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All Journal Saintika Medika: Jurnal Ilmu Kesehatan dan Kedokteran Keluarga. Jurnal Kesehatan Hesti Wira Sakti Jurnal Kesehatan Vokasional Journal of Islamic Medicine Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan Jurnal Keperawatan Muhammadiyah Amerta Nutrition Manuju : Malahayati Nursing Journal INTERNATIONAL JOURNAL OF NURSING AND MIDWIFERY SCIENCE (IJNMS) Care : Jurnal Ilmiah Ilmu Kesehatan Journal of Health Sciences 2-TRIK: TUNAS-TUNAS RISET KESEHATAN Jurnal Ilmu Kesehatan Bhakti Husada: Health Sciences Journal Jurnal Ilmiah PANNMED (Pharmacist, Analyst, Nurse, Nutrition, Midwivery, Environment, Dentist) Health Information : Jurnal Penelitian JURNAL ILMIAH OBSGIN : Jurnal Ilmiah Ilmu Kebidanan & Kandungan NURSING UPDATE JURNAL ILMIAH ILMU KEPERAWATAN Jurnal MID-Z (Midwivery Zigot) Jurnal Ilmiah Kebidanan Nutrix Journal Jurnal Kesehatan Tambusai MAHESA : Malahayati Health Student Journal Journal of Midwifery Care Journal of Public Health Innovation (JPHI) Journal of Nursing Practice and Education Indonesian Journal of Health Community Nursing and Health Sciences Journal (NHSJ) Jurnal Ilmiah Kesehatan (JIKA) Hospital Majapahit : Jurnal Ilmiah Kesehatan Politeknik Kesehatan Mojokerto Jurnal Ilmu Kebidanan dan Kesehatan Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Jurnal Fisioterapi dan Ilmu Kesehatan Sisthana (JUFDIKES) Jurnal Locus Penelitian dan Pengabdian Kolaborasi Jurnal Pengabdian Masyarakat Hang Tuah Medical Journal Maternity and Neonatal : Jurnal Kebidanan Jurnal Sehat Indonesia (JUSINDO) SENTRI: Jurnal Riset Ilmiah Jurnal Pengabdian Masyarakat Medika Jurnal Indonesia Sosial Sains Journal of Artificial Intelligence and Digital Business Jurnal Asuhan Ibu dan Anak Jurnal Multidisiplin West Science Health and Technology Journal (HTECHJ) Jurnal Ilmu Kesehatan dan Gizi Vitamedica: Jurnal Rumpun Kesehatan Umum Journal of Innovative and Creativity Journal Research Midwifery Politeknik Tegal Health Dynamics EDUCATIONE: Journal of Education Research and Review Horizon: Indonesian Journal of Multidisciplinary Seroja Husada: Jurnal Kesehatan Masyarakat International Journal Of Public Health Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) Jurnal Siti Rufaidah Jurnal Bioteknologi & Biosains Indonesia (JBBI) Proceeding International Conference Of Innovation Science, Technology, Education, Children And Health Proceeding International Conference Of Innovation Science, Technology, Education, Children And Health Jurnal Bioteknologi & Biosains Indonesia Borneo Nursing Journal Klinik: Jurnal Ilmiah Kedokteran dan Kesehatan
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Pengaruh Konseling KB dengan Metode Pendekatan Keluarga terhadap Kesertaan Menjadi Akseptor KB di Wilayah Kerja Puskesmas Tepeleo Tahun 2025 Rianti Rianti; Rifzul Maulina
VitaMedica : Jurnal Rumpun Kesehatan Umum Vol. 3 No. 2 (2025): April : VitaMedica : Jurnal Rumpun Kesehatan Umum
Publisher : STIKES Columbia Asia Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62027/vitamedica.v3i2.693

