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Penggunaan Obat yang Tidak Rasional pada Balita dengan Diare di Kalangan Bidan, di Kabupaten Sumedang Tahun 2006 Wahyudin, Uyu; Besral, Besral
Kesmas Vol. 1, No. 3
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Pengobatan diare pada balita di Puskesmas Kabupaten Sumedang dilaksanakan di Poli KIA yang sehari-harinya ditangani oleh bidan. Tujuan penelitian ini adalah untuk mengetahui tingkat kepatuhan bidan dan faktor-faktor yang berhubungan dengan kepatuhan bidan dalam penggunaan obat secara rasional pada balita diare akut non spesifik. Desain penelitian yang digunakan adalah cross-sectional dengan jumlah sampel 109 bidan yang berasal dari 18 puskesmas yang dipilih secara random. Pengukuran kepatuhan dilakukan dengan pengamatan terhadap resep yang ditulis oleh bidan untuk balita penderita diare akut non spesifik. Hasil penelitian memperlihatkan tingkat kepatuhan bidan adalah 69,7%. Hasil analisis regresi logistik ganda memperlihatkan bahwa faktor yang berhubungan dengan kepatuhan adalah adalah pengetahuan dan sikap bidan terhadap obat rasional dan supervisi dari atasan. Penelitian ini juga mendapatkan hubungan yang bermakna antara pengetahuan dan persepsi orang tua balita terhadap obat rasional dengan kepatuhan bidan dalam penggunaan obat rasional. Dalam rangka mengatasi ketidakrasionalan pengobatan diare akut non spesifik, maka Puskesmas harus berupaya meningkatkan pengetahuan bidan terhadap penggunaan obat rasional, melakukan supervisi, dan meningkatkan penyuluhan kepada pasien tentang penggunaan obat rasional. Diarrhea medication among children under five years old at primary health care, sub-province of Sumedang is performed at Mother and Child Polyclinic which is handled by a midwife everyday. This research purpose to obtain the description of compliance level of midwives and its factors related of midwives compliance in the usage of rational drugs among children with non specific acute diarrhea. Research used cross-sectional design with samples size were 109 midwives which were come from 18 primary health care, which were selected randomly. To measure the compliance, the observation was performed of prescriptions that written by midwives to children with non specific acute diarrhea. This research result showed that compliance level was 69.7%. Result analysis of multiple logistic regression showed that related factors were knowledge and midwives attitude of usage of rational drugs and supervision. This research also showed the association between knowledge and parent’s perception of children under five years old of rational drugs and compliance level of midwives in the usage of rational drugs. It is suggested that primary health care should increase midwives knowledge in usage of rational drugs, doing supervision and improve socialization the usage of rational drugs to patient.
Kinerja Bidan di Desa dalam Program Jaminan Pemeliharaan Kesehatan Masyarakat Miskin Husna, Arfah; Besral, Besral
Kesmas Vol. 4, No. 1
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Cakupan pelayanan kebidanan program Jaminan Pelayanan Kesehatan Masyarakat Miskin (JPKMM) di Kabupaten Aceh Selatan tahun 2006 yang belum mencapai target mengindikasikan kinerja bidan di desa dalam pelayanan kebidanan program JPKMM masih rendah. Penelitian ini bertujuan mengetahui kinerja bidan desa dan faktor-faktor yang berhubungan. Kinerja bidan desa diukur dengan melihat cakupan pelayanan kebidanan program JPKMM meliputi cakupan pemeriksaan kehamilan minimal 4 kali dan cakupan pertolongan persalinan. Disain penelitian yang digunakan adalah cross sectional dengan populasi seluruh bidan desa yang bertugas di Kabupaten Aceh Selatan tahun 2007. Sampel adalah bidan desa yang sudah bertugas minimal setahun yang berjumlah 104 orang. Disimpulkan bahwa sebagian besar kinerja bidan desa masih rendah (56%). Faktor-faktor yang berhubungan dengan kinerja bidan desa adalah: tidak adanya pesaing, adanya pembinaan, pengetahuan dan motivasi. Faktor-faktor yang tidak berhubungan dengan kinerja bidan desa adalah umur, status pernikahan, status kepegawaian (PNS/PTT), domisili, jumlah desa, sikap, imbalan, kemampuan dan pendidikan. Disarankan kepada Dinas Kesehatan untuk memberikan pembinaan yang lebih intensif kepada bidan desa dan memberikan penghargaan untuk meningkatkan motivasinya. Disarankan kepada bidan di desa untuk terus-menerus melakukan peningkatan pelayanan kepada pasien dan selalu menerapkan prinsip 3S (salam, senyum dan sopan) serta proaktif mendatangi pasien ke rumahnya untuk memberikan pelayanan kebidanan ataupun memelihara hubungan sosial yang baik. This research aimed to find out the performance of village midwife and its determinant factors. The performance of midwifery service within the Jaminan Pemeliharaan Kesehatan Masyarakat Miskin (JPKMM) program was measured by the coverage of antenatal care and coverage of trained birth attendance. The design of this study is cross sectional and data was analyzed using univariate, bivarite, and multivariate logistic regression. The population was all village midwives (137 persons) in Aceh Selatan District in the year 2007. The sample was village midwife who has at least one year work experience in a certain village and it consists of 104 persons. The result shows that the performance of village midwife is still low (56%). Multivariate logistic regression analysis confirmed that the dominant factor related to good performance were no competitor, good supervision, knowledge and motivation. Factors which not associated with performance were age, marital status, employee status, domicile, number of village to be covered, attitude, reward, and education. We recommend that the District Health Office must supervise intensively and giving more reward to improve work motivation. The village midwife should improve their quality of services and implement the 3S principle ( salam, senyum and sopan) and conducting home visit to provide maternal health services and to maintain good social relationship with the community.
Effect of Local Culture-based Nutrition Education on Compliance with Iron and Folic Acid Supplementation in Female Adolescent Rahmiwati, Anita; Djokosujono, Kusharisupeni; Krianto, Tri; Utari, Diah Mulyawati; Djuwita, Ratna; Setiarini, Asih; Besral, Besral; Purnama, Dadang Hikmah; Dwiriani, Cesilia Meti; Mulyana, Nana
Kesmas Vol. 18, No. 2
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The non-compliance of female adolescents with the consumption of iron and folic acid supplementation (IFAS) poses a challenge to reducing the incidence of anemia. Therefore, this study aimed to determine the effect of nutrition education using the local culture-based approach on the level of knowledge and attitudes regarding awareness, interest, evaluation, trial, and adoption dimensions, as well as compliance of female adolescents in consuming IFAS. The intervention was conducted using a quantitative quasi-experimental design approach. The sample comprised 68 and 58 senior high school girls in the control and intervention groups. The intervention group received IFAS and local culture-based nutrition education for 12 weeks and followed up after four weeks; while, the control group was given a leaflet and IFAS. Univariate analysis was conducted to analyze the participants’ characteristics; while, bivariate analysis used an independent T-test. The multivariate analysis was carried out using multiple linear and logistic regression analyses. The study showed a statistically significant increase in knowledge and attitudes scores in the intervention group (p-value<0.01) compared to the control group. In conclusion, the compliance with IFAS in the intervention group was 82.8%.
