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All Journal Paediatrica Indonesiana Berita Kedokteran Masyarakat
Kusila, Gilbert Renardi
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Health Professions Medicine & Pharmacology Nursing Public Health

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Maternal barriers to stimulating early childhood development on Tidore Island Kusila, Gilbert Renardi
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.361-9

Abstract

Background The first 5 years of life provide a foundation for neuroplastic development, which establishes the capacity to accomplish complicated tasks in later life. However, this period is vulnerable to multiple stressors and adversities that prevent children from achieving age-related developmental milestones. Mothers as primary caregivers may find it challenging to engage her child in stimulating activities. Objectives To understand maternal barriers to stimulating early childhood development and potential interventions that can be developed. Methods This explorative, qualitative study was conducted in 13 different service coverage areas of the Soasio Community Health Center (Puskesmas), Tidore Islands, North Maluku, Indonesia. A total of 30 mothers participated in structured interview sessions. The analysis was conducted inductively, by generating some key issues from the interview. Results Eight maternal barriers to engaging in child stimulation activities were found: (1) family members, (2) gender-related interaction, (3) partial understanding of child health-related information, (4) prioritizing one developmental achievement over others, (5) timidity in decision making, (6) delaying stimulation due to overreliance on the role of school, (7) responsive feeding, and (8) media. Maternal motivation, societal awareness of child development, and support of maternal and family mental health are needed to improve maternal engagement in child stimulation. Conclusions Family, community, and life experiences may become maternal barriers to stimulating childhood development. Providing better social support, information access, and woman empowerment in decision-making will help mothers to be more engaged in child development stimulation activities.
Utilization and expenditure of Indonesia National Health Insurance before and during COVID-19 pandemic in Indonesia: a descriptive study Hafidz, Firdaus; Kusila, Gilbert Renardi; Nadhira, Farrasila; Daniel; Baros, Wan Aisyah; Revelino, Dedy; Dhanalvin, Erzhan; Saut, Benjamin; Jaya, Citra; Oktavia, Ayunda
BKM Public Health and Community Medicine Vol 38 No 07 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v38i7.4964

Abstract

Purpose: This study describes the utilization of healthcare facilities before and during the COVID-19 pandemic and the expenditure of national health insurance at primary and secondary healthcare facilities. Methods: This is a descriptive study with a cross-sectional design. We utilized claim data from the National Health Insurance from January 2018 to June 2021. The population included in this study were all Indonesian citizens who contracted COVID-19. Both the Ministry of Health and National Health Insurance expenditure for COVID-19 services were captured. The data were analyzed in frequency and proportions. Results: There was a consistent utilization trend across all types of healthcare facilities (primary vs. secondary; public vs. private), with an upward trend before the Covid-19 pandemic, a downward trend in 2020, and a slight increase before June 2021. Primary healthcare utilization jumped by 19% during the 2018-2019 period and dropped by 34% from March to April 2020. A similar trend was observed in the secondary healthcare facilities, with the utilization cost being lower in the 2020 and 2021 periods than in previous years. Hospital visits also showed a decreasing trend during the start of the pandemic (both public and private-owned), which was linear to the expenditure of inpatient and outpatient visits. The total claim for COVID-19 health care increased to IDR 77.8 trillion by August 2021 (inpatient and outpatient), with the highest cost per patient for inpatients with comorbidities. Conclusion: Healthcare utilization decreased significantly during the COVID-19 pandemic period. On the other hand, since COVID-19 increased expenditure, particularly due to inpatient services and comorbidities, National Health Insurance needs to prepare a health financing strategy to anticipate the shift of financing in time of the endemic.
Co-Authors Baros, Wan Aisyah Citra Jaya Daniel Dhanalvin, Erzhan Firdaus Hafidz As Shidieq Nadhira, Farrasila Oktavia, Ayunda Revelino, Dedy Saut, Benjamin