Kesmas: National Public Health Journal
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The Impact of National Health Insurance Policy to the Implementation of Health Promotion Program on Public Health Center in Indonesia
No full textNational Health Insurance (NHI) Program has been implemented in Indonesia on January 2014. That program definitely brings some changes into managerial aspect in public health center (PHC). This study aimed to determine an impact of NHI policy in the implementation of health promotion programs at PHC in South Tangerang City, Indonesia. This study was conducted using qualitative method during February and March 2016. The impact of NHI is seen on policy, budget, equipment, human resource and implementation of health promotion program. With purposive sampling method, six policy makers, eight service providers and eight service users were selected for in-depth interview. As many as 17 documents were analyzed. Observation conducted at four selected PHC. Data analysis used thematic content analysis. There was no difference of PHC’s functions before and after NHI period. Budget expended for health promotion programs had increased after NHI implemented which it could be opportunity for PHC to make innovations, procure materials and implement better health promotion programs. Capitation budget which could be used for executing health promotion program and some recently implemented health promotion programs in NHI era becomes an evidence that NHI policy has a positive impact in the implementation of health promotion program at PHCAbstrakJaminan Kesehatan Nasional (JKN) telah diimplementasikan di Indonesia pada 1 Januari 2014. Hal tersebut membawa beberapa perubahan pada aspek manajerial pada pusat kesehatan masyarakat (puskesmas). Penelitian ini bertujuan untuk mengidentifikasi dampak dari kebijakan JKN terhadap implementasi program promosi kesehatan di puskesmas di Kota Tangerang Selatan, Indonesia. Penelitian menggunakan metode kualitatif. Data dikumpulkan pada Februari – Maret 2016. Dampak program dilihat dalam hal kebijakan, pendanaan, fasilitas, sumber daya manusia dan pelaksanaan program promosi kesehatan. Dengan menggunakan metode purposive sampling, enam pengambil kebijakan, delapan pemberi layanan dan delapan penerima layanan diambil sebagai informan dalam penelitian ini. Pada analisis dokumen, 17 dokumen telah dianalisis. Observasi dilakukan dengan melihat kegiatan yang dilakukan di empat puskesmas. Analisis data menggunakan analisis konten tematik. Tidak terdapat perbedaan dari fungsi puskesmas sebelum dan setelah adanya JKN. Dana yang digunakan untuk kegiatan promosi kesehatan telah mengalami peningkatan setelah implementasi kebijakan JKN dimana dana tersebut dapat digunakan untuk berinovasi, memberi peralatan dan melakukan promosi kesehatan dengan lebih baik. Dana kapitasi yang dapat digunakan untuk melaksanakan program promosi kesehatan dan beberapa kegiatan promosi kesehatan yang baru dilaksanakan pada saat era JKN menjadi bukti bahwa kebijakan JKN memiliki dampak positif terhadap pelaksanaan program promosi kesehatan di puskesmas
Bancroftian Filariasis Transmission Parameters after the Fifth Year of Filiariasis Mass Drug Administration in Pekalongan City
Get PDFAbstractThis study aimed to measure parasitology parameters (microfilariae rate, microfilariae density), immunology parameter (antigen prevalence), and entomology parameters (infection rate and infective rate) after the fifth year of mass treatment at Pabean Village, Pekalongan City. This study was an observational study with cross-sectional approach that was conducted in July to August 2015 in Pabean Subdistrict, Pekalongan City. The microfilaria rate and microfilariae density were determined by finger blood survey of 313 respondents. Meanwhile, the antigen prevalence was determined by calculating the circulating antigen using the immunochromatographic test (ICT) Wuchereria bancrofti method. Finally, the infective rate and infection rate were both