Kesmas: National Public Health Journal
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Evaluation of Vitamin D and Anti-Müllerian Hormone Levels in Iraqi Infertile Women
Full text linkAlthough the mechanism underlying the relationship between vitamin D insufficiency and reproduction is unknown, research suggests that it may have a direct deleterious impact on ovarian function. This is primarily because vitamin D insufficiency can affect gonadal function. The anti müllerian hormone (AMH) is one of the most important biomarkers produced by granulosa cells and plays a key role in folliculogenesis. This study wanted to look at and compare vitamin D and AMH levels in infertile and fertile women, as well as the relationship between them in both groups. A hundred infertile and fertile women participated in the study. Anti-müllerian, prolactin, follicle-stimulating, and luteinizing hormones, as well as 25 hydroxyvitamin D, were estimated. Vitamin D deficiency was found in 72% of infertile women (n = 36), compared to 48% (n = 24) of the fertile group. There was no significant link between 25-hydroxyvitamin D and AMH in both groups. Infertile women exhibited a significantly lower serum AMH and higher body mass index. This study's findings suggested that the correlation between vitamin D and ovarian reserve markers was unlikely to present. However, the infertile group has a more significant vitamin D deficiency and insufficiency rate
The Effect of Health Promotion Program on Perceived Self-Efficacy and Self-Care Practices among Elderly with Multimorbidity in Chiang Mai, Thailand
Full text linkMultimorbidity in the elderly is a major public health issue with serious consequences. This study investigated the effects of health promotion programs on perceived self-efficacy and self-care practices among the elderly with multimorbidity using a quasi-experimental study design from February to July 2021. The study samples were the elderly from Doi Saket District, Chiang Mai Province, Thailand, selected by a multistage random sampling technique. The experimental and control groups each comprised 40 elderlies with multimorbidity. All elderly participants took part in a 12-week health promotion program. The perceived self-efficacy and self-care practices of the study samples were assessed using interviews, and the group results were compared using the independent t-test. Repeated measures analysis of variance (ANOVA) was applied at a significance level of 0.05 for three different periods. Follow-up results after the intervention showed that the experimental group had significantly higher mean scores of perceived self-efficacy and self-care practice than the control group (p-value<0.05). The health promotion program enhanced perceived self-efficacy and self-care practices in the elderly with multimorbidity. It can also be applied to improve the quality of life of people in other age groups
Medication Adherence and Self-Management Practices among Type 2 Diabetes Mellitus Patients in Jeli District, Kelantan, Malaysia
Full text linkThis study was carried out to investigate the level of medication adherence and diabetic knowledge among type 2 diabetes mellitus patients in Jeli District, Kelantan, Malaysia. This cross-sectional study was done from February to July 2019 by giving a questionnaire to 150 type 2 diabetes mellitus patients aged 40-80 years at three primary health cares in Jeli District, Kelantan, Malaysia. The quantitative descriptive method was used in this study. The findings of this study revealed that knowledge was significantly related to poor adherence. When sex, history of diabetes, and education were accounted for, patients with low diabetic knowledge had an odds ratio of 4.53 for poor adherence compared to those with high knowledge (adj 95% CI (1.92-10.69), p-value = 0.001). To achieve the goal of regulating diabetes management in primary health care, a clinical supervision program should be implemented to improve staff competence in diabetes management and to empower patients through self-management
The Effect of COVID-19 Pandemic-Induced Stress on Reproductive-Age Women's Menstrual Cycle Regularity
Full text linkIntense stress resulting from major life events can affect women's menstrual cycle. The current Coronavirus Disease 2019 (COVID-19) pandemic, impacting various sectors, is considered a major form of stress. During May-November 2020, some women in Iraq have experienced menstrual disruptions, which can happen whether they get infected with the COVID-19 or simply deals with pandemic-induced stress. Thus, this study aimed to evaluate the effect of the COVID-19 pandemic-induced stress on menstrual cycle regularity of reproductive-age women. This study used an observational cross-sectional design conducted in Iraq from May to November 2020. A sample of 500 reproductive-age women filled out an online questionnaire about their menstrual records and psychological stress levels using a Perceived Stress Scale-10 for three months during the pandemic. A comparison between menstrual cycle irregularity and stress levels before and during the pandemic was done with a p-value of <0.05 and statistically significant. It was found that 47.72% of women had irregular menstrual cycles and high perceived stress scales during the pandemic compared to 20.94% with irregular cycles and high-stress levels before the pandemic. In brief, the high-stress level induced by the COVID-19 pandemic is associated with the irregular menstrual cycle in the sampled reproductive-age women
Effectiveness of Using Information, Education, and Communication Flowchart Media in Implementation of Early Breastfeeding Initiation
Full text linkEarly initiation of breastfeeding (EIB) has many benefits for both the baby and the mother. However, in Bogor City, there are still many babies who do not get EIB when they are born (33.6%). The implementation of EIB is not optimal due to the absence of standard procedures to equalize its theory and perception. This study aimed to investigate the effectiveness of using Information, Education, and Communication (IEC) flowchart media concerning the standard procedure for EIB implementation in the Primary Health Care (PHC) in Bogor City. A quasi-experimental research was conducted on 58 midwives divided into the intervention and control groups. The intervention group was given IEC flowchart media, the EIB standard procedure, whereas the control group was given a brief explanation about EIB. The results indicated that the intervention group (96.0) had a higher average EIB implementation score than the control group (84.7). Furthermore, the success rate of EIB was higher in the intervention group (93.1%) than in the control group (20.7%). In conclusion, the IEC flowchart media is effectively used to optimize EIB implementation by midwives in the PHC in Bogor City
Perspectives on Reproductive Health Education among Javanese Parents
Full text linkThis study aimed to investigate the perspectives of reproductive health education among Javanese parents of children aged 9-11 years. This cross-sectional study was conducted with 12,306 parents in Semarang City, Central Java Province, Indonesia, using a purposive sampling technique. Some parents agreed that reproductive health education at home was unnecessary (29.5%), taboo (45%), difficult (73.1%), and awkward (41.5%). Most parents (72.7%) were not transparent in providing reproductive health information to their children by using other terms to name the genitals, considering the politeness aspect. Good practices of providing reproductive health information are slightly more common in mothers (54.2%), unemployed parents (52.9%), those with a higher education level (69.5%), and those with a family income above the regional minimum wage (59.8%). As many as 76.9% of parents intensely monitor their children; however, 60.63% of parents have poor communications with their children. Parents believe that reproductive health information is essential for their children, but parents find the topic difficult with their children due to taboos and awkward feelings. Accordingly, the Indonesian Ministry of Health should empower parents to discuss reproductive health issues with their children openly
COVID-19 in Indonesia: Is There a Shift from Pandemic to Endemic?
