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Putu Ayu Swandewi Astuti
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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 310 Documents
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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.
Disease History and Delayed Diagnosis of Dengue Infection as Risk Factors for Dengue Shock Syndrome in Wangaya Hospital Denpasar I Made Suganda Yatra; I Wayan Gede Artawan Eka Putra; Gede Ngurah Indraguna Pinatih
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.p11

Abstract

Background and purpose: Dengue Haemorrhagic Fever (DHF) is a serious public health concern in Bali Province, especially in Denpasar wherein the incidence rate amounted to 217.7 per 100,000 in 2014. This figure is much higher than national incidence of 51 per 100,000. Dengue Shock Syndrome (DSS) frequently occur alongside high mortality. This research aims to identify risk factors of DSS among DHF patients hospitalized in Wangaya Hospital Denpasar. Methods: A case-control study was conducted. Cases (47) were DSS patients and controls (94) were dengue patients hospitalized in Wangaya Hospital in 2013- 2014. Data were collected from medical records on as age, gender, duration of fever, dengue history, haematocrit, platelets, class of care and health insurance. Results: Risk factors that independently associated with DSS were history of previous dengue infection with adjusted OR=11.6 (95%CI=1.83-73.96), duration of fever before admission ≥4 days with adjusted OR=5.5 (95%CI: 2.03-14.96), haematocrit ≥42% with adjusted OR=2.8 (95%CI: 1.02-7.68), platelets <50,000/mm3 with adjusted OR=5.2 (95%CI: 1.88-14.36), and third class ward with adjusted OR=2.9 (95%CI: 1.01-8.29). Conclusion: History of previous dengue infection and delay in recognizing the symptoms of dengue fever increased risk of DSS. In addition, patients who hospitalized in the third class ward had higher risk of DSS.
Factors Associated with the Behavior of Food Handlers in the Application of Good Manufacturing Practice (GMP) in the Household Food Industry (HFI) in Karangasem Regency Ni Made Astini Handayani; Kadek Tresna Adhi; 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.p12

Abstract

Backgrounds and purpose: Indonesia is considered of the countries in Southeast Asia with low food quality. The poor behaviors of food handlers in applying good manufacturing practice may bring about a decline in food quality which can lead to the risk of health conditions such as diarrhea, worm infection or food poisoning. This study aims to determine the factors associated with the behaviors of food handlers in the application of good manufacturing practice at the household food industry level. Methods: Cross-sectional survey was conducted among 79 food handlers, working at the household food industry in Karangasem. Data were collected through interviews and observations and analyzed using poisson regression to understand the association of knowledge, attitudes and managerial support with behavior of food handlers. Results: The knowledge and attitude of food handlers were relatively poor at respectively 48.10% and 53.16%. The behavior of food handlers classified as good was 49.37%. Behavior of food handlers was significantly associated with knowledge (PR=1.48; 95%CI: 1.01-2.15), attitude (PR=2.13; 95%CI: 1.47-3.08) and managerial support (PR=3.01; 95%CI: 1.77-5.13). Conclusion: The behavior of food handlers in the application of good manufacturing practice at the household food industry remains low and was associated with knowledge, attitude and level of managerial support.
Perceived Benefits as Variable Related to Voluntary Enrolment in the National Health Insurance Program (JKN) at Public Health Centre I East Denpasar Ida Ayu Putri Widhiastuti; Pande Putu Januraga; 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.p13

Abstract

Background and purpose: By 2019 all Indonesian citizens should be covered by the JKN program. In 2015 the proportion of population covered by JKN was 53.4%, constituting 34.0% paid by the government, 4.3% by their employer and 3.9% independently, while 57.8% were not covered by JKN. In order to achieve universal coverage there needs to be increased enrolment from non-government employees and people who work independently. This study aims to understand the relationship between out patient enrolment and sociodemographic variables, information about JKN, perceived risk of falling sick, perceived benefits and barriers to access JKN. Methods: Cross sectional sample survey was conducted among 188 households, consist of 94 non-employee JKN participants and 94 respondents not yet enrolled. Data was collected through interview and analyzed by univariate, bivariate and multivariate analysis using logistic regression. Results: Exposure to JKN information was 89.36%. Bivariate and multivariate analysis showed that the only variable associated with JKN enrollment was perceived benefits with adjusted OR=4.53 (95%CI: 2.15-9.55). There was no association with sociodemographic variables, information regarding JKN and health status risk perception. Conclusion: Variable connected with voluntary JKN enrolment at Primary Health Care I Denpasar East was perception of benefits.
Association of Physical Fitness Participation with Cognitive Function and Balance among the Elderly in Denpasar Lanawati; Rina Listyowati; Raden Ayu Tuty Kuswardhani
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.p14

Abstract

Background and purpose: Aging is known to cause cognitive impairment and body imbalance. Studies have found that physical exercise helps to delay such depreciation. The purpose of this study was to assess the relationship between participation in physical fitness and cognitive function and body balance among the elderly in Denpasar. Methods: Study was cross sectional, involving 60 elderly who were categorised into those who participated in physical exercise and those who did not, using proportional stratified random sampling. MoCa-Ina was used to determine the level of cognitive function and Romberg Test was applied to determine body balance. Data were analysed using chi-square and logistic regression tests. Results: The proportion of normal cognitive function among elderly who did and did not participate in physical fitness were 80% and 20%, respectively. Similarly, proportions of normal body balance among the elderly who did and did not participate in physical fitness were 86.7% and 20.0% respectively. These differences were statistically significant. In logistic regression analysis, it was shown that the variables affecting cognitive function were participation in physical fitness and in a hobby, and variables that affected body balance were participation in physical fitness and disease history. Conclusion: Participation in physical fitness was associated with cognitive function and body balance among elderly.
Factors that Contribute to the Acceptance of Vasectomy as Contraception Option in East Lombok Regency Yudi Ardiana; Pande Putu Januraga; 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.p15

Abstract

Background and purpose: The national family planning program currently promotes the role of husbands as acceptors of vasectomy as contraception. The Wanasaba Sub-district of the East Lombok Regency is one of the areas with a high number of acceptors. This phenomenon needs to be understood more deeply in order to increase vasectomy contraception uptake in other areas. This study aims to understand in depth the factors that contribute to the acceptance of vasectomy as contraception in the Sub-District of Wanasaba of East Lombok. Methods: The study used a qualitative design with phenomenology approach. The data were collected through in-depth interviews. The study was conducted among 20 participants consisting of five couples of vasectomy acceptors and five couples of non-vasectomy acceptors. Data were analyzed using thematic analysis. Results: Research showed that the decision to undergo vasectomy was voluntarily and swift without any pressure or coercion from providers or others. The main factor contributing to the acceptance of vasectomy was the availability of free, direct and fast services facilitated efficiently by providers and cadres. Another factor was economical owing to the fact that hormonal contraceptive was considered costly. The driving factor for the acceptance of vasectomy was active support from the spouse along with social acceptability of the process from the community. Conclusion: Service availability, in addition to the involvement from health workers and cadres were crucial in providing information on the procedure, and in promoting and facilitating vasectomy uptake. It is necessary to improve the capacity of cadres, family planning field workers and family planning motivators in order to increase the number of vasectomy acceptors.

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