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Maternal Mortality Analysis Through AMP-SR Review in East  Kalimantan Province, Indonesia, 2023–2024 Utari, Ari; Adrianto, Ratno; Gunawan, Ike Anggraeni
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Abstract

Background : Maternal mortality remains a major public health challenge in East Kalimantan Province, despite a decline in reported cases from 83 deaths in 2023 to 74 deaths in 2024. Objective : This study aimed to describe the pattern of maternal deaths based on maternal characteristics, timing and place of death, and to analyze preventable factors through the Audit Maternal Perinatal Surveillance and Response (AMP-SR) approach. Research Methods/ Implementation Methods : A descriptive-analytic case series design was applied using secondary data from the East Kalimantan Maternal Perinatal Death Notification (MPDN) database for 2023–2024. Results : The results revealed that more than 51% of deaths occurred during the postpartum period and 77% took place in hospitals, indicating the predominance of Delay 3 (delays in receiving adequate care). Analysis of modifiable factors showed that most deaths were preventable through improvements in the quality of obstetric services, increased antenatal care (ANC) compliance, and strengthened referral and postnatal follow-up systems. The major risk factors included delays in family decision-making, weak interfacility referral coordination, and inadequate case management at referral hospitals. Conclusion/Lesson Learned : These findings highlight that reducing the Maternal Mortality Ratio in East Kalimantan requires the completion of 100% AMP-SR case reviews, the strengthening of Postnatal Care (PNC) implementation, and the enhancement of Emergency Obstetric and Neonatal Care (EmONC) capacity across all levels of healthcare facilities.
Community Satisfaction Index on Public Service Performance of UPTDLabkesda Samarinda Budi, Eko Prasetya; Adrianto, Ratno; Gunawan, Ike Anggraeni
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Public service satisfaction surveys are an essential instrument for evaluating the quality and performance of government institutions in delivering public services. The Regional Health Laboratory Unit (UPTD Labkesda) of Samarinda City periodically conducts Community Satisfaction Surveys (CSS) to assess public perceptions, identify strengths and weaknesses in service delivery, and ensure compliance with the service quality standards established under Ministerial Regulation of PANRB No. 14 of 2017 on Guidelines for Conducting Community Satisfaction Surveys. Objective : The study aims to measure the level of community satisfaction with the services provided by UPTD Labkesda Samarinda during the first semester of 2025 and to identify service elements that require improvement to enhance the overall quality and efficiency of public health laboratory services. Research Methods/ Implementation Methods : A descriptive quantitative approach was employed using a structured survey method. Respondents rated nine service elements using a four-point Likert scale, and the results were processed to obtain the Community Satisfaction Index (CSI) Results : The survey results show that the Community Satisfaction Index reached 87.28, categorized as “Satisfactory.” This indicates that most respondents perceive the services as effective, professional, and aligned with their expectations. Conclusion/Lesson Learned : The findings reveal that UPTD Labkesda Samarinda has successfully maintained a high level of public satisfaction through consistent service quality, competent staff, and adequate facilities. Continuous efforts in staff development, process optimization, and community feedback mechanisms are essential to sustain and further improve service outcomes.
Achievement of capitation indicators based on Performance (kbk) bpjs at puskesmas makroman Samarinda Listiyani, Dwi; Adrianto, Ratno; Pakki, Irfansyah Baharuddin
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background: The National Health Insurance Program (JKN) applies Performance-Based Capitation (KBK) to improve efficiency and service quality at primary health facilities. Makroman Health Center, however, has not consistently met key indicators—contact rate, controlled Prolanis participants, and non-specialistic referral ratios—affecting both service quality and capitation funding. Evidence on KBK implementation in semi-urban primary care settings remains limited.ObjectiveTo describe the achievement of the three KBK indicators—contact rate, controlled Prolanis participant ratio, and non-specialistic referral ratio—and analyze their implications for capitation payments at Makroman Health Center, Samarinda, during 2022–2024. Research Methods / Implementation Methods : This descriptive observational study used secondary quantitative data from BPJS Health and the P-Care application. Variables included the three KBK indicators and corresponding capitation fund adjustments. Data were collected through document review and analyzed descriptively to identify annual trends and performance achievements across the study period. Results : Performance achievement varied over the three years. The contact rate rose from 45.02‰ in 2022 to 77.21‰ in 2024 but remained far below the KBK target of 150‰, indicating limited service accessibility. The non-specialistic referral ratio consistently met the <2% target in 2023–2024, showing improved primary care case management. However, the proportion of controlled Prolanis participants remained below the minimum 5% target throughout the period, reflecting ongoing challenges in chronic disease management. As a result, capitation payment adjustments ranged only from 85% to 90% of the expected amount. These findings demonstrate progress in referral control but persistent gaps in accessibility and chronic care continuity. Conclusion / Lesson Learned : KBK implementation at Makroman Health Center has not yet reached optimal performance. While referral quality has improved, low contact rates and poor Prolanis control continue to reduce capitation payments. Strengthening outreach activities, data quality monitoring, and structured Prolanis programs is essential for improving service performance and maximizing the effectiveness of KBK as a performance-based financing mechanism.
