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Path Analysis on the Biopsychosocial Determinants and Genital Hygiene on Cervical Cancer at Dr. Moewardi Hospital, Surakarta, Central Java Afriza Umami; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health

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Background: Cervical cancer is the fourth most common cancer in women worldwide and the second most common cancer in women in developing countries after breast cancer. The prevalence of cervical cancer in Indonesia was 0.8‰ with an estimated 98.692 cases. This study aimed to determine the biopsychosocial and genital hygiene factors for cervical cancer.Subjects and Method: This was an analytic observational study with a case-control design, conducted at Dr. Moewardi Hospital, Surakarta, from December 2017 to February 2018. A total of 178 study subjects including 95 women with cervical cancer (case) and 83 women without cervical cancer (control) were selected by fixed disease sampling. The dependent variable was cervical cancer. The independent variables were the age at first sexual intercourse, a number of sexual partners, body mass index (BMI), stress, education, income, and genital hygiene. Cervical cancer data was collected by medical record. The other data were collected by questionnaire. The data were analyzed by path analysis model.Results: The risk of cervical cancer increased with the number of sexual partner >1 (b=1.91; 95% CI= 0.31 to 3.49; p=0.019), BMI ≥25 (b= 0.98; 95% CI= -0.06 to 2.04; p=0.067), and stress (b= 1.59; 95% CI= 0.39 to 2.80; p=0.009). The risk of cervical cancer decreased with higher education (b= -3.58; 95% CI= -4.77 to -2.39; p<0.001), higher income (b= -1.49; 95% CI= -2.73 to -0.25; p=0.019), age at first sexual intercourse ≥18 years (b= -1.36; 95% CI= -2.52 to -0.21; p= 0.020), and genital hygiene (b= -1.24; 95% CI= -2.35 to -0.13; p=0.028). Income increased with higher education (b= 2.48; 95% CI= 1.71 to 3.25; p<0.001). Genital hygiene increased with education (b= 1.16; 95% CI= 0.47 to 1.86; p=0.001). Age at first sexual intercourse ≥18 years increased with higher education (b= 1.30; 95% CI= 0.58 to 2.01; p<0.001). Stress increased with number of sexual partner >1 (b= 1.36; 95% CI= 0.12 to 2.61; p=0.032).Conclusion: The risk of cervical cancer increases with the number of sexual partners, BMI, and stress, but decreases with higher education, higher income, age at first sexual intercourse, and genital hygiene.Keywords: cervical cancer, biopsychosocial determinants, genital hygiene, path analysisCorrespondence:

The Effect of Iron Deficiency Anemia on the Child Death Related to HIV/AIDS Infection: Meta-Analysis Dyah Ambarwati; Yulia Lanti Retno Dewi; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health

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Background: A quarter of the world's popula

Do Places of Delivery Have Contextual Effect on the Perceived Quality of Intrapartum and Postpartum Services? A Multilevel Evidence from Kebumen, Central Java Helmi Nurlaili; Didik Tamtomo; Bhisma Murti
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Background: The maternal mortality rate (MMR) in Indonesia in 2015 was 305 per 100,000 live births. The majority of maternal deaths occur during labor and the puerperium. Increasing access to health services is not enough so that attention is more focused on the quality of services provided. This study aimed to determine the determinants of the quality of childbirth and childbirth by midwives in Kebumen Regency.Subjects and Method: This study was a cross sectional study at 25 health facilities in Kebumen, Central Java, and was conducted during September-October 2019. The study sample consisted of 200 women giving birth and childbirth selected using the proportionate stratified sampling technique. The dependent variable was the quality of childbirth and childbirth services. The independent variables were age, parity, education, occupation, family income, and type of financing. The data collection was performed using a questionnaire and the data analysis was performed using multilevel multiple linear regression with Stata 13.Results: The quality of childbirth and childbirth services increased with maternal age 34 years (b= 1.89; 95% CI = 0.48 to 3.31; p = 0.009), multiparaous (b = 2.20; 95% CI = 0.78 to 3.63; p = 0.002), and type JKN financing (b = 0.27; 95% CI = -0.94 to 1.47; p = 0.659). The quality of childbirth and childbirth services decreased with the education of high education (b= -0.87; 95% CI = -2.02 to 0.28; p= 0.139), working outside the home (b= -1.28; 95% CI= -2.64 to 0.08; p= 0.065), and family income of Rp 1,686,000 (b= -1.85; 95% CI= -3.24 to -0.47; p= 0.009). There was a contextual influence of the place of delivery and postpartum on the quality of services received by mothers with ICC= 51.26%.Conclusion: The quality of childbirth and childbirth services has improved with the age of 34, multiparous, and JKN types of financing. The quality of childbirth and childbirth services declined with the education of mothers who were high school graduates, working outside the home, and family income of Rp1,686,000. There is a contextual influence of the place of delivery and postpartum on the quality of service received by the mother.Keywords: quality of service, childbirth, community health center, multilevel analysisCorrespondence: Helmi Nurlaili. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: helminurlaili@gmail.com. Mobile: 085869950546Journal of Health Policy and Management (2020), 5(1): 23-34https://doi.org/10.26911/thejhpm.2020.05.01.03