Abstract

One effort to address the increasing population in Indonesia is through the Family Planning (FP) program. One of the roles of midwives in implementing this program is through family planning counseling. This study aimed to determine the relationship between family planning counseling and participation as family planning acceptors in the Tepeleo Community Health Center (Puskesmas) work area. This study was conducted from October to November 2021. The analytical method used in this study was descriptive analytic, which examines the relationship between two variables in a situation or group of objects. The results were obtained by distributing questionnaires to 45 respondents and then tested using the Chi-Square test with a significance level of 0.05. The analysis results showed a relationship between family planning counseling and participation as family planning acceptors in the Tepeleo Community Health Center work area. Furthermore, the family planning counseling program was implemented quite well (84.4%), as indicated by community participation as family planning acceptors (88.9%).
Factors Related to Stress Levels in Pregnant Women During Childhood Sutrini Rone; Rifzul Maulina
Jurnal Ilmu Kesehatan dan Gizi Vol. 3 No. 4 (2025): Oktober: Jurnal Ilmu Kesehatan dan Gizi
Publisher : Lembaga Pengembangan Kinerja Dosen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jig.v3i4.8788

Abstract

Pregnancy can trigger a maturity crisis that can cause stress. Stress in pregnant women is related to stress during pregnancy, childbirth, and postpartum. The purpose of this study was to examine factors related to stress levels in pregnant women facing childbirth. This type of research was an analytical survey with a cross-sectional approach conducted in the Lubuk Buaya Community Health Center Work Area from April 25 to May 7, 2022. The population was all pregnant women who visited the Lubuk Buaya Community Health Center Work Area in Padang in 2022, totaling 178 people, with a sample of 64 people, using an accidental sampling technique. Data were collected using a questionnaire with a validity analysis result of r>0.267 and a reliability test with a Cronbach's Alpha value>0.7. They were processed manually, using univariate and bivariate analysis with the chi-square test. The results of the study showed that 26.6% experienced moderate stress, 37.5% had poor family support, 37.5% had poor husband support, 40.6% had trauma, 46.9% had a personal readiness level in the unprepared category, and 46.9% had a heavy activity level. There is a relationship between family support and stress levels, there is a relationship between husband support and stress levels, there is a relationship between traumatic experiences and stress levels, there is a relationship between personal readiness levels and stress levels, and there is a relationship between activity levels and stress levels.
The Effectiveness Of Soy Milk In Reducing Premenstrual Syndrome Symptoms In Adolescent Girls Putri Amarela Wardana; Rifzul Maulina; Nila Widya Keswara
Saintika Medika : Jurnal Ilmu Kesehatan dan Kedokteran Keluarga Vol. 21 No. 1 (2025): June 2025
Publisher : Universitas Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22219/sm.Vol21.SMUMM1.40739

Abstract

Background : Premenstrual Syndrome (PMS) is a common condition affecting women of reproductive age, marked by a variety of physical, emotional, and behavioral symptoms that typically arise a few days before menstruation and diminish afterward. While the exact cause remains uncertain, hormonal fluctuations throughout the menstrual cycle are believed to be a key factor. Management strategies for PMS include both pharmacological and non-pharmacological approaches, one of which is soy milk consumption. Soy milk contains isoflavones, naturally occurring plant compounds that mimic estrogen activity and may help ease PMS symptoms. This study seeks to examine the impact of soy milk consumption on alleviating PMS symptoms in adolescent girls.. Methods : The research employed a pre-experimental method with a one-group pretest-posttest design, conducted from March 3 to 17, 2025. A total of 18 participants were selected using purposive sampling, and the sample size was determined using the Federer formula. Data were analyzed using a paired t-test with SPSS version 16.0. Results of the Paired T-test showed that the p-value ≤ α (0.05), namely 0.001 < 0.05, indicating that H1 is accepted and H0 is rejected. Conclusion : The data indicates that the administration of soy milk has an effect in reducing premenstrual syndrome symptoms in adolescent girls.
The Effect Of Giant Snakes And Ladders Game On Changes In The Development Of Cognitive Abilities Of Children Aged 5-6 Years At Cut Nyak Dhien Kindergarten In Malang City. Mira Diadhita Prameswari; Rifzul Maulina; Reny Retnaningsih
Saintika Medika : Jurnal Ilmu Kesehatan dan Kedokteran Keluarga Vol. 21 No. 1 (2025): June 2025
Publisher : Universitas Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22219/sm.Vol21.SMUMM1.40789

