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All Journal Archive of Community Health E-Jurnal Medika Udayana Media Kesehatan Masyarakat Indonesia ODONTO Dental Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran Public Health and Preventive Medicine Archive Odonto dental journal
Komang Ayu Kartika Sari
Bagian Ilmu Kedokteran Komunitas Dan Ilmu Kedokteran Pencegahan Fakultas Kedokteran Universitas Udayana
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Perceptions of patients and providers on the use of acupressure services at Public Health Centres, Tabanan District, Bali I Made Sukawinaca; Komang Ayu Kartika Sari; I Made Ady Wirawan
Public Health and Preventive Medicine Archive Vol. 5 No. 2 (2017)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2017.v5.i2.p10

Abstract

Background and purpose: Acupressure services are available at some public health centres (PHCs) in Bali, but the service utilisation remains low. The purpose of this study is to explore the perception of patients and service providers on the use of acupressure services at PHC in Tabanan. Methods: This study used a qualitative design based on observation and in-depth interviews with 13 informants consisting of patients, health service practitioners, head of PHC and program manager at Tabanan Health Office. The informants were chosen purposively and the data were analysed thematically. Results: There were different perceptions regarding the benefits of acupressure services between patients utilising the services and those who had not. Patients who had undergone acupressure demonstrated positive perception of the service. Acupressure services are considered to be effective in dealing with patient complaints, have no side effects, and patients reported being satisfied with the services provided by the PHC. Patients who did not utilise acupressure services, view acupressure as an ineffective therapy with potential side effects that may endanger their health. These patients experienced trauma from similar massage techniques. Service providers lamented the absence of government support in the form of local regulations that would enable them to access funding, increase human resources and facilitate promotion of the services. Conclusions: Patient perceptions of acupressure services still vary, with some contraints in the implementation that consist of local regulation, operational fund and human resources. Acupressure services still require synergy between central and local government policies to support its implementation.
Differences in post-placental intra uterine device acceptance with and without couples counseling in private practice midwifery clinics, West Denpasar Putu Ayu Ratna Darmayanti; Dewa Nyoman Wirawan; Komang Ayu Kartika Sari; Mangku Karmaya; Ni Luh Putu Suariyani
Public Health and Preventive Medicine Archive Vol. 6 No. 1 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i1.p02

Abstract

Background and purpose: The post-placental intra uterine device (IUD) program is one intervention to increase IUD uptake however the acceptance remains low. Contraceptive counseling during pregnancy is expected to increase IUD uptake. The primary objective of this study is to determine the efficacy of counseling by involving the husband in order to improve post-placental IUD uptake. The secondary objective is to compare knowledge and perceptions of IUD before and after intervention. Methods: A randomized controlled trial was conducted with 58 pregnant women at 37-40 weeks’ gestation in three private midwifery clinics in Denpasar, Bali. Subjects were divided into two groups: 29 intervention groups that were given couples counseling and 29 control groups that were given counseling without involving husbands. Base line interview was conducted during enrollment and follow up interview was carried out immediately after delivery. Results: Acceptance of post-placental IUD was found in 21 women (72.41%) in the intervention group and 10 women (34.48%) in the control group (RR=2.2; 95%CI: 1.23-3.84). The mean difference in pretest and post-test scores of knowledge, perceptions of susceptibility and benefits were found to be higher in the intervention group but not statistically significant. The result of multivariate analysis indicated that the variables influencing post-placental IUD acceptance were the child’s gender (AOR=45.9, 95%CI: 4.53-465.25), couples counseling with husband (AOR=17.4, 95%CI: 2.55-119.56) and maternal education (AOR=7.1; 95%CI: 1.17-43.40). Conclusions: Couples counseling was found to increase postplacental IUD uptake. In addition, post-placental IUD acceptance is also influenced by the child’s gender and maternal education levels. To increase uptake of post-placental IUDs there is a need for upscalling of couples counseling at the time of antenatal care.
Determinants of long-acting contraceptives use among reproductive-age couples in Tanjung Karang Public Health Centre Mataram City, West Nusa Tenggara Widya Aryati; Dewa Nyoman Wirawan; Komang Ayu Kartika Sari; Anak Agung Sagung Sawitri
Public Health and Preventive Medicine Archive Vol. 6 No. 1 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i1.p03

