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MEDICA (International Medical Scientific Journal)
Published by Borneo Scientific Publishing
ISSN : 26226596     EISSN : 2622660X     DOI : https://doi.org/10.53770/medica
Core Subject : Health, Science,
Chemistry Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary
MEDICA (International Medical Scientific Journal), with registered number ISSN 2622-6596 (Print), 2622-660X (Online) is an Open Access and peer-reviewed journal presenting timely research on all aspects of health that other media have not published. Managed by the Borneo Scientific Publishing, published by Borneo Scientific Publishing. MEDICA (International Medical Scientific Journal) will publish journals three times yearly: January, May, and October. Manuscripts are published as original articles, review articles, and case reports. The Journal invites public health concerned with any of these areas to submit research on topics including, but not limited to Health promotion & disease prevention in all stages of human life, Medical laboratory, Nursing, Environmental Health, Epidemiology and biostatistics. Health policy and administration, Public health nutrition, Occupational health and safety, Health Promotion, Reproductive health, maternal and child health, and other related articles in public health.
Arjuna Subject : Profesi Kesehatan - Profesi Kesehatan (Lain-Lain)
Articles 124 Documents
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Multiple Intelligences Plus Strategy for Health Workforce Development in Central Sulawesi Amsal Amsal; Budiman Budiman; Hamidah Hamidah; Zhanaz Tasya; Ahmad Yani; Sudirman Sudirman; Munawir H. Usman; Rajindra Rajindra
MEDICA (International Medical Scientific Journal) Vol. 8 No. 8 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i8.1039

Abstract

Health transformation requires health human resources (HHR) with multidimensional competencies that extend beyond technical expertise, encompassing emotional, social, ethical, digital, financial, and governance capabilities. However, regional health workforce development systems remain predominantly technical and program-oriented. This study aimed to analyze the current HHR development system, identify competency gaps, and formulate a Multiple Intelligences Plus (MI+) based strategy incorporating Political Quotient (PolQ) to support health transformation at the Central Sulawesi Provincial Health Office. A qualitative descriptive case study was conducted from February to July 2026. Three key informants representing the policy, training-management, and implementation levels were selected purposively. Data were collected through in-depth semi-structured interviews, non-participant observation, and document review, and analyzed using Miles, Huberman, and Saldaña's interactive model with source and method triangulation, member checking, and an audit trail. The results showed that HHR development remained program-driven, administrative, and dominated by technical competencies, while emotional, social, creative, digital, moral, physical, environmental, financial, and political competencies were not systematically integrated. Supporting factors included leadership commitment, regulatory support, and the presence of a health training center, whereas barriers included budget limitations, uneven digital infrastructure, high workload, and resistance to change. The study formulated an eleven-dimension MI+ strategy IQ, EQ, SQ, SoQ, CQ, DQ, MQ, PQ, EnQ, FQ, and PolQ integrated into an Input–Process–Output–Outcome–Impact framework, with Financial Quotient and Political Quotient as novel dimensions. The MI+ strategy provides a holistic conceptual model for transforming health professionals into adaptive, ethical, innovative, collaborative, and governance-oriented human resources.
Modulation of the Gut–Kidney Axis Through Probiotics and Synbiotics in Chronic Kidney Disease: A Narrative Review Agung Susanto; Muhammad Ifham Hanif; Mentari Maratus Sholihah
MEDICA (International Medical Scientific Journal) Vol. 8 No. 9 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i9.1073

