Berita Kedokteran Masyarakat
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Probabilitas dan determinan pemanfaatan asuransi kesehatan di Indonesia (berdasarkan data IFLS tahun 2015)
Get PDFThe probability and determinants of the utilization of health insurance in Indonesia: analysis of 2015 IFLS data Purpose: This study investigates the probability and the determinants of use of health insurance in Indonesia.Method: The Indonesian Family Life Survey (IFLS) 2015 data were used and analyzed by logistic regression/probit. Age, gender, marital status, family status, education, employment status, and area of residence were used as determinant variables.Results: The proportion of utilization of health insurance is 39.9%. A total of 60.02% of health insurance owners do not use health insurance and issueout of pocket (OOP) fees. Age variables (0.037), education (0,000) and residential areas (0,000) were significantly significant (p-value <0.05) for the use of health insurance.
Cegah politisasi fogging dalam penanggulangan DBD! (Policy Brief)
Get PDFLatarbelakang: Pengasapan insektisida (fogging) merupakan salah satu upaya dalam menanggulangi wabah Demam Berdarah Dengue di masyarakat, namun fogging merupakan upaya penanggulangan yang hanya bersifat sementara. Fogging saat ini tidak hanya dilakukan oleh Dinas Kesehatan saja namun juga oleh swasta, masyarakat maupun pihak tertentu misalnya partai politik. Menjelang momentum politik seperti Pilkada maupun Pemilu dan bersamaan dengan naiknya angka kasus DBD, fogging menjadi populer sebagai strategi kampanye dari para elit politik maupun partai politik. Tujuan: Kajian ini bertujuan mengungkap fenomena politisasi fogging dan dampak negatifnya serta memberikan rekomendasi kebijakan (policy brief). Metode: Kajian ini merupakan literature review dari berbagai sumber informasi dan hasil penelitian terkait fenomena politisasi fogging, dan dianalisis secara deskriptif untuk mengeksplorasi fenomena tersebut. Hasil: Fogging digunakan sebagai alat kampanye untuk menarik simpati dan dukungan masyarakat sehingga menjadi program unggulan partai politik dan para calon legislatif. Para elit politik memanfaatkan pemahaman masyarakat yang keliru yang menganggap fogging adalah upaya yang ampuh memberantas DBD. Masih adanya pengawasan yang kurang dari Dinas Kesehatan terhadap pihak-pihak lain yang menyelenggarakan fogging sehingga fogging semakin merajalela. Fogging yang dilakukan dengan kepentingan politik seringkali tidak melalui penyelidikan epidemiologi dan prosedur yang seharusnya, sehingga dapat mengakibatkan dampak negatif berupa keracunan pada manusia, pencemaran lingkungan dan memicu resistensi nyamuk. Kesimpulan dan Rekomendasi: Pemerintah harus menetapkan kebijakan yang tegas untuk mengatur bahkan melarang upaya fogging yang menyalahi prosedur dan hanya digunakan sebagai alat politik. Program perlu melakukan upaya sosialisasi secara meluas ke masyarakat mengenai dampak negatif fogging dan penekanan kembali kepada upaya PSN yang berkelanjutan
Penanganan kasus abortus inkomplit pada puskesmas PONED di Kabupaten Sumbawa Barat
Get PDFSuccess rate in handling incomplete abortion in EmOC primary health care in West SumbawaPurposeThis study explored the success of incomplete abortion in EmOC PHC in West Sumbawa.MethodThis research used descriptive analytic design with mix method approach. Quantitative research with cross sectional design and qualitative research with multiple-case study approach. The quantitative research sample is mother with incomplete abortion and qualitative research sample that is midwife, doctor and head of Puskesmas. Quantitative data analysis used chi-square test and logistic regression. Qualitative data collection using indepth interview method.ResultsHandling of successful incomplete abortus was 63,3% and most of EmOC PHC was complete 67,3%. There is a significant correlation between the success of incomplete abortion handling with the completeness of EmOC PHC. The likelihood of successful completion of incomplete abortion cases in complete EmOC PHC was 4.1 times greater than that of incomplete EmOC PHC. There was a significant relationship between maternal gestational age at abortion with successful incomplete abortion treatment (OR = 7,1; CI95% 1.27-40,2). Qualitative results show that EmOC teamwork can influence the success of handling incomplete abortion cases.ConclusionCompleteness of EmOC PHC has relationship with handling of incomplete abortus case. Increased knowledge and competence of health workers