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All Journal Jurnal Gizi dan Pangan Jurnal Kebijakan Kesehatan Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Masyarakat Jurnal Riset Kesehatan Jurnal Kebijakan dan Administrasi Publik Amerta Nutrition Jurnal Ilmu Kebidanan (Journal of Midwivery Science) Jurnal Kesehatan Jurnal Sehat Mandiri Jurnal Kesehatan Indonesia Health Sciences and Pharmacy Journal JURNAL ONLINE KEPERAWATAN INDONESIA Jurnal Ilmiah PANNMED (Pharmacist, Analyst, Nurse, Nutrition, Midwivery, Environment, Dentist) Narra J Jurnal Ilmu Kebidanan (Journal of Midwivery Science) Journal of Information Systems for Public Health Berita Kedokteran Masyarakat Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) Al Gizzai: Public Health Nutrition Journal Indonesian Journal of Community Development JKAP (Jurnal Kebijakan dan Administrasi Publik) Media Penelitian dan Pengembangan Kesehatan

Mubasysyir Hasanbasri

Departemen Biostatistik, Epidemiologi, Dan Kesehatan Populasi, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan Universitas Gadjah Mada

Author-ID : 277914

Arts Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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PELATIHAN SEPERTI APA YANG DAPAT MENDUKUNG IMPLEMENTASI KEBIJAKAN: PERSPEKTIF PESERTA - EVALUASI TRAINING MANAJER MID LEVEL UNTUK IMUNISASI DI KOTA BANDA ACEH Mubasysyir Hasanbasri, Alfian R Munthe Hari Kusnanto
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 01 (2013)
Publisher : Jurnal Kebijakan Kesehatan Indonesia

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Background: Training is an effort to develop knowledge andskills and change attitudes through learning experiences toachieve effective perfomance in an activity or range ofactivities. Tsunami disaster on December, 26th 2004 attackedAceh Province, in 2007-2009, the Ministry of Health incollaboration with UNICEF/PATH conducted mid levelmanagement training on immunization in Aceh Province withthe main objective to improve performance of health workerswho served as manager in implementing the policy of nationalprogram on immunization service at the provincial level, district/city and clinic.Research: This is a case study design using descriptivequalitative and quantitative analysis. The unit of analysis is themanagers of the immunization in District Health Office and inthe health centres that have been trained in Banda Aceh. Themethods of data collection are brainstorming, in-depthinterviews, focus group discussions, reports and documents,and assesment.Result: Immunization managers have a good knowledge ofmanagement and type of the vaccine, vaccine logistics, placeand schedule of vaccinations. The number of cases ofdiseases preventable by immunization have decreased andresults coverage of routine immunization has been increasingafter mid-level management training.Conclusion: Trainees have a positive reaction to training,results of immunization coverage and knowledge wereincreased and behavioral change occured.Keywords: Evaluation, Training Mid Level Management,Immunization.

KEBIJAKAN PEMERINTAH DAERAH DALAM MENINGKATKAN SISTEM RUJUKAN KESEHATAN DAERAH KEPULAUAN DI KABUPATEN LINGGA PROVINSI KEPULAUAN RIAU Lutfan Lazuardi, Ignasius Luti, Mubasysyir Hasanbasri,
Jurnal Kebijakan Kesehatan Indonesia Vol 1, No 01 (2012)
Publisher : Jurnal Kebijakan Kesehatan Indonesia

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Ignasius Luti1, Mubasysyir Hasanbasri2, Lutfan Lazuardi21 Dinas Kesehatan Kabupaten Lingga, Kepulauan Riau2 Program Studi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran,Universitas Gadjah Mada, YogyakartaABSRACTBackground: One of the critical issues in the development ofnational health care is the limited accessibility to health services.Such problems also occur in Linga District of KepulauanRiau Province. It is caused by many factors, such as geographicallocation, cost, number of health personnel and conditionof health care facilities, such as health centers and theirnetworks which are not accessible to the public. Several attemptshave been made, for example, by improving the statusof sub-health centers to be health centers, health centers tobe treatment centers, assinging health workers both medicaland paramedical, improving health financing and making budgetpolicies. However, its implementation has not been maximal.In accordance with the above background, it would requirea study on the role of local government policy in improvingthe referral system which is useful to know the problemsin the field, so that in the future a variety of improvement canbe done.Objective: To determine the referral system in the islandsarea of Linga District.Methods: This was a case-study research. The researchsubjects were head of health centers / health center doctors,nurses/midwife assistants, ambulance drivers/sea ambulancedrivers, patient families, community figures, jamkesmas/Jamkesda managers, head of health care section/head ofhealth office, director of local hospital/mobile hospital and emergencyroom nurses. The variables in this study were independentvariable (referral system) and dependent variable (ambulanceservice). The research location was in Linga Districtof Kepualauan Riau Province.Results: The results showed that policy efforts of the LingaGovernment District in improving the referral system had existed.The existing financing policy had encompassed twoaspects both from the demand side (medical expenses) andfrom the supply side (a system that supported health care).The process of referral from primary care to advanced serviceshad been going well although there was still lack as theunavailability and completeness of services. Most of the healthworkers had received training; there were also specialist doctors(in collaboration with the faculty of medicine), but networkingin the referral process was done partially and notintegrated.Conclusion: The health referral system in Linga District hadrun pretty well, but did not fully involve community participationin an integrated service system. The local government in thiscase Linga District Health Office needs to revitalize as well asaccelerate the development of Desa Siaga (alert villages) readinessto increase community participation in the developmentof a referral system.Keywords: policy, referral systems, islands, ambulance service