Abstract

Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality, partly mediated through disruption of the gut–kidney axis. Gut microbiota dysbiosis contributes to the accumulation of uremic toxins, systemic inflammation, and oxidative stress, thereby accelerating CKD progression. This narrative review summarizes current evidence on the role of probiotics and synbiotics in modulating the gut–kidney axis in CKD. Literature was identified through searches of PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library up to April 2025, with emphasis on randomized controlled trials, systematic reviews, meta-analyses, and mechanistic studies. Current evidence indicates that probiotics and synbiotics may improve gut microbial balance, enhance short-chain fatty acid production, and reduce circulating uremic toxins and inflammatory markers. Additional approaches, including dietary interventions, fecal microbiota transplantation, and pharmacological modulation of the microbiome, have also shown potential benefits. However, despite favorable effects on surrogate biomarkers, evidence demonstrating significant improvements in kidney function and long-term clinical outcomes remains limited. Further well-designed randomized controlled trials with standardized formulations and clinically relevant endpoints are required to establish the therapeutic role of gut microbiota modulation as an adjunctive strategy in CKD management.
The Effect of Leaflet-Based Health Promotion on Mothers’ Knowledge and Handwashing Practices Beny Suyanto; Mustafa Mustafa; Abdul Ganing
MEDICA (International Medical Scientific Journal) Vol. 8 No. 8 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i8.1098

Abstract

Diarrhea remains an important public health problem among toddlers, and caregiver handwashing is an important preventive practice. This study aimed to assess changes in mothers’ knowledge and reported handwashing behavior regarding the prevention of toddler diarrhea following leaflet-based health promotion in Mamboro Barat Urban Village, Palu City. A quantitative quasi-experimental study with a one-group pretest-posttest design was conducted among 30 mothers of toddlers who completed the pretest, leaflet-based health promotion, and posttest. Data were collected using structured questionnaires covering knowledge and reported handwashing behavior, with scores converted to a 0–100 scale. Univariate analysis described respondent characteristics and outcome distributions, while paired-samples t-tests compared pretest and posttest mean scores at a 0.05 significance level. Before the intervention, 18 respondents (60.0%) had poor knowledge, and 21 (70.0%) had poor handwashing behavior. After the intervention, 22 respondents (73.3%) had good knowledge, and 26 (86.7%) had good handwashing behavior. The mean knowledge score increased from 56.33 to 82.50, while the mean behavior score increased from 58.10 to 85.20. Paired-samples t-tests indicated significant within-group differences in knowledge (t = -21.85, p = 0.001) and reported handwashing behavior (t = -20.84, p = 0.001). Leaflet-based health promotion was associated with short-term improvements in mothers’ knowledge and reported handwashing behavior. Because the study used a single group and an immediate posttest, the findings should be interpreted as short-term within-group changes rather than as evidence of sustained behavior change or reduced incidence of diarrhea.
Compliance with National Health Insurance Contribution Payments among Non-Wage Workers Ari Winarto; Endang Budiati; Bambang Setiaji; Atikah Adyas; Aila Karyus
MEDICA (International Medical Scientific Journal) Vol. 8 No. 8 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i8.1139

Abstract

National Health Insurance (JKN) contribution compliance among Non-Wage Workers (PBPU) is crucial for maintaining sustainable access to healthcare services; however, 16,182 (58.14%) PBPU members in Tanggamus Regency remain inactive. This study aimed to identify factors associated with JKN contribution compliance among PBPU members. A quantitative cross-sectional study was conducted among 124 Non-Wage Workers selected using simple random sampling. Data were collected using structured questionnaires and analyzed using univariate, bivariate, and multivariate analyses to assess compliance, self-efficacy, and Health Belief Model constructs. The results showed that 60.5% of respondents were non-compliant with JKN contribution payments. Most respondents reported low perceived vulnerability (57.3%), perceived seriousness (58.1%), and cues to action (53.2%), but high perceived benefits (57.3%), perceived barriers (61.3%), and self-efficacy (54.8%). Significant associations were found between JKN contribution compliance and perceived vulnerability, perceived benefits, perceived seriousness, perceived barriers, cues to action, and self-efficacy (all p < 0.05). In the multivariate analysis, perceived vulnerability emerged as the dominant factor associated with compliance (p < 0.001; adjusted OR = 13.481; 95% CI: 5.017–36.219), although the wide confidence interval indicates that the magnitude of the association should be interpreted with caution. These findings suggest that interventions to improve PBPU contribution compliance should prioritize risk-based health education emphasizing the potential financial consequences of high healthcare costs without JKN coverage. Such interventions could be integrated through JKN cadres, the Mobile JKN platform, and targeted social media campaigns to strengthen participants’ perceptions of health vulnerability and encourage sustained contribution compliance.
Dietary Patterns, Hydration, and Hypertension among Community-Dwelling Older Adults in Indonesia: A Cross-Sectional Study Lilis Setyowati; Azzahra Amelia Putri; Hilda Mazarina Devi; Zahid Fikri; Sunardi Sunardi; Chairul Huda Al Husna; Nur Melizza
MEDICA (International Medical Scientific Journal) Vol. 8 No. 8 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i8.1168

