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All Journal Journal of Epidemiology and Public Health Indonesian Journal of Medicine Journal of Health Policy and Management Journal of Health Promotion and Behavior Journal of Maternal and Child Health
Didik Tamtomo
Faculty of Medicine, Universitas Sebelas Maret
Medicine & Pharmacology Public Health

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Factors Associated with Healthy Preventive Behavior among the Elderly in Lamongan, East Java Nurul Jannah; Didik Tamtomo; RB Soemanto
Journal of Health Promotion and Behavior Vol. 3 No. 4 (2018)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Health promotion behaviors in the elderly have potential effects in promoting health and quality of life and reducing the cost of health care services. Changes in the lifestyle of the people affected by cardiovascular diseases have more potential shares in reducing vascular problems than medicinal treatments of hypertension and high cholesterol. By convincing more people to maintain and obtain healthy lifestyles, there will be considerable reduction in emergence and disabilities due to cardiac problems. This study aimed to determine factors associated with health preventive behavior among the elderly in Lamongan, East Java.Subjects and Method: This was a cross sectional study conducted in Lamongan, East Java, from November to December 2018. A sample of 200 elderly was selected by stratified random sampling. The dependent variable was health behavior. The independent variables were education, attitude, peer support, family support, cadre support, perceived behavioral control, subjective norm, and intention. The data were collected by questionnaire and analyzed by a multiple linear regression.Results: Health behavior in elderly was influenced by education (b = 0.76; 95% CI = 0.27 to 1.24; p = 0.002), intention (b= 0.08; 95% CI = 0.01 to 0.16; p = 0.033), attitude (b = 0.20; 95% CI = 0.07 to 0.33; p= 0.002), perceived behavioral control (b= 0.18; 95% CI= 0.06 to 0.30; p= 0.002), family support (b = 0.19 ; 95% CI = 0.08 to 0.30; p = 0.001), cadre support (b = 0.13; 95% CI = 0.04 to 0.23; p = 0.005), peer support (b = 0.07; 95% CI = - 0.01 to 0.15; p = 0.060), and subjective norm (b = 0.10; 95% CI = - 0.01 to 0.22; p = 0.064).Conclusion: Health behavior in elderly is influenced by education, intention, attitude, perceived behavioral control, family support, cadre support, peer support, and subjective norm.Keywords: health behavior, elderly, linear regressionCorrespondence: Nurul Jannah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: njannah.31@gmail.com. Mobile: +6282230300405.Journal of Health Promotion and Behavior, 2018, 3(4): 223-229https://doi.org/10.26911/thejhpb.2018.03.04.01
Socioeconomics Factors Associated with the Utilization of Primary Health Services of Mothers and Children at Nunukan District, North Kalimantan Yunita Kristiani; Didik Tamtomo; Mahendra Wijaya
Journal of Maternal and Child Health Vol. 2 No. 4 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: One of the main health development agenda in Indonesia 2015 to 2019 is reduction in maternal mortality ratio and infant mortality rate, and improve access and quality of maternal and child health services. However, variance in socioeconomics status between individual and between rural-urban have caused to difference in utilization of health service. This study aimed to analyze socioeconomics factors associated with the utilization of primary health services of mothers and children at Nunukan District, North Kalimantan.Subjects and Method: This was an analytic observational study with cross-sectional design. The study was conducted at six community health centers in Nunukan, North Kalimantan, from October to November, 2017. A total sample of 208 mothers was collected using multistage random sampling. The dependent variables were antenatal care (ANC) service, place of birth delivery, and basic immunization. The independent variables were maternal education, maternal employment status, family income, family welfare, and residence. The data were collected by questionnaire and analyzed by path analysis.Results: Utilization of ANC increased with better family welfare (b= 1.42; 95% CI= 0.34 to 2.49; p=0.010). Use of basic immunization increased with higher maternal education (b= 0.71; 95% CI= 0.06 to 1.35; p= 0.032). Place of birth delivery at formal health facility increased with living in urban area (b= 3.2; 95% CI= 1.97 to 4.44; p <0.001), maternal employment (b= 2.34; 95% CI= 0.77 to 3.91; p=0.003), and regular ANC (b=1.04; 95% CI= -0.10 to 2.18; p=0.074). Family income increased with higher maternal education level (b= 1.21; 95% CI= 0.50 to 1.92; p= 0.001) and maternal employment (b= 2.54; 95% CI= 1.67 to 3.41; p <0.001). Family welfare increased with living in urban area (b= 1.4; 95% CI= 0.09 to 2.68; p=0.035) and higher family income (b=2.5; 95% CI= 0.44 to 4.54; p= 0.017). Maternal employment status increased with higher maternal education level (b= 2.45; 95% CI= 1.63 to 3.26; p <0.001).Conclusion: Utilization of ANC directly increases with better family welfare. Utilization of basic immunization increases with higher maternal education. Place of birth delivery at formal health facility increases with living in urban area, maternal employment, and regular ANC.Keyword: social economics factors, ANC, place of birth delivery, basic immunization, mother, children
Path Analysis on the Effects of Psychosocial Development, Nutritional Status, and Family Acceptance on Learning Achievement in Autistic Children, in Jember, East Java Tutut Okta Diana; Didik Tamtomo; Bhisma Murti
Journal of Maternal and Child Health Vol. 3 No. 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: The prevalence of autism has been increasing worldwide annually. Autistic children are at higher risk of physical, mental, and intellectual disorders. However, autistic children may have above average academic achievement. With support from family, teacher, and society, autistic children can gain maximum academic achievement. This study aimed to determine the effects of psychosocial development, nutritional status, and family acceptance, on learning achievement in autistic children, in Jember, East Java.Subjects and Method: This was an analytic observational study with cross-sectional design. The study was conducted at Special Elementary School in Jember, East Java. A total sample of 50 autistic students were collected for this study by exhaustive sampling. The dependent variable was learning achievement. The independent variables were nutritional status, psychosocial development, and family acceptance. The data were collected by questionnaire and analyzed by path analysis.Results: Learning achievement was directly affected by psychosocial development (b= 0.36; SE= 0.13;p= 0.005) and nutritional status (b= 1.42; SE= 0.65; p= 0.029). Nutritional status was positively affected by strong family acceptance (b= 0.07; SE= 0.01; p<0.001).Conclusion: Learning achievement of autistic children is affected by psychosocial development and nutritional status.Keywords: learning achievement, psychosocial development, nutritional status, family acceptance, path analysisCorrespondence:
Effect of Social Suport and Social Interaction on Anxiety Among Pregnant Women Imelda Dearni Simarmata; Uki Retno Budihastuti; Didik Tamtomo
Journal of Maternal and Child Health Vol. 4 No. 4 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: There is growing evidence that the antenatal period is a time of increased liability to mental disorders. The most common psychiatric illnesses during pregnancy and the postpartum period are depressive and anxiety disorder. The purpose of this study was to examine the effect of social support and social interaction on anxiety among pregnant women.Subjects and Method: A cross-sectional study was carried out in community health centers in Kutai Kartanegara, East Kalimantan, from November to December 2018. A sample of 200 pregnant women was selected by simple random sampling. The dependent variable was anxiety. The independent variables were education, parity, stress, family income, family support, social interaction, and counseling. The data were collected by questionnaire and analyzed by multiple linear regression.Results: Anxiety among