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The Effect of Health Insurance Ownership, Travel Time, and Transportation Costs on the Use of Health Facilities by Stunted Toddlers in North Sumatera Province Syafrina Ulfah; Lubis, Fithri Handayani; Manullang, Hengki Frengki
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/5evn8x84

One of the causes of stunting is limited access to health care and essential services. Based on SKI 2023 data, there are still stunted toddlers in North Sumatera who have not used healthcare facilities in the past year since the survey was conducted. The purpose of this study was to analyze the determinants of healthcare facilities utilization in stunted toddlers in North Sumatera, focusing on the factors of health insurance ownership, travel time, and transportation costs. The study design used was cross-sectional with a sample size of 801 stunted toddlers aged 24-59 months in North Sumatera. Univariate data analysis was performed by presenting the results in the form of frequency tables, bivariate analysis using chi-square, and multivariate analysis using logistic regression. Based on the results of bivariate analysis using the chi-square test, it was found that there was no effect of health insurance ownership (p=0.059) and travel time (p=0.108), and there was an effect of transportation costs (p=0.001) on the use of healthcare facilities. Multivariate analysis using logistic regression showed that the variable of transportation costs (p=0.001) had a significant effect on the use of healthcare facilities with an Odd Ratio (OR) value of 3.894. This shows that transportation costs are still a barrier to accessing health care, especially for stunted toddlers. Therefore, a service approach through home visits could be a potential solution so that high transportation costs no longer become a barrier to accessing health services.

Determinan Cakupan Imunisasi Dasar Lengkap Sebagai Bagian Upaya Pencegahan Stunting Di Kota Medan: Studi Literatur Syafrina Ulfah; Nurcholisah Fitra
VitaMedica : Jurnal Rumpun Kesehatan Umum Vol. 3 No. 4 (2025): Oktober : VitaMedica : Jurnal Rumpun Kesehatan Umum
Publisher : STIKES Columbia Asia Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62027/vitamedica.v3i4.602

Stunting is a chronic nutritional problem characterized by a child’s height being inappropriate for their age, particularly among children under five years old. One of the interventions implemented to prevent stunting is immunization. However, immunization coverage, especially complete basic immunization, has not yet reached the target, including in Medan City. Therefore, this literature study aims to explore the determinants of complete basic immunization coverage in Medan City using the Google Scholar database. The literature search identified nine articles that were extracted and discussed in this study. The determinants of complete basic immunization coverage include individual maternal factors such as age, education level, knowledge, attitudes, and mothers’ beliefs or perceptions toward immunization; social support factors including family support, economic conditions, and prevailing norms and cultural practices within families and communities; as well as health service factors. Comprehensive and integrated interventions are urgently needed to achieve optimal complete basic immunization coverage in Medan City.

Transformasi Administrasi Kesehatan Masyarakat Dalam Penguatan Tata Kelola Pelayanan Kesehatan Primer Di Era Digital Tahun 2025: Suatu Tinjauan Literatur Nurcholisah Fitra; Syafrina Ulfah
VitaMedica : Jurnal Rumpun Kesehatan Umum Vol. 3 No. 4 (2025): Oktober : VitaMedica : Jurnal Rumpun Kesehatan Umum
Publisher : STIKES Columbia Asia Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62027/vitamedica.v3i4.603

Public health administration plays a strategic role in strengthening primary health care governance amid increasingly complex health system challenges. This study aimed to synthesize recent evidence on the development, challenges, and implications of public health administration during the period 2020–2025. A literature review with a systematic approach was conducted by analyzing peer-reviewed articles retrieved from major scientific databases and selected through a PRISMA 2020 flow process. The findings indicate that effective public health administration—characterized by strong governance, adaptive leadership, and the integration of digital health information systems—contributes to improved performance of primary health care services in terms of service quality, efficiency, and sustainability. However, the review also reveals persistent gaps, particularly the limited empirical evidence examining causal relationships between administrative capacity and health service performance, as well as challenges related to human resource readiness and data governance in digital transformation. These findings highlight the need to strengthen administrative capacity, leadership competencies, and integrated information systems to support resilient primary health care. The study provides theoretical and practical implications for policymakers, health managers, and researchers in advancing public health administration toward more effective and sustainable health systems.

HUBUNGAN ANTARA DAERAH TEMPAT TINGGAL DENGAN KEJADIAN DIARE PADA BALITA USIA 24-59 BULAN DI SUMATERA UTARA Hengki Frengki Manullang; Fithri Handayani Lubis; Syafrina Ulfah; Monika Nina Ginting
Jurnal Penelitian Kesmasy Vol. 8 No. 1 (2025): Jurnal Penelitian Kesmasy
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Deli Husada Delitua

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36656/jpksy.v8i1.2696

Diarrhea is an endemic disease of significant concern in Indonesia and ranks as the second-largest cause of mortality among children under the age of five. This study aims to identify the correlation between residential location and the incidence of diarrhea in toddlers aged 24–59 months in North Sumatra Province, utilizing data from the 2023 Indonesian Health Survey (SKI). This research used a quantitative design with a cross-sectional approach and included 3784 toddlers aged 24 to 59 months. Analysis was performed using the chi-square test. The results of the analysis showed a p-value of 0,002 (p < 0,05), indicating a strong correlation between place of residency and the incidence of diarrhea. An odds ratio (OR) of 1,670 indicates that toddlers living in urban areas are 1,670 times more predisposed to experiencing diarrhea compared to their rural counterparts. The findings underscore the necessity of considering regional context in the fight against diarrhea in North Sumatera, necessitating interventions adapted to urban and rural settings to enhance the specificity and efficacy of prevention programs aimed at lowering diarrhea incidence in toddlers.

