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Contagion: Scientific Periodical Journal of Public Health and Coastal Health
Published by Universitas Islam Negeri Sumatera Utara
ISSN : -     EISSN : 26850389     DOI : 10.30829/contagion
Core Subject : Health,
Health Professions Public Health
Contagion: Scientific Periodical Journal of Public Health and Coastal Health, A Scientific Periodic Journal of Public Health published by the Public health Study Program of The Faculty of Public Health UINSU Medan. This Journal prioritiez the collaboration of lecturers and students with scope of the discussion is about Public Health, Health and Islam, and Coastal Health. This Journal is published twice, published on June and December.
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Articles 569 Documents
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Health Workers’ Experiences and Challenges in Providing Comprehensive Antenatal Care in Rural Primary Health Centers in West Nias District Putri Ayu Yessy Ariescha; Peny Ariani; Nur Mala Sari; Friska Ernita Sitorus
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.26599

Abstract

Antenatal care (ANC) plays a critical role in reducing maternal and neonatal risks, yet its delivery in rural and remote areas remains constrained by geographic isolation, limited health resources, workforce shortages, and sociocultural barriers. This study explored the experiences and challenges of health workers in providing comprehensive ANC services in rural primary health centers in West Nias District, North Sumatra, Indonesia. A qualitative study with a grounded theory approach was conducted among 16 health workers, consisting of 11 midwives and five physicians, who were selected through purposive sampling. Data were collected through in-depth semi-structured interviews, supported by field notes, limited participant observation, and review of relevant service documents. Data were analyzed using open, axial, and selective coding. The findings identified professional resilience as the core category explaining how health workers sustain ANC services in resource-limited and culturally complex settings. This resilience was shaped by four interrelated themes: limited resources and infrastructure, human resource constraints, sociocultural influences, and adaptation strategies. Health workers maintained service continuity through manual examination methods, mobile services, home visits, informal counseling, community-based education, and collaboration with village leaders, religious leaders, and traditional birth attendants. These strategies helped strengthen community trust and improve access to ANC services. The study highlights the need to strengthen rural maternal health systems through improved infrastructure, adequate staffing, supportive supervision, and culturally responsive service planning Keywords: Antenatal Care, Health Workers, Maternal Health, Professional Resilience, Rural Health Services, Community Collaboration
The Interplay of Transcultural Competence, Therapeutic Communication, and Self-Efficacy Among Community Health Nurses Dwi Nopriyanto; Bahtiar Bahtiar; Ruminem Ruminem; Rita Puspasari; Mayusef Sukmana; Iwan Samsugito; Ratna Wati
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.26621

Abstract

Nurses working in culturally diverse environment possess valuable knowledge and experience in fostering interpersonal communication and can strengthen their self-efficacy. Nursing competence is defined as a continuous, dynamic process of providing care to patients from diverse cultural backgrounds, aimed at reducing risk and understanding patient needs. This study aimed to investigate the relationship between transcultural nursing competence, therapeutic communication skills, and self-efficacy among community health nurses in Samarinda. A quantitative descriptive cross-sectional study was employed, involving 224 nurses from 26 public health centers in Samarinda.  Data were collected from April to June 2025 using validated questionnaires assessing transcultural nursing competence, therapeutic communication skills, and self-efficacy. Statistical analyses included chi-square tests and logistic regression to explore correlations and predictive relationships. Results showed that 52.7% of nurses demonstrated good transcultural nursing competence, 55.8% exhibited good therapeutic communication skills, and 58.5% reported high self-efficacy. Transcultural nursing competence significantly influenced therapeutic communication skills (OR=2.044, p=0.011) and self-efficacy (OR=2.256, p=0.004). Length of work also positively correlated with self-efficacy (OR=2.574, p=0.016), while demographic factors such as gender, age, and education showed no significant associations. Transcultural nursing competence emerged as a critical factor in enhancing therapeutic communication and self-efficacy among nurses. The findings highlights the importance of cultural competency training to improve nursing care in multicultural settings.Keywords: Transcultural Nursing, Therapeutic Communication, Self-Efficacy, Community Health Nurses.
Therapeutic Effect of Phaleria macrocarpa Flavonoid Extract on TGF-β Modulation in Endometriosis Mice Model Novrida Ratna Dewi; Cyntia Hemas Febrina Putri; Sutrisno Sutrisno; Safrina Dewi Ratnaningrum
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 7, No 3 (2025): CONTAGION
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v7i3.25544