ANALISIS UNTUK PENERAPAN KEBIJAKAN: ANALISIS STAKEHOLDER DALAM KEBIJAKAN PROGRAM KESEHATAN IBU DAN ANAK DI KABUPATEN KEPAHIANG Lutfan Lazuardi, Iswarno Mubasysyir Hasanbasri2
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 02 (2013)
Publisher : Jurnal Kebijakan Kesehatan Indonesia

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Background: Maternal, neonatal and child health (MNCH)program is a national priority programs in health development.In 2006 the Ministry of Health to provides the largest budgetallocation to the KIA programs. This policy was taken in orderto accelerate the decline in maternal mortality and infant throughthe implementation of the making pregnancy safer strategy(MPS) with focus on some activities that are considered to becost effective. MNCH sustainability of the program dependson political commitment and support from stakeholders in theregion. Therefore, stakeholder analysis is important for theimplementation of policy to support the MNCH program.Objectives:Assessing the political commitment of the localgovernment to MNCH program in Kepahiang Regency.Methods: This research is a descriptive, qualitative designwith a case study. Unit of analysis is a research MNCH programstakeholder. How do the data with the brainstorming, depthinterviews, reports and documents, and direct observation.Results: Political commitment of the local government tomaternal, neonatal and child health program is still low, this isevidenced by the lack of budget allocation maternal, neonataland child health program. Essentially all stakeholders agreeand support the program. The involvement of local stakeholdersin the process of planning and budgeting programs is still lacking.Coordination among health agencies with key stakeholders inthe planning and budgeting also are not running well, so oftenthere are differencesin understanding the program. Besidesthe quality planning activities are still considered low, and thereis still weak advocacy capacity of health district office.Conclusion: The small budget allocation for the programshows the commitment to maternal, neonatal and child healthprogram of the local government is still low. This problem wasmore due to the quality of the program planning (design) that isnot well-developed. Also the role and involvement ofstakeholders in the planning process is still lacking.Keywords: Stakeholder, MNCH policy

EVALUASI KEBIJAKAN PEMBANGUNAN PUSKESMAS PEMBANTU DI PROPINSI KALIMANTAN TENGAH Deni Kurniadi Sunjaya, Kus Winarno Mubasysyir Hasanbasri
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 02 (2013)
Publisher : Jurnal Kebijakan Kesehatan Indonesia

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Background: The objective of health development is improvingcommunity health status through increasing public access tohealth services. One of strategy is by supporting facilities forhealth service by developing auxiliary health center for allremote district at Central Kalimantan Province. CentralKalimantan Province with 1,9 million of population, consistedof 14 district, 1348 villages, 805 auxiliary health center. It meansthat only 59% village have facilities for health service such asauxiliary health center.Objectives: This research aimed to know how formulationprocess and implementation of policy of developing auxiliaryhealth center by using provincial funds.Method: It was descriptive case study using mainly methodqualitative designed by semi structured in-depth interview anddocument study. Research subject is stakeholder at levelprovince and chosen district. This research executed inProvince Public Health Service of Central Kalimantan and onechosen district.Result: Development of secondary health center in CentralKalimantan Province is the realization of Central KalimantanProvince local decree number 12 and 13 year 2005 fulfilmenton RPJPD and RPJMD. Initially, the budgeting concept wasplanned by Tugas Pembantuan mechanism, but this mechanismwas not agreed. This scheme was a top down program fromprovince government. Problems occurred in the implementationare 1). Bad monitoring, 2). Lack of reporting by developer, 3).Remote location of, 4). Varieties in cost of production, 5).Shortage health care workforce, 6). Equipments unmatchedthe need of health care provider. Evaluation is executed, butonly concerning physical progress problem. In the meantime,there was increased allocation of DAK fund in each district.Conclusion: Development of auxiliary health center in CentralKalimantan Province which funded by province fund, is notrequired by district. There was no agenda surroundingdevelopment of auxiliary health center. The role of stakeholderin compilation of agenda setting for this policy was only anormative role.Keyword. Auxiliary health center policy, evaluation,decentralization, central Kalimantan

