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Berita Kedokteran Masyarakat
Published by Universitas Gadjah Mada
ISSN : 02151936     EISSN : 26148412     DOI : https://doi.org/10.22146/bkm.v37i2.2320
Core Subject : Health,
Nursing Public Health
Berita Kedokteran Masyarakat (BKM Public Health and Community Medicine) is a peer-reviewed and open access journal that deals with the fields of public health and public medicine. The topics of the article will be grouped according to the main message of the author. This focus covers areas and scope related to aspects of: - Epidemiology - Infectious diseases control - Clinical Epidemiology - Environmental Health - Occupational Health - Healthy City - Public Health and Primary Health Care - School of Health Promotion - Healthy lifestyles - Health promotion - Health and Social Behavior - Tobacco and smoking - Adolescent Health - Public Health Nutrition - Maternal and Child Health - Reproductive Health - Population Health - Health of Vulnerable People - Social Determinants of Health - Water, Sanitation and Hygiene - Human Resource Management
Arjuna Subject : Kedokteran - Kesehatan Masyarakat, Kesehatan Lingkungan dan Pekerjaan
Articles 1,528 Documents
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Food poisoning outbreak caused dioscorea hispida dennst in Gading 10 Village, Gunung Kidul, Yogyakarta august 2020: a case report study Ayu Cahyaningtyas; Aryanto, Samsu; Hidayati, Titiek
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: On August 12 2020, a food poisoning outbreak occurred in Gading 10 Village Gunung Kidul District. Health office of Gunung Kidul District were revealing three attendances who hospitalized in the hospital of Nur Rohmah after consuming gadung tubers (dioscorea hispida dennts.) and one of them passed away. Based on the information, we were doing an epidemiological investigation immediately to make sure of the existence of the outbreak. This study aimed to investigate the causative agents, source of food poisoning and mode of food poisoning transmission in Gading 10 Village. Method: This epidemiological investigation was using case report study design. Case defined as any residence who consumed gadung tubers in Gading 10 Village on August 12 2020. The data were collected using food poisoning questionnaire and medical record. Results: Based on the investigation results, three villagers who consumed gadung tubers were ill (100%) and one of them) was passed away (33,33%). The incubation period was around 5 minute until 4 hours. The predominate symptoms were vomiting, nausea, and headache. Gadung tubers (dioscorea hispida dennts.) was determined as the source of this food poisoning outbreak. Based on the incubation period and symptoms to the comparison diagnosis, dioscorine agent are suspected to be the cause of this food poisoning outbreak. Conclusion: The most likely source of contamination based on incubation period and symptoms was Dioscorine. Food poisoning outbreak was occurred in Gading 10 Village, Gunung Kidul District on August 12 2020. We recommend strengthening intervention community health education about safe processing gadung tubers for consumption.
Daycare dilemmas in covid-19 pandemic, should it be opened or not? a case study of a daycare in Yogyakarta Asma, Syifa Nurul; Susyanto, Bambang Edi; Rusadi, Cici Permata; Wahab, Abdul
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: Covid 19 pandemic cause changes in various aspects. To avoid the spread of the virus, physical distancing is enforced. Since March 2020 offices and schools have been closed, including the daycare in Yogyakarta. By June 2020 offices have started to enter and some parents will have to work. It becomes a dilemma for stakeholders when parents with children must back to the office to work while the government still restricts daycare opening. This study intends to illustrate the considerations of a daycare in Yogyakarta that was reopened despite being in the red zone of the pandemic and provide alternatives solutions based on a literature review. Method: A qualitative method with a descriptive observational case study approach was used in this study. The data was collected with an interview with one of the daycare owner, and a literature study. Results: The financial needs of managers and daycare employees and the request of the working parents to reopen the daycare became the argument that prompted the reopening of daycare. In general, during this pandemic, the parent's mental health, especially mothers when undergoing dual roles, as mothers and also workers, worsening child’s behaviors and the possibility of violence to children at home are consideration of the need for solutions to this dilemma. Conclusions: Keeping children from the risk of coronavirus transmission should be the priority. The possible alternative solution is the enactment of a home visit by employees of daycare under the supervision of child caregivers, children gathered with a limited number of only one region with attention to health protocols, as well as an invitation for the office to provide a flexible working arrangement for mothers with children.
