4%), mostly in secondary school (60.3%) and spent more than IDR 11,000 per week (71.1%). Adolescent smokers were exposed to ASM at a rate of 92.4%. Furthermore, ASM exposure happened to 60.5% of the low-intensity youth smoker group and 39.5% of the high-intensity youth smoker group. Meanwhile, 93% of adolescent smokers were exposed to PSM, with 40.8% in the high-intensity youth smoker group and 59.2% in the low-intensity youth smoker group.
Conclusion: The exposure to ASM and PSM in the adolescent smoker group was relatively the same.
Keywords: ASM, PSM, prevention, public health, tobacco control, yout
COST-ANALYSIS OF REDUCING MORTALITY RATE FOR LBW BABIES AT FATMAWATI HOSPITAL'S NICU
Full text linkBackground: As a developing country that still struggles with infant mortality, Indonesia needs high-quality and efficient neonatal care. However, due to the complexity of neonatal care, the neonatal intensive care unit (NICU) still has a high cost, approximately USD 950 - 31,000, as the last line of care.
Aims: This study analyzes the cost incurred due to service improvement at Fatmawati General Hospital. The cost analysis may serve as useful evidence for other hospitals with NICUs that seek to improve their service.
Methods: We used cost analysis to examine pre-intervention costs in 2015 and post-intervention costs in 2021. Our data were gathered primarily in the NICU of Fatmawati General Hospital for three months in 2023.
Results: The results showed an increase in total cost of IDR 1,898,040,489 (55%). The largest cost increase was personnel and supplies costs, which accounted for 83.8% of the cost increase. However, this cost increase was also followed by a significant decrease in mortality rates, from 128 deaths per 1,000 births to 17 deaths per 1,000 births.
Conclusion: This study found a correlation between investment in service improvements and decreased infant mortality rates in the NICU of Fatmawati General Hospital. Although the 55% increase in total cost was associated with a significant decrease in infant mortality rates in the NICU of Fatmawati General Hospital, further studies are needed to determine the effectiveness of improvements in the NICU's services.
Keywords: cost, Indonesia, LBW, NIC
LYMPHATIC FILARIASIS DRUG TREATMENT POLICIES IN EASTERN INDONESIA: WHAT TARGET CHARACTERISTICS MATTER?
Full text linkBackground: Lymphatic filariasis (LF) drug treatment compliance remains a challenge in Eastern Indonesia.
Aims: The study sought to determine which aspects of Eastern Indonesia's LF drug treatment compliance policies were most pertinent.
Methods: The 2018 Indonesian Basic Health Survey data was employed. The analysis units were adults (≥ 15 years) who had received LF drug treatment. LF drug treatment compliance was analyzed based on respondent characteristics (age, gender, marital status, education, occupation, wealth and comorbidities) using binary logistic regression.
Results: The proportion of adherence to LF treatment in Eastern Indonesia was 73.1%. Respondent characteristics that influenced LF treatment compliance were age group > 24 (aOR = 1.374, 95% CI: 1.305-1.447), female (aOR = 1.307, 95% CI: 1.263-1.353), all educated respondent status (aOR = 2.152, 95% CI: 2.043-2.268), and all employed respondents (aOR = 1.437, 95% CI: 1.365 - 1.512). Married respondents and those with all levels of wealth status were less likely to take LF drug treatment.
Conclusion: Policy focus on improving LF treatment compliance among the younger male, the less educated, the unemployed, and those with lower social economic status.
Keywords: compliance, Eastern Indonesia, lymphatic filariasis, public healt
POVERTY LEVELS MUST BE REDUCED TO IMPROVE ACCESSIBILITY TO HEALTH SERVICES
Full text linkBackground: Access to health services is a fundamental right for every citizen, but its equitable distribution remains challenging due to the influence of several variables. Indonesia has achieved Universal Health Coverage (UHC), but access to health services for those with health problems is still low.
Aims: This study aims to determine the variables influencing access to health services in Indonesia.
Methods: Longitudinal analysis of panel data was used, and the dataset was taken from the 34 provinces of Indonesia from 2018 to 2022. The data obtained were then analyzed descriptively and analytically by linear regression using STATA software.
Results: Individual and family variables influencing access to health services for the population with health problems included variable need (health problem), ownership of health insurance, and ability to pay. Furthermore, the results showed that the number of areas with high poverty rates (socioeconomic) was a contextual factor with a higher level of influence.
Conclusion: Based on the results, policies to improve access to health services, a basic human right, could not be solely achieved by the health sector. Therefore, integrated comprehensive planning collaboration of Penta-Helical elements was needed to reduce poverty enclaves.
Keywords: ability to pay, access to health services, health insurance, povert
PERCEPTIONS AND THEIR CORRELATION WITH ENROLLMENT IN THE INDONESIAN NATIONAL HEALTH INSURANCE SCHEME
Full text linkBackground: Health insurance serves as a key mechanism in facilitating wider and more equitable availability of healthcare services, ensuring that every individual can access the services they need.
Aims: This research aims to examine the correlation between community perceptions and enrollment in the National Health Insurance (JKN) in the Musi Rawas Utara District, Indonesia.
Methods: This research applied a cross-sectional study by collecting data from 384 respondents. Logistic regression analysis was used to assess the correlation between perceptions and JKN enrollment.
