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KESIAPAN INTEGRASI LAYANAN TB-HIV PUSKESMAS DI KABUPATEN KULON PROGO
No full textBackground: Indonesia is a country with a high burden of tuberculosis and the human immunodeficiency virus. In response, countries adopted WHO recommendations on integrated services, including diagnostic screening and care for TB-HIV patients. Kulon Progo seeks to improve services under existing health system resources, and it is very important to understand its capacity to provide integrated TB-HIV services.Objective: This study aims to assess the readiness of TB-HIV integrated services in Puskesmas for the health system in the Kulon Progo Regency.Method: The research method uses mixed methods explanatory sequential design. The unit of analysis is the Puskesmas. Observation of the availability and readiness of TB services and cross-sectional HIV services using SARA modified questionnaires, followed by in-depth interviews exploring barriers and opportunities for integration of TB-HIV services at the Puskesmas.Results: Puskesmas service readiness, 93.3% (95% CI; 92.7% -93.9). Puskesmas had the readiness to provide basic health services, 63.8% (95% CI, 60.7-66.8). Puskesmas TB service readiness, 80.9% (95% CI: 73.6–88.2) HIV test counseling service readiness, only 1 Puskesmas (4.7%) has readiness for both services. Based on the domain assessment, 40.4% of the Puskesmas had trained TB diagnosis and treatment officers, 61.9% had trained officers and HIV testing counseling guidelines. The dominant themes include non-supportive staffing, not optimal human resource capacity, the lack of coordination and teamwork, and lack of monitoring and supervision system. With the support of leaders and good policies to mobilize funding, the availability of facilities becomes an opportunity for integrated TB-HIV services to run.Conclusion: Towards readiness to integrate TB-HIV services under the TB-HIV collaboration recommendation, efforts to address the needs of the number of health workers and equip staff with knowledge and skills as capacity building to manage integrated care. The involvement and support of the leadership of the determinants of readiness to ensure the availability of facilities, diagnostic supplies, and medicines as a continuous implementation.Latar belakang: Indonesia menjadi salah satu negara dengan beban tuberkulosis (TB) dan Human Immunodeficiency Virus (HIV) tinggi. Sebagai respons, negara yang mendukung kampanye TB-HIV, WHO menyediakan layanan yang disediakan termasuk skrining diagnostik dan perawatan untuk pasien TB-HIV. Kulon Progo menyetujui peningkatan layanan di bawah sumber daya sistem kesehatan yang ada, sangat penting untuk memfasilitasi kemampuannya menyediakan layanan TB-HIV yang lengkap.Tujuan: Penelitian ini bertujuan menilai kesiapan integrasi layanan TB-HIV di Puskesmas untuk sistem kesehatan di Kabupaten Kulon Progo.Metode: Metode penelitian menggunakan mixed methods explanatory sequential design. Unit analisis adalah Puskesmas. Observasi ketersediaan dan kesiapan layanan TB dan layanan HIV cross sectional menggunakan kuesioner modifikasi SARA dilanjutkan wawancara mendalam mengekplorasi hambatan dan peluang integrasi layanan TB-HIV di Puskesmas.Hasil: kesiapan layanan Puskesmas, 93,3% (CI 95%; 92,7%-93,9) Puskemas memiliki kesiapan memberikan layanan kesehatan dasar, 63,8% (CI 95%, 60,7–66,8) Puskesmas kesiapan layanan TB, 80,9% ( 95% CI: 73.6–88.2) kesiapan layanan konseling tes HIV, hanya 1 Puskesmas (4,7%) memiliki kesiapan baik untuk kedua layanan. Berdasarkan penilaian domain, 40,4% Puskesmas memiliki petugas terlatih diagnose dan pengobatan TB, 61,9% memiliki petugas terlatih dan pedoman konseling tes HIV. Tema utama diidentifikasi sistem kepegawaian tidak mendukung, kapasitas sumber daya manusia belum optimal, koordinasi dan kerjasama tim masih lemah dan sistem monitoring dan supervisi belum komprehensif. Dukungan pimpinan dan kebijakan yang baik memobilisasi pendanaan, ketersediaan sarana menjadi peluang layanan TB-HIV terintegrasi dijalankan.Kesimpulan: Menuju kesiapan mengintegrasikan layanan TB-HIV di bawah persetujuan kolaborasi TB-HIV, dukungan kebutuhan jumlah tenaga kesehatan dan membekali petugas dengan pengetahuan dan ketrampilan sebagai peningkatan kapasitas mengelola perawatan terintegrasi. Terkait dengan dukungan faktor penentu kesesuaian untuk penyediaan dukungan, suplai dan obat-obatan sebagai keberlanjutan implementasi.
