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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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Differences in post-placental intra uterine device acceptance with and without couples counseling in private practice midwifery clinics, West Denpasar Putu Ayu Ratna Darmayanti; Dewa Nyoman Wirawan; Komang Ayu Kartika Sari; Mangku Karmaya; Ni Luh Putu Suariyani
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.p02

Abstract

Background and purpose: The post-placental intra uterine device (IUD) program is one intervention to increase IUD uptake however the acceptance remains low. Contraceptive counseling during pregnancy is expected to increase IUD uptake. The primary objective of this study is to determine the efficacy of counseling by involving the husband in order to improve post-placental IUD uptake. The secondary objective is to compare knowledge and perceptions of IUD before and after intervention. Methods: A randomized controlled trial was conducted with 58 pregnant women at 37-40 weeks’ gestation in three private midwifery clinics in Denpasar, Bali. Subjects were divided into two groups: 29 intervention groups that were given couples counseling and 29 control groups that were given counseling without involving husbands. Base line interview was conducted during enrollment and follow up interview was carried out immediately after delivery. Results: Acceptance of post-placental IUD was found in 21 women (72.41%) in the intervention group and 10 women (34.48%) in the control group (RR=2.2; 95%CI: 1.23-3.84). The mean difference in pretest and post-test scores of knowledge, perceptions of susceptibility and benefits were found to be higher in the intervention group but not statistically significant. The result of multivariate analysis indicated that the variables influencing post-placental IUD acceptance were the child’s gender (AOR=45.9, 95%CI: 4.53-465.25), couples counseling with husband (AOR=17.4, 95%CI: 2.55-119.56) and maternal education (AOR=7.1; 95%CI: 1.17-43.40). Conclusions: Couples counseling was found to increase postplacental IUD uptake. In addition, post-placental IUD acceptance is also influenced by the child’s gender and maternal education levels. To increase uptake of post-placental IUDs there is a need for upscalling of couples counseling at the time of antenatal care.
Determinants of long-acting contraceptives use among reproductive-age couples in Tanjung Karang Public Health Centre Mataram City, West Nusa Tenggara Widya Aryati; Dewa Nyoman Wirawan; Komang Ayu Kartika Sari; Anak Agung Sagung Sawitri
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.p03

Abstract

Background and purpose: The national family planning program prioritises the use of long-acting contraceptives which include intrauterine devices (IUD), tubectomy, vasectomy, and implant. However, the coverage of long-acting contraceptives in Indonesia remains low. This study aims to identify the determinants of longacting contraceptives uptake among reproductive-age couples in Tanjung Karang Public Health Centre (PHC) Mataram City. Methods: A cross-sectional study was conducted involving 169 reproductive age couples in Tanjung Karang PHC in 2016. Samples were selected from six sub-villages (dusun) in two villages using systematic random sampling. We selected 85 samples from coastal and 84 samples from non-coastal areas. Data on sociodemographic characteristics, perception, husband support, access to service, and information regarding long-acting contraceptives were collected through home interview. Analysis with logistic regression was applied to determine the factors influencing long-acting contraceptives uptake. Results: The majority of respondents aged 20–35 years-old, and most of them have a lower level of education and knowledge regarding longacting contraceptives. Among all current users, as many as 37.0% use long-acting contraceptive methods. The respondents refused to use long-acting contraceptives due to prohibited by the husband (92.8%) and desire to have more children (38.7%). Multivariate analysis using logistic regression showed that the uptake of long-acting contraceptives was significantly associated with area of residence (noncoastal) with an adjusted odds ratio (AOR)=2.89 (95%CI; 1.39-6.01), employment status with AOR=0.40 (95%CI; 0.18-0.90), income at minimum wages and above with AOR=2.47 (95%CI; 1.16-5.26), and husband support with AOR=2.19 (95%CI; 1.18-3.41). Conclusions: The use of long-acting contraceptives are associated with husband support, living in non-coastal areas, and having a higherincome. Ongoing support from the husband, especially among those who live in coastal areas and from the lower socioeconomic background, is required to improve the coverage of long-acting contraceptives.
Nutritional status and associated factors in under-five children in Lembar Village West Lombok, Indonesia Widya Dwijayanti; Dewa Nyoman Wirawan; Luh Seri Ani; Ni Wayan Arya Utami
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.p04