in the handling of incomplete abortion, so that in case management is more prepared and competent.Success rate in handling incomplete abortion in EmOC primary health care in West SumbawaPurposeThis study explored the success of incomplete abortion in EmOC PHC in West Sumbawa.MethodThis research used descriptive analytic design with mix method approach. Quantitative research with cross sectional design and qualitative research with multiple-case study approach. The quantitative research sample is mother with incomplete abortion and qualitative research sample that is midwife, doctor and head of Puskesmas. Quantitative data analysis used chi-square test and logistic regression. Qualitative data collection using indepth interview method.ResultsHandling of successful incomplete abortus was 63,3% and most of EmOC PHC was complete 67,3%. There is a significant correlation between the success of incomplete abortion handling with the completeness of EmOC PHC. The likelihood of successful completion of incomplete abortion cases in complete EmOC PHC was 4.1 times greater than that of incomplete EmOC PHC. There was a significant relationship between maternal gestational age at abortion with successful incomplete abortion treatment (OR = 7,1; CI95% 1.27-40,2). Qualitative results show that EmOC teamwork can influence the success of handling incomplete abortion cases.ConclusionCompleteness of EmOC PHC has relationship with handling of incomplete abortus case. Increased knowledge and competence of health workers in the handling of incomplete abortion, so that in case management is more prepared and competent
Hazard identification, risk assesment and risk control serta penerapan risk mapping pada rumah sakit hewan Prof. Soeparwi Universitas Gadjah Mada
Get PDFHazard identification, risk assesment and risk control and the application of risk mapping at Hospital of the Animal Prof. Soeparwi Universitas Gadjah Mada Purpose: This research was held to analyze the work accident using HIRARC method and the applied of Risk Mapping at the hospital of the animal of Prof. Soeparwi Gadjah Mada University, Yogyakarta.Method: This research used descriptive qualitative research method. The qualitative method used to describe the condition, assess, and to recognize the work accident analysis. The data used was grabbed from Hazard Identification Risk Assessment and Risk Control (HIRARC) method and questionnaire.Results: Hazard identification used HIRARC method at the hospital of the animal of Prof. Soeparwi Gadjah Mada University was about 198. The work hazard commonly includes physical hazard, chemistry, biologist, ergonomics, and psychosocial. The risk assessment which held denoted that there were 61 low risks, 108 medium risks, and 15 high risks. The recommendations of risk restraint that can be given were technician control, administrative, and the use of personal protective equipment (PPE).Conclusion: HIRARC method had been applied at the hospital of animal of Prof. Soeparwi with the result to that grooming unit was high risk work place, assessed with risk mapping. The risk was from animal contact phisically. Latar belakang: Rumah Sakit Hewan merupakan sarana dan prasarana dalam melayani masyarakat untuk menangani masalah terkait dengan hewan. Paramedis hewan sangat rentan dengan kecelakaan kerja yang berasal dari potensi bahaya yang berada di lingkungan kerja. Tujuan: Untuk menganalisis kecelakaan kerja dengan metode HIRARC serta penerapan Risk Mapping pada Rumah Sakit Hewan Prof. Soeparwi Universitas Gadjah Mada Yogyakarta. Metode: Penelitian ini menggunakan metode penelitian kualitatif dengan rancangan deskriptif. Penelitian kualitatif untuk mendeskripsikan atau menggambarkan keadaan, menilai, serta mengetahui tentang analisis kecelakaan kerja. Data yang digunakan berasal dari metode Hazard Identification Risk Assesment and Risk Control (HIRARC) dan Pedoman Wawancara. Hasil: Identifikasi bahaya dengan menggunakan metode HIRARC pada Rumah Sakit Hewan Prof. Soeparwi berjumlah 198 bahaya kerja secara umum meliputi bahaya fisik, kimia, biologi, ergonomi dan psikososial. Penilaian risiko yang dilakukan menunjukkan terdapat 61 risiko bahaya rendah, 108 risiko bahaya sedang dan 15 risiko bahaya tinggi. Rekomendasi pengendalian risiko yang dapat diberikan yaitu pengendalian secara teknik, administratif dan penggunaan Alat Pelindung Diri (APD). Simpulan : Metode HIRARC telah dapat diterapkan pada Rumah Sakit Hewan Prof. Soeparwi dengan hasil pemetaan risiko unit grooming merupakan lingkungan kerja