PERILAKU IBU DALAM POLA PEMBERIAN GULA, GARAM, LEMAK PADA MAKANAN BALITA DI KECAMATAN CIPAYUNG, JAKARTA TIMUR TAHUN 2019
No full textAccording to the 2014 DKI Jakarta Provincial Individual Food Consumption Survey (SKMI), the proportion of children under five whose intake of sugar, sodium and fat exceeds the recommended limits (sugar intake is 1.9%, sodium intake is 15%, and fat intake is 22, 2%). Food preferences and eating behavior of children are influenced by the eating experience in childhood and are closely related to the eating choices and behavior of their parents. This preference for taste at an early age will lead to eating habits in the future and become a negative behavior, which results in non-communicable diseases, not only in adulthood but also at the age of children. This study examines the practice of mothers in feeding sugar, salt, and fat to toddlers aged 6-59 months.This cross sectional study was conducted in July-August 2019. Two hundred mothers who have children aged 6-59 months in the Cipayung District area. This study shows 53% of mothers have negative behavior in the pattern of giving sugar, salt, fat to toddler food. A total of 73.5% of mothers have low knowledge in the pattern of giving sugar, salt, fat to toddlers and 95.5% of respondents have a negative attitude in giving sugar, salt, fat to toddler food. Mother's behavior in giving sugar, salt, fat to toddlers' food has a significant relationship with knowledge of p-value = 0.005 (p <0.05), social media utilization p-value = 0.001 (p <0.05) and support of health workers. p-value = 0.005 (p <0.05).Healthy family approach program needs to find strategies in improving mother's knowledge on the use of sugar, salt, and fat in the daily consumption of food for children under five.ABSTRAK Menurut Data Survei Konsumsi Makanan Individu (SKMI) Provinsi DKI Jakarta tahun 2014, proporsi balita dengan asupan gula, natrium, dan lemak yang melebihi batas yang dianjurkan,yaitu untuk asupan gula sebesar 1,9%, asupan natrium sebesar 15%, dan asupan lemak sebesar 22,2%. Preferensi makanan dan perilaku makan anak-anak dipengaruhi oleh pengalaman masa balita dan erat kaitannya dengan pilihan dan perilaku makan orang tuanya. Preferensi rasa saat usia dini ini akan menjadi kebiasan makan dikemudian hari dan menjadi perilaku negatif.Hal inilah yang menimbulkan timbulnya Penyakit Tidak Menular tidak hanya terjadi pada usia dewasa tetapi juga pada usia anak. Tujuan dari penelitian ini adalah untuk mengetahui perilaku ibu dalam pola pemberian gula, garam, lemak pada makanan balita umur 6-59 bulan di Kecamatan Cipayung, Jakarta Timur. Penelitian ini menggunakan desain studi cross sectional yang dilakukan pada bulan Juli-Agustus 2019 di wilayah Kecamatan Cipayung, Jakarta Timur. Sampel pada penelitian ini berjumlah 200 responden dengan subjek ibu yang memiliki balita umur 6-59 bulan di wilayah Kecamatan Cipayung yang didapat dengan purposive sampling. Hasil penelitian menunjukkan sebesar 53% Ibu memiliki perilaku negatif dalam pola pemberian gula, garam, lemak pada makanan balita. Sebesar 73,5% Ibu memiliki pengetahuan yang rendah dalam pola pemberian gula, garam, lemak pada balita dan sebesar 95,5% responden memiliki sikap negatif dalam pemberian gula, garam, lemak pada makanan balita. Berdasarkan uji multivariat regresi logistik diketahui bahwa perilaku ibu dalam pemberian gula, garam, lemak pada makanan balita memiliki hubungan yang signifikan dengan pengetahuan p-value=0,005 (p<0,05), pemanfaatan media sosial p-value=0,001 (p<0,05) dan dukungan petugas kesehatan p-value= 0,005 (p<0,05). Oleh karena itu diperlukan adanya pengembangan strategi dalam meningkatkan pengetahuan ibu akan penggunaan gula, garam, lemak di dalam konsumsi makanan balita sehari-hari melalui program indonesia sehat pendekatan keluarga
Hubungan Pengetahuan dan Sikap Kesehatan Gigi Mulut dengan Angka Karies pada Masyarakat Perdesaan (Kajian pada Desa Karangtengah, Kecamatan Baturraden, Kabupaten Banyumas)