Menopause and Biopsychosocial Factors Associated with Quality of Life in Women in Surakarta, Central Java Dwi Hesti Ermawati; Uki Retno Budihastuti; Bhisma Murti
Journal of Maternal and Child Health Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Women spend a third of life during menopause. The number of women entering menopause worldwide is estimated at 25 million annually. Women of menopausal age have decreased estrogen hormone which can decrease the quality of life. This study aimed to analyze the biopsychosocial factors and menopause affecting the women's quality of life.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in Surakarta, from January to February 2018. A sample of 200 women was selected by cluster sampling. The dependent variable was quality of life. The independent variables were self-efficacy, healthy behavior, menopause, and social support. The data were collected by questionnaire and analyzed by path analysis.Results: Women

Logistic Regression Analysis on the Determinants of Stunting among Children Aged 6-24 Months in Purworejo Regency, Central Java Atika Rakhmahayu; Yulia Lanti Retno Dewi; Bhisma Murti
Journal of Maternal and Child Health Vol. 4 No. 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Stunting is a representation of the state of chronic malnutrition in the first 1000 days of life that occurred in the world at an incidence of 22.2% in 2017. Stunting in children has impact on morbidity and mortality, resulting in a long-term decline socio-economic productivity of the community. The purpose of this study was to analyze the determinants of stunting in children aged 6-24 months in Purworejo, Central Java.Subjects and Method: This was an analytic observational study with a case control design. It was conducted in 25 integrated community health posts (posyandu) in Purworejo, from October to December 2018. A sample 200 children under five was selected using by simple random sampling. The dependent variable was stunting. The independent variables were maternal mid-upper arm circumference (MUAC) at pregnancy, maternal education, paternal education, family income, family food allocation, infant birth weight, exclusive breastfeeding, complementary feeding (CF), posyandu strata, stunting monitoring at posyandu, and posyandu stunting intervention. The data was collected by questionnaire and analyzed by a multiple logistic regression.Results: Maternal MUAC at pregnancy ?23.5 cm (b= -1.56; 95% CI= 0.06 to 0.67; p = 0.009), high maternal education (b= -1.70; CI95% = 0.06 to 0.57; p = 0.003), high paternal education (b= -1.90; 95% CI= 0.05 to 0.51; p= 0.002), high family income (b= -1.85; 95% CI= 0.05 to 0.50; p = 0.002), family food allocation (b= -2.26; 95% CI= 0.03 to 0.37; p<0.001), birth weight ?2,500 g (b= -1.39; 95% CI= 0.08 to 0.83; p= 0.024), exclusive breastfeeding (b = -2.04; 95% CI= 0.04 to 0.48; p= 0.002), and adequate complementary feeding (b= -1.61; 95% CI= 0.06 to 0.65; p= 0.007) reduced the risk of stunting in children aged 6-24 months.Conclusions: Maternal MUAC at pregnancy ?23.5 cm, high maternal education, high paternal education, high family income, family food allocation, birth weight ?2,500 g, exclusive breastfeeding, and adequate complementary feeding reduce the risk of stunting in children aged 6-24 months.Keywords: stunting, determinants, children aged 6-24 monthsCorrespondence:

Health Service Quality Management at dr. Siswanto Air Force Hospital, Colomadu, Karanganyar, Central Java Dwi Marwanto; Bhisma Murti; Didik Gunawan Tamtomo
Journal of Health Policy and Management Vol. 6 No. 3 (2021)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Background: Patient satisfaction is an important indicator of health care success. Patients assess the quality of service received based on their satisfaction with the services provided. The purpose of this study was to describe the quality management of health services at dr. Siswanto Air Force Hospital (RSAU) Colomadu, Karanganyar.Subject and Method: This study is a qualitative study with a descriptive approach. The study was conducted from March to May 2021. The data for this study were taken from two sources, namely internal hospitals as health service providers and the community as users of health services. Informants in this study were the director of the dr. Siswanto Air Force Hospital, staff of dr. Siswanto Air Force Hospital, and 7 patients who used health services at dr. Siswanto Air Force Hospital. Data was collected by means of in-depth interviews, observations, documents and focused group discussions. The data analysis techniques carried out were data reduction, data display and conclusion and also verification.Results: The quality of health services from the side of health service users (patients) showed that dr. Siswanto Air Force Hospital has good quality health services based on the following aspects: (1) reliability: patient registration services, administrative management, provision of treatment rooms that are fast and easily accessible to patients, (2) assurance: health personnel have a polite, friendly, and respectful attitude towards patients, (3) tangible: the hospital room is comfortable, the staff is neat and clean, and medical equipment is complete, clean, and ready to use, (4) empathy: the officer gives special attention to patients and patient complaints, and there is no difference in attitude and treatment in general patient care and insurance, and (5) responsiveness: there is good communication from hospital staff to patients and quick action if the patient needs immediate help.Conclusion: The quality of health service management at dr. Siswanto air force hospital fulfills the criteriaof reliability, assurance, tangible, empathy and responsiveness.Keywords: Management of health services, quality of health servicesCorrespondence: Dwi Marwanto. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: dwiantox74@gmail.com. Mobile: 082138064130.Journal of Health Policy and Management (2021), 06(03): 182-189 https://doi.org/10.26911/thejhpm.2021.06.03.03

Management Analysis of the Implementation of Covid-19 Vaccination in Reducing Positivity Rate in Regency Health Office of Boyolali, Central Java Tifa Aviandari; Eti Poncorini Pamungkasari; Bhisma Murti
Journal of Health Policy and Management Vol. 6 No. 3 (2021)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Background: The results of a vaccine acceptance survey conducted by the Ministry of Health together with the Indonesian Technical Advisory Group on Immunization (ITAGI) with the support of UNICEF and WHO in September 2020 showed that most people (74%) were aware of the government's plan to carry out COVID-19 vaccination. The government targets 181,500,000 Indonesians to receive the vaccine to achieve herd immunity. Through this vaccination effort, it is hoped that it will reduce the COVID-19 positivity rate. The positivity rate is the ratio between the number of positive cases of Covid-19 and the number of tests carried out. The purpose of this study was to qualitatively examine the management analysis of the implementation of Covid-19 vaccination in reducing positivity rate in Boyolali Regency Health Office.Subjects and Method: This was a type of descriptive research using a qualitative approach. Determination of informants is done by purposive sampling. Data was collected through indepth interviews, document review and observation. The data is processed through the stages of data reduction, data presentation and conclusion drawing and triangulation of sources and methods.Results: The implementation of vaccination in the coverage area of the Boyolali Health Service was able to reduce the positivity rate in Boyolali. The COVID-19 vaccination procedure is carried out based on the requirements for the vaccine recipient community. According to the coordinator of the vaccination implementation at one of the hospitals in Boyolali (informant 1), they screened the patient's condition before starting the vaccination. In addition to screening medical history, vaccine participants must be confirmed to be in a negative condition or not suffering from COVID-19 disease. Data from the Boyolali Health Office shows that since the vaccine began (mid-February), the number of COVID-19 sufferers has decreased.Conclusion: The management of the Covid-19 vaccination implementation in the Boyolali Health Service coverage area was able to reduce the positivity rate in Boyolali Regency. After giving the vaccine, the number of positive Covid-19 patients is in the range of 10 to 20 cases per day.Keywords: vaccination, Covid-19, positivity rateCorrespondence: Tifa Aviandari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: aviandaritifa@gmail.com. Mobile: 089682108211Journal of Health Policy and Management (2021), 06(03): 190-202https://doi.org/10.26911/thejhpm.2021.06.03.04

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