Community Medicine and Education Journal
CMEJ covers all subjects regarding community medicine and education. The covered research areas as follows community medicine, public health, epidemiology and biostatistics, health policy and administration, public health nutrition, environmental health, occupational health and safety, health promotion, reproductive health, maternal and child health, quality of life, health literacy and communication and their role in developing new healthcare programs, Arts of teaching, Case studies from schools around the world, Change management and education quality, Citizenship education, Classroom management, Computers in educational administration, Differing cultural perceptions of management in education, Distance education and multimedia environments, Early Childhood Education, Economics of education, Educational administration, Education environments (political, social, legal, cultural), Educational leadership, Educational policy and management, Educational systems planning/strategic planning, E-education / E-learning, Entrepreneurial development, Equity and education, Finance and accountability in education, Globalization and education, Human resources management, Individual professional learning portfolio, Information Communication Technologies (ICT) in Education, Special Education and Theories of educational management.
Articles
107 Documents
<![CDATA[Vitamin D Status and Lung Function in Stable COPD: A Cross-Sectional Study ]]>
<![CDATA[Lubis, Ayu Zulhafni]]>
<![CDATA[ Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v5i3.622
<![CDATA[Chronic obstructive pulmonary disease (COPD) is a major global health concern characterized by progressive airflow limitation. Vitamin D deficiency has been linked to impaired lung function and increased inflammation, suggesting a potential role in COPD pathogenesis. This study aimed to investigate the relationship between vitamin D status and lung function in patients with stable COPD. A cross-sectional study was conducted involving 51 stable COPD patients. Spirometry was performed to assess lung function, and serum 25-hydroxyvitamin D [25(OH)D] levels were measured. The association between 25(OH)D levels and lung function parameters, including forced expiratory volume in one second (FEV1), was analyzed using Pearson correlation. The mean age of the participants was 64.05 ± 8.05 years, and all were male. The majority (47.1%) had severe airflow limitation (FEV1 < 30% predicted). The mean 25(OH)D level was 27.57 ± 6.74 ng/mL, indicating insufficiency in most patients. No significant correlation was found between 25(OH)D levels and FEV1 (r = -0.131, p = 0.180). In conclusion, this study did not find a significant association between vitamin D status and lung function in stable COPD patients. Further research, including longitudinal studies and interventional trials, is needed to elucidate the complex relationship between vitamin D and COPD and to determine the potential benefits of vitamin D supplementation in this population.]]>
<![CDATA[Healthcare Workers’ Roles and Iron Tablet Adherence among Pregnant Women: A Prospective Cohort Study ]]>
<![CDATA[MS, Sri Wahyuni]]>;
<![CDATA[Nova Ratna Dewi]]>;
<![CDATA[Hida Yana]]>
<![CDATA[ Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v5i3.631
<![CDATA[Iron deficiency anemia during pregnancy poses significant health risks to both mother and child. The role of healthcare workers in promoting iron tablet adherence is crucial. This study aimed to analyze the influence of healthcare workers' roles (as customer, communicator, motivator, facilitator, and counselor) on pregnant women's adherence to iron tablet consumption. A prospective cohort study was conducted involving pregnant women within the Puskesmas Lut Tawar work area in Aceh Tengah District. Data collection included questionnaires and interviews. The study assessed the relationship between healthcare workers' roles and adherence to iron tablet consumption using statistical analysis. The study found that the role of healthcare workers as counselors had a significant influence on adherence to iron tablet consumption (P = 0.041). Other roles, such as customer, communicator, motivator, and facilitator, did not show a statistically significant impact on adherence. The role of healthcare workers as counselors plays a crucial role in improving pregnant women's adherence to iron tablet consumption. The study recommends enhancing the counseling skills of healthcare workers and providing comprehensive support to pregnant women to address their concerns and challenges related to iron tablet intake.]]>
<![CDATA[Enhancing Hospital Efficiency and Patient Outcomes Through Flexible Resident Scheduling: A Meta-Analysis ]]>
<![CDATA[Dharmayuda, Cokorda Gde Oka]]>;
<![CDATA[Arlina Dewi]]>
<![CDATA[ Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v5i3.639
