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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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Clinical characteristics and risk factors for mortality in COVID-19 patients with diabetes: A literature review Iskandar, Arik
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: Diabetes is one of the comorbid causes of death for patients with COVID-19. The Indonesian government records diabetes as one of the comorbidities with the highest proportion of causes of death. This study is a literature review study that aims to describe the clinical character and risk factors for death in diabetic patients with COVID-19 disease. Methods: A literature review was conducted by searching for articles from the PubMed and Google Scholar databases. Inclusion criteria were open access, articles in English, and full text published in journals between 2020 to 2021. The keywords used are "coronavirus disease 2019 AND Clinical Characteristics AND Diabetes". Results: the results of the study found 16 articles that matched, namely Covid-19 patients with diabetes. The clinical characteristics of the patients were 57% male. The average age of the patient was 68 years with other comorbid diseases, the highest was hypertension 57%, heart disease 29%, and followed chronic kidney disease 9.8%. The most common signs and symptoms were fever 64%, cough 59%, fatigue 45%, Dyspnea 43%. The highest risk factors, namely age 70 years, comorbid hypertension, and male sex contributed to the death of COVID-19 patients with diabetes. Conclusion: the clinical characters that appear are fever, cough, fatigue, and difficulty breathing. The risk factor for death in COVID-19 patients with diabetes is age 70 years. Hypertension also contributes to mortality. Comprehensive efforts are needed to identify risk factors early and carry out effective treatment in a timely manner to reduce the mortality of COVID-19 patients with diabetes.
Health screening for children of primary education age (7 – 15 years) during the COVID-19 pandemic: The experience of Banyumas Regency Wijayanti, Ayi; Suryo Bintoro, Bagas
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: Implementation of Health Screening for Elementary Education Age Children (Udiksar) is a routine program carried out by Puskesmas, including Banyumas Regency. The Puskesmas visit schools and carries out health screenings for children offline and simultaneously with the implementation of learning. Face-to-face learning has not run optimally due to the COVID-19 pandemic, so adjusting the Udiksar Health Screening is necessary without increasing the risk of COVID-19 transmission. Content: Udiksar's health screening is one of the indicators of Minimum Service Standards and regional performance indicators. Performance achievements for the Udiksar Health Screening in the first quarter of 2021 in Banyumas Regency decreased compared to 2020. In evaluating the activities in the first quarter of 2021, the main problem in implementing the Udiksar Health Screening activities were officers' difficulty reaching targets during the pandemic. The officer then consulted the evaluation results with the Central Java Provincial Health Office and referred to the implementation instructions issued by the Ministry of Health of the Republic of Indonesia. The plan to adjust Udiksar's Health Screening activities during this pandemic focuses on using Google Forms as a data collection tool for children's health information. This plan was presented in a Coordination Meeting with the Heads of Health Centers throughout Banyumas Regency in April 2021. The follow-up to be carried out was the Training of Officers in the use of Google Forms as an alternative solution to implementing the Udiksar Health Screening in April 2021. An evaluation in the 3rd quarter of 2021 showed 71.1% of successfully implemented new Google forms in urban areas. It is ineffective in rural areas and requires an alternative solution for implementing the Udiksar Health Screening. One practical recommendation is to provide a printed questionnaire collected within the regular collection of school assignments. Also, increasing cross-sectoral collaboration in implementing Udiksar screening activities can be done mainly