PELAKSANAAN KEBIJAKAN OBAT GENERIK DI APOTEK KABUPATEN PELALAWAN PROVINSI RIAU Nunung Priyatni, Aini Suryani Mubasysyir Hasanbasri
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 02 (2013)
Publisher : Jurnal Kebijakan Kesehatan Indonesia

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Background: Medicine is an integral part of community healthservice. Therefore it must be available in sufficient quantity,types and adeqaute quality, properly distributed and accessiblefor community when its needed. In order to meet thecommunityâs need for medicine and to guarantee medicineaccessibility, the government released generic medicine policy.Although the price of the generic medicine has already beenset up and fixed by government, there are variety of the pricestill can be found on implementation of the generic medicinesold in the pharmacy store or in the market, and can causeprice uncertainty for community in finding medicine they need.That is why a research needs to be conduct towardimplementation of the generic medicine price policy on thedistribution channel especially at the pharmacy store.onPelalawan District in Riau Province.Method: This research is non experimental/observationalresearch with qualitative and quantitative method using crosssectional design, data analyzed descriptively.Result: Research result indicates that access to genericmedicine at pharmacy store for available medicine are 99,3%,for un available medicine are 0,7% and for replaced medicineare 0,5%. Average availability of the medicine at the pharmacystore are 4-7,3 months. Highest availability rate for medicine isHidrocortison cream 2,5% for 7,3 months and the lowest isPirazinamid tablet 500 mg for 4 months. Pharmacy store thathave an expired medicine are PR (0,7%) and KH (2%). Everypharmacy store have no damaged medicine, 0% percentage.Almost all pharmacy store experiencing out of supply formedicine between 4 to 90 days. Price of the medicine soldaveragely increasing from its pharmacy store Highest RetailPrice (HRP). But there are several medicine that sold under theHRP The highest price medicine that are sold higher than itsHRP is Clorfeniramin Maleat (CTM) tablet by 515,4% increaseand Dexametason tablet is the lowest price sold under HRP by65,2%. Even so they are Alopurinol, Digoksin, and Ranitidin.From in depth interviews with patients, can be learn that theyhave a purchase ability for generic medicine.Conclusion: Implementation of generic drug price on Pelalawandistrict is good. It can be seen from generic medicine accessby community that are high after the release of regulation fromHealth Department of Republic Indonesia, the level of availabilityof generic medicine on pharmacy store at Pelalawan Districtare low but there are no expired or damaged medicine. Theprice of generic medicine at Pelalawan District are variable butthe community still can afford to buy them.Keyword: Generic medicine, availability and affordability.

EVALUASI IMPLEMENTASI KEBIJAKAN PERSALINAN BAGI MASYARAKAT MISKIN OLEH BIDAN PRAKTEK SWASTA DI KOTA TANJUNGPINANG Mubasysyir Hasanbasri, Elfrida Tambun
Jurnal Kebijakan Kesehatan Indonesia Vol 2, No 02 (2013)
Publisher : Jurnal Kebijakan Kesehatan Indonesia

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Background: Economy factor is one of the factors that couldhampered communityâs access in the utilization of health service.To guarantee effort of poor community access towardhealth service, the government was conducted managed program.The limitation of working hours in primary health carewas causing limited service hours. Therefore, in order to solvethe problem, the government stated that private midwife practiceas one of the health services could be utilized by poorcommunity with budget that was covered by government. Thegovernmentâs policy has not yet able to improve the coverageof delivery attendant by health care provider. Hence, an evaluationto find out the phenomenon occurred in the community isnecessary to solve this problem in order to improve the healthservice in the future.Objective : This research was aimed to find out the descriptionof delivery care for poor community by private midwife inTanjungpinang Municipality.Method: This was a descriptive research that used qualitativeapproach with case study design. The research subjectwas civil servant midwife who had midwifery private practice,head of primary health care, head of health office, headof family health division, and mothers who delivered and hadaskeskin (health insurance for poor community) card. Theselection for midwife and mothers who delivered was usingpurposive sampling technique. Furthermore, the data wascollected by using primary data that was obtained from indepthinterview result that used interview guidance, while the secondarydata was obtained from document observation, andthe data will be analysed qualitatively.Result: The policy of delivery for poor community inTanjungpinang Municipality has not yet obtained optimalsupport.The limited bugdet availability affected in a way thatnot all of the midwives were willing to assist askeskin patientwith cost claim to primary health care. Private practice midwifeasked for fee from askeskin patient. There was no differencethe treatment given between askeskin patient and private/paying patient. However, askeskin patient was satisfiedwith the service given by private practice midwife.Conclusion: The implementation of delivery policy for poorcommunity by private practice midwife has not yet optimal asthere was a lack of support from municipality government,administratively or financially.Keyword: Evaluation, policy implementation, private midwifepractice and poor community

