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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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Maternal characteristics and toddler food intake in the Sleman area during the COVID-19 pandemic Ryveka, Aurellia
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Abstract

Objective: To determine the relationship between maternal characteristics, which consist of mother's knowledge, mother's employment status, and mother's education level, as well as food access and food intake of toddlers in Sleman Regency. Method: The method used in this study was a cross-sectional method with a purposive sampling technique on 45 pairs of mothers and children in 4 posyandu included in the working area of ​​Depok 3 Puskesmas, namely Nologaten, Kledokan, Janti Barat, and Karangmalang. Maternal characteristics and access to food were measured using a questionnaire, and food intake was measured using the SQ-FFQ questionnaire. The statistical test used was the Fisher exact test. Results: From the results of the descriptive analysis obtained, most of the respondents have a good level of knowledge (75.6%), respondents do not work (71.1%), respondents have a secondary education level (51.1%), respondents have difficult access to food (55,6%). Then, most toddlers have excess energy intake (80%), toddlers have excess protein intake (100%), toddlers have excess fat intake (86.7%), and toddlers have excess carbohydrate intake (71.1%). Mother's knowledge, mother's employment status, mother's education level, and food access are not related to the food intake of children under five. Conclusion: There is no significant relationship between maternal characteristics and access to food with toddler food intake.
The validity of maternal perceptions on child’s nutrition status: An alternative to growth monitoring method during COVID-19 crisis Fika Ilmiyani, Saskia; Hartriyani, Yayuk; Kusuma, Mutiara Tirta Prabandari Lintang
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: The purpose of this study were 1) to test the usability of maternal perceptions as method to determine child’s nutrition status and 2) to estimate the preliminary validity of the maternal perceptions questionnaires. Method: A diagnostic test with cross-sectional design among 80 mother and child dyads within the sampling frame of the Sleman Health and Demographic Surveillance System (HDSS Sleman). The maternal perception were assessed using a verbal and visual questionnaire. All anthropometric measurements were conducted by trained community health workers using standardized technique and calibrated tools. Statistical analyses were performed to cross-tabulate child’s nutrition status (Weight/Height) with maternal perceptions. We tested the data for sensitivity, specificity, positive predictive value, negative predictive value, and ROC curve. Results: Most mothers could accurately determine child’s nutrition status using both verbal and visual questionnaires, with 82.5% and 85% respectively. The verbal method has higher sensitivity and negative predictive value than the visual questionnaire. Both questionnaires have similar positive predictive value, yet the specificity was higher in the visual technique The ROC curves of verbal and visual methods were 0,605 and 0,527. Conclusions: Our study found that mothers are generally able to utilize both the verbal and visual questionnaires. Despite the usability of the instruments, the data indicates mothers’ inability to perceive malnutrition in children. It stands to reason that the anthropometric measurements remain the best method to determine nutrition status in children, monitor growth and detect nutrition problems. It is also worth noting that intervention is needed to help promote an accurate perception of children healthy weight among mothers.
Mother perception of child nutritional status and toddler food intake Danumaya, Almira
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: Nutritional problems in children under five are still significant. Malnutrition can have a negative impact on the growth and health of toddlers. One of the reasons for this can be improper food intake. Inappropriate food intake for toddlers can occur because the wrong perception of the mother influences it. This wrong perception leads to improper feeding as well. This study aims to determine the relationship between mothers' perception of the nutritional status of children under five with food intake (energy, protein, fat, and carbohydrates) under five. Methods: A quantitative observational research design was used with a cross-sectional design. The study was conducted on 45 pairs of mothers and children aged 12-59 months who live in Sleman who were taken by purposive sampling method. The instrument used was a toddler silhouette scale questionnaire, SQ-FFQ, and knowledge of maternal nutrition, which were filled out independently by the respondents. The analytical method used is Fisher's Exact test for bivariate test and stratification analysis with Haenszel Mantel. Result: The nutritional status of children under five in this study mostly (84.4%) had good nutritional status. Most mothers under five (88.9%) have an appropriate perception of the nutritional status of their children. Toddlers in this study mostly had excessive energy intake (80%), excess fat intake (86.6%), excessive carbohydrate intake (71.1%), and all toddlers had excessive protein intake. There is no statistically significant relationship between mothers' perceptions of the nutritional status of their toddlers and their toddler's food intake (p>0.05).