through the collaboration of the School Health Business Development Team at the district and sub-district levels to obtain appropriate alternative solutions. Tujuan: Pelaksanaan Skrining Kesehatan pada Anak Usia Pendidikan Dasar (Udiksar) merupakan program rutin yang dilaksanakan oleh Puskesmas, termasuk di Kabupaten Banyumas. Puskesmas mengunjungi sekolah dan melaksanakan skrining kesehatan pada anak secara luring dan bersamaan dengan pelaksanaan pembelajaran. Pembelajaran tatap muka belum berjalan optimal akibat pandemi COVID-19, sehingga diperlukan penyesuaian Skrining Kesehatan Udiksar agar kegiatan tetap dapat dilaksanakan tanpa menimbulkan peningkatan risiko penularan COVID-19. Isi: Skrining kesehatan Udiksar merupakan salah satu indikator Standar Pelayanan Minimal dan indikator kinerja daerah. Pencapaian kinerja untuk Skrining Kesehatan Udiksar pada triwulan 1 2021 di Kabupaten Banyumas mengalami penurunan dibandingkan dengan tahun 2020. Pada evaluasi kegiatan triwulan 1 2021 didapatkan bahwa masalah utama pelaksanaan kegiatan Skrining Kesehatan Udiksar adalah kesulitan petugas untuk menjangkau sasaran di masa pandemi. Petugas kemudian mengkonsultasikan hasil evaluasi kepada Dinas Kesehatan Provinsi Jawa Tengah dan merujuk pada petunjuk pelaksanaan yang dikeluarkan oleh Kementerian Kesehatan Republik Indonesia. Rencana penyesuaian kegiatan Skrining Kesehatan Udiksar di masa pandemi ini mengerucut pada pemanfaatan Google Form sebagai alat pengumpulan data informasi kesehatan anak. Rencana ini dipaparkan dalam Rapat Koordinasi dengan Kepala Puskesmas se-Kabupaten Banyumas pada bulan April 2021. Tindak lanjut yang dilakukan adalah Pelatihan Petugas dalam pemanfaatan Google Form sebagai alternatif solusi pelaksanaan Skrining Kesehatan Udiksar pada periode April 2021. Evaluasi pada triwulan 3 2021 menunjukkan bahwa pemanfaatan Google Form baru berhasil diterapkan di kawasan urban dengan capaian sebesar 71,1%. Penggunaan Google Form tidak efektif di kawasan rural dan membutuhkan alternatif solusi pelaksanaan Skrining Kesehatan Udiksar. Salah satu rekomendasi praktis yang dapat dilakukan adalah dengan memberikan kuesioner cetak untuk pengumpulan data kesehatan yang dapat disisipkan bersamaan dengan pengambilan dan pengumpulan tugas sekolah berkala. Peningkatan kerjasama lintas sektor dalam pelaksanaan kegiatan skrining Udiksar dapat dilakukan terutama melalui kerjasama Tim Pembina Usaha Kesehatan Sekolah. Kerjasama ini dilakukan di level kabupaten maupun kecamatan, sehingga dapat diperoleh solusi alternatif yang tepat.
Management of infectious waste from COVID-19 self-isolation patient in Puskesmas Kasihan 2 working area Khairani, Nadhira; Rahastri, Ajeng; Surbakti, Hana Yesica
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: This study aims to explore the management of infectious waste in COVID-19 self-isolated patients in ​Ngestiharjo and Tirtonirmolo villages of Puskesmas Kasihan 2, Kasihan Bantul Regency. Method: The study used a qualitative research design. Stakeholders and technical officers related to waste management in the study area were selected to be informants. Data were collected during September – October 2021 by in-depth interview and analyzed using thematic analysis techniques. Data source triangulation was conducted to improve the trustworthiness of the data. Results: This analysis showed two themes related to the management of infectious waste generated by self-isolation patients. The first one is the incompatibility of waste handling implementation. The patients should be responsible for the infectious waste they generate so that burning waste and mixing it with general household garbage becomes an issue. The other theme Is the importance of local policy regarding the COVID-19 waste management. Since the pandemic, waste management has been referring to the Ministry of Environment and Forestry policy (SE.3/MENLHK/PSLB3/PLB.3/3/2021), which was not socialized to the local community so that infectious waste did not become a concern of Covid-19 control in the area. Conclusion: A policy directly related to infectious waste from self-isolated patients is essential in implementing safe infectious waste management. Besides, the lack of adequate facilities and human resources also contributed to the issues.