No full textIntroduction: The results of Riskesdas (Baseline Health Research) by Indonesian Ministry of Health in 2018 showed that the caries rate in rural areas was higher than in urban areas. However, the number of villagers receiving dental and oral health care was lower in comparison to urban communities. Karangtengah Village was located in the Baturraden District, Banyumas Regency which is a rural area. Purpose: This study aimed to determine the correlation of knowledge and attitude about oral health with caries rate in Karangtengah Village. Method:The study was an observational analytical research. Subjects were chosen using purposive sampling technique. Total subjects were 388 residents. The knowledge and affective data were collected using questionnaire and the caries rate was scored using DMF-T. Data was analyzed using Pearson correlation test (SPSS 22). Results: The results showed that the oral health knowledge and attitude of the majority of Karangtengah Village residents were in moderate category (48.7% and 66.8% respectively), while the average DMF-T score was 13.12 (very high). The statistical analysis showed no significant correlation between knowledge and DMF-T score as well as between attitude of oral health and DMF-T score (p>0.5). Conclusion:The moderate category of oral health knowledge and attitude in rural may have not applied as oral health behaviors therefore contribute to high dental caries rates.The results of Riskesdas (Baseline Health Research) by Indonesian Ministry of Health in 2018 showed that the caries rate in rural areas was higher than in urban areas. However, the number of villagers receiving dental and oral health care was lower in comparison to urban communities. Karangtengah Village was located in the Baturraden District, Banyumas Regency which is sociodemographically a rural area. Purpose: This study aimed to determine the correlation of knowledge and affective of oral health with caries rate in Karangtengah Village. Method:The study was an observational analytical research. Subjects were chosen using purposive sampling technique. Total subjects were 388 residents. The knowledge and affective data were collected using questionnaire and the caries rate was scored using DMF-T. Data was analyzed using Pearson correlation test (SPSS 22). Result:The results showed that the oral health knowledge and affective of the majority of Karangtengah Village residents were in moderate category (48.7% and 66.8% respectively), while the average DMF-T score was 13.12 (very high). The statistic analysis showed no significant correlation between knowledge and DMF-T score as well as between affective of oral health and DMF-T score (p>0.5). Conclusion:The moderate category of oral health knowledge and affective in rural may have not applied as oral health behaviors therefore contribute to high dental caries rates
PENGARUH METODE BERMAIN ULAR TANGGA DAN CERAMAH DALAM MENINGKATKAN PENGETAHUAN DAN SIKAP SISWA MIN TENTANG BAHAYA MEROKOK DI MIN 12 MEDAN
No full textPurpose: The purpose of this study was to analyze the effect of the “snakes and ladders” game and lecture method in improving the knowledge and attitude of primary school students about smoking hazards.Method: This quasi-experimental study used 60 students, 30 of them played the game and the other 30 got a lecture. The analysis of this study used the Wilcoxon and Mann Whitney test. Results: Health promotion using snakes and ladder games and lectures have been proven to increase knowledge and attitudes about the dangers of smoking. The use of the snake-ladder game has proved to be more effective than lectures in increasing knowledge and attitudes about the dangers of smoking. Conclusion: The snake and ladder game should be used more often in reminding the dangers of smoking. Elementary school principals must be more active in socializing the dangers of smoking to primary school students to prevent smoking behavior among elementary school students.ABSTRAKSmoking is still a problem in developing countries, including Indonesia. Various attempts have been made to reduce the number of smokers in Indonesia, but in reality the number of smokers increase. The behavior of smoking groups is carried out by various groups including teenagers and children. The purpose of this study was to analyze the effect of the method of playing snakes and ladders, and lecture methode in improving the knowledge and attitude of primary school students about smoking hazards in “MIN 12 “primary school.This research uses quasi