risiko tinggi berupa bahaya fisik terkaman dari hewan.Hazard identification, risk assesment and risk control and the application of risk mapping at hospital of the animal Prof. Soeparwi Universitas Gadjah MadaBackground: The hospital of the animal is the facilities and infrastructures to look after and carry the animal health problem. Veterinaries are the people who make the contact with the animal itself directly, as the result the injury that face by these people is always shadowing. The injury could found from the animal and human mistakes. Purpose: This research was held to analyze the work accident using HIRARC method and the applied of Risk Mapping at the hospital of the animal of Prof. Soeparwi Gadjah Mada University, Yogyakarta. Method: This research used descriptive qualitative research method. The qualitative method used to describe the condition, assess, and to recognize the work accident analysis. The data used was grabbed from Hazard Identification Risk Assessment and Risk Control (HIRARC) method and questionnaire. Results: Hazard identification used HIRARC method at the hospital of the animal of Prof. Soeparwi Gadjah Mada University was about 198. The work hazard commonly includes physical hazard, chemistry, biologist, ergonomics, and psychosocial. The risk assessment which held denoted that there were 61 low risks, 108 medium risks, and 15 high risks. The recommendations of risk restraint that can be given were technician control, administrative, and the use of personal protective equipment (PPE). Conclusion: HIRARC method had been applied at the hospital of animal of Prof. Soeparwi with the result to that grooming unit was high risk work place, assessed with risk mapping. The risk was from animal contact phisically.Keywords: the hospital of the animal; veterinaries; HIRARC; work accident
Two part model analysis household out of pocket for traditional medicine consumption in Central Java
Get PDFTwo part model analysis household out of pocket for traditional medicine consumption in Central JavaPurpose: Traditional medicine is primary health care that uses natural ingredients for treatment in accordance with norms in society. The proportion of traditional medicine utilization was 49% from all traditional health care. Based on Riskesdas 2013, Central Java was one of the provinces that had the highest proportion of traditional medicine utilization, which was 65.2%. This study aimed to determine traditional medicine expenditure in households in Indonesia based on socio-economy.Method: Method in this study was two part model assumption (probit) then compared with log linear value (non zero) ordinary least square (OLS) and also comparing two part model OLS with tobit model as output estimation.Results: The proportion of traditional medicine expenditure within total drugs expenditure was 15.33%. Variable of interest in this study was household region and economy status of household. From two part model (OLS) and tobit, it can be obtained that urban region and household that has expenditure above poverty line, could increase traditional medicine expenditure.Conclusion: This study showed that even though estimators from all situation did not significantly difference, but result from two part (OLS) models has higher coefficient value than tobit model. Traditional medicine is primary health care that use natural ingredients for treatement in accordance with norms in society. The proportion of traditional medicine utilization was 49% from all traditional health care. Based on Riskesdas 2013, Central Java was one of province that had highest proportion of traditional medicine utilization, which was 65.2%. This study aimed to determine traditional medicine expenditure in households in Indonesia based on socio-economy. Method in this study was two part model assumption (probit) then compared with log linear value (non zero) ordinary least square (OLS) and also comparing two part model OLS with tobit model as output estimation. The proportion of traditional medicine expenditure within total drugs expenditure was 15.33%. Variable of interest in this study was household region and economy status of household. From two part model (OLS) and tobit, it can be obtained that urban region and household that has expenditure above poverty line, could increase traditional medicine expenditure. This study showed that even though estimators from all situation did not significantly difference, but result from two part (OLS) models has higher coefficient value than tobit model.