pregnant women increased with stress (b= 0.33; 95% CI= 0.16 to 0.49; p= 0.001). It was decreased by high education (b= - 2.37; 95% CI= -3.93 to -0.81; p= 0.003), high income (b= -4.69; 95% CI= -7.81 to -1.57; p= 0.003), parity (b= 0.38; 95% CI= -2.98 to -0.26; p= 0.001), strong family support (b= -0.38; 95% CI= 0.52 to 0.24; p= 0.001), social interaction (b= -0.27; 95% CI= -0.42 to -0.12; p= 0.001), and conselling (b= -0.91; 95% CI= - 1.77 to -0.05; p= 0.004).Conclusion: Anxiety among pregnant women increases with stress. It is decreased by high education, high income, parity, strong family support, social interaction, and counseling.Keywords: anxiety, stress, social interaction, pregnant womenCorrespondence:
Determinants of the Difference between Actual Cost and Indonesian Case Based Groups (INA-CBGs) Reimbursement for Birth Delivery at Hospitals in Mataram, West Nusa Tenggara Baiq Holisatul Ismiana; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 4 No. 3 (2019)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Background: Health is the part of the economic and social development of the state. The application of the BPJS Health national social security system in Indonesia is one of the government's efforts to provide health financing protection for all citizens and prevent catastrophic health expenditures. Hospitals as providers of secondary or tertiary health services often suffer losses because the payment system from BPJS Kesehatan uses a case-based payment method or INA-CBGs. This study aimed to examine the factors that influence the difference in rates between INA-CBGs rates and real hospital rates in labor cases.Subjects and Method: This was an analytic observational study with a cross-sectional design.  The study was carried out in Mataram and Siti Hajar Mataram Islamic hospitals, Mataram, West Nusa Tenggara, in May 2019. A sample of 200 postpartum women was selected by stratified random sampling. The dependent variable was the difference between real cost and INA-CBGs reimbursement. The independent variables were the type of hospital, class of treatment, type of birth delivery, length of stay, and severity disease. The data were collected from the medical record and analyzed by a multiple linear regression run on Stata 13.Results: Difference between real cost and INA-CBGs tariff of birth delivery reimbursement was negatively affected by type III of class treatment (b = -390,725; 95% CI= -790,082 to 8,631; p= 0,055), section caesarean (b= -1,429,648; 95% CI= -1,811,275 to -1,048,022; p <0.001), length of stay (b= -211,912; CI (95%) = -427,786 to 3,960; p = 0.054), moderate severity (b= -114,028; 95% CIi= -507,057 to 279,000; p = 0.568), and the high level of severity (b = -1,735,612; CI (95%) = -3,482,347 to 11,123; p = 0.051). The INA-CBGs rate difference and RS real rates of labor cases decreased due to the classification of private hospitals (b = 281,021; CI (95%) = -73,054 to 635,097; p = 0,119), treatment class II (b = 8,736; CI (95 %) = -392,068 to 409,541; p = 0.966).Conclusion: The difference in rates between INA-CBGs rates and hospital real rates in childbirth cases would increase if it serves treatment class III, type of cesarean delivery, care days which are longer, and moderate or severe severity. The difference in rates between INA-CBGs rates and hospital real rates in childbirth cases can decrease in services at private hospitals and serve treatment classes II.Keywords: INA-CBGs rates, hospital real rates, labor costs.                                                                            Correspondence: Baiq Holisatul Ismiana. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta 57126, Jawa Tengah, Indonesia. Email: baiqholis26@gmail.com. Mobile: +6287739031046.Journal of Health Policy and Management (2019), 4(3): 161-169https://doi.org/10.26911/thejhpm.2019.04.03.03
Multilevel Analysis on the Contextual Effect of Community Health Center on Health Workers Performance Anindyah Tri Lhaksmi Kusuma Wardhani; Didik Tamtomo; Uki Retno Budihastuti