Pengelolaan Sampah Berbasis Masyarakat di Kampung Rawajati Jakarta Selatan Puspawati, Catur; Besral, Besral
Kesmas Vol. 3, No. 1
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Kampung Rawajati di Jakarta yang menerapkan sistem pengelolaan sampah berbasis masyarakat merupakan alternatif upaya mengatasi sampah rumah tangga. Penelitian ini bertujuan mengetahui pengaruh sistem tersebut terhadap penurunan berat sampah rumah tangga. Dengan desain studi potong lintang, penelitian ini dilakukan pada sampel 175 ibu rumah tangga yang dipilih secara acak. Hasil penelitian ini menunjukan bahwa pengelolaan sampah berbasis masyarakat dapat menurunkan berat sampah sebesar 28,3%. Analisis regresi linier ganda memperlihatkan bahwa kegiatan pengelolaan yang berpengaruh terhadap penurunan berat sampah adalah kegiatan reuse, daur ulang, dan pembuatan kompos (nilai-p < 0,05). Pembuatan kompos merupakan variabel yang berkontribusi terhadap penurunan berat sampah 657,3 gram setelah dikontrol variabel perancu. Penurunan berat sampah ditemukan lebih besar pada rumah tangga yang mendapat pelatihan. Tidak ada perbedaan penurunan berat sampah menurut jumlah anggota keluarga, penghasilan rumah tangga, dan pengetahuan ibu. Disarankan agar Pemerintah DKI Jakarta dapat melakukan replikasi model pengelolaan sampah berbasis masyarakat kepada wilayah lainnya, dengan memberikan pelatihan pengelolaan sampah kepada masyarakat. Kampung Rawajati in Jakarta applies community-based solid waste management system as an alternative way to overcome household waste problem. The objective of the research is to assess the effect of community-based solid waste management on reduction of household waste weight. This study has crosssectional study design and was conducted on 175 housewife as respondent who were selected randomly. The data was collected by interview using structured questionnaire and weighing of household waste. The result shows that the community-based solid waste management can reduce 28.3% of household waste weight (weight before: 1.845 gram/house/day and after: 1.324 gram/house/day). Multiple linear regression analysis shows that variables affecting the reduction of solid waste including re-using activity, recycling, and composting (p-value <0.05). Composting represents the biggest effect to reduction (657.26 gram) after controlled by potential confounders. The reduction was higher among household with waste training and number of trained household member. It was found that number of family member, family income, and mother knowledge are not significant. It was recommended to the Government of DKI Jakarta to replicate this community-based waste management system to other regions by providing training facilities on solid waste management.
Efektivitas dan Efisiensi Sistem Informasi Keluarga Berencana di Puskesmas Putri, Aragar; Besral, Besral
Kesmas Vol. 5, No. 4
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Efisiensi dan efektivitas sistem informasi keluarga berencana (KB)-kesehatan yang telah disosialisasikan sejak tahun 2007 dibandingkan dengan sistem yang lama belum diketahui. Suatu penelitian survei dilakukan di empat provinsi, yaitu DKI Jakarta, Lampung, Kalimatan Tengah, dan Bali. Di tiap provinsi dipilih dua kabupaten/kota dan pada tiap kabupaten/kota dipilih dua puskesmas (kecamatan) yang sudah menerapkan sistem informasi KB-kesehatan tersebut. Pengumpulan data dilakukan pada bulan Juni-September 2008. Penelitian ini menemukan bahwa efektivitas dan efisiensi sistem informasi KB yang baru cukup baik, 77,8% responden menyatakan lebih efektif atau sangat lebih efektif dan 66,7% responden menyatakan lebih efisien atau sangat lebih efisien dibandingkan dengan sistem yang lama. Skor efektivitas dan efisiensi berbeda antar provinsi (nilai p <0,01), skor terendah di provinsi Bali (rata-rata 68,9 untuk efektivitas dan 61,3 untuk efisiensi), dan skor tertinggi di Kalimantan Tengah (rata-rata 82,7 untuk efektivitas dan 82,2 untuk efisiensi). Tidak ada perbedaan skor efektivitas dan efisiensi sistem informasi KB menurut lingkup kerja dan jabatan responden (nilai p> 0,05). Disarankan kepada Kementerian Kesehatan untuk dapat melakukan perbaikan pada komponen sistem informasi keluarga berencana, terutama dalam pembuatan grafik pemantauan wilayah setempat KB dan mengimplementasikannya di pelayanan KB di puskemas beserta jaringannya. A study is to know the efficiency and effectiveness of the new family planning information system that has been socialized since 2007. To compare with the previous information system, this study was conducted in four provinces i.e., DKI Jakarta, Lampung, Central Kalimatan, and Bali. In each province two districts were randomly selected, and from each selected district two health centers were then randomly selected. Data was collected from June to September 2008. Results of this study revealed that the effectiveness and efficiency of the new family planning information system is considered good, where 77,8% of the respondents reported it as effective or more effective, and 66,7% stated more or much more efficient compared to the previous system. The mean score for effectiveness and efficiency vary between provinces (p-value <0,01). The lowest score was found in Bali (mean 68,9 for effectiveness and 61,3 for efficiency), and the highest score was in Central Kalimantan (mean 82.7 for effectiveness and 82.2 for efficiency). There is no significant difference of the score according to characteristics of the respondents. This study recommends to improve the family planning information system, especially by providing and implementing the local monitoring graph, in the health center and its network.