Memperkokoh Posisi Departemen Kesehatan dalam Sektor Kesehatan Publik Hasanbasri, Mubasysyir
JKAP (Jurnal Kebijakan dan Administrasi Publik) 1999: JKAP VOLUME 3 NOMOR 1, TAHUN 1999
Publisher : Magister Administrasi Publik (MAP) FISIPOL Universitas Gadjah Mada

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There have been many dissappointed tendencies that health services are currently biased to the more wealthy groups in the society. Corporatisms, competitions, and the emanation of more profit-oriented health institutions have put aside the public health service for the poor. Unfortunately, even the Department of Health have failed to stand for its fundamental functions in maintaining the public health and protecting the unfortunate people. The Department have been unable to respond the competitive environment and prevent the brain drain of qualified doctors from the public hospitals to the private institutions. It is suggested that the Department of Health should reorient its mission and tasks by applying strategic management approach. This new approach should also be accompanied with stronger external control of the public through the parliament and other pressure group; in the society. The author points out the importance of two elements of the society which would be effective as the control: 1) the researchers, who should be more assertive in contending the inequality of public health services; and 2) the NGO activists, who should be more sensitive and susceptible to various issues in public health. Finally, it is very important that the Department of Health has to comply with the public accountability so that their programmes would be more focused on objective issues of public health.

Village based information display of health facility data and public awareness of Dengue Hemorrhagic Fever: a lesson from Mlati Primary Health Care Center of Yogyakarta Province Setyaningrum, Veronika Evita; Purwandari, Ari; Sudiyo, Sudiyo; Hasanbasri, Mubasysyir
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Public health agencies concern about the disease contraction processes at the population level. Early detection and prompt treatment can be made to prevent transmission in the earliest stage. Understanding that their areas are endemic to DHF and the fact that cases continue to occur from year to year, community and public health stakeholders have a reduced motivation to take actions to have precaution to dengue. The village community will not be aware of the problems until patients from their areas visit health facility. The goal of this paper is to illustrate health center initiative to raise DHF precaution through village based spatial data display of dengue for the villagers attention in raising agenda in the management of dengue hemorrhagic fever at the level where they live. The paper points out the success story of the team of health facility manager, active public health program managers, an information technology literate administrators, and participation of local and private health workers asking DHF suspects to have their blood test in the health center. Supporting staff with health informatics training background has been able to work together with laboratory workers. The laboratory workers input the computer application that translate patient thrombocyte count data into village based geographic-spatial display. These data provide quick evidence about what is happening in the population. Puskesmas manager has the MPH training with population health perspective and the moral of public health problem solving. By having this data, she could make the health promotion actions at the population level. This paper shows the ability of health center manager to link health facility data and the population level evidence for public health action. The data can be used to trigger community be aware of DHF and to raise agenda in the prevention of local diseases. This is an easy and feasible things to do. Primary care and public health are under the common responsibility of the puskesmas managers. It is clear that data of health facility serve as the warning system of disease contracting process at the population level and the promotion of simple evidence to push community to get involved in prevention activities.

Kesehatan Reproduksi Remaja Djama, Nuzliati Tahir
Jurnal Kesehatan Poltekkes Ternate Vol 10 No 1 (2017): Jurnal Kesehatan Poltekkes Ternate, Bulan Mei 2017
Publisher : UPPM Politeknik Kesehatan Kemenkes Ternate, Maluku Utara, Indonesia

