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I Nyoman Sutarsa
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Public Health

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Reasons for switching the primary health providers among national health insurance participants in Klungkung District, Bali Province, Indonesia Windu, I Kadek; I Ketut Suarjana; I Nyoman Sutarsa
Public Health and Preventive Medicine Archive Vol. 11 No. 2 (2023)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2023.v11.i2.p03

Abstract

Background and purpose: National Health Insurance Provider (BPJS Kesehatan) facilitates the distribution of National Health Insurance (NHI) participants. High number of 1,947 NHI participants were switched primary health providers in Klungkung, Bali between July to December 2021.This study aims to explore the reasons for the switching of providers among NHI participants and the health providers’ efforts to minimize it. Methods: A qualitative descriptive study guided by an access theory was conducted in Klungkung District between December 2022 to March 2023. A total of 18 informants were purposively recruited, consisting of NHI participants (12 people), health service providers (4 people), BPJS Kesehatan (1 person) and staff of the district health office (1 person). Data was collected through in-depth interviews guided by interview guidelines. Data were analyzed using a thematic approach and presented in a descriptive narrative. Results: NHI participants in Klungkung District switched provider due to spatial and non-spatial reasons. Spatial reason was the distance and time to the health provider. Non-spatial reasons included (1) conflict in social relations due to service and negative attitudes of health workers, (2) economic considerations in the health system which are difficult to reach, and (3) external encouragement. Strategies that have been or can be implemented to minimize the switching of PHCs were adjusting operational hours, improving the infrastructures, administration through fulfilling accreditation, service quality and training for human resources. Conclusion: The dominant reason for switching of PHCs is associated with negative social interaction experiences related to human resources and service facilities at PHCs. PHCs are expected to be able to improve the quality of services through improving human resources and service delivery facilities.
The Evaluation of human papillomavirus vaccination coverage for school aged girls in Badung District, Bali, Indonesia, 2016 – 2018 Yuliyatni, Putu Cintya Denny; Sawitri, Anak Agung Sagung; I Gusti Agung Alit Naya; Mego Windyningtyas; Ni Kade Erveni; I Nyoman Sutarsa
Public Health and Preventive Medicine Archive Vol. 12 No. 1 (2024)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2024.v12.i1.p02

Abstract

Background and purpose: Since 2016, Badung District, Bali has implemented a free HPV vaccination program for school children, with vaccination coverage reported to be over 90% in 2016-2018. This study aims to objectively assess the coverage of HPV vaccination among school children in Badung District. Methods: This survey used a cross-sectional design that conducted between March and June 2019. Sample selection was done by systematic random sampling, following the WHO guidelines. A total of 216 families met the sample criteria, with a total of 249 children from all families. Respondents in this study were eligible girls' mothers or families who knew the child's vaccination history. Variables of this study were sociodemographic characteristics of respondents and children, HPV vaccination recall and HPV child vaccination validation. The data collected were analyzed descriptively to calculate the coverage of recall and validation of HPV vaccination. Results: The majority of respondents were mothers (70.83%) with a high school education (51.85%). The median age was 43 years (IQR=8 years). Each family had a mean of 1.15 eligible children (SD=0.39). Of the 249 children, most were aged 16-19 years (43.37%), with age at vaccination mostly ≤12 years (46.52%). HPV vaccination coverage by recall was 82.32% (95%CI: 77.56-87.09), with HPV vaccination coverage by validation was 76.59% (95%CI: 70.74-82.43). Conclusion: After validation, vaccination coverage was lower than vaccination coverage by recall. The health office needs to improve the vaccination registration system, in particular the uniformity of registration and record keeping to ensure proper traceability of vaccination history.
Co-Authors I Gusti Agung Alit Naya Ketut Suarjana Mego Windyningtyas Ni Kade Erveni Putu Cintya Denny Yuliyatni Sawitri, Anak Agung Sagung Windu, I Kadek