Peran Dokter Ahli Kebidanan dan Kandungan Meiyetriani, Eflita; Utomo, Budi; Besral, Besral; Salmah, Sjarifah
Kesmas Vol. 7, No. 1
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Salah satu bentuk medikalisasi kelahiran adalah angka persalinan sectio caesarea yang tinggi. Hasil beberapa studi menunjukkan bahwa dokter ahli kebidanan dan kandungan merupakan faktor penting yang menentukan persalinan yang dijalani responden. Penelitian ini bertujuan menilai perandokter ahli kebidanan dan kandungan dalam mengambil keputusan untuk melakukan sectio caesarea dibandingkan persalinan normal dengan mengontrol variabel sosiodemografi dan faktor risiko ibu. Penelitian dilakukandengan metode cross sectional menggunakan data Survei Demografi dan Kesehatan Indonesia (SDKI) DKI Jakarta. Populasi penelitian adalah wanita pernah kawin usia 15 - 44 tahun yang memiliki riwayat melahirkan 5 tahun terakhir sebelum survei dilakukan. Hasil penelitian menunjukkanpemilihan petugas pelayanan antenatal berhubungan dengan persalinan sectio caesarea, tetapi hubungan ini tidak berdiri sendiri, terkait dengan pengaruh status ekonomi rumah tangga. Dari penelitian ini disimpulkan bahwa terdapat hubungan yang signifikan antara responden yang memilih dokter ahli kebidanan dan kandungan sebagai petugas pelayanan antenatal dengan persalinan sectio caesarea yang juga dipengaruhi oleh status sosial ekonomi rumah tangga responden. Selain status sosial ekonomi, variabel yang berhubungan dengan persalinan sectio caesarea adalah usiaibu, paritas ibu, pendidikan ibu, riwayat komplikasi kehamilan, dan riwayat perdarahan. One of the birth medicalization form is the high number of sectio caesarea deliveries. Result of some studies shows that obstetrician is a factor which can determine the preference type of delivery. The purpose of this study is to assess the role of the obstectrician in order to make decision making inpreference sectio caesarea delivery than vaginal delivery after controlled with sociodemographic factors and maternal risk factor. The study was a cross sectional study using a quantitative approach. This study using secondary data which obtained from Indonesia Demographic and Health Survey 2007 with subset of the research is DKI Jakarta region. Population of this study was married women with age between 15 - 44 years old who has delivery history in term of 5 years before the survey. The study shows significant correlation between prenatal care workers with sectio caesarea delivery but this correlation also has an interaction with household economic status variables. There is significant correlation between respondent whose prenatal care with obstectrician with sectio caesarea delivery. This correlation also related with household economic status. Others variables related to sectio caesarea delivery beside social economic status are maternalage, parity, maternal education, complication during pregnancy history, and bleeding history.
Pengaruh Perawatan Metode Kanguru terhadap Respons Fisiologis Bayi Prematur Deswita, Deswita; Besral, Besral; Rustina, Yeni
Kesmas Vol. 5, No. 5
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Saat ini, perawatan metode kanguru mulai dianjurkan bagi bayi prematur karena kelahiran prematur dan bayi dengan berat badan lahir rendah merupakan salah satu penyebab kematian bayi terbesar. Tujuan penelitian ini adalah untuk mengetahui pengaruh perawatan metode kanguru terhadap respons fisiologis bayi prematur. Desain quasi experiment one group pre and post-test dilakukan di 2 rumah sakit di Jakarta. Sebanyak 16 bayi prematur yang memenuhi kriteria inklusi dipilih sebagai sampel. Hasil penelitian menunjukkan bahwa terdapat pengaruh yang bermakna dari perawatan metode kanguru terhadap respons fisiologis bayi prematur seperti peningkatan suhu tubuh ke arah suhu normal (p value = 0,000), peningkatan frekuensi denyut jantung ke arah normal (p value = 0,003), dan peningkatan saturasi oksigen ke arah normal (p value = 0,023). Oleh karena itu, metode perawatan kanguru merupakan cara yang efektif, mudah, dan murah untuk merawat bayi prematur. As premature birth and low birth weight are the main cause of neonatal mortality, kangaroo mother care is now suggested to care premature infants. The purpose of this study was to identify the effect of kangaroo mother care on physiological response of preterm infants. A quasi experiment design with one group pre and post test design was conducted in two hospitals in Jakarta. Sixteen preterm infants matching the inclusive criteria were selected as sample. The study found significant effect of kangaroo mother care intervention on physiological response of preterm infants, i.e. increasing body temperature to normal (p value = 0,000), increasing heart rate to normal (p value = 0,003), and increasing oxygen saturation (p value = 0,023). Therefore, the kangaroo mother care is therefore an effective, simple, and cheap method to care the preterm infants.
