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Public Health and Preventive Medicine Archive

phpma
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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 315 Documents

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Community participation in the utilization of village fund for stunting prevention: Case study in two villages in Gianyar District Prabasari, Made Ayu Diah; Lubis, Dinar Saurmauli; Sutiari, Ni Ketut
Public Health and Preventive Medicine Archive Vol. 9 No. 2 (2021)
Publisher : Universitas Udayana

Background and purpose: The Indonesian government has set a target to reduce stunting prevalence from 27.7% in 2019 to 14% in 2024. There are 10 villages in Gianyar District have been selected as stunting loci since 2018, however, the percentages of the village fund utilized for health and nutrition were low. This research aims to identify the level of community participation in the utilization of village fund for stunting prevention in two stunting loci villages in Gianyar. Methods: This was a qualitative study using a multiple case study approach conducted in two stunting loci villages in Gianyar, Bali. Data collection was conducted from May to June 2020 through in-depth interview with 12 key informants. Thematic qualitative analysis was done using the ladder of participation concept with Arnsteinand political approach by Carpentier which involves several key concepts such as process, field, actor, decision making moment and power. Results: The level of community participation in the village fund utilization for stunting prevention was still in the of pseudo participation – Placation level. The majority of proposals or recommendation for stunting prevention program came from cadres of community health post, health care workers and the village assistants. Final decision making in the planning stage was largely depending on the village government. The community plays the role as program recipient. Several challenges for optimal utilization of village fund for stunting prevention were geographical condition, paternalistic leadership as well as the lack of understanding and capacity of key actors. Conclusion:The community participation in utilization of the village fund for stunting program in the two villages was in the vague participation level. The village government should provide more rooms to empower the community in order to increase their participation level.

Analysis of the Birth Insurance Program (Jampersal) utilization in Bangli District, Bali, Indonesia Ni Made Ayu Kemala Dewi; Yuli Kurniati; Pande Putu Januraga
Public Health and Preventive Medicine Archive Vol. 8 No. 1 (2020)
Publisher : Universitas Udayana

Background and purpose: The Birth Insurance Program or called Jaminan Persalinan (Jampersal) aims to reduce maternal and newborn deaths. Bangli is one of the districts in Indonesia with low utilisation of Jampersal program. The study aims to explore factors associated with the low utilization and uptake of Jampersal Program in Bangli District. Methods: This was a qualitative study conducted between April- May 2019. The study involved 24 informants who were selected purposively. The informants were 18 pregnant women, two community leaders, three health workers and one Bangli Health Office’s staff. Data were collected through in-depth interviews which explore factors associated to utilisation of Jampersal using PRECEDE-PROCEED Framework. Data were analyzed by thematic analysis. Results: We found that informants who used Jampersal had sufficient knowledge about Jampersal, were exposed to the program informed by health workers and community leaders, and were supported by their families. Whereas, those who yet to utilize Jampersal had a poor understanding on Jampersal service mechanisms, lack of spousal support in preparing Jampersal requirements and private midwives had not signed the Jampersal MoU. Conclusion: Low utilisation of Jampersal Program in Bangli District partially influenced by low understanding of the program and in-optimal involvement of midwifery networks. The local health office should further expand cooperation with the private midwife network for optimum utilization of Jampersal, elucidation of the Jampersal technical guidelines to health workers, as well as technical support for participants in completing required documents.

