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Putu Ayu Swandewi Astuti
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Department of Public Health and Preventive Medicine, Udayana University, Bali-Indonesia Phone: +62 361 4744646 Fax: +62 361 4744646 Email: editor@phpmarchive.org
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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
 1   2 
Search results for , issue "Vol. 5 No. 2 (2017)" : 15 Documents clear
Predictors of treatment interruption among tuberculosis patients in public health centres in Bali, Indonesia Putu Ika Farmani; Dewa Nyoman Wirawan; Anak Agung Sagung Sawitri; I Wayan Gede Artawan Eka Putra
Public Health and Preventive Medicine Archive Vol. 5 No. 2 (2017)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2017.v5.i2.p11

Abstract

Background and purpose: Tuberculosis treatment interruption (TB TI) is one factor that leads to treatment failure, tuberculosis (TB) drug resistance and drop out. The purpose of this study is to identify the incidence and the predictors of TB TI in public health centres (PHCs) in Bali. Methods: A retrospective longitudinal study was conducted using secondary data of 644 cohorts of TB patients on the first regiment who enrolled in 11 PHCs in Denpasar Bali during 2011-2012. Information from TB program officers in PHCs was also obtained to determine the differences within the practical implementation of TB treatment. Data were analysed using Kaplan Meier and Cox Proportional Hazard Regression. Results: The study revealed that 378 patients experienced TB TI with the total events of 535. The incidence rate of TB TI event was 5.1 per 1.000 person days and the median time was 56 days (IQR: 56-57). Predictors of the TB TI were male (AHR=1.22; 95% CI: 1.02-1.45; p=0.027) and a more flexible schedule to take the medicine (AHR=1.47; 95%CI: 1.22-1.76; p<0.0001). Conclusions: The implementation of fixed schedule and shortened time lapse for patients to take TB drug will enable more close contact between patients and health providers. Intensive adherence counselling especially tailored for male patients is also required.
Relationship between institution status and the organizational culture of community health centres in Bali Maria Magdalena Zulian Puji Astuti; Ni Made Sri Nopiyani; Pande Putu Januraga
Public Health and Preventive Medicine Archive Vol. 5 No. 2 (2017)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2017.v5.i2.p12

Abstract

Background and purpose: The adoption of an appropriate organizational culture model can be instrumental in ensuring the success of an institution. Currently, public health centres (PHCs) in Indonesia are being remodeled to function as independent units managed as regional public service agencies (BLUD). This study aims to determine whether there are differences in the organizational culture of BLUD PHCs with non BLUD PHCs. Methods: Survey was conducted with 142 staff from BLUD PHCs and with 109 staff from non BLUD PHCs, selected using stratified random sampling technique. Data were collected by completing the organizational culture assessment instrument (OCAI) according to the concept of Competing Values ​​Framework (CVF) and analyzed descriptively to determine aspects of the organizational culture. Results: Staff at the BLUD PHCs presented with lower education levels, were older and with an average longer working period compared to staff at the non BLUD PHCs. A hierarchical organizational culture was found in three BLUD PHCs and in one BLUD PHCs, while the other two non BLUD PHCs indicated a tendency towards a clan culture. It is hoped that in the next two years all PHC will adhere to a clan organizational culture model. Conclusions: Significant differences in age, education and number of working years between BLUD PHCs and non BLUD PHCs determine the organizational culture model adopted. The current adopted organizational culture is hierarchical whereas a transition to clan culture is desired.
The provision of promotive and preventative healthcare services by private primary care physicians in the era of the national health insurance program Ketut Ary Diana Artha; I Ketut Suarjana; Pande Putu Januraga
Public Health and Preventive Medicine Archive Vol. 5 No. 2 (2017)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2017.v5.i2.p13