explicitly defined by detecting filarial worm larvae in the mosquitoes of man biting mosquitos collection. The results showed that the mf rate was 0.32% with average microfilariae density of 167/mL blood, the antigen prevalence of the calculation was 0%, the infection rate was 0.06% and the infective rate was 0%. In conclusion, after the fifth year of mass treatment in Pabean Area, Pekalongan City, the area is no longer included into the filariasis-endemic areas and the transmission parameters has no potential in causing the filariasis spreading. AbstrakPenelitian ini bertujuan untuk mengukur parameter parasitologi (microfilaria rate, kepadatan mikrofilaria), parameter imunologi (antigen prevalence) dan parameter entomologi (infection rate dan infective rate) pada tahun kelima pelaksanaan mass drug administration di Kelurahan Pabean Kota Pekalongan. Penelitian ini merupakan penelitian observasional dengan pendekatan potong lintang yang dilaksanakan pada bulan Juli sampai dengan Agustus 2015 di Kelurahan Pabean Kota Pekalongan. Microfilaria rate dan kepadatan mikrofilaria ditentukan dengan pemeriksaan darah jari pada 313 responden. Antigen prevalence ditentukan dengan mengukur antigen beredar menggunakan metode immunochromatographic test (ICT) Wuchereria bancrofti. Incective rate dan infection rate diukur dengan cara menemukan larva cacing filaria pada nyamuk hasil penangkapan nyamuk umpan orang. Hasil penelitian menunjukkan mf rate sebesar 0,32% dengan kepadatan mikrofilaria 167/mL darah, antigen prevalence pada hasil 0%, infection rate sebesar 0,06% dan infective rate sebesar 0%. Dapat disimpulkan bahwa pasca tahun kelima pengobatan massal filariasis di Kelurahan Pabean, Kota Pekalongan tidak lagi menjadi wilayah endemis filariasis dan parameter-parameter transmisi tidak berpotensi menimbulkan penularan
Psychosocial Determinants of Risky Sexual Behavior among Senior High School Students in Merauke District
Get PDFAdolescents aged 10-24 years old are susceptible group to premarital sex, drugs abuse, and HIV/AIDS infection. Papua is the largest contributor to AIDS/HIV number in Indonesia. To overcome such problem, Rutgers WPF formed Dunia Remajaku Seru!(DAKU!), an intervention program towards adolescent reproductive health at senior high school level. This study aimed to determine psychosocial determinants of risky sexual behavior among senior high school students in Merauke District through cross-sectional approach. Samples were 1,364 second grade students that got DAKU!Program and matching process was conducted on schools that did not get DAKU!Program. Data analysis included univariate analysis, bivariate (chi square test) and multivariate (logistic regression test). Results showed that variables significantly related to adolescent risky sexual behavior were peer group with negative behavior, self-efficacy, parents’control, exposure to DAKU!Program and sex. Meanwhile, based on multivariate analysis, peer group with negative behavior (RP = 4.7 CI = 2.8 - 7.7) was the most dominant factor influencing risky sexual behavior.AbstrakRemaja usia 10-24 tahun merupakan kelompok yang rentan terhadap perilaku seksual pranikah, penyalahgunaan narkoba dan infeksi HIV/AIDS. Papua merupakan penyumbang angka HIV/AIDS terbesar di Indonesia. Untuk menanggulangi permasalahan tersebut Rutgers WPF membentuk suatu program intervensi kesehatan reproduksi remaja di tingkat sekolah menengah atas (SMA) yakni program Dunia Remajaku Seru! (DAKU!). Penelitian ini bertujuan untuk mengetahui determinan psikososial perilaku seksual berisiko pada siswa SMA di Kabupaten Merauke dengan menggunakan pendekatan potong lintang. Sampel berjumlah 1.364 siswa SMA kelas dua yang mendapatkan program DAKU!dan dilakukan proses pencocokan pada sekolah yang tidak mendapat program DAKU!. Analisis data meliputi analisis univariat, bivariat (uji kai kuadrat) dan multivariat (uji regresi logistik). Hasil analisis menunjukkan bahwa variabel yang signifikan berhubungan dengan perilaku seksual berisiko remaja adalah kelompok teman sebaya dengan perilaku negatif, efikasi diri, kontrol orangtua, keterpaparan dengan program DAKU!dan jenis kelamin. Sedangkan berdasarkan hasil analisis multivariat, kelompok teman sebaya dengan perilaku negatif merupakan faktor yang paling dominan memengaruhi perilaku seksual berisiko
