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Social Capital Role on Pregnant Woman Health in Klaten, Central Java Sri Panuntun; Ravik Karsidi; Bhisma Murti; Muhammad Akhyar
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Maternal class, partnership with traditional birth attendant (TBA), and maternity waiting home are health community empowerment programs in North Klaten Subdistrict, Central Java, seem to be partial, even though they involve the same parties and the same goal to improve the health of pregnant women. The purpose of this study was to explore social capital role on pregnant woman health in Klaten, Central Java.Subjects and Method: This was a qualitative study with a case study design in North Klaten Sub-district, Klaten, Central Java. The data were collected by in-depth interview, observation, and document review.Results: This study shows that in order for a pregnancy health program to run effectively it requires the integration of information on the health of pregnant women and the development of pregnancy can reduce the risk of late three, namely late decision making, late bringing to health facilities, and late getting health services that can affect maternal mortality. As an effort to provide the best service to pregnant women in maternal class, partnership with TBA, and maternity waiting home programs requires a network of cooperation (interconnection) between all parties involved through social capital in accordance with the agreement supported by the village government. Conclusion: Maternal class, partnership with TBA, and maternity waiting home programs must run simultaneously to improve the health of pregnant women. social capital model is a model of collaboration between all parties involved in KBD, KIH and RTK through interconnection based on telephone and/or internet networks, so that information is exchanged about health conditions and the development of pregnancy.Keywords: social capital, pregnant women, health, maternal classCorrespondence: Sri Panuntun. Doctoral Program in Health Promotion/Community Development, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: ichaku06@yahoo.com.Journal of Health Policy and Management (2019): 4(1): 59-66https://doi.org/10.26911/thejhpm.2019.04.01.07

Contextual Effect of Community Health Center on Patient Satisfaction of Health Care Service in Ngawi, East Java Hendra Dwi Kurniawan; Didik Tamtomo; Bhisma Murti
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Perceived patient satisfaction is an important component of health care quality. This study aimed to determine the effect of age, education, income, health financing, quality of health care service, and the contextual effect of community health center on patient satisfaction. Subjects and Method: This was a cross-sectional study conducted in 25 community health centers in Ngawi, East Java, from October to November 2018. A sample of 200 patients was selected by stratified random sampling. The dependent variable was patient satisfaction. The independent variables were age, education, income, health insurance, and quality of health care service. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: Age ≥35 years (b = 0.99; 95% CI= 0.17 to 1.81; p<0.019) and good quality of health care service (b= 1.68; 95% CI= 0.78 to 2.59; p<0.001) increased patient satisfaction. Education ≥senior high school (b= -1.59; 95% CI= -2.49 to -0.68; p<0.001), income ≥Rp 1,569,832 (b= -1.32; 95% CI= -2.25 to -038; p<0.006), and membership of national health insurance (b= -1.55; 95% CI= -2.47 to-0.63; p< 0.001) decreased patient satisfaction. Community health center had contextual effect on patient satisfaction with ICC= 13.03%.Conclusion: Age ≥35 years and a good quality of health care service increase patient satisfaction. Education ≥senior high school, high income, and membership in national health insurance decrease patient satisfaction. The community health center has a contextual effect on patient satisfaction.Keywords: patient satisfaction, community health center, multilevel analysisCorrespondence: Hendra Dwi Kurniawan. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: hendradeeka@gmail.comJournal of Health Policy and Management (2019), 4(1): 23-30https://doi.org/10.26911/thejhpm.2019.04.01.03