The ways urban marginalized group conceptualizes health and wellbeing: The case of the waste pickers in Surabaya, Indonesia Yohanes Kambaru Windi; Dyah Wijayanti; Eko Rustamaji Wiyatno
Public Health and Preventive Medicine Archive Vol. 8 No. 2 (2020)
Publisher : Universitas Udayana

Background and purpose: Health and wellbeing have a different meaning for an individual, institution, ethnicity and organization. The study aims to overview the ways waste pickers conceptualize health and wellbeing. Methods: A qualitative procedure deployed to identify the predictors of health and wellbeing according to the waste pickers and how they perceive them. Forty waste pickers were involved as participants. Semi-structured in-depth interviews, natural group discussion (NGD) and casual conversation are the main methods for collecting information. The information was analysed using a thematic and inductive approach. Results: The waste pickers identify health as free from diseasesand illness, being able to work, a peaceful mind, positive relation within the family and social life, being grateful for life, surrender to God, and being happy. They relate wellbeing with gratefulness with achievements, sense of enough, being satisfied with life, submission to God, sense of “enough”, frugality and some assets back hometown. Conclusion: The study concludes that waste pickers provide apractical understanding of health and wellbeing. It recommendsthat understanding and measuring health and wellbeing should on the context of the target population.

Husband’s behavior and early marriage as risk factors for hepatitis B virus infection among pregnant women in Karangasem, Bali, Indonesia Surapathi, I.N. Adnyana; Wirawan, Dewa Nyoman; Sawitri, Anak Agung Sagung
Public Health and Preventive Medicine Archive Vol. 9 No. 1 (2021)
Publisher : Universitas Udayana

Background and purpose: Indonesia is categorized as a country with moderate level of hepatitis B virus (HBV) infection, where the majority of HBV transmissions occur from mother to child, horizontal transmission during childhood and adulthood, and transmission in health services. This study aims to determine factors associated with HBV infection among pregnant women. Methods: A case control study was conducted among 80 pregnant women with sero-positive HBsAg as cases and 80 pregnant women with sero-negative HBsAg as controls. The sources of cases and controls were the registers of pregnant women at 12 public health centers (PHCs) and Karangasem District Hospital from June 2017 to December 2018. Cases were selected by systematic random sampling from 129 pregnant women with sero-positive HBsAg and controls were selected through the same method from 1,408 pregnant women with sero-negative HBsAg. They were then matched based on village or residence. Data collected were including history of marriage, pregnancy, childbirth and abortion, history of health services relevant to HBV infection, use of contraception, mobility, permanent tattoos and history of injecting drug use. Data collection was carried out from June to August 2019 through face-to-face interviews with pregnant women as respondents in their respective homes using a pre-tested questionnaire. Bivariate data analysis was conducted with chi square test and multivariate analysis with logistic regression. Results: The case and control groups were similar in terms of age, number of pregnancy and parity. Risk factors which found to be significantly associated with HBV infection in pregnant women were age at first marriage <19 years with AOR=2.51 (95%CI: 1.13-5.60), history of husband’s mobility with AOR=3.07 (95%CI: 1.13-8.34), husband has a permanent tattoo with AOR=2.77 (95%CI: 1.04-7.44) and low level of maternal education with AOR=2.47 (95%CI: 1.06-5.73). Conclusion: Young marital age, low education, husband’s mobility and husband with permanent tattoos increase the likelihood of HBV infection among pregnant women. The coverage of HBV examination among pregnant women and early detection of HBV among husbands ought to be increased, especially among those with associated risk factors.

Length of caring duration increases burden and reduces health status of cancer patients’ family caregivers in Surabaya, Indonesia Yesiana Dwi Wahyu Werdani
Public Health and Preventive Medicine Archive Vol. 8 No. 1 (2020)
Publisher : Universitas Udayana