Journal of Health Policy and Management Vol. 4 No. 3 (2019)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Background: One of the high maternal mortality rates is caused by bleeding factors. The imple­mentation of preventive effort that is less than optimal as well as the ability, understanding, and compliance of health personnel with Standard Operating Procedures (SPO) is still lacking and not in accordance with professional standards, allegedly a factor that affects the Maternal Mortality Rate (MMR). The performance of midwives in accordance with the SPO would have an impact on reducing mortality and improving the welfare of mothers and babies. This study aimed to analyze the factors that influence the performance of midwives in the early detection of bleeding.Subjects and Method: This was a cross sectional study conducted at 25 public health centers in Banyuwangi, East Java, from February to May 2019. A total sample of 200 midwives was selected for this study by simple random sampling. The dependent variable was midwife performance. The independent variables were training, skill, leadership style, incentive, work motivation, age, and human source. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression run on Stata 13. Results: Midwife performance increased with training (b= 1.46; 95% CI= 0.48 to 2.42; p= 0.003), skill (b= 2.32; 95% CI= 1.28 to 3.36; p= 0.001), high motivation (b= 1.66; 95% CI= 0.71 to 2.61; p= 0.001), incentive >Rp 1,000,000 (b= 2.59; 95% CI= 1.53 to 3.65; p= 0.001), positive leadership style (b= 1.95; 95 % CI= 0.93 to 2.96; p= 0.001), and human source>8 midwives (b= 1.05; 95% CI= 0.08 to 2.02; p= 0.033). Midwife performance decreased with age ≥35 years (b= -1.16; 95% CI= -2.16 to -0.16; p= 0.023). Community health center had strong contextual effect on midwife performance with ICC= 25.74%.Conclusion: Midwife performance increases with training, skill, high motivation, incentive >Rp 1,000,000, positive leadership style, and human source>8 midwives. Midwife performance decreases with age ≥35 years. Community health center has strong contextual effect on midwife performance.Keywords: work performance, midwives, multilevel analysisCorrespondence: Anindyah Tri Lhaksmi Kusuma Wardhani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: anin­dyah­tri@­gmail.com. Mobile: +6285258917339.Journal of Health Policy and Management (2019), 4(3): 182-194https://doi.org/10.26911/thejhpm.2019.04.03.06
Contextual Effect of Health Centers and Quality Dimensions of Antenatal Services on Patient Satisfaction in Klaten, Central Java Leny Rahmawati; Didik Tamtomo; 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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Abstract

Background: Puskesmas plays an important role in reducing maternal and neonatal morbidity and mortality. Contextual health centers and dimensions of service quality can improve maternal and child health services. This study aimed to analyze the factors that influence patient satisfactionSubjects and Method: A cross sectional study was conducted in Klaten Regency, Central Java. A sample of 200 pregnant women at the community health centers was selected by simple random sampling. The dependent variable was patient satisfaction. The independent variables were reliability, tangible, empathy, responsiveness, and assurance. The data were analyzed by multiple multilevel linear regression using the Stata 14 application.Results: Patient satisfaction was influenced by reliability (b=0.30; 95% CI= -0.48 to -0.13; p= 0.001), tangible (b= 0.28; 95% CI= 0.14 to 0.42; p<0.001), responsiveness (b= 0.17; 95% CI= 0.07 to 0.27; p= 0.001), and assurance (b= 0.16; 95% CI= 0.04 to 0.28; p= 0.007), while empathy has no effect on patient satisfaction (b= -0.02; 95% CI= -0.28 to 0.23; p= 0.837). Health center had strong contextual effect on patient satisfaction with ICC= 36.4%.Conclusion: Patient satisfaction is influenced by reliability, tangible (physical evidence), responsiveness, and assurance, while empathy has no effect on patient satisfaction.Keywords: satisfaction, puskesmas, multilevel linear regressionKorespondensi:  Leny Rahmawati. Program Magister Kesehatan Masyarakat, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah. Email: lovejesus251200@gmail.com. Ponsel: +6288981023493.