Abstract

Background and purpose: In addition to their duties in addressing the curative and rehabilitative needs of the community, private primary care physicians (PCP) play an important role in providing promotive and preventative healthcare services. This study aims to determine the behaviours, enabling and inhibiting factors involved with the provision of promotive and preventative services by PCP in the era of national health insurance (JKN) implementation. Methods: This research is a mix method study using a combination of quantitative and qualitative approaches. Quantitative surveys were conducted with all PCPs already in working collaboration with the Social Security Administering Agency (BPJS) in the Denpasar City area (61 people). Data analysis techniques used descriptive techniques in order to explore the kinds of promotion and preventative services provided by PCPs. Qualitative research was conducted through in-depth interviews of 8 informants selected by purposive sampling and analyzed thematically to discover the enabling and inhibiting factors of the provision of promotive and preventative services by PCPs. Results: The results showed that 91.8% of PCPs did perform promotive and preventative services in their practice site. PCPs who did not carry out promotive and preventative services demonstrate perceptions, beliefs and motivations categorized as low and weak as well as attitudes that do not support the implementation of such services. Enabling factors of promotion and preventative services by PCPs, include among others, quality of facilities and infrastructure, the receipt of awards from BPJS and capitation systems that benefit physicians financially. Inhibiting factors include a low willingness of the patient to carry out doctor's advice, limitations in the PCPs work time and limited funds to perform preventative/promotive services. Conclusions: Promotive and preventative services are not being optimally carried out by PCPs in Denpasar. This is due to the low willingness of the patients, the limited time of the doctor, and the limited allocated funds for promotive and preventative services and low capitation.
Predictors of improved nutritional status among HIV/AIDS patients who received antiretroviral therapy (ART) at Sanglah General Hospital Denpasar Gusti Ayu Eka Utarini; Anak Agung Sagung Sawitri; Ketut Tuti Parwati Merati
Public Health and Preventive Medicine Archive Vol. 5 No. 2 (2017)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2017.v5.i2.p14

Abstract

Background and purpose: Antiretroviral therapy (ART) is associated with improved nutritional status among HIV/AIDS patients. This study aims to examine proportion, median time, incidence rate, and predictors of improved nutritional status among HIV/AIDS patients who received ART at Sanglah General Hospital Denpasar. Methods: A restrospective cohort study was conducted in Denpasar City. A total of 207 medical records of HIV/AIDS patients who received ART between 1st of January 2012 and 30th of June 2015 were included in the study. Kaplan Meier analysis was performed to calculate incidence rate and median time of improved nutritional status among HIV/AIDS patients. Sociodemographic characteristics and clinical variables included body mass index (BMI), body weight, haemoglobin level, CD4 count, HIV clinical stadium, ART regiments, and opportunistic infections (OIs). Data were analysed using cox proportional hazard model to identify predictors of improved nutritional status among HIV/AIDS patients. Results: As many as 65.22% of HIV/AIDS patients who received ART experienced an improvement in their nutritional status with the incidence rate of 9.1 per 100 person months and median time of 6.1 months. Multivariate analysis showed that predictors of improved nutritional status were BMI at ART initiation (AHR=1.34; 95%CI: 1.16-1.5), HIV clinical stadium (AHR=1.45; 95%CI: 1.02-2.06), CD4 count at ART initiation (AHR=0.89; 95%CI: 0.81-0.99) and the presence of diarrhoea (AHR=1.83; 95%CI: 1.06-3.14). Conclusions: Predictors of improved nutritional status among HIV/AIDS patients who received ART were BMI, HIV clinical stadium, CD4 count and diarrhoea.
The role of communication contact in capitation implementation at public health centres in Denpasar Ni Putu Purlimaningsih; I Ketut Suarjana; Pande Putu Januraga
Public Health and Preventive Medicine Archive Vol. 5 No. 2 (2017)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2017.v5.i2.p15

Abstract

care is the contact between the provider and the recipient (communication contact). Targets set regarding communication contacts are often not achieved which in turn results in consequent cuts in the capitation rates received by the public health centres (PHCs). The purpose of this research is to understand the implementation, inhibiting and enabling factors of supporting communication contact in the era of National Health Insurance (Jaminan Kesehatan Nasional/JKN). Methods: This study used a qualitative explorative design through in-depth interviews and focus group discussion (FGD) with 22 informants consisting of heads of PHCs, PHCs staff, Head of Denpasar Health Office, Head of Social Security Administering Agency (BPJS) Denpasar Branch and JKN members. This research was conducted at 11 PHCs in Denpasar City from April to July 2017. The informants were chosen purposively and the data were analysed thematically to explore aspects of implementation, the inhibiting and enabling factors of communication contact. Results: Communication contacts can be assessed both inside and outside the PHCs buildings. The inhibiting factor of communication contact implementation related to difference in understanding of the concept of PHCs working area, the absence of a standard operational procedure (SOP) for communication contact, heavy workload of PHCs service providers, lack of optimal means of supporting application of pcare convoluted and confusing information from BPJS, and lack of understanding from JKN enrolees on the particulars of the administration and desire for speedy service. Supporting factors are the availability of media, training and orientation for the implementing staff and the feedback from BPJS to PHCs staff. Driving factors are the effective authority of the PHCs head, commitment and motivation from government agencies and cross-sectoral support. Conclusions: Implementation of communication contact is influenced by both inhibiting and enabling factors, from the BPJS stakeholders and the members of the BPJS. Achieving the target of communication contact requires synergy of central government policy and BPJS managers.

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