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Determinants of Midwife Performance on Antenatal Care in Surakarta and Karanganyar, Central Java Titis Eka Gusti; Didik Tamtomo; Bhisma Murti
Journal of Health Policy and Management Vol. 3 No. 1 (2018)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: A high maternal mortality rate is one of the major health problems in developing countries. Midwives have an important role to reduce maternal mortality rate by looking after a pregnant women and her baby throughout a phase of antenatal care, during labor and birth, and for up to 28 days after the baby has been born. The WHO Expert Committee on Midwifery stated that the competence of the midwife must extend beyond the provision of service at the time of delivery to total antenatal and postnatal care. This study aimed to examine the determinants of midwife performance on antenatal care in Surakarta and Karanganyar, Central Java.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted at 25 community health centers in Surakarta and Karanganyar, Central Java, from April to May 2018. A total sample of 200 midwives was selected by simple random sampling. The dependent variable was midwife performance. The independent variables at level 1 of multilevel modeling (MLM) were age, tenure, motivation, knowledge, training, facility, and leadership. Community health center (Puskesmas) was taken as level 2 in the MLM. The data were collected by questionnaire and analyzed by MLM.Results: Longer tenure (b= 1.57; 95% CI= 0.11 to 3.02; p=0.035), provision of training (b=1.92; 95% CI= 0.45 to 3.40; p=0.011), high motivation (b=1.48; 95% CI =-0.13 to 3.09; p=0.072), better knowledge (b=1.61; 95% CI= 0.03 to 3.19; p=0.046), facility (b=1.44; 95% CI= 0.14 to 2.73; p=0.030), strong leadership (b=1.66; 95% CI= 0.18 to 3.13; p=0.028), and age ?27 years (b=2.08; 95% CI= 0.04 to 4.12; p=0.046) were positively associated with better performance of midwives. A large portion of variation in midwives performance was determined at Puskesmas level with ICC= 45.78%.Conclusion: Longer tenure, provision of training, high motivation, better knowledge, facility, strong leadership, and age ?27 years are positively associated with better performance of midwives. Community health center has an important contextual effect on midwife performance.Keywords: midwife, performance, age, tenure, motivation, training, leadership, community health centerCorrespondence:

Does Accreditation Status Affect Job Performance of the Electronic Medical Record Clerks at Community Health Center? Harinto Nur Seha; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 3 No. 1 (2018)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Primary care doctors and other staff working in primary care require comprehensive and accurate data on patients at the point-of-care if they are to provide high quality health services to their patients. Electronic patient records are an effective method of achieving this objective, by dispensing with the need to use difficult to access, and often illegible, paper-based records. This study aimed to analyze the effect of accreditation status on job performance of the electronic medical record clerks at community health center.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study conducted for 25 puskesmas (community health centers), in Yogyakarta, from March to June 2018. A sample of 200 patient medical records was selected by simple random sampling. The dependent variables were completeness and accuracy of medical record. The independent variables were tenure and multi task as level 1 in the multilevel model (MLM). Accreditation status of puskesmas was taken as level 2 in the MLM. The data were collected by questionnaire and analyzed by MLM.Result: Longer tenure (b= 1.03; 95% CI= 0.30 to 1.77; p= 0.006) and single task occupation (b= 4.21; 95% CI= 6.23 to 2.20; p<0.001) were positively associated with completeness of electronic medical record. Likewise, longer tenure (b= 0.54; 95% CI= 0.079 to 1.01; p= 0.022) and single task occupation (b= 2.14; 95% CI= 3.42 to 0.87; p= 0.001) were positively associated with accuracy of medical record medical record. Accreditation status of puskesmas showed negligible contextual effect on completeness (ICC= 0.36%) and accuracy (ICC= 1.17%) of the electronic medical record.Conclusion: Longer tenure and single task occupation are positively associated with completeness and accuracy of medical record. Accreditation status of puskesmas shows negligible contextual effect on completeness and accuracy of the electronic medical record.Keywords: completeness, accuracy, tenure, occupation, accreditation status, community health center, electronic medical recordCorrespondence:

Motivation, Competence, Workload, and Their Association with Nurse Performance in Dr. Arif Zaenudin Hospital, Surakarta Tia Martha Pundati; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Nurses performance remains long standing determinates of quality service rendered for patients admitted to hospitals. Improvements in quality health service can be achieved by improving nurse performance. This study aimed to analyze the relationship of competence, motivation, and workload on the nurse performance in Surakarta.Subjects and Method: This was a cross sectional study conducted at Dr. Arif Zaenudin Mental Hospital, Surakarta, Central Java, from November 24 to December 24, 2017. A sample of 200 study subjects was selected by total sampling. The dependent variable is the nurse's performance, while the independent variables are competence, motivation, workload, employment status, education and the distance between the nurse's residence and the hospital. The dependent and independent variables were measured using a questionnaire. The data analysis was done using path analysis with the STATA 13 program.Results: The performance is influenced by competence (b= 1.08; 95% CI= 0.32 to 1.74; p= 0.005), motivation (b= 0.91; 95% CI= 0.15 to 1.68; p= 0.019), workload (b= 2.65; 95% CI= 1.91 to 3.40, p<0.001), there are 2 variables that have an indirect relationship with the nurse's performance, namely education (b= 0.67; 95% CI= -1.24 to -0.11; p = 0.019) and the distance of residence (b= -0.61; 95% CI= -1.20 to -0.20; p= 0.043).Conclusion: There is a direct relationship between competence, motivation, workload and work period with nurse performance. There is an indirect relationship between education and home distance with performance.Keywords: pathway analysis, competence, motivation, workload, performanceCorrespondence:

Contextual Effect of Community Health Center on Patient Satisfaction of Health Care Service in Ngawi, East Java Hendra Dwi Kurniawan; Didik Tamtomo; Bhisma Murti
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Perceived patient satisfaction is an important component of health care quality. This study aimed to determine the effect of age, education, income, health financing, quality of health care service, and the contextual effect of community health center on patient satisfaction. Subjects and Method: This was a cross-sectional study conducted in 25 community health centers in Ngawi, East Java, from October to November 2018. A sample of 200 patients was selected by stratified random sampling. The dependent variable was patient satisfaction. The independent variables were age, education, income, health insurance, and quality of health care service. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: Age ≥35 years (b = 0.99; 95% CI= 0.17 to 1.81; p<0.019) and good quality of health care service (b= 1.68; 95% CI= 0.78 to 2.59; p<0.001) increased patient satisfaction. Education ≥senior high school (b= -1.59; 95% CI= -2.49 to -0.68; p<0.001), income ≥Rp 1,569,832 (b= -1.32; 95% CI= -2.25 to -038; p<0.006), and membership of national health insurance (b= -1.55; 95% CI= -2.47 to-0.63; p< 0.001) decreased patient satisfaction. Community health center had contextual effect on patient satisfaction with ICC= 13.03%.Conclusion: Age ≥35 years and a good quality of health care service increase patient satisfaction. Education ≥senior high school, high income, and membership in national health insurance decrease patient satisfaction. The community health center has a contextual effect on patient satisfaction.Keywords: patient satisfaction, community health center, multilevel analysisCorrespondence: Hendra Dwi Kurniawan. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: hendradeeka@gmail.comJournal of Health Policy and Management (2019), 4(1): 23-30https://doi.org/10.26911/thejhpm.2019.04.01.03

Linear Regression Analysis on Factors Affecting Health Surveillance Personnel Performance in Early Detection of Preeclampsia in Semarang, Central Java Zella Cahyandaru; Didik Tamtomo; RB Soemanto
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Preeclampsia is a major cause of maternal death both globally and regionally. It can be prevented either through continuous surveillance and early detection activities. City Health Office in Semarang recruited health surveillance officers as an effort to reduce maternal mortality especially due to preeclampsia. The purpose of this study was to analyze factors associated with health surveillance personnel performance in the early detection of preeclampsia.Subjects and Method: This was an analytic observational study with a cross sectional design. The study was conducted in 26 community health centers in Semarang, from October to December 2018. A sample 148 health surveillance personnels was selected by exhaustive sampling. The dependent variable was health surveillance personnels performance. The independent variables were age, work motivation, work stress, job satisfaction, leadership style, and supervision. The data were collected by questionnaire and analyzed by a multiple linear regression.Results: Health surveillance personnel’s performance in early detection of preeclampsia was positively associated with strong work motivation (b= 0.12; 95% CI= 0.07 to 0.16; p<0.001), low work stress (b= 0.08; 95% CI= -0.01 to 0.15; p= 0.058), work satisfaction (b= 0.10; 95% CI= 0.05 to 0.15; p<0.001), leadership style (b= 0.23; 95% CI= 0.10 to 0.37; p= 0.001), and good supervision (b= 0.31; 95% CI= 0.18 to 0.45; p<0.001). Health surveillance personnel’s performance was negatively associated with older age (b= -0.08; 95% CI= -0.16 to 0.01; p= 0.050).Conclusions: Health surveillance personnel performance in early detection of preeclampsia is positively associated with strong work motivation, low work stress, work satisfaction, leadership style, and good supervision. Performance is negatively associated with older age.Keywords: early detection, preeclampsia, performance, health surveillance personnelCorrespondence: Zella Cahyandaru. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java 57126, Indonesia. Email: zellacahyandaru@gmail.com. Mobile: +6287832622469.Journal of Health Policy and Management (2019), 4(1): 13-22https://doi.org/10.26911/thejhpm.2019.04.01.02