Abstract

Endometriosis is a chronic estrogen-dependent inflammatory disorder characterized by ectopic endometrial-like tissue growth and dysregulated immune responses. Transforming Growth Factor Beta (TGF-β), although classically known as a profibrotic cytokine, also exhibits context-dependent anti-inflammatory activity, creating uncertainty regarding its net impact on endometriotic progression. This gap in the literature highlights the need to investigate agents that may modulate TGF-β in a controlled experimental setting. Phaleria macrocarpa, a flavonoid-rich medicinal plant, has demonstrated immunomodulatory potential, yet its relationship with TGF-β regulation in endometriosis remains poorly understood. This study aimed to evaluate the effect of Phaleria macrocarpa flavonoid extract on TGF-β levels in a Balb/C mouse model of endometriosis. A true experimental post-test only controlled design was conducted using 30 mice divided into six groups: negative control, positive control, and four treatment groups receiving 3.75, 7.5, 15, or 30 mg/mouse/day for 14 days. TGF-β levels were quantified using ELISA and analyzed with ANOVA followed by Tukey’s post-hoc test. The results demonstrated a non-linear dose–response pattern, with the 7.5 mg/mouse/day dose producing the highest increase in TGF-β, while higher doses showed attenuated or reduced responses. These findings indicate a biphasic modulatory effect of Phaleria macrocarpa flavonoids on TGF-β, suggesting a dose-dependent immunoregulatory influence that warrants further investigation. Keywords: Phaleria macrocarpa, TGF-β,  Endometriosis,  Mice.
Ketupat Processing Traditions in Minangkabau: An Eco-Theological, Health, and Cultural Resilience Study Azhari Akmal Tarigan; Jufri Naldo; Syahrial Arif Hutagalung; Uswatun Hasanah; Ismail Ismail
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.28872

Abstract

This study examines the Ketupat tradition, a Minangkabau food wrapped in young coconut leaves, through the lenses of eco-theology, public health, and cultural resilience. Employing a qualitative methodology that integrates in-depth interviews with 25 informants (15 entrepreneurs, 5 cultural leaders, and 5 academics), participatory observation, and textual analysis with data analyzed thematically using NVivo software the research was conducted across key centers of Minangkabau diaspora life in Padang (West Sumatra, Indonesia), Yogyakarta (Indonesia), and Negeri Sembilan (Malaysia). The findings reveal three interrelated dimensions. First, the use of natural leaf wrappers embodies the Islamic eco-theological principle of khalifah fil-ardh (humans as stewards of the earth), expressed through faith-driven ecological awareness among tradition bearers. Second, coconut leaves provide tangible health benefits by eliminating risks of chemical migration from plastic and styrofoam packaging, reinforcing community-based food safety rooted in natural materials. Third, Ketupat-making sustains cultural identity and social cohesion within diaspora communities through intergenerational transmission and collective rituals. Overall, the study argues that traditional food practices grounded in natural materials represent a convergence of ecological wisdom, health protection, and spiritual values, underscoring the importance of integrating local wisdom into sustainable food policies and national food security strategies Keyword: Ketupat  ; Ketupat; Minangkabau; eco-theology; traditional food systems; public health; cultural resilience; food packaging
The Relationship Between Anthelmintic Therapy Compliance and The Health Status and Quality of Life of Young Adults Muhamad Sulthan Tanjung; Ali Napiah Nasution; Qori Fadillah
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.29597

Abstract

Helminth infection remains a significant public health concern that may affect the health status and quality of life of young adults living in high-risk areas. However, this productive age group is often under-represented in soil-transmitted helminth (STH) research. This study aims to examine the relationship between adherence to anthelmintic therapy and both health status and quality of life among young adults in the working area of UPT Puskesmas Stabat. An analytic cross-sectional design was employed. A total of 47 young adults (aged 18–25 years) with a history of anthelmintic therapy in the previous 6–12 months were recruited through purposive sampling. Adherence was assessed using the modified 8-item Morisky Medication Adherence Scale (MMAS-8), health status with a validated complaints questionnaire combined with objective Body Mass Index (BMI) measurement, and quality of life with the WHO Quality of Life-BREF (WHOQOL-BREF) instrument covering the physical, psychological, social, and environmental domains. Data were analyzed using the chi-square test (with Yates correction or Fisher’s exact test where appropriate) on collapsed 2×2 tables, complemented by odds ratios (ORs) with 95% confidence intervals (CIs) and the phi coefficients.  Most respondents were female (57.4%), aged 22–25 years (51.1%), students (55.3%), and had a normal BMI (68.1%). Adherence was high in 68.1% and moderate in 31.9% of respondents; 61.7% had good health status and 72.3% reported high quality of life. Adherence was not significantly associated with health status (χ² = 2.11; p = 0.147; OR = 2.51, 95% CI 0.71–8.86; φ = 0.21). In contrast, adherence was strongly and significantly associated with quality of life (Fisher’s exact p < 0.001; φ = 0.90). Within the limitations of a cross-sectional design, higher adherence to anthelmintic therapy was associated with better quality of life but not with measurable health status. Strengthening adherence through education and health-promotion efforts may therefore enhance the quality of life of young adultsKeywords: Anthelmintic Therapy Adherence; Health Status; Quality of Life; Young Adults; Soil-Transmitted Helminth
A Conceptual Model of Family Assistance for Working Mothers in Preventing and Managing Postpartum Blues in Urban Areas Elvalini Warnelis Sinaga; Rahmawani Fauza; Debora Lestari Simamora; Nova Linda Rambe; Wellina Br. Sebayang
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.28729