experiment design. Respondents who received intervention in the study were 60 people divided into 30 people playing snakes and 30 people getting lectures. The analysis of this study used wilcoxons and Mann Whitney testHealth promotion using snakes and ladders games and lectures has been proven to increase knowledge and attitudes about the dangers of smoking. The use of the snakes and ladders game has proved to be more effective than lectures in increasing knowledge and attitudes about the dangers of smokingSnakes and ladders media should be used more often by primary schools in increasing the knowledge and attitudes of primary school students about the dangers of smoking. Elementary school principals must be more active in socializing the dangers of smoking to primary school students to prevent smoking behavior among elementary school students.
Assessing Implementation Fidelity Following the Mass Drug Administration Programme for Lymphatic Filariasis in South Bangka District, Indonesia: an Implementation Research
No full textBackground: Since the MDA for LF started, a significant progress has been made in Indonesia. However, some challenges have been found in the implementation of MDA. South Bangka District failed post-MDA surveillance and re-implemented MDA in 2018 and 2019. If this failure continue to happen, the elimination goal might be difficult to attain. Therefore there is a need to investigate why there is a persistent transmission of LF despite eight rounds of MDA which has sufficient reported coverage.Objectives: This study aimed to assess implementation fidelity and its potential moderators of the MDA programme for LF in South Bangka District.Method: This was a qualitative study which used case study approach that took place in South Bangka District and Bedengung Village. Data were collected through IDI with six stakeholders from different level of health offices, one village secretary and fourteen community members. Meanwhile, FGD were conducted with eight CHWs and five community members. All participants should have involvement in the previous MDA programme to be recruited in this study.Results: MDA programme were implemented according to its guideline with some changes in terms of timeline, screening process of target population, implementation strategy, and monitoring process. Community leader engagement and DOT-MDA strategy have improved the community compliance. However, noncompliance and low participation in community-based health education were found as main challenges. Training, intersectoral socialization and advocacy, and health education were suboptimal. There was also potential bias on the screening process of eligible population. In addition, policy influenced the resources allocation during MDA implementation.Conclusion: The implementation of MDA can be improved by focusing on community mobilization. The screening process should also be done carefully in order to cover all eligible population. Besides, it is important to optimize the resource allocation by improving the coordination with all potential partners
Melasma severity and use duration among hormonal injection contraception users: a study in a puskesmas in Semarang
Full text linkTujuan : Penelitian ini bertujuan untuk mengetahui hubungan lama pemakaian kontrasepsi hormonal jenis suntik terhadap keparahan melasma. Metode : Penelitian ini merupakan penelitian observasional dengan desain Cross-Sectional. Jumlah sampel 60 peserta pemakai kontrasepsi suntik 1 bulan dan 3 bulan menggunakan metode consecutive sampling. Penentuan keparahan melasma menggunakan perhitungan skor MASI (Melasma Area and Severity Index). Data didapat dari BKIA Puskesmas Bangetayu Semarang periode Januari-September 2019, yang dilakukan dengan wawancara terstruktur. Uji statistik menggunakan uji Korelasi Spearman, Korelasi Parsial dan Mann-Whitney. Hasil : uji Korelasi Spearmen pada lama pemakaian kontrasepsi suntik 1 bulan dengan keparahan melasma diperoleh nilai p=0,357.Untuk lama pemakaian kontrasepsi suntik 3 bulan didapatkan nilai p=0,795 (p>0,05). Sedangkan, pada lama pemakaian kontrasepsi suntik tanpa melihat jenis didapatkan nilai p=0,006 (p0,05). Pada uji Mann-Whitney untuk melihat perbedaan keparahan melasma di peroleh nilai p=0,000 (p 0.05). A similar finding was found in the three months of injection contraception users (p = 0.795, p> 0.05). Conclusion: Use of injected contraception, whether one or three-month duration, has nothing to do with melasma severity. Injectable contraceptives users should not worry about melasma