Abstract

Hypertension is a growing public health issue among community-dwelling elderly in Indonesia. Dietary patterns and daily fluid intake are modifiable lifestyle factors that may influence blood pressure, yet their combined effects in community settings remain underexplored. This study aimed to examine the associations between dietary patterns and daily fluid intake and hypertension among Indonesian community-dwelling elderly and to identify implications for preventive geriatric nursing. A cross-sectional study was conducted among 146 elderly participants at the Elderly Integrated Health Post in Malang, East Java, Indonesia. Dietary patterns and daily fluid intake were assessed using a validated Food Frequency Questionnaire (FFQ). Dietary pattern scores were categorised as low (≤50), moderate (51-75), and high (≥76). Daily fluid intake was classified as adequate (≥2 liters/day) or inadequate (<2 liters/day) based on self-reported consumption. Blood pressure was measured following WHO guidelines. Multiple logistic regression was used for data analysis. The prevalence of hypertension was low (9.6%). A moderate dietary pattern was significantly associated with lower odds of hypertension (AOR = 0.189; 95% CI: 0.039–0.912; p = 0.038), while a high dietary pattern showed a non-significant protective trend. Daily fluid intake was not significantly associated with hypertension. The low prevalence may have limited statistical power. This study suggests an association between better dietary patterns and lower hypertension odds among community-dwelling older adults. These findings support the development of practical dietary education programs by nurses at the Elderly Integrated Health Post as part of preventive geriatric nursing strategies in Indonesia.
Working Status and Cervical Cancer Screening Experience among Urban Women in Indonesia: Evidence from the 2023 Indonesia Health Survey Fitri Indrawati; Maria Ulfa Nur Hidayanti
MEDICA (International Medical Scientific Journal) Vol. 8 No. 9 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i9.1250

Abstract

Cervical cancer remains the second most common cancer among women in Indonesia, while lifetime cervical cancer screening remains low. This study examined the association of current working status, age, education, and household wealth with self-reported lifetime cervical cancer screening experience among urban women in Indonesia. This cross-sectional study used secondary data from the 2023 Indonesia Health Survey (Survei Kesehatan Indonesia/SKI), including urban women aged ≥15 years eligible for the cervical cancer screening item (G43.G) (n=156,722; n=156,716 in the multivariable model due to missing wealth-quintile data). Analyses accounted for the multistage stratified cluster sampling design, including primary sampling units, strata, and sampling weights. Design-based chi-square tests and weighted multivariable logistic regression were performed. Overall, 8.97% (95% CI: 8.71–9.25%) of urban women reported ever undergoing cervical cancer screening by Pap smear or visual inspection with acetic acid (IVA). After adjustment, non-working women had lower odds of ever being screened than working women (aOR=0.91; 95% CI: 0.86–0.97; p=0.002). Screening odds were higher among women aged up to 45–54 years, those with higher education (aOR=3.42 for university graduates versus no formal education), and those in higher wealth quintiles (aOR=2.05 for the wealthiest versus poorest quintile). Working status, education, and household wealth were significantly associated with cervical cancer screening experience among urban Indonesian women. Equity-focused strategies should prioritize non-working, less-educated, and economically disadvantaged women to improve screening coverage and support cervical cancer elimination efforts.
Effectiveness of Loranthus sp. Liquid Soap in Improving Skin Moisture among Pregnant Women with Gestational Diabetes Mellitus Siti Choirul Dwi Astuti; Nancy Oiii; Hasnawatty Surya Porouw; Dicki Bakhtiar Purkon; Ayu Nala El Muna Haerussana
MEDICA (International Medical Scientific Journal) Vol. 8 No. 8 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i8.1266