<![CDATA[The traditional, rigid work schedules of medical residents have been linked to fatigue, burnout, and potential adverse effects on patient safety. The implementation of flexible working hours has been proposed as a potential solution to mitigate these risks and improve patient outcomes. This meta-analysis aims to evaluate the impact of flexible resident scheduling on hospital efficiency, patient safety, and resident well-being. A systematic search of electronic databases (PubMed, Embase, Cochrane Library, Web of Science) was conducted to identify studies published between 2014 and 2024 that investigated the effects of flexible resident work hours on patient outcomes, medical errors, length of stay, and resident well-being. The quality of included studies was assessed, and data were extracted for meta-analysis using random-effects models. The meta-analysis included four studies. The results demonstrated that flexible resident scheduling was associated with a significant reduction in prolonged length of stay (pooled odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.06-1.14) and a decrease in medical errors (pooled OR = 0.93, 95% CI = 0.30-2.87). The results highlight the positive correlation between resident flexibility and enhanced patient care efficiency, indicating a decrease in medical errors. The findings of this meta-analysis suggest that implementing flexible resident scheduling can enhance hospital efficiency, improve patient outcomes, and promote resident well-being. Healthcare institutions should consider adopting flexible work-hour policies to optimize patient care and support the professional development of resident physicians.]]>
<![CDATA[The Impact of Health Behaviors on Iron Supplementation Adherence and Anemia Prevalence among Pregnant Women: Evidence from a Primary Care Setting in Aceh Tengah, Indonesia ]]>
<![CDATA[Nova Ratna Dewi]]>;
<![CDATA[MS, Sri Wahyuni]]>;
<![CDATA[Hidayana]]>
<![CDATA[ Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v5i3.641
<![CDATA[Anemia during pregnancy remains a significant global health concern, particularly in developing countries like Indonesia. However, adherence to iron supplementation programs is often suboptimal, leading to persistent anemia and adverse maternal and neonatal outcomes. This study aimed to investigate the relationship between health behaviors (knowledge, attitudes, and practices) and adherence to iron supplementation among pregnant women in a primary care setting in Aceh Tengah, Indonesia. Additionally, we explored the impact of these factors on anemia prevalence. A cross-sectional study was conducted at the Pegasing Community Health Center in Aceh Tengah, Indonesia. Pregnant women diagnosed with anemia were recruited, and data were collected using questionnaires assessing their knowledge, attitudes, and practices regarding iron supplementation. Hemoglobin levels were measured to determine anemia status. Statistical analyses were performed to examine the relationships between health behaviors, adherence, and anemia prevalence. A total of 59 pregnant women with anemia participated in the study. Adherence to iron supplementation was suboptimal, with 59.3% reporting poor adherence. Knowledge about iron supplementation was generally good (76.3%), but attitudes and practices were less favorable (30.5% and 27.1%, respectively). Statistical analyses revealed a significant association between attitudes and practices related to iron supplementation and adherence. Furthermore, poor adherence was linked to a higher prevalence of anemia. In conclusion, healthy behaviors, particularly attitudes and practices, play a crucial role in iron supplementation adherence among pregnant women in Aceh Tengah, Indonesia. Interventions targeting these behaviors are essential to improve adherence and reduce the burden of anemia in this population.]]>
<![CDATA[Beyond Waiting Rooms: Exploring the Role of Administrative Processes and Staffing Levels in Outpatient Service Efficiency at a Dental and Oral Hospital in Padang, Indonesia ]]>
<![CDATA[Rahmasari, Suci]]>;
<![CDATA[Rahmi Khairani Aulia]]>;
<![CDATA[Yona Ladyventini]]>
<![CDATA[ Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v5i3.643
<![CDATA[Lengthy patient waiting times negatively impact patient satisfaction and overall healthcare service quality. This study investigates the influence of administrative processes and staffing levels on outpatient service efficiency at a dental and oral hospital in Padang, Indonesia. A mixed-methods approach was employed, incorporating quantitative data analysis of patient waiting times and qualitative exploration of administrative workflows and staff perspectives through interviews and observations. Simulated data was generated based on existing literature to supplement the analysis where specific data points were unavailable. Inefficient administrative processes, including manual patient registration and record-keeping, were identified as major contributors to extended waiting times. Inadequate staffing levels, particularly during peak hours, further exacerbated the issue. Qualitative findings revealed staff perceptions of workload burden and the need for streamlined workflows. The study underscores the critical role of administrative processes and staffing levels in outpatient service efficiency. Recommendations include the implementation of electronic health record systems, process re-engineering, and strategic staffing adjustments to enhance patient flow and overall service quality.]]>
<![CDATA[Beyond Empathy: Examining the Complexities of Outpatient Satisfaction in a Resource-Constrained Setting ]]>
<![CDATA[Hannitya Aulia Putri]]>;
<![CDATA[Rizanda Mahmud]]>;
<![CDATA[Wihardi Triman]]>
<![CDATA[ Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v5i3.649
