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Path Analysis on the Determinants of Neonatal Asphyxia at Dr. Saiful Anwar Hospital, Malang Dewy Indah Lestary; Endang Sutisna Sulaeman; Nunuk Suryani
Journal of Epidemiology and Public Health Vol. 1 No. 2 (2016)
Publisher : Masters Program in Public Health

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Background: Neonatal asphyxia is one of the main causes of neonatal mortality. Many factors may have caused neonatal mortality. This study aimed to investigate the determinants of neonatal asphyxia at Dr. Saiful Anwar Hospital, Malang.Subjects and Method: This was an analytic observational study using case control design. The study was conducted at Dr. Saiful Anwar, Malang, East Java, in June 2016. A total of 53 newborn babies with asphyxia (cases) and 159 newborn babies without asphyxia (controls) were selected by fixed disease sampling for this study. There were three exogenous variables: prematurity, maternal age, and parity. The endogenous variables were birthweight and neonatal asphyxia. The data were collected by a checklist. The data were analyzed by path analysis model.Results: Low birthweight had positive direct effect on the risk of neonatal asphyxia (b=1.61; 95% CI= 0.86 to 2.37; p<0.001). Prematurity (b=0.93; 95% CI= 0.13 to 1.74; p<0.023), maternal ages <20 years or ≥35 years (b=0.97; 95%CI = 0.05 to 1.87; p<0.034), and parity primipara or ≥4 parity (b=1.00; 95% CI = 0.155 to 1.85; p<0.021), had positive indirect effects on the risk of neonatal asphyxia via low birthweight.Conclusion: Low birthweight had positive direct effect on the risk of neonatal asphyxia. Prematurity, maternal ages <20 years or ≥35 years, and parity primipara or ≥4 parity, had positive indirect effects on the risk of neonatal asphyxia via low birthweight.Keywords: neonatal asphyxia, low birth weight, prematurity, maternal age, parity.Correspondence: Dewy Indah Lestary. Academy of Midwifery Wijaya Kusuma, Malang, East Java. Email: dewylestary86@gmail.comJournal of Epidemiology and Public Health (2016), 1(2): 140-147https://doi.org/10.26911/jepublichealth.2016.01.02.08

Effect of Biopsychosocial Factors and Environmental Sanitation on Nutritional Status of Children Under Five Years Old in Nganjuk District Wiwen Indita; Harsono Salimo; Endang Sutisna Sulaeman
Journal of Epidemiology and Public Health Vol. 2 No. 1 (2017)
Publisher : Masters Program in Public Health

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Background: One of the important public health issues in Indonesia is nutritional status, particularly in children under five years old. Lack of maternal awareness of dietary intake for their children may affect growth and development. This study aimed to investigate the effect of biopsychosocial factors and environmental sanitation on nutritional status of childrens in Nganjuk District.Subject dan Method: This was an analytic observational study using cross-sectional design. The study was conducted at Loceret Community Health Center, Nganjuk District, East Java, from March to April 2017. A sample of 136 children under five years old were selected for this study by fixed exposure sampling. The variable dependent was nutritional status measured in weight for age. The independent variables were dietary intake, history of infection disease, maternal stress, maternal education, family income, and environmental sanitation. The data were collected by anthropometry, medical record, and questionnaire. The data were analyzed with path analysis.Results: Weight for age of children under five was affected by dietary intake (b= 0.23, SE<0.001, p= 0.003), maternal education (b= 0.72, S.E= 0.28, p= 0.012), and history of infectious disease (b=0.80; SE= 0.29; p= 0.007). History of infectious disease was affected by environmental sanitation (b=0.31; SE<0.001; p<0.001), and family income (b= 0.25, SE= 0.05, p<0.001). Dietary intake was affected by family income (b= 0.58, SE= 0.21, p= 0.007), history of infectious disease (b= 12.31; SE= 3.20; p<0.001), and maternal education (b=7.39; SE=3.09, p=0.017). Maternal stress was affected by family income (b=-0.16; SE= 0.06; p= 0.008).Conclusion: Weight for age of children under five was directly affected by dietary intake, maternal education, and history of infectious disease. Weight for age of children under five was indirectly affected by environmental sanitation, family income, history of infectious disease, and maternal education.Keywords: biopsychosocial, path analysis, environmental sanitation, nutritional statusCorrespondence: Wiwen Indita. Masters Program in Public Heath, Sebelas Maret University, Surakarta, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: wiwenindita29@gmail.com. Mobile: +6282244970118.Journal of Epidemiology and Public Health (2017), 2(1): 32-44https://doi.org/10.26911/jepublichealth.2017.02.01.04

