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Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Published by Universitas Indonesia
ISSN : 19077505     EISSN : 24600601     DOI : https://doi.org/10.7454/kesmas
Core Subject : Health,
Health Professions Public Health
The focus of Kesmas is on public health as discipline and practices related to preventive and promotive measures to enhance the public health through a scientific approach applying a variety of technique. This focus includes areas and scopes such as Biostatistics, Environmental Public Health, Epidemiology, Health Policy, Health Services Research, Nutrition, Occupational Health and Industrial Hygiene, Public Health, Public Health Education and Promotion, Women Health.
Arjuna Subject : Kedokteran - Epidemilogi
Articles 9 Documents
 1 
Search results for , issue "Vol. 20, No. 4" : 9 Documents clear
Workplace Policy and Associated Factors of Minimum Acceptable Diet Practices: An Online Survey Among Working Mothers in Indonesia Deandra, Fadhila Iswi; Februhartanty, Judhiastuty; Mansyur, Muchtaruddin
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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Abstract

Working mothers in Indonesia may influence complementary feeding practices, particularly their ability to ensure that their infants properly meet the minimum acceptable diet (MAD). In this cross-sectional study, an online survey was distributed through various online platforms where participants were recruited using convenience sampling. The questionnaire covered sociodemographic factors, workplace policies, and infant and young child feeding (IYCF) practices. Descriptive and logistic regression analyses were conducted. A total of 394 working mothers participated, of which over 90% of the respondents reported meeting minimum dietary diversity, minimum milk frequency, minimum milk feeding frequency, and MAD indicators as assessed with a standardized questionnaire based on the WHO’s IYCF assessment. Multivariate analysis identified two workplace policy variables significantly associated with meeting MAD requirements: physical facility support (AOR: 2.99; 95% CI [1.03, 8.70]; p-value <0.05) and workplace flexibility scores (AOR: 0.18; 95% CI [0.05, 0.65]; p-value <0.05). These findings highlighted the importance of having supportive workplace environments that enable working mothers to ensure that their infants meet MAD requirements. Additionally, the negative association between workplace flexibility and meeting MAD requirements may have been due to the homogeneity of this study’s subjects' characteristics.
Challenges and Policies for Female Sex Workers’ Readiness to Participate in Pre-Exposure Prophylaxis Program: An Explorative Qualitative Study Sitorus, Rico Januar; Rahmiwati, Anita; Sartika, Diana Dewi; Sunarsih, Elvi; Maharani, Asri
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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Abstract

The prevalence of human immunodeficiency virus is high among female sex workers (FSWs) in Indonesia, underscoring the need for integrated prevention strategies supported by strong government policies. This study aimed to investigate FSWs' willingness to participate in a pre-exposure prophylaxis (PrEP) program. This qualitative study employed semi-structured interviews with 20 participants residing in Pangkal Pinang City, Indonesia (4 stakeholders and 16 FSWs), recruited through purposive sampling. Data were collected from July to September 2024. This non-probability sampling method was adopted due to the focus on specific study objectives and a targeted population. The analysis of the interviews revealed three theme clusters comprising eight themes. The identified clusters were government policy, knowledge of effectiveness and willingness to follow PrEP, and readiness for side effects and long-term compliance. Improving health services in areas where FSWs are concentrated is crucial for facilitating easier access with lower transportation costs. Furthermore, supporting the privacy of FSWs is crucial, and the cost of health screening before PrEP initiation should be waived to eliminate financial barriers and encourage participation in the PrEP program.
Risk Assessment of Salmonella spp. Exposure Among Chicken Farm Workers in Phatthalung Province, Southern Thailand Onmek, Nutthajit; Mueangdee, Nongyao
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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Abstract

