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Public Health and Preventive Medicine Archive
Published by Universitas Udayana
ISSN : 23031816     EISSN : 25032356     DOI : https://doi.org/10.53638/
Core Subject : Health,
Public Health
ublic Health and Preventive Medicine Archive (PHPMA) is an open access, peer reviewed journal published by Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University. Issues covered in the journal are as the following: Environmental and occupational health Field and Clinical Epidemiology Global health Health policy analysis Health promotion Health systems and health care management Maternal and child health Program monitoring and evaluation Public health nutrition Reproductive health, sexually transmitted infections and HIV related issues Travel health and health tourism Population and family planning Disaster management
Arjuna Subject : Kedokteran - Kesehatan Masyarakat, Kesehatan Lingkungan dan Pekerjaan
Articles 15 Documents
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Search results for , issue "Vol. 3 No. 2 (2015)" : 15 Documents clear
Mengembalikan Kondisi Bali Menjadi Bebas Rabies Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p01

Abstract

Upaya-upaya yang bisa ditempuh untuk kembali pada kondisi Bali sebelum tahun 2008 yaitu bebas rabies, antara lain seperti berikut. 1) Melakukan vaksinasi rutin setiap tahun pada sekurangkurangnya 70% dari populasi anjing. Hal ini juga akan meningkatkan citra Bali di manca negara sehingga turis tidak merasa khawatir untuk datang ke Bali. 2) Karena vaksinasi anjing harus dilakukan setiap tahun, maka agar pelaksanaannya bisa berkelanjutan dan bisa mencapai cakupan 70%, perlu dibentuk Tim Rabies Tingkat Desa. 3) Tim Rabies Tingkat Desa perlu dilatih dalam hal: a) keterampilan pendekatan kepada masyarakat, b) pemetaan jumlah anjing di masing-masing desa, c) teknik menangkap anjing yang sulit ditangkap, d) pemberian tanda yang baik pada anjing sesudah diberikan vaksinasi, e) teknik surveilans, f) sistem pencatatan dan pelaporan serta g) cara-cara pertolongan pertama yang benar bila ada anggota masyarakat yang digigit anjing. 4) Sebelum dilakukan pada semua desa, diperlukan pelatihan di 3-4 desa sebagai percontohan. Kelemahan dan kekurangan dalam percontohan kemudian disempurnakan sebelum diterapkan pada jumlah desa yang lebih banyak. 5) Pelatihan hendaknya dilaksanakan oleh pelatih profesional yang telah berpengalaman dalam bidang pemberdayaan masyarakat, pelatihan partisipatif dan penanggulangan rabies. 6) Penanggulangan rabies di masing-masing desa hendaknya dirancang dalam penyusunan Rencana Pembangunan Jangka Menengah Desa (RPJM Desa) dan Rencana Kerja Pemerintah Desa (RKP Desa) dan insentif untuk Tim Rabies Tingkat Desa dianggarkan dalam Anggaran Pendapatan dan Belanja Desa (APB Desa) yang dananya bersumber dari Alokasi Dana Desa (ADD). 7) Tata laksana penanggulangan rabies pada manusia (pengadaan VAR, keberlanjutan rabies center, pelatihan-pelatihan kepada petugas kesehatan serta kegiatan lainnya) yang telah dilaksanakan selama ini hendaknya tetap dipertahankan atau disempurnakan.
Duration of Exclusive Breastfeeding, Housing and Environmental Conditions as Risk Factors of Pneumonia among Under–Five Children at Public Health Center II South Denpasar Ni Kadek Ethi Yudiastuti; Anak Agung Sagung Sawitri; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p02