Self-stigma among people living with HIV/AIDS: revisiting human rights values for inclusive health service Nur Faizah, Ida; Cuyno Mellen, Renie; Syafriani, Syafriani; Wijayanti Subronto, Yanri; Hasanbasri, Mubasysyir; Siwi Padmawati, Retna
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Purpose: This study explores self-stigma in people living with HIV/AIDS (PLHIV) who used Puskesmas services in Yogyakarta and its impact on their health service access. Method: Data come from in-depth interviews with three PLHIVs (one male and two female). Results: Self-stigma occurs among the respondents at the first diagnosis as HIV positive. Self-stigma is triggered by wrong judgments about HIV disease from health workers and communities. Self-stigma is based on negative thoughts of feeling different, having exclusivity (different from their environment). Thus, it is easier to feel rejected, showing the worst if they are discriminated against. The first thought when the respondent was diagnosed with positive HIV was, “how do I die? How will I die tomorrow?” "Not expect, why should I?" "My world has been destroyed; I have no hope anymore.” Feeling of vulnerability and helplessness related to death and illness trigger hypersensitive responses, so they tend to withdraw from social relationships. Continuous exposure will result in a reluctance to access health services due to decreased motivation for treatment. Conclusions Self-stigma is a defense mechanism to fight stigma and discrimination. Hypersensitivity protects to anticipate rejection from the surrounding environment. Thus, PLWHA understands disclosure to reveal the status or not to the closest people. However, this condition needs to be regulated so that self-stigma does not develop to interfere with life functions such as social relations, economy, and work. Self-stigma can reduce treatment prognosis and increase comorbidity and mortality due to lack of a support system, decreased treatment motivation. Therefore, Puskesmas should collaborate with families and communities. Puskesmas can create volunteer groups from people with stigmatized diseases as agents of change to build trust between PLWHA, families, and health workers. For suggestion, meetings with patients as well as an activity to support human rights in celebration day to develop equal and acceptance feelings.
Addressing COVID-19 pandemic implication on mental health in community: Perspective towards important issue behind the crisis Prabandari, Valentina Lakhsmi
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: COVID-19 pandemic gives rise to various health problems experienced by everyone in a community, not only physical condition but also psychosocial condition. COVID-19 was stated to be associated with an increased risk of psychiatric disorders. Nevertheless, besides the stigma on COVID-19, COVID-19 survivors may avoid being open and aware of their mental health condition because of public stigma on mental health. This might lead to late management of mental health and psychosocial issues. The purpose of this initiative was to give a view of the management of mental health care and psychosocial support by empowering the role of community and Puskesmas as one of the closest parts of the health system to the community. Content: Mental health has been the concern of health programs done by Puskesmas through promotive, preventive, curative, and rehabilitative efforts. One measure to be done is to perform monitoring of mental health status of COVID-19 survivors using digital health instruments. Mobile phone-based monitoring might allow early detection and treatment toward mental or psychosocial issues experienced by COVID-19 survivors. Promotive and preventive messages can be shown at the end of the questionnaire. Furthermore, there should be a program designed to develop community-based mental health support by implementing DKJPS (Dukungan Kesehatan Jiwa dan Psikososial) through a collaboration of Puskesmas, community health workers, and other public as well as private sectors. This might be achieved by training and mentoring. The last but not least, there is a need to strengthen the capability of Puskesmas in handling mental health and psychosocial issues by sending psychiatrists or psychologists down to Puskesmas. It doesn’t necessarily mean that they have to be there all the time, but improvement of the capacity of health workers in Puskesmas, as well as consultation and mentoring, are all important needs.