Abstract

Background and purpose: The national family planning program prioritises the use of long-acting contraceptives which include intrauterine devices (IUD), tubectomy, vasectomy, and implant. However, the coverage of long-acting contraceptives in Indonesia remains low. This study aims to identify the determinants of longacting contraceptives uptake among reproductive-age couples in Tanjung Karang Public Health Centre (PHC) Mataram City. Methods: A cross-sectional study was conducted involving 169 reproductive age couples in Tanjung Karang PHC in 2016. Samples were selected from six sub-villages (dusun) in two villages using systematic random sampling. We selected 85 samples from coastal and 84 samples from non-coastal areas. Data on sociodemographic characteristics, perception, husband support, access to service, and information regarding long-acting contraceptives were collected through home interview. Analysis with logistic regression was applied to determine the factors influencing long-acting contraceptives uptake. Results: The majority of respondents aged 20–35 years-old, and most of them have a lower level of education and knowledge regarding longacting contraceptives. Among all current users, as many as 37.0% use long-acting contraceptive methods. The respondents refused to use long-acting contraceptives due to prohibited by the husband (92.8%) and desire to have more children (38.7%). Multivariate analysis using logistic regression showed that the uptake of long-acting contraceptives was significantly associated with area of residence (noncoastal) with an adjusted odds ratio (AOR)=2.89 (95%CI; 1.39-6.01), employment status with AOR=0.40 (95%CI; 0.18-0.90), income at minimum wages and above with AOR=2.47 (95%CI; 1.16-5.26), and husband support with AOR=2.19 (95%CI; 1.18-3.41). Conclusions: The use of long-acting contraceptives are associated with husband support, living in non-coastal areas, and having a higherincome. Ongoing support from the husband, especially among those who live in coastal areas and from the lower socioeconomic background, is required to improve the coverage of long-acting contraceptives.
Achieving ideal mentoring: working patterns among clinical instructors, nurses, and nursing students Ayu Sugiantari; Komang Ayu Kartika Sari; Pande Putu Januraga
Public Health and Preventive Medicine Archive Vol. 6 No. 1 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i1.p09

Abstract

Background and purpose: The relationships between those responsible for clinical training, clinical instructors (CIs) and nurses, and the nursing students, have a great impact upon student learning during clinical placements. The present study investigates the pattern of working relationships among CIs, nurses, and student nurses, and analyses the extent to which they achieve ideal mentoring practices. Methods: Qualitative study employing in-depth interviews with CIs (n=3), nurses (n=8), and nursing students (n=8) on a clinical placement was undertaken from June-July, 2017, at Badung District Hospital, Denpasar, Bali. Content analysis was conducted to identify the key themes that emerged from these interviews and formed the basis of the findings. The results are presented narratively in order to highlight the patterns of the working relationships identified and perceived by CIs, nurses, and nursing students, with the aim of developing improved mentoring practices. Results: Analysis of the in-depth interviews identified three main themes: (i) perceptions on the hospital’s mentoring practices, (ii) the role(s) and behaviour in the mentoring process, and (iii) the patterns of working relationships between those involved in the mentoring process. In general, participants defined mentoring in terms of the provision of guidance and instruction to students. Participant’s contrasting perceptions of their role(s) affected how they behaved in the mentoring process. Furthermore, participant’s perceptions of their own’s roles and their behaviour provides a detailed overview of the working relationships pattern of the nursing students, nurses and CIs. Specifically, working relationships between CIs and nurses tend to fit an employee-employer type pattern, whereas those between CIs/nurses and nursing students do not appear to reflect typical mentor-mentee relationships. Conclusions: The pattern of working relationships identified between CIs/nurses and nursing students do not, in fact, reflect a typical mentor-mentee relationship. Furthermore, this paper highlights the impact that suboptimal mentoring may have on nursing students’ achievement of medical competence, as well as on the quality of nursing care provided to patients in teaching hospitals.
Why do HIV-positive pregnant women discontinue with comprehensive PMTCT services? A qualitative study Putu Emy Suryanti; Komang Ayu Kartika Sari; Pande Putu Januraga; Dinar Lubis
Public Health and Preventive Medicine Archive Vol. 6 No. 1 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i1.p13