Full text linkThe world is still facing the Coronavirus Disease 2019 (COVID-19) pandemic, and the current challenge is the epidemic, which was thought to have become endemic, but it seems far from that. This article describe the recent progress of the COVID-19 globally, including in Indonesia, and what should be done towards building community health resilience. Each day, more than 500,000 new cases are being detected worldwide. This condition shows that the present pandemic is not over and still requires global vigilance. The challenge faced by the world, and Indonesia, is to develop resilient communities as a prerequisite to controlling any future epidemic. This can be achieved by adopting five strategies: strengthen and promote access to public health and social services, promote health and wellness and disaster preparedness, expand communication and collaboration, engage at-risk individuals and activate programs to protect their health, and build social connectedness
Impact of Instrumental Support from Family on Medication Adherence among Tuberculosis Patients
Full text linkInstrumental support is concrete and tangible, for instance, helping to provide food or accompanying patients to health care facilities. However, its impact on medication adherence among tuberculosis patients in Indonesia needs to be explored. This study aimed to examine the impact of instrumental support from family on tuberculosis patients’ adherence to medication in Bogor City, West Java Province, Indonesia. A cross-sectional study involving 106 participants with an age average of 39.7 (SD = 14.9) was conducted in 12 primary health care (PHC). The independent variables (age, sex, education, employment status, wealth index, and the distance between home and PHC) of instrumental support from family was assessed using MMAS-8. In contrast, the dependent variable of medication adherence was assessed using a self-reported instrument. Multivariate binary logistic regression was used in the analysis and indicated that participants receiving family support were more likely to adhere to medication protocol (95% CI = 1.1–6.3; p-value = 0.029). Instrumental support from family was associated with medication adherence among tuberculosis patients in Bogor City, West Java Province, Indonesia. It is necessary to design further comprehensive interventions in the community setting to encourage the family to support tuberculosis patients following medication protocol
The Significance of Trimester-Specific Thyroid Hormones Reference Intervals in Iraqi Pregnant Women
Full text linkIn Iraq, there is no obvious considerable data regarding trimester-specific reference intervals of thyroid hormones despite documented multiple physiological hormonal changes during pregnancy. Thus, this study aimed to determine trimester-specific reference intervals for serum TSH, FT3, and FT4 and assess the incidence of thyroid function test misinterpretation and misdiagnosis among pregnant women using non-pregnant reference intervals. A thyroid function test was performed for 774 enrolled pregnant women. Reference intervals of TSH, FT3, and FT4 were ascertained in each pregnancy trimester. It was then compared to the adult non-pregnant values, and the incidence of misinterpretation was later calculated. TSH and FT4 reference interval values were lower than non-pregnant reference interval values. The application of non-pregnant women references values in pregnant women caused a serious misinterpretation and misdiagnosis in 66 (8.5%) pregnant women regarding TSH, and 34 (4.4%) pregnant women regarding FT4, while no misdiagnosis was noticed regarding FT3. The trimester-specific reference interval values of TSH, FT3, and FT4 in Iraqi pregnant women showed an obvious variation from non-pregnant reference intervals and the urgent advice to use the trimester-specific reference intervals to avoid misclassification of thyroid dysfunction during pregnancy
Public Perception and Obedience with Social Distancing Policies during the COVID-19 Pandemic in Jakarta, Indonesia
Full text linkThe Indonesian Government established a social distancing policy to prevent COVID-19 transmission. However, this implementation will be ineffective without the compliance of the people. This study aimed to analyze the relationship between public perception and obedience with social distancing in terms of the variables based on the Health Belief Model. This study used a cross-sectional design with a population of Daerah Khusus Ibukota (DKI) Jakarta’s indigenes within the productive age of 15-64 years. The sample comprised 408 participants, with the independent variables of sociodemographics (age, gender, occupation, and education) and health beliefs (perceived susceptibility, severity, benefits, barriers, and self-efficacy). Meanwhile, obedience to social distancing was the dependent variable. Data were obtained through an online questionnaire and evaluated with the bivariate and multivariate analysis using Chi-square and logistic regression tests. Gender (OR = 2.327; 95% CI = 1.404-3.857) and perceived self-efficacy (OR = 2.609; 95% CI = 1.726-3.945) were significantly related to social distancing obedience. Meanwhile, no statistical correlation (p-value>0.05) was found with sociodemographics, perceived susceptibility, severity, benefits, and barriers. The males with low self-efficacy were more likely to disobey the social distancing policies. The individual’s self-efficacy perception increased with their level of obedience to social distancing policies