Nilai agama dan persepsi tentang praktik pemberian air susu ibu dua tahun: studi kualitatif di Aceh
Get PDFPurpose: This research aims to explore the value and perception of two-year breastfeeding in Dewantara Sub-district, North Aceh Regency.Method: The methodology employed in this study is qualitative research with phenomenology method. Research participants consist of eight mothers who has toddler over the age of two and two parents as supporting participants. The data is collected by in-depth interview, which will be analysed through phenomenology approach.Results: This research finds that two-year breastfeeding is the recommendation and implementation of the religious value. However, the participant fails to provide breastfeeding because of a lack of knowledge of breastfeeding. The perceptions of breastfeeding still exist such as the breast milk is not coming out, the milk is insufficient for children’s needs, and longer breastfeeding contains blood and can reduce the intelligence of the children. These perceptions is the factors stopping breastfeeding. Also, there is a family tradition to stop for breastfeeding before a two-year-old child.Conclusion: Health professional needs the effort to promote a two-year breastfeeding through coordination, collaboration, outreach, assistance, and reinforcement at the community level, Posyandu cadres, and religious leaders, to achieve the successful two-year breastfeeding. The government of North Aceh Regency needs to accelerate advocacy for issuing policy or Qanun that covers the protection and promotion of two-years breastfeeding program. This includes support and commitment from all stakeholders in order to escalate the scale of public health in North Aceh Regency.
Psychological challenges faced by multidrug-resistant tuberculosis patients: a systematic review
Get PDFPurpose: Multidrug-resistant tuberculosis (MDR-TB) patients have few adverse effects due to treatment regimens, including psychological side effects that play an important role in the successful MDR-TB management. This study was aimed to identify MDR-TB patients’ challenges within the context of psychological issues and to determine suitable intervention to address psychological problems in MDR-TB patients.Method: We conducted a systematic review as PRISMA guidelines using databases PubMed, ProQuest, ScienceDirect, Scopus, and Portal Garuda to search for all related articles. From studies identified, 10 were included in the final analysis.Results: It was found that all studies have documented a range of psychological challenges faced by MDR-TB patients that were depression, anxiety, suicidal tendencies and common issues reported in the studies.Conclusion: Three main strategies can be implemented in every country to address MDR-TB adverse effects and scale-up MDR-TB treatment efficacy. These strategies require high levels of support from health workers and family member which has an important role in the treatment process
Manfaat rumah singgah bagi pasien kanker (lesson learned dari Sasana Marsudi Husada YKI cabang DIY)
Get PDFLatar belakang: Di Indonesia, prevalensi penyakit kanker meningkat dari 1,4‰ pada tahun 2013 menjadi 1,8‰ pada tahun 2018. Terbatasnya rumah sakit rujukan kanker di Indonesia, membuat banyak pasien kanker harus menempuh jarak yang jauh, waktu yang lama dan biaya yang lebih besar untuk mendapatkan perawatan. Keadaan ini menambah beban pasien selama menjalani pengobatan. Rumah singgah menjadi solusi alternatif untuk mendekatkan pasien dengan rumah sakit rujukan, sekaligus menjadi sarana dukungan perawatan paliatif bagi pasien kanker.Tujuan: Mendeskripsikan manfaat rumah singgah bagi pasien kanker.Metode : Observasi dan wawancara pada pasien di rumah singgah Sasana Marsudi Husada YKI cabang DIY.Hasil: Selama di rumah singgah, pasien dan pendamping menyatakan merasakan manfaat rumah singgah secara 1) fisik, yaitu: biaya sewa murah, tersedia sarana untuk kebutuhan harian, akses ke pedagang/penyedia bahan pangan, pasien dapat beristirahat selama masa tunggu sebelum perawatan di RS, jarak ke RS dekat, pasien dapat memperoleh atau bertukar informasi mengenai kanker dan perawatannya; 2) psikologis, yaitu: pasien, pendamping dan relawan dapat saling berbagi motivasi, pengalaman, kecemasan dan kekhawatiran yang dirasakan; pasien merasa tidak berjuang sendiri menghadapi penyakitnya; ada motivasi untuk sembuh setelah melihat pasien lain dapat pulih dan hidup sehat; pasien tetap merasa dihargai dan bernilai sebagai individu; pasien merasa bisa tetap mandiri menjalani pengobatan tanpa harus membebani keluarga; 3) spiritual, yaitu: mendapat motivasi dan dukungan untuk memperbanyak doa bagi kesembuhan pasien; 4) sosial, yaitu: melakukan kegiatan bersama, melakukan kegiatan yang menyenangkan, menerima kunjungan dari keluarga, rekan dan relawan.Simpulan: rumah singgah memberikan manfaat dalam mendukung perawatan paliatif bagi pasien kanker