Multilevel Analysis on the Effect of Marketing Mix Strategy toward Patient Satisfaction in Magelang, Central Java Luâ€™luatul Fuad; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Hospital marketing is becoming increasingly competitive all over the world. The marketing mix strategy is considered one of the core concepts of marketing theory. This study aimed to examine the effect of marketing mix strategy toward patient satisfaction in Magelang, Central Java.Subjects and Method: A cross sectional study was conducted at Magelang Hospital, Central Java, in December 2018. A sample of 200 patients was selected by simple random sampling. The dependent variable was patient satisfaction. The independent variables were product, price, place, promotion, process, people, physical appearance, and ward. The data were collected by questionnaire and analyzed by multilevel multiple logistic regression.Results: Patient satisfaction increased with good product (b= 3.42; 95% CI= 0.76 to 2.81; p<0.001), low price (b= 1.92; 95% CI= -0.05 to 1.70; p= 0.054), right place (b= 2.41; 95% CI= 0.19 to 1.92; p= 0.016), attractive promotion (b= 2.92; 95% CI= 0.43 to 2.19; p= 0.004), people (b= 1.91; 95% CI= -0.24 to 1.75; p= 0.057), good physical appearance (b= 2.42; 95% CI= 0.20 to 1.97; p= 0.015), and sound process (b= 2.07; 95% CI= 0.45 to 1.72; p= 0.039). Ward had a considerable contextual effect on patient satisfaction with ICC= 14.65%.Conclusion: Patient satisfaction increases with good product, low price, right place, attractive promotion, people, good physical appearance, and sound process. Ward has a considerable contextual effect on patient satisfaction.Keywords: marketing mix, patient satisfaction, hospital, multilevel analysisCorrespondence: Lu’luatul Fuad. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: afuadlulu@gmail.com. Mobile: +6285643702066.Journal of Health Policy and Management (2019), 4(1): 39-46https://doi.org/10.26911/thejhpm.2019.04.01.05

Linear Regression Analysis on Factors Affecting Health Surveillance Personnel Performance in Early Detection of Preeclampsia in Semarang, Central Java Zella Cahyandaru; Didik Tamtomo; RB Soemanto
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Preeclampsia is a major cause of maternal death both globally and regionally. It can be prevented either through continuous surveillance and early detection activities. City Health Office in Semarang recruited health surveillance officers as an effort to reduce maternal mortality especially due to preeclampsia. The purpose of this study was to analyze factors associated with health surveillance personnel performance in the early detection of preeclampsia.Subjects and Method: This was an analytic observational study with a cross sectional design. The study was conducted in 26 community health centers in Semarang, from October to December 2018. A sample 148 health surveillance personnels was selected by exhaustive sampling. The dependent variable was health surveillance personnels performance. The independent variables were age, work motivation, work stress, job satisfaction, leadership style, and supervision. The data were collected by questionnaire and analyzed by a multiple linear regression.Results: Health surveillance personnel’s performance in early detection of preeclampsia was positively associated with strong work motivation (b= 0.12; 95% CI= 0.07 to 0.16; p<0.001), low work stress (b= 0.08; 95% CI= -0.01 to 0.15; p= 0.058), work satisfaction (b= 0.10; 95% CI= 0.05 to 0.15; p<0.001), leadership style (b= 0.23; 95% CI= 0.10 to 0.37; p= 0.001), and good supervision (b= 0.31; 95% CI= 0.18 to 0.45; p<0.001). Health surveillance personnel’s performance was negatively associated with older age (b= -0.08; 95% CI= -0.16 to 0.01; p= 0.050).Conclusions: Health surveillance personnel performance in early detection of preeclampsia is positively associated with strong work motivation, low work stress, work satisfaction, leadership style, and good supervision. Performance is negatively associated with older age.Keywords: early detection, preeclampsia, performance, health surveillance personnelCorrespondence: Zella Cahyandaru. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java 57126, Indonesia. Email: zellacahyandaru@gmail.com. Mobile: +6287832622469.Journal of Health Policy and Management (2019), 4(1): 13-22https://doi.org/10.26911/thejhpm.2019.04.01.02