Abstract

Background and purpose: Prevention of mother to child transmission (PMTCT) is a government program aimed at preventing mother-to-child transmission of HIV. A comprehensive PMTCT program involves the implementation of HIV testing up to antiretroviral (ARV) treatment for mothers with positive HIV test results. Coverage of comprehensive PMTCT remains low, with many HIV-positive pregnant women who discontinued ARV treatment. This study aims to explore the reasons of HIV-positive pregnant women to discontinue with the comprehensive PMTCT program. Methods: A qualitative study was carried out in Badung District, Bali Province, with seven respondents: one HIV-positive pregnant woman who did not continue the ARV treatment, two HIV-positive women who gave birth the previous year and did not take ARV, three public health centre (PHC) providers, and one head of PHC. Respondents were selected using a purposive sampling technique. Data were collected through in-depth interviews and analyzed thematically. The results presented narratively to illustrate the reasons why HIV-positive pregnant women discontinued with the comprehensive PMTCT program. Results: The emerging themes related to the reasons of HIVpositive pregnant women discontinued with the comprehensive PMTCT program included the lack of comprehensive PMTCT-related information, the lack of health provider assistance, and the high stigma towards people living with HIV (PLHIV). These barriers were affecting the willingness of HIV-positive pregnant women to continue with the program. Conclusions: Lack of comprehensive PMTCT-related information, lack of assistance by health care providers, and high public stigma impacts upon HIV-positive pregnant women’s willingness to continue with comprehensive PMTCT program. There is a need for a minimum service standard in the implementation of comprehensive PMTCT services and comprehensive information on HIV infection in order to reduce the stigma towards PLHIV.
Barriers to mental health services at public health centers: Providers’ perspectives Putu Aryani; Pande Putu Januraga; Komang Ayu Kartika Sari; Lisanne Gerstel; Willem F Scholte
Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i1.p13

Abstract

Background and purpose: The disparity between the increasing prevalence of mental health (MH) illness and the availability of treatment in Indonesia remains high, despite the campaign to provide MH services at public health centers (PHCs) initiated by the government in 2014. This study explored barriers to MH service provision at PHCs in Denpasar, Bali, Indonesia in order to identify priorities for service improvement. Methods: This explorative qualitative study was conducted from March to December 2015 and employed in-depth interviews and focus group discussions (FGDs). In-depth interviews were conducted with the Head of Denpasar City Health Office and with general practitioners (GPs) from four PHCs in Denpasar, to explore the perspective of policy and service management and experiences in PHC clinics, respectively. To further explore MH service implementation in the community, two FGDs were conducted with MH program managers and community health workers (CHWs). The interviews and FGDs were recorded, and verbatim transcripts were analyzed using thematic framework analysis. Results: Barriers to MH service provision identified in our study are poor dissemination of the national policy to the local government and PHCs; low prioritization of MH issues; organization workforce issues; funding concerns; poor coordination and supervision; poor management and recording system; scarcity of ancillary facilities and other resources such as psychotropic medicines. Conclusion: The findings of this study highlight the importance of national policy dissemination and collaboration between local government, health providers and CHWs to overcome the barriers in providing MH services at PHC level.
Prevalence and determinants of pentavalent booster immunization in children aged three to five years in Denpasar, Bali Ni Rai Sintarini; Komang Ayu Kartika Sari; I Gusti Agung Trisna Windiani; Anak Agung Sagung Sawitri
Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i1.p05

Abstract

Background and purpose: Pentavalent booster immunization coverage in Denpasar City is reported to be relatively low. This study aims to determine the prevalence and determinants of pentavalent immunization uptake. Methods: A cross-sectional study was conducted in one banjar (hamlet) which was selected purposively in the work area of Public Health Centre (PHC) I West Denpasar, Bali Province. Banjar was selected with consideration of the diversity of local residents and migrants. All mothers who had children aged 3-5 years (138 people) in the banjar were chosen as respondents. Interviews were conducted in each respondent's house with variables included age, education, employment, parity, region of origin, knowledge on immunization, perception of susceptibility to and severity of disease, perceptions of benefits and barriers to immunization, sources of information, family support and acceptance of immunization. Data analysis was performed with poisson regression to determine the determinants of pentavalent booster immunization. Results: The majority of respondents were aged <30 years, high school education or above, unemployed, had 1-2 children and were from Bali. The proportion of respondents who reported that their children had been given pentavalent immunization in children aged three to five years was found to be 78.3%. Immunization prevalence was found to be higher in the population that originated from Bali (82.1%). Determinants of pentavalent immunization are perceptions of benefits (APR=4.78; 95%CI: 1.35-16.96) and more sources of information (APR=1.21; 95%CI: 1.04-1.41). Conclusion: The prevalence of pentavalent booster immunization is found to be lower than the average prevalence of the Bali Province but higher than the reported coverage of Denpasar City. The determinants of immunization acceptance was perception of high benefits and more sources of information. Information dissemination on the benefits of pentavalent booster immunization in children needs to be enhanced through health workers and various media to increase the coverage of pentavalent immunization.
Factors affecting the use of electronic cigarettes in Udayana University students Luh Pitriyanti; Dewa Nyoman Wirawan; Komang Ayu Kartika Sari; I Made Ady Wirawan; Desak Putu Yuli Kurniati
Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i2.p03

