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All Journal Journal of Epidemiology and Public Health Journal of Health Policy and Management Journal of Maternal and Child Health
Bhisma Murti
Faculty of Medicine, Universitas Sebelas Maret
Medicine & Pharmacology Public Health

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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 : Masters Program in Public Health, Sebelas Maret University

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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:
Co-Authors Afriza Umami Atika Rakhmahayu Didik Tamtomo Dwi Hesti Ermawati Dyah Ambarwati Helmi Nurlaili Setyo Sri Rahardjo Uki Retno Budihastuti Yulia Lanti Retno Dewi Yulia Lanti Retno Dewi