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Fajarina, Mira
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Factors influencing late antenatal care of Muslim pregnant women: A predictive correlational study in Aceh, Indonesia Fajarina, Mira; Terathongkum, Sangthong; Lininger, Jiraporn
Belitung Nursing Journal Vol. 10 No. 3 (2024): May - June
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3339

Abstract

Background: Late antenatal care (ANC) has significant implications for maternal and infant morbidity and mortality among Muslim pregnant women in Indonesia. Existing literature has primarily focused on gestational weeks at the first ANC contact, with limited attention to the total number of ANC visits. Objective: This study aimed to explore the factors predicting late antenatal care contact among Muslim pregnant women, including the gestational weeks of the first ANC contact and the total number of ANC visits in Aceh, Indonesia. Methods: A predictive correlational study design was utilized. Eighty postpartum women who received late ANC were purposively sampled and included in the study. Data were collected in May 2023 using ANC knowledge, beliefs, and social support questionnaires. Statistical analyses included descriptive statistics, Spearman’s rank correlation, Chi-Square tests, and binary logistic regression with the enter method. Results: Pregnant women residing farther from home to ANC services were more likely to have their first ANC contact after 20 weeks than those with a shorter distance (AOR = 1.06; 95% CI: 1.02-1.10; p = 0.007). Additionally, women with a history of multiple abortions were more inclined to have four or more ANC visits compared to those with fewer abortions (AOR = 6.78; 95% CI: 1.64-28.09; p = 0.008). Conclusion: Distance from home to healthcare services emerged as a significant barrier to ANC contact, while a history of abortion appeared to motivate pregnant women to seek ANC more frequently. To address these issues effectively, nurses should consider implementing telemedicine services for ANC provision, integrating information on pregnancy complications to better support pregnant women in their care journey.
Efektivitas penerapan audit maternal perinatal surveilans responsif (AMPSR) dalam mengidentifikasi faktor risiko kematian ibu Khalidah, Khalidah; Utama, Reka Julia; Fajarina, Mira; Kartikasari, Komala; Saputra, Mahruri; Ristiani, Ristiani
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1537

Abstract

Background: Maternal mortality remains a major challenge in Indonesia's health system, including in Banda Aceh. Responsive Maternal Perinatal Surveillance Audits (AMPSR) are recognized as a crucial strategy for reducing maternal mortality, but their implementation is often hampered by poor documentation quality, follow-up, and interprofessional team involvement. A Point of Care Quality Improvement (POCQI) approach is proposed to strengthen the audit's effectiveness. Purpose: To evaluate the effectiveness of the implementation of maternal perinatal audit responsive surveillance (AMPSR) in identifying risk factors for maternal mortality. Method: The study used a quasi-experimental one-group pretest-posttest design with a sample of 16 AMPSR team members at three healthcare facilities (Meuraxa Regional Hospital, Banda Aceh Women's Hospital, and Meuraxa Community Health Center). Data were collected through audit forms, compliance checklists, and POCQI questionnaires, then analyzed using the Wilcoxon Signed Rank Test and logistic regression. Results: POCQI training significantly improved knowledge (p=0.001), practice and documentation (p=0.001), audit effectiveness (p=0.000), and perceived barriers and support (p=0.025). Multivariate analysis showed that practice and documentation were the dominant factors influencing the effectiveness of AMPSR implementation (OR=4.75; p=0.017). Conclusion: The implementation of the POCQI-based AMPSR has proven effective in strengthening the capacity of interprofessional teams and improving the quality of maternal audits. This strategy has the potential to become a sustainable approach to maternal mortality prevention in Indonesia.   Keywords: Maternal Mortality; Maternal Perinatal Surveillance Responsive Audit (AMPSR); Risk Factors.   Pendahuluan: Angka kematian ibu masih menjadi tantangan besar dalam sistem kesehatan di Indonesia, termasuk di Kota Banda Aceh. Audit Maternal Perinatal Surveilans Responsif (AMPSR) diakui sebagai strategi penting untuk menurunkan angka kematian maternal, namun pelaksanaannya sering terkendala kualitas dokumentasi, tindak lanjut, serta keterlibatan tim lintas profesi. Pendekatan Point of Care Quality Improvement (POCQI) ditawarkan untuk memperkuat efektivitas audit. Tujuan: Untuk mengevaluasi efektivitas penerapan audit maternal perinatal surveilans responsif (AMPSR) dalam mengidentifikasi faktor risiko kematian ibu. Metode: Penelitian ini menggunakan desain quasi experiment one group pretest-posttest dengan sampel 16 anggota tim AMPSR di tiga fasilitas kesehatan (RSUD Meuraxa, RSIA Banda Aceh, dan Puskesmas Meuraxa). Data dikumpulkan melalui formulir audit, checklist kepatuhan, dan kuesioner POCQI, kemudian dianalisis menggunakan Wilcoxon Signed Rank Test dan regresi logistik. Hasil: Pelatihan POCQI meningkatkan secara signifikan pengetahuan (p=0.001), praktik dan dokumentasi (p=0.001), efektivitas audit (p=0.000), serta persepsi hambatan dan dukungan (p=0.025). Analisis multivariat menunjukkan bahwa praktik dan dokumentasi merupakan faktor dominan yang memengaruhi efektivitas penerapan AMPSR (OR=4.75; p=0.017). Simpulan: Penerapan AMPSR berbasis POCQI terbukti efektif dalam memperkuat kapasitas tim lintas profesi dan meningkatkan kualitas audit maternal. Strategi ini berpotensi menjadi pendekatan berkelanjutan dalam pencegahan kematian ibu di Indonesia.   Kata Kunci: Audit Maternal Perinatal Surveilans Responsif (AMPSR); Faktor Risiko; Kematian Ibu.
Dampak climate crisis terhadap pola penyakit ibu hamil dan maternal mortality Fajarina, Mira; Utama, Reka Julia; Malem, Rehmaita
Holistik Jurnal Kesehatan Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1571