Background and purpose: The duration of care taking of cancer patients can trigger stress which impacts on the emergence of a burden which further affects the physical health of the family caregivers. This study aims to determine the effect of caring duration on the burden and health status of cancer patient’s family caregivers. Methods: This was a cross-sectional study. Samples were 56 cancer patient’s family caregivers who were selected by a purposive sampling technique based on specified inclusion criteria from two public health centers (PHCs) in Surabaya Indonesia. Participants completed the questionnaire which comprised of questions on caring duration, caregiver burden scale and physical health status. Statistical tests using simple linear regression and multiple linear regression were performed. Results: The average age of family caregivers was 49.91 (SD=12.24), mostly female (66.7%), while half of the patients (51.8%) were a stage III cancer patients and the most frequent type of therapy (35%) received was chemotherapy. The average of caring duration was 4.44 (SD=1.92) years, score of burden was 51.07 (SD=18.45) and score health status was 60.32 (SD=10.81). After adjusted for age, gender, cancer stage and type of therapy, caring duration was significantly associated with increased burden of family caregivers (b=9.186, 95%CI: 7.85-10.10, p<0.001) and with reduced health status (b=5.282, 95%CI: 4.50-5.85, p< 0.001) Conclusion: The longer caring duration of cancer patients causes a higher burden and also a lower health status of family caregivers. Health workers and community have an important role in reducing the burden and improving the health status of caregivers by providing supports and appropriate prevention measures.

Efficacy of sport and slow stroke back massage as a non-pharmacological therapy to lower blood pressure in elderly with chronic hypertension Azmy, Liza Ulil; Subrata, I Made; Suariyani, Ni Luh Putu
Public Health and Preventive Medicine Archive Vol. 9 No. 1 (2021)
Publisher : Universitas Udayana

Background and purpose: The prevalence of hypertension has been increasing along with the increasing elderly population. Non-pharmacological therapies such as sports and slow stroke back massage offer a potential adjuvant therapy for elderly patient with chronic hypertension. This study aims to determine the efficacy of sports and slow stroke back massage as nonpharmacological therapies to lower blood pressure in this age group. Methods: This study was a Parallel Group Randomized Controlled Trial, conducted in Patrang, Jember, East Java. The study involved a total of 72 elderly aged between 60 to 79 years old who had blood pressure of ≥140/90mmHg, and not taking antihypertensive drugs. The study participants were assigned randomly into three groups namely, the sports massage, slow stroke back massage, and control groups. Subject characteristics, stress level, physical activity level and eating habit were collected through structured interview using standardized questionnaires (Global Physical Activity Questionnaire, Food Frequency Questionnaire, Depression Anxiety Stress Scale (DASS 21)). Blood pressure measurements were done twice, before and after treatment. Before and after comparison was conducted with Wilcoxon test, between group comparison was conducted with Kruskal Wallis test followed by Mann Whitney test. Results: The average systolic blood pressures before and after sports massage were 168.96±SD 16.02 mmHg and 147.50±SD 15.95 mmHg, respectively. For the slow stroke back massage was 165.42±12.50 mmHg before treatment and 154.58±16.15 mmHg after treatment. The systolic and diastolic blood pressures before and after treatment in the treatment groups (sports massage and slow stroke back massage) were statistically different from the control group (p <0.05). Further, the Mann Whitney results indicated that slow stroke back massage was more effective than sports massage in lowering blood pressure in elderly with hypertension. Conclusions: Sport massage and slow stroke back massage are effective as a non-pharmacological therapy in lowering blood pressure in elderly with hypertension. These non-pharmacological therapies should be considered for controlling blood pressure in elderly.

The impact of hospital accreditation on patient safety culture in the health services implementation at Sanglah General Hospital, Bali Indrayani, Putu May; Januraga, Pande Putu; Negara, Surya
Public Health and Preventive Medicine Archive Vol. 9 No. 2 (2021)
Publisher : Universitas Udayana

Background and purpose: Hospital accreditation is carried out to evaluate hospitals’ performance in providing patients with excellent and safe health services. One aspect of service quality is patient safety culture. This study aims to determine the impact of hospital accreditation on patient safety culture in health service implementation at the Sanglah General Hospital in Denpasar City, Bali Province. Methods:This study used a qualitative research design. In-depth interviews were conducted to 11 informants consisting of hospital management, clinicians and nurses which were chosen purposively since they were directly related to the assessment and supervision of health service providers at Sanglah Hospital. The interview guide was based on the Modified Manchester Patient Safety Framework (MaPSaF). Data were analyzed with a thematic approach. Results: The interview results show that the ten dimensions of patient safety culture had been implemented well but still need to be improved in the dimensions of giving priority to safety, system errors and responsibilities, recording incidents and best practices, learning and influencing change, also education and training of staff and teamwork. The maturity level of patient safety culture at Sanglah Hospital is at generative culture in four dimensions and at proactive culture on the six dimensions of patient safety culture. Conclusion: Accreditation had a positive impact on the maturity level of patient safety culture at a proactive level, mainly changes in knowledge, attitudes, and behavior in health service providers. However, in its implementation, there were still constrained on infrastructure, time, and energy.

