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All Journal Proceeding Mulawarman International Conference on Tropical Public Health
Ardin Hermansyah Siagian
University of North Sumatra
Public Health

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Determinants of Sanitation and Menstrual Hygiene Adherence Among Female Students in Coastal North Sumatera Indonesia Evi Naria; Indra Chahaya; Rusmalawaty Rusmalawaty; Novita Olivia Sinurat; Raihana Atika; Ardin Hermansyah Siagian
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Menstrual hygiene of women in coastal areas which do not fulfill the health standard can increase the risk of reproductive tract infections, such as vaginal discharge, candidiasis, fungal infections, and cervical cancer. Limited access to sanitation facilities, lack of information, and poor hygiene habits negatively affect menstrual hygiene practices Objective : to analyze predisposing, reinforcing, and enabling factors related to menstrual hygiene among female students in coastal areas Research Methods/ Implementation Methods : This research was an observational study with a crosssectional design conducted in Medan City and Batubara Regency. The sample consisted of 300 female junior high school students who had experienced menstruation. Variables included age at menarche, sources of information, and knowledge of menstrual hygiene (Predisposing), family support and menstrual restrictions (Reinforcing), availability of clean water, soap, and dustbins (Enabling). Data were analyzed using cross-tabulation and the Chi-square test with a 95% confidence interval. Results : The results showed that 56% had their first menstruation (menarche) after the age of 12, 94.3% received information from their families, and 52% had good knowledge, all significantly related to menstrual hygiene practices (p = 0.005). Family support was also significantly associated (p = 0.014). Despite the availability of clean water (93.7%), soap (81.7%), and dustbins (81.7%), poor menstrual hygiene was still found in 86.7% of the students Conclusion/Lesson Learned : Knowledge, as a predisposing factor, and family support, as a reinforcing factor, need to be improved to improve the sanitation and menstrual hygiene practice
DETERMINANTS OF SANITATION AND MENSTRUAL HYGIENE ADHERENCE AMONG FEMALE STUDENTS IN COASTAL NORTH SUMATERA INDONESIA Evi Naria; Indra Chahaya; Rusmalawaty Rusmalawaty; Novita Olivia Sinurat; Raihan Atika; Ardin Hermansyah Siagian
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Service quality is a key determinant of patient satisfaction and loyalty. While extensive evidence exists in hospital settings, findings in primary care remain fragmented, particularly in contexts undergoing health financing reforms. This review aims to synthesize empirical evidence on the relationships between SERVQUAL dimensions, patient satisfaction, and patient loyalty in primary care settings. Methods: A narrative review was conducted on 34 primary empirical studies published between 2020 and 2025. Studies examining SERVQUAL dimensions—tangibles, reliability, responsiveness, assurance, and empathy—in relation to satisfaction and loyalty were included. Data were extracted and synthesized narratively, supported by an evidence frequency mapping. Responsiveness, empathy, and tangibles consistently demonstrated strong associations with patient satisfaction. Satisfaction frequently mediated the relationship between service quality and loyalty, whereas direct effects of service quality on loyalty were inconsistent. Reliability and assurance showed variable effects across contexts. Most studies employed crosssectional designs and SEM-PLS analytical approaches. Evidence supports a service quality–satisfactionloyalty pathway in primary care. Contextual and financial factors, such as institutional financing models, may moderate these relationships and warrant further investigation using longitudinal and context-sensitive designs.
Co-Authors Evi Naria Indra Chahaya Novita Olivia Sinurat Raihan Atika Raihana Atika Rusmalawaty Rusmalawaty