Contextual Effect of Community Health Center and Other Determinants of Midwife Performance in the Implementation in the Prevention Mother to Child Transmission Counselling and Testing: A Multilevel Model Evidence Sringatin Sringatin; Uki Retno Budihastuti; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: High transmission of HIV from mother to child can contribute to an increase in the number of pandemic events. Transmission of HIV from mother to baby can be prevented by the PMTCT (Prevention of Mother to Child HIV Transmission) program. The purpose of this study is to analyze the implementation of PMTCT program policies by midwives.Subjects and Method: The design used in this study was observational analytic with cross sectional approach. The number of samples is 184 subjects. The sampling was done using total sampling. The independent variables included midwives' knowledge, midwife's age, job satisfaction, team performance, work environment, community support, training, and length of work. Meanwhile, the dependent variable is the implementation of PMTCT policies. Variable data collection was performed using a questionnaire and analyzed using multilevel analysis with Stata 13.Results: The implementation of PMTCT policies increased influenced by period of working ≥8 years (b= 0.50; 95% CI= 0.61 to 0.85; p= 0.004), training ≥2 times (b= 0.44; 95% CI= -0.13 to 0.76; p= 0.005), good midwife knowledge (b= 0.65; 95% CI= 0.36 to 0.93; p<0.001), midwife satisfaction is good (b= 0.05; 95% CI= -0.21 to 0.31; p= 0.694), and midwife performance is good (b= 0.59; 95% CI= 0.25 to 0.93; p= 0.001). The implementation of PMTCT policies decreased influenced by bad working environment (b= -0.09; 95% CI= -0.36 to 0.16; p= 0.451), age ≥35 years (b= -0.51; 95% CI= -0.80 to -0.24; p<0.001), and small community support (b= -0.06; 95% CI= -0.38 to 0.25; p= 0.692). Public health ceneters have weak contextual influence on the implementation of PMTCT program policies with ICC= 6.6%.Conclusion:The midwife's period of work, knowledge, training, midwife's performance, and midwife's satisfaction improve PMTCT implementation. Whereas midwives' age, work environment and community support reduce PMTCT implementationKeywords: HIV / AIDS, implementation of PMTCT, multiple linear regression analysis.Correspondence:Sringatin, Dolopo Regional Public Hospital, Madiun, East Java. Jl. Raya Dolopo no.117 Dolopo, Madiun 63174, East Java. Email: sringatine22@gmail.com. Mobile: 081231683090Journal of Health Policy and Management (2020), 5(1): 35-47https://doi.org/10.26911/thejhpm.2020.05.01.04

The Association Between the Integrated Health Post Activity and the Performance of Community Health Workers in Child Growth and Development Care Service in Karanganyar, Central Java Lidia Ekiq Kurniavie; Pawito Pawito; Bhisma Murti
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Active integrated health post is an integrated health post that conducts routine activities every month and conducts additional activities. There are 61.32% active integrated health posts in Indonesia. Early detection of growth and development is one of the tasks of the cadres at the integrated health post. The role of the integrated health post cadre that is not optimal will have direct and indirect effects on children. This study aimed to analyze the effect of the integrated health post activity on cadre performance in children under five in Karanganyar Regency.Subjects and Method: This study used cross sectional design. This study was conducted in the integrated health post in Karanganyar from August-September 2019. There were 200 female college students involved as the sample of the study. They were selected by simple random sampling. The dependent variable was cadre performance of the integrated health post. The independent variables were cadre education, knowledge, attitude, employment status, years of service, training of children under five growth and development, facilities and infrastructure of the integrated health post, community support, and village government support. This study used questionnaires to collect the data. The data were analyzed by multiple logistic regression run on Stata 13.Results: Cadre performance in children under five growth and development in the integrated health post increased with high cadre education (OR=3.04; 95%CI=1.24 to 7.47; p=0.015), cadres who worked at home (OR=3.66; 95%CI=1.57 to 8.50; p=0.003), high knowledge (OR=4.11; 95%CI= 1.79 to 9.42; p=0.001), good attitude (OR=3.31; 95%CI= 1.31 to 8.38; p=0.011), participation in growth and development training by ≥2 times (OR=3.36; 95%CI=1.49 to 7.60; p=0.004), length of service of the cadres ≥10 years (OR=3.21; 95% CI=1.39 to 7.43; p=0.006), complete facilities and infrastructure of the integrated health post (OR=4.17 ; 95%CI=1.74 to 9.99; p=0.001), strong community support (OR=2.99; 95% CI=1.26 to 7.10; p=0.013), and high village government support (OR=2.76; 95% CI=1.17 up to 6.51; p=0.020).Conclusion: Cadre performance in children under five growth and development is affected by cadre education, cadre occupation, cadre knowledge, cadre attitude, training of growth and development, length of service, facilities and infrastructure of the integrated health post, community support, and village government support.Keywords: cadre performance, integrated health post activity, growth and development, children under fiveCorrespondence:Lidia Ekiq Kurniavie. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: ekiqlkv@gmail.com. Mobile: +6285852540575.Journal of Health Policy and Management (2019), 5(1): 48-60https://doi.org/10.26911/thejhpm.2020.05.01.05