Abstract

Background and purpose: Electronic cigarettes (e-cigarettes) have been marketable since 2003 and first became for sale in Indonesia in 2010. Users tend to be predominately young people. The purpose of this study is to determine the proportion, characteristics and factors that influence the use of e-cigarettes among university students. Methods: This study used a cross sectional survey with 351 undergraduate students from a variety of study programs at Udayana University. Students were selected by multistage random sampling. In the first step, 10 out of 47 study programs at Udayana University were chosen randomly. Students who responded by filling out online questionnaires were included in this study. Data collection was conducted using questionnaires with the Survey Monkey Application. Analysis with logistic regression was applied to determine the factors influencing e-cigarettes use. Results: The proportion of university students who used tobacco cigarettes was 14.53%. The number of respondents who reported had ever used e-cigarettes was 61 (17.38%, 95%CI: 13.46%-21.3%) and 25 of them (40.98%) were current smokers. As many as 88.52% of respondents who had ever used e-cigarettes were male and 11.48% were female. Students who had ever used e-cigarettes in the campus area were 22 (36.07%). The reasons of using e-cigarettes included a desire to stop using tobacco cigarettes (29.51%), the fact that e-cigarettes are considered safer (26.23%), are considered “cool” (22.95%) and other reasons (26.23%). Multivariate analysis showed that the variables found to be associated with the use of e-cigarettes were gender (AOR=14.72; 95%CI: 4.34-49.87), a history of smoking tobacco cigarettes (AOR=42.16; 95%CI: 13.56-131.08), a history of consuming alcoholic beverages (AOR=5.72; 95%CI: 2.04-16.04) and coming from a smoking household (AOR=3.87; 95%CI: 1.33-11.21). Conclusion: The proportion of university students who had ever used e-cigarettes was found to be higher than tobacco cigarettes users. In addition, use was found to be greater among male students than females. Influencing factors associated with the use of e-cigarettes are gender, a history of tobacco smoking, a history of consuming alcoholic beverages and coming from a smoking household. There is a need for prevention efforts including education and regulations to reduce the use of e-cigarettes among students as well as community in general.
Risk factors for hepatitis B virus infections among pregnant women in East Lombok District Eka Faizaturrahmi; Luh Seri Ani; Komang Ayu Kartika Sari
Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i2.p06

Abstract

Background and purpose: The World Health Organization (WHO) has set a target of 90% reduction in new hepatitis B infections by 2030. The WHO program includes prevention of new infections, and increases testing uptake and treatment. In order to effectively foster prevention, it is necessary to understand the risk factors for transmission. This study aims to determine the risk factors of hepatitis B infection in pregnant women. Methods: A case control study was carried out among 52 pregnant women with HBsAg (+) as cases and 104 pregnant women with HBsAg (-) as controls. The source of cases and controls was the register of pregnant women at the Pringgasela Public Health Center from January 2016 to October 2017. Cases were selected using systematic random sampling from 67 HBsAg (+) pregnant women and controls were selected in the same way from 1644 pregnant women with HBsAg (-). Cases and controls were matched by domicile. The data collected were age, age of first marriage, education, family income, parity, history of miscarriage, maternal or husband’s history of working abroad, frequency of marriage, history of injection, surgery, blood transfusion and dental care. Data collection was carried out with a pre-tested questionnaire in April-May 2018 through interviews at the home of each respondent. Multivariate analysis with logistic regression was carried out to determine the adjusted odds ratio of each risk factor. Results: Cases and controls characteristics were found to be similar in terms of age, domicile, education and income. Significant risk factors were the history of husband working abroad (AOR=4.28; 95%CI: 1.66- 11.08), age of first marriage ≤19 years (AOR=2.52; 95%CI: 1.16-5.48) and frequency of husband's marriage more than one time (AOR=3.08; 95%CI: 1.35-7.08). Conclusion: Husbands with history of working abroad, age of first marriage <20 years and frequency of husband's marriage more than one time were found to be the risk factors for hepatitis B infection in pregnant women. These factors require public health attention in order to reduce the transmission of hepatitis B.
Anemia as a risk factor of postpartum hemorrhage at dr. R. Soedjono Hospital, Selong, East Lombok Ernawati; Komang Ayu Kartika Sari; Nyoman Gede Budiana; Luh Seri Ani
Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i2.p09