An Overview of Anxiety Levels Among Prolanis Participants at the Islamic Center Primary Clinic Samarinda Aminah, Aminah; Adrianto, Ratno; Mahardhika, Rizqa; Priansyah, Dedi
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Anxiety is common among individuals with chronic diseases such as diabetes and hypertension due to lifelong treatment demands and risks of complications. WHO (2022) reported that one in seven adults experiences a mental disorder, with anxiety being the most prevalent. In Indonesia, the burden of chronic diseases continues to rise, often accompanied by psychological distress. The Prolanis program aims to improve chronic disease management through education, monitoring, and support, yet most studies focus on clinical outcomes rather than mental health. Assessing anxiety among Prolanis participants is essential to ensure holistic patient care. Objective : To describe anxiety levels among Prolanis participants at the Islamic Center Primary Clinic in Samarinda using the Generalized Anxiety Disorder-7 (GAD-7) instrument and provide baseline information for integrating mental health monitoring into chronic disease management. Research Methods / Implementation Methods : This quantitative descriptive study was conducted in August–September 2025 among 30 active Prolanis participants selected through accidental sampling. Anxiety was measured using the validated Indonesian version of the GAD-7 questionnaire. Scores were categorized into minimal, mild, moderate, and severe anxiety. Data collection used self-administered questionnaires assisted by enumerators when needed, and results were analyzed descriptively using mean, median, standard deviation, and frequency distributions. Results : Participants generally showed low anxiety levels. The mean GAD-7 score was 3.00 (SD 2.89), with most respondents experiencing minimal or no anxiety (73.3%). Mild anxiety occurred in 16.7% of participants and moderate anxiety in 10%, with no severe cases. These findings indicate good psychological well-being among participants, potentially supported by Prolanis activities such as routine health checks, group education, exercise sessions, and community support. Similar trends have been reported in several previous studies, suggesting that continuous social interaction and psychosocial support may help reduce anxiety in chronic disease patients. Conclusion / Lesson Learned: Most Prolanis participants experienced minimal anxiety, suggesting that Prolanis contributes positively to both physical and mental health outcomes. Regular monitoring, supportive group activities, and community engagement appear to help maintain emotional stability. Mental health screening, staff training in basic psychological assessment, and strengthened family and community support are recommended to enhance comprehensive chronic disease management.
A Descriptive Overview of Patient Visit Patterns at the Joint Medical Practice Tenggarong. Astuti, Ayu Sri Mega; Adrianto, Ratno; Rohmah, Nur
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Backgorund : A joint medical practice is a modern health service model that integrates several types of medical services such as general practitioners, dentists, and ophthalmologists within a single facility. This model aims to improve efficiency, accessibility, and quality of care for the community, especially for individuals with limited time due to work or study. Objective : Describe the general pattern of patient. Viewed from the type of service visited, time of visit, age group, gender, education level and monthly distribution. Methods : A descriptive observational study with a retrospective approach using secondary data from patient medical records. The population included all patient visits recorded from Jan-June 2025, totaling 593 visits. Data were analyzed univariately using frequency and percentage. Results : The study showed that the highest number of visits was to dentists (48.7%), ophthalmologists (34.4%), general practitioners (16.9%). Most patients visited during evening hours (43.3%), the majority belonged to the productive age group of 21–35 years (37.5%). In terms of occupation, housewives (22.3%), employees (19.9%), private workers (19.4%) dominated. Most patients had a senior high school education (51.4%), were male (53.5%). Monthly distribution indicated an increase in patient visits, peaking in May (20.7%) and lowest in January (9.1%). Conclussion : The pattern of patient visits at Apotek Sejiwa Joint Medical Practice shows an upward trend with a predominance of productive-age patients seeking dental and eye care services. The evening time became the most preferred period for visits. This indicates that the joint medical practice model is an effective and adaptive form of healthcare delivery.