Abstract

Background and purpose: Studies on determinants of nutritional status in under-five children in Indonesia have been widely explored. However, most studies utilised only one out of three nutritional status indicators–weight/age, height/age, or weight/height. These studies also show inconsistent results. This present study aims to examine nutritional status in under-five children by using all three indicators and associated factors which include mother’s characteristics, nutrition intake, and child’s history of infectious diseases. Methods: A cross-sectional study was conducted with a total sample of 100 under-five children who were randomly selected. Data on the mother’s characteristics, nutrition intake, and child’s history of infectious diseases were collected through structured interview with the mother, while data on nutritional status were obtained through measurements. Data were analysed using logistic regression to identify association between the nutritional status of under-five children with the mother’s characteristics, nutrition intake, and child’s history of infectious diseases. Results: There was no association between the nutritional status of under-five children based on weight/age, height/age, and weight/ height with the mother’s characteristics and nutrition intake. However, there was an association between the nutritional status of under-five children and child’s history of infectious diseases with an adjusted odd ratio (AOR)=41.0 (95% CI: 12.10-139.14) for weight/age, AOR=3.52 (95%CI: 1.53-8.05) for height/age, and AOR=10.69 (95%CI: 1.31-87.11) for weight/height. Conclusions: Child’s history of infectious diseases is the only determinant associated with nutritional status in under-five children based on weight/ age, height/age, and weight/height. Prevention measures are required to prevent infection among children by improving environmental hygiene as well as providing prompt treatment for infectious diseases especially diarrhoea and upper-respiratory tract infection.
Early marriage as a risk factor for undernutrition among children aged under three years old in Gangga Subdistrict, North Lombok District Suhartiningsih; Ni Luh Putu Suariyani; Mangku Karmaya
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.p05

Abstract

Background and purpose: The prevalence of severe and mild undernutrition among children aged under five years in North Lombok District is ranked second in West Nusa Tenggara Province after Bima City. The number of reported cases of early marriages in West Nusa Tenggara is higher than the national average. This study aims to examine the association between early marriages and undernutrition among children aged under three years in Gangga Subdistrict, North Lombok District. Methods: A case-control study was conducted with a total of 49 cases (severe undernourished children) and 98 controls (normalweight children). A systematic random sampling was used to select all cases and controls from the health post register based on the weight/age indicator in Gangga Public Health Centre. Variables of sex and residency were matched between cases and controls. Data were collected from October to November 2016 through interviews with the mother at their house. Logistic regression using a software STATA SE 12.1 was employed to identify the association between early marriages and nutritional status of the children. Results: Cases and controls were comparable based on children’s gender, mother’s age, area of residency, employment status of mother, and family income. There were significant differences on children’s age and mother’s education. Multivariate analysis showed an association between the nutritional status and early marriages with adjusted odds ratio (AOR)=5.21 (95%CI: 1.36-19.95), the frequency of sickness over the last three months (AOR=1.93; 95%CI: 1.26-2.97) and low birth weight (AOR=14.12; 95%CI: 3.37-59.05). Conclusions: Early marriages, frequency of sickness over the last three months, and low birth weight are associated with undernutrition among children aged under three years. Preventative measures to prevent early marriages, child infections and low birth weight need to be enhanced.
Alcohol consumption and risk of type 2 diabetes mellitus among males in The Manggis Area, Karangasem, Bali I Gusti Ayu Mirah Adhi; Ni Luh Putu Suariyani; I Wayan Weta; Anak Agung Sagung Sawitri
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.p06

Abstract

Background and purpose: Diabetes mellitus (DM) is a serious health problem worldwide. Local alcohol consumption is one of Balinese’s traditions considered to be associated with the high incidence of DM. This study aims to determine the pattern of alcohol consumption and risk of type 2 DM in Manggis Subdistrict, Karangasem, Bali. Methods: A case control study was conducted in 55 men with type 2 DM as cases and 55 non-diabetic men as controls. Non-diabetic men were defined with fasting glucose level (GDP) <100 mg/dl and without clinical symptoms of DM. Cases were recruited from the patient’s register at the public health centre (PHC) in Manggis Sub-District and controls were recruited from similar neighborhood with the cases and matched by age. Data were collected over May-July 2017 by households’ interview using structured questionnaires. Multivariate analysis was employed using logistic regression to identify the risk factors of type 2 DM. Results: The characteristics of cases and controls were similar in terms of age, education and physical activity, but there was a significant difference in employment. Multivariate analysis showed that heavy alcohol consumption (AOR=7.84; 95%CI: 1.46-42.28), frequent consumption of high sugar alcohol drinks (AOR=3.45; 95% CI: 1.16-10.22), history of obesity (AOR=8.82; 95% CI: 2.43-32.01), employed (AOR=5.98; 95%CI: 1.89-18.93) and frequent consumption of sweetened beverages (AOR=39,57; 95%CI: 4.00-391,8) were significantly associated with the incidence of type 2 DM. No significant association was found between the duration of alcohol consumption and the incidence of type 2 DM. Conclusions: Alcohol consumption, a history of obesity, consumption of high sugar alcohol drinks, retirement/unemployment and consumption of sweetened beverages are associated with the incidence of type 2 DM. Education regarding those risk factors should be enhanced to reduce the incidence of type 2 DM.
The determinants of early breast cancer detection via breast self-examination (BSE) in Denpasar, Bali Ni Made Ari Febriyanti; Dinar Lubis; Dewa Nyoman Wirawan; Ni Luh Putu Suariyani; Mangku Karmaya
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.p07

