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All Journal Jurnal Kesehatan Reproduksi Jurnal Kesehatan Masyarakat Jurnal Kesehatan Masyarakat Andalas (Andalas Journal of Public Health) Jurnal Populasi Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education Public Health of Indonesia Media Kesehatan Politeknik Kesehatan Makassar Journal of Social Research Berita Kedokteran Masyarakat Prosiding University Research Colloquium Jurnal Mitrasehat Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Siswanto Agus Wilopo
Departemen Biostatistik, Epidemiologi, Dan Kesehatan Populasi, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada
Arts Humanities Computer Science & IT Economics, Econometrics & Finance Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health Social Sciences

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Journal : Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)

 1 
Determinan Abortus di Indonesia Kuntari, Titik; Wilopo, Siswanto Agus; Emilia, Ova
Kesmas Vol. 4, No. 5
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Abortus menjadi masalah yang penting dalam kesehatan masyarakat karena berpengaruh terhadap morbiditas dan mortalitas maternal. Di Indonesia, belum ada data yang komprehensif tentang kejadian abortus, berbagai data yang ada sebelumnya berdasarkan survei dengan cakupan yang relatif terbatas. Abortus yang tidak aman bertanggung jawab terhadap 11% kematian ibu di Indonesia. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian abortus di Indonesia. Penelitian ini dilaksanakan dengan metode observasional menggunakan disain studi cross sectional. Data penelitian diperoleh dari data Survei Demografi dan Kesehatan Indonesia 2002-2003. Analisis data dilakukan secara bertahap yaitu: analisis univariat, analisis bivariat dan analisis multivariat dengan regresi logistik. Hasil menunjukkan bahwa risiko abortus meningkat seiring dengan peningkatan usia ibu. Wanita dengan paritas 0-2 berisiko lebih tinggi untuk mengalami abortus dibandingkan wanita dengan paritas 3 atau lebih (OR=5,2, IK 95%=3,49-7,89). Wanita yang bekerja berisiko 2,7 kali lebih tinggi untuk mengalami aborsi daripada wanita yang tidak bekerja (OR= 2,7 , IK 95%= 2,10-3,58). Selain itu, risiko abortus meningkat pada wanita yang menikah pada usia 30 tahun atau lebih (OR=1,8, IK95%= 1,30-2,48). Risiko abortus tidak berhubungan bermakna dengan riwayat abortus sebelumnya, tingkat pendidikan dan tingkat sosial ekonomi. Abortion has become a main problem in public health because of its impact on maternal morbidity and mortality. There is no comprehensive data on abortion in Indonesia. So far, data were based on survey with limited coverage. Unsafe abortion is responsible to 11 percent of maternal mortality in Indonesia. This research objective is to determine factors related to abortion in Indonesia. The study was an observational method with cross sectional design. These data are gathered from Indonesian Demography and Health Survey 2002–2003. Data analysis used univariate, bivariate and multivariate analysis with logistic regression. The risk of an abortion increased in line with the increasing of maternal age. Women with 0-2 parity have higher risk than multiparity (OR=5.2, IK95%=3.49-7.89). Employed women have higher risk than unemployed (OR=2.7, IK95%=2.10-3.58). The risk of abortion increased among women married at 30 years old or over (OR=1.8, IK95%=1.30-2.48). There is no significant association between history of abortion, education, socioeconomic and risk of abortion.