Analysis of Ability To Pay & Willingness To Pay BPJS Health Contribution Among Informal Sector Workers in Indonesia Syauqi, Ferdhitya Rizky; Adrianto, Ratno
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : BPJS Kesehatan is Indonesia’s national health financing scheme supporting equitable access to healthcare and the achievement of Universal Health Coverage. However, premium payment compliance among informal sector workers remains low due to unstable income, high basic household expenditures, and limited financial security. This condition creates a persistent gap between Ability to Pay (ATP) and Willingness to Pay (WTP). Beyond economic constraints, perceived service benefits, service quality, and health insurance literacy significantly influence WTP. Considering the large proportion of informal workers in the national labor market, understanding ATP and WTP determinants is essential for designing adaptive and sustainable financing policies. Objective : To analyze factors influencing ATP and WTP for BPJS Kesehatan premiums among informal sector workers in Indonesia through a systematic review of national literature published from 2020–2025, and to identify policy implications for strengthening long-term financing sustainability. Research Methods / Implementation Methods : A Systematic Literature Review (SLR) was conducted using national SINTA-indexed journals and Indonesian scientific databases. Keywords related to “Ability to Pay BPJS,” “Willingness to Pay BPJS,” and “Informal Sector Workers” were used. Inclusion criteria covered quantitative Indonesian-language studies (2020–2025) examining ATP/WTP in the context of BPJS Kesehatan. Fourteen articles met the criteria and were thematically analyzed based on economic factors, socio-demographic characteristics, household expenditure patterns, and perceived health service quality. Results : Findings show that ATP is mainly shaped by unstable income, high basic household expenditures, and fluctuating informal earnings. These structural characteristics make consistent premium payments difficult and indicate that a uniform flat-rate contribution is incompatible with the economic realities of informal workers.WTP, meanwhile, is strongly influenced by perceived benefits, service experience, information access, and trust in healthcare services. Higher WTP is observed when workers perceive real value and understand the long-term advantages of BPJS participation. Low health insurance literacy and lack of perceived service quality reduce willingness to pay.The review highlights the need for flexible premium schemes tailored to informal economic segments, such as micro-installment models, and emphasizes that improving WTP also requires better communication, transparency, and service quality. Conclusion / Lesson Learned : ATP among informal workers is dominated by economic constraints, while WTP is shaped by perceived benefits and service trust. Sustainable BPJS financing requires flexible, segmented premium models and parallel improvements in service quality. Future policies should integrate both economic and perception-based strategies to enhance compliance and reduce premium arrears.
A Descriptive Study of Patient Safety Culture at Inche Abdoel Moeis Regional Hospital, Samarinda, Indonesia Pratiwi, Fierda Eka; Adrianto, Ratno; Ningsih, Riyan
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Patient safety culture is a key pillar in improving the quality of health services. In 2025, the Indonesian Ministry of Health adapted the Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 as a national instrument to measure hospital staff perceptions of patient safety culture. Objective : This study aimed to describe the patient safety culture based on the 2025 Ministry of Health’s Patient Safety Culture Survey Instrument at Inche Abdoel Moeis Regional Hospital, Samarinda. Research Methods/ Implementation Methods : A descriptive quantitative study with a cross-sectional approach was conducted using secondary data from the 2025 patient safety culture survey. The population included all healthcare workers and non-medical staff (n=259). Data were analyzed descriptively by calculating the average score of each dimension of patient safety culture. Results : The overall mean score was 3.66 (73.2%), categorized as good. The highest dimensions were general perception of safety (4.30), teamwork and collaboration (4.14), and organizational learning (4.08). The lowest were incident reporting (2.03), communication openness (2.40), and non- punitive response to errors (2.62). Conclusion/Lesson Learned : The patient safety culture at Inche Abdoel Moeis Regional Hospital was in the good category, although improvements are needed in incident reporting and non-punitive response aspects. Strengthening leadership commitment and implementing a safe, anonymous reporting system are essential to enhance the overall patient safety culture.