Abstract

Background and purpose: In 2012, the South Denpasar II Public Health Center (PHC) had the 2nd highest percentage of reported cases of pneumonia (15.9%). This study aims to determine duration of exclusive breastfeeding, housing and environment conditions as risk factors of pneumonia among under-five children. Methods: The study design was a case control. The cases were 60 under-five children with pneumonia and recorded in the PHC register between 1 January 2014 to 31 March 2015. Controls were 60 healthy under-five children visiting the PHC during study. Interviews with parents were conducted using questionnaires, and observation carried out using specific guidelines. Measurements of house physical environment variables were conducted using hygrometer, lux meter and roll meter. Data were analyzed using Stata SE 12.1. Results: Characteristics of mothers were comparable in terms of age, education, and income; while the children were comparable in terms of age and gender. Risk factors found to increase pneumonia were duration of exclusive breastfeeding <2 months with OR=5.24 (95%CI: 1.96-14.01), no Hib and pneumococcal immunization with OR=3.68 (95%CI: 1.11-12.17), access to natural lighting with OR=2.72 (95%CI: 1.05-7.00) and house density with OR=3.11 (95%CI: 1.18-8.19). Frequency of acute respiratory tract infection (ARTI) >1 time in 6 months with OR=10.14 (95%CI: 3.67-28.02) were also found to be risk factors. Conclusion: Duration of exclusive breastfeeding, lack of natural lighting and house density were risk factors for pneumonia among under-five children.
Hygiene, Sanitation and Potential Existence of Virulent Genes of E.coli in Lawar in Kuta: The Challenge for Tourism and Safe Food Provision in Bali Ni Putu Eka Trisdayanti; Anak Agung Sagung Sawitri; I Nengah Sujaya
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p03

Abstract

Background and purpose: The reoccurrence of food-borne parasitic outbreaks may be related to contamination by pathogenic strains of E.coli. As lawar (Balinese food) is a favorite of locals and tourists, there needs to be an examination into the presence of pathogenic strains of E.coli in lawar and its relation to hygiene and sanitation standards at food stalls in Kuta. Methods: Cross-sectional analytical study was conducted on 43 stalls that selling white lawar in North Kuta, Kuta and South Kuta. Observations and interviews to sellers were conducted to assess the personal hygiene practices, equipment/stall sanitation and sanitary facilities. Lawar samples were tested in the laboratory. Indicators of the food quality was the number of bacterial colonies with Total Plate Count (TPC), the presence of E.coli with fertilization techniques and the detection of E.coli virulence genes by PCR. Data were analyzed using univariate, bivariate and multivariate analysis. Results: As many as 44.2% of lawar contained bacterial colony >106 CFU/g; 46.5% of lawar positively contained E.coli, and 20% of those positive E.coli had the similar size band of Shiga Like Toxin Type I (SLT-I). The sellers with poor hygiene had higher risks of the presence of E.coli in the lawar compared with those having higher hygiene standards (adjusted OR=7.29; 95% CI 1.473-36.088). Conclusion: Lawar quality in Kuta was poor, as were hygiene practices and seller/stall sanitation.
Predisposing, Supporting and Driving Factors for Utilization of Adolescent Care Health Services in South Kuta Rini Winangsih; Desak Putu Yuli Kurniati; Dyah Pradnyaparamita Duarsa
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p04

Abstract

Background and purpose: Targetted adolescent health services (PKPR) at the South Kuta Health Center have been offered since 2007. However, these are rarely accessed (less than 5 visits per month) whereas adolescent health incidents/concerns such as abortion, HIV/AIDS and drug use are reported to increase. This study aimed to determine the predisposition, supporting and reinforcing factors of PKPR utilization. Methods: The study was qualitative and conducted among 27 students in four sessions of focus group discussions, as well as indepth interviews with four key informants. Data collected consisted of knowledge, attitudes and views of participants on PKPR facilities. Thematic analysis was conducted to identify predisposition, supporting and reinforcing PKPR utilization factors. Results: The study participants intimated that their knowledge about PKPR was low, although they recognised the benefits of such service. They also acknowledged that the quality of facilities/infrastructure were poor, the IEC materials were interesting but the deliverance was unclear and the attitude of providers was unfriendly. Funds, inappropriate clinic hours and labor provided were minimal. Schools, health centers and the government health office strongly supported PKPR activities and the role of peer counselors. School health programs also encouraged students to take advantage of PKPR. Conclusion: Local schools, health centers and the government health office were supportive of PKPR activities, however the student’s knowledge about PKPR was low because coverage of PKPR was very limited.
Risk Factors of Hypertension among Adults in Banyuwangi: A Case-Control Study Aripin; Anak Agung Sagung Sawitri; Nyoman Adiputra
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p05