Results: The results showed that 68.49% of respondents were not enrolled in the JKN. Factors associated with JKN enrollment include perceptions regarding JKN, income, and the history of illness. People with favorable perceptions have a 1.90 times higher chance to join the JKN membership. People with income ≥ provincial minimum wage (UMR) have an opportunity of 0.50 times higher than people with income < UMR to join the JKN membership. The history of illness is likely to enhance JKN enrollment by 7.86 times.
Conclusion: In the Musi Rawas Utara District, the rate of enrollment in the JKN program remains low. Strategic policy reforms, accompanied by targeted advocacy and health education promotion, have the potential to significantly increase JKN enrollment and contribute to the realization and sustainability of universal health coverage (UHC) goals.
Keywords: Perception, Enrollment, National Health Insurance
THE COST OF SMS REMINDER TO IMPROVE ARV ADHERENCE AMONG KEY POPULATIONS
Full text linkBackground: HATI is an implementation trial aimed at improving HIV care and treatment, including through SMS reminders.
Aims: This study aimed to estimate the cost and analyze the outcomes of providing SMS Reminders within the HATI program in different settings.
Methods: Data were analyzed using a micro-costing approach from providers' and health systems' perspectives. Subjects were divided into intervention and control groups for outcome analysis, with adherence as the outcome indicator.
Results: From a provider's perspective, the highest cost was incurred in primary health care (PHC) clinics, while the lowest was in hospital clinics, most likely due to a much higher volume of SMS sent from hospitals. Costs from the health system perspective were more than two times higher than those from the provider perspective, as they included costs borne by HATI management and intervention setup. In one year, the number of patients with >95% adherent visits was higher in the intervention group than the control group, although visits decreased over time in both groups. The highest number of patients with >95% adherent visits was found in PHC clinics, while the lowest was in hospital clinics.
Conclusion: SMS reminders can be expensive initially due to setup and program costs. However, they become cheaper once they are embedded into the existing system. Further studies are necessary to determine better site options for scaling up SMS reminder intervention and to study the declining adherence rate in all clinics.
Keywords: Adherence, cost analysis, HIV, Indonesia, SMS reminde
BUILDING RESILIENT HEALTH SYSTEMS: THE CRITICAL ROLE OF PRIMARY HEALTH CARE AND NATIONAL HEALTH INSURANCE
Full text linkThis editorial article explores the critical role of primary health care (PHC) in building resilient health systems, particularly within the context of Indonesia's National Health Insurance (JKN) program. It emphasizes the importance of universal access to comprehensive health services as a fundamental aspect of effective PHC. The discussion highlights best practices for strengthening PHC, including enhancing collaboration between public and private sectors, improving information exchange, and establishing quality evaluation systems. The article also addresses significant challenges, such as workforce shortages and coordination issues between primary and secondary health services. Furthermore, it underscores the necessity of developing suitable assessment tools, such as the Primary Care Assessment Tool (PCAT), to evaluate and enhance PHC services tailored to local needs. The findings suggest that addressing poverty is essential for improving access to health care, requiring collaborative efforts across various societal sectors. Overall, the article advocates for sustained investment in PHC to achieve better health outcomes and resilience in health systems.
Keywords: Health Insurance, Health System, Primary Health Car
EFFECTIVENESS OF TELEMEDICINE HEALTHCARE SERVICES IN RURAL AREAS OF BANGLADESH: A STUDY ON SELECTED VILLAGES
Full text linkBackground: Bangladesh's healthcare system faces challenges in providing equitable access and quality healthcare to rural and remote communities compared to urban areas. To address these issues, the country has incorporated telemedicine into its healthcare system.
Aims: This study aimed to assess the effectiveness of telemedicine services in rural Bangladesh.
Methods: The study employed a mixed-method approach, including survey questionnaires and in-depth interviews. 100 participants were selected for the questionnaire survey for quantitative data, and 20 in-depth interviews were conducted to collect qualitative data.
Results: The findings indicate that telemedicine has garnered a positive reception among rural residents. An overwhelming 86% regarded telemedicine as a cost-effective healthcare option. 44% reported accessing telemedicine services within 10 minutes, demonstrating their accessibility. Furthermore, a majority (54%) expressed satisfaction with telemedicine services. However, dissatisfaction was noted concerning the physical environment of the telemedicine centers.
Conclusion: Overall, telemedicine in Bangladesh has proven effective in cost savings and time efficiency and has gained significant acceptance among rural residents. To further improve healthcare accessibility, expanding telemedicine centers to reach every remote union in Bangladesh is imperative. Additionally, raising awareness, providing ICT and telemedicine education, and ensuring affordable and reliable internet connectivity will maximize the potential of telemedicine services, ultimately benefiting underprivileged rural populations.
Keywords: healthcare, rural Bangladesh, telehealth, telemedicin
POLICY ADVICE ON EQUAL ACCESS TO HEALTHCARE: WHAT'S NEW?
Full text linkWe have less than ten years to achieve the 2030 Sustainable Development Goals (SDGs). In the health sector, it is crucial to focus on Goal 3, which aims for the health and well-being of everyone. Despite progress, disparities in healthcare access continue to affect vulnerable populations. Some countries have implemented Universal Health Coverage (UHC) to ensure equal healthcare access. This editorial emphasized the need for targeted interventions, policy reforms, and increased public awareness to achieve equitable healthcare access and better health outcomes for diverse populations.
Keywords: disparities, policy reforms, SDGs, UH