Customer Satisfaction Level of Pharmaceutical Care at Mulawarman Mitra Medika Pharmacy Payung, Boli Matius Tandi; Adrianto, Ratno
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : A pharmacy is one of the facilities for carrying out pharmaceutical work and distributing pharmaceutical supplies to the public, aimed at improving community health. One of the indicators used to assess the quality of health services is customer satisfaction measurement. Satisfaction refers to the level of a person’s feelings when comparing perceived performance or results with their expectations. Objective : This study aimed to determine the level of patient satisfaction with pharmaceutical services at Apotek Mulawarman Mitra Medika. Research Methods/ Implementation Methods : The research was descriptive and used a satisfaction questionnaire. The subjects were patients who visited Apotek Mulawarman Mitra during a one-month period. Results : Based on the reliability dimension, the majority of respondents (29 people or 58.0%) stated that the service was of good quality, while 21 respondents (42.0%) considered it not good. For the responsiveness aspect, 27 respondents (52.0%) stated that the service was good, and 23 respondents (46.0%) stated otherwise. Regarding assurance, 26 respondents (52.0%) rated the service as good, while 24 respondents (48.0%) did not. Similarly, in the empathy dimension, 26 respondents (52.0%) stated that the service was of good quality, while 24 respondents (48.0%) stated it was not. For the tangible dimension, 26 respondents (52.0%) stated that the service was good, and 24 respondents (48.0%) stated it was not. Overall, the findings indicate that pharmaceutical services at Apotek Mulawarman Mitra Medika are considered to have achieved a satisfactory level of quality across all assessed dimensions. Conclusion/Lesson Learned :
Analysis of Health Service Performance at Loa Bakung Health CenterAfter Implementation The e-Puskesmas System Atthoba, La Debi; Anggraeni, Ike; Adrianto, Ratno
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Digital transformation is a key strategy in modernizing the health sector globally and nationally. In Indonesia, the implementation of health information systems such as E-Puskesmas aims to improve work efficiency, clinical data accuracy, service effectiveness at First-Level Health Facilities. Objective : This study analyzes the performance indicators of health services at UPTD Puskesmas Loa Bakung after the implementation of the E-Puskesmas system, focusing on service time efficiency, curative workload, and the achievement of promotive–preventive programs. Research Methods/ Implementation Methods : A descriptive approach was used based on secondary data from E-Puskesmas operational reports from January to September 2025. Data were obtained from individual service unit (UKP) reports, monthly BPJS Health reports, and public health program records. The analysis focused on operational efficiency, disease burden profiles, and priority program achievements. Results : Findings reveal a gap between digitalization goals and operational reality. Only 50.1% of patients were served within less than 10 minutes, indicating workflow bottlenecks. Essential Hypertension (2,985 cases), Acute Respiratory Infections (1,300 cases) dominated curative services, while screening achievements for Hypertension (16.43%) and Diabetes (4.10%) remained below targets. This reflects a reactive service orientation with limited promotive and preventive efforts. Conclusion/Lesson Learned : : E-Puskesmas has improved data recording accuracy but has not fully enhanced systemic performance. Optimization is needed through better network infrastructure, improved digital competence among health workers, and data-driven decision-making. Strategic focus should emphasize strengthening promotive and preventive programs as the core of primary health digital transformation.
Influence of Customer Relationship Management on RelationshipQuality at Abdul Wahab Sjahranie Hospital Sumarni, Sumarni; Adrianto, Ratno; Chaerunnisa, Chaerunnisa; Rahayu, Eka Putri
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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As hospital competition and service demands rise, patient loyalty becomes a critical asset. Therefore, understanding how Customer Relationship Management (CRM) influences Relationship Quality (RQ) is essential. CRM is no longer just an administrative tool; it is a core strategy to strengthen RQ. By improving understanding, interaction, and personalization, CRM directly builds the trust, satisfaction, and commitment that form a strong RQ, which is the foundation for patient loyalty. This study analyzes the influence of Customer Relationship Management on Relationship Quality in inpatient services at Abdul Wahab Sjahranie Hospital. Method Using a quantitative analytical survey design, data were collected from 390 purposively selected inpatients who had visited the hospital at least twice in the past six months. A closed-ended Likert scale questionnaire was used, and data were analyzed with the Chi-Square tests and Logistic Regression were included. The results show that Customer Knowledge, Customer Knowledge Management Capability, and Customization have a significant effect on RQ, while Customer Interaction has no significant effect. Overall, RQ plays a central role as a mediator, where the application of the Customer Relationship Management strategy is significantly able to strengthen the loyalty of inpatients at Abdul Wahab Sjahranie Samarinda Hospital through the formation of quality relationships. These findings highlight that understanding patients comprehensively, effectively managing patient knowledge, and tailoring services to patient needs are strategic in strengthening hospital–patient relationships. Practical implications suggest prioritizing CRM strategies focused on patient needs and experiences to foster long-term, mutually beneficial relationships.
