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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 315 Documents
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The role of information sources and characteristics of children in the acceptance of Japanese encephalitis (JE) mass immunization in Bali Province Nyoman Suardani; Dewa Nyoman Wirawan; Anak Agung Sagung Sawitri
Public Health and Preventive Medicine Archive Vol. 7 No. 2 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i2.p02

Abstract

Background and purpose: Japanese encephalitis (JE) is a public health issue that can be prevented by immunization programs. Indonesia began the JE immunization campaign in Bali through simultaneous immunization for children aged 9 months to 15 years. Although information dissemination has been carried out, knowledge, perceptions and characteristics of mother and child can influence the acceptance and uptake of immunization for children. This study aims to determine the factors that influence acceptance of JE mass immunization in Bali Province. Methods: Secondary data analysis was performed on the results of the JE Supplementary Immunization Activities (SIA) Udayana University survey which consisted of 1,284 mothers and 2,107 children. The survey was conducted from June-August 2018 in nine districts/cities in Bali Province. The association between knowledge, perception and respondents’ characteristics with acceptance of JE mass immunization was analyzed with chi square test and multivariate analysis was conducted using logistic regression. Results: The proportion of children who received immunization was 93.9% (95%CI: 92.8-94.9). The results of the bivariate analysis showed that there was a significant association between acceptance of JE mass immunization with the child’s age, sex, educational status, complete basic immunization history, mother’s perception of severity, benefits, barriers, knowledge and sources of information (p<0.05). Multivariate analysis shows that the variables which significantly increase JE mass immunization acceptance are information from a combination of media and face to face education (AOR=3.95; 95%CI: 2.01-7.77), schooling children (AOR=2.43; 95%CI: 1.23-4.79), living outside of Denpasar City (AOR=2.32; 95%CI: 1.49-3.62), children who have received complete basic immunization (AOR=2.22; 95%CI: 1.42-3.49), face to face information only (AOR=2.11; 95%CI: 1.21-3.70) and girls (AOR=1.68; 95%CI: 1.15-2.46). Conclusion: Information disseminated via a combination of media and face to face is the strongest variable influencing JE mass immunization acceptance. Providing appropriate information through a combination of media and face to face education by health or non-health workers needs to be considered.
Healthy tourism initiatives at destinations: opportunities and challenges I Made Ady Wirawan
Public Health and Preventive Medicine Archive Vol. 6 No. 1 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i1.p01

Abstract

Last but not least is the interaction between the various professions in the health sector especially doctors, nurses, and public health experts. This inter-professional collaboration coupled with cross-sectoral collaboration with the tourism sectors, including the government and the tourism industry, will play a major role in the realization of tourism health efforts in accordance with the concepts described in this article. If this can work well, a vision for healthy tourism can be a reality.
Determinants of unmet needs for family planning in Indonesia: Secondary data analysis of the 2017 Indonesia Demographic and Health Survey Luh Nyoman Sumiati; Dewa Nyoman Wirawan; Luh Seri Ani
Public Health and Preventive Medicine Archive Vol. 7 No. 2 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i2.p03

Abstract

Background and purpose: Globally, the unmet need for family planning remains high. The proportion of unmet needs for family planning in Indonesia was found to have declined but was still higher than the set target. In the last 5 years there have been significant development in Indonesia including infrastructure, the national health insurance program and the increasing allocation of funds to all villages throughout Indonesia with a possible impact in decreasing the unmet need for family planning. This study aims to determine the factors associated with unmet needs for family planning in Indonesia. Methods: This study uses secondary data from the 2017 Indonesia Demographic and Health Survey (IDHS) that was carried out in 34 provinces in Indonesia. The number of the analyzed samples was 26,479 of the total 2017 IDHS sample of 35,681 married women/living together with their partner aged between 15-49 years. The dependent variable is the unmet need for family planning, while the independent variables consist of four core variables namely individual, household, community and programmatic variables. Data analysis was performed with a binary logistic regression to obtain the adjusted odd ratio of each factor. Results: The proportion of unmet needs in this analysis was 14.3% (95%CI: 13.9-14.7%). Factors associated with unmet needs are maternal age 25-34 years (AOR=1.17; 95%CI: 1.01-1.36), 35-44 years (AOR=1.47; 95%CI: 1.24-1.74), ≥45 years (AOR=2.20; 95%CI: 1.81-2.68), age of last child ≥10 years (AOR=1.30; 95%CI: 1.16-1.45), number of living children <2 (AOR=1.66; 95%CI: 1.49-1.85), ideal number of children >2 (AOR=1.34; 95%CI: 1.24-1.44), have >1 son (AOR=1.12; 95% CI: 1.00-1.25), husband not working (AOR=1.89; 95%CI: 1.44-2.48), lack of knowledge about family planning methods (AOR=1.42; 95%CI: 1.24-1.63), not discussing family planning with partners (AOR=1.12; 95%CI: 1.03-1.21), living in urban area (AOR=1.24; 95%CI: 1.14-1.34) and regions with TFR >2.4 (AOR=1.59; 95%CI: 1.43-1.78). Conclusion: The proportion of unmet needs in Indonesia is still high and the dominant associated factor is the age of the mother ≥45 years. In order to decrease the family planning unmet needs, the intervention programs should be targeted to groups of women who are at risk of experiencing such unmet needs.
Sociodemographic factors and current contraceptive use among ever-married women of reproductive age: Analysis of the 2017 Indonesia Demographic and Health Survey data Ni Kadek Ayu Dwi Utami Ds; Dewa Nyoman Wirawan; Luh Seri Ani
Public Health and Preventive Medicine Archive Vol. 7 No. 2 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i2.p04