Seksualitas dan kesehatan reproduksi remaja didefinisikan sebagai keadaan sejahtera fisik dan psikis seorang remaja, termasuk keadaan terbebas dari kehamilan yang tak dikehendaki, aborsi yang tidak aman, penyakit menular seksual (PMS) ter-masuk HIV/AIDS, serta semua bentuk kekerasan dan pemaksaan seksual (FCI, 2000). Masa remaja adalah masa transisi antara masa kanak-kanak dengan dewasa dan relatif belum mencapai tahap kematangan mental dan sosial sehingga mereka harus menghadapi tekanan-tekanan emosi dan sosial yang saling bertentangan. Banyak sekali life events yang akan terjadi yang tidak saja akan menentukan kehidupan masa dewasa tetapi juga kualitas hidup generasi berikutnya sehingga menempatkan masa ini sebagai masa kritis. Di negera-negara berkembang masa transisi ini berlangsung sangat cepat. Bahkan usia saat berhubungan seks pertama ternyata selalu lebih muda daripada usia ideal menikah (Kiragu, 1995:10, dikutip dari Iskandar, 1997). Pengaruh informasi global (paparan media audio-visual) yang semakin mudah diakses justru memancing anak dan remaja untuk mengadaptasi kebiasaan-kebiaasaan tidak sehat seperti merokok, minum minuman berakohol, penyalahgunaan obat dan suntikan terlarang, perkelahian antar-remaja atau tawuran (Iskandar, 1997). Pada akhirnya, secara kumulatif kebiasaan-kebiasaan tersebut akan mempercepat usia awal seksual aktif serta mengantarkan mereka pada kebiasaan berperilaku seksual yang berisiko tinggi, karena kebanyakan remaja tidak memiliki pengetahuan yang akurat mengenai kesehatan reproduksi dan seksualitas serta tidak memiliki akses terhadap informasi dan pelayanan kesehatan reproduksi, termasuk kontrasepsi. Kebutuhan dan jenis risiko kesehatanreproduksi yang dihadapi remaja mempunyai ciri yang berbeda dari anak-anak ataupun orang dewasa. Jenis risiko kesehatan reproduksi yang harus dihadapi remaja antara lain adalah kehamilan, aborsi, penyakit menular seksual (PMS), ke-kerasan seksual, serta masalah keterbatasan akses terhadap informasi dan pelayanan kesehatan. Risiko ini dipe-ngaruhi oleh berbagai faktor yang saling berhubungan, yaitu tuntutan untuk kawin muda dan hubungan seksual, akses terhadap pendidikan dan pekerjaan, ketidaksetaraan jender, kekerasan seksual dan pengaruh media massa maupun gaya hidup. Khusus bagi remaja putri, mereka kekurangan informasi dasar mengenai keterampilan menegosiasikan hubungan seksual dengan pasangannya. Mereka juga memiliki kesempatan yang lebih kecil untuk mendapatkan pendidikan formal dan pekerjaan yang pada akhirnya akan mempengaruhi kemampuan pengambilan keputusan dan pemberdayaan mereka untuk menunda perkawinan dan kehamilan serta mencegah kehamilan yang tidak dikehendaki (FCI, 2000). Bahkan pada remaja putri di pedesaan, haid pertama biasanya akan segera diikuti dengan perkawinan yang menempatkan mereka padarisiko kehamilan dan persalinan dini (Hanum, 1997:2-3). Kadangkala pencetus perilaku atau kebiasaan tidak sehat pada remaja justru adalah akibat ketidak-harmonisan hubungan ayah-ibu, sikap orangtua yang menabukan pertanyaan anak/remaja tentang fungsi/proses reproduksi dan penyebab rangsangan seksualitas (libido), serta frekuensi tindak kekerasan anak (child physical abuse). Mereka cenderung merasa risih dan tidak mampu untuk memberikan informasi yang memadai mengenai alat reproduksi dan proses reproduksi tersebut. Karenanya, mudah timbul rasa takut di kalangan orangtua dan guru, bahwa pendidikan yang menyentuh isu perkembangan organ reproduksi dan fungsinya justru malah mendorong remaja untuk melakukan hubungan seks pranikah (Iskandar, 1997). Kondisi lingkungan sekolah, pengaruh teman, ketidaksiapan guru untuk memberikan pendidikan kesehatan reproduksi, dan kondisi tindak kekerasan sekitar rumah tempat tinggal juga berpengaruh (O’Keefe, 1997: 368-376). Remaja yang tidak mempu-nyai tempat tinggal tetap dan tidak mendapatkan perlin-dungan dan kasih sayang orang tua, memiliki lebih banyak lagi faktor-faktor yang berkontribusi, seperti: rasa kekuatiran dan ketakutan yang terus menerus, paparan ancaman sesama remaja jalanan, pemerasan, penganiayaan serta tindak kekerasan lainnya, pelecehan seksual dan perkosaan (Kipke et al., 1997:360-367). Para remaja ini berisiko terpapar pengaruh lingkungan yang tidak sehat, termasuk penyalahgunaan obat, minuman beralkohol, tindakan kriminalitas, serta prostitusi (Iskandar, 1997). Pilihan dan keputusan yang diambil seorang remaja sangat tergantung kepada kualitas dan kuantitas informasi yang mereka miliki, serta ketersediaan pelayanan dan kebijakan yang spesifik untuk mereka, baik formal maupun informal (Pachauri, 1997). Sebagai langkah awal pencegahan, peningkatan pengetahuan remaja mengenai kesehatan reproduksi harus ditunjang dengan materi komunikasi, informasi dan edukasi (KIE) yang tegas tentang penyebab dan konsekuensi perilaku seksual, apa yang harus dilakukan dan dilengkapi dengan informasi mengenai saranan pelayanan yang bersedia menolong seandainya telah terjadi kehamilan yang tidak diinginkan atau tertular ISR/PMS. Hingga saat ini, informasi tentang kesehatan reproduksi disebarluaskan dengan pesan-pesan yang samar dan tidak fokus, terutama bila mengarah pada perilaku seksual (Iskandar, 1997). Di segi pelayanan kesehatan, pelayanan Kesehatan Ibu dan Anak serta Keluarga Berencana di Indonesia hanya dirancang untuk perempuan yang telah menikah, tidak untuk remaja. Petugas kesehatan pun belum dibekali dengan kete-rampilan