Efek Penyakit Kronis terhadap Gangguan Mental Emosional Widakdo, Giri; Besral, Besral
Kesmas Vol. 7, No. 7
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Hasil Riset Kesehatan Dasar tahun 2007 menunjukkan 11,6% penduduk Indonesia berumur 15 tahun ke atas mengalami gangguan mental emosional. Penelitian ini bertujuan untuk mengetahui efek penyakit kronis terhadap gangguan mental emosional. Desain penelitian ini adalah potong lintang menggunakan data Riskesdas tahun 2007. Sebanyak 660.452 responden berusia di atas 15 tahun yang tidak mengalami gangguan jiwa dijadikan sampel. Gangguan mental emosional dinyatakan ada jika responden mem-punyai paling tidak enam dari 20 gangguan. Penyakit kronis seperti tuberculosis (TB) paru, hepatitis, jantung, diabetes, kanker, dan stroke diukur melalui wawancara yang didasarkan pada diagnosis petugas kesehatan. Hasil penelitian menunjukkan bahwa dari sepuluh penderita penyakit kronis, dua sampai lima penderita akan mengalami gangguan mental emosional. Analisis regresi logistik multivariat memperlihatkan bahwa risiko gangguan mental emosional semakin tinggi bersamaan dengan semakin banyak jumlah penyakit kronis yang diderita oleh responden. Responden yang menderita satu penyakit kronis berisiko 2,6 kali lebih besar untuk mengalami gangguan mental emosional, yang menderita dua penyakit kronis berisiko 4,6 kali, yang menderita tiga penyakit kronis atau lebih berisiko 11 kali. Kementerian Kesehatan disarankan untuk mengembangkan standar pelayanan penyakit kronis terkait dengan pengurangan dampak pada gangguan mental emosional dan dibentuknya tim bimbingan teknis pelayanan penyakit kronis. Basic Health Research (Riskesdas) year 2007 showed that 11.6 percent of Indonesia’s population aged 15 years and above suffering from mental emotional disorder. This study aimed to examine the effects of chronic illness to the mental emotional disorders. A cross-sectional study was performed that used Riskesdas 2007 data. Atotal of 660,452 respondents aged 15 years and over who are mentally health become sample of this study. Mental emotional disorders exist if they have at least six of the 20 disorder. Chronic diseases such as pulmonary tuberculosis, hepatitis, heart disease, diabetes, cancer, and stroke were measured based on diagnosis by health pro-fesional. The results showed that out of ten respondents with chronic illness, aproximately two to five will suffering from mental emotional disorder. Multivariat logistic regression analysis shows that the risk of developing mental emotional disorders higher as more number of chronic illnesses suffered by the respondent. Respondents suffering from one chronic disease were 2.6 times greater risk for emotional mental disorder, suffering from two chronic dis-ease have risk 4.6 times, which had three or more chronic disease risk have risk 11 times. It is suggested that the Ministry of Health to develop a standard of care of chronic diseases associated with reducing impact on the mental emotional disorders and establishment of teams for technical guidance chronic disease care.
