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All Journal JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Zamrotul Izzah
Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
Chemistry Education Health Professions Medicine & Pharmacology Other

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Effect of Integrated TOGA-Nutrition Education on Stunting Prevention Knowledge among Health Volunteers and Adolescents in Lamongan, Indonesia: A Pre-Post Intervention Study Idha Kusumawati; Hanni Prihhastuti Puspitasari; Pratiwi Soesilawati; Zamrotul Izzah; Anisa Lailatul Fitria; Firmansyah Ardian Ramadhani; Subhan Rullyansyah; Yusuf Alif Pratama; Charlyna Veronika Puspitasari Pattymahu; Fahmi Haitsami Ibnu Gamar; Ruzainah Ali
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 12 No. 3 (2025): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v12i32025.342-354

Abstract

Background: Lamongan, Indonesia, is facing a significant public health issue, with high rates of stunting (27.5% in 2022) and adolescent anemia (60.0% in Babat district). A significant knowledge gap exists in the community, particularly regarding the effective use of Family Medicinal Plants (TOGA) for prevention, highlighting the need for structured intervention programs to address these public health issues. This study evaluated an integrated education program designed to improve knowledge and shift perceptions regarding TOGA, assessing differential knowledge gains between health volunteers and adolescents. Methods: This pre-post intervention study involved 54 female participants (27 health volunteers and 27 adolescents) from Kebalanpelang Village, Babat District, Lamongan. All participants received the same 120-minute integrated TOGA-nutrition education based on Social Cognitive Theory, covering stunting prevention, complementary feeding, breastfeeding optimization, and TOGA applications using evidence-based traditional medicinal plants. Knowledge was assessed using the same validated 10-item questionnaire (Cronbach's α=0.81) for both groups, covering three domains: complementary feeding guidelines (3 items), breastfeeding optimization (3 items), and TOGA applications for stunting prevention (4 items), administered before and immediately after the intervention. Results: The intervention was highly effective, yielding a statistically significant 25.4% mean knowledge gain across all participants (3.6±2.1-point gain, p<0.001). Adolescents showed the most dramatic improvement, achieving a 39.7% knowledge increase (a 4.8-point gain). While health volunteers had a more modest gain of 14.7% (a 2.4-point increase), the intervention successfully narrowed the initial knowledge disparity between the two groups by 57% (reducing the gap from Δ4.2 to Δ1.8 points). Domain-specific analysis revealed significant gains across all areas: complementary feeding (+26.8%), breastfeeding (+26.7%), and TOGA applications (+23.9%, all p<0.001). A strong inverse correlation between age and knowledge gain (r=-0.72, p<0.001) indicated that younger participants, particularly those aged 15-17 years, demonstrated superior learning capacity. Conclusions: The implementation of integrated TOGA-nutrition education significantly enhanced stunting prevention knowledge. This intervention is particularly effective for adolescents, which employs role-specific content, successfully mitigates cultural barriers and leads to a measurable reduction in knowledge equity gaps. Strong evidence of participant confirms the program's cultural fit and operational readiness, making a compelling case for its integration and scaling within Indonesia’s broader stunting prevention efforts.
Antiretroviral Adherence and Treatment Outcomes Among People Living with HIV Receiving Monthly and Multi-Month Dispensing: A Cross-Sectional Study Zamrotul Izzah; Mirzario Aryananda Verrian; Madona Dwi Fitriani; Tri Pudy Asmarawati; Din Amalia Widyaningrum
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 13 No. 2 (2026): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v13i22026.184-193

Abstract

Background: Human immunodeficiency virus (HIV) requires lifelong antiretroviral therapy (ART), and sustained adherence is essential for achieving viral suppression and preventing disease progression. Multi-month dispensing (MMD) was introduced to reduce clinic visits and improve treatment continuity; however, comparative evidence between MMD and monthly dispensing remains limited in Indonesia. Objective: This study aimed to assess treatment adherence and therapeutic outcomes among people living with HIV who received ART through MMD and monthly dispensing systems. Methods: A cross-sectional study was conducted at the HIV clinic of Universitas Airlangga Hospital, Indonesia, involving 160 people living with HIV, consisting of 80 patients in the MMD group and 80 in the monthly care group. MMD was operationally defined as ART dispensation for two or more months in the study setting. Adherence was assessed using the Self-Reported Adherence (SERAD) questionnaire and pill count method, while therapeutic outcomes were evaluated based on viral load (VL) results. Data were analyzed using appropriate statistical tests to determine the differences between the groups. Results: Significant differences were found in adherence based on the pill count (p = 0.03) and SERAD drug use (p = 0.00). Viral suppression rates were significantly higher in the MMD group (p < 0.001), with all patients achieving undetectable VL levels. Conclusion: MMD was associated with better adherence and improved virological outcomes than monthly dispensing, suggesting an association that warrants further evaluation with a longitudinal design to optimize HIV treatment outcomes.
Association Between Beliefs About Antiretroviral Therapy and Medication Adherence Among People Living with HIV: A Cross-Sectional Study Zamrotul Izzah; Wiweka Santikrama; Toti Cahyaningsih; Indira Dhany Kharismawati; Erika Marfiani
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 13 No. 2 (2026): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Adherence to antiretroviral therapy (ART) is a key factor in managing HIV/AIDS. Positive beliefs about ART among people living with HIV (PLHIV) are crucial for maintaining good treatment adherence, whereas negative beliefs about ART result in low treatment adherence. Objective: This study aimed to analyze the association between beliefs regarding treatment and ART adherence among PLHIV receiving outpatient care. Methods: A cross-sectional study was conducted on 157 PLHIV at the HIV clinic of Universitas Airlangga Hospital between April and June 2025. Adherence was measured using the Self-Reported Adherence (SERAD) questionnaire and pill count, with a cutoff of ≥80%. The relationship was analyzed using binary logistic regression analysis. Results: Most respondents held positive beliefs regarding the necessity of ART (87.9%) and were classified as adherent (86%). However, no statistically significant associations were observed between ART adherence and the BMQ domain scores for necessity, concerns, overuse, or harm. The odds ratios were 1.00 (95% CI: 0.88–1.12) for necessity, 0.99 (95% CI: 0.89–1.12) for concerns, 0.97 (95% CI: 0.82–1.16) for overuse, and 0.97 (95% CI: 0.82–1.15) for harm. Psychological factors such as depression and low motivation, as well as practical reasons such as forgetfulness, were identified as causes of non-adherence despite a strong belief in the medication. Conclusion: Although most PLHIV had strong beliefs and adherence, no statistically significant association was observed between beliefs about treatment and ART adherence. These findings suggest that ART adherence may be influenced by multiple factors beyond treatment beliefs, underscoring the need for holistic and comprehensive interventions that address the diverse barriers to sustaining ART adherence.
Co-Authors Anisa Lailatul Fitria Charlyna Veronika Puspitasari Pattymahu Din Amalia Widyaningrum Erika Marfiani Fahmi Haitsami Ibnu Gamar Firmansyah Ardian Ramadhani Hanni Prihhastuti Puspitasari Idha Kusumawati Indira Dhany Kharismawati Madona Dwi Fitriani Mirzario Aryananda Verrian Pratiwi Soesilawati Ruzainah Ali Subhan Rullyansyah Toti Cahyaningsih Tri Pudy Asmarawati Wiweka Santikrama Yusuf Alif Pratama