Abstract

Background and purpose: Globally, the number of new contraceptive users in mid-2017 was only around half of the target. According to the results of the Indonesian Demographic and Health Survey (IDHS), the use of all methods of contraception in Indonesia has increased but is still lower than the target. This study aims to determine the factors associated with the use of contraception in Indonesia. Methods: This study uses secondary data from the 2017 IDHS that was carried out in 34 provinces in Indonesia. The total sample was 35,681 of 49,627 women aged 15-49 years. The dependent variable was current contraceptive use. The independent variables consisted of socio-demographic and socio-economic factors, knowledge, discussion with husband, and access to health services. Data analysis was performed through a binary logistic regression test to obtain the adjusted odd ratio of each factor. Results: The proportion of current contraceptive use was found to be 63.6% (95%CI: 63.2-64.0%). Factors related to current contraceptive use were family planning information from health workers (AOR=1.67; 95%CI: 1.59-1.77), maternal age of 35-44 years (AOR=1.54; 95%CI: 1.42-1.66), maternal age of 25-34 years (AOR=1.37; 95%CI: 1.27-1.48), maternal age ≥45 years (AOR=0.75; 95%CI: 0.68-0.82), living in the Java-Bali region (AOR=1.28; 95%CI: 1.22-1.35), living in rural areas (AOR=1.07; 95%CI: 1.01-1.12), having more than two living children (AOR=1.52; 95%CI: 1.44-1.60), level of education not attending school until not graduating from high school (AOR=1,46; 95%CI: 1.35-1.59), high school graduation level (AOR=1.25; 95%CI: 1.16-1.35), not working status (AOR=1.08; 95%CI: 1.03-1.13), medium wealth index (AOR=1.07; 95%CI: 1.00-1.14) and good knowledge (AOR=1.17; 95%CI: 1.11-1.23). Conclusion: The proportion of current contraceptive use in couples of childbearing age in Indonesia has not reached the government target. Factors that were more likely to increase current contraceptive use were family planning information from health workers, age, region, number of living children, mothers’ education, and knowledge. The family planning program in Indonesia should therefore consider those factors to increase the current contraceptive use.
Perceived importance of structural factors are associated with the selection of primary care by national health insurance participants Putu Nitya Nirmala; Pande Putu Januraga; Putu Ayu Indrayathi
Public Health and Preventive Medicine Archive Vol. 7 No. 2 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i2.p05

Abstract

Background and purpose: Primary care are the entry point for health services in an insurance-based health financing system, including the National Health Insurance Program or Jaminan Kesehatan Nasional (JKN) in Indonesia. This study aims to understand the association between structural factors in health service management with primary care selection among JKN participants. Methods: The study used a cross sectional analytic design, conducted with 273 self-paid JKN participants in Denpasar as respondents. The samples were selected using multistage random sampling. Data was collected from April to May 2018 with interviews using a questionnaire covering the characteristics of respondents and perceptions on the importance of health care facilities, the capabilities of health providers, service distance, operational time, availability of drugs and medical equipment. Data analysis was carried out with multinomial logistic regression to determine the structural factors of health service management associated with the selection of primary care. Results: Most respondents (65.9%) chose private clinics, 21.3% chose public health centres (PHCs) and 12.8% chose individual practicing physicians. Multivariate analysis showed that the variables which significantly associated with the selection of primary care among JKN participants were the perceived importance of the health care facilities at PHCs and private clinics, each with AOR=7.83 (95%CI: 2.72–22.54) and AOR=7.18 (95%CI: 2.76–18.68), the perceived importance of the capability of health workers in private clinics with AOR=0.29 (95%CI: 0.12–0.77), the perceived importance of health service time in private clinics with AOR=2.67 (95%CI: 1.05–6.74) and history of health services utilization at private clinics with AOR=4.51 (95%CI: 1.86–10.96). Conclusion: Structural factors are associated with the selection of primary care among JKN participants. Attention to the quality and quantity of structural factors in the management of health services is important to improve the equitable distribution of JKN membership in the registered primary care.
Where do we go with HIV pre-exposure prophylaxis in Indonesia? I Nyoman Sutarsa
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.p01

