Ruben Dharmawan
Medicine Faculty of Sebelas Maret University

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The Effectiveness of Mosquito Breeding Site Eradication and Role of Wiggler Controller toward Countermeasure Effort of Dengue Hemorrhagic Fever in Klaten, Central Java Riska Chandra Pradana; Ruben Dharmawan; Endang Sutisna Sulaeman
Journal of Epidemiology and Public Health Vol. 1 No. 1 (2016)
Publisher : Masters Program in Public Health

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Abstract

Background: Countermeasure of Dengue Hemorrhagic Fever (DHF) is more prioritizing in preventive activities such as implementing mosquito breeding site eradication or PSN through 3M plus by involving the society and facilitating the establishment of wiggler controllers or Jumantik. Role of wiggler controllers is very important especially in initial vigilance system moreover in the outbreaks of DHF because of their function in monitoring the wigglers’ position and hampering the initial development of DHF transmitter vector. The activeness of wiggler controllers in monitoring their environment is expected to decrease the number of DHF cases. This study was aimed to investigate analyzing the effectiveness of mosquito breeding site eradication and the roles of wiggler controllers or Jumantik in prevention and countermeasure efforts of DHF.Subject and Methods: This was a qualitative study with case design. This was conducted in Juwiring, Ngawen, North Klaten community health center in Klaten, Central Java were selected by Purposive Sampling. The data was collected with observation, document analysis, and in-depth interview. The data validity included a triangulation, methodological triangulation, and theory triangulation. The data was analyzed with data collection, data reduction, data presentation, and drawing the conclusion were included in the data analysis of this research.Results: Several obstacle factors were people’s behavior which was not routinely doing the eradication of mosquito breeding site or PSN, lack of knowledge about PSN, lack of health workers especially in PSN program and the role of public figure was not maximum yet. Those could be seen from the outcome of PSN program which was divided by the output of PSN. Morbidity rate of DHF and mortality rate of DHF in Klaten District were still high and did not achieve the national target yet. Then, people’s knowledge about PSN program was quite good, people’s behavior was also good especially to the implementation of PSN program although some of them behaved poorly, their reliance and trust were good especially to the implementation of PSN program, then, there were no contradictions between society values and PSN Program. Health facilities and infrastructures were adequate to perform individual health effort in promotive, preventive, curative, or rehabilitative which were done by the government, regency government, or the society especially to encourage the implementation of PSN program. Amount of health officers for the implementation of PSN Program was not ideal yet, especially for Epidemiology officers and Health Promotion officers. Public and government supports were quite good in the implementation of PSN Program. Attitude and behavior of public figures, religious leaders, and also health officers were quite good. Although some of public figures did not give their full support. Government policy in encouraging the implementation of PSN Program itself was quite good. That was proven by publishing Region Regulation No. 03 of 2010 and Regent Regulation No. 05 of 2013 about prevention and disease control from animal sources, but its implementations were not maximum and binding yet. The role of wiggler controllers in decreasing the rate of DHF cases could be optimized by specific commitment from the policy makers, started from the highest to the lowest in order to build better initial vigilance system. Operational fund for the wiggler controllers (Jumantik) in Klaten District was not ideal yet, so, commonly they spent their own money for the operational fund when they did their job.Conclusion: The effectiveness of PSN Program in Klaten District to overcome DHF was effective enough. The role of predisposition factor toward mosquito breeding site eradication or PSN in order to overcome DHF in Klaten District was became the booster of the implementation of mosquito breeding site eradication program (PSN). Enabling Factors are enormously important in implementing the PSN Program in the public. The encourage factor on PSN program was not maximum yet, especially in the implementation of Region Regulations and Regent Regulations particularly about Prevention and Disease Control from Animal Source. The roles of wiggler controllers in the countermeasure of DHF in Klaten District was very important especially for the initial vigilance of DHF because its functions were used to monitor their existences and also hamper the initial development of DHF transmitter vectorKey words: mosquito breeding site eradication, DHF, the role of wiggler controllersCorrespondence : Riska Chandra Pradana. Dr. R Soeprapto Cepu Hospital. Email: pradanachan@gmail.comJournal of Epidemiology and Public Health (2016), 1(1): 37-48https://doi.org/10.26911/jepublichealth.2016.01.01.05
Path Analysis and Health Belief Model on the Association between Education and Cadre Performance in Tuberculosis Control in Baki Community Health Center, Sukoharjo, Indonesia Dhian Nurayni Sulistyo Ningrum; Bhisma Murti; Ruben Dharmawan
Journal of Health Policy and Management Vol. 1 No. 1 (2016)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Abstract

Background: The new cases of tuberculosis in 2014 as many as 9.6 million. There are 6 million cases reported findings. The efforts to increase the number of case finding through cooperate community and community health workers. This study aimed to analyze the association of education and health belief model with a performance of cadres in tuberculosis control.Subjects and Method: This was an observational analytic with a cross sectional design. This was conducted in community health center of Baki, Sukoharjo, Indonesia, in April 2016. A total of sample was 90 subjects were selected by random sampling. The data collection used questionnaire. The data were analyzed using path analysis.Results: There was no relationship between education and the performance of cadres in tuberculosis control cases through the perception of vulnerability, perceived seriousness, perceived benefit, perceived barriers and self-efficacy. There was a direct positive relationship between the perception of vulnerability to the performance of cadres in tuberculosis control cases (b = 3.35; 95% CI= 1.43 to 5.27; p=0.001), seriousness (b=2.21; 95% CI=0.43 to 3.9; p = 0.015), benefits (b= 2.11; 95% CI= 0.42 to 3.80; p = 0.014), self-efficacy (b = 2.04; 95% CI= -0.01 to 4.09; p = 0.051), the impulse to act (b = 1.64; 95% CI= 0.06 to 3.22; p= 0.042) with the performance of cadres in the control of tuberculosis cases. There was a direct negative relationship between perceptions of barriers to the performance of cadres in tuberculosis control (b=-4.54; 95% CI= -7.56 to - 1.52); p = 0.003).Conclusion: There is indirect relationship between education and performance of cadres in tuberculosis control cases through the perception of vulnerability, seriousness, benefits, barrier and self-efficacy. There is a direct relationship between construct of health belief model with the performance of cadres in tuberculosis control cases.Keywords: path analysis, education, health belief model, the performance of cadres, tuberculosisCorrespondences: Dhian Nurayni. Sulistyo Ningrum. Faculty of Public Health, Sebelas Maret University, Surakarta. Email: dhiannuraynis@gmail.comJournal of Health Policy and Management (2016), 1(1): 38-43https://doi.org/10.26911/thejhpm.2016.01.01.06