Perilaku Seks Pranikah Remaja Rahyani, Komang Yuni; Utarini, Adi; Wilopo, Siswanto Agus; Hakimi, Mohammad
Kesmas Vol. 7, No. 4
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Hubungan seksual sebelum nikah pada remaja merupakan masalah yang serius, berhubungan dengan peningkatan penularan penyakit menular seksual, mempunyai pasangan lebih dari satu, dan kehamilan dini. Suatu kerangka kerja model perilaku terintegrasi (Integrated Behavioral Model, IBM) digunakan untuk menilai berbagai faktor prediktor hubungan seksual prematur pada remaja. Tujuan penelitian ini adalah mengeksplorasi inisiasi hubungan seksual sebelum nikah pada remaja level 10 dan 11 berdasarkan kerangka kerja IBM, meliputi komunikasi tentang seks kelompok peers, orang tua, paparan perilaku pornografi, kepercayaan normatif, agen personal, dan keinginan hubungan seksual. Metode yang digunakan adalah menyertakan 626 responden dalam survei awal. Responden adalah siswa sekolah menengah atas level 10 – 11 di kota Denpasar. Data dikumpulkan dengan kuesioner laporan sendiri khususnya prediktor inisiasi hubungan seksual sebelum menikah. Penelitian ini menemukan bahwa pajanan pornografi, perilaku langsung dan tidak langsung berhubungan secara signifikan dengan inisiasi hubungan seksual sebelum nikah (nilai p < 0,05). Remaja laki-laki tampaknya melakukan lebih banyak aktivitas seksual daripada remaja perempuan. Penelitian ini berimplikasi terhadap pemahaman perilaku langsung dan pajanan pornografi mungkin digunakan dalam meningkatkan program kesehatan dan kesehatan remaja. Premarital sexual inisiation on adolescence is a serious problem, associated with increased transmition sexually transmitted disease/STD, had having more partners, and early pregnancy. An Integrated Behavioral Model (IBM) framework used to assess predictors of premarital sexual on adolescents. The purpose of this research is to explore predictors of premarital sexual inisiation in adolescents grade 10 and 11 based on IBM framework, includes: communication about sex with peers, parents, pornography exposure, attitude, normative belief, personal agency, and intention to have sex. Method that used is 626 respondent included in earlier survey, and respondent were students of senior high school grade 10 – 11 in Denpasar City. Data collected with self reported questionaire particularly predictor of premarital sexual initiation. The result found that pornography exposure, indirectly attitude, and directly attitude were significantly associated with premarital sexual initiation (p < 0,05). Male adolescents engage in more sexual activity like premarital sexual inisiation than female adolescents. This study has implications for understanding how directly attitude and pornography exposure may be used in intervention to promoting adolescents health program and adolescents ressiliency.
Are We Passing on Violence to the Next Generation?: Gender Norms and Gender-based Violence Attitudes among Early Adolescents in Indonesia Mahendra, I Gusti A A; Pinandari, Anggriyani Wahyu; Choiriyah, Ifta; Wilopo, Siswanto Agus
Kesmas Vol. 16, No. 4
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Intensification of gender norms during puberty affects adolescents’ perceptions and behavior related to violence. This study examined the association between gender norms and gender-based violence (GBV) among early adolescents considering socio-ecological variables using cross-sectional data from 3,618 Indonesian Global Early Adolescent Study pupils. Chi square tests with simple and multiple logistic regression analyses examined how different factors' levels predict GBV. Among boys, GBV attitudes were found high (53%). Furthermore, they also had high heteronormative expectations, threatened feelings, experiences of violence, porn access, and 5+ adverse childhood experiences (ACEs). Logistic regression results revealed that adolescent boys having one or two scores of gender norms at the above-median are 1.3 times more likely to commit GBV and even 2.2 times higher if all were above median [AOR (CI) = 1.3(1.1-1.6); 2.2 (1.7 2.8)], respectively. Boys, having 5+ ACEs, and stronger endorsement on heteronormative relationships were also more likely to commit GBV [AOR (CI) = 1.5 (1.3-1.7); 1.5 (1.2-1.9); 1.5 (1.3-1.7)], respectively. This research concluded that unequal gender norms intensified during puberty strongly correlate to attitudes towards GBV among early adolescents. Strengthening the individual aspects by providing a more conducive environment, such as comprehensive sexual education at school, is essential to prevent GBV.