Implementation of Context Input Process Product Model on Healthy Indonesia Program Policy with a Family Approach Ninawati Ninawati; Endang Sutisna Sulaeman; Didik Tamtomo
Journal of Health Policy and Management Vol. 7 No. 1 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Background: The Healthy Indonesia Program with a Family Approach started in 2017, has now reached the first visit coverage rate of 26.80% as of October 3, 2018, with a Healthy Family Index (IKS) value of 0.165. This figure is still far below the expected target, namely in 2019 it is expected that the visit coverage rate has reached >90% so that in 2019 an intervention plan at the com­mu­nity health center (puskesmas) level can be carried out in accordance with the roadmap of the Ministry of Health. This study aimed to investigate the implementation of the context input process product (CIPP) model in the healthy Indonesia program policy with a family approach.Subjects and Method: This research is a qualitative descriptive study using a sample of policy makers and implementers of the Healthy Indonesia program with a Family Approach (PIS – PK), namely: Head of Public Health Center, Head of Health Service Division of Karanganyar District Health Office, Person in Charge of Healthy Indonesia Program, implementer of PIS – PK visits, and the surrounding community. The research was conducted in August 2021. Data were collected by means of document review, in-depth interviews, focus group discussions (FGD), and partici­patory observations. Data is presented in analytical descriptive form.Results: Data were collected from 16 research respondents. In the input aspect, the implemen­tation of PIS PK is supported by sufficient human resources, although there are still gaps in the fulfillment of types of positions. Financial support, infrastructure, methods, implementation time and cross-sectoral support look very good and in accordance with the mandate of the Minister of Health 39 of 2019 concerning PIS PK. There are still problems in the application of healthy families, making the PIS PK output results not in accordance with manual calculations, so that family interventions both individually and in groups cannot be carried out optimally. Not all puskesmas have also implemented total coverage in the implementation of PIS PK, nor have all puskesmas used IKS value data as one of the inputs in planning puskesmas in the form of RUK and RPK.Conclusion: The Healthy Indonesia Program (PIS PK) in Karanganyar Regency can be imple­mented well in terms of context, input and process, but it is still not optimal in the aspect of output because of obstacles in the application of healthy families and the output of PIS PK has not been fully used as a basis for planning at the puskesmas level.Keywords: : context, input, process, product, Healthy Indonesia ProgramCorrespondence: Ninawati. Masters Program in Public Health, Universitas Sebelas Maret. Jalan Ir. Sutami 36A, Surakarta 57126, Central Java. Email: dimniasna@yahoo.com. Mobile: 08112632356.Journal of Health Policy and Management (2022), 07(01): 34-45https://doi.org/10.26911/thejhpm.2022.07.01.04. 
Readiness of Application of Electronic Medical Records in Bethesda Lempuyangwangi Hospital, Yogyakarta I Gusti Agung Ngurah Putra Pradnyantara; Bhisma Murti; Didik Tamtomo
Journal of Health Policy and Management Vol. 7 No. 2 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Background: Based on the strategic plan of the Ministry of Health of the Republic of Indonesia for 20202024, all hospitals can gradually implement electronic medical records. However, there are still many obstacles experienced by hospitals in implementing Electronic Medical Record (EMR), readiness assessments can be used to determine readiness, indications and requirements in facilitating the implementation of EMR so as to avoid various obstacles during the implementation process.Subjects and Method: This was a qualitative descriptive study with a case study design. The study was conducted at Bethesda Lempuyangwangi Hospital, Yogyakarta, from May to June 2022. The data collected was the readiness to implement EMR in terms of organizational alignment and management capacity, by conducting indepth interviews with 7 people. The study subjects were determined by purposive sampling who were considered to have the capacity to make decisions related to EMR.Results: Bethesda Lempuyangwangi Hospital in implementing EMR from organizational alignment is said to be ready, the board of directors has known and understood that the implementation of RME has many benefits, the organization has been planned and the unit leadership understands the implementation risk in case of failure, to anticipate this, a