Problems in implementation gerakan satu rumah satu jumantik (G1r1j) In Mempawah Regency, Kalimantan Barat Province Tri Isnani
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Dengue Hemorrhagic Fever (DHF) is still a health problem in Indonesia. One of the programs in controlling dengue fever is Gerakan Satu Rumah Satu Jumantik (G1R1J). G1R1J involved every household active to do mosquito control PSN 3M PLUS. G1R1J as a community empowerment requires an assessment to identify community problems and needs in controlling DHF. Objective. This paper describes the problems in implementing G1R1J from the community, regional government, and stakeholders. Methods The research method was carried out qualitatively. The research was conducted in the East Mempawah Subdistrict, Mempawah Regency, Kalimantan Barat Province in March - November 2019. Data collection techniques were observation, in-depth interviews, and group discussions. Informants were officers from Dinas Kesehatan Kabupaten, Puskesmas, Camat, Lurah, community leaders, and citizens. The data is stored in the form of a transcript and analyzed qualitatively. The validity of the data by triangulasi sources and methods. Results. The need for clean water in this area uses rainfed water. Water is collected in a jar (tempayan) with a capacity of about 500 liters so that if there are larvae, just leave it. There are citizens who refuse fogging and the use of larvicides. Knowledge of DHF, Jumantik, and G1R1J is not yet understood. The special socialization about G1R1J has not been done. There are no G1R1J activities even though the SK already exists. Officers feel a lack of resources and funds. Community activities were in a vacuum, resulting in difficulties in forming the G1R1J organization. Potential as agents of change, midwives who are well-known and close to the community.
The village food bank, against stunting on poor children in Sibalaya Barat Lago, Rossalin
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Abstract

Sibalaya Barat Village is located in Tanambulava sub-district, Sigi Regency, Central Sulawesi. The prevalence of stunting of children under five in Tanambulava sub-district in 2019 was 21.6%, the third highest of 15 sub-districts. In 2020, the Sigi Regency Government has designated Sibalaya Barat village as one of the 10 locus for accelerating stunting reduction. Banua Ntovea is an innovation program to reduce stunting in Sibalaya Barat village.
Exploring the Si Slamet program: whats impact of the technology-based emergency service system in solving Batang Regency's health problems? Haniifah, Matsna
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: This paper explores emergency cases' handling by the district government of Batang through a technology-based health service system. Content: The Batang Regency government optimises easy-to-reach and responsive public services for medical emergency services through Sistem Informasi Spesial Keselamatan Elektronik Terpadu (Si Slamet). This system is supported by artificial intelligence technology that is integrated with health facilities and across sectors. The principles promoted are anti-discrimination, responsiveness, fast and precise handling. The services provided are free for payment and are held 24 hours in 7 days. One of the services is offering directions firsthand by telephone and accelerating emergency events by sending victims' images to streamline response time. This system has four post location points located in the Center, Tulis District, Subah District, and Gringsing District because these four points are located on the main route (Pantura), prone to traffic accidents. This innovation program has succeeded in assisting in preventing disability and reducing the mortality rate due to emergencies. In 2019 there were 295 emergency cases and 525 non-emergency cases that Si Slamet successfully served. Existing cases such as trauma from KLL, maternity, internists, work accidents, fires and others. However, some people do not know about this innovative program. The existence of an optimal level of awareness in the community is one of the reasons. Also, health workers' ability to gain patient trust is a challenge in obtaining patient satisfaction by building empathy. In implementing this program, the health office coordinates with cross-sectors such as PMI, the police, and health service facilities. Therefore, the health office needs to disseminate information to the community to increase awareness and intensify training for human resources involved in the program to improve the quality of services.