Association between Doctor’s Motivation, Age, and Leadership on Patient’s Satisfaction: A Path Analysis Evidence Lukman Aryoseto; Didik Tamtomo; Bhisma Murti
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Quality health care needs are increasing. The service quality of one public health center and another does not have the same standard yet. One of the factors that influence the assessment of service quality is patient satisfaction. Several factors can influence patient satisfaction, especially from the doctor's side. This study aims to determine the effect of physician motivation, the age of the doctor, and the head of the health center on physician job satisfaction and patient satisfaction.Method: This was an analytic observational study with a cross-sectional design. The study was conducted at community health centers in Karanganyar and Surakarta, Central Java, in August 2018. A total of 25 doctors and 225 patients were selected using proportional random sampling. The dependent variable in this study is patient satisfaction. The independent variables in this study were the doctor's motivation, doctor's work satisfaction, doctor’s age, and the head of the health center. Data were obtained using questionnaires and analyzed using path analysis.Results: Patient satisfaction was directly increased by by the doctor's work satisfaction (b = 0.10; SE= 0.02; p<0.001) but decreased by doctor’s age (b= -0.82; SE= 0.02; p<0.001). Patient satisfaction was indirectly affected by doctors' motivation and head of community health center.Conclusions: Patient satisfaction is directly increased by the doctor's work satisfaction but decreases by doctor’s age. Patient satisfaction is indirectly affected by doctors' motivation and head of community health center.Keywords: patient satisfaction, doctor’s motivation, leadership, community health centerCorrespondence: Lukman Aryoseto. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: lukmanaryoseto@gmail.com.Journal of Health Policy and Management 4(1): 31-38https://doi.org/10.26911/thejhpm.2019.04.01.04

Multilevel Analysis on the Effect of Marketing Mix Strategy toward Patient Satisfaction in Magelang, Central Java Luâ€™luatul Fuad; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Hospital marketing is becoming increasingly competitive all over the world. The marketing mix strategy is considered one of the core concepts of marketing theory. This study aimed to examine the effect of marketing mix strategy toward patient satisfaction in Magelang, Central Java.Subjects and Method: A cross sectional study was conducted at Magelang Hospital, Central Java, in December 2018. A sample of 200 patients was selected by simple random sampling. The dependent variable was patient satisfaction. The independent variables were product, price, place, promotion, process, people, physical appearance, and ward. The data were collected by questionnaire and analyzed by multilevel multiple logistic regression.Results: Patient satisfaction increased with good product (b= 3.42; 95% CI= 0.76 to 2.81; p<0.001), low price (b= 1.92; 95% CI= -0.05 to 1.70; p= 0.054), right place (b= 2.41; 95% CI= 0.19 to 1.92; p= 0.016), attractive promotion (b= 2.92; 95% CI= 0.43 to 2.19; p= 0.004), people (b= 1.91; 95% CI= -0.24 to 1.75; p= 0.057), good physical appearance (b= 2.42; 95% CI= 0.20 to 1.97; p= 0.015), and sound process (b= 2.07; 95% CI= 0.45 to 1.72; p= 0.039). Ward had a considerable contextual effect on patient satisfaction with ICC= 14.65%.Conclusion: Patient satisfaction increases with good product, low price, right place, attractive promotion, people, good physical appearance, and sound process. Ward has a considerable contextual effect on patient satisfaction.Keywords: marketing mix, patient satisfaction, hospital, multilevel analysisCorrespondence: Lu’luatul Fuad. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: afuadlulu@gmail.com. Mobile: +6285643702066.Journal of Health Policy and Management (2019), 4(1): 39-46https://doi.org/10.26911/thejhpm.2019.04.01.05