Medical students participation on KKN program (community service learning): Improving community health through health promotion Helen Natalia; Hasna Fikriya; Herdifitrianne Saintissa Yanuaristi
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: This study aims to describe the medical students' involvement in KKN Program (community service learning) to improve community health through health promotions. Content: KKN Program is a multidisciplinary research-based community service program to enhance, empower, and enable society to increase control over, and improve, their lives including health. Among community health improvement approaches, KKN Program heavily highlights health promotion. In line with ‘organized effort’ as the core definition of public health by WHO, KKN Program requires collaboration between multidisciplinary students, the community (partners and government), and the university. As a type of experiential learning, KKN Program allows medical students to apply their knowledge and skills in relevant community-based contexts. Students learn to develop critical thinking skills, explore ethical and social justice concerns, and reflect according to their perspectives. KKN Program provides a platform to implement health promotion interventions to boost health outcomes. Numerous examples of health intervention in the KKN program include building health policy, generating a health-promoting environment, community action, helping health care services, and developing personal skills. A range of actions in KKN programs such as community visits, campaigns, facilitated counseling & support, and assistance of current primary health care programs are essential for students to obtain public health skills comprising analytical/assessment skills, program planning skills, communication skills, and management and evaluative reasoning skills. In conclusion, the KKN program provides common ground for medical students to equally learn first-hand from the community and assist their role to become 5-star physicians: care-provider, decision-maker, communicator, community leader, and manager. It equips medical students as future general practitioners with public health skills and the mindset required to improve community health.
Enhancing vulnerable communities’ resilience in public health through intersectoral collaboration: A study case of global empowerment steps’ project in Piyungan landfill Yanuaristi, Herdifitrianne Saintissa; Hidayat, Ikhtiar Anugrah; Putri, Kintansari Adhyna
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
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Objective: This study explores the role of social community to alleviate public health problems through partner collaboration, by three-sector interventions: economy, environment, and health. Content: Covid-19 pandemic has become a global challenge in public health efforts, mainly due to the barrier for social movements to take place and the shifting focus of government policy in public health intervention. This challenge becomes more tangible in vulnerable communities, namely but not limited to the economically disadvantaged communities. As their health heavily intersects with social factors, including housing environment, poverty, and inadequate information & education, their resilience in facing this pandemic highly depends on it. One example of these vulnerable communities is Piyungan Landfill Yogyakarta as the target population of this study. This study analyses the role of Global Empowerment Steps (GPS), a student-powered organization in the effort of increasing public health resilience by the utilization of multisectoral collaboration of its members and other stakeholders to alleviate public health problems in the area. GPS works with ten other organizations mostly student-powered, with each specific area of concern and conducting numerous projects that encourage society to engage and be responsible for their own health, as well as involving stakeholders responsible for social determinants of health in the area. By far, GPS has conducted serial entrepreneurial classes and empower local women to producing & marketing organic fertilizer to increase the community’s economic resilience, conducted researches and recommendations that has been presented to local government that resulted in technological improvement to separate the landfill from the residence for a better environmental resilience for the inhabitants, and increased health education of the inhabitants through numerous health education projects. In conclusion, the social community plays a significant role in increasing the resilience of vulnerable communities to face the pandemic. Keyword: Intersectoral collaboration; Public health resilience; Vulnerable community
Factors related to the nutritional status of children under five in the HDSS Sleman working area Rania Aisyah Herima; Hartriyanti, Yayuk; Ermamilia, Aviria
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Background: The nutritional status factors of children under five are divided into two categories: direct factors (history of infectious diseases, history of birth weight, and food intake) and indirect factors (household income, mother's occupation, mother's education, father's occupation, family members number, and history of exclusive breastfeeding and complementary feeding). The achievement of good nutritional status in children under five in Sleman Regency is not optimal. Meanwhile, the nearest academic institution is expected to be able to contribute to solving this problem through a science-based approach. Objectives: To determine the prevalence of nutritional status and factors related to the nutritional status of children under five in the HDSS Sleman working area. Methods: The sample of this study was 103 toddlers aged 12-59 months who lived in Sleman Regency with a purposive sampling technique. The design of this study is cross-sectional, with the bivariate test used is the Fisher's Exact test. Results: The prevalence of overweight and obesity, which includes overweight and obesity, is four people (3.88%), and good nutrition is 95 people (92.23%). Four people (3.88%) were malnourished. Factors related to the nutritional status of children under five were a history of breastfeeding and complementary feeding (p=0.008). In addition, from other direct and indirect factors, no significant relationship was found with the nutritional status of children under five in the HDSS Sleman working area. Conclusion: Most toddlers in the Sleman HDSS work area have good nutritional status (92.23%). Factors related to the nutritional status of children under five are the history of breastfeeding and complementary feeding, which are indirect factors.