The campaign of brushing teeth before going to bed to prevent dental caries in "Pesantren Dayah Insan Qurani" students in Aceh Besar Irmi Fitria
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Abstract

Dental and oral health is very important. The incidence of dental and oral disease in Indonesia, especially Aceh, is still relatively high. Riskesdas data (2018) noted that the proportion of dental and oral problems was 57.6%, and those who received services from dental personnel were 10.2%. The proportion of correct tooth brushing behavior is 2.8%. The high number is inseparable from the low behavior of good oral hygiene in individuals and communities. Promotive and preventive programs as an initial step to prevent dental and oral diseases are still often neglected. Santri in pesantren is also inseparable from this problem so that it is not uncommon for many students to experience a toothache. Students in boarding schools understand that cleanliness is part of faith. However, there are times when they neglect to perform oral hygiene properly, and the lack of information is obtained so that the condition of their teeth and mouth often becomes problematic. Promotive and preventive programs through brushing teeth before bed are the first step in preventing dental caries and periodontal disease. Caries can occur due to several factors, namely dental plaque, host (teeth), food (substrate)and, and time. The four components are interconnected so that doing the right toothbrush (action oral hygiene) is an action to break the chain of these four components. The students are encouraged to brush their teeth twice a day (morning after breakfast and night before going to bed). The hope can be optimistic in maintaining the health of their oral cavity. This action was carried out with the full supervision of the hostel caregivers as the person in charge (parents) of fostering students at the boarding school. The dormitory caretaker is the closest person to the students and protects them so that their orders will be easily heard and followed by the students. In addition, the dormitory caregivers are also substituting parents so that they are more aware of the ins and outs of the health problems experienced by students. This program has been well designed by the dentist at the pesantren clinic. In addition, this program is approved by the director of the boarding school's health. The pesantren leadership is also involved in enforcing this program as the main person in charge. Students' activities start from waking up before dawn and at night after reading the Koran. In the evening, the santri activities will be closed by reading the Qur'an together in their respective dormitories. The program of brushing teeth before bed is carried out simultaneously with the students taking ablution and reading the Qur'an together. Before going to bed, all the students had gathered in their respective dormitories with a total of 18-24 students. The gathering of the students made it easy for the caregivers to coordinate so that this tooth brushing activity would be easy to carry out. Before this activity begins, the dentist will first provide socialization to each dormitory. Caregivers have full responsibility for these activities. Dentists monitor the team's performance. Each day will be made a list checklist to monitor anyone who commits a toothbrush at night. If dormitories have not carried out this activity thoroughly, evaluation and re-socialization will be carried out periodically. Then, students in dormitories who brush their teeth regularly before going to bed will be named the best dormitory and get a reward as a form of appreciation. Kesehatan gigi dan mulut merupakan hal yang sangat penting. Angka kejadian penyakit gigi dan mulut di Indonesia khususnya Aceh masih tergolong tinggi. Data Riskesdas (2018) mencatat proporsi masalah gigi dan mulut sebesar 57,6% dan yang mendapatkan pelayanan dari tenaga medis gigi sebesar 10,2%. Adapun proporsi perilaku menyikat gigi dengan benar sebesar 2,8%. Tingginya angka tersebut tidak terlepas dari rendahnya perilaku oral hygiene yang baik pada individu maupun komunitas. Program promotif dan preventif sebagai langkah inisial mencegah terjadinya penyakit gigi dan mulut masih sering diabaikan. Santri di pesantren juga tidak terlepas dari permasalahan ini sehingga tidak jarang banyak santri yang mengalami sakit gigi. Santri yang tinggal di pesantren tentunya mengerti bahwa kebersihan sebagian daripada iman. Namun, ada kalanya mereka abai untuk melakukan oral hygiene secara benar dan kurangnya informasi yang didapatkan sehingga kondisi gigi dan mulutnya menjadi sering bermasalah. Program promotif dan preventif melalui menyikat gigi sebelum tidur merupakan