Abstract

Background : Cognitive abilities represent a fundamental component of mental functions, encompassing processes such as perception, thinking, memory, and information processing. These cognitive functions are essential in facilitating individuals to acquire knowledge, address challenges, and formulate future plans. Data from UNICEF (2022) reveals that children aged 36–59 months across the globe continue to face challenges in their cognitive development. In Indonesia, about 7.51% of children under the age of five exhibit signs of developmental delays. Additionally, the Central Statistics Agency (BPS) reported in 2020 that approximately 60% of preschool-aged children in the country experience issues related to cognitive development. One effective and enjoyable approach to stimulate cognitive growth in early childhood is through the use of educational games. Among these, the giant snakes and ladders game has been recognized for its potential to enhance cognitive functioning in young children. Research Methods : This research utilized a pre-experimental method with a one-group pretest-posttest design. Participants were selected through purposive sampling based on predetermined criteria. Data collection was carried out using structured observation sheets, and the results were analyzed through a paired sample t-test. The findings revealed a 2-tailed significance value of 0.000, which is below the threshold of 0.05. This indicates a statistically significant impact of the giant snakes and ladders game on the cognitive development of children aged 5 to 6 years at Cut Nyak Dhien Kindergarten in Malang City. Conclusion : Hence, the giant snakes and ladders educational game has been shown to be an effective pedagogical medium for promoting and enhancing cognitive development among early childhood learners.
Pengaruh Slow Deep Breathing terhadap Kecemasan Ibu saat Pemasangan KB Implan HELEN MARSHANDA; RETNO DEWI PRISUSANTI; RIFZUL MAULINA
Hang Tuah Medical Journal Vol 23 No 2 (2026): Hang Tuah Medical Journal
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/htmj.v23i2.976

Abstract

The Family Planning (FP) program is a government initiative to control population growth through the use of long-term contraceptive methods, including implant contraception. However, fear and anxiety regarding pain during implant insertion often become barriers for acceptors. This study aimed to determine the effect of slow deep breathing relaxation techniques on anxiety levels of women during implant insertion at TPMB Afita Delianah, Turen, Malang Regency. A quantitative quasi-experimental study with a Nonequivalent Control Group design was conducted with 32 respondents divided equally into an intervention group and a control group. The intervention group received slow deep breathing exercises for 15 minutes before implant insertion, while the control group did not receive any intervention. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS) before and after the intervention. Data analysis included Shapiro-Wilk normality test, paired t-test, Levene’s homogeneity test, and Independent Sample T-Test. Results showed that before the intervention, the mean anxiety score of the intervention group was 28.75 and the control group was 27.88. After the intervention, the intervention group’s anxiety score significantly decreased to 20.00, while the control group only decreased to 27.13. Independent Sample T-Test results indicated that the reduction in anxiety was significantly greater in the intervention group compared to the control group (p < 0.05). These findings indicate that slow deep breathing relaxation is effective in reducing anxiety during implant insertion. This technique can serve as a practical, safe, and applicable non-pharmacological strategy in midwifery practice to enhance women’s psychological comfort during reproductive health procedures.
FACTOR INFLUENCING HEALTHY EATING PATTERNS AND NUTRITIONAL STATUS OF CHILDREN AGED 3-7 YEARS: LAWRENCE GREEN THEORY APPROACH Widia Shofa Ilmiah; Rifzul Maulina; Anik Sri Purwanti
Jurnal Bioteknologi & Biosains Indonesia (JBBI) Vol. 13 No. 1 (2026)
Publisher : BRIN - Badan Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55981/jbbi.2026.15186