Abstract

PrEP is an effective additional prevention strategy at trial settings. Decision to adopt PrEP as a public health intervention must be made based on the need and capacity of current systems. Instead of allocating substantial resources for PrEP, the limited resources could be wisely allocated to scale-up the existing prevention strategies including access to ART, as well as to ensure equality of access of people to full-range of HIV prevention and treatment measures.
Continuation rates for injectable contraception and intra-uterine device (IUD) at Banyuning Village, Buleleng District Lina Anggaraeni Dwijayanti; Dewa Nyoman Wirawan; Anak Agung Sagung Sawitri
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.p02

Abstract

Background and purpose: Surveys on the proportion of contraception uptake have been regularly conducted in Indonesia, including Bali Province. However, very limited studies have explored contraceptive continuation rates. This study aims to examine continuation rates for injectable contraception and IUD including its determinants. Methods: A cross-sectional survey was conducted in Buleleng District. A total of 100 reproductive age women who ever used or currently using injectable contraception or IUD were recruited to participate in the study. One village at Buleleng District was purposively selected and samples were selected from all registered reproductive age couples at the village using a systematic random sampling method. Data were collected through home interviews and were analysed using survival analysis to calculate contraceptive continuation rates. Multivariate analysis were performed using cox regression to identify factors associated to continuation rates for injectable contraception and IUD. Analysis was done using STATA SE 12.1. Results: The one year continuation rate for IUD for first child was 84.62% whereas for injectable contraception was 71.03%. When sex variable of the child was applied, the one year continuation rate for IUD for first child was higher among those who have male child (81.82%) than female child (66.67%). Similarly, the one year continuation rate for injectable contraception was higher among those who have male child (79.10%) than female child (57.58%). The one year contraceptive continuation rate is also higher for the second child than the first one (79.56 vs 71.03 for injectable and 87.88 vs 84.62 for IUD). The multivariate analysis showed that perceived quality of family planning services was associated to contraceptive continuation rates (AHR=2.54; 95%CI: 1.22-5.29). Conclusions: The continuation rate for IUD was higher than injectable contraception. Higher contraceptive continuation rate was found among those who have male children. The contraceptive continuation rate was associated with perceived quality of family planning services. Interventions to improve the quality of family planning services are warranted.
Electronic prescribing reduces prescription errors in Sanglah General Hospital Denpasar Ni Luh Putu Nurhaeni; I Ketut Suarjana; I Made Ady Wirawan
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.p03