Evaluation of the simplicity and completeness on two models (manual and web-based) reporting of the case-based measles surveillance system in Special Region of Yogyakarta (DIY)
Get PDFPurpose: In order to eliminate measles in 2020, the Health Office of DIY has developed the surveillance system by implementing CBMS into two different models (Manual and Web-Based Reporting) that has the main purpose to increase the performance of CBMS in detecting new cases, reporting data about the spread of measles after conducting massive campaign of measles in 2017. This study aimed to evaluate the simplicity and completeness of the CBMS in both models.Method: Descriptive evaluative study was conducted in DIY from January 2019 to March 2019. A total of thirty-four (n=34) respondents of health offices in 5 districts, 20 public health care offices and 4 hospitals. Samples were defined by using purposive sampling based on the completeness of the report. Data about simplicity was collected by using structure questioners from 34 respondents. While in measuring completeness, due to lack of information in the health offices, we only observed secondary data in primary health care offices and hospitals. Data were analyzed by using stata 13.Results: For the attribute of simplicity, 64.31% of respondents mentioned that the manual reporting form was too complicated. Meanwhile, only 8.82% of respondents considered that web-based reporting was more complicated. For the attribute of completeness, we observed the reporting completeness of 9 variables on both models which completeness of 4 variables in manual reporting including the number of epidemiology (77%), the number of vaccination (73%), date of specimen collection (89.1%), and final classification (36%) were lower than the target (90%). Compared to web-based reporting, there were only 2 variables including date of specimen collection (79%) and final classification (65) which were lower than the target (90%).Conclusion: The study revealed that CBMS web-based reporting is more simple and complete than CBMS manual reporting. It was clearly seen that completeness in the final classification has the lowest percentage in both models. The system must be simplified, so that lack of reporting completeness on both models can be overcome
Traditional Indonesian storytelling: a potential multilevel health promotion tool for the poor and a search for a community model
No full textIn 2018 nearly 10% of Indonesians lived in poverty and a significantly larger number were at risk of falling into poverty. Health promotion efforts which target this population ideally need to be holistic and multilevel so as to address the inequities they experience in health, nutrition, living conditions, education, and employment. This paper explores the potential of traditional Indonesian stories as a health promotion tool and seeks to open discussion into how they can be used in the future. Narratives have the potential to influence people’s beliefs, knowledge, attitudes, values and behaviours. They are increasingly used in health communication due to their ability to overcome resistance in the listener, culturally ground messages and reach less educated audiences. While the use of traditional Indonesian stories in early childhood education is well documented, their potential to address multiple social determinants of disease in a public health context has not been explored. Indonesian stories are a rich source of local wisdom containing important messages about environmental preservation, food wastage and social values such as honesty, justice and peace. They can also be adapted to focus on hygiene, nutrition and encourage preventative health actions. Stories which build resilience and courage might be helpful for the poor, while stories that highlight injustice and discrimination could promote equity in the mindset of the powers that oppress them. There are several limitations however, so an indiscriminate use of traditional stories would be inadvisable. In conclusion it appears that traditional storytelling is currently an underutilised health promotion tool in Indonesia and its potential as a low cost, culturally appropriate and enjoyable way to address determinants of health at multiple levels could be further explored