Husband’s Education Level and Alcohol Drinking Habit as Risk Factors of HIV Infection among Housewives in Pati District
Get PDFCases of Human Immunodeficiency Virus (HIV) infection in Pati District increase, particularly among housewives. The aim of this study was to analyse the risk factors of HIV infection among housewives in Pati District using case-control study design. The respondents were 90 housewives divided into case and control group. The case group consisted of 30 housewives living with HIV, while the control group comprised 60 housewives living in the similar area of the counterparts. The data collection was focused on demographic, sexual behaviour, and sociocultural variables possessed by housewives and their husbands. The study resulted that the risk factors of HIV infection among housewives based on bivariate analysis were housewife’s level of education, husband’s level of education, husband’s occupation, housewife’s sexual transmission disease (STD) record, husband’s STD record, husband’s participation in religious activities, and husband’s alcohol drinking habit. The risk factors that fitted to logistic regression model were education level and alcoholic behaviour of husbands that contributed to 29.1% HIV infection among housewives. In conclusion, the husband’s variables are proved having stronger and very significant correlation with HIV infection among housewives than housewife’s variables
Counterfeit Medicines in Socioeconomic Perspective
Get PDFCounterfeit medicines potentially reach 70% of the global drug markets, and the largest proportion is found in developing countries. Increasing public awareness of counterfeit medicines will automatically affect the demand for counterfeit medical products that will finally reduce counterfeit medicine activities. However, raising awareness of the dangers of counterfeit medicines is a challenging task because public health professionals need to consider diversity of social, economic and educational factors. This study examined peer-reviewed journal articles, media reports, official government and non-government reports. As many as 179 papers (1990 to 2014) were retrieved to identify the relationship between Human Development Index (HDI) of the USA, Japan, Brazil, Iran, Vietnam, Indonesia, Pakistan and Nigeria, and the type of counterfeit medicines. An electronic search was conducted using the following databases, such as Medline, Scopus, CINAHL, Embase, Google Scholar. Counterfeit disease curing medicines are found in high varieties most likely in countries with low HDI. At the same time, medicines for lifestyle are not solely found in countries with high HDI, but also exist in low to medium HDI.AbstrakObat-obatan palsu berpotensi mencapai 70% dari pasaran obat internasional dengan proporsi terbanyak ditemukan di negara berkembang. Meningkatkan kesadaran masyarakat akan adanya obat-obatan palsu akan secara langsung memengaruhi permintaan produk obat palsu yang akhirnya akan mengurangi kegiatan pemalsuan obat. Akan tetapi, meningkatkan pengetahuan masyarakat akan bahaya obat-obatan palsu tidaklah mudah sebab profesi kesehatan masyarakat harus juga mempertimbangkan keberagaman faktor-faktor sosial, ekonomi dan pendidikan. Laporan ini menelaah artikel jurnal yang ditelaah oleh kelompok seminat, laporan media, laporan resmi pemerintah dan non-pemerintah. Sebanyak 179 artikel (dari 1990 sampai 2014) ditelaah untuk mengetahui hubungan antara indeks pembangunan manusia (IPM) dari USA, Jepang, Brasil, Iran, Vietnam, Indonesia, Pakistan dan Nigeria, dan tipe pemalsuan obat. Pencarian elektronik menggunakan pangkalan data seperti Medline, Scopus, CINAHL, Embase, Google Scholar. Obat-obatan palsu untuk pengobatan ditemukan dalam banyak ragam terutama di negara dengan IPM rendah. Pada saat yang sama, obat-obatan untuk keperluan gaya hidup tidak hanya ditemukan di negara dengan IPM tinggi, akan tetapi juga beredar di negara dengan IPM rendah dan sedang