Contextual Effect of Integrated Health Post on the Community Health Personnel Performance: A Multilevel Evidence from Purworejo, Central Java Ulfah Hidayati; Didik Gunawan Tamtomo; Bhisma Murti
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Integrated health post (posyandu) is an effort to improve the health of the nearest infants in the community. The community health personnel are in charge of managing and carrying out posyandu activities. Community health personnel performance influences the success of the posyandu program. This study aimed to determine posyandu contextual factors on the performance of community health personnels in infant health services.Subjects and Method: This was a cross sectional study conducted at 25 posyandu in Purworejo Regency, Central Java, in October 2019. The sample consisted of 200 community health personnels selected by simple random sampling. The dependent variable was community health personnel performance. The independent variables were number of children, education, occupation, income, tenure, skills and work environment. The data was collected by questionnaire. The data were analyzed by multilevel multiple logistic regression.Results: Posyandu community health personnel performance increased with the number of children <3 (b = 1.89; 95% CI= 0.51 to 3.26; p = 0.007), education ≥Senior high school (b= 1.88; 95% CI = 0.31 to 3.44; p= 0.019), community health personnels worked at home (b= 2.15; 95% CI= 0.48-3.82; p = 0.011), income ≥Rp 1,200,000 (b= 1.86; 95% CI= 0.19-3.54; p= 0.029), tenure ≥3 years (b= 2.29; 95% CI= 0.71 to 3.87; p= 0.005), good skills (b= 2.34; 95% CI= 0.53 to 4.16; p = 0.011), and good working environment (b= 1.54; 95% CI= 0.01 to 3.06; p= 0.048). Posyandu had a contextual effect on community health personnel performance with ICC= 34.98%.Conclusion: Community health personnel performance increases with the number of children <3, education ≥senior high school, community health personnels working at home, family income ≥Rp 1,200,000, working period ≥ 3 years, good skills, and good work environment. Posyandu has a contextual effect on community health personnel performance.Keyword: performance, community health personnels, posyandu, multilevel analysisCorrespondence: Ulfah Hidayati. Master Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: ulfahhidayatimg13@gmail.com. Mobile: +6285725932516.Journal of Health Policy and Management (2020), 5(1): 1-12https://doi.org/10.26911/thejhpm.2020.05.01.01

Application of Health Belief Model on Factors Affecting Participation in the National Health Insurance Scheme among Informal Sector Workers in Kudus, Central Java Anom Dwi Prakoso; Endang Sutisna Sulaeman; Arief Suryono
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Universal Health Coverage is the mandate of the Pancasila and 1945 Constitution. UHC's target on January 1st, 2019 is that all Indonesians are covered by the National Health Insurance (JKN). Meanwhile, the participation of informal workers as of May 1, 2019 only reached 57%. The cross subsidy system is not optimal and the budget deficit will continue to be experienced because there are still many citizens who have not joined JKN. This study aimed to analyze the determinants of the participation of informal workers in the national health insurance program in Kudus using the Health Belief Model.Subjects and Method: This was case control study,conducted in 5 sub-districts in Kudus Regency, Central Java from September to October 2019. Total of 200 informal workers were selected by purposive sampling, it were devided into two groups including 100 in case group and a 100 in control group. The dependent variable was the participation of informal workers in the JKN program. The independent variables were perception of vulnerability, perception of seriousness, perspective of benefits, family support, self-efficacy, and social environment. The data collection was performed using a questionnaire and data analysis with logistic regression using stata 13.Results: The participation of informal workers in the JKN program increased with knowledge of ≥Senior high school (b = 5.09; 95% CI = 0.32 to 9.87; p = 0.036), high perception of vulnerability (b = 3.01; 95% CI = 0.26 to 5.75; p = 0.031), high perceived seriousness (b= 5.38; 95% CI = 2.14 to 8.61; p= 0.001), high perceived benefit (b= 3.86; 95% CI= 0.39 to 7.34; p= 0.029), strong family support (b= 7.26; 95% CI= 2.69 to 11.82; p= 0.002), strong self-efficacy (b = 3.98; 95% CI = 0.98 to 6.98; p= 0.009) and a supportive social environment (b = 4.51; 95% CI= 1.61 to 7.40; p= 0.002).Conclusion:Knowledge, perception of vulnerability, perception of seriousness, perceived usefulness, family support and social environment influence the participation of informal workers in the JKN program.Keywords: universal health coverage, national health insurance, health belief modelCorrespondence: Anom Dwi Prakoso, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: anomdwiprakoso@gmail.com. Mobile: +62895363054393.Journal of Health Policy and Management (2020), 5(1): 61-73https://doi.org/10.26911/thejhpm.2020.05.01.06