Abstract

Background and purpose: Medication error is any preventable event that may lead to inappropriate medication use or patient harm. Prescription error, one component of medication error, at Sanglah General Hospital Denpasar is high. An electronic prescribing has been piloted at Angsoka Ward, Sanglah General Hospital Denpasar to reduce prescription errors. However, the evaluation of such implementation is never been conducted. This study aims to evaluate the effect of electronic prescribing on prescription errors at Sanglah General Hospital Denpasar. Methods: An evaluation study was conducted by adopting pre and post control design at Sanglah General Hospital Denpasar. Prescription errors at Angsoka Ward where the electronic prescribing is implemented, were compared to Kamboja Ward that uses manual prescribing. Heterogeneity of patients in these two wards was comparable. Prescription samples were selected using a simple random sampling. Prescription samples prior to implementation of electronic prescribing were taken from June and July 2016, while samples after implementation were taken from March and April 2017. Prescription samples from the control group were also taken from the same periods. A total of 96 prescriptions were taken from each arm – leading to 384 prescription samples in total. Prescription error was evaluated using three requirements namely: administrative (9 components), pharmacy (5 components) and clinical (3 components). Results: Our study found that there was a significant difference of prescription errors between pre and post implementation of electronic prescribing at Angsoka Ward (p<0.05). The median values [IQR] for prescription error based on administrative requirements between pre and post intervention were 2 [3] vs. 0 [0] (p<0.001); based on pharmacy requirements were 1 [2] vs. 0 [0] (p<0.001); based on clinical requirements were 1 [2] vs 0 [0] (p<0,001). In contrast, prescription error based on administrative and pharmacy requirements in Kamboja Ward was insignificantly reduced. The median values [IQR] for prescription error based on administrative requirements between pre and post intervention were 2 [2] vs. 2 [2] (p=0.505) and based on pharmacy requirements were 1 [2] vs. 1 [1] (p=0.295). There was a significant difference of prescription errors (p<0.05) based on clinical requirements with median values [IQR] of 1 [1] vs. 1 [1]. Implementation of electronic prescribing reduced the proportion of prescription errors by 67.8%. After implementation of electronic prescribing, some errors were still apparent related to drug administration and order duplication. Conclusions: Implementation of electronic prescribing reduces prescription errors. Scaling-up of electronic prescribing followed by training on standardised prescribing practices are warranted.
Causes of unwanted pregnancy among adolescents in Bali Province: a qualitative study Kadek Anggie Wisandewi Mayun; Luh Seri Ani; Ni Luh Putu Suariyani
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.p04

Abstract

Background and purpose: Teenage pregnancy is a major contributing factor of high maternal and infant mortality rates in Indonesia. Unwanted pregnancy among adolescents is increasing, therefore an understanding of its causes is essential. This study aims to explore causes of unwanted pregnancy among adolescents. Methods: A qualitative study was conducted in Bali Province. Data were obtained through in-depth interviews with 10 adolescents aged between 12-21 years who experienced unwanted pregnancy. Data were collected between September and October 2016. Data were analysed thematically and presented using a narrative approach. Results: Our study revealed that determinants associated to unwanted pregnancy among adolescents included the lack of systematic education on sexual and reproductive health both at home and school, as well as the lack of self-efficacy of teenage girls to reject pre-marital sex with their partner. Our study found that this pre-marital sex was done as an expression of love, because of being forced by the partner, and due to stressful home environments. Conclusions: The main causes of unwanted pregnancy among adolescents are the lack of sexual and reproductive health education and a weak self-efficacy of teenage girls to reject pre-marital sex demanded by their partner. Given the complexities of teenage pregnancy, overarching policy to facilitate an early comprehensive sexual and reproductive health education program at home, schools, and youth-friendly health facilities is warranted.
Association of supplementary feeding with stunting among children in Kintamani, Bangli, Bali Province Istiana Marfianti; I Made Ady Wirawan; I Wayan Weta
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.p05

Abstract

Background and purpose: The prevalence of stunting among under-five children in Indonesia and also in Bali is high. Studies on risk factors of stunting have been widely conducted in Indonesia, however association between stunting and diet pattern is still inconsistent. The aim of this study is to examine association of supplementary feeding pattern with stunting among children aged 1-3 years. Methods: A case control study was conducted in Bangli District. A total of 48 cases and 48 controls were selected to participate in the study. Age and sex variables between cases and controls were matched. Cases and controls were selected using a systematic random sampling method from 26 health post registers in Kintamani I Public Health Centre between November and December 2016. Data were collected in March 2017 by interviewing the mother at the health post. Data were analysed using bivariate and multivariate analysis. A logictic regression was performed to calculate adjusted odd ratio (AOR). Results: Cases and controls were comparable for age (p=0.773), sex (p=0.219), mother’s education (p=0.673) and history of infectious diseases (p=0.584). Cases and controls differed in several variables: frequency, variability and type of supplementary feeding (p=0.002, <0.001 and <0.001), family income (p=0.038), poor personal hygiene (p<0.001), environmental sanitation (p=0.022) and access to clean water (p<0.001). Our analysis showed that several variables were associated with stunting among children aged 1-3 years, which included lack of supplementary feeding variability (AOR=12.45; 95%CI: 2.25-69.71), poor personal hygiene (AOR=3.52; 95%CI: 1.03-12.03), and poor access to clean water (AOR=6.49; 95%CI: 1.61-26.19). Other variables included supplementary feeding initiation, frequency of supplementary feeding, consistency or type of supplementary feeding, sex, and family income were not associated with stunting among children aged 1-3 years. Conclusions: Variability of supplementary feeding, personal hygiene, and access to clean water were all associated with stunting among children aged 1-3 years.

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