Abstract

Physical recovery after childbirth. This study aimed to analyze factors influencing prevention and management efforts for postpartum blues among working mothers in an urban setting and to formulate a conceptual family-assistance model based on the significant predictors. A quantitative analytic study with a cross-sectional design was conducted among 206 working postpartum mothers in urban areas of Medan City, Indonesia. Postpartum blues symptoms were screened using the Edinburgh Postnatal Depression Scale (EPDS), with a cut-off score of ≥10. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The measurement model was evaluated through outer loading, Cronbach's alpha, rho_A, composite reliability, and average variance extracted (AVE). In contrast, the structural model was assessed using R-square, path coefficients, t-statistics, and p-values. Results: The mean EPDS score was 12.45 ± 3.18, and 142 respondents (69.0%) were categorized as having postpartum blues symptoms. All indicators demonstrated adequate outer loadings (>0.70), and all constructs met reliability and convergent validity criteria. The model explained 95.1% of the variance in prevention and management efforts for postpartum blues (R² = 0.951; adjusted R² = 0.947). The Health Belief Model had the strongest effect (β=0.312; T=7.428; p=0.000), followed by family assistance (β=0.288; T=5.236; p=0.000), psychological factors (β=0.254; T=5.644; p=0.000), social factors (β=0.210; T=3.442; p=0.001), physical factors (β=0.198; T=3.413; p=0.001), and demographic factors (β=0.185; T=3.557; p=0.000). Prevention and management of postpartum blues among working mothers should emphasize health beliefs, family assistance, psychological readiness, social support, physical recovery, and demographic vulnerability. The proposed conceptual model highlights the family as a key support system for early detection, help-seeking, and adherence to postpartum care Keywords: Postpartum Blues, Family Assistance, Working Mothers, Health Belief Model
Effects of Digital Maternal Referral Systems on Referral Performance and Maternal Survival-Related Outcomes: A Systematic Review Erni Suryani Wongso; Zulvayanti Zulvayanti; Hadi Susiarno
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.29264

Abstract

Timely maternal referral is essential for emergency obstetric care, but the effectiveness of digital maternal referral systems in improving referral performance and maternal survival-related outcomes remains uncertain. This systematic review synthesized evidence on digital, mobile, or information-based referral interventions that have core functions comparable to those of integrated referral systems such as SISRUTE. Scopus and PubMed were searched for English-language records published from 1 January 2000 to 31 December 2025. The review followed PRISMA 2020 guidance. Eligible studies involved pregnant, intrapartum, or postpartum women, obstetric emergency referrals, or health workers managing maternal referrals, and evaluated implemented digital or mobile referral interventions. Studies limited to non-digital referral barriers, prototype development without evidence of implementation, or non-maternal referral populations were excluded. Owing to heterogeneity in design, interventions, and outcomes, narrative synthesis was conducted. Six studies from Uganda, Ghana, Liberia, and Iraq were included in the primary synthesis. Evidence for a reduction in direct maternal mortality was insufficient. However, digital referral interventions were associated with improved process and survival-related proxy outcomes, including lower adverse maternal-fetal outcomes, faster referral response, better identification of receiving hospitals, improved preparedness, and shorter decision-to-incision intervals for emergency cesarean delivery. The most consistent benefits were observed in communication, triage, coordination, and treatment timeliness. Digital maternal referral systems appear to be more strongly supported as tools for improving referral performance than as interventions with proven direct effects on mortality. Their potential contribution to maternal survival is most plausibly indirect and depends on transport, receiving-facility readiness, clinical triage, and implementation support Keywords: Digital health, e-referral, maternal referral, maternal survival, mHealth, obstetric emergency, triage
Effectiveness of Early Warning Score (EWS) Implementation in Improving the Accuracy of Early Preeclampsia Detection in Antenatal Care Rapida Saragih; Christin Jayanti; Sitha Paradilla Delarosa
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.28454