Active standby village/sub-district transformation after the COVID-19 pandemic Novianti, Diana
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: The standby village is part of the community empowerment effort developed since 2006 to accelerate the achievement of the Millennium Development Goals. The standby village activities mainly provide primary health services and community empowerment through developing community-based health efforts (UKBM). It encourages community-based surveillance, environmental health, health emergencies, disaster management, and clean and healthy living behavior (PHBS). The COVID-19 pandemic has given rise to various community-based activities made by the government and local initiatives at the village level. Not all villages/subdistricts are responsive and independent in efforts to control and prevent diseases, including COVID-19, by the elements in active-standby villages/subdistricts. Active-standby villages/subdistricts have the potential to play a role in controlling and preventing COVID-19 and being developed for handling other health problems. Content: Strengthening the health system starting from the countryside has a big impact because rural areas are vulnerable to public health crises. In dealing with post-pandemic conditions, it is necessary to transform the health system by utilizing its potential in disease-tracking activities from the central to the village level, an increase in the budget for health financing, an increase and distribution of health workers in all regions, and an adjustment of health services based on the values ​​prevailing in the local community. More than 83 thousand villages/subdistricts with high enough social capital make the health system at the rural level have the potential to help solve health problems, including COVID-19. Strengthening the active-standby village/subdistrict program and increasing development efforts through the role of the village government needs support from the district/city government, as well as integration with community empowerment programs to have a broader impact on the community. The strengthening and development of active-standby villages/subdistricts will bring a healthy, caring, and responsive community to health problems in their area. Objective: Desa siaga adalah bagian dari upaya pemberdayaan masyarakat yang dikembangkan sejak tahun 2006 sebagai bentuk percepatan pencapaian Millennium Development Goals. Kegiatan desa siaga terutama adalah penyediaan pelayanan kesehatan dasar, pemberdayaan masyarakat melalui pengembangan UKBM, mendorong upaya survailans berbasis masyarakat, kedaruratan kesehatan dan penanggulangan bencana serta penyehatan lingkungan, dan PHBS. Pandemi COVID-19 telah memunculkan berbagai kegiatan berbasis masyarakat baik itu yang dibuat pemerintah maupun inisiatif lokal di tingkat desa. Belum semua desa/kelurahan tanggap dan mandiri dalam upaya pengendalian dan pencegahan penyakit termasuk COVID-19 sesuai dengan unsur yang ada pada desa/kelurahan siaga aktif. Desa/kelurahan siaga aktif berpotensi untuk dapat berperan dalam pengendalian dan pencegahan COVID-19 dan dikembangkan untuk penanganan masalah kesehatan lainnya. Content: Penguatan sistem kesehatan mulai dari pedesaan memberikan dampak yang besar karena wilayah pedesaan cukup rentan terhadap krisis kesehatan masyarakat. Dalam menghadapi kondisi pasca pandemi diperlukan transformasi sistem kesehatan dengan memanfaatkan potensi dalam kegiatan pelacakan penyakit. Diperlukan kebijakan yang sama dari tingkat pusat hingga desa, penambahan anggaran pembiayaan kesehatan, peningkatan dan pemerataan tenaga kesehatan di semua wilayah, serta penyesuaian layanan kesehatan yang berdasar pada nilai yang berlaku di masyarakat setempat. Lebih dari 83 ribu desa/kelurahan dengan modal sosial yang cukup tinggi membuat sistem kesehatan di tingkat pedesaan memiliki potensi dalam membantu penyelesaian masalah kesehatan termasuk COVID-19. Penguatan program desa/kelurahan siaga aktif serta peningkatan upaya pengembangan melalui peranan pemerintah desa perlu mendapat dukungan dari pemerintah kabupaten/kota, serta integrasi dengan program pemberdayaan masyarakat untuk memberikan dampak yang lebih luas kepada masyarakat. Penguatan dan pengembangan desa/kelurahan siaga aktif akan menghadirkan masyarakat yang sehat, peduli, dan tanggap terhadap masalah kesehatan di wilayahnya.