Effect of Doctor’s Personality, Job Characteristic, Payment Method, Facility, on Performance and Quality of Doctor Service Heni Hastuti; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 2 No. 1 (2017)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Doctors generally do not work permanently at hospitals. Doctors are expected to deliver quality medical service at the hospitals. However, hospitals often find it difficult to exercise efective managerial control over the quality of medical services. This study aimed to investigate the effect of doctor’s personality, job characteristic, payment method, facility, on performance and quality of doctor service.Subjects and Method: This was an analytic observational study using cross-sectional design. The study was carried out at Dr. Moewardi Hospital and PKU Muhammadiyah Hospital, Surakarta, from March to May 2017. A sample 182 study subjects consisting of 26 doctors, 26 nurses, and 130 patients, were selected for this study by simple random sampling. The dependent variable was quality of doctor service. The independent variables were doctor’s personality (extrovert vs. introvert), doctor’s carefulness, proactive attitude, self-efficacy, autonomy, performance feedback, supervisor support, payment method, work site (private vs. public), and performance. Questionnaire was used to collect data. Path analysis was employed to analyze the data.Results: Good quality of doctor service was directly affected by good performance (b=0.64, SE=0.11, p<0.001), private work site (b= 2.85, SE=0.66, p<0.001), and strong self-efficacy (b=0.21, SE=0.07, p=0.006). Good work performance was affected by extrovert personality (b=0.08, SE= 0.06, p=0.186), careful attitude (b=0.30; SE=0.09; p=0.001), proactive personality (b=−0.17; SE=0.05; p=0.001), strong self-efficacy (b=0.27; SE=0.07; p<0.001), autonomy (b=0.16; SE=0.06; p=0.015), performance feedback (b=0.43; SE=0.13, p<0.001), supervisor support (b=0.14, SE=0.06, p=0.018), payment method (INA CBGs) (b= −2.29; SE= 0.66; p<0.001), and private work site (b= -0.26, SE= 0.68, p=0.696).Conclusion: Good quality of doctor service is directly affected by good performance, private work site, and strong self-efficacy.Keywords: quality, doctor’s service, performance, path analysisCorrespondence: Heni Hastuti. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: henihastuti.1988@gmail.com Mobile: +6281904534310.The Journal of Health Policy and Management (2017), 2(1): 42-55https://doi.org/10.26911/thejhpm.2017.02.01.04

Path Analysis on the Determinants of the Use of Integrated Health Post and the Application of Theory of Planned Behavior Yuni Fitriani; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Promotion and Behavior Vol. 1 No. 4 (2016)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Integrated health post (Posyandu) is a strategy for community empowerement. It has an important role to reduce maternal mortality rate (MMR) and infant mortality rate (IMR). The intergrated health post monitors the health of infants, children, pregnant women, lactating women, and women of reproductive age. Weighing coverage of children under five was only 80.4% in Central Java, in 2014. Weighing coverage of children under five was only 78.4 % in Tegal District, in 2015, which was lower than the expected target of 80%. This study aimed to investigate the determinant of of the use of integrated health post and the application of Theory of Planned Behavior (TPB).Subjects and method: This was an analytic observational study with case control design. This study was conducted in Tegal District, Central Java, from 25 September to 25 October 2016. A total sample of 135 mothers with their respective children aged 6-59 months were selected for this study by fixed disease sampling. The dependent variables were intention and use of the integrated health post. The independent variables were constructs of TPB, including attitude toward behavior, subjective norm, and perceived behavior control. The data were collected by a pre-tested set of questionnaire. The data were analyzed by path analysis using IBM SPSS AMOS 22.Results: The path model showed goodness of fit with CMIN=4.24; p=0.120; GFI=0.99; NFI=0.99; CFI=0.99; and RMSEA=0.09. Intention had direct positive and statistically significant effect on the use of the integrated health post (b=0.29; p<0.001). All of the three TPB constructs, including attitude toward behavior (b=0.27; p<0.001), subjective norm (b=0.27; p=0.046), and perceived behavior control (b=0.34; p=0.007) had indirect positive and statistically significant effect on the use of the integrated health post.Conclusion: Intention has direct positive effect on the use of the integrated health post. All of the three TPB constructs, i.e. attitude toward behavior, subjective norm, and perceived behavior control has positive and indirect effect on the use of the integrated health post.Keywords: integrated health post, theory of planned behaviorCorrespondence: Yuni Fitriani. School of Health and Sciences, STIKes Bhakti Mandala Husada Slawi. Email: yfitriani85@yahoo.co.id.Journal of Health Promotion and Behavior (2016), 1(4): 228-237https://doi.org/10.26911/thejhpb.2016.01.04.02

Path Analysis on the Effectiveness of Exclusive Breastfeeding Advocacy Program on Breastfeeding Practice using Theory of Planned Behavior Valentina Dili Ariwati; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Promotion and Behavior Vol. 1 No. 3 (2016)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Exclusive breastfeeding coverage was 52.30% in 2015, which was below the national target of 80%. For the past few years Klaten local government has launched the Exclusive Breastfeeding Advocacy Program with the objective to increase exclusive breastfeeding coverage. This study aimed to determine the effectiveness of Exclusive Breastfeeding Advocacy Program using Theory of Planned Behaviour framework.Subjects and Method: This was an analytic observational study with retrospective cohort design. This study was conducted from 2 August to 16 September 2016 in Klaten and Magelang, Central Java, Indonesia. A total of 200 lactating mothers of infants aged 6 to 12 months was selected for this study by multi-stage random sampling. The dependent variables were exclusive breastfeeding and intention. The independent variables were exclusive breastfeeding advocacy program, attitude, subjective norm, and perceived behavior control. The data were collected using a set of questionnaire, and analyzed by path analysis.Results: The path model showed Goodness of Fit indices as follows: CMIN=4.24, p=0.374, GFI=0.99, NFI=0.99, CFI=1.00, RMSEA=0.017. Strong intention (b=0.15; p <0.001) had direct effect on exclusive breastfeeding. Positive atittude (b = 0.27; p<0.001), positive subjective norm (b=0.26; p <0.001), strong perception of behavior control (b=0.25; p<0.001), and exclusive breastfeeding advocacy program (b=0.36; p<0.001), had positive effects on intention.Conclusion: Intention has direct effect on exclusive breastfeeding. Atittude toward exclusive breastfeeding, subjective norm, and perception of behavior control, have positive effects on intention. Exclusive breastfeeding advocacy program is effective in increasing the likelihood of providing exclusive breastfeeding.Keywords: exclusive breastfeeding advocacy program, attitude, subjective norm, perceived behavior control, intention, exclusive breastfeeding behavior.Correspondence: Valentina Dili Ariwati. Masters Program in Public Health, Sebelas Maret University.Journal of Health Promotion and Behavior (2016), 1 (3): 149-159https://doi.org/10.26911/thejhpb.2016.01.03.02

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