Abstract

Gestational diabetes mellitus frequently causes skin dryness due to impaired microcirculation, peripheral neuropathy, and reduced sweat gland function, increasing the risk of skin infection and decreasing maternal quality of life. Natural topical products containing bioactive compounds may provide a safe alternative for improving skin hydration during pregnancy. This study aimed to determine the most effective concentration of Loranthus sp. liquid soap for improving skin moisture in pregnant women with gestational diabetes mellitus. A quasi-experimental study using a nonequivalent control group design was conducted at the Tilango Community Health Center, Gorontalo Regency, Indonesia. Thirty pregnant women with gestational diabetes mellitus were allocated into three intervention groups receiving Loranthus sp. liquid soap containing 5%, 10%, or 15% extract (n=10 per group). Participants used 500 mL of the assigned soap twice daily for seven consecutive days. Skin moisture was measured before and after the intervention using digital skin moisture analyzer EH900U. Within-group differences were analyzed using the Wilcoxon signed-rank test, while differences among intervention groups were assessed at a significance level of 0.05. Mean skin moisture increased from 34.6±3.1% to 37.1±5.1% in the 5% group, from 34.8±4.8% to 37.9±4.9% in the 10% group, and from 37.0±5.3% to 45.6±4.3% in the 15% group. Significant improvements were observed in all groups (p=0.041, p=0.026, and p=0.0001, respectively), with a significant difference among concentrations (p=0.0017). The 15% Loranthus sp. liquid soap demonstrated the greatest improvement in skin moisture and showed potential to improve skin moisture in pregnant women with gestational diabetes mellitus. Further studies with larger sample sizes, longer follow-up periods, and an appropriate control group are needed to confirm these findings.
Potential of Stevia rebaudiana as a Safe Sweetener Alternative for Women with Gestational Diabetes Mellitus Magdalena Martha Tompunuh; Siti Choirul Dwi Astuti; Hasnawatty Surya Porouw; Rabia Zakaria; Dyah Noviawati Setya Arum; Munica Rita Hernayanti
MEDICA (International Medical Scientific Journal) Vol. 8 No. 8 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i8.1267

Abstract

Gestational diabetes mellitus (GDM) is a common metabolic disorder during pregnancy and is associated with adverse maternal and fetal outcomes. Dietary modification, particularly reducing the intake of added sugars, is an important component of glycemic management. This study aimed to examine the effect of replacing conventional sugar with Stevia rebaudiana liquid sweetener on fasting blood glucose among pregnant women with GDM. A quasi-experimental pre–posttest control group design was conducted among 120 pregnant women with GDM at Pilolodaa Community Health Center, Gorontalo, Indonesia. Participants were allocated to an intervention group receiving 25 drops of liquid Stevia rebaudiana daily (n = 60) or a control group receiving 25 g of conventional sugar daily (n = 60) for 30 days. The assigned sweetener was used as a replacement for the sweetening component of the participants’ usual diet. Fasting blood glucose was measured in the morning after an overnight fast of at least 8 hours using a calibrated glucometer before and after the intervention. Baseline characteristics were assessed to evaluate comparability between groups. The intervention group showed a reduction in mean fasting blood glucose from 163.5 ± 19.8 mg/dL to 128.7 ± 15.6 mg/dL, whereas the control group decreased from 161.8 ± 20.1 mg/dL to 156.9 ± 18.7 mg/dL. The mean reductions were 34.8 and 4.9 mg/dL, respectively, resulting in a between-group mean difference of 29.9 mg/dL (p < 0.001). Overall, 90.0% of participants in the Stevia rebaudiana group experienced a reduction in fasting blood glucose. These findings indicate that replacing conventional sugar with liquid Stevia rebaudiana was associated with a greater reduction in fasting blood glucose over 30 days among pregnant women with GDM. However, given the quasi-experimental design and the possibility of uncontrolled confounding factors, the observed reduction should not be interpreted as definitive evidence of a specific effect of Stevia rebaudiana. Further studies with randomized designs and longer follow-up are needed to confirm these findings.
Proxy-Based Classification of Care Patterns and Social Support Among TB Patients in Papua: A Routine Surveillance Data Analysis Agustina Regina Yufuai; Dolfinus Yufu Bouway; Katarina Lodia Tururop; Inriyanti Assa; Lenny Lea Pangkali
MEDICA (International Medical Scientific Journal) Vol. 8 No. 9 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i9.1274