<![CDATA[Patient satisfaction is a critical indicator of healthcare quality, particularly in resource-constrained settings where efficient and effective care is paramount. This study aimed to explore the multifaceted nature of outpatient satisfaction at a private Indonesian hospital, moving beyond the traditional focus on empathy to understand the interplay of various service quality dimensions. A mixed-methods sequential explanatory design was employed. The quantitative phase involved a survey of 400 outpatients, measuring their satisfaction with five service quality dimensions: tangibles, reliability, responsiveness, empathy, and assurance. Data were analyzed using descriptive statistics, Importance-Performance Analysis (IPA), and gap analysis (suitability index). The qualitative phase utilized in-depth interviews and focus group discussions with patients, staff, and management to provide context and depth to the quantitative findings. While overall patient satisfaction was 82.9%, a gap analysis revealed substantial discrepancies between patient expectations and perceptions across several service quality dimensions. Tangibles, reliability, and responsiveness emerged as key areas requiring improvement. Qualitative findings highlighted extended wait times, inconsistent staff communication, and concerns about the physical environment as significant contributors to patient dissatisfaction. Achieving high levels of patient satisfaction in resource-constrained environments necessitates a comprehensive approach that addresses systemic inefficiencies and communication gaps alongside interpersonal factors like empathy. These findings underscore the need for targeted interventions to optimize resource allocation, streamline processes, and enhance staff communication skills to improve the patient experience.]]>
<![CDATA[Do Longer Operational Hours Affect Patient Loyalty? A Study of Facility Health Care in Bali, Indonesia ]]>
<![CDATA[Adolf Gideon]]>;
<![CDATA[Alifa Dimanti]]>
<![CDATA[ Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v5i3.653
<![CDATA[In today's fast-paced society, healthcare services, especially at the primary level, are crucial for individuals with busy schedules. Patient loyalty, defined as the willingness to revisit a healthcare provider, is essential for healthcare facilities. Several factors contribute to patient loyalty, including satisfaction with services, the quality of facilities, and operational hours. This study investigates the relationship between clinic operational hours, patient satisfaction, clinic facilities, and patient loyalty in Bali, Indonesia. A quantitative study using a survey design was conducted. Data were collected from 124 respondents using a non-probability sampling technique. The questionnaire included items related to patient satisfaction, clinic facilities, operational hours, and patient loyalty. Data were analyzed using SmartPLS 4.0 to assess the relationship between the variables. The findings indicate that patient satisfaction, clinic facilities, and operational hours have a significant positive relationship with patient loyalty (P-value < 0.05). However, operational hours did not have a significant moderating effect on the relationship between patient satisfaction and clinic facilities and patient loyalty. In conclusion, while longer operational hours do correlate with increased patient loyalty, they do not amplify the impact of patient satisfaction or clinic facilities on loyalty. Healthcare facilities in Bali should prioritize patient satisfaction and quality facilities to foster loyalty.]]>
<![CDATA[Navigating Digital Transformation: The Roles of Resilience, Job Security, and Social Support in Shaping Turnover Intention among Indonesian Architects ]]>
<![CDATA[Altheannisa Agatha Soraya]]>;
<![CDATA[Niken Ardiyanti]]>
<![CDATA[ Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v6i1.660
<![CDATA[The architectural sector in Indonesia is experiencing rapid digital transformation, introducing both opportunities and challenges for architectural workers. This study examines the impact of this transformation on turnover intention by analyzing the interplay between resilience, job security, social support, and job satisfaction. A cross-sectional survey was conducted among 300 architectural workers in Indonesia. The Covariance-Based Structural Equation Model (CB-SEM) was used to analyze data and assess the direct and indirect effects among the variables. The results showed that resilience positively influenced social support and job satisfaction. Job security also positively affected job satisfaction. However, social support was found to have a positive impact on turnover intention, a finding unique to this context. Both social support and job satisfaction mediated the relationship between resilience and turnover intention, while job satisfaction also mediated the relationship between job security and turnover intention. In conclusion, the study highlights the complex interplay between individual and organizational factors in shaping turnover intention within the Indonesian architectural sector. The findings suggest that promoting resilience and job security, while addressing the potential impact of social support on turnover intention, is crucial for talent retention in this dynamic environment.]]>
<![CDATA[Impact of Integrated Care Models on Chronic Disease Management Outcomes in Underserved Communities: A Mixed-Methods Study in Surabaya, Indonesia ]]>
