Journal of Evidence-based Nursing and Public Health
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Mapping environmental contamination of carbon footprints and health impact from the breastmilk substitutes consumption in Southeast Asia: A scoping review
No full textBackground: In Southeast Asia, breastmilk substitutes (BMS) have quickly turned into a widely accepted social practice. But the health and environmental effects are not thoroughly examined. BMS producers and manufacturers, through their industrial processes, packaging waste, and transportation, are the major contributors to ecological degradation, while formula feeding brings health risks for infants. Methods: This scoping review was performed in accordance with the PRISMA-ScR guidelines and brought together results from 23 articles published in reputable journals between 2015 and 2025. The databases explored were PubMed, Scopus, Cochrane Library, Google Scholar, and Crossref. Data was gathered, and the latter was done through the Joanna Briggs Institute tools, and then it was analyzed thematically. Findings: There is a clear link between BMS production and consumption, and major environmental impacts resulting from these 3-MCPD, glycidyl esters are examples of chemical contaminants; microplastics and large amounts of GHG emissions are also included (3–6 kg CO₂-eq per kg product). Water and energy use are augmented due to formula preparation, and the disposal of materials has worsened plastic pollution in urban rivers. Health investigations pointed out that babies on a formula diet are more exposed to infections. Economists' forecasts have also pointed to avoidable health and environmental costs arising from reduced breastfeeding, and these are found to be considerable. Conclusion: The use of BMS has a detrimental effect on both mankind and nature, while breastfeeding is still the most eco-friendly and health-producing feeding technique. Novelty/Originality: Besides being the first study to establish BMS consumption with environmental contamination, carbon footprints, and health outcomes in Southeast Asia, this review also redefined infant feeding as an issue of planetary health
Spatial autocorrelation analysis of tuberculosis incidence: Identifying geographical clusters and socio-environmental risk factors
No full textBackground: Indonesia ranks second as the country with the highest number of tuberculosis cases in the world. The three most populous provinces on the island of Java (West Java, East Java, and Central Java) contribute the most TB cases in Indonesia. The Provincial Health Offices of West Java, East Java, and Central Java have data on tuberculosis incidence and influencing risk factors, but most of the data is processed manually and presented in tables and graphs. Spatial and mapping approaches can be used to visualize the distribution of tuberculosis incidence and its risk factors. Method: This study used an ecological study design with a spatial approach. The population in this study consisted of 100 districts/cities in the provinces of West Java, East Java, and Central Java. The data used were aggregated from annual publications issued by the health offices and the central statistics agencies of the three provinces for the period 2024. Findings: The tuberculosis case notification rate distribution in the three regions of Java Island exhibited positive spatial autocorrelation. Three independent variables had negative spatial autocorrelation with the TB CNR, namely the percentage of poor people, the percentage of households with access to proper sanitation, and the percentage of livable houses. Meanwhile, population density is the only variable that has positive spatial autocorrelation with TB CNR. Conclusion: TB prevention, case finding, and intervention can adopt and modify the policy implications of these spatial analysis results by considering the conditions of each region. Originality of this article: This study applies spatial analysis using Moran's Index and LISA approaches in the regions of West Java, East Java, and Central Java, as well as its use of variables such as BPJS Health insurance ownership, access to proper sanitation, and livable housing, which have not been widely studied in previous research
Stunting incidence factors based on environmental health and economic status perspectives: A narrative review