Abstract

Preeclampsia remains a major contributor to the maternal morbidity and mortality rates, in which the delayed detection at the primary healthcare level often leads to late referrals and further severe complications. Objective: This study aimed to evaluate the effectiveness of an Early Warning Score (EWS) implementation for improving the accuracy of early preeclampsia detection during Antenatal Care (ANC) services at a Community Health Center. Methods: This study employed a pre-experimental one-group pretest-posttest design. A total of 20 pregnant women were selected through the total sampling. Detection accuracy was defined as the precision in systematically integrating vital signs and subjective clinical symptom assessments compared to conventional methods. Data were analyzed using a paired sample t-test with a significance level of 0.05. Results: The findings showed a significant improvement in the mean accuracy score for early detection from 62.45 (pretest) to 78.90 (posttest), with a mean difference of 16.45 (p < 0.05). Power analysis revealed a Cohen’s d value of 2.12, indicating that the EWS intervention had a large clinical effect size in enhancing the provider detection sharpness. Conclusion: The EWS implementation proved to be significantly effective for improving the accuracy of early preeclampsia detection within the scope of ANC services at the Mandala Community Health Center. Integrating EWS into the routine ANC practices is highly recommended to support a timely clinical decision-making and to prevent severe maternal complications Keywords:  Early Warning Score, Preeclampsia, Antenatal Care, Early Detection, Maternal Health
The Impact of Nutritional Counseling Using Flyers on Knowledge of Chronic Energy Deficiency (CED) Among Pregnant Women Desidarius Bela Dhesa; Asran Asran; Jenny Qlifianti Demmalewa
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.28757

Abstract

Chronic energy deficiency (CED) is one of the nutritional problems of pregnant women that can be prevented through counseling. The prevalence of CED at Waara Community Health Center increased from 2022 (20.9%), in 2023 (29.8%), and in 2024 (32.2%). The purpose of this study was to determine the effect of nutritional counseling using flyers on pregnant women’s knowledge of CED. This research is a pre-experimental study with a one-group pre-test and post-test design. This study was conducted in the working area of the Waara Community Health Center in Muna Regency from Juny 6 to November 10, 2025. The sample comprised 27 pregnant women in the working area of the Waara Community Health Center in 2025, during the October to November period, selected through total sampling. Data were collected using a questionnaire to measure knowledge about CED and tested using a paired t-test. The results of the study on 27 samples, the average score of knowledge of pregnant women increased from 7.00 to 10.00. The results of the paired t-test obtained a p < 0.001. The conclusion is that nutritional counseling using flyers resulted in a significant increase in knowledge about CED among pregnant women in the Waara Community Health Center, Muna Regency Keywords: Counseling, Flyer, Knowledge, Nutrition, Pregnant women
The Relationship Between Postpartum Mothers' Knowledge of Personal Hygiene and The Healing of Perineal Tears at Romana Clinic, Tanjung Anom Village Helmi Wardah Nasution; Ferika Desi; Khoirunnisa’a Batubara
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 2 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i2.25367

Abstract

Postpartum perineal wounds are common complications during vaginal delivery that significantly affect maternal health and recovery. The healing process of these wounds is influenced by multiple factors, including the mother's knowledge and practice of personal hygiene. This study aimed to examine the relationship between postpartum mothers' knowledge of personal hygiene and the healing duration of perineal tears at Romana Clinic, Tanjung Anom Village, Pancur Batu Subdistrict, Deli Serdang Regency. A quantitative descriptive-analytic study with a cross-sectional design was employed. A total of 32 postpartum mothers who experienced perineal tears were included using total sampling. Data were collected via a validated structured questionnaire on knowledge and hygiene practices, supplemented by clinical wound healing assessment conducted by qualified midwives on postpartum day 6. Data were analyzed using Fisher's Exact Test, with a significance threshold of p < 0.05. The results indicated that 40.6% of respondents had fair knowledge, 37.5% had poor knowledge, and 21.9% had good knowledge of personal hygiene. Regarding wound healing outcomes, 65.6% of respondents experienced delayed healing (>6 days), while 34.4% achieved wound healing within six days (≤6 days). Statistical analysis revealed a significant association between knowledge of personal hygiene and the healing of perineal tears (p = 0.003), with a large effect size (Cramer's V = 0.60). Respondents with good knowledge demonstrated substantially higher rates of timely wound healing (85.7%) compared to those with fair (30.8%) or poor knowledge (8.3%). Higher levels of knowledge regarding personal hygiene are significantly associated with faster perineal wound healing. These findings underscore the importance of integrating structured hygiene education into routine antenatal and postnatal midwifery services to minimize postpartum complications and promote maternal recovery.Keywords: Maternal Knowledge, Postpartum Mothers, Personal Hygiene, Perineal Wound Healing, Wound Healing Duration.Key

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