Empowered elderly: Assistance in modifying urban elderly lifestyles from hypertension during the COVID-19 pandemic Sundari, Fitriana
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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This study aims to develop a health improvement program for the elderly with hypertension during the COVID-19 pandemic. Based on the guidebook for elderly health services during the Ministry of Health's COVID-19 pandemic, posbindu sessions have been postponed. In addition, the lack of promotional media for the elderly during the COVID-19 pandemic causes an increased risk of hypertension among the elderly population. In achieving healthy, efficient, and independent elderly during in pandemic, it is necessary to improve health services for the elderly by making lifestyle modifications that adapt to the pandemic situation. The proposed program initiative is forming an elderly peer group in each RT, which is empowered by Posbindu cadres. In this program, several activities are formed, including basic health checks such as blood pressure, health consultations, health education, light exercise, sharing stories to increase the physical and mental health of the elderly. Health promotion activities are carried out in direct meetings at the RT level or monitoring by calling the elderly or their family using the telephone, especially those who live alone in their homes, to inquire about their health conditions. The challenge of this program is the commitment of Posbindu cadres, intensive posbindu cadres, and the condition of some older adults whose reception is slow so that it needs good preparation in planning this program. Posbindu cadres' empowerment to form elderly peer groups can be an alternative solution to improve the health of the elderly from hypertension during the COVID-19 pandemic.
Implementation and obstacles to the multi-sectoral approach in COVID-19 tracing and testing at Puskesmas: experience from Cilacap, Central Java Maulana, Yusup
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
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Objective: This study describes the Covid-19 tracing and testing activities at the Karangpucung II Health Center, Cilacap, Central Java, and the obstacles and multi-sectoral cooperation in handling them. Contents: The data comes from the daily Covid-19 reports in the work area and describes how to carry out tracing and testing for Covid-19 and handling of Covid-19, the flow of multi-sectoral cooperation, and obstacles regarding the implementation of policies related to tracking and testing. This health center has an area bordering the Banyumas and Brebes regencies, which has the potential to spread cases, especially with high population mobility. The results of tracing and testing found 439 positive points out of 960 PCR swabs. Swabs with antigen got 25 positive out of 250 examined. Further studies need to focus on the coverage of tracing and testing according to WHO standards, examining one person per 1,000 population every week to measure the rate of transmission in the region.
Coping strategies for people living with HIV/AIDS in overcoming physiological, emotional, and psychosocial problems at the Victory Plus Yogyakarta Zulaifah, Heni; Puspitawati, Theresia; Fitriani, Ayu
BKM Public Health and Community Medicine Vol 37 No 11 (2021)
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Background: Human Immune Deficiency Virus (HIV) is a potentially deadly virus that attacks the body's immune system. People with HIV/AIDS (PWHA) faced physiological disease, emotional problems such as depression, and psychosocial problems, such as stigma and discrimination. Preliminary studies revealed physiological problems as a side effect of antiretroviral virus (ARV), emotional problems such as stress and depression, and psychosocial issues of being stigmatized. Objective: This study aimed to explore deeply the coping strategies for physiological, emotional, and psychosocial problems of people living with HIV/AIDS (PLWHA). Method: This study was a qualitative study with a phenomenological research design. Researchers used a purposive sampling technique with a maximum variation sampling strategy collecting data through in-depth interviews and analyzing by content analysis. There were five subjects. Results: The five subjects experienced physiological problems as a side effect of using ARV and opportunistic infections. The coping strategies included problem-solving, utilizing social support, and looking for a silver lining. They treated themselves according to the symptoms. If they could not treat the disease by themselves, they visited the doctor for examination. However, if it was untreatable, they ignored it. For emotional problems, the informants used coping strategies that include problem-solving, utilizing social support, and looking for a silver lining; they encourage themselves and then ask their peers for help and instill positive thinking attitudes. However, some informants also vented negative issues, such as avoidance, self-blame, and wishful thinking. Some might suffer from drinking and blaming the self. The coping strategies for the psychosocial problems included compromise and looking for a silver lining; they used an approach to spend with friends and instill positive thinking in themselves. Conclusions: PLWHA used two-types strategies to cope with physiological, emotional, and psychosocial problems, namely positive coping strategies such as problem-solving, utilizing social support, looking for a silver lining, and compromise, and negative coping strategies such as self-avoidance, self-blame, and wishful thinking.