No full textBackground: Stunting is when a child's height or length is shorter than their age due to chronic malnutrition and repeated infections occurring during the first 1,000 days of life. According to data from the Ministry of Health, Indonesia's stunting rate was 19.8% in 2024, despite the Indonesian government's target of reducing stunting prevalence by 14% by that year. The persistently high prevalence of stunting has profound implications for the Indonesian nation. This study examines the factors contributing to stunting from the perspective of environmental health and economic status in Indonesia. Methods: This study used a narrative literature review on method based on previous studies sourced from PubMed, Scopus, Google Scholar, Science Direct, and MEDLINE published from January 2021 to October 2025, as well as reports on the results of the SSGI and SKI data from 2021 to 2024. Findings: This study focuses on the multifactorial causes of stunting related to Indonesia's environmental health and economic status. The availability of clean water, inadequate sanitation and latrines, and low economic conditions can cause stunting. Stunting requires a multisectoral strategy focusing on maternal and child nutrition, environmental health, and improving economic status. Conclusion: The evidence presented could guide policy development strategies and targeted interventions to prevent stunting, especially from an environmental health perspective, and improve economic status to prevent stunting in Indonesia. Novelty/Originality of this article: This study highlights the relationship between stunting incidence factors based on an environmental health and economic status perspective in Indonesia. The narrative review offers a holistic perspective in understanding the complexity of stunting factors and designing more effective intervention strategy policies and guidelines
The policies and strategies for prevent and control non-communicable diseases: a bibliometric analysis of global research trends
No full textBackground: Reducing premature mortality from non-communicable diseases (NCDs) is a key target of the Sustainable Development Goals (SDGs). This study aimed to map global research trends about policies and strategies for the prevention and control of NCDs using a bibliometric approach. Methods: A bibliometric analysis was conducted using the Scopus database. Articles published in English between 1 January 2023 and 6 November 2025 were retrieved. Bibliometric networks of authors, institutions, countries, sources, keywords, and co-cited references were analyzed and visualized using VOSviewer. Findings: A total of 555 articles were included. The field is dominated by collaborative networks of authors and institutions from high-income countries, particularly the United States, the United Kingdom, Australia, and Iran. The Lancet and other leading journals in public health and medicine formed the main co-citation hubs. Frequently co-occurring keywords highlighted policy implementation, health systems, risk factors, health promotion, and prevention and control strategies for major NCDs. Conclusion: Global research on NCD policies and strategies is increasing, yet remains concentrated in high-income settings. Future studies should prioritize implementation and evaluation of NCD policies in low- and middle-income countries, integration of digital health technologies, development of context-specific risk-based strategies, and assessments of policy impacts on health and economic inequalities. Novelty/Originality of this article: This study provides one of the first up-to-date bibliometric overviews (2023–2025) of global publications on NCD prevention and control policies and strategies, offering evidence-based directions for future research and policymaking
Socio-demographic and environmental determinants of hepatitis A preventive behaviors in densely populated urban communities
No full textBackground: Urban hepatitis A outbreaks in Indonesia highlight the need to understand preventive behaviors beyond biomedical factors. This study applies Green's health behavior theory to examine demographic, behavioral, and environmental determinants of hepatitis A preventive in an urban Jakarta community. The purpose of this study is to identify and analyze the relationship between individual characteristics and preventive behaviors toward Hepatitis A, in order to provide evidence-based recommendations for effective public health interventions. Methods: This study conducted a cross-sectional analytic study among residents aged 15–45 years using a validated questionnaire. Variables included knowledge, attitudes, and information exposure alongside demographics. Data were analyzed with chi-square tests for categorical associations. Findings: Older age, female gender, higher education, employment, better knowledge, positive attitudes, and information exposure were associated with practicing hepatitis A preventive behaviors (e.g., safe water/food handling, hand hygiene) (p < 0.05). The survey in the Kemayoran District showed a high level of compliance in hand washing and clean water use, but inconsistent practices still occurred in relation to thorough cooking of food and technical understanding of the virus etiology. The results of the study identified a significant gap between