Co-Authors 'Aina 'Uruba, Huurul Adiyatsa, Reza Jales Mahesa Agustina Simanangi Pamowa Agustina, Elvi Akhmad Azmiardi Akhmad Azmiardi Alvie Magda Lesiwal Aminah Aminah Angelina, Grace Annisa Nurrachmawati Annisa Nurracmawati AR, Chaerunnisa AR., Chaerunnisa Astuti, Ashri Budi Astuti, Ayu Sri Mega Astuti, Prima Yulia Atik Suhargiati Atthoba, La Debi Auralia, Syalmita Auralia, Syalmitha Ayu Indira Dwika Lestari Baharuddin Pakki, Irfansyah Baharudin, Irfansyah Bahtiar, Rahmat Bakhtiar, Rahmat Basri, Samsinar Blego Sedionoto Budi, Eko Prasetya Cahyana, Yudi Jaya Chaerunnisa AR Chaerunnisa, Chaerunnisa Dahlia Dahlia Danu Putra, Muhammad Rangga Dedi Priansyah Dias Pratama Eka Dewi Sitepu, Abira Ivanca Eka Putri Rahayu Elvira, Vivi Filia Fajri, Audya Nada Fatimatuzzahra, Siti Firnanda, Rivana Gloria Priska Britani Sumlang Hamri, Ahmad Ahsyar Hapsari, Palupi Setyo Hasan, Hismawati Hilda Hilda Hutauruk, Hutauruk Huwaidah, Ayu Ida Ayu Indira Dwika Lestari Ike Anggraeni Ike Anggraini G Imanuddin, Khairul Irfansyah Baharuddin Pakki Irfansyah Bahruddin Pakki Iriyani K Iriyani Kamaruddin, Iriyani Isnaniah, Enny Ivanca, Abira Iwan M. Ramdan Iwan Muhamad Ramdan Iwan Muhamad Ramdan Jami'an, Jami'an Jaya Mualimin Juliana Hasibuan Jumliana, Jumliana K., Iriyani Kartikasari , Dina Khalisha, Nailah Khalishah az Zahra Kurniawan Khotimah, Vika Khusnul Khusnul, Vika Kurniawan, Khalishah az Zahra Lasari, Aramika Laura, Najoan Brigitta Lenik Gah, Regina Lestari, Ida Ayu Indira Dwika Listiyani, Dwi Mahardhika, Rizqa Mardiana, Desy Indah Marinda, Indri Masruroh1,2, Ah Yusuf3 , Nikmatur Rohmah4, Irfansyah Baharudin Pakki5 , Anita Dewi Prahastuti Prasojo6 , Qurnia Andayani1 , *Agung Dwi Laksono7 Maulana, Ady Mochamad Makin, Mochamad Muhammad Rangga Muhammad Sultan Muhammad Sultan, Muhammad Nada, Abira Ivanca Audya Nada, Audya Najla, Syarifah Amira Najoan Brigitta Laura Nauli, Ruth Sekar Noor, Zulhijrian Noors, Ilfa Pratiwi M Noriah, Noriah Norsehan, Norsehan Nur Asiyah Nur Rohmah Nur Rohmah Nur, Syalmitha Auralia Nurlinda, Fitria Nursakti Nursakti Nurul Rizkiana Tistania Nuryanto, Muhammad Khairul Paramita, Tri Ratna Pasha, Yuliana Payung, Boli Matius Tandi Pratama, Dias Pratiwi, Fierda Eka Purnama, Tasha Citra Rahayu, Eka Putri Rahmat Bakhtiar Rahmi Susanti Ramadhani, Dewi Endah Ramdam, Iwan Muhammad Ramdan , Iwan M. Rangga, M. Ratih Wirapuspita Wisnuwardani Reny Noviasty Risky Amelia Rhamadani Riyan Ningsih Sadaria, Sadaria Saputra, Rudi Septiana, Lisa Septimaulida, Firda Setianingtyas, Endah Dwi Setiawati, Ronny Setyo Nugroho Sinar, Sinar siti nurlela Subirman - SUMARNI Sumarni Sumarni Syauqi, Ferdhitya Rizky Syawalia, Zheditya Ayu Taqie, Sayyid Muhammad Tricindra, Dzulhannisa Ulfah, Meilida Ulpah, Rini Wahidatul Utari, Ari W, Ratih Wirapuspita. Wahyudi, Ayu Huwaidah Wahyudianto, Yogik Wardani, Citra Rizki Wijayanti, Dwi Astuti Noor Wirapuspita W, Ratih Wirapuspita Wisnuwardani, Ratih Yadi, Yadi Yunus, Mudassir