Endang Sutisna Sulaeman
Faculty of Medicine, Sebelas Maret University

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Effects of Predisposing, Enabling, and Reinforcing Factors on Completeness of Child Immunization in Pamekasan, Madura Nur Jayanti; Endang Sutisna Sulaeman; Ety Poncorini Pamungkasari
Journal of Epidemiology and Public Health Vol. 2 No. 2 (2017)
Publisher : Masters Program in Public Health

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Background: According to WHO Weekly Epidemiological Record, Indonesia ranked fourth the lowest country in immunization coverage after India, Nigeria, and Democratic Republic of Congo. Likewise, Pamekasan District in Madura was one of districs in East Java with the lowest immunization coverage. This study aimed to determine the effects of predisposing, enabling, and reinforcing factors on completeness of child immunization, using PRECEDE and PROCEED model and health belief model.Subjects and Method: This was an observational analytic study with case control design. This study was carried out at 4 community health centers in Pamekasan District, Madura, East Java, in March to April, 2017. A sample of 135 mothers who had infants aged 10 to 12 months were selected for this study by fixed disease sampling. The dependent variable was completeness of immunization use. The independent variables were maternal education, attitude towards immunization, perceived susceptibility, perceived severity, perceived benefit, perceived barrier, self efficacy, family support, and distance to health service. The data were collected by questionnaire and analyzed using path analysis.Results: Perceived barrier (b= -0.5; 95% CI = -1.5 to 0.4; p= 0.255) and distance to health service (b= -1.0; 95% CI= -2.0 to -0.1; p= 0.037) had a negative effect on completeness of immunization. Perceived susceptibility (b= 1.1; 95% CI= 0.2 to 2.0; p= 0.022), perceived severity (b= 1.5; 95% CI= 0.5 to 2.5; p= 0.003), perceived benefit (b= 0.7; 95% CI= -0.1 to 1.6; p= 0.110), and self efficacy (b= 0.6; 95% CI= -0.3 to 1.5; p= 0.193) had a positive effect on completeness of immunization. Perceived susceptibility was affected by maternal education (b= 1.0; 95% CI= 0.3 to 1.7; p= 0.005). Perceived severity was affected by maternal education (b= 0.9; 95% CI= 0.5 to 1.6; p= 0.018) and attitude towards immunization (b= 1.0; 95% CI= 0.3 to 1.8; p= 0.007). Perceived benefit was affected by family support (b= 0.7; 95% CI= -0.1 to 1.4; p= 0.078). Likeliwise, self efficacy was affected by family support (b= 0.6; 95% CI = 0.1 to 1.3; p= 0.134).Conclusion: Perceived barrier and distance to health service have a negative effect on completeness of immunization. Perceived susceptibility, perceived severity, perceived benefit, and self efficacy have a positive effect on completeness of immunization.Keywords: completeness of immunization, PRECEDE and PROCEED model, health belief modelCorrespondence: Nur Jayanti. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: Yanti_nurjayanti13@yahoo.co.id. Mobile: +6282233829768.Journal of Epidemiology and Public Health (2017), 2(2): 106-118https://doi.org/10.26911/jepublichealth.2017.02.02.02
Patient Characteristics, Financing Type, Accreditation Status, and Quality of Health Services at Community Health Center, Surakarta Yeni Tri Utami; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 2 No. 1 (2017)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: An indicator of quality health service is the extent of patient expectation fulfilment. Perceived quality of health services may be influenced by various factors such as patient socio-demographic factors, financing type, and accreditation status. As statistics have shown, the number of patient visits at Surakarta Community Health Center has been decresing for the last few years. This study aimed to determine the associations between patient characteristics, financing type, accreditation status, and the quality of  health services at community health center.Subjects and Method: This was a quantitative study with cross-sectional design. It was conducted at Community Health Center, Surakarta, Central Java, from May to July 2017. A sample of 120 patients were selected for this study from 2 Community Health Centers selected at random from all 17 Community Health Centers existing in Surakarta. The independent variables were patient characteristics, financing type, and accreditation status of the Community Health Centers selected. The dependent variable was quality of health service. The data were collected using a set of questionnaire and  analyzed using multiple logistic regression.Results: Quality of service was negatively associated with patient education (OR = 0.27 ; 95% CI = 0.08 to 0.90; p = 0.033), being employed (OR = 0.15 ; 95% CI= 0.04 to 0.48; p = 0.002), higher patient income (OR = 0.28 ; 95% CI= 0.08 to 0.94; p = 0.039), being insured (OR = 3.06 ; 95% CI= 0.81 to 11.52; p = 0.099), and higher accreditation status of Community Health Care (OR = 2.96 ; 95% CI= 1.03-8.50; p = 0.044).Conclusion: Quality of service at Community Health Care is negatively associated with patient education, being employed, higher patient income, being insured, and higher accreditation status.Keywords: patient characteristic, financing type, accreditation status, quality of servicesCorrespondence: Yeni Tri Utami. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: yenie_03@yahoo.co.id. Mobile: +6285642339053.Journal of Health Policy and Management (2017), 2(1): 79-90https://doi.org/10.26911/thejhpm.2017.02.01.07 
PRECEDE and PROCEED Model on the Determinants of Teacher’s Role in the Provision of Reproductive Health Education for Students with Mild Mental Retardation at School of Disability in Sleman, Yogyakarta Putri Rahmasari; Ismi Dwi Astuti Nurhaeni; Endang Sutisna Sulaeman
Journal of Health Promotion and Behavior Vol. 1 No. 2 (2016)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Access to reproductive health information is lacking among students with mental retardation (MR). Teachers at the School of Disability have potentially important role in improving access to reproductive health information among students with MR. This study aimed to investigate the determinants of teachers role in the provision of reproductive health education for students with mild MR at School of Disability, in Sleman, Yogyakarta.Subjects and Method: This was a qualitative study with phenomenology approach, conducted at School of Disability, Sleman, Yogyakarta. Key informants were selected by purposive sampling (i.e. criterion sampling), consisting 7 teachers of disability school, 5 personnels from the District Office of Education and Sport. PRECEED and PROCEDE model was used as a framework to identify the determinants under study. The data were collected by in-depth interview, observation, and document review. The data were analyzed by Miles and Hubberman method.Results: The seven teachers have shown their good roles in the provision of reproductive health education. Factors that determined teachers role included knowledge, experience, attitude, subjective norms, perceived behavior control, external support, and availibility of resources. Weak perceived behavior control (e.g. perceived teacher’s incompetence) and negative subjective norms (e.g. teaching about reproductive health was considered taboo by the community) of the teachers weakened the teachers role. Lack of educational media, substandard rooms, reproductive health materials that were unintegrated in the curriculum, weakened teachers intention to perform their roles.Conclusion: Teachers at the school of disability in Sleman, Yogyakarta, have shown their good role in the provision of reproductive health education for students with mild MR. Knowledge, experience, attitude, subjective norms, perceived behavior control, external support, and availibility of resources, are important determinants of teachers role in the provision of reproductive health education.Keywords: teachers role, school of disability, mental retardation, studentCorrespondence: Putri Rahmasari. School of Midwifery, ‘Aissyiah University, Yogyakarta. Email: putrialzam@gmail.com.Journal of Health Promotion and Behavior  (2016), 1(2): 109-119https://doi.org/10.26911/thejhpb.2016.01.02.06