langkah awal dalam mencegah terjadinya karies gigi dan penyakit periodontal. Karies dapat terjadi karena beberapa faktor yaitu plak gigi, host (gigi), makanan (substrat) dan waktu. Keempat komponen tersebut saling berhubungan sehingga melakukan sikat gigi (tindakan oral hygiene) yang tepat merupakan tindakan untuk memutus mata rantai keempat komponen tersebut. Para santri dianjurkan untuk melakukan sikat gigi dua kali sehari (pagi setelah sarapan dan malam sebelum tidur). Harapannya dapat bernilai positif dalam memeliharan kesehatan rongga mulut mereka. Aksi ini dilakukan dengan pengawasan penuh dari pengasuh asrama sebagai penanggungjawab (orangtua) asuh santri di pesantren. Pengasuh asrama merupakan sosok yang paling dekat dengan santri dan yang mengayomi mereka sehingga perintahnya akan mudah didengar dan diikuti oleh santri. Selain itu, pengasuh asrama juga merupakan orangtua pengganti sehingga lebih mengetahui seluk beluk permasalahan kesehatan yang dialami oleh santri. Program ini sudah dirancang dengan baik oleh dokter gigi klinik pesantren. Selain itu program ini disetujui oleh direktur kesehatan pesantren. Pimpinan pesantren juga ikut terlibat dalam menegakkan program ini sebagai penanggungjawab utama. Kegiatan santri dimulai dari bangun tidur sebelum subuh dan malam setelah mengaji. Pada malam hari kegitatan santri akan ditutup dengan membaca al-Qur’an bersama di asrama masing-masing. Program menyikat gigi sebelum tidur ini dilakukan bersamaan dengan para santri mengambil wudhu dan melakukan baca al-Qur’an bersama tersebut. Sebelum tidur seluruh santri sudah berkumpul di asrama masing-masing dengan jumlah santri sekitar 18-24 orang. Berkumpulnya para santri ini menjadi mudah bagi pengasuh untuk melakukan koordinasi sehingga kegiatan menyikat gigi ini akan mudah dilaksanakan. Sebelum aski ini dimulai, terlebih dahulu dokter gigi akan memberikan sosialisasi ke tiap-tiap asrama. Tindakan ini juga diberikan tanggungjawab penuh kepada pengasuh dan dokter gigi berperan sebagai tim pemantau untuk melihat progress program ini. Setiap harinya akan dibuat daftar check list untuk memantau siapa saja yang melakukan sikat gigi pada malam hari. Apabila ada asrama yang masih belum melakukan kegiatan ini secara menyeluruh maka akan dilakukan evaluasi dan sosialisasi ulang secara berkala. Kemudian, untuk asrama yang melakukan kegiatan menyikat gigi secara teratur sebelum tidur akan dinobatkan sebagai asrama terbaik dan mendapatkan reward sebagai bentuk apresiasi.
New strategy of web-based mental health intervention for psychological distress among working housewives during Covid-19 pandemic in Indonesia: a review Rusadi, Cici Permata; Wahab, Abdul; Asma, Syifa Nurul
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: This paper aims to describe the use of web-based mental health services (telepsychology) that can reduce anxiety symptoms, improve positive emotions and sleep quality during the Covid-19 outbreak for working housewives.Content: In Indonesia, the dual role of mothers as workers and housewives during the Covid-19 pandemic increases stress so that it has an impact on the treatment of mothers towards their children and is associated with strict parenting in the form of punishment so that children are at risk of experiencing cognitive and motor development disorders and psychopathology in children. In terms of overcoming anxiety and psychological pressure experienced by housewives, targeted an early intervention strategy is needed to prevent the long-term impact of the COVID-19 pandemic on the mental health of mothers and families. Mental health interventions based on positive psychology principles that include elements of cognitive-behavioral therapy and behavioral activation therapy aim to reduce symptoms of anxiety and depression and improve positive emotions and sleep quality during the Covid-19 outbreak through the telepsychology system. Effectiveness of web-based interventions for cognitive behavioral therapy and therapy for therapist-guided and non-therapist-guided acceptance and commitment tested in case and control groups by comparing the results of the Patient Health Questionaire-9 (PHQ-9) measurement scale and the General Anxiety Disorder-7 scale (GAD-7) showed that GAD-7 scores in the intervention group had a significant reduction (β = -3.27; 95% CI: -5.71, -0.83) with R2 0.106. PHQ-9 score was significantly reduced in the intervention group (β = -4.311; 95% CI: -7.33, -1.29) with R2 0.173. There is a growing body of literature showing the effectiveness of online therapy on the psychological impact of COVID-19. In fact, having therapist support makes a substantial difference in the effectiveness of online interventions especially for working housewives.