Multilevel Analysis of Community Health Center, Performance of Health Personnel: Evidence from Ngawi, East Java Rahayu Zulaikah; Didik Tamtomo; Endang Sutisna Sulaeman
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Quality health services are one of the priorities and development goals in the health sector. Community Health Center as the first-line public services in the health sector are expected to provide quality services for the community. The quality of health services in community health center can be seen from the performance of the health personnel. This study aims to determine the factors that determine the performance of health personnel in health centers.Subjects and Method: This study used an observational analytic method with a cross sectional approach. The study was conducted in 24 community health center in Ngawi, East Java on June-July 2019. The total sample of 216 health personnel of the community health center was selected based on proportional random sampling. The dependent variable of this study was the performance of health personnel. The independent variables in this study were accreditation status, education, income, work length, motivation, satisfaction, and workload. The data collections used questionnaires and were analyzed using multilevel linear regression test with Stata 13.Results: The performance of health personnel significantly improved with good accreditation status (b = 2.87; 95% CI= 0.03 to 5.71; p= 0.048), high education (b= 0.63; 95% CI = 0.13 to 1.13; p= 0.013), and high workload (b= 0.86; 95% CI= 0.34 to 1.39; p= 0.001). There was a contextual effect of the performance health personnel (ICC= 53.69%).Conclusion: Good accreditation status, higher education and high work responsibilities increase the performance of the health personnel. There was a contextual effect of health centers on the health personnel.Keywords: performance of health personnel, community health center, multilevel linear regressionCorrespondence:Rahayu Zulaikah, Ngawi Health Office, Jl. S. Parman 25 A, Ngawi, East Java. Email: dokterrahayu@yahoo.co.id. Mobile phone: 081946059306Journal of Health Policy and Management (2020), 5(1): 13-22https://doi.org/10.26911/thejhpm.2020.05.01.02

Effect of Leadership Style of the Head of the Community Health Center and Other Determinants on the Health Personnel Performance in Boyolali, Central Java David Marwandi; Endang Sutisna Sulaeman; Pawito Pawito
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Leadership in health services is needed to utilize resources efficiently, design management processes, and encourage health workers to work towards achieving common goals. The purpose of this study was to analyze the effect of leadership style of the head of community health center and other determinants on the performance of health personnel.Subjects and Method: This was an analytic observational study with a cross sectional design. The study was conducted in Boyolali, Central Java, from June to July 2019. A sample of 206 health personnel from 22 community health centers was selected for this study. The dependent variable was the performance of health personnel. The independent variables were perceived transformational leadership, perceived income, type of community health center, accreditation status, education level, tenure, training, community health center, and employee status. The data were collected by questionnaire and analyzed by a multilevel multiple linear regression run on Stata 13.Results: Health personnel performance increased with transformational leadership style (b= 2.23; 95% CI= 0.94 to 3.52; p <0.001), type of health workers (b= 1.80; 95% CI= 0.10 to 3.49; p = 0.037), and accreditation status (b= 3.01; 95% CI= 0.58 to 5.44; p= 0.015). Health personnel performance increased with education ≥Diploma III (b= 0.55; 95% CI= -1.46 to 2.56; p= 0.592), tenure ≥3 years (b= 0.05; 95% CI= -1.49 to 1.59; p = 0.947), adequate income (b= 1.16; 95% CI= -0.10 to 2.42; p= 0.072), and had attended training (b= 0.67; 95% CI= -0.68 to 2.03; p= 0.329), but they were statistically non-significant. Health personnel performance decreased with the status of civil servant (b= -1.32; 95% CI= -3.82 to 1.16; p= 0.298) and treatment status of community health center with hospitalization (b= -2.97; 95% CI = -5.03 to -0.91; p = 0.005).Conclusion: Health personnel performance increases with transformational leadership style, type of health workers, accreditation status, education ≥Diploma III, tenure ≥3 years, adequate income, and had attended training. Health personnel performance decreases with the status of civil servant and treatment status of community health center with hospitalization.Keywords: transformational leadership style, health personnel, performance.Correspondence:David Marwandi. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: david.marwandi88@gmail.com. Mobile: +6281348789393Journal of Health Policy and Management (2020), 5(1): 74-84https://doi.org/10.26911/thejhpm.2020.05.01.07

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