This study examined the risk of Salmonella spp. exposure among chicken farm workers by evaluating occupational health management practices. The probability of exposure was determined by assessing the number of contamination points. Sampling for Salmonella spp. contamination was conducted at 7 and 45 days of chicken batches across five areas, alongside evaluation of worker behaviors to assess exposure risk. Three of the 12 large closed-system farms, each housing >10,000 chickens, were selected. Results indicated that boots were the most contaminated items. Workers generally adhered to habitual boot-wearing, which reduced the risk of exposure. Moderate levels of workers' exposure prevention practices, combined with good farm environmental management, resulted in low contamination levels. Reducing Salmonella spp. accumulation was therefore crucial for minimizing contamination. In brief, the chicken farm workers in Phatthalung face measurable risks of Salmonella spp. Exposure reduction, strengthening occupational health management, and improving workplace practices are essential to mitigating these risks and protecting both farm workers and the broader community.
Analysis of Public Knowledge, Attitudes, and Practices in Food and Drug Selection in Indonesia Wikara, Tina; Astuti, Sri; Nurhayati, Sri; Carolina, Rotua Uli; Sari, Evi Ratna
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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As consumers, the public plays a vital role in ensuring the safe and appropriate use of products. This study aimed to assess awareness of food and drug safety and quality among the Indonesian population. Using a cross-sectional survey, the authors measured public awareness across three key dimensions: knowledge, attitudes, and practices. Data were collected from 20,610 respondents aged 17–65 years from 34 provinces in Indonesia. The survey approach employed a three-stage stratified sampling design. Data were collected through structured face-to-face interviews, and the results were presented as an index ranging from 0 to 100 (low to high awareness). The respondents demonstrated good knowledge (92.85), attitudes (90.46), and practices (80.97). The average overall Awareness Index was 88.09. The authors observed significant variations by region, age, education, and occupation, but not by sex. The gap between knowledge and attitudes, and practices can be regarded as a public health concern. Awareness of food and drug safety and quality that does not manifest in behavioral practices does not protect consumers from harm.
General Practitioners' Perspectives on Identifying Early Symptoms for Breast Cancer Detection in the Primary Care Facilities: A Case Study Andinata, Bob
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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Abstract

In primary care settings, general practitioners (GPs) frequently face challenges in identifying the early symptoms of breast cancer. This study aimed to explore, in depth, the perspectives of GPs regarding the identification and interpretation of early-stage breast cancer symptoms during the early detection process in primary care facilities. This study used a qualitative approach based on a case study. Data were collected through in-depth interviews with GPs at primary health care and private clinics in Depok City, Indonesia, complemented by observations and documentation. The data was analyzed using the Miles and Huberman method. The questionnaire assessment and focus group discussion findings revealed that only 3.8% of GPs demonstrated good responses of understanding early and late-stage breast cancer symptoms. Most participants (82.7%) provided fair responses, whereas 13.5% provided poor responses, indicating significant gaps in clinical understanding and highlighting the need for improved training and clearer diagnostic guidance. In conclusion, GPs in primary care facilities tend to have general knowledge of breast cancer but lack the ability to distinguish specific early-stage symptoms from those of more advanced stages.
Improving Glycemic Control Among Indonesian Urban Adults: A Digital and Behavioral Extension of the Information–Motivation–Behavioral Skills Model Appulembang, Imelda
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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Abstract

Management of type 2 diabetes mellitus (T2DM) in Indonesia continues to face challenges due to behavioral, informational, and technological gaps among patients. This study analyzed the influence of self-regulatory competence and information, motivation, family support, and digital health literacy on glycemic control behavior. A cross-sectional survey was conducted from February to April 2025 among 587 adults aged >30 years with T2DM enrolled in the Chronic Disease Management Program at primary health care in six major cities: Jakarta, Surabaya, Yogyakarta, Medan, Makassar, and Banjarmasin. Data were collected through structured questionnaires and analyzed using partial least squares structural equation modeling. The findings revealed that motivation, followed by information and family support, exerted the strongest effect on self-regulatory competence. Self-regulatory competence significantly predicted glycemic control behavior, whereas digital health literacy directly improved behavior and strengthened the effect of self-regulatory competence. These results suggested that behavioral competence and digital engagement were mutually reinforcing capacities essential for the self-management of chronic diseases. This study extends the Information–Motivation–Behavioral Skills model by incorporating digital and social dimensions, offering a contextually grounded framework for strengthening diabetes care in Indonesia’s urban health system.
Emission Characterization and Health Risk Assessment of Volatile Organic Compounds from Automotive Painting in Thailand Kultan, Vanitchaya; Thepanondh, Sarawut; Keawboonchu, Jutarat; Pinthong, Nattaporn; Malakan, Wissawa
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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Abstract