OPTIMIZATION OF MEDICAL RECORD DATA FOR CLINICAL DECISION-MAKING IN TUBERCULOSIS PATIENTS: A LITERATURE REVIEW Akhmad Fatikhus Solikh; FITHRI HANDAYANI LUBIS, S.K.M., M. Kes.; Herawati Br Bukit; Syafrina Ulfah; Hengki Frengki Manullang; Fitri Handayani
Jurnal Penelitian Kesmasy Vol. 8 No. 2 (2026): JURNAL PENELITIAN KESMASY
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Deli Husada Delitua

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36656/jpksy.v8i2.2961

Tuberculosis (TB) remains a major global health problem with a high disease burden, particularly in developing countries such as Indonesia. The complexity of TB management requires accurate and comprehensive data to support clinical decision-making. Medical records and health information systems play a crucial role in providing relevant patient data, yet their utilization is often not optimal due to issues related to data quality, system integration, and limited interoperability. This study aims to analyze the optimization of medical record data in supporting clinical decision-making for TB patients through a literature review approach. This study employed a systematic literature review (SLR) method by analyzing scientific articles published between 2022 and 2025 from databases including Scopus, PubMed, ScienceDirect, and Google Scholar. The selection process followed the PRISMA approach, with inclusion criteria focusing on studies related to medical records, health information systems, and clinical decision-making in tuberculosis cases. The results indicate that electronic medical records (EMR) and integrated health information systems significantly contribute to improving the accuracy of diagnosis, treatment monitoring, and clinical decision-making. The use of technologies such as clinical decision support systems (CDSS), big data, and artificial intelligence enhances data utilization and supports evidence-based clinical practices. However, several challenges remain, including incomplete data, inconsistent documentation, lack of system integration, and variability in human resource capacity, particularly in Indonesia. The implementation of systems such as the Tuberculosis Information System (SITB) has improved reporting and case management, although its integration with electronic medical records is still limited. In conclusion, optimizing medical record data is essential to enhance clinical decision-making in TB management. Strengthening data quality, improving system interoperability, and maximizing the use of digital technologies are necessary to support more effective and evidence-based healthcare services, particularly in high TB burden settings.

Implementasi Artificial Intelligence Dalam Manajemen Rumah Sakit: Systematic Review Terhadap Efisiensi Operasional, Mutu Pelayanan, Dan Keselamatan Pasien Nurcholisah Fitra; Syafrina Ulfah
VitaMedica : Jurnal Rumpun Kesehatan Umum Vol. 4 No. 3 (2026): Juli : VitaMedica : Jurnal Rumpun Kesehatan Umum
Publisher : STIKES Columbia Asia Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62027/vitamedica.v4i3.780

The development of Artificial Intelligence (AI) has driven significant transformation in hospital management, particularly in operational efficiency, service quality, and patient safety. This study aims to analyze the implementation of AI in hospital management based on recent scientific evidence from 2020 to 2026. The method used was a systematic review guided by the PRISMA 2020 framework. Literature was retrieved from PubMed, ScienceDirect, SpringerLink, Google Scholar, and ProQuest. From 360 identified articles, a stepwise selection process was conducted, resulting in 15 articles that met the inclusion criteria. The findings indicate that AI contributes to improved operational efficiency through patient flow optimization, operating room management, workforce scheduling, and electronic medical record management. AI also enhances service quality through predictive data analytics and supports patient safety through risk detection and early warning systems. In conclusion, AI has strong strategic potential to support modern hospital management. However, its implementation still faces several challenges, including human resource readiness, data security, algorithmic bias, system interoperability, and investment requirements. Therefore, AI implementation should be carried out in a planned, ethical manner and evaluated from a health economics perspective.

Implementasi Program Cek Kesehatan Gratis Di Pelayanan Kesehatan Primer: Studi Literatur Syafrina Ulfah; Nurcholisah Fitra
VitaMedica : Jurnal Rumpun Kesehatan Umum Vol. 4 No. 3 (2026): Juli : VitaMedica : Jurnal Rumpun Kesehatan Umum
Publisher : STIKES Columbia Asia Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62027/vitamedica.v4i3.783

The Free Health Check-up (CKG) is a government program designed to strengthen promotive and preventive health efforts through the early detection of risk factors, pre-disease conditions, and diseases across the community according to the life-cycle approach. As a relatively new initiative, the implementation of the CKG program in primary healthcare settings still requires further evaluation to assess implementation readiness, digital support systems, and community participation. This literature review aimed to examine the implementation of the Free Health Check-up Program in primary healthcare services. Relevant literature was retrieved from the Google Scholar database using the keyword "implementation of the free health check-up program" and was limited to open-access, full-text articles published between 2025 and 2026. The search identified eight eligible articles, which were extracted and analyzed in this review. The synthesis revealed three major themes in the implementation of the CKG program: (1) primary healthcare service readiness, (2) digitalization and reporting systems, and (3) community participation and communication strategies. Primary healthcare readiness includes the availability of human resources, infrastructure, medical equipment, consumable medical supplies, funding, service workflows, and cross-sectoral coordination. Digitalization through the SATUSEHATplatform and integrated reporting systems has the potential to improve service efficiency; however, challenges remain regarding digital literacy, internet connectivity, and the technical capacity of healthcare personnel. Community participation is influenced by knowledge, attitudes, the roles of community health volunteers, teachers, healthcare workers, and communication strategies tailored to the characteristics of the target population. The successful implementation of the CKG program requires strengthening primary healthcare systems, optimizing digital health platforms, and adopting community-based communication strategies to ensure the program is more effective, inclusive, and sustainable.

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