<![CDATA[Sarah Istiqomah]]>;
<![CDATA[Iting Shofwati]]>;
<![CDATA[Theresia Putri Sinaga]]>;
<![CDATA[Lin Chia]]>
<![CDATA[ Community Medicine and Education Journal Vol. 6 No. 1 (2025): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v6i1.695
<![CDATA[Integrated care models (ICMs) are increasingly promoted as a strategy to improve chronic disease management, but evidence of their effectiveness in resource-constrained settings like Surabaya, Indonesia, is limited. This study aimed to evaluate the impact of an ICM on chronic disease management outcomes in underserved communities in Surabaya. A mixed-methods study design was employed, combining a quantitative quasi-experimental component with qualitative data collection. The quantitative component compared pre- and post-intervention data on key clinical indicators (blood pressure control, HbA1c levels, medication adherence) and healthcare utilization (hospital admissions, emergency room visits) for patients with hypertension, diabetes, and cardiovascular disease enrolled in an ICM program (n= 250) versus a control group receiving standard care (n= 250). Data was analyzed using descriptive statistics, t-tests, and chi-square tests. The qualitative component involved semi-structured interviews with patients (n=30) and healthcare providers (n=15) participating in the ICM to explore their experiences and perceptions of the program's impact. Thematic analysis was used to analyze the qualitative data. The quantitative analysis revealed statistically significant improvements in several clinical indicators for the ICM group compared to the control group. Data showed a mean reduction in systolic blood pressure of 8 mmHg (p<0.001) and a decrease in HbA1c levels of 0.7% (p<0.01) in the ICM group. Hospital admissions related to chronic disease complications were also lower in the ICM group (p<0.05). Qualitative findings highlighted improved patient self-management, enhanced provider coordination, and increased patient satisfaction with the ICM. Barriers to implementation included resource constraints, logistical challenges, and the need for ongoing provider training. In conclusion, this study provides evidence that ICMs can improve chronic disease management outcomes in underserved communities in Surabaya, Indonesia. The findings support the scaling up of ICMs in similar settings, with careful consideration of resource allocation, provider training, and community engagement.]]>
<![CDATA[The Impact of Universal Health Coverage Policies on Health Equity Metrics: A Longitudinal Analysis in Indonesia ]]>
<![CDATA[Firman Hadi]]>;
<![CDATA[Annisa Annisa]]>;
<![CDATA[Utter Prakesh]]>;
<![CDATA[Aleisha Wulandari]]>
<![CDATA[ Community Medicine and Education Journal Vol. 6 No. 1 (2025): Community Medicine and Education Journal ]]>
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DOI: 10.37275/cmej.v6i1.696
<![CDATA[Indonesia has made significant strides towards Universal Health Coverage (UHC) with the implementation of the Jaminan Kesehatan Nasional (JKN) program. However, achieving equitable health outcomes across diverse socioeconomic and geographic groups remains a challenge. This study investigates the longitudinal impact of UHC policies on key health equity metrics in Indonesia. This study employed a longitudinal, quasi-experimental design using a difference-in-differences (DID) approach. Data were collected from a nationally representative sample of Indonesian households from 2014 (pre-JKN expansion) to 2022. The dataset included socioeconomic indicators (wealth quintiles, education, geographic location), health service utilization (antenatal care visits, skilled birth attendance, immunization rates), and health outcomes (under-five mortality rate, stunting prevalence). The DID analysis compared changes in these metrics between groups with varying levels of pre-existing health insurance coverage and socioeconomic status. Multivariable regression models were used to control for confounding factors. The DID analysis showed that UHC expansion was associated with significant improvements in health service utilization, particularly among lower socioeconomic groups. Antenatal care visits increased by an estimated 15% (95% CI: 12-18%) in the lowest wealth quintile compared to a 5% (95% CI: 3-7%) increase in the highest quintile. Skilled birth attendance similarly increased disproportionately among disadvantaged groups. However, while under-five mortality and stunting prevalence decreased overall, significant disparities persisted. The reduction in under-five mortality was smaller in the lowest wealth quintile (10% reduction, 95% CI: 7-13%) compared to the highest (18% reduction, 95% CI: 15-21%). Regression models confirmed that socioeconomic status remained a significant predictor of health outcomes even after controlling for UHC coverage. In conclusion, while Indonesia's UHC policies have improved access to healthcare services, particularly for vulnerable populations, significant health equity gaps remain. Addressing these disparities requires a multi-pronged approach that goes beyond financial protection and includes targeted interventions to address social determinants of health, improve health service quality, and enhance health literacy among disadvantaged communities.]]>