Analisis Risiko Kesehatan Lingkungan Konsentrasi Mangan dalam Sayuran dan Air terhadap Kesehatan Masyarakat
No full textPurpose: The research aimed to analyze the environmental health risks of manganese concentration in vegetables and water on public health.Methods: The research used a cross-sectional study with 138 households. Water analysis using spectrophotometric methods and for vegetable samples using the wet destruction method. The environmental sample consisted of 3 vegetables (spinach, kale, and mustard greens), three river water, and 13 resident groundwater. Results: The Mangan concentration on three vegetable samples (spinach, kale, and mustard greens) had the same result, 0.1 mg/L. The results of manganese measurements concentration in river water were 0.2 mg/L, 0.4 mg/L, and 0.4 mg/L. The average manganese concentration in 13 groundwaters were 0.32 mg/L, 0 mg/L- 1.1 mg/L.Conclusion: The RQ calculation result for vegetables and drinking water was <1, which meant that the community's manganese intake from vegetables (spinach, kale, mustard greens) and drinking water was still within safe limits.Purpose: The research aimed to analyze the environmental health risks of manganese concentration in vegetables and water on public health.Methods: The research used cross sectional study with 138 households. Water analysis using spectrophotometric methods and for vegetable samples using the wet destruction method. The environmental sample consisted of 3 vegetables (spinach, kale and mustard greens), 3 river water and 13 resident ground water. Results: The Mangan concentration on 3 vegetable samples (spinach, kale and mustard greens) had the same result, 0.1 mg / L. The results of manganese measurements concentration in river water were 0.2 mg / L, 0.4 mg / L and 0.4 mg / L. The average manganese concentration in 13 groundwaters were 0.32 mg/L, 0 mg/L- 1.1 mg/L.Conclusion: The RQ calculation result for vegetables and drinking water was <1 which meant that the community's manganese intake from vegetables (spinach, kale, mustard greens) and drinking water were still within safe limits
The roles of hajj and umrah facilitating guides in promoting healthy lifestyles among Indonesian pilgrims
No full text Background: Hajj pilgrimage has the potential to spread acute and rapid infectious respiratory and digestive diseases because of the gathering of over two million people from various countries with different characteristics. Purpose: This study explored the role of KBIHU in promoting the healthy behavior of prospective pilgrims in the Cilacap Regency.Method: Qualitative methods with a case study approach. Data analysis uses the thematic analysis of Miles and Huberman's interactive model. Results: The results showed five themes, six categories, and twenty-five subcategories. 1]. Internal management roles in promoting healthy behavior: (a) institutional perception of authority and its limitation, and networking, (b) guidance, service, assistance, and protection functions, and (c) planning, implementation, and evaluation. 2]. Efforts to promote healthy behavior: coordination between agencies, coordination with the public health office and community health center, and the role of innovation. 3]. tips on promoting healthy behaviors: maximizing the role of mentors, involving pilgrims and alumni of health workers, involving fellow worshipers, use of social media, AKHI, TKHI, and "karu-karom." 4]. KBIHU support: health policy, the pilgrimage "istithaah," and pilgrims' rights and obligations. 5]. Problems in implementation: the fact of pilgrims and pilgrimage diseases
External quality assessment of AFB smear microscopy in public health centers