Perceived quality of primary healthcare services among the National Health Insurance members and fee for service patients in the West Denpasar II Public Health Center Bali, Indonesia Nitya Nijyoti; Putu Ayu Indrayathi; I Made Ady Wirawan
Public Health and Preventive Medicine Archive Vol. 8 No. 1 (2020)
Publisher : Universitas Udayana

Background and purpose: The Government of Indonesia established the National Health Insurance or in Indonesia called Jaminan Kesehatan Nasional (JKN) in 2014 with the target of achieving universal health coverage (UHC) by 2019. However, many have not become JKN participants and still use the fee for service financing system. The purpose of this study was to determine patient’s perceptions of the quality of health services under the JKN and fee for service payment methods. Methods: A cross-sectional study was conducted at West Denpasar II Public Health Centre (PHC) with 133 outpatient respondents who were selected sequentially. Data collection was carried out in June 2019 through interviews. Patients’ perceptions of service quality were measured according to the six domains of health service quality established by the Institute of Medicine (IOM) which include effectiveness, efficiency, timeliness, patient-centered approach, safety and equity. Bivariate analysis was conducted with Mann Whitney test and multivariate analysis with Ancova. Results: Patients’ perceptions of the quality of services in the JKN and fee for service payment methods were found to be quite good with an average of 3.08 and 3.17 of the maximum value of 4.0. Bivariate analysis showed a significant difference with a mean rank of 54.28 for JKN and 79.16 for fee for service (p<0.01). Patients’ perceptions of service quality also differed significantly based on the dimensions of efficiency (p=0.001), effectiveness (p=0.005), timeliness (p=0.007) and patient-centered approach (p=0.032). Multivariate analysis showed that the variable that was significantly related to patient perceptions of service quality was the payment methods (p<0.001). Conclusion: Patients with a fee for service payment methods have a better perception of service quality than patients who use JKN. Advocacy to policy makers and service providers should be conducted in order to ensure the equal quality of service for all patients.

Determinants of caesarean section among women of childbearing age in Indonesia: Secondary data analysis of the 2017 Indonesia Demographic Health Survey Desak Nyoman Purniati; Dewa Nyoman Wirawan; Luh Seri Ani
Public Health and Preventive Medicine Archive Vol. 8 No. 2 (2020)
Publisher : Universitas Udayana