Impact of Women’s Empowerment on Infant Mortality in Indonesia
Get PDFWomen’s autonomy and empowerment has generally been recognized as one of most important factors of development. A lack of autonomy and empowerment may lead to negative outcomes on child health and mortality. Yet no study to-date has analyzed links between women’s empowerment and infant mortality in Indonesia. This study tried to fill this gap to investigate the effect of women’s empowerment on infant mortality in Indonesia. Sample of 9,754 women aged 15-49 years who had their last childbirth in period 2007-2012 were drawn from 2012 Indonesia Demographic and Health Survey. Composite index was considered to measure women’s empowerment. Eight indicators were considered to measure three dimensions of women’s empowerment, namely participation in economic decision-making, participation in health decision-making, and autonomy in mobility. Furthermore, the binary logistic model had been specified and estimated to investigate the effect of women’s empowerment on infant mortality. Results showed that women who were more empowered were significantly less likely to experience infant mortality. This highlights the importance of women’s empowerment in efforts to reduce infant mortality.AbstrakSecara umum, otonomi dan pemberdayaan perempuan menjadi salah satu faktor penting dalam pembangunan. Kurangnya otonomi dan pemberdayaan perempuan dapat menyebabkan hasil negatif pada kesehatan dan kematian anak. Belum terdapat penelitian terkini yang menganalisis hubungan antara pemberdayaan perempuan dan kematian bayi di Indonesia. Penelitian ini berusaha mengisi kekosongan tersebut dengan menelusuri pengaruh pemberdayaan perempuan terhadap kematian bayi di Indonesia. Sampel berjumlah 9.754 perempuan berusia 15-49 tahun yang terakhir melahirkan pada periode tahun 2007-2012 diambil dari Survei Demografi dan Kesehatan Indonesia 2012. Pemberdayaan perempuan diukur dengan menggunakan indeks komposit yang dibangun dari delapan indikator dari tiga dimensi pemberdayaan perempuan, yaitu partisipasi dalam pengambilan keputusan di bidang ekonomi, partisipasi dalam pengambilan keputusan di bidang kesehatan, dan kebebasan untuk berpindah. Selanjutnya, estimasi dampak pemberdayaan perempuan pada kematian bayi menggunakan model regresi logistik. Hasil penelitian menunjukkan bahwa perempuan dengan tingkat pemberdayaan yang lebih baik akan memiliki peluang yang lebih rendah untuk mengalami kejadian kematian bayi. Hal ini menekankan pentingnya pemberdayaan perempuan untuk mengurangi kematian bayi
Implementation of Cigarette Excise Policy against Cigarette Consumption Reduction among Adolescent in Kuningan, Indonesia
Get PDFIndonesia has the highest prevalence of smoking (50.68%) compared to other ASEAN countries. On January 1st, 2017, the Indonesian government raised cigarette excise taxes. The purpose of this study was to analysis the impact of cigarette excise increase on cigarette consumption among adolescents aged 17 to 25 years. The study design used cross-sectional survey. A total of 153 adolescents were recruited in this study through simple random sampling technique. Questionnaires and observation papers were used in this study. A face-to-face interview was conducted to fulfill the data collection through home visit for each respondent. The data were obtained during May – June 2017. This study used paired t test analysis. The number of cigarettes consumed by adolescent decreased significantly by two cigarettes per day after the increase in cigarette excise tax. There is a significant difference of the average cigarettes price based on the brand after the implementation of cigarette excise tax increase, the difference of cigarette price is IDR 200 per stick of cigarettes after excise tax increase. Increased cigarette excise taxes may affect the increasing of cigarette prices. Threfore, it could reduce the number of cigarette consumption