Abstract

Background and purpose: Breast cancer is the leading cause of death in females, followed by colorectal cancer. Early detection of breast cancer can be done through breast self-examination (BSE). BSE behaviour is influenced by an individual’s level of knowledge and perceptions of the procedure. This study examines the determinants of BSE behaviour in married women aged 15-49 in six villages in the working area of Puskesmas (public health centre) II in West Denpasar, Bali, Indonesia. Methods: A cross-sectional survey was employed with 180 respondents selected by multistage random sampling. Data were collected using standardised questionnaire carried out from November-December 2016. Multiple poisson regression was used to identify the determinants of the BSE behaviours. Results: The proportion of respondents who performed BSE in the three months prior to interview is 55.6%, and, of these, 50.0% reported performing BSE regularly. Multivariate analysis shows the significant determinants of BSE are: high-school and above (APR=2.03; 95%CI:1.41 to 2.92); having a good knowledge of BSE (APR=1.41; 95%CI:1.09 to 1.82); perceived benefits (APR=2, 24; 95%CI:1.53-3.29); perceived low barrier (APR=1.63; 95%CI: 1.16-2.29); and high self-efficacy (APR=1.50;95%CI:1.16-1.95). Conclusions: Level of education, good knowledge of BSE, perceived benefits, perceived low barriers, and high level of self-efficacy are the significant determinants of BSE practice. These findings suggest that education on BSE should be enhanced, particularly for women with lower levels of education.
Readiness to change towards accredited public health centres (PHCs) in West Lombok I Made Santiana; Ni Made Sri Nopiyani; Dyah Pradnyaparamita Duarsa
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.p08

Abstract

Background and purpose: The 2016 Report of Performance Accountability of Government Agencies, Ministry of Health of Indonesia showed only a small proportion of public health centres (PHCs) are accredited. In West Lombok District, some PHCs are not accredited. This study aims to examine factors associated with PHC’s staff readiness for accreditation. Methods: A cross-sectional survey was employed involving seven non-accredited PHCs. A total of 165 out of 310 PHC’s staff were recruited using a systematic random sampling. Data was collected from February to March 2017. Self-administered questionnaire was used to collect data on socio-demographic characteristics, duration of service, content, process, and context changes, individual attributes, and readiness to change. Logistic regression was applied to examine the association between readiness to change with independent variables. Results: As many as 72.1% of respondents are ready to change. From the change efficacy and appropriateness dimensions, as many as 46.1% and 97.0% of respondents are ready to change. Multivariate analysis shows an association between readiness to change with administrative systems (AOR=4.47;95%CI:2.05-9.74) and working procedure (AOR=2.95; 95%CI: 1.19-7.30). There is no significant association between readiness to change with technological improvement, promotional strategy, staff engagement, organisational commitment and managerial support from health offices. Conclusions: The readiness to change among PHC’s staff is high. The availability of working procedure and administrative systems improves PHC’s staff readiness for the accreditation. These findings suggest the importance of inclusion of all PHC’s staff during the accreditation processes.
Achieving ideal mentoring: working patterns among clinical instructors, nurses, and nursing students Ayu Sugiantari; Komang Ayu Kartika Sari; Pande Putu Januraga
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.p09