Abstract

Background and purpose: Hypertension leads to an increase in vulnerability to heart and kidney disease as well as stroke. Although there are numerous studies regarding risk factors of hypertension, many of these are inconclusive. This study aimed to explore risk factors of hypertension among patients at Sempu Public Health Center, Banyuwangi. Methods: The study design was a case control with 158 samples consisting of 79 cases and 79 controls (1:1). Data were collected by interview using structured and IPAQ questionnaires, as well as through secondary data collated from medical records of patients. Subjects were selected using consecutive sampling technique over the period of February to April 2015. Data were analyzed using bivariate (chi-square test) to determine crude OR and multivariate (logistic regression) to calculate adjusted OR. Results: Multivariate analysis found that risk factors of hypertension were: low levels of physical activity (OR=24.89; 95%CI: 4.15-149.31), moderate stress (OR=19.72; 95%CI: 4.43-87.62) and heavy stress (OR=32.55; 95%CI: 3.92-270.07). High education levels (≥seniorhigh school-university) found to be protective towards hypertension (OR=0.16; 95%CI: 0.04-0.57). Tobacco use was not found as risk factor of hypertension (OR=0.58; 95%CI: 0.18-1.86). Conclusions: Low levels of physical activity, moderate stress and severe stress can increase the risk of hypertension of patients at Sempu Public Health Center, Banyuwangi.
Difference in Satisfaction Levels of National Health Insurance Patients at Four Types of First Level Health Facilities Ni Made Widiastuti; Ni Made Sri Nopiyani; I Nyoman Mangku Karmaya
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p06

Abstract

Backgrounds and purpose: The road map of the National Health Insurance Scheme (JKN) aims to ensure that 75% of patients are satisfied with the quality of health facilities. This study was designed to determine differences in patients’ satisfaction in general, as well as at each individual first-level health facility (FKTP) and based on dimensions of quality. Methods: Study was a cross-sectional sample survey with the respondents of 148 JKN patients selected consecutively from 4 types of FKTP. A total of 4 health centers, 3 government clinics, 4 private clinics and 4 general practitioners randomly selected from 11 health centers, 7 government clinics, 13 private clinics and 70 general practitioners in the city of Denpasar. Data were collected through interviews over March-April 2015 in each health facility using questionnaires by trained interviewers. Data were analyzed by univariate, bivariate and multivariate. Results: A total of 69,59% of JKN patients said that they were satisfied with the quality of FKTP services. This figure was lower than the target of JKN i.e. 75%. The highest satisfaction (90,00%) was in the general practitioners while lowest was in the private clinics (47,46%). Based on the dimensions of quality, JKN patients’ satisfaction in the four FKTPs was significantly different (p=0,008) in physical and empathic dimensions (p=0,013). In the multivariate analysis, variables found related to the satisfaction of the respondents were the FKTP of general practitioners (adjusted PR=1,91; 95%CI: 1,05-3,47) and health centers (adjusted PR=1,76; 95%CI: 1,04-2,97). Conclusion: In general, the patients’ satisfaction rate was still lower than the target of JKN and when viewed per care facilities, the highest satisfaction was found in FKTP of general practitioners and health centers.
Perceptions of Community Health Center’s Workers on National Health Insurance (JKN) Healthcare Services Payment System in Karangasem Regency Ni Wayan Ani Hendrayani; Putu Ayu Indrayathi; I Putu Ganda Wijaya
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p07

Abstract

Background and purpose: National Health Insurance (JKN) healthcare services payment system is a financial compensation given to employees of health centers through an allocation system implemented by the Ministry of Health Regulation (Permenkes No. 28 of 2014). This study aims to explore health care workers perception of the JKN health care services payment system. Methods: In-depth interviews conducted among 12 participants selected purposively namely heads of health centers (doctors and public health graduated), medical personnel, paramedics, other health professionals, non-health personnel (both civil servants and noncivil servants). Data were analyzed using thematic analysis approach presented narratively. Results: Participants intimated that the amount of points based on the variable of kind of personnel and/or positions were not proportional/not in accordance with the actual condition of the health center. The use of attendance rates made for an unconducive atmosphere as it was evident that this variable was not applied to all employees but only to the central health centers. The differentiation of employment status with the same workload, and the uneven amount of points and grouping of years of service rather than workload was viewed as unfair and bias by respondents therefore they believed this needs further assessment. Conclusion: The allocation of the JKN health care services payment system was perceived as prejudicial by the employees of the health centers in Karangasem Regency. The amount of points distributed were not proportional to the type of personnel and/or position, and the use of the level of attendance, differentiation of employment status, grouping of years of service not based on workloads were all issues raised by respondents.
Risk Factors of Low Birth Weight (LBW) among Infants at dr. R. Soedjono General Hospital East Lombok Yuliani; I Wayan Gede Artawan Eka Putra; I Gusti Ayu Trisna Windiani
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p08