No full textPurpose: Microscopic examination is the main diagnostic method in countries with a high TB burden. Microscopic examination has an important role in TB case detection. The purpose of this study was to examine the quality of TB microscopic sputum examination at the level of the Public Health Center of Kulon Progo District, Indonesia. Method: This research was a cross-sectional study with 21 Health Center subjects. A Structured questionnaire is used to record HR and logistical availability. Blinded rechecking was done for nine public health centers; data were analyzed to evaluate smear quality indicators and examine the error. Results: The majority of laboratory workers were women (88.1%), aged 36-45 years (42.86%). Most laboratory staff had 11-20 years of work of length (42.86%). Logistical availability was good, but there were shortages of stock boxes, filter paper, and lens paper. A total of 762 slides from 9 health centers were rechecked. The positivity was 1.57%, error was 1.57% (FP= 41.7% FN= 58.3% sensitivity= 75% specificity= 98.9%). Major errors found 33.37% and 66.73% minor errors from 12 errors. Quality issues found were thickness (38%), salivary specimens (27%), and size (26%). Conclusion: The performance of TB microscopic examination at The Health Center level in Kulon Progo was quite good, but it needs efforts to get better quality sputum to improve case detectio
Efek Permainan Edukatif oleh Teman Sebaya Terhadap Pengetahuan Kesehatan Reproduksi, HIV-AIDS, dan NAPZA
No full textPurpose: We intended to analyze the effects of educative games provided by peer groups as a method to increase knowledge of reproductive health, HIV-AIDS, drug abuse among high school students.Method: Twenty students (peer-counselor group) of junior high school in Keruak, East Lombok were educated using board games and a series of flashcards containing information on reproductive health, HIV-AIDS, and drug abuse before they educated other students (non-counselor group, n=119) using the same educative game. Pre and post scores analysis was conducted among both groups. Results: The post-game scores of both peer-counselor and non-counselor groups were increased significantly after playing board games and flashcards. The non-counselor group gained a 1.9-fold, 2.6-fold, and 4.5-fold increase in post-game scores compared to pre-game scores (p < 0.01) in reproductive health, HIV-AIDS, and drug abuse topics, respectively. After completing the educative games, the proportion of students who had a high level of knowledge about reproductive health, HIV-AIDS, and drug abuse was increased significantly (0% to 26.9% p <0.01, 3.4% to 26.9% p <0.01, 18.5% to 61.3% p <0.01, respectively). Conclusion: Using educative games and peer-group approach as health promotion methods increased knowledge in reproductive health, HIV-AIDS, and drug abuse among adolescent students. In the future, this method could be adopted nationally as part of an educational health promotion program.Keywords: HIV-AIDS, Reproductive Health, Educative Games, Peer-group, Drug abusePurpose: Here we intend to analyze the effects of educative games provided by peer groups as method to increase knowledge of reproductive health, HIV-AIDS, drugs abuse among high school students. Method: Twenty students (peer-counselor group) of junior high school in Keruak, East Lombok were educated using boardgames and series of flashcards containing information of reproductive health, HIV-AIDS, and drugs abuse before they educated other students (non-counselor group, n=119) using the same educative game. Pre and post scores analysis was conducted among both groups. Results: The post-game scores of both peer-counselor and non-counselor groups were increased significantly after playing boardgames and flashcards. The non-counselor group gained 1.9-fold, 2.6-fold, and 4.5-fold increase of post-game scores compared to pre-game scores (p < 0.01) in reproductive health, HIV-AIDS, and drug abuse topics respectively. After completing the educative games, the proportion of students who had high level of knowledge about reproductive health, HIV-AIDS, and drug abuse was increased significantly (0% to 26.9% p <0.01, 3.4% to 26.9% p <0.01, 18.5% to 61.3% p <0.01, respectively). Conclusion: Using educative games and peer-group approach as health promotion method were proven to increase knowledge in reproductive health, HIV-AIDS, and drug abuse among adolescent students. In the future, this method could be adapted nationally as part of educational health promotion program