Abstract

Background and purpose: The relationships between those responsible for clinical training, clinical instructors (CIs) and nurses, and the nursing students, have a great impact upon student learning during clinical placements. The present study investigates the pattern of working relationships among CIs, nurses, and student nurses, and analyses the extent to which they achieve ideal mentoring practices. Methods: Qualitative study employing in-depth interviews with CIs (n=3), nurses (n=8), and nursing students (n=8) on a clinical placement was undertaken from June-July, 2017, at Badung District Hospital, Denpasar, Bali. Content analysis was conducted to identify the key themes that emerged from these interviews and formed the basis of the findings. The results are presented narratively in order to highlight the patterns of the working relationships identified and perceived by CIs, nurses, and nursing students, with the aim of developing improved mentoring practices. Results: Analysis of the in-depth interviews identified three main themes: (i) perceptions on the hospital’s mentoring practices, (ii) the role(s) and behaviour in the mentoring process, and (iii) the patterns of working relationships between those involved in the mentoring process. In general, participants defined mentoring in terms of the provision of guidance and instruction to students. Participant’s contrasting perceptions of their role(s) affected how they behaved in the mentoring process. Furthermore, participant’s perceptions of their own’s roles and their behaviour provides a detailed overview of the working relationships pattern of the nursing students, nurses and CIs. Specifically, working relationships between CIs and nurses tend to fit an employee-employer type pattern, whereas those between CIs/nurses and nursing students do not appear to reflect typical mentor-mentee relationships. Conclusions: The pattern of working relationships identified between CIs/nurses and nursing students do not, in fact, reflect a typical mentor-mentee relationship. Furthermore, this paper highlights the impact that suboptimal mentoring may have on nursing students’ achievement of medical competence, as well as on the quality of nursing care provided to patients in teaching hospitals.
Association between breakfast-eating habit and attention-concentration in primary school children: a cross-sectional study in Badung District Ni Made Ari Sukmandari; Ni Wayan Septarini; Gede Ngurah Indraguna Pinatih
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.p10

Abstract

Background and purpose: One of the main benefits of breakfast eating habit for schoolchildren is to maintain the attention concentration. The current trend shows a steady decline in the breakfast-eating habit among primary school children. This present study aims to examine the association between breakfast-eating habit and attention-concentration in primary school children. Methods: A cross-sectional study was conducted involving 160 primary school students year 5 and 6. Samples were selected from six public primary schools within two villages. There were a total of 16 classes of year 5 and 6 in these six schools, and five classes were selected randomly. All students from the selected classes included in the study. Attention concentration was measured using a digit symbol test, and breakfasteating habit and total calories intake were measured using the recall 24 hours and a standardised questionnaire. Multivariate analysis with logistic regression was employed to examine the association between breakfast-eating habit and attention-concentration. Results: The majority of students were found to have good concentration (60.63%), with breakfast-eating habit (75.00%), and consumed sufficient amount of calories (53.13%). Our multivariate analysis found a significant association between breakfast-eating habit and attention-concentration among schoolchildren (AOR=14.0; 95%CI: 4,9–67,8). Conclusions: Students with breakfast-eating habit tend to have a good attention-concentration. The total calories intake during breakfast is not associated with attention-concentration among primary school students in Badung District.
Early marriage practices and the health impacts on female adolescent health in Central Lombok: a qualitative study Baiq Rizka Herliana; Ni Wayan Arya Utami; Desak Putu Yuli Kurniati
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.p11

Abstract

Background and purpose: Early marriage through merariq or eloping tradition is a common practice in West Nusa Tenggara particularly in Central Lombok. Early marriage leads to several negative consequences on the reproductive health of female adolescents. This study aims to explore early marriage practices and its impacts on the reproductive health of female adolescents in Central Lombok. Methods: A qualitative study with a case study approach was conducted, and seven early married female adolescents purposively selected as the study participants. Interviews were also conducted with two family members of the female adolescents, one community leader, and a midwife who worked as an adolescent health coordinator at a public health centre. Data were analyzed using a thematic approach to map the reasons for early marriage and its impacts on the reproductive health of female adolescents. Results: Our in-depth interviews revealed that several reasons associated to early marriage practices were: lacking in knowledge regarding the effects of early marriages, perceived benefits of early marriages including perception on maturity and logical thinking, and social sanctions from the society because it considered a disgrace when the eloped girl returned home. Several negative consequences of early marriages emerged from this study were complicated pregnancy/delivery, low birth weight, and undernourished children. Our informants concerned about the psychological effects of early marriages which include fear, regret, and depression. Eloped female adolescents lose their agency for decision making including the right for further education. Conclusions: Early marriage practices bring negative health consequences to female adolescents. An active collaboration across health sector and community leaders is required to provide sufficient information regarding the harmful effects of early marriages. Also, a more effective communication strategy using a family-based approach is required to appropriately target female adolescents with health information associated with the impacts of early marriage.

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