Prevalensi dan Determinan Sindrom Metabolik pada Kelompok Eksekutif di Jakarta dan Sekitarnya Kamso, Sudijanto; Purwantyastuti, Purwantyastuti; Lubis, Dharmayati Utoyo; Juwita, Ratna; Robbi, Yull Kurnia; Besral, Besral
Kesmas Vol. 6, No. 2
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Data tentang faktor-faktor yang berhubungan dengan sindrom metabolik pada kelompok eksekutif di Indonesia yang diperlukan untuk upaya pencegahan penyakit kardiovaskular sangat terbatas. Penelitian ini bertujuan untuk mengetahui prevalensi dan determinan sindrom metabolik pada kelompok eksekutif. Penelitian dilakukan di Jakarta dan sekitarnya dengan menggunakan rancangan cross sectional. Jumlah responden yaitu 220 orang eksekutif laki-laki dan 68 orang eksekutif wanita. Pengumpulan data dilakukan dengan pengukuran antropometri, analisis biokimia darah, analisis asupan makanan, pengukuran angka stres, dan pengukuran indeks aktivitas. Analisis regresi logistik ganda dilakukan untuk mengetahui hubungan beberapa independen variabel dengan dependen variabel. Analisis ini menghasilkan indeks massa tubuh (overweight, odds ratio (OR) = 5,54; obesitas, OR = 7,44) dan rasio total kolesterol/high density lipoprotein (HDL)-kolesterol (OR = 8,83) sebagai determinan sindrom metabolik pada kelompok eksekutif. Penelitian ini menunjukkan bahwa pemeriksaan profil lipid dan pengukuran antropometri sederhana yang teratur pada kelompok eksekutif penting dilakukan untuk mendeteksi risiko sindrom metabolik. Available datas on metabolic syndrome among Indonesian executives are limited, despite the fact of the importance of these data for cardiovaskular prevention. The objective of this study was to assess prevalence of metabolic syndrome and its associations between anthropometric measures, lipid profiles, blood pressure, nutrient intakes, and life style in executive group. A cross sectional study was undertaken in some factories in Jakarta, using multistage random sampling. The respondents were 287 executives, 219 male and 68 female. Data were collected through anthropometric measurements, biochemical blood analysis, nutrient intake, stress score, and activity index assessment. Multiple logistic regression analysis used to assess associations between independent variables and metabolic syndrome. This study showed that body mass index (overweight, odds ratio (OR) = 5,54; obesity, OR = 7,44) and ratio serum total cholesterol to high density lipoprotein (HDL)-cholesterol (OR = 8,83) were potential determinants of metabolic syndrome. This study shows the importance of routine check of lipid profile, blood pressure, and simple anthropometric assessment to detect the risk of metabolic syndrome in the elderly.
Antenatal Care Provider and Cesarean Section in Urban Areas in Indonesia Pristya, Terry Yuliana Rahadian; Herdayati, Milla; Besral, Besral; Fika, Dheni Fidyah
Kesmas Vol. 12, No. 3
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Abstract

