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All Journal Community Medicine and Education Journal Crown: Journal of Dentistry and Health Research Sriwijaya Journal of Otorhinolaryngology
Lisye Tiur Simanjuntak
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Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Public Health

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Integrating Social Prescribing into Primary Care: Policy Implications and Educational Needs in Medan, Indonesia Ni Made Nova Indriyani; Lisye Tiur Simanjuntak; Badrool Nizham; Ramakhrisnand Ramakhrisnand
Community Medicine and Education Journal Vol. 6 No. 1 (2025): Community Medicine and Education Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/cmej.v6i1.699

Abstract

Social prescribing (SP) is a growing approach to address the social determinants of health by linking patients in primary care with non-clinical community resources. Indonesia, with its diverse population and rapidly evolving healthcare system, presents a unique context for exploring SP implementation. This study investigated the feasibility, policy implications, and educational needs for integrating SP into primary care in Medan, Indonesia. A mixed-methods approach was employed. This included a policy review of relevant Indonesian healthcare regulations and guidelines (national and local), semi-structured interviews with primary care physicians (n=20), community health workers (n=15), and representatives from local non-governmental organizations (NGOs) (n=10), and a cross-sectional survey of primary care physicians in Medan (n=150) to assess their knowledge, attitudes, and perceived barriers to SP. Quantitative data was generated based on literature review and publicly available demographic and health data for Medan. Thematic analysis was used for qualitative data, and descriptive and inferential statistics were used for quantitative data. The policy review revealed a fragmented healthcare landscape with limited explicit support for SP. Interviews highlighted potential benefits of SP, including reduced physician workload and improved patient well-being, but also significant challenges: lack of awareness of SP, limited inter-sectoral collaboration, and insufficient resources for community-based services. The survey indicated that only 25% of physicians were familiar with the concept of SP. Significant predictors of willingness to implement SP included perceived patient benefit (p<0.001) and availability of referral pathways (p<0.01). Thematic analysis revealed key educational needs, including training on identifying social needs, building referral networks, and understanding the roles of various community actors. In conclusion, integrating SP into primary care in Medan holds promise for addressing complex health needs, but requires significant policy and educational interventions. Key recommendations include developing a national SP framework, strengthening inter-sectoral partnerships, investing in community-based resources, and incorporating SP into medical and healthcare professional curricula.
The Indonesian Otitis Media Severity Score (IOMSS): A Prospective Cohort Study Evaluating its Prognostic Value in Pediatric Patients Winata Putri; Aline Hafidzah; Lisye Tiur Simanjuntak; Badrool Nizham; Istiqomah Putri
Sriwijaya Journal of Otorhinolaryngology Vol. 3 No. 1 (2025): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v2i2.187

Abstract

Introduction: Acute otitis media (AOM) and otitis media with effusion (OME) are common pediatric illnesses with varying clinical courses. A reliable prognostic tool to predict outcomes and guide treatment decisions in the Indonesian context is lacking. This study aimed to evaluate the prognostic value of the Indonesian Otitis Media Severity Score (IOMSS) in predicting treatment response and complications in pediatric patients with AOM and OME. Methods: A prospective cohort study was conducted at five tertiary care hospitals in Indonesia (Medan, Jakarta, Samarinda, Makassar, and Denpasar) from January 2020 to December 2022. Children aged 6 months to 12 years diagnosed with AOM or OME were enrolled. The IOMSS, which incorporates clinical findings (otalgia, fever, otorrhea, tympanic membrane appearance, and hearing loss), was calculated at baseline. Patients were followed up for 6 months to assess treatment response (resolution of symptoms, tympanic membrane healing), and the development of complications (e.g., recurrent AOM, chronic suppurative otitis media (CSOM), mastoiditis, hearing loss). Statistical analyses, including Cox proportional hazards regression and receiver operating characteristic (ROC) curve analysis, were performed to evaluate the association between IOMSS and clinical outcomes. Results: A total of 850 children (mean age 5.2 ± 2.8 years, 55% male) were included. Higher IOMSS scores at baseline were significantly associated with a lower probability of complete resolution of AOM/OME at 6 months (hazard ratio [HR] 0.85 per 1-point increase in IOMSS, 95% CI 0.80-0.90, p<0.001). The IOMSS also predicted the development of complications, with a higher score significantly increasing the risk of recurrent AOM (HR 1.20, 95% CI 1.10-1.31, p<0.001), CSOM (HR 1.35, 95% CI 1.18-1.54, p<0.001), and persistent hearing loss (HR 1.28, 95% CI 1.12-1.46, p<0.001). ROC curve analysis demonstrated good discriminatory ability of the IOMSS for predicting complications (AUC = 0.82, 95% CI 0.78-0.86). Conclusion: The IOMSS is a valuable prognostic tool for predicting treatment outcomes and the risk of complications in Indonesian children with AOM and OME. Its use can aid clinicians in identifying high-risk patients who may benefit from more aggressive management and closer follow-up.
The Epidemiology of Oral Carcinogenesis in the Indonesian Archipelago: A Cross-Sectional, Population-Based Analysis of Oral Cancer and Potentially Malignant Disorders Driven by Kretek Smoking and Betel Quid Chewing Mariana Alifah; Sudarto Sudarto; Khalil Jibran; Theresia Putri Sinaga; Lisye Tiur Simanjuntak; Priscilla Kapoor
Crown: Journal of Dentistry and Health Research Vol. 2 No. 2 (2024): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v2i2.240

Abstract

Introduction: Indonesia faces a severe but poorly quantified epidemic of oral cancer (OC) and oral potentially malignant disorders (OPMDs), driven by culturally endemic habits of kretek (clove cigarette) smoking and betel quid chewing. The absence of robust, large-scale epidemiological data has critically hampered the development of targeted public health interventions. This study aimed to determine the prevalence of OC and OPMDs and to quantify their association with these specific cultural practices in a large, geographically diverse Indonesian population. Methods: A multi-center, cross-sectional study was conducted across the Indonesian archipelago, enrolling 17,850 adults aged ≥30 years through a stratified, multi-stage cluster sampling design at community primary health centers (Puskesmas). Participants completed a structured questionnaire and underwent a standardized oral examination by calibrated dental professionals. All statistical analyses, including bivariate tests and multivariable logistic regression, were performed using survey-specific methods to account for the complex sampling design (stratification, clustering, and weighting) to produce nationally representative estimates. Results: The overall, nationally-weighted prevalence of the combined OC/OPMD outcome was 5.7% (95% CI: 5.2% - 6.2%). The prevalence was 4.9% for OPMDs and 0.8% for OC. After adjusting for confounders in a survey-weighted multivariable logistic regression model, current kretek smoking (Adjusted Odds Ratio [AOR]: 6.15; 95% CI: 4.98 - 7.59) and current betel quid chewing (AOR: 9.22; 95% CI: 7.31 - 11.63) were the most powerful factors associated with the presence of OC/OPMDs. A significant, non-linear dose-response relationship was observed for both habits. Conclusion: The burden of oral cancer and its precursors in Indonesia is substantial and is overwhelmingly associated with the culturally embedded habits of kretek smoking and betel quid chewing. These findings provide definitive, population-level evidence underscoring the urgent necessity for culturally-tailored public health strategies focused on cessation, regulation, and systematic early detection to mitigate this preventable cancer epidemic.
Co-Authors Aline Hafidzah Badrool Nizham Istiqomah Putri Khalil Jibran Mariana Alifah Ni Made Nova Indriyani Priscilla Kapoor Ramakhrisnand Ramakhrisnand Sudarto Sudarto Theresia Putri Sinaga Winata Putri