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All Journal Journal of Health Policy and Management Journal of Maternal and Child Health
Eti Poncorini
Faculty of Medicine, Universitas Sebelas Maret
Medicine & Pharmacology Public Health

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Multilevel Analysis: The Effect of Socioeconomic, Birth Weight, and Nutrition Intake with Wasting in Boyolali, Central Java Nur Fika Roobiati; Eti Poncorini; Bhisma Murti
Journal of Maternal and Child Health Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Wasting is a major health problem. Globally, wasting accounts for 4.7% of all deaths of children aged under 5 years. Severely wasted children are, on average, 11 times more likely to die than their healthy counterparts. This study aimed to investigate the effect of socioeconomic, birth weight, and nutrition intake with wasting in Boyolali, Central Java, using multilevel analysis.Subjects and Method: This was an analytic observational study with a case control design. The study was conducted in Boyolali, Central Java, from April to May 2018. Twenty five posyandus (integrated health posts) were selected and positioned at level 2 in the multilevel model (MLM) analysis. A sample of 200 children under five was selected for this study by fixed disease sampling and positioned at level 1 in the MLM. The dependent variable was wasting. The independent variables were birth weight, nutrition intake, maternal education, family income, and family size. Data on wasting was measured by microtoise and weight scale. Nutrition intake was measured by food recall. The other variables were collected by questionnaire. Data were analyzed by a MLM analysis.Results: The risk of wasting decreased with high family income (b= -1.92; 95% CI= -3.77 to -0.08; p= 0.041), high maternal education (b= -2.68; 95% CI= -4.97 to -0.38; p= 0.022), small family size (b= -2.01; 95% CI= -3.67 to -0.35; p= 0.018), normal birth weight (b= -2.55; 95% CI= -4.89 to -0.21; p= 0.033), good nutritional intake (b= -2.18; 95% CI= -3.95 to -0.41; p= 0.016). Posyandu had a contextual effect on wasting with ICC= 21.45%.Conclusion: The risk of wasting decreases with high family income, high maternal education, small family size, normal birth weight, good nutritional intake. Posyandu has a contextual effect on wasting.Keywords: wasting, socioeconomic, birth weight, nutrition intake, children under fiveCorrespondence:
Does Health Center Have Contextual Effect on Midwife Performance? Multilevel Analysis Evidence from East Kalimantan, Indonesia Latifah Nur Rahmadani; Uki Retno Budihastuti; Eti Poncorini
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: The maternal mortality rate (MMR) which is still high has now become the priority in order to find its solution. Midwives play a very significant role in making efforts to reduce MMR through antenatal care (ANC) services. The performance of midwives directly influences the quality of service and health outcomes in the public health centers. The performance of midwives in ANC can be seen based on the coverage of K1 and K4. This study aimed to determine the contextual effect of public health centers and other factors that influence the performance of midwives in antenatal care services.Subjects and Method: This study was conducted using observational analytic with cross sectional approach. It was done in 25 health centers in Samarinda, East Kalimantan in April-May 2019. The number of samples was 180 midwives selected using the total sampling technique. The dependent variable is the performance of the midwife. The independent variables include age, knowledge, tenure, training, workload, incentive, supervision, and motivation. The data were collected by questionnaire and analyzed by multilevel multiple logistic regression.Results: Midwife performance was influenced by age >45 years (b = -2.48; 95% CI = -4.53 to -4.34; p = 0.018), good knowledge (b = 1.35; 95% CI = 0.38 to 2.31; p = 0.006), tenure ≥13 years (b = 1.89; 95% CI = -0.07 to 3.86; p = 0.059), training ≥2 (b = 1.30; 95% CI = 0.29 to 2.30; p = 0.011), heavy workload (b = -1.30; 95% CI = -2.27 to -0.34; p = 0.008), incentive (b = 1.74; 95% CI = 0.30 to 3.18; p = 0.018), supervision (b = 1.12; 95% CI = 0.19 to 2.05; p = 0.017), and high motivation (b = 1.42; 95% CI = 0.45 to 2.38; p = 0.004). There was no contextual influence of public health center on the performance of midwives in antenatal care services (ICC = <1%).Conclusion: Age, knowledge, tenure, training, workload, incentives, supervision, and motivation are associated with midwives performance. There is no contextual influence of public health centers on the performance of midwives.Keywords: work performance, midwife, contextual effect, antenatal careCorrespondence: Latifah Nur Rahmadani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Jawa Tengah. Email: latifahnr8@gmail.com. Mobile: 085250118907.Journal of Health Policy and Management (2019), 4(3): 150-160https://doi.org/10.26911/thejhpm.2019.04.03.02
Co-Authors Bhisma Murti Latifah Nur Rahmadani Nur Fika Roobiati Uki Retno Budihastuti