untuk melayani kebutuhan kesehatan reproduksi para remaja (Iskandar, 1997). Jumlah fasilitas kesehatan reproduksi yang menyeluruh untuk remaja sangat terbatas. Kalaupun ada, pemanfaatannya relatif terbatas pada remaja dengan masalah kehamilan atau persalinan tidak direncanakan. Keprihatinan akan jaminan kerahasiaan (privacy) atau kemampuan membayar, dan kenyataan atau persepsi remaja terhadap sikap tidak senang yang ditunjukkan oleh pihak petugas kesehatan, semakin membatasi akses pelayanan lebih jauh, meski pelayanan itu ada. Di samping itu, terdapat pula hambatan legal yang berkaitan dengan pemberian pelayanan dan informasi kepada kelompok remaja (Outlook, 2000). Karena kondisinya, remaja merupakan kelompok sasaran pelayanan yang mengutamakan privacy dan confidentiality (Senderowitz, 1997a:10). Hal ini menjadi penyulit, mengingat sistem pelayanan kesehatan dasar di Indonesia masih belum menempatkan kedua hal ini sebagai prioritas dalam upaya perbaikan kualitas pelayanan yang berorientasi pada klien. Sebuah survei terbaru terhadap 8084 remaja laki-laki dan remaja putri usia 15-24 tahun di 20 kabupaten pada empat propinsi (Jawa Barat, Jawa Tengah, Jawa Timur dan Lampung) menemukan 46,2% remaja masih menganggap bahwa perempuan tidak akan hamil hanya dengan sekali melakukan hubungan seks. Kesalahan persepsi ini sebagian besar diyakini oleh remaja laki-laki (49,7%) dibandingkan pada remaja putri (42,3%) (LDFEUI & NFPCB, 1999a:92). Dari survei yang sama juga didapatkan bahwa hanya 19,2% remaja yang menyadari peningkatan risiko untuk tertular PMS bila memiliki pasangan seksual lebih dari satu. 51% mengira bahwa mereka akan berisiko tertular HIV hanya bila berhubungan seks dengan pekerja seks komersial (PSK) (LDFEUI & NFPCB, 1999b:14). Remaja seringkali merasa tidak nyaman atau tabu untuk membicarakan masalah seksualitas dan kesehatan reproduksinya. Akan tetapi karena faktor keingintahuannya mereka akan berusaha untuk mendapatkan informasi ini. Seringkali remaja merasa bahwa orang tuanya menolak membicarakan masalah seks sehingga mereka kemudian mencari alternatif sumber informasi lain seperti teman atau media massa. Kebanyak orang tua memang tidak termotivasi untuk memberikan informasi mengenai seks dan kesehatan reproduksi kepada remaja sebab mereka takut hal itu justru akan meningkatkan terjadinya hubungan seks pra-nikah. Padahal, anak yang mendapatkan pendidikan seks dari orang tua atau sekolah cenderung berperilaku seks yang lebih baik daripada anak yang mendapatkannya dari orang lain (Hurlock, 1972 dikutip dari Iskandar, 1997). Keengganan para orang tua untuk memberikan informasi kesehatan reproduksi dan seksualitas juga disebabkan oleh rasa rendah diri karena rendahnya pengetahuan mereka mengenai kesehatan reproduksi (pendidikan seks). Hasil pre-test materi dasar Reproduksi Sehat Anak dan Remaja (RSAR) di Jakarta Timur (perkotaan) dan Lembang (pedesaan) menunjukkan bahwa apabila orang tua merasa meiliki pengetahuan yang cukup mendalam tentang kesehatan reproduksi, mereka lebih yakin dan tidak merasa canggung untuk membicarakan topik yang berhubungan dengan masalah seks (Iskandar, 1997:3). Hambatan utama adalah justru bagaimana mengatasi pandangan bahwa segala sesuatu yang berbau seks adalah tabu untuk dibicarakan oleh orang yang belum menikah (Iskandar, 1997:1). Responden survei remaja di empat propinsi yang dilakukan pada tahun 1998 memperlihatkan sikap yang sedikit berbeda dalam memandang hubungan seks di luar nikah. Ada 2,2% responden setuju apabila laki-laki berhubungan seks sebelum menikah. Angka ini menurun menjadi 1% bila ditanya sikap mereka terhadap perempuan yang berhubungan seks sebelum menikah. Jika hubungan seks dilakukan oleh dua orang yang saling mencintai, maka responden yang setuju menjadi 8,6%. Jika mereka berencana untuk menikah, responden yang setuju kembali bertambah menjadi 12,5% (LDFEUI & NFPCB, 1999a:96-97). Sebuah studi yang dilakukan LDFEUI di 13 propinsi di Indonesia (Hatmadji dan Rochani, 1993) menemukan bahwa sebagian besar responden setuju bahwa pengetahuan mengenai kontrasepsi sudah harus dimiliki sebelum menikah. Survei remaja di empat propinsi kembali melaporkan bahwa ada 2,9% remaja yang telah seksual aktif. Persentase remaja yang telah mempraktikkan seks pra-nikah terdiri dari 3,4% remaja putra dan 2,3% remaja putri (LDFEUI & NFPCB, 1999:101). Sebuah survei terhadap pelajar SMU di Manado, melaporkan persentase yang lebih tinggi, yaitu 20% pada remaja putra dan 6% pada remaja putri (Utomo, dkk., 1998). Sebuah studi di Bali menemukan bahwa 4,4% remaja putri di perkotaan telah seksual aktif. Studi di Jawa Barat menemukan perbedaan antara remaja putri di perkotaan dan pedesaan yang telah seksual aktif yaitu berturut-turut 1,3% dan 1,4% (Kristanti & Depkes, 1996: Tabel 8b). Sebuah studi kualitatif di perkotaan Banjarmasin dan pedesaan Mandiair melaporkan bahwa interval 8-10 tahun adalah rata-rata jarak antara usia pertama kali berhubungan seks dan usia pada saat menikah pada remaja putra, sedangkan pada remaja putri interval tersebut adalah 4-6 tahun (Saifuddin dkk, 1997:78). Tentu saja angka-angka tersebut belum tentu menggambarkan kejadian yang sebenarnya, mengingat masalah seksualitas termasuk masalah sensitif sehingga tidak setiap orang bersedia mengungkapkan keadaan yang sebenarnya. Oleh karena itu, tidaklah mengejutkan apabila angka sebenarnya jauh lebih besar daripada yang dilaporkan.