Abstract

Background: Nutrition issues among children in Indonesia remain a significant challenge, with the prevalence of stunting in children under five reaching 24.4% in 2021. Objective: This study aim to analyse the dominant factors affecting healthy eating patterns and nutritional status in children aged 3-7 years: Lawrence Green's theory approach. Material and Methods: Used observational study with a cross-sectional approach, the sample consisted of 44 children. Data collection was carried out using weight scales, microtoises, observation sheets, and food recall questionnaires. Results: Showed that the knowledge level was quite good (52.3%); family support was quite good (56.8%); children's eating patterns were mostly healthy (65.9%); children's nutritional status scored between ≥-2SD and ≤+2SD (65.9%). Heteroscedasticity scatter plot shows a certain pattern, normal PP Plots closely approach the line. Conclusion: That the most dominant factor affecting children's nutritional status is the parents' knowledge level about nutrition and children's eating patterns.
FACTOR INFLUENCING HEALTHY EATING PATTERNS AND NUTRITIONAL STATUS OF CHILDREN AGED 3-7 YEARS: LAWRENCE GREEN THEORY APPROACH Widia Shofa Ilmiah; Rifzul Maulina; Anik Sri Purwanti
Jurnal Bioteknologi & Biosains Indonesia (JBBI) Vol. 13 No. 1 (2026)
Publisher : BRIN - Badan Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55981/jbbi.2026.15186

Abstract

Background: Nutrition issues among children in Indonesia remain a significant challenge, with the prevalence of stunting in children under five reaching 24.4% in 2021. Objective: This study aim to analyse the dominant factors affecting healthy eating patterns and nutritional status in children aged 3-7 years: Lawrence Green's theory approach. Material and Methods: Used observational study with a cross-sectional approach, the sample consisted of 44 children. Data collection was carried out using weight scales, microtoises, observation sheets, and food recall questionnaires. Results: Showed that the knowledge level was quite good (52.3%); family support was quite good (56.8%); children's eating patterns were mostly healthy (65.9%); children's nutritional status scored between ≥-2SD and ≤+2SD (65.9%). Heteroscedasticity scatter plot shows a certain pattern, normal PP Plots closely approach the line. Conclusion: That the most dominant factor affecting children's nutritional status is the parents' knowledge level about nutrition and children's eating patterns.
Pengaruh Pemberian Sari Kurma Terhadap Produksi ASI Pada Ibu Nifas Di PMB Prima Apriantika Kota Malang Sisca Indah Maharani; Rifzul Maulina; Tut Rayani Aksohini Wijayanti
Borneo Nursing Journal (BNJ) Vol. 8 No. 1 (2026)
Publisher : Akademi Keperawatan Yarsi Samarinda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61878/bnj.v8i2.720

Abstract

Air Susu Ibu (ASI) merupakan sumber nutrisi utama bagi bayi yang berperan penting dalam tumbuh kembang dan daya tahan tubuh. Namun, cakupan ASI eksklusif masih belum optimal. Data menunjukkan bahwa secara global hanya 48% bayi yang mendapatkan ASI eksklusif, di Indonesia sebesar 58,6%, dan di Kota Malang sebesar 65,2%, yang masih belum mencapai target. Salah satu faktor penyebabnya adalah produksi ASI yang kurang pada ibu nifas. Upaya peningkatan produksi ASI dapat dilakukan melalui pendekatan nonfarmakologis, salah satunya dengan konsumsi sari kurma yang mengandung nutrisi dan fitohormon yang dapat merangsang produksi ASI. Penelitian ini bertujuan untuk menganalisis pengaruh pemberian sari kurma terhadap produksi ASI pada ibu nifas di TPMB Prima Apriantika Kota Malang. Penelitian ini menggunakan desain quasi eksperimen dengan pendekatan posttest-only control group design. Sampel berjumlah 32 responden yang dibagi menjadi kelompok intervensi dan kontrol masing-masing 16 orang. Hasil penelitian menunjukkan bahwa kelompok intervensi mayoritas memiliki produksi ASI kategori banyak (50%), sedangkan kelompok kontrol didominasi kategori kurang (43,8%). Uji Mann-Whitney menunjukkan nilai p = 0,028 (p < 0,05), sehingga terdapat pengaruh signifikan pemberian sari kurma terhadap produksi ASI. Disarankan ibu nifas mengonsumsi sari kurma secara rutin, menjaga pola makan seimbang, dan meningkatkan frekuensi menyusui agar produksi ASI optimal.
Perbandingan Efektivitas Konsumsi Daun Kelor Dan Daun Katuk Terhadap Produksi ASI Pada Ibu Nifas Di TPMB Masturoh Tajinan Wulan Rindiani Husain; Rifzul Maulina; Retno Dewi Prisusanti
Borneo Nursing Journal (BNJ) Vol. 8 No. 1 (2026)
Publisher : Akademi Keperawatan Yarsi Samarinda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61878/bnj.v8i2.730