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

Effect of Date Palm (Phoenix dactylifera) Fruits Consumption on Birth Delivery Outcome: Meta-Analysis Ratna Purwani Siwi; Bhisma Murti; Didik Tamtomo
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: The choice of cesarean section continues to increase in the world and is expected to continue to increase over the coming decades, which is almost a third of all deliveries in 2030. The benefits of dates for improving labor processes are considered to increase vaginal deliveries and also reduce the frequency of cesarean sections with the aim of reducing bigger complications. This study aims to analyze and estimate the influence of the consumption of dates on labor outcomes.Subjects and Method: This study is a systematic review and meta-analysis with PICO, P: Pregnant women, I: consumption of dates, C: No consumption dates, O: Bishop's score, length of labor, and postpartum hemorrhage. Data collection was obtained from databases, namely: PubMed, Science Direct, Springer Link, and Google Scholar. Keywords used “date fruit” OR “date palm” OR “phoenix dactylifera” AND “labor” AND “delivery”, AND “oxytocin” AND “hemorrhage”. The inclusion criteria used were full papers in English with the design of randomized controlled trials in 20002022. This study was analyzed using RevMan 5.3 software.Results: Meta-analysis was conducted on 4 primary studies from several countries such as Iran, Malaysia, and Saudi Arabia with a sample size of 603 pregnant women. The meta-analysis concluded that there was an effect of date consumption on cervical dilatation upon admission to the hospital (SMD= 0.73; CI 95%= 0.09 to 1.38; p=0.030). Consumption of dates also has an effect on the duration of active 1st stage labor (SMD= 0.46; CI 95%= 0.82 to 0.09; p= 0.010). Consumption of dates has a weak effect on the length of stage II labor (SMD= 0.05; 95% CI= 0.88 to 0.78; p= 0.910). In addition, the consumption of dates also has a weak effect on the length of stage III labor (SMD=0.16; CI95%=0.46 to 0.79; p=0.610).Conclusion: Consumption of dates has an influence on labor outcomes.Keywords: phoenix dactylifera, dates, labor, postpartum hemorrhage, Bishop scoreCorrespondence: Ratna Purwani Siwi. Masters Program in Public Health, Universitas Sebelas Maret. Jalan Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ratnapsiwi@yahoo.com. Mobile: 085602389598.Indonesian Journal of Medicine (2023), 08(01): 79-91https://doi.org/10.26911/theijmed.2023.08.01.08

Theory of Planned Behavior Implementation on the Factors Affecting Self-Care Management in Type 2 Diabetes Mellitus Patients Ana Damayanti; Didik Tamtomo; Dono Indarto
Journal of Health Promotion and Behavior Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Diabetes mellitus (DM) is one of the largest global health emergencies in the 21st century. Diabetes self-management education (DSME) is a continuous process of knowledge transfer in order to improve skill and ability of diabetic patient to perform self-care management, which reduces blood glucose level and prevent diabetic complications. The success of DSME is determined by behavior changes of diabetic patients, which can be assessed using behavior theories including Theory of Planned Behavior (TPB). This study aimed to analyze the factors affecting self-care management in patients with type 2 DM using TPB.Subjects and Method: A randomized controlled trial study was carried out in 7 community health centers in Tarakan City, North Kalimantan, from March to May, 2018. A sample of 126 type 2 DM patients was selected by simple random sampling. The dependent variable was self-care management. The independent variables were intention, attitude, subjective norm, self-efficacy, and education level. The data was collected by questionnaire and analyzed by path analysis.Results: Self-care management was positively and directly affected by education ?senior high school (b= 7.10; SE= 3.22; p= 0.028) and strong intention (b= 2.40; SE= 0.75; p= 0.001). Self-care management was indirectly affected by self-efficacy, attitude, and subjective norm trough intention.Conclusion: Self-care management in type 2 DM is directly affected by education and strong intention. These findings support the TPB implementation in self-care management.Keywords: self- care management, type 2 DM, Theory of Planned BehaviorCorrespondence:

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