Threats to animal life and Indonesian search for social-economic causes of forest fires Fauziah, Saidatul
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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[ACCIDENTS DUE TO SOCIAL CONDITIONS] Impact on sufferers of the acute respiratory tract (ARI). Not only that, the existence of orangutans and other wildlife is also a threat. Therened. This process occurs during an unpredictable dry season, increasing the risk of forest and peatland fires. The results show that exposure to smog reduces health and education in the long term for children. It was found that in a day, the health service served about 50 to 70 patients with complaints of cough and shortness of breath due to smog. [COMMUNITY OR ORGANIZATION WHERE THE DISEASE PRODUCTION PROCESSES] Communities that have developed illegal oil palm plantations, illegal burning, and communities have not been able to switch to alternative livelihoods that are environmentally friendly. [“INTELLIGENCE” THAT ALLOWS SUCH SOCIAL CONDITIONS TO HAPPEN] Deliberately this happens because of group interests in commercial production. For example, peatland areas are used for new plantations, especially oil palm. [POWERFULNESS OF THE VICTIMS OF THAT SOCIAL CONDITION] It was found that the administrators of the farmer groups benefited greatly. The powerlessness of farmer groups in refusing the offers of certain actors risks harming the local community. These actors influence the decision-making process through their network of partners for their benefit. These farmer group administrators are protected by a network that provides strength, support, protection, and access to various resources. This condition is exacerbated by hot weather, causing land conditions to become drier, worsening the thickness of the smog, and the level of air pollution has reached "dangerous" levels. [ACTION THAT CAN REDUCE OR AGAINST THAT SOCIAL CONDITIONS] Forest fires are a continuing phenomenon year after year, and little progress has been made in reducing their incidence. Currently, the government is trying to issue a series of policies related to forest protection and peat restoration. The government is also trying to stop the issuance of new plantation permits in forest areas, restore damaged forests and peatlands and tackle land fires. The Task Force Team monitors peatland areas that are prone to fires, and patrols monitor the location points of peatlands. [KORBAN AKIBAT DARI KONDISI SOSIAL] Berdampak pada penderita saluran pernapasan akut (ISPA). Tidak hanya itu, keberadaan orang utan dan satwa liar lainnya juga terancam. Proses ini terjadi saat musim kering yang tidak bisa diperkirakan sehingga meningkatkan resiko kebakaran hutan dan lahan gambut. Hasil penelitian menunjukkan paparan asap kabut menurunkan Kesehatan dan Pendidikan dalam jangka panjang bagi anak-anak. Ditemukan dalam sehari layanan Kesehatan melayani sekitar 50 hingga 70 pasien dengan keluhan batuk dan sesak nafas akibat kabut asap. [KOMUNITAS ATAU ORGANISASI TEMPAT PROSES PRODUKSI PENYAKIT ITU] Masyarakat yang telah melakukan pengembangan perkebunan kelapa sawit illegal, pembakaran liar serta masyarakat belum dapat beralih ke mata pencaharian alternatif yang ramah lingkungan. [“KESENGAJAAN” YANG MEMBIARKAN KONDISI SOSIAL SEPERTI ITU TERUS TERJADI] Kesengajaan terjadi karena kepentingan golongan untuk produksi komersial contohnya area lahan gambut difungsinkan untuk perkebuanan baru, terutama kelapa sawit. [KETIDAK-BERDAYAAN KORBAN DARI KONDISI SOSIAL ITU] Ditemukan bahwa pengurus kelompok tani memperoleh manfaat besar.ketidakberdayaan kelompok tani dalam menolak tawaran aktor tertentu beresiko merugikan masyarakat setempat. Aktor-aktor ini mempengaruhi proses pengambilan keputusan melalui jarigan partonase mereka untuk kepentingan mereka sendiri. Pengurus kelompok tani ini lindungi oleh jaringan yang memberikan kekuatan, dukungan, perlindungan dan akses ke berbagai sumber daya. Kondisi ini diperparah dengan cuaca panas menyebabkan kondisi lahan semakin kering, memperparah ketebalan kabut asap dan tingkat polusi udara sudah mencapai level “berbahaya”. [AKSI YANG BISA MEGURANGI ATAU MELAWAN KONDISI SOSIAL ITU] Kebakaran hutan merupakan fenomena yang berlanjut dari tahun ke tahun dan hanya sedikit kemajuan yang dicapai dalam mengurangi kejadian. Saat ini pemerintah berupaya mengeluarkan serangkaian kebijakan terkait perlindungan hutan dan restorasi gambut. Pemerintah juga berupaya menghentkan pemberian izin baru perkebunan dikawasan hutan, memulihkan hutan serta lahan gambut yang rusak dan menanggulangi kebakaran lahan. Adapun pengawasan itu nantinya di monitor oleh tim satgas pada Kawasan lahan gambut yang rentan terjadi kebakaran serta patrol memantau titik-titik lokasi lahan gambut.