Abstract

Air Susu Ibu (ASI) merupakan sumber nutrisi terbaik bagi bayi, namun cakupan pemberian ASI eksklusif masih rendah. Data menunjukkan hanya 44% bayi di dunia yang mendapatkan ASI eksklusif, sedangkan di Indonesia sebesar 52,5%, di Jawa Timur 65,2%, dan di Kabupaten Malang masih terdapat 37,2% ibu yang belum memberikan ASI eksklusif . Selain itu, hasil studi menunjukkan sebagian besar ibu nifas mengalami produksi ASI kurang, yaitu 60,0% pada kelompok daun kelor dan 66,7% pada kelompok daun katuk . Kondisi ini menunjukkan perlunya intervensi untuk meningkatkan produksi ASI. Penelitian ini bertujuan untuk mengetahui perbandingan efektivitas konsumsi daun kelor dan daun katuk terhadap produksi ASI pada ibu nifas. Penelitian ini menggunakan desain quasi experimental dengan pendekatan two group pretest–posttest. Sampel berjumlah 30 responden yang dibagi menjadi dua kelompok, masing-masing 15 orang. Teknik sampling menggunakan purposive sampling. Intervensi diberikan selama 14 hari. Analisis data menggunakan uji Wilcoxon Signed Ranks. Hasil penelitian menunjukkan terdapat perbedaan signifikan produksi ASI sebelum dan sesudah intervensi pada kedua kelompok, dengan nilai p-value 0,001 pada daun kelor dan 0,004 pada daun katuk (p<0,05) . Peningkatan rata-rata produksi ASI pada kelompok daun kelor sebesar 1,00, lebih tinggi dibandingkan kelompok daun katuk sebesar 0,67. Konsumsi daun kelor dan daun katuk sama-sama efektif dalam meningkatkan produksi ASI pada ibu nifas, namun daun kelor terbukti lebih efektif. Diharapkan ibu nifas dapat memanfaatkan daun kelor maupun daun katuk sebagai alternatif alami untuk meningkatkan produksi ASI serta tetap menjaga pola makan seimbang dan frekuensi menyusui yang optimal.
High-calcium tuna bone meal cookies improve linear growth in stunted toddlers Rifzul Maulina; Eka Diah Kartiningrum; Dian Pitaloka Priasmoro
Nursing and Health Sciences Journal (NHSJ) Vol. 6 No. 2 (2026): June 2026
Publisher : KHD-Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v6i2.699

