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Journal : Narra J

Implementation of Aceh Health Insurance (Jaminan Kesehatan Aceh) 2013–2021: Has health equity been achieved for all Acehnese after armed conflict? Yani, Muhammad; Ruby, Mahlil; Puspandari, Diah A.; Munawar, Munawar; Fachrurrozi, Kamal; Candra, Aditya; Ilzana, Teuku M.; Khaled, Teuku M.; Rahmi, Cut R.
Narra J Vol. 3 No. 1 (2023): April 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i1.160

Abstract

Aceh Health Insurance (Jaminan Kesehatan Aceh—JKA) has been implemented since 2010 to increase the health equity by covering the health expenses and guaranteeing that all Acehnese are covered regardless of their economic, educational, and social statuses. However, since its implementation, there has been no study on its impact on health quality, particularly regarding the utilization of the main referral hospital (Dr Zainoel Abidin Hospital located in Banda Aceh) and the effects of the geographic accessibility and the number of specialist doctors in each regency/city on hospital utilization. This retrospective study assessed the equity factors during the Aceh Health Insurance implementation and during its integration to National Health Insurance (Jaminan Kesehatan Nasional—JKN) from 2013 to 2021 using data of travel time (time spent for travelling from the origin regency/city of referred patients to the main referral center) and healthcare resources (number of specialist doctors). The data were analyzed using Student’s t-tests, Kolmogorov-Smirnov or Mann-Whitney U test when appropriate. Williamson Index was calculated to determine the disparities of health equity between regencies. Our data indicated the noticeably increase of health facilities utilization since the implantation of Aceh Health Insurance. However, there was no equity in the use of main referral facility by the residents in Aceh - was dominated by residents who lived closer and from more populated regencies/cities. In conclusion, there are accessibility and financial hardship barriers in accessing the health care facilities during the implementation of Aceh Health Insurance that need to be addressed by the government to achieve the health equity for all Acehnese.
Risk factors of MDR-TB and impacts of COVID-19 pandemic on escalating of MDR-TB incidence in lower-middle-income countries: A scoping review Ichsan, Ichsan; Redwood-Campbell, Lynda; Mahmud , Nissa N.; Dimiati, Herlina; Yani, Muhammad; Mudatsir , Mudatsir; Syukri, Maimun
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.220

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is affecting tuberculosis (TB) treatment in many ways that might lead to increasing the prevalence of multi-drugs-resistance tuberculosis (MDR-TB), especially in lower-middle-income-countries (LMICs). This scoping review aimed to identify the risk factors of MDR-TB and to determine the impacts of the COVID-19 pandemic on MDR-TB prevalence in LMICs. This study was reported according to the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guideline. The relevant keywords were used to search studies in three databases (PubMed, ScienceDirect and SpringerLink) to identify the related articles. The English-written articles published from January 2012 to December 2022 that explored risk factors or causes of MDR-TB in LMICs were included. Out of 1,542 identified articles, 17 retrospective, prospective, case-control and cross-sectional studies from ten LMICs met were included in this scoping review. Twenty-one risk factors were discovered, with prior TB treatment (relapsed cases), diabetes, living area, living condition, smoking and low socioeconomic status were the main factors in developing MDR-TB during COVID-19 pandemic. The pandemic increased the MDR-TB prevalence through drug resistance transmission inside households, the distance between home and healthcare facilities and low socioeconomic status. This scoping review demonstrates how the COVID-19 pandemic has affected the rising incidence of MDR-TB in LMICs.
Predicting early in-hospital mortality in acute hemorrhagic stroke: Implications for improving stroke care and health outcomes in low-income settings Harnold, Shefina P.; Syahrul, Syahrul; Imran, Imran; Musadir, Nasrul; Yani, Muhammad
Narra J Vol. 6 No. 1 (2026): January 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.2977