Pendidikan Kesehatan Reproduksi Formal dan Hubungan Seksual Pranikah Remaja Indonesia Pinandari, Anggriyani Wahyu; Wilopo, Siswanto Agus; Ismail, Djauhar
Kesmas Vol. 10, No. 1
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Transisi demografi kedua akan terjadi di Indonesia dan ditandai dengan revolusi seksual dan reproduksi. Masalah potensial di masa ini adalah peningkatan perilaku seksual pranikah, kehamilan yang tidak diinginkan, infeksi menular seksual dan penyalahgunaan obat. Penelitian ini bertujuan untuk menguji pengaruh pendidikan kesehatan reproduksi formal terhadap penundaan hubungan seksual pranikah pada remaja dan dewasa muda Indonesia. Penelitian potong lintang yang dianalisis sebagai kohort retrospektif menggunakan data Survei Kesehatan Reproduksi Remaja Indonesia tahun 2012 (10.980 laki-laki dan 8.902 perempuan). Efek pendidikan kesehatan reproduksi formal terhadap penundaan perilaku hubungan seksual dianalisis menggunakan kurva kaplan meier, uji log-rank, dan uji chi square, sedangkan analisis multivariabel menggunakan regresi logistik. Semua tes menggunakan tingkat kepercayaan 95% dan nilai p = 0,05. Hasil analisis keberlangsungan berpantang melakukan hubungan seksual pranikah menunjukkan bahwa remaja yang tidak menerima atau hanya menerima salah satu dari materi pendidikan kesehatan reproduksi memiliki hazard ratio yang lebih besar (berturut-turut 1,55 ( CI= 1,32 – 1,82); 0,99 (CI=0,86 – 1,15) dan 2,26 (CI=1,43 – 3,56). Menerima informasi secara lengkap memberikan waktu berpantang yang lebih lama. Penyalahgunaan obat, merokok, minum alkohol, laki-laki, berusia 20 - 24 tahun dan miskin berpeluang lebih besar untuk melakukan hubungan seksual pranikah. Penerimaan informasi kesehatan reproduksi pada jenjang pendidikan formal dapat menunda terjadinya hubungan seksual pranikah. The second demographic transition will occur in Indonesia and be marked by sexual and reproductive revolution. Potential problems in this era are the increase of premarital sexual behavior, unwanted pregnancy, sexual transmitted infection and drug abuse. This study aimed to examine the influence of formal reproductive health education to delay premarital sexual intercourse among Indonesian teenagers and young adults. Cross sectional study analyzed as retrospective cohort used data of Indonesian Teenage Reproductive Health Survey in 2012 (10,980 men and 8,902 women). Effects of formal reproductive health education to delay sexual intercourse behavior was analyzed using kaplan meier curve, log-rank test, and chi square test, meanwhile multivariat analysis used logistic regression. All tests used confidence interval 95% and p value = 0.05. Results of survival analysis of abstinence committing sexual intercourse showed that teenagers who didn’t receive or only receive one of reproductive health education materials had bigger hazard ratio (respectively 1.55 (CI=1.32 – 1.82); 0.99 (CI=0.86 – 1.15) and 2.26 (CI=1.43 – 3.56)). Receiving complete information gave longer abstinence time. Drug abuse, smoking, alcohol, men, aged between 20 – 24 years old and poor were more likely to commit premarital sexual intercourse. Receipt of reproductive health information at formal education level may delay the occurrence of premarital sexual intercourse.