Abstract

Tuberculosis (TB) remains a major public health challenge in Indonesia, particularly in Papua. However, routine TB surveillance systems do not directly measure caregiver characteristics, limiting evidence on care patterns and social support. This study aimed to construct a proxy-based typology of care patterns and social support from routine TB surveillance data and assess its association with TB treatment success. A retrospective cohort study using secondary data was conducted at Puskesmas Waibhu, Jayapura Regency, Papua. A total of 768 TB treatment episodes from 729 unique patients were included using total sampling. Because the typology was derived from administrative proxies rather than direct caregiver assessment, it was considered exploratory and hypothesis-generating. Data were analyzed using descriptive statistics, chi-square tests, Fisher’s exact test, and binary logistic regression. The Low Care–Low Support group was the largest typology. High social support was significantly associated with treatment success in bivariate analysis (p = 0.012) and multivariable analysis (adjusted OR = 2.22; 95% CI: 1.24–3.99; p = 0.007), whereas the care-pattern proxy was not significantly associated with treatment outcomes. Bacteriologically confirmed diagnosis and unknown diabetes mellitus status were independently associated with lower treatment success. These findings suggest the importance of family social support and the feasibility of a proxy-based typology from routine surveillance data. However, findings should be interpreted cautiously because some episodes originated from the same patients and model explanatory power was modest (pseudo-R² = 0.067). Prospective studies using direct caregiver assessment are needed for validation.
Outdoor Activity and Dietary Vitamin D Intake as Moderators of Caries Risk Factors in Preschool Children Ryan Nanda Syahbana; Darmawan Setijanto; Taufan Bramantoro
MEDICA (International Medical Scientific Journal) Vol. 8 No. 8 (2026): MEDICA (International Medical Scientific Journal)
Publisher : Borneo Scientific Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53770/medica.v8i8.1306

Abstract

Dental caries remains a major public health problem among preschool children and is strongly influenced by behavioral risk factors, particularly frequent sugar consumption and inadequate toothbrushing. Outdoor activity and dietary vitamin D intake may contribute to oral health through their potential roles in vitamin D status and dental mineralization. This study examined whether outdoor activity and dietary vitamin D intake moderate the association between caries risk factors and dental caries status among preschool children. An analytical cross-sectional study was conducted among children aged 5–6 years in the Kedungdoro Community Health Center area, Surabaya. From a target population of 393 children, 200 participants were selected using simple random sampling. Data on sugary food and beverage consumption, toothbrushing habits, outdoor activity, and dietary vitamin D intake were collected using parent-administered questionnaires, while dental caries status was clinically assessed using the dmf-t index. Spearman’s rank correlation and hierarchical moderated regression analyses were performed. Among the 200 children, sugary food and beverage consumption (r = 0.737, p < 0.001) and poor toothbrushing habits (r = 0.744, p < 0.001) were strongly and positively associated with dental caries status. Outdoor activity was inversely associated with caries status (r = −0.355, p < 0.001), whereas dietary vitamin D intake was not significantly associated with caries status (r = −0.069, p = 0.333). In the final regression model, sugary food and beverage consumption (β = 0.401, p < 0.001) and poor toothbrushing habits (β = 0.350, p < 0.001) remained significant predictors, while outdoor activity showed an inverse association (β = −0.147, p = 0.009). Neither outdoor activity nor dietary vitamin D intake significantly moderated the associations between caries risk factors and dental caries. These findings highlight the importance of behavioral factors in preventing dental caries among preschool children.

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