Tren persalinan sesar di Indonesia (2007-2012) mengalami peningkatan dua kali lipat berisiko pada munculnya masalah kesehatan jangka panjang maupun pendek. Penelitian ini bertujuan mengetahui hubungan tenaga kesehatan pemeriksa kehamilan dengan persalinan sesar. Penelitian kuantitatif ini menggunakan desain potong lintang dengan sampel penelitian 5143 wanita usia subur berusia 15-49 tahun yang melahirkan anak terakhirnya, baik melahirkan sesar maupun tidak di wilayah perkotaan yang terpilih dalam sampel Survei Demografi Kesehatan Indonesia tahun 2012. Analisis multivariat regresi logistik digunakan untuk mengetahui hubungan tenaga pemeriksa kehamilan dengan persalinan sesar, dikontrol oleh usia ibu, tempat periksa kehamilan, paritas, dan tempat melahirkan. Hasil penelitian menunjukkan bahwa pemeriksaan kehamilan pada spesialis kandungan 6,6 kali lebih tinggi, sedangkan pemeriksaan kehamilan pada spesialis kandungan dan bidan 2,1 kali lebih tinggi untuk melakukan persalinan sesar dibandingkan dengan ibu yang melakukan pemeriksaan kehamilannya di bidan setelah dikontrol usia ibu, tempat periksa kehamilan, paritas, dan tempat melahirkan. Terdapat interaksi antara spesialis kandungan dengan status sosial ekonomi untuk persalinan sesar. Implementasi peraturan dilakukannya persalinan sesar oleh institusi kesehatan, serta melakukan upaya protektif dan preventif persalinan pada kelompok masyarakat ekonomi tinggi dapat mengurangi terjadinya persalinan sesar yang tidak perlu. Trends of cesarean section trend in Indonesia (2007-2012) have doubled the risk of long-term and short-term health problems. This study was aimed to determine relation between antenatal care provider and cesarean section. This quantitative study used cross-sectional design with a total sample of 5,143 women aged 15-49 years who gave birth to the last child through cesarean section or not as in urban areas selected in samples of 2012 Indonesia Demographic and Health Survey. Logistic regression multivariate analysis was used to determine relation between antenatal care provider and section cesarean, which was controlled by maternal age, antenatal care facility, parity, and place of birth. Results showed that antenatal care at obstetrician was 6.6 times higher, while antenatal care at obstetrician and midwife was 2.1 times higher for cesarean section compared to women who had antenatal care at midwife after controlled by maternal age, antenatal care facility, parity, and place of birth. There is interaction between socioeconomic status and obstetrician for a cesarean section. Regulation on cesarean section by health authority, as well as protective and preventive labor applied towards on the high economic class community may reduce unnecessary cesarean section.
Co-Authors Abdul Basit Abdul Wakhid Abdullah Fadilly Abram Kamiza Achmad Fauzi Kamal Adang Bachtiar Agung Waluyo Ainin Ainin Ainin, Ainin Aisyah Apriliciciliana Aryani Akmad Rosanji Ali Asman Harahap Allenidekania Allenidekania Andri Prima Zani Andri Yan Prima Zani Anggraini Ramadhaningtyas Anita Rahmiwati Aprilia Daracantika Apriyanah, Deasy Apriza, Cici Aragar Putri Aragar Putri Arfah Husna Arfah Husna Arriawan, Iwan Arta Marisi Dame Artha Prabawa Asih Setiarini Awinda, Rinka Citra Bimandra Adiputra Djaafara Budi Anna Keliat Budi Hairani Budi Hidayat Budi Hidayat Budi Iman Santoso Budi Utomo Budi Utomo Budi Utomo Budi Utomo Catur Puspawati Catur Puspawati Cesilia M Dwiriani Cesilia Meti Dwiriani cindy prastika Dadang Hikmah Purnama Dadang Purnama Dahlia, Debie - Damayanti, Triya Daracantika, Aprilia Darmayenti darmayenti, Darmayenti Darsana, Wayan Denalian, Fatimmah Deswita Deswita Deswita Dewi Gayatri Dharmayati Utoyo Lubis Dharmayati Utoyo Lubis Dheni Fidyah Fika Diah Mulyawati Utari Dian Novita Dian Novita Kurniasih Dian Ramawati Dihartawan, Dihartawan Dion Zein Nurizin Djaafara, Bimandra Adiputra Djokosujono, Kusharisupeni Eflita Meiyetriani Eflita Meiyetriani