The automotive industry is a significant source of volatile organic compound (VOC) emissions, particularly from solvent-based painting processes. This study evaluated VOC characteristics and distribution to assess associated health risks for workers and communities at varying distances from automotive painting facilities in Thailand, focusing on stacks and wastewater treatment plants that handle solvent-containing wastewater. The findings revealed aromatic compounds were predominant (66% of the total emissions), followed by oxygenated VOCs (26%). The stacks mainly emitted aromatics such as toluene and ethylbenzene, whereas the wastewater released oxygenated VOCs, particularly methyl isobutyl ketone and methyl ethyl ketone. The exposure concentrations in each area were primarily influenced by wind direction, with higher levels observed by downwind. The hazard index for areas was less than 1, indicating safe noncarcinogenic risk levels. The lifetime cancer risk showed that ethylbenzene posed a probable risk in all areas (maximum 8.15 × 10⁻⁶ μg/m³), whereas 1,2-dichloroethane exhibited a probable risk within 200 meters of the facility (maximum 4.13 × 10⁻⁵ μg/m³). This study supports the development of comprehensive emission standards covering health-related compounds and guides residential planning to avoid potential health impacts.
Post-Release Health Insurance Utilization Among Ex-Prisoners: A Scoping Review Khaerunnisa, Icha; Andriany, Megah; Dwiantoro, Luky
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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Abstract

The lack of health insurance coverage after prison release significantly reduces access to essential healthcare services, hindering the continuity of care during community reintegration. The evidence on studies of health insurance use following prison release is limited. This scoping review aimed to summarize research on health insurance utilization after release from prison. Literature searches were conducted across databases including ScienceDirect, PubMed, and Scopus. Relevant articles were selected through a two-stage screening process. Data were extracted from the included studies and presented in tabular and descriptive formats. The keywords used were "health insurance AND post-release" and "inmates OR prisoners." This scoping review showed that post-release health insurance utilization varied internationally. Coverage gaps, such as those in the United States, limit access to and continuity of care, whereas Canada and Australia provide more stable services. Barriers included administrative challenges, housing and employment instability, stigma, and poor coordination within the health system. The findings highlight the influence of national insurance frameworks and the need for policies supporting prerelease-release enrollment, coverage continuity, cross-sector collaboration, and adherence to the World Health Organization and Nelson Mandela Rules for equitable healthcare.
Burnout Assessment Tool Development and Validation for Healthcare Workers: A Psychometric Approach Using Rasch Modelling and Exploratory Factor Analysis Ismail, Rosnah; Vallasamy, Suriya Kumareswaran
Kesmas Vol. 20, No. 4
Publisher : UI Scholars Hub

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Abstract

Burnout remains a significant occupational threat to healthcare workers (HCWs). Existing instruments, e.g., the Maslach Burnout Inventory, have limited applicability in healthcare-specific contexts. This study aimed to develop and validate the Burnout Scale for Assessing Stress in Healthcare Workers (BSAS-HCW), designed to measure cognitive and emotional exhaustion. A cross-sectional survey was conducted among 245 Malaysian HCWs representing diverse roles, including staff nurses (57.7%), house officers (14.3%), medical officers (13.5%), specialists (5.7%), pharmacists (4.5%), and other HCWs. Exploratory factor analysis revealed a two-factor structure with strong internal consistency (Cronbach's alpha: cognitive = 0.95; emotional = 0.97), and all items loaded above 0.4. Rasch analysis supported unidimensionality, robust item fit, and minimal differential item functioning across sex and ethnicity. Person and item reliability exceeded 0.93, with Wright Maps indicating effective item-person targeting. The instrument explained over 70% of the total variance, demonstrating strong psychometric validity. The BSAS-HCW provided a culturally and occupationally relevant tool for assessing burnout among HCWs in high-stress clinical environments. Its dual-domain design addresses the cognitive and emotional toll of burnout more comprehensively than existing tools, enabling more effective detection, monitoring, and intervention strategies across diverse healthcare roles.

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