longterm vision has been prepared. Readiness to implement EMR from management capacity can be improved because the IT committee has not yet been formed consisting of stakeholder representatives and hospitals, organization is still within the scope of the hospital, where ICT has been included in the organization's strategic plan. The roles and responsibilities for EMR implementation are defined with clear accountability to vendors and have been documented, the board of directors has considered planning the EMR implementation budget, funding for ongoing clinical IT adoption and the required standards are included in future planning and will be part of the IT budget.Conclusion: Bethesda Lempuyangwangi Hospital is ready to implement electronic medical records that will be applied to inpatient units, this can be seen from the alignment of the organization and management capacity where the culture, organization, leadership, strategy, information management, clinical staff, accountability and budget finance have been planned and have started held.Keywords: Readiness, Electronic Medical RecordCorrespondence: I Gusti Agung Ngurah Putra Pradnyantara. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: gustipradnyantara1997@gmail.com. Mobile: +62 82146804776.Journal of Health Policy and Management, (2022), 07(02): 149-157https://doi.org/10.26911/thejhpm.2022.07.02.06
Utilization of Health Insurance for Outpatient in the Community: A Meta-Analysis Sulaiman Putra Nagaring; Bhisma Murti; Didik Tamtomo
Journal of Health Policy and Management Vol. 7 No. 2 (2022)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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Background: Health insurance is the answer to the uncertainty of the occurrence of illness and the need for health services. To ensure that the need for health services can be adequately financed, a person or small group of people transfers risk to another party called an insurer/insurer, or an insurance agency.Subjects and Method: This was a systematic review and meta-analysis conducted with PRISMA flow diagrams. Search articles through journal databases including: Google Scholar, MEDLINE/ PubMed, Science Direct and Spinger Link by selecting articles published in 2000-2021 The keywords used are “health care”AND “outpatient” OR “insurance” AND “private health insurance” AND “outpatient” OR “health insurance” AND “private health insurance” AND “utilization of public health care” AND “inpatient service” AND “outpatient service” AND “logistic regression aOR”. The inclusion criteria were full paper articles with retrospective study cohort research methods, the analysis used was multivariate with adjusted Odds Ratio (aOR), the intervention provided was health insurance, the research subjects were private health insurance users. Eligible articles were analyzed using the RevMan 5.3 application.Results: A meta-analysis of 9 articles showed that people with private health insurance were 1.98 times more likely to use outpatient services than those without health insurance, and the effect was statistically significant (aOR = 1.98; 95% CI = 1.39 to 2.81; p<0.001).Conclusion: The use of private health insurance has a statistically significant effect in increasing outpatient use.Keywords: health insurance, private health insurance, outpatient, meta analysis.Correspondence: Sulaiman Putra Nagaring. Masters Program in Public Health. Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: sulaimanputran@gmail.com Mobile: 085855533027Journal of Health Policy and Management, (2022), 07(02): 158-165https://doi.org/10.26911/thejhpm.2022.07.02.07 
Co-Authors Adriana Mardiah Agung Kurniawan Ana Damayanti Andreza Anindyah Tri Lhaksmi Kusuma Wardhani Argyo Demartoto Aulia Siti Nur Rahmah Ayu Novita Wulandari Ayunda Prisilia Kusuma Ningtyas Baiq Holisatul Ismiana Bhisma Murti Bhisma Murti Bhisma Murti Bhisma Murti Burhannudin Ichsan Dinda Ika Pratiwi Dinta Lestari Dono Indarto Endang Sutisna Sulaeman Endang Sutisna Sulaeman Endang Sutisna Sulaeman Fadila Alfiasari Fara Rizky Punjung Hapsari Farahdilla Aribowo Putri Galuh Wulansari Hanung Prasetya Hanung Prasetya Harinto Nur Seha Helmi Nurlaili Hendra Dwi Kurniawan I Gusti Agung Ngurah Putra Pradnyantara Imelda Dearni Simarmata Leny Rahmawati Lilik Anggar Sri Rahayuningsih Lu’luatul Fuad Lukman Aryoseto Mahendra Wijaya Moh Maulana Niken Yuliani Untari Ninawati Ninawati Nureesa Doloh Nurul Jannah Nurussyifa Afiana Zaen Purwa Adrianta Wibawa Ratna Purwani Siwi RB Soemanto Rosyida, Muslihatin Khuril Siti Luluk Khamidahtun Ni'mah Sukma Sukma Sulaiman Putra Nagaring Tegar Wahyu Yudha Pratama Tia Martha Pundati Titis Eka Gusti Tutut Okta Diana Uki Retno Budihastuti Yunita Kristiani Zella Cahyandaru