Eka Budiarto, Eka Eka Wahyuni, Sri Elly Nurachmah Ema Novita Deniati Endang L Achadi Endang L Achadi Evi Martha Farida Isroani Fatma Lestari Fauzi Kamal, Achmad Fauziyyah, Rifa Fentiana, Nina Fika, Dheni Fidyah Fitrian Raya Sari Ginting, Lea Morry Br Giri Widakdo Hadi Pratomo Hadi Pratomo Hadi Pratomo Harimat Hendarwan Harimat Hendarwan Hasbullah Thabrany Hasnawati Hasnawati Hasnawati Hasnawati Helda Khusun Herlina J. EL- Matury Hermawan, Lukas C Herni Susanti Huda, Muhammad Jamalul Ilmaskal, Radian Ingan Ukur Tarigan Ingan Ukur Tarigan Ingriza, Resva Intan Rachmita Sari Irawati, Diana Iwan Ariawan Iwan Arriawan Jenny Anna Siauta Juliana Karniastuti Junadi, Purnawan Junaiti Sahar Kalamullah Ramli Kamiza, Abram Kemal N. Siregar Khaliza, Cindy Nur Krisna Yetti Krisna Yetti Kumala, Siti Sunya Kusharisupeni Djokosujono Leny Sang Surya Lia Meilianingsih Lubis, Sri Novita Lukas C Hermawan Luli Sari Yustina Luluk Rosida Lusiana Primasari Lutfiah, Umi Makful, Martya Rahmaniati Mardiati Nadjib Mario Ekoriano Martin Kustati Martya Rahmaniati Martya Rahmaniati Mas'udah, Anni Fithriyatul Masfuri - Masrizal Masrizal Mentari, Asti Sauna Mieska Despitasari Mieska Despitasari Miftakul Fira Maulidia Milla Herdayati, Milla Misnaniarti Misnaniarti Mona Lisa Mona Lisa, Mona Mudiyah, Siti MUHAMMAD AGUS SUPRAYUDI Muhammad Rasyid Ridha Muhani, Nova Mulya Sari, Dian Murtiani, Farida Mustikasari Nadjib, Mardiati Nana Mulyana Nana Mulyana Ni Made Dian Sulistiowati Nina Fentiana Nova Muhani Novitasari, Prihatini Dini Nur Hairunnisa Nur Handayani Utami Nur Ighwana Sari Nurizin, Dion Zein Nurmiati Nurmiati Okky Assetya Pratiwi Poppy Yuniar Popy Yuniar Prihatini Dini Novitasari Pristya, Terry Yuliana Rahadian Priyanto Priyanto Priyanto Pujiyanto Pujiyanto Pujiyanto, Pujiyanto Purnawan Junadi Purwantyastuti Purwantyastuti Purwantyastuti Purwantyastuti Purwoko, Bambang Putri Rahmadani Putri Rahmadani, Putri Putri, Nur A'isyah Amalia R Sutiawan Rachmita Sari, Intan Radian Ilmaskal Radian Ilmaskal Rahmah Rahmah Ramadhaningtyas, Anggraini Rapingah, Siti Ratna Djuwita Ratna Djuwita Ratna Juwita Ratna Juwita Ratna Sitorus Ratna Sitorus Rayasari, Fitrian Reny Widyasari Ria Utami Panjaitan Rifa Fauziyyah Rilantias Utami Rinaldi Daswito Rini Sekartini Rinka Citra Awinda Risatianti Kolopaking Ruddy J Suhatril Saifudin, I Made Moh. Yanuar Sali Rahadi Asih Sari, Dian Mutia Sari, Nur Ighwana Satriani Gultom Serli Wulan Safitri Setiadi, Rizky Setyowati Setyowati Shelly Maya Lova Sianipar, Novitri Siti Mudiyah Siti Nur Kholifah Siti Rapingah Sjarifah Salmah Sjarifah Salmah Sri Arini Winarti R. Sri Hariyati, Roro Tutik Sri Windiarti Sri Windiarti ST Khumaidah Sudarto Ronoatmodjo Sudijanto Kamso Sudijanto Kamso Sudikno . Sudikno ., Sudikno Susanti Widiastuti Susilawati Sutanto Priyo Hastono Sutiawan . Sutiawan, R Syamsul Rizal Tawahusna Tawahusna Terry Yuliana Rahadian Pristya Thabrany, Hasbullah Toha Muhaimin Tri Hapsari Retno Agustiyowati Tri Hapsari Retno Agustiyowati Tri Krianto Tri Krianto Trihono Trihono Trihono, Trihono Trini Sudiarti Trini Sudiarti Umi Kalsum Umi Lutfiah Umi Sukowati Uyu Wahyudin Uyu Wahyudin Vernonia Yora Saki Vivi Triana Vivi Yulaswati Widanarko, Baiduri Windiarti, Sri Winne Widiantini Winne Widiantini Winny Kirana Hasanah Wiyanti, Zulvi Wulan Sari Rasna Giri Sembiring Yani Sofiani Yeni Rustina Yulaswati, Vivi Yulia Pratiwi Yulia Pratiwi Yull Kurnia Robbi Yull Kurnia Robbi Yuniar, Poppy Yuyun Yuniar Yuyun Yuniar