The Profile and Determinant Factors of Quality of Life in Patients with Diabetic Neuropathy
Get PDFAbstractNeuropathy is one of the most common complications in patients with diabetes mellitus (DM). Neuropathy has contributed to some impacts of quality of life (QOL), general health status, and socio-economy level. Therefore, it is important to understand more about this issue, so appropriate treatment could be taken to improve QOL of patients with diabetic neuropathy. This study aimed to measure the profile of a patient’s life quality in DM with neuropathy. This study was a observational study using Short Form 8 (SF-8) Health Survey Standard Indonesia to measure the QOL in patients with diabetic neuropathy that were treated consecutively from March to August 2016 in the Department of Neurology in Bethesda Hospital, Yogyakarta. Fifty seven patients with diabetic neuropathy were enrolled as subjects in this study. Most of them were women (52,6%). The mean age of subjects was 57.3 ± 5.85 years. The lowest QOL score in patients with diabetic neuropathy were observed in general health perceptions category (45.26%), followed by bodily pain (57.19%), vitality or energy (69.12%), physical functioning (69.82%), social role functioning (74.03%), mental health (78.59%), physical role functioning (80.70%), and emotional role functioning (81.05%). Patients with diabetic neuropathy have poor QOL. Sex and age were not significantly related to the QOL in patients with diabetic neuropathy. AbstractNeuropati merupakan salah satu komplikasi tersering pada diabetes melitus (DM). Neuropati dapat memengaruhi kualitas hidup, derajat kesehatan, maupun tingkat ekonomi. Oleh karena itu, penting untuk mengetahui kualitas hidup pasien DM dengan neuropati beserta dampak yang ditimbulkannya terlebih dahulu agar mendapatkan penanganan yang tepat demi meningkatkan kualitas hidup pasien. Penelitian ini bertujuan untuk mengetahui profil kualitas hidup pasien DM dengan neuropati. Penelitian ini merupakan studi observasional menggunakan Short Form 8 (SF-8) Health Survey Standard Indonesia terhadap pasien diabetes melitus dengan neuropati yang diambil secara konsekutif pada bulan Maret hingga Agustus 2016 di Poli Saraf Rumah Sakit Bethesda, Yogyakarta. Terdapat 57 subjek yang dimasukkan dalam penelitian ini. Sebanyak 52,6 % di antaranya adalah perempuan dengan rerata usia 57,3 ±5,85 tahun. Skor kualitas hidup pasien neuropati DM yang paling rendah terdapat pada kategori kesehatan umum (45,26%) disusul nyeri pada tubuh (57,19%), vitalitas atau energi (69,12%), fungsi fisik (69,82%), fungsi sosial (74,03%), kesehatan mental (78,59%), kemampuan peran dengan masalah kesehatan fisik (80,70%), dan kemampuan peran dengan masalah emosi (81,05%). Jenis kelamin dan usia tidak berhubungan secara signifikan terhadap kualitas hidup pasien DM dengan neuropati
Knowledge and Behavior Change of People Living with HIV through Nutrition Education and Counseling
Get PDFHIV, AIDS and nutrition are interconnected. In the HIV Integrated Care Unit of Dr. Cipto Mangunkusumo Public Hospital, nutrition education and counseling services are provided within a collaborative service for people living with HIV (PLWH). This study aimed to determine influence of nutrition education and counseling to knowledge and behavior of PLWH. This study was conducted with quasi experimental design using treatment and control groups. The treatment group consisted of 25 samples and 29 samples for control group. Samples were adults between 18 – 50 years old selected by applying inclusion and exclusion criteria. A pretested questionnaire was used to assess knowledge. Paired t-test sample was used to analyze data. This study was conducted on May – July 2014. Based on results of this study, there was effect in form of knowledge change (p value = 0.000) with score 6.38 point lower on the control group and any significant differences in behavior change (p value = 0.048) for the treatment group after receiving nutrition education and counseling. This study shows that nutrition and counseling using media of education which is more complete and continuously provided may improve knowledge and change behavior of PLWH.AbstrakHIV, AIDS, dan gizi saling berhubungan. Pada Unit Pelayanan Terpadu HIV Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, layanan edukasi dan konseling gizi disediakan secara kolaboratif untuk orang yang hidup dengan HIV. Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan dan konseling gizi terhadap pengetahuan dan perilaku orang yang hidup dengan HIV. Penelitian ini dilakukan dengan desain kuasi eksperimental menggunakan kelompok perlakuan dan kontrol. Kelompok perlakuan terdiri dari 25 sampel dan 29 sampel untuk kelompok kontrol, dilakukan sebelum dan setelah perlakuan. Sampel berusia dewasa antara 18 – 50 tahun dipilih dengan menerapkan kriteria inklusi dan eksklusi. Sampel uji-t berpasangan digunakan untuk menganalisis data. Penelitian ini dilakukan pada bulan Mei – Juli 2014. Berdasarkan hasil penelitian, diketahui bahwa adanya efek berupa perubahan pengetahuan (nilai p = 0,000) dengan nilai 6,38 poin lebih rendah pada kelompok kontrol dan terdapat perbedaan yang signifikan dalam perubahan perilaku (nilai p = 0,048) untuk kelompok perlakuan setelah menerima edukasi dan konseling gizi. Penelitian ini menunjukkan bahwa edukasi dan konseling gizi menggunakan media edukasi yang lebih lengkap dan diberikan secara berkelanjutan dapat meningkatkan pengetahuan dan mengubah perilaku orang yang hidup dengan HIV
Birth Intervals among Multiparous Women in Indonesia
Get PDFMaternal mortality rate and infant mortality rate in Indonesia are currently high. One of factors causing the high risk of maternal and infant mortality is too short birth intervals. This study aimed to learn determinants of birth intervals among multiparous women in Indonesia. This study used data from the Indonesia Demographic and Health Survey 2012 with 9,945 multiparous women. The data was analyzed using Mann Whitney, Kruskal Wallis and logistic regression tests. Median of birth intervals was 62 months and 22.8% women had birth interval less than three years. Results showed that determinants of birth intervals included maternal education, the last age of childbirth, ideal family size, the use of contraception, infant mortality records and survival of preceding child (p value < 0.05). The age of childbirth was a major risk factor of too short birth intervals. It needs the improvement of communication, information and education regarding maturation of age for marriage, ideal number of children as well as the increase of contraception use in order to increase optimum birth intervals.AbstrakAngka kematian ibu dan angka kematian bayi di Indonesia masih tinggi. Salah satu faktor yang menyebabkan tingginya risiko kematian pada ibu dan bayi adalah kelahiran terlalu dekat. Penelitian ini bertujuan untuk mempelajari determinan jarak antarkelahiran pada perempuan multipara di Indonesia. Penelitian ini menggunakan data Survei Demografi Kesehatan Indonesia tahun 2012 pada 9.945 perempuan multipara. Analisis data menggunakan uji Mann Whitney, Kruskal Wallis, dan regresi logistik. Median jarak antarkelahiran sebesar 62 bulan dan 22,8% perempuan memiliki jarak antarkelahiran kurang dari tiga tahun. Hasil menunjukkan determinan jarak antarkelahiran pendek meliputi pendidikan ibu, usia terakhir melahirkan, ukuran ideal keluarga, pemakaian kontrasepsi, riwayat kematian anak, dan kelangsungan hidup anak sebelumnya (nilai p < 0,05). Usia melahirkan merupakan faktor yang paling berisiko terhadap jarak kelahiran terlalu dekat. Diperlukan peningkatan komunikasi, informasi, dan edukasi mengenai pendewasaan usia pernikahan, jumlah anak ideal serta peningkatan pemakaian kontrasepsi dalam upaya meningkatkan jarak antarkelahiran optimum