Abstract

Background and purpose: Globally, maternal mortality rate due to labor complications remains high, with postpartum hemorrhage as the most common cause. Studies on the risk factors of postpartum hemorrhage have been widely published, however, its association with maternal anemia is inconsistent. This study aims to explore anemia as a risk factor for postpartum hemorrhage. Methods: A case control study was carried out with 69 women who experienced postpartum hemorrhage as cases and 207 women who had given birth but did not experience hemorrhage as controls. Cases and controls were taken from medical records at the dr. R. Soedjono Hospital, Selong, East Lombok District, West Nusa Tenggara. Cases were selected by systematic random sampling from 147 mothers who experienced postpartum hemorrhage during 2017. Controls were selected in the same way from 2,855 mothers who did not experience postpartum hemorrhage. Cases and controls were matched for birth weight of infants and maternal employment. Data were obtained by medical record extraction in May 2018 consisting of information on hemoglobin concentration, parity, age at pregnancy, birthing method, gestational age, birth spacing and length of labor. Data analysis was performed using logistic regression to determine the adjusted odds ratio (AOR) of anemia. Results: Characteristics of cases and controls were found to be similar in terms of infant birth weight, maternal occupation, parity, gestational age and length of delivery but statistically different by maternal age at pregnancy and birth spacing. Analysis with logistic regression showed that anemia during pregnancy with hemoglobin concentration ≤10 gr/dL was a significant risk factor for postpartum hemorrhage with AOR=16.32 (95%CI: 7.69-34.64). Delivery through caesarean section (SC) or oxytocin drip was also found to significantly reduce the risk of postpartum hemorrhage (AOR=0.03; 95%CI: 0.01-0.13). Conclusion: Anemia during pregnancy with hemoglobin concentration ≤10 gr/dL was found to be a risk factor for postpartum hemorrhage. Prevention and control of anemia in pregnant women need to be enhanced to prevent postpartum hemorrhage.
Co-Authors Adi Yulianto Ariastuti, Luh Putu Ayu Sugiantari Desak Putu Yulita Kurniati Dewa Nyoman Wirawan Dhanesh Sukumar Nair Dinar Lubis Dinar Lubis Dwi Puji Tiarah Astuti Dyah Pradnyaparmita Duarsa Eka Faizaturrahmi Ernawati Gede Aditya Ersa Krisnawan Gede Anantha Restu Permana Hermawan Hermawan I Dewa Ayu Ari Ritmawati I Gusti Agung Trisna Windiani I Gusti Ngurah Yuda Bagus Aryana I Ketut Suastika I Made Ady Wirawan I Made Sukawinaca I Nyoman Gede Budiana I Nyoman Sutarsa I Wayan Weta Indah Purnama Ketut Adi Jaya Sutana Ketut Sri Astuti Lisanne Gerstel Luh Made Hannisa Sandha Luh Pitriyanti Luh Seri Ani Made Laras Fatmala Eni Mangku Karmaya Manik Parmelia Merry S Afriani Ni Kadek Neza Dwiyanti Ni Kadek Wiwik Dwipayanti Ni Komang Ekawati Ni Luh Putu Ariastuti Ni Luh Putu Suariyani Ni Made Rahayu Pradnyasari Ni Made Rai Sintya Devi Ni Made Sri Nopiyani Ni Rai Sintarini Nicholas Prathama Limalvin Nyoman Yuni Suryani Dharmaputri Pinatih Pande Nyoman Dhandy Wirakesuma Pande Putu Januraga Patricia Stephanie Pradnyaparamita D, Dyah Purnama Sari, I Dewa Ayu Widya Putu Aryani Putu Ayu Ratna Darmayanti Putu Cintya Denny Yuliyatni Putu Eksa Bidja Yudha Putri Putu Emy Suryanti Putu Sindy Reiska Jayanti Raditya Putra Pratama Suryadhi Sari Kusumadewi Sawitri, Anak Agung Sagung Shobana Raveendran Suyasa Adryan Yunanda Thivyaroobini Ramah Wayan Citra Wulan Sucipta Putri Widowati, I Gusti Ayu Rai - Widya Aryati Willem F Scholte Yoga Yatindra, Ida Bagus Gde Tirta