Abstract

Stunting remains a critical public health challenge in Indonesia, necessitating innovative, locally sourced nutritional interventions. Tuna fish bones represent an underutilized source of bioavailable calcium and essential nutrients. This study evaluated the efficacy of high-calcium tuna bone meal cookie supplementation in improving the nutritional status of stunted toddlers. A quasi-experimental pretest–posttest control group design was conducted in Bandungrejosari Regency, Indonesia. Thirty-two stunted toddlers aged 12–60 months were recruited through purposive sampling and allocated into intervention (n=16) and control (n=16) groups. The intervention group received tuna bone meal cookies twice daily for 60 consecutive days, while the control group received no supplementation. Anthropometric measurements were obtained at baseline and post-intervention. Data were analyzed using independent and paired t-tests, with α=0.05. The intervention group demonstrated significantly greater linear growth compared to controls, with a mean height difference of 4.53 cm (p=0.008). Post-intervention mean height was 96.00 cm in the intervention group versus 91.47 cm in the control group. Tuna bone meal cookie supplementation significantly improves nutritional status and linear growth among stunted toddlers. This cost-effective, sustainable intervention using marine by-products shows promise for integration into community-based stunting-reduction programs
Co-Authors ., Sulistiyah Ainiyah, Anisatul Amalia, Waifti Anggelina Fernandes Anggie Nur'aini Ramadhani Anik Purwati Anik Purwati Anik Sri Purwanti Anik Sri Purwanti Anik Sri Purwanti Anitawati, Yuyun Asnawati Asriani M. Djauhar Aura, Annastasya Ayunda Aprilia Cece Indrawati Chrisye Rani Kuheba Citra Dondo Clairine Limpad Rosa Siwi Damaiyanti, Putri Darwati Darwati Dewinta Ristawati Dewiyanti Kiyuk Dian Pitaloka Priasmoro Dian Pitaloka Priasmoro, Dian Pitaloka Dian Setyorini Diana Puji Lestari, Diana Puji Didin Prasetya Cahyaningsih Eka Diah Kartiningrum Eka Putri, Lita Immanda Etni Yeyem Sumaila Evi Nurhidayah Fadya, Bianca Adinda Mustika FAHMI ALFIANI Firda Ponelo Fitrianti Mohune Halwani, Horidatul Hanifatul Hidayah Hasanah, Siti Imatul Hasriah Hasriah Hatim, Nelma Bin HELEN MARSHANDA HELEN MARSHANDA Hetty Johana Sulung Ika Sari Widayanti Ima Rusmawati Imatul Hasanah, Siti Indriati, Ina Intan Ramadani D.P Jeinni G Rotikan Karisma, Riski Candra Karlina Miringit, Alfiani Kartikasari, Tititan Nur Ari Dwi Kaumpungan, Kristesa Lista Keswara, Nila Keswara, Nila Widya Kurnia, Erisa Vatiatul Kurniawan, Ardhiles Wahyu Lailatul Badriyah Lilik Handayani Listiawati, Anni Mahastra Aulya Kartika Marwah Marwah Mega Sanjaya Meilanny G.H Warouw Mira Diadhita Prameswari Mochammad Bagus Qomaruddin Mokhtar Jamil Nabilla, Anggita Cantika Nariswari, Nuzul Dian Na’ifah, Sinta Lailatul Nila Widya Keswara Nila Widya Keswara Nila Widya Keswara Nurul Annisa&#039;un Sholihah Nurul Wahidatil Yusro Islami Ofa, Susanti F. Pinatis, Mersi Anneke Pingkan JB Walean Pondaag, Olfi Puji Lestari, Diana Putri Amarela Wardana Putri Aprillia Brilliant Pratama Qomariah Khusnul Khotimah Quds Alifah Qatrunada Raden Maria Veronika Raden Maria Veronika Widiatrilupi Raden Maria Veronika Widiatrilupi Rani Safitri Reny Retnaningsih Retno Dewi Prisusanti Rianti Rianti Rieza Junava Saffrilia Rosidah, Yessa Safira Adelia Tohari Sakti, Pika Oktavinny Aulia Samitrawati, Kurnia Sandrina Dewi Marshanda Sanjang, Meilany Leidy Setiya, Rani Sinta Lailatul Na’ifah Sisca Indah Maharani Siwi, Clairine Limpad Rosa Sofyani, Ajeng Ani Soleha, Lailatul Badriatus Solly Aryza Sri Mahmut Ambar Wati Sri Yolanda Daud Sulistiyah Sulistiyah Sulistiyah Sulistiyah Sulistiyah Susanti Bioto Susilowati Susilowati Sutrini Rone Syafiatul Maghfiroh Syamsidar Syamsidar tompoliu, Destie N Tut Rayani Tut Rayani Aksohini Wijayanti Ursalina, Ajeng Via Viky Aulia Restyo Wenny Diah Kurniasari Widia Shofa Ilmiah Widia Shofa Ilmiah Widia Shofa Ilmiah WINDI SAFITRI Wulan Rindiani Husain Wulandari, Eka Yusnia Yena Novia Puspita Herawati Yeyen Fujilestari Yuni Asri Yuni Asri Yunni Kartika Kapuangan Zaenal Alim Zangga, Mardiana Ina