Background and purpose: The caesarean section (CS) trendcontinues to increase throughout the world, including Indonesia. Indonesia is one of the countries where the proportion of CS exceeds the WHO recommendation. CS on medical indications can save the mother and baby, but if the CS is performed without any medical indication it will affect the welfare and health of both. This study was conducted to determine the factors associated with CS deliveries in women of childbearing age (WCA) in Indonesia. Methods: This study is a secondary data analysis using the 2017Indonesia Demographic and Health Survey (IDHS) data. The data analyzed in this study were CS deliveries in the last 5 years and predictors variables which were collected via interviews. The number of samples in this analysis were 14,533 respondents from the total sample size of the 2017 IDHS as many as 50,730 female respondents aged 15-49 years. Data analysis was performed using multivariate logistic regression with backward method. Results:The proportion of CS among women aged 15-49 years in Indonesia was 17.7% (95%CI: 17.4-18%). The risk factors for CS were age >35 years with AOR=2.35 (95%CI: 1.61-3.44), primiparity with AOR=2.03 (95%CI: 1.54-2.68), multiparity with AOR=1.53 (95%CI:1.18-1.99), low infant weight with AOR=1.71 (95%CI: 1.45-2.03),maternal high education level with AOR=2.15 (95%CI: 1.79-2.59), husband’s middle education level with AOR=1.41 (95%CI: 1.231.62), urban areas of residence with AOR=1.28 (95%CI: 1.15-1.41), high family wealth index with AOR=1.87 (95%CI: 1.64 2.13), hasa health insurance with AOR=1.54 (95%CI: 1.41–1.70), delivered the baby at a private health facility with AOR=1.18 (95%CI: 1.07-1.31), number of ANC visits ≥4 times with AOR=1.87 (95%CI: 1.42-\2.32), and have been exposed to information media with AOR=2.01(95%CI: 1.02-3.97). Conclusion: The proportion of CS delivery in Indonesia remains relatively high. Education for mothers and families about the impact of unnecessary CS delivery needs to be increased so that mothers and families are able to make appropriate and rational decisions. Interventions should be focused on mothers and husbands who are more educated, have higher socioeconomic status, live in urban areas and have chosen delivery in private health facilities

Analysis of Public Health Centre Financing using the District Health Account (DHA) Model in Karangasem District, Bali, Indonesia Ni Nengah Murniati; Putu Ayu Indrayathi; Pande Putu Januraga
Public Health and Preventive Medicine Archive Vol. 8 No. 1 (2020)
Publisher : Universitas Udayana

Background and purpose: Health financing aspects of the public health centres (PHC) may influence the achievement of PHC’s programs and its minimum service standards (SPM). The District Health Account (DHA) is a model used to describe and evaluate health financing at the PHC level. The purpose of this study was to analyze health financing mechanism from both the government and national health insurance in the Karangasem District using the DHA Model. Methods: This study was an evaluation research with a case study approach using the DHA Model. Evaluations were carried out at two PHC, Manggis II PHC and Abang I PHC, between March and April 2018. Data were collected from the Karangasem District Health Office and the PHCs. These include PHC realization data, report on program achievements and SPM. The research instrument used for the data collection and analysis was the DHA extraction form and pivot table which includes information on cost sources, financing managers, service providers, functions, programs, types of activities, budget lines, levels of activities and beneficiaries. Results: We found the source of budget in both PHC was dominated by the district budget (APBD) and the national budget (APBN). The institutions which manage the budget and provide service were predominantly the Health Office and PHC. The most frequent financing functions was for governance and administration, while the largest types of activities covered was the indirect activities. Budget spending for operational costs was higher than for maintenance and investment. Realization of the activity for community program efforts (UKM) and prevention program (UKP) was lower than for the capacity building program. Conclusion: The DHA model was able to identify patterns of health budget allocation by health agencies. The use of the DHA model to analyze health financing should be adopted routinely in order to provide evaluation reports for health agencies at the district level.

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Putu Ayu Swandewi Astuti

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editor@phpmarchive.org

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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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Kota denpasar,

Bali

INDONESIA

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Putu Ayu Swandewi Astuti

Contact Email editor@phpmarchive.org

Phone +62361-4744646.

Journal Mail Official editor@phpmarchive.org

Editorial Address Department of Public Health and Preventive Medicine, Udayana University, Bali-Indonesia Phone: +62 361 4744646 Fax: +62 361 4744646 Email: editor@phpmarchive.org

Location Kota denpasar, Bali INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Putu Ayu Swandewi Astuti

Contact Email
editor@phpmarchive.org

Phone
+62361-4744646.

Journal Mail Official
editor@phpmarchive.org

Editorial Address
Department of Public Health and Preventive Medicine, Udayana University, Bali-Indonesia Phone: +62 361 4744646 Fax: +62 361 4744646 Email: editor@phpmarchive.org

Location
Kota denpasar,

Bali

INDONESIA