FAKTOR-FAKTOR YANG MEMPENGARUHI KEJADIAN ABORTUS INKOMPLETUS DI RSUD DR. H. CHASAN BOESOIRIE TERNATE TAHUN 2014 Djama, Nuzliati T
Jurnal Kesehatan Poltekkes Ternate Vol 8 No 01 (2015): Jurnal Kesehatan Poltekkes Ternate, November 2015
Publisher : UPPM Politeknik Kesehatan Kemenkes Ternate, Maluku Utara, Indonesia

Abstract : Abortus inkompletus is bleeding in early pregnancy where most of the products of conception have been out of the uterine cavity through the cervical canal it can be fatal to the mother such as bleeding, perforation, infection, and shock. This study aims to get a picture of maternal age, parity, education, history of abortus and marital status on the incidence of abortus inkompletus in hospitals Dr. H. Chasan Boesoeirie Ternate in 2014. Method this research is descriptive. The population in this study were 101 people and samples in this study were all women who had been treated with a diagnosis of miscarriage incompletus period January to August 2014. The data used are secondary data obtained from the hospital medical record Dr.H. Chasan Boesoirie Ternate. From the results, the incidence of abortus inkompletus much as 101 cases in 2014. Inkompletus most abortus cases were found at the age of 20-35 years by 74 cases (73,3%), parity 2-4 kids (49,5%), high school education or equivalent total of 64 cases (63,4%), not having abotus history (80,2%) and married status (84,2%). Looking at the data it will need the participation of various stakeholders from health, the family and the general public to prevent the factors that cause the incidence of abortus, such as counseling by health workers about the danger signs of pregnancy, the mother will need to plan and prepare for pregnancy by using contraception so as to regulate the child's birth and change mindsets through education must be made either through the school or outside the school on reproductive health so that they can establish a rational and personal responsibility, especially for the younger generation.

