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Hubungan Antara Lama Bekerja dan Aspek Afektif Triage START pada Perawat Puskesmas: The Relationship Between Length of Work Experience and the Affective Aspect of START Triage Among Community Health Center Nurses Suwardianto, Heru; Mahyuvi, Tata; Jaoquim, Pinto; Atta-Doku, John Foster; Ferede, Abebaw Jember
Jurnal Abdi Keperawatan dan Kedokteran Vol 5 No 1 (2026): Jurnal Abdi Kesehatan dan Kedokteran
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/jakk.v5i1.131

Abstract

Emergency situations and mass casualty incidents require nurses to make rapid, accurate, and evidence-based decisions, particularly in triage using the Simple Triage and Rapid Treatment (START) system. Nurses’ affective competence, including confidence, motivation, and emotional readiness, is crucial for effective triage. However, the relationship between length of service and affective competence remains underexplored in Indonesian community health centers. This cross-sectional study involved 27 nurses from 18 community health centers in Banten Province, Indonesia. A 15-item 4-point Likert questionnaire assessed affective competence in START triage, categorized into low, moderate, and high levels. Descriptive statistics and Pearson correlation analyzed the relationship between length of service and affective competence, with significance set at p < 0.05. Respondents were nearly evenly distributed by gender (48.1% male, 51.9% female) with a mean age of 37.07 ± 7.01 years and mean work experience of 14.81 ± 7.40 years. Most nurses (70.8%) demonstrated high affective competence, 29.2% moderate, and none low. Participants reported high confidence in understanding, explaining, and applying START, although some experienced difficulty in real-life scenarios. Correlation analysis indicated no significant relationship between length of service and affective competence (r = -0.053, p = 0.793). Nurses’ affective competence appears more influenced by training and practical experience than years of service. Structured training programs are essential to enhance affective competence in START triage, regardless of professional tenure.
Intersectionality-Based Policy Analysis of HIV-Related Stigma as a Structural Barrier to Health Equity: Evidence from Ghana with Implications for Sub-Saharan Africa Atta-Doku, John Foster
International Journal of Health Concord Vol. 2 No. 1 (2026): International Journal of Health Concord
Publisher : Lembaga Chakra Brahmanda Lentera (Chakra Brahmanda Lentera Institute) [CANDLE]

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/ihc.v21.34

Abstract

Background: Despite substantial advances in HIV prevention and treatment, HIV-related stigma remains a persistent structural barrier to equitable healthcare, particularly in Sub-Saharan Africa (SSA), where the epidemic is most concentrated. Ghana exemplifies this challenge, as progressive HIV policies coexist with entrenched forms of stigma that disproportionately affect marginalized populations. This study applies the Intersectionality-Based Policy Analysis (IBPA) framework to examine how intersecting social identities and policy assumptions shape HIV-related stigma and influence access to health services. Methods: A conceptual policy analysis was conducted using the IBPA framework. The analysis synthesized evidence from peer-reviewed literature, national HIV policy documents, and institutional reports relevant to HIV stigma, health equity, and healthcare access in Ghana and the broader SSA context. The analytical process focused on four IBPA dimensions: power relations, intersecting categories, policy assumptions, and equity implications. Result: The analysis revealed that HIV-related stigma persists despite formal non-discrimination policies, reflecting enduring structural and institutional inequities. Marginalized populations, including young women, men who have sex with men, sex workers, and rural communities, experience compounded barriers arising from the intersection of gender, sexuality, socioeconomic status, and geographic location. Current HIV policies predominantly emphasize biomedical interventions while inadequately addressing the social and structural determinants of stigma. These policy blind spots contribute to inequitable healthcare access and reduce the effectiveness of HIV prevention, treatment, and care services. Conclusion: Applying the IBPA framework demonstrates that HIV-related stigma is fundamentally a structural and intersectional challenge that requires policy responses extending beyond biomedical approaches. Embedding intersectionality, equity, and community engagement into HIV policy and service delivery may strengthen stigma reduction, improve healthcare utilization and treatment adherence, and advance health equity in Ghana and across Sub-Saharan Africa.