Abstract

Stroke is a leading cause of death and disability worldwide, and mortality in acute intracerebral hemorrhagic (ICH) stroke is influenced by many factors, and early identification of high-risk patients is crucial for guiding clinical management. This study aimed to evaluate the role of blood pressure, blood glucose level, and Glasgow coma scale (GCS) on admission as predictors of 10-day in-hospital mortality and to develop a predictive scoring system in patients with acute ICH stroke. A cross-sectional study was conducted at Dr. Zainoel Abidin Hospital, a provincial referral hospital in Banda Aceh, Indonesia, in 2025. Patients with acute ICH were consecutively recruited. Clinical parameters on admission, including systolic and diastolic blood pressure, random blood glucose level, and GCS, were recorded. Associations with 10-day mortality were assessed with a Chi-squared test, and a predictive scoring system was developed based on independent predictors. A total of 62 patients were included in this study. Higher systolic blood pressure (≥140 mmHg), diastolic blood pressure (≥90 mmHg) and GCS <9 on admission were significantly associated with 10-day mortality (p=0.031, p=0.023 and p<0.001, respectively). Multivariate analysis identified that GCS <9 was the only independent predictor. A predictive scoring system assigned 8 points for GCS <9, 5 points for systolic ≥140 mmHg, 4 points for diastolic ≥90 mmHg, and 1 point for random blood glucose ≥200 mg/dL, estimating patient-specific mortality risk, highest when all risk factors were present. This study indicates that GCS <9 and elevated blood pressure on hospital admission are key predictors of 10-day mortality in acute ICH. The developed scoring system may assist in early risk stratification and management, and further exploration of predictive models is warranted to optimize clinical outcomes.
Co-Authors A. Haris Abdul Hadi Aditya Candra, Aditya Agustina, Devi Ahmad Firdausi Aisha Hanif Aiza, Izatul Al Adawiyah, Eka Robi’atul Alam, Imam Bahrul Ali, Siti Arisya Nurfika Alshaf Pebrianggara Amaliyah, Fitrotul Anita Anita Annafiyah Aprilia, Rena Eka Ardiansyah, Bayu Aswan Aswan Authary, Nailul Azhari Azhari Aziz Setyawan Hidayat, Aziz Setyawan Azkia, Annisa Barutu, Risca Noviana Bayu Hari Prasojo Bustami Bustami Chariri, Mochammad Iqbal Damayanti, Putri Detak Prapanca Dewi Komala Sari Didik Hariyanto Dyah Suryani Eva, Adelia F. V. Astrolabe Sian Prasetya Fadli, Bagus Muhamad Fadli, Bagus Muhammad Fahmi, Moh Faizul, Nur Irdina Wahidah Fajar Muharram Fauzi, Azra Febiantika, Tivani Nadia Ferdiansyah, Daeng Sani Ferry Adhi Dharma Fikri, Andi Finada, Cinta Firman Kurniawan, Firman Fitriyasni, Fitriyasni Gadjong, Agussalim A. Galuh Ratmana Hanum Gan, Connie Cai Ru Gerung , Vido Michael Gumardi, Yuanita Seva Hamzah, Muhammad Syauqi Harnold, Shefina P. Helmanda, Cut Mawar Herlina Dimiati, Herlina Hibah, Amirah Najchan Huda, Raden Muhammad Syamsul Ichsan Ichsan Ihsan, Hamzani Khairul Ikhbar, Samsul Ikra, Ikra Ilham Wahyudi Ilmah, Khafidzotul Ilyasa, Erik Ilzana, Teuku M. Imran Imran Indayani , Lilik Indriyani, Risa Iskandar, Fahra Azzahra Ismail Ismail Junjunan, Mochammad Ilyas Kamal Fachrurrozi Karina, Nadila Karuniawan Puji Wicaksono Kasmir Kasmir, Kasmir Khahirul Anuar, Ahmad Nur Ariff Khairunnisah, Noni Antika Khaled, Teuku M. Khalid, Hasbuddin Kholida, Anzely Rohmatul Lilik Indayani Liza Salawati, Liza Lukman Ibrahim Maharani, Silfa Mahdi, Umar Mahendra, Aldi Dwi Mahmud , Nissa N. Maimun Syukri, Maimun Maimunah Maimunah Mardhiana, Tryesa Marsha, Deni Maulana, Ahmad Wildan Maulidiyah, Nur Laili Meutia Zahara Misti Hariasih Mohamad Quraiza, Nur Qasrina Eillya Mohammad Fattah Mohd Baharuddin, Nurbalqis Nabilah Mudatsir , Mudatsir Muhammad Abror Muhammad Agus Muljanto Muhammad Fikry Muhammad Rivai Munandar, Amirul Munawar Munawar Muslim, Siti Chairunnisa Nafisah, Eri Nazariah, Nazariah NELI SUSANTI, NELI Nia Kurniadin Ningsi, Fitri Nugroho, Agung Nugroho, Tovan Tri Nur Maghfirah Aesthetika Nur Ravita Hanun Nuralam Syamsuddin Nurdiani, Ira Nurfidah, Nurfidah Nurgiantoro, Nurgiantoro Nurhidayat Nurhidayat Nurindrawati, Feny Yuan Nurjannah Nurjannah Nurnaningsih Nurnaningsih, Nurnaningsih nuryanti, eka Oetarjo, Mas Oktaviani, Moch Ari Ora, Erna Yunita Nopitasari Palanee, Matthuri Poppy Febriana Prapanca , Detak Prasetya, Atina Nabila Ade Prasetyo, Lilik Ozy Prasetyo, Lilik Ozy Pratama, Handraswara Prayoga, Bagas Adi Puspandari, Diah A. Putri , Dhea Ariesta Putri, Nur Fransiska Maulidia Rachamawati, Aisyah Radik Khairil Insanu Rahmawati, Vivi Indri Rahmi, Cut R. Ramli Ramli Redwood-Campbell, Lynda Renaldi Renaldi Renny Oktafia, Renny Resmi Resmi Restu Andrian, Restu Reza Fahmi Rizka Puspitasari, Rizka Rizky Eka Febriansah Rohmi, Arbiya Magfiroh Romansah Wumu Roni, Mochammad Noval Nur Rosdiyanti, Evi ROSMERI, ROSMERI Ruby, Mahlil Rukayah Rukayah Rusnanti, Delia Putri Saifudin, Muhamad Vicky Sanjaya, Fifi Sarfiah, Sarfiah Sari , Herlinda Maya Kumala Sekar Kinasih, Putri setiawan, akhmad david Setiyono, Wisnu Panggah Shabri Indra Suryalfihra Silahuddin Silahuddin Siti Rahmi, Siti Siti Ulfah SITTI HAJAR Sri Suryaningsih Sriyono Sriyono Subhan Subhan Subramaniam, Barathimani Subroto, Anggraini Cahyaning Tias Sukmaya, Fajar Sukmaya, Fajar Sumarsaid, Roni Sumartik Supardi Supardi Supardi Supriyadi Supriyadi Syahida, Nur Syahrul Syahrul Syarifuddin Syarifuddin Taufik Fuadi Abidin Tita Menawati Liansyah Tofan Tri Nugroho Totok Wahyu Abadi Ufah, Siti Umah, Umdatul Vera Firdaus Waluyo, Sabka Ardi Wardana, Anggit Pranatya Wardana, Anggit Pranatya Wardana, Oktavia Putri Wardani, Dwi Sukma Wardatunnissa, Yeni Warul Walidin Ak Wathoni, Nur Ilmi Wulandari, Sintiya Ayu Yunita Yunita Yusuf Yusuf Zahrina, Zahrina Zuhroh, Siti Zulfadli Zulkifli Zulkifli