Co-Authors A Tudiono A.A. Ketut Agung Cahyawan W Abdullah, Fadila Achmad Nursyandi Affan, Auf Ahmad Watsiq Maula Ahmad Zacky Anwary Aini Suryani Alfian R Munthe Alvi Purwati Andina Vita Sutanto Andina Vita Sutanto Andri Satriadi Firmana Aphrodite Nadya Nurlita Arjuna, Tony Aulawi Aulawi Azis Bustari Bagian PKMK, Fakultas Kedokteran UGM Bagian Prodi Kesehatan Masyarakat, FKM UNISKA Bagian Prodi S2 Ilmu Kesehatan Masyarakat, Fakultas Kedokteran UGM Bambang Hastha Yoga Batubara, Irwan Bayu, Yoni Setyo Nugroho BSA, Amira Candra Candra Christantie Effendy Christina Pernatun Kismoyo Citra Widya Kusuma Darwito, Darwito Deni Kurniadi Sunjaya Detty S. Nurdiati DEWI HERAWATI Dian Mawarni Djaswadi Dasuki Djoko Mardijanto Djonny Sinaga Eko Nugroho Eko Nugroho Eko Sriyanto Elfrida Tambun Emy Huriyati Ester Febe Eva Rusdianah Fahri, Kharis Vidi Faisal Mansur Fauziah, Saidatul Febria Rahmi Fitriani Mediastuti Ghani Ikhsan Majid Ghosyasi, Arfiny Guardian Yoki Sanjaya Gufria D.Irasanty Hamdiah, Irma Hari Kusnanto Hari Kusnanto Hari Kusnanto Hariawan, Muhammad Hafizh Heri Priyatmoko Hieronimous Amandus Ignasius Luti Inriyani Takesan Isak Iskandar Radja Ishak SKM., MPH Isnaini Putri Iswarno Iswarno Jairani, Eka Nenni Jati Untari Jumarko Jumarko Juraidin JURAIDIN JURAIDIN JURAIDIN krisnawati, arini Kus Winarno Laksono Trisnantoro Lely Lusmilasari, Lely Lisma Evareny, Mohammad Hakimi, Retna Siwi Padmawati Lucia Sri Rejeki Lussy Messiana Gustantini Lussy Messiana Gustantini, Lussy Messiana Lutfan Lazuardi Lutfan Lazuardi Lutfan Lazuardi Lutfan Lazuardi Lutfan Lazuardi Maria Wigati Marnaza Yusman Mohamad Hakimi Mohammad Hakimi Mohammad Hakimi Mohammad Hakimi Mohammad Hakimi Monica Dara Delia Suja Musa Musa Mustofa Mustofa Nana Diana Nina Rahmadiliyani Ningrum, Ema W. Nisa, Syifa Nisa Novi Inriyanny Suwendro Noviana Nur Sari Nunung Priyatni Ova Emilia Pandawa, Rugaya Pandawa, Rugaya Munawar Pratiningsih, Widya Ayu Priyatni, Nunung Purwandari, Ari Retno Heru Riris Andono Ahmad Riska Novriana Rofiatun Rofiatun Rofiatun Rofiatun Rofiatun, Rofiatun Rossi Sanusi Said Muntahaza Setyaningrum, Vernika Evita Setyaningrum, Veronika Evita Shofan Ardianto Siti Helmyati Siti Suryati Siwi Padmawati, Retna Sri Surahmiyati Sri Wiyanti Sudiyo, Sudiyo Suka, Veronika Sulistyo, Dwi Handono Supriyati Susi Irawati Syamsinar Tiara Marthias Titik Nuryastuti Tri Wahyudi Tri Wibawa Upiek Sumanti Utami Putri Kinayungan Vena Jaladara Veronika Evita Setianingrum Veronika Suka Vicka Oktaria Wahyudi Wahyudi Wahyudi Wahyudi Widodo Wirawan Yayuk Hartriyanti Yodi Mahendradata Yuliastuti Saripawan Yundari, Yundari Zahra Anggita Pratiwi Zul Afril

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