People living with HIV AIDS (PLWHA) in Batujajar public health center: Improving quality of life through adherence antiretroviral treatment “Antreat ARV” program Ami Kamila; Anzar Ismail; Hani Nurani Permani
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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One of the efforts to improve the quality of life of PLWHA is to maintain ARV therapy. ARV therapy is also the key to the success of HIV/AIDS treatment. Although it is not curative, continuous therapy can inhibit the growth and the spread of the virus in the body of PLWHA. Based on the data from the AIDS Commission of West Bandung Regency, 10% of the total 474 PLWHA in West Bandung Regency lost to follow-up ARVs. Some of the causes of it can be related to Lawrence Green's theory, such as predisposing factors (knowledge, attitudes), enabling factors (access to ARV services, transport costs), and reinforcing factors (boredom, side effects). Therefore, AIDS Commission of West Bandung Regency tried to prevent increased lost follow-up ARVs by conducting an empowerment program for PLWHA through "Antreat ARVs" Program. Antreat ARV Program aims to improve adherence to ARV treatment in PLWHA by providing health assistance through counseling using the brainstorming method, using digital module and video. In West Bandung Regency, this program was first carried out with the initiation of the AIDS Commission itself in collaboration with Health Institutions, on the target of PLWHA who were in the working area of ​​the Batujajar Health Center, West Bandung Regency. This activity positively impacts the adherence of PLWHA to ARV treatment based on the data from the AIDS Commission, which was followed up one month after the activity. This Antreat ARV Program needs to be regularly carried out by increasing health assistance innovation by empowering the PLWHA community as Peer Support Groups as peer educators and motivators and services for PLWHA at the Public Health Centre to facilitate ARV access.
The use of growth velocity z-scores to early detect growth faltering in Indonesian infants Dinari, Rizka; Oktaria, Vicka; Danchin, Margie
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Objective: This study aimed to describe infant growth patterns using attained growth z-scores and growth velocity z-scores in the first year of life in Indonesia. Method: A cohort study of 359 newborns was conducted in 2015-2017 in Yogyakarta, Indonesia. Weight and length were routinely measured throughout the first year of life to calculate the attained growth z-scores (weight-for-age/WAZ, length-for-age/LAZ, and weight-for-length z-scores/WLZ) and growth velocity z-scores (weight velocity/WVZ and length velocity z-scores/LVZ). Undernutrition was categorized into underweight (WAZ<-2), stunting (LAZ<-2), and wasting (WLZ<-2). Growth faltering was categorized into weight faltering (WVZ<5th centile) and length faltering (LVZ<5th centile) using WHO child growth standards. Results: The proportion of undernutrition and growth faltering varied throughout infancy. The highest proportion of undernutrition was the proportion of stunting at 12 months (15.3%) which was two times higher than at birth (7.3%). The highest proportion of weight and length faltering was in 4-6 months with 28.6% and 39.4%, respectively. Median WAZ was relatively stable at around -0.30 SD in the first six months before it slightly decreased to -0.64 SD at 12 months of age. Median LAZ increased from -0.62 SD at birth to -0.23 SD at four months before declining to -0.83 SD at 12 months. In comparison to attained growth z-scores, growth velocity z-scores depicted an opposing pattern. Median WVZ decreased from 0.33 SD at 0-2 months to -0.80 SD at 4-6 months, while median LAZ dropped from 1.33 SD at 0-2 months to -1.20 SD at 6-9 months. Conclusion: The proportions of undernutrition and growth faltering were relatively high in the first year of life. Growth velocity z-scores showed an earlier downward pattern than attained growth z-scores. Therefore, routine monitoring, particularly in growth velocity z-scores, might allow earlier detection and treatment of child growth faltering.

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