Key populations and PLHIVs’ expectation of inclusive HIV/AIDS services: A study of four puskesmas in Yogyakarta and Cilacap Mellen, Renie; Ida N Faizah; Syafriani; Puji Rahayu; Dwi Maiyanthi; Fithri Zamzam; Fajar Wahyuni; Yanri Subronto; Hasanbasri, Mubasysyir; Retna Siwi Padmawati
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
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Objective: To describe the expectation of PLHIV and key populations regarding HIV/AIDS services, especially on pandemic COVID-19. Method: This study conducted a pilot questionnaire survey in Puskesmas Tegalrejo and Mantrijeron, Yogyakarta; and Puskesmas Cilacap Selatan 2, Puskesmas Kesugihan 2, in Cilacap Region, Central Java. The participants were 62 PLWHA and 60 key populations (transgender, male sex workers, IDUs, and sex workers). This paper uses the data from an open-ended item in the questionnaire on respondents' expectation of HIV services in the puskesmas. Result: Both PLHIV and key populations expected equal service, friendly and respectful services without differentiating from other patients. Health workers would be better to know about the diversity of gender and sexual orientation and educate about HIV/AIDS transmission to reduce the fear and stigmatization of the community. In addition, the rotation issues of health workers should not change the quality standards of HIV/aids services. PLHIVs expected that health workers do not disclose their status to others (which should have become the standard of health professionals’ practice) and provide complete support and counseling related to HIV/AIDS with explaining details to the patients. ARV stock is expected to get a one-month stock supply, and queuing for taking drugs. Furthermore, key populations expect flexible time on VCT tests, especially in pandemic COVID-19. Conclusion: The availability and access of puskesmas services for PLHIVs and key populations was significant progress in health care systems. Notes from users emphasize the need for management support in building inclusive services, where health and administrative workers and other puskesmas treated everyone in need equitably.
Reasons and obstacles in drug-resistant tuberculosis treatment in Yogyakarta: A qualitative study Handayani, Nur; Riyandini, Kristi
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
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Objective: Drug-Resistant Tuberculosis patients need counseling, psychosocial support, nutrition repair, to even family economic support. The study aims to explore the experience of Drug-Resistant Tuberculosis patients receiving treatment. Method: Qualitative research with a design of phenomenology research. Snowball sampling technique and recruitment via WhatsApp to get informants, then informant chose by purposive sampling according to predetermined inclusion criteria. The study was conducted from April through May 2021 in Yogyakarta. The data is gathered via in-depth interviews of three men who have finished the March 2021 treatment, one woman finished April 2019, and 8 as significant others. Validity of data through triangulation and member literacy. Results: The reason for taking medication, not just for health reasons such as wanting to be healthy, can return to normal activities and not wish to harm others. But it's also for non-health reasons, like the economic factors in which informants are the backbone of the family and the family factor. Financial and psychological factors are internal barriers to tuberculosis. And there are external obstacles such as side effects, stigma, medications, and distance from health care facilities. Conclusion: Health and non - health reasons are factors that prompt the patient to accept treatment. Medical barriers come from within as well as from without. Both patients and families need counseling, health education, and motivation, and psychosocial support. Advanced vocational training and venture capital for cured Drug-Resistant Tuberculosis patients are required to regain their power.
Improving mother’s knowledge for stunting prevention through customized health promotion during COVID-19 pandemic Kalesaran, Angela Fitriani Clementine; Lotulung, Cindy Celine; Mandagi, Chreisye Kardinalia Francisca
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
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Objective: This study aims to improve the knowledge of mothers of kids with stunting with different types of health promotion depending on the situation and restrictions during the COVID-19 pandemic. Method: This was a quasi-experimental research study with pre and post-test design. Fifty mothers from Wori District in North Sulawesi were included in the study. Twenty-five mothers received conventional health promotions in groups, and twenty-five mothers received health promotions one-on-one by home visits from healthcare workers. A questionnaire about mothers’ knowledge regarding stunting prevention was collected before and after the health promotion. Results: The number of mothers with a low level of knowledge was 36% before the health promotion, but then decreased to only 14% after the health promotion. There was a significant difference (p<.000) between pre and post-test regarding mother’s knowledge. Between groups receiving conventional health promotion and one-on-one health promotion, there were no significant differences regarding the knowledge of mothers after being given health promotion. Conclusion: Health promotion is an effective way to improve the knowledge of mothers with stunting kids. Health promotion one-on-one by the home visit is just as effective as health promotion in groups. Healthcare workers should be flexible and adaptive to the situation during the COVID-19 pandemic, so health promotion can always be delivered.

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