An evaluation of surveillance system for anthrax disease in Gunungkidul District 2020 Asmi Rizal Abdillah
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: Recording and reporting fast and precise anthrax cases play an important role in the process of prevention and control of anthrax. Evaluation of the anthrax surveillance system aims to determine the implementation of the anthrax disease surveillance system in the Gunungkidul District. Method: The evaluation design used is a descriptive study. The evaluation subjects are surveillance officers in each community health center and health office was conducted in January - March 2021. We use a checklist and questioner to collect data. The surveillance system attributes were used to assess are simplicity, flexibility, and acceptability. Results: Human resources of community health centers surveillance in Gunungkidul District at the community health centers level are nurses 76.67%, epidemiologists 20%, and midwives 3.33%. The health office level is an epidemiologist. Only 23.33% of surveillance officers have ever attended zoonotic surveillance training. The data collection process conducted by community health centers amounted to 100%. Data processing conduct as much as 87.5% and analysis anthrax case data by 62.5% of the total community health centers. Recording and reporting of anthrax cases from community health centers only 100% of the cases. Dissemination information is not carried out to the maximum on cross-programs. Another identifiable obstacle is that sampling is only done by 18.75% of surveillance officers and is also late. Anthrax management manuals, epidemiological investigation forms, and Standards Operating Procedure (SOP) are also not available in all health centers. Simplicity attributes include ease of facilities (62.5%) and ease of case recapitulation (81.25%). Acceptability attributes: the willingness of people and organizations to participate in reporting anthrax cases (81.25%). Flexible attribute: data/information that can already be used for new needs. Conclusion: The implementation of anthrax surveillance in Gunungkidul District has several disadvantages. It is recommended to periodically monitor and evaluate anthrax surveillance on the implementation of anthrax surveillance.
A co-ownership healthy canteen, a school-based innovation to tackle anemia among high school girls in Kota Yogyakarta Yasinta, Riesta
BKM Public Health and Community Medicine PHS7 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: This purpose of this initiative program is to promote healthy and balanced nutrition meals for students consisting of vegetables and fish as the food of choice to prevent anemia Content: High school girls who live in a growing city like Kota Yogyakarta, have a high risk of developing anemia. They are not only familiar with modern and unhealthy lifestyles, but also have abundant access to high-energy low nutrition foods. Based on a local health survey conducted in 2012, one-third of young women in Kota Yogyakarta (35,2%) suffered from anemia. The condition even exacerbated with the less supportive school environment such as unhealthy meals and snacks in the school canteen. The ideas are to grow vegetables and raise fishes at school. Students build vegetable gardens, adopting the green vertical garden concept that is widely implemented in the densely populated city of Kota Yogyakarta. Fishes’ pond is built in school as an alternative way to manage and reuse the ablution water. the products can be processed by the school's canteen into affordable and healthy meals for students. The healthy canteen concept transforms ordinary school canteen into a place for promoting vegetables and fish as a food of choice to prevent anemia. The canteen’s keeper and students’ council share cost and profit as a form of co-ownership. This program will be integrated with the students’ council’s entrepreneurship program. A combination between the co-ownership healthy canteen and iron supplementation may result in a greater impact to combat adolescents’ anemia in Kota Yogyakarta.

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