knowledge and behavior, where moderate attitudes and incomplete health literacy hindered the transition from general awareness to consistent protective actions. Conclusion: Predisposing (knowledge, attitudes), enabling (access to clean water/sanitation), and reinforcing factors (community and health-worker support) jointly predict preventive practices. Findings inform culturally responsive, nurse-led community interventions in low-resource urban settings. Novelty/Originality of this article: This article addresses the gap that most studies in Indonesia have focused only on biomedical or knowledge-based aspects. The study provides a culturally relevant framework for targeted public health interventions in urban communities by integrating demographic, behavioral, and environmental factors
Association between access to water, sanitation, and hygiene (WASH) practices and stunting among children under five: A systematic review and meta-analysis
No full textBackground: Stunting is a chronic malnutrition condition that leads to impaired growth and development, primarily caused by inadequate water, sanitation, and hygiene (WASH) conditions. This study aims to systematically review and meta-analyze the association between WASH factors and stunting in children under five. Methods: This meta-analysis was conducted using the PICO research question. The study population involves children aged 0 to 59 months to analyze how unimproved water, sanitation, and hygiene compare with improved practices in affecting stunting outcomes. Relevant articles were systematically retrieved from several databases including PubMed, BMC, ScienceDirect, and Springer Link, with inclusion criteria focusing on cross-sectional and longitudinal studies published between 2020 and 2025. All gathered data were subsequently synthesized and analyzed using the Review Manager 5.4 application to ensure a rigorous evaluation of the research findings. Findings: Meta-analysis included 6 studies from Indonesia and Ethiopia. The risk of stunting increased with unimproved sanitation (aOR = 1.33; 95% CI = 1.20–1.48; p < 0.00001), unimproved hygiene (aOR = 1.16; 95% CI = 0.73–1.84; p = 0.530) unimproved water (aOR = 1.10; 95% CI = 0.94–1.29; p = 0.250) increased the risk of stunting, but it was statistically not significant. Conclusion: Unimproved water, sanitation and hygiene increase the risk of stunting. Novelty/Originality of this article: This study provides a separated evaluation of water, sanitation, and hygiene factors using evidence from 2020–2025 to clarify specific WASH-related determinants contributing to stunting among children under five
The impact of sedentary behavior on blood glucose levels in type 2 diabetes mellitus patients: A literature review
Get PDFBackground: Sedentary behavior, characterized by prolonged sitting or lying down, is increasingly recognized as a major health risk, particularly for individuals with type 2 diabetes mellitus (T2DM). Previous studies have shown that sedentary lifestyles can exacerbate glucose control issues, leading to poor glycemic regulation and an increased risk of complications. This study aims to explore the relationship between sedentary behavior and blood glucose levels in T2DM patients, highlighting the potential benefits of interrupting sedentary time with physical activity. Methods: This research utilized a comprehensive literature review methodology, analyzing studies published over the past decade to assess the impact of sedentary behavior on glycemic control in T2DM patients. The review focused on both observational studies and experimental trials, employing data from clinical studies and patient monitoring. Findings: Prolonged sedentary behavior was found to be associated with worsening glucose control, including prolonged hyperglycemia and reduced euglycemia. Interrupting sedentary time with short bouts of physical activity (e.g., walking or light exercise) was shown to significantly improve glucose uptake in skeletal muscles, providing effects similar to anti-diabetic medications. Consistent and frequent interruption of sedentary behavior resulted in improved daily blood glucose control, potentially offering a non-pharmacological intervention for T2DM management. Conclusion: The study underscores the importance of reducing sedentary behavior in T2DM patients as a strategy to enhance blood glucose control and prevent complications. Regular physical activity interruptions can serve as a critical non-pharmacological intervention to manage and control blood glucose levels. Novelty/Originality of this article: This review contributes to the growing body of evidence on the health risks of sedentary behavior in T2DM patients, emphasizing the potential of simple lifestyle interventions to improve glycemic control, which has been insufficiently explored in previous literature.