Abstract

Background and purpose: The infant mortality rate related to low birth weight (LBW) in the East Lombok district increased from 18.0% in 2012 to 26.1% in 2013. This study aimed to identify the risk factors of LBW among infants in dr. R. Soedjono General Hospital, East Lombok. Methods: A case-control study was conducted in dr. R. Soedjono General Hospital involving 59 LBW and 118 normal weight infants as controls (1:2) which were selected by systematic random sampling. Secondary data regarding chronic energy deficiency and anemia were collected using medical records and delivery register. Data on maternal characteristics,birth spacing, access to antenatal care,  socioeconomic status, cigarette smoke exposure, wood smoke exposure and mosquito repellent exposure were collected through interviews. Data were analyzed using bivariate to determine crude OR and multivariate to calculate adjusted OR. Results: Characteristics of cases and controls was similar in terms of education, employment and maternal parity, but significantly different in age. Multivariate analysis showed that variables significantly associated with LBW were income with OR=2.3 (95%CI: 1.06-4.9), cigarette smoke exposure with OR=2.9 (95%CI: 1.31- 6.33), chronic energy deficiency with OR=3.1 (95%CI: 1.24-7.59) and maternal ages <20 years or >35 years with OR=3.2 (95%CI: 1.46-6.90). Wood smoke exposure and anemia were not significantly associated with LBW with OR=1.2 (95%CI: 0.44-2.88) and OR=1.1 (95%CI: 0.82-1.27). Conclusion: Risk factors associated with LBW among infants were low income, cigarette smoke exposure, chronic energy deficiency and mother’s age <20 years or >35 years.
Hormonal Contraceptive Use and History of Sexually Transmitted Infection as Risk Factors of the Pre‑Cancerous Cervical Lesions Ni Made Parwati; I Wayan Gede Artawan Eka Putra; I Nyoman Mangku Karmaya
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p09

Abstract

Background and purpose: Screening for pre-cancerous cervical lesions is already being implemented in Bali. This study aims to determine hormonal contraceptives and STI history as risk factors of pre-cancerous cervical lesions. Methods: A case-control study was conducted involving 76 women of childbearing age diagnosed with pre-cancerous cervical lesions who screened at two health centers in Denpasar Bali from January to March 2015. Control was 76 women of childbearing age with no pre-cancerous cervical lesions who screened at the same period. Consecutive sampling was used to select cases and controls. Data were collected through interview using questionnaires and analyzed using logistic regression to calculate adjusted odd ratio of each risk factor. Results: Multivariate analysis indicated that the use of hormonal contraceptives over ≥5 or <5 years increase risk of pre-cancerous cervical lesions with OR=10,7 (95%CI: 1,04-108,17) and OR=3,0 (95%CI: 1,16-7,84) compared to those who were not using hormonal contraception. History of sexually transmitted infections also increases risk of pre-cancerous cervical lesions with OR=9,7 (95%CI: 3,83 24,18). Conclusion: The use of hormonal contraceptives and history of sexual transmitted infections increased risks of pre-cancerous cervical lesions.
Association of Competence, Motivation and Nurse Workload with Nurse Performance at Mental Hospital in Bali Province I Nengah Budiawan; Ketut Suarjana; I Putu Ganda Wijaya
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p10

Abstract

Background and purpose: Average Bed Occupation Rate (BOR) of Mental Hospital in Bali Province in 2014 amounted to 85.3% with an average length of stay about 50 days. Preliminary study indicated inadequate performance of nurses at Mental Hospital in Bali. The purpose of this study was to determine the association of competence, motivation and nurses workload with the performance of nurses in wards of Mental Hospital in Bali Province. Methods: This research was a cross sectional survey. The subjects of the study consisted of all nurses in the inpatient unit, amounting to 111 people. Data were collected using self-administered questionnaires and observation sheet filled out by the head of the room. Data were analyzed using bivariate with chi-square test, and multivariate with logistic regression method. Results: Bivariate analysis showed significant association between the performance of nurses with competence and motivation (p<0.001), however no association with workload (p=0.94). Multivariate analysis showed that the performance of nurses was associated with competence with AOR=65.38 (95%CI: 6.88-621.52) and with motivation (AOR=61.71; 95%CI: 7.15-532.59), however was not significantly associated with workload (AOR=1.012; 95%CI: 0.32-3.17). Conclusion: The performance of nurses was significantly associated with competence and motivation, however not associated with workload.

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