Asupan Vitamin D Rendah dan Keparahan Demam Berdarah Dengue pada Anak Usia 1-14 Tahun Siyam, Nur; Wilopo, Siswanto Agus; Hakimi, Mohammad
Kesmas Vol. 9, No. 1
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Demam berdarah dengue (DBD) menimbulkan syok dan kematian. Penderita DBD di Yogyakarta sebagian besar usia 1 - 12 tahun dengan DBD parah. Asupan vitamin D rendah diasumsikan penyebab DBD parah. Asumsi ini perlu dibuktikan dengan menganalisis pengaruh asupan Vitamin D dan keparahan DBD. Rancangan penelitian adalah studi kasus kontrol. Penelitian di bangsal rawat inap anak dan instalasi catatan medik RS Jogja dan RSUP Dr. Sardjito. Kasus adalah anak usia 1 - 14 tahun dengan DBD grade III & IV, kontrolnya DBD grade I & II. Data asupan vitamin D diambil dengan food frequency questionnaire (FFQ). Variabel luar adalah indeks massa tubuh (IMT), usia, status penyakit kronis dan intensitas terpapar matahari pagi. Analisis dengan uji-t dan regresi logistik. Hasil penelitian didapatkan 60 kasus dan 60 kontrol tanpa matching. Cut-off point asupan vitamin D berdasarkan ROC curve adalah 2,7 µg/hari. Penderita DBD parah rata-rata asupan vitamin D 1,10 kali lebih sedikit dibandingkan DBD tidak parah. Rata-rata asupan vitamin D lebih rendah 1 µg/day bersama IMT ≥18,75 kg/m2, penyakit kronis, dan kurang terpapar matahari pagi berpengaruh pada DBD parah (OR=0,47; 95% CI: 0,32-0,71). Cukup Asupan vitamin D disarankan untuk menghindari keparahan DBD. Penyakit kronis dan berat badan lebih perlu menjadi perhatian tenaga medis sebagai kewaspadaan dini terjadinya shock. Dengue hemorrhagic fever (DHF) lead to shock and death. Patient in Yogyakarta mostly aged 1 - 12 years old with severe dengue. A low vitamin D intake is assumed to be the cause of severe dengue. This assumption needs to be proved by analyzing the effect of vitamin D intake and severity of DHF. Study design was a case control study. Research on children’s wards and medical record installation in hospital. Cases were children with DHF grade III and IV, the control of DHF grade I & II. Data vitamin D intake was obtained by FFQ. Outer variables: BMI, age, chronic diseases and intensity morning sun exposure. Analysis by t-test and logistic regression. The results showed 60 cases and 60 controls without matching. Cut-off point vitamin D intake based ROC curve was 2.7 µg/day. Patients with severe dengue average vitamin D intake of 1.10 times less than not severe dengue. The average vitamin D intake lower 1 µg/day with a BMI ³ 18.75 kg/m2, chronic disease, and less exposed to the morning sun effect on severe dengue (OR = 0.47, 95% CI: 0.32 to 0.71). Sufficient vitamin D intake is recommended to avoid the dengue severity. Chronic diseases and more weight should be a concern of medical personnel as early warning shock occurrence.
Co-Authors Adi Utarini Agnes Montolalu, Agnes Anggriyani Wahyu Pinandari Anita, Dewi Nur Asep Hermawan Astuti, Bariana Widitia BUDI WAHYUNI Chamy Rahmatiqa Choiriyah, Ifta Citra Indriani Dian Herawati Dian Rosdiana, Dian Djaswadi Dasuki Djauhar Ismail Djauhar Ismail Fatwa Sari Tetra Dewi Husnawati Husnawati Izzatul Arifah Lilik Ariyanti Lisma Evareny, Mohammad Hakimi, Retna Siwi Padmawati M. Akbar Alwi Mahendra, I Gusti A A Mohammad Hakimi Mohammad Hakimi Ni Komang Yuni Rahyani Nur Siyam Ova Emilia Pinandari, Anggriyani W. Prima Dhewi Ratrikaningtyas Priscilla Bawing Reni Dwi Setyaningsih Risalia Reni Arisanti Shinta Prawitasari Sinta Prawitasari, Sinta Suandana, Iwan Abdi Sukamdi Sumarni Sumarni Supriyatna Supriyatna Titik Kuntari Tunjung Wibowo Utami Dewi Vivi Triana Yayi Suryo Prabandari