Factors contributing to delayed health insurance outpatient claims and administrative optimization strategies
Get PDFBackground: Pending claims in BPJS Kesehatan (National Health Insurance) systems can cause significant financial and administrative inefficiencies. At Universitas Indonesia Hospital, a notable number of outpatient health insurance claims remain unresolved, affecting both hospital revenue and claim processing performance. Methods: This study uses a cross-sectional observational approach, collecting data at one specific point in time to analyze pending outpatient health insurance claim files at Universitas Indonesia Hospital in 2023. Claim submission and verification procedures were examined, from medical record processing to claim file transfer to the insurer. Findings: Out of 102,530 outpatient claims submitted in 2023, 1,557 (1.5%) were pending, amounting to a total of IDR 1.84 billion. The main causes were incomplete files and medical resumes (47.1%), coding discrepancies and incorrect medical actions (38.1%), and indications of repeated actions (14.8%). Conclusion: The high rate of pending claims can be mitigated through targeted strategies such as increasing human resources in the support services unit, routine hardware maintenance, ongoing training for coders on the latest coding agreements, and better communication with doctors to ensure clarity in diagnosis documentation. Novelty/Originality of this article: This study offers an in-depth, institution-specific analysis of outpatient claim delays in a major Indonesian hospital, identifying root causes and practical solutions. It contributes to optimizing hospital administration and health insurance efficiency by addressing operational gaps often overlooked in broader policy discussions
Safe breath: A concept for air quality monitoring app using internet of things and early detection to support Tuberculosis elimination by 2030
Get PDFBackground: Tuberculosis (TB) remains a significant global health challenge, particularly in countries with poor air quality and high population density. Delayed diagnosis and environmental factors, such as air pollution, contribute to the high prevalence and mortality rates associated with this disease despite advancements in treatment and prevention. A review of the literature highlights a significant association between long-term exposure to air pollutants, such as delicate particulate matter ( ) and an increased risk of TB. Internet of Things (IoT) technology, which integrates real-time environmental sensors with analytical algorithms, offers the potential to support TB prevention through data-driven and modern technological approaches. This study aims to design a conceptual framework based on IoT technology to enhance early TB detection through air quality monitoring. Methods: A literature review was conducted from 2020 to 2025, focusing on designing the Safe Breath conceptual framework. Relevant articles were retrieved from databases including PubMed, ScienceDirect, and Google Scholar, filtered by inclusion criteria and full-text availability. Data were synthesized to explore the relationship between air quality and TB incidence. Findings Poor air quality is closely linked to TB risk, making environmental monitoring essential in disease control. IoT technology can collect real-time data through air quality sensors, monitoring environmental risk factors continuously. The Safe Breath application concept integrates air sensors with early detection features to improve TB screening accuracy while encouraging community participation in disease prevention efforts. Conclusion: The proposed Safe Breath application combines IoT technology with air quality monitoring and early detection systems, improving screening accuracy and proactive TB control through a community-based approach. Novelty/Originality of this article: This study presents a novel approach by integrating IoT technology and environmental monitoring for TB control. The combined use of air sensors and early detection tools offers a scalable, data-driven solution for global TB prevention
Exploring the influence of demographic factors on COVID-19 prevention behaviors in traditional market settings
Get PDFBackground: Covid-19 prevention behaviors are essential in controlling the spread of the virus, particularly in public spaces such as traditional markets. This study aimed to analyze the factors influencing the Covid-19 prevention behavior of traders at Yada Traditional Market, Palembang. Previous studies have indicated that demographic factors such as age, gender, education level, and knowledge significantly impact preventive actions. Methods: his cross-sectional study involved 110 traders as respondents, utilizing a structured questionnaire for data collection. Descriptive and inferential statistics, including Chi-Square and logistic regression, were employed to analyze the relationships between demographic factors and Covid-19 prevention behavior. Findings: The study found no significant relationship between gender and Covid-19 prevention behavior (p-value=0.156). However, significant associations were found between age, education level, and knowledge with prevention behavior (p-value<0.05). Older adults and individuals with higher education levels exhibited better prevention behaviors. Conclusion: Age, education, and knowledge were identified as key factors influencing Covid-19 prevention behaviors. This suggests that improving education and knowledge could enhance preventive measures among traders and the broader community. Novelty/Originality of this article: This study provides new insights into the Covid-19 prevention behavior of traders in a traditional market setting, highlighting the importance of demographic factors in health behavior interventions