Abstract

Background: Climate change directly impacts maternal health, increasing the risk of pregnancy complications, delayed antenatal care (ANC) visits, and maternal mortality. Purpose: To analyze the impact of the climate crisis on maternal disease patterns and maternal mortality. Method: An observational analytic study with a case-control design was conducted on 364 pregnant women at the Baitussalam and Blang Bintang Community Health Centers in Aceh Besar. The sample was selected purposive sampling, consisting of case groups (mothers with complications) and controls. Data were collected using a validated questionnaire (CVI by three experts, Cronbach's Alpha ≥0.7) and medical records. Analysis used Chi-square and multiple logistic regression. Results: Exposure to extreme temperatures (OR=2.27; p=0.010), air pollution (OR=1.91; p=0.036), and weather changes (OR=2.85; p=0.006) were significantly associated with pregnancy complications, while counseling played a protective role (OR=0.49; p=0.010). Cancelling antenatal care due to extreme weather increases the risk of complications (OR=3.16; p=0.001). Conclusion: Environmental factors related to the climate crisis impact maternal health, necessitating mitigation strategies such as education, increasing access to antenatal care, and strengthening health system capacity to reduce the risk of maternal complications.   Keywords: Climate Crisis; Maternal Diseases; Maternal Mortality.   Pendahuluan: Perubahan iklim berdampak langsung pada kesehatan maternal, meningkatkan risiko komplikasi kehamilan, keterlambatan kunjungan antenatal care (ANC), dan mortalitas ibu. Tujuan: Untuk menganalisis dampak climate crisis terhadap pola penyakit ibu hamil dan maternal mortality. Metode: Studi observasional analitik dengan desain kasus-kontrol dilakukan pada 364 ibu hamil di Puskesmas Baitussalam dan Blang Bintang, Aceh Besar. Sampel dipilih secara purposive sampling, terdiri dari kelompok kasus (ibu dengan komplikasi) dan kontrol. Data dikumpulkan menggunakan kuesioner tervalidasi (CVI oleh tiga ahli, Cronbach’s Alpha ≥0.7) dan rekam medis. Analisis menggunakan Chi-Square dan regresi logistik berganda. Hasil: Paparan suhu ekstrem (OR=2.27; p=0010), polusi udara (OR=1.91; p=0.036), dan perubahan cuaca (OR=2.85; p=0.006) berhubungan signifikan dengan komplikasi kehamilan, sedangkan penyuluhan berperan protektif (OR=0.49; p=0.010). Batal ANC karena cuaca ekstrem meningkatkan risiko komplikasi (OR=3.16; p=0.001). Simpulan: Faktor lingkungan terkait krisis iklim memengaruhi kesehatan ibu hamil, sehingga diperlukan strategi mitigasi seperti penyuluhan, peningkatan akses ANC, dan penguatan kapasitas sistem kesehatan untuk mengurangi risiko komplikasi maternal.   Kata Kunci: Climate Crisis; Maternal Mortality; Penyakit Ibu Hamil.
Hubungan Dukungan Keluarga Dengan Peningkatan Kepatuhan Pengobatan Dan Pencegahan Tbc Pada Anak Di UPTD Puskesmas Langkahan Nazari, Nuri; Lestari, Jayanti Ridha; Fajarina, Mira; Riansyah, Ferdi; Maulida, Maulida
Teewan Journal Solutions Vol. 1 No. 4 (2024): Desember
Publisher : Teewan Solutions

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62710/tdncx403

Abstract

Penyakit Tuberkulosis  telah dikenal lebih dari satu abad yang lalu yakni sejak ditemukannya kuman penyebab Tuberkulosis oleh Robert Koch tahun 1882. WHO pada tahun 1993 mengatakan bahwa Tb sebagai suatu poblema kesehatan masyarakat yang sangat penting dan serius di seluruh dunia serta merupakan penyakit yang menyebabkan kedaruratan global (Global Emergency), karena satu dari tiga pendudujk dunia diperkirakan telah teinfeksi dengan Mycobacterium tuberkulosis (disebut juga Basil Tahan Asam=BTA) sebagai kuman penyebab TB yang dibuktikan dengan pemeriksaan Mantouxtes. Secara geografis kasus TBC terbanyak di Southeast Asia (45,6%), Afrika (23,3%) dan Western Pacific (17,8%), dan yang terkecil di Eastern Mediterranean (8,1%), The Americas (2,9%) dan Eropa (2,2%).Penelitian ini menggunakan pendekatan kuantatif, dengan merumuskan hipotesis yang selanjutnya dilakukan pengujian statistik untuk menerima atau menolak hipotesis. Penelitian ini bertujuan mengetahui hubungan antara dukungan keluarga dengan kepatuhan pengobatan pada pasien tuberculosis. Berdasarkan tabel diatas tentang dukungan instrumental menunjukkan bahwa dukungan instrumental kurang (10%) pada pasien yang tidak patuh lebih rendah dibandingkan dengan dukungan instrumental baik (57,1%) . Berdasarkan uji statistik, nilai p-value pada dukungan instrumental adalah 0,001 yang berarti memiliki hubungan yang bermakna antara dukungan instrumental dengan kepatuhan pengobatan tuberculosis.
Co-Authors Kartikasari, Komala Khalidah Khalidah, Khalidah Lestari, Jayanti Ridha Lininger, Jiraporn Mahruri Saputra Maulida, Maulida Nazari, Nuri Rehmaita Malem Reka Julia Utama Riansyah, Ferdi Ristiani, Ristiani Terathongkum, Sangthong