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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 7 Documents
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Search results for , issue "Vol. 3, No. 1" : 7 Documents clear
Malaria Vivax di Kabupaten Nias Selatan Siahaan, Lambok
Kesmas Vol. 3, No. 1
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Diperkirakan sekitar 2,5 milyar manusia hidup di wilayah endemis malaria dengan ± 300 juta kasus dan ± 1 juta kematian yang sebagian besar adalah anak-anak. Di Indonesia, malaria tak pernah tereradikasi dan mengalami pasang surut dari tahun ke tahun. Di Jawa-Bali, API pada tahun 2001 (0,62%) dan 2004 (0,15‰) dan di luar Jawa-Bali, AMI pada tahun 2001 (26,20‰) dan 2004 (21,20‰) terlihat menurun. Kabupaten Nias Selatan merupakan daerah endemis malaria dengan angka Monthly Malaria Incidence (MoMI) pada 2005 (124,24 ‰). Gempa bumi tektonik dan tsunami dan gempa bumi susulan yang terjadi berpengaruh meningkatkan angka insiden. Lingkungan menjadi lebih kondusif bagi perkembangan vektor penyakit malaria. Hidup di pengungsian dan penurunan daya beli penduduk menurunkan daya tahan tubuh. Kerusakan sarana dan prasarana kesehatan juga sangat berpengaruh pada pregram pencegahan dan pengendalian penyakit. Penelitian ini bertujuan untuk mendapatkan data tentang prevalensi penderita malaria vivax di Kabupaten Nias Selatan. Penelitian dengan desain epidemiologi diskriptif kasus seri ini menegakkan diagnostik malari secara klinis dan laboratorium. di Kabupaten Nias Selatan lebih sedikit daripada malaria spesies plasmodium yang lain. Kasus terbanyak dijumpai pada jenis kelamin perempuan (3,6%) dan kelompok umur 35-44 tahun (1,9%). The South Nias District is an endemic malaria area with Monthly Malaria Incidence (MoMI), in 2005 of 124.24 ‰. The increase of the M0MI rate is influenced by tectonic earthquake and tsunami. The enviroment become more condusive for vector development. Living condition in barrack and the decreasing buying ability affected body immunity. The destruction of health facilities affected prevention and disease control program. The study was conducted to obtain data on prevalence of malaria vivax in South Nias District. Data was collected through structured interviewed in a cross sectional study design. The diagnosis of malaria was made by microscopic blood examination. The prevalence of malaria vivax in South Nias district was 5.1%. Most cases were found among women (3.6%) and 35-44 years of age group (1.9%). It was concluded that in South Nias district, patient of malaria vivax was fewer than other types of malaria.
Pre-Eklampsia Berat di RSUD Bayu Asih Purwakarta Yulianti, Lia; Fikawati, Sandra
Kesmas Vol. 3, No. 1
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Pada periode 2004 - 2005, kejadian pre-eklampsia berat pada ibu hamil di RSUD Bayu Asih Purwakarta meningkat dari 15,2% menjadi 23,6%. Peningkatan kejadian PEB ini diperkirakan dipengaruhi faktor pendidikan, pekerjaan, umur ibu, paritas, umur kehamilan, riwayat penyakit, dan pemeriksaan antenatal. Penelitian ini bertujuan melakukan analisis berbagai faktor determinan pre-eklampsia berat pada Ibu hamil di RSUD Bayu Asih Purwakarta. Penelitian dengan disain studi case control ini dilakukan pada 133 kasus ibu dengan pre-eklampsia berat dan 133 kontrol ibu dengan non pre-eklampsia berat di RSUD Bayu Asih Purwakarta tahun 2004-2005. Metoda analisis yang digunakan adalah metoda analisis regresi logistik ganda. Penelitian ini menemukan faktor-faktor umur ibu, riwayat penyakit, dan pendidikan berhubungan secara bermakna dengan kejadian pre-eklampsia berat. Faktor yang berhubungan paling erat dengan kejadian pre-eklampsia berat adalah riwayat penyakit. Disarankan untuk melakukan penyuluhan pada ibu hamil, khususnya yang berumur >35 tahun dan primigravida dan ibu yang pernah mengalami pre-eklampsia berat agar mampu mendeteksi secara dini gejala dan tanda pre-eklampsia berat untuk segera mencari pelayanan rumah sakit juga melengkapi pengisian data file rekam medis pasien agar dapat memberikan tindakan medis yang sesuai dan tepat. In the period of 2004 - 2005, the severe preeclampsia condition among pregnant woman in RSUD Bayu Asih Purwakarta had been increased from 15,2% to 23,6%. It was predicted that the increase was related to factors such as education, job, mother age, parity, pregnancy age, illness and antenatal care. The objective of this study is to analyse several factors related to severe preeclampsia condition among pregnant woman who delivered in RSUD Bayu Asih Purwakarta in the period of 2004-2005. The study design used in this research is case control that conducted among 133 cases mother who suffered from severe preeclampsia condition and 133 mothers who did not suffer from severe preeclampsia. The method of analysis used in this study is logistic regression method. This research found that mother age, illness, and education were related to severe preeclampsia condition. On the other hand, job, parity, pregnancy age, and antenatal care were not related to the severe preeclampsia condition. Illness has the strongest relationship to severe preeclampsia condition. According to the study results, pregnant women especially those age more than 35 year and primigravida need clear information about severe preeclampsia condition so they can seek the needed health service. The hospital must collect complete information about patiens’ medical record.
Analisis Praktek Bidan pada Pelayanan Ibu Bersalin dan Bayi Baru Lahir Putra, Alhafiza
Kesmas Vol. 3, No. 1
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Sekitar tigapuluh persen kematian bayi terjadi pada periode neonatal yang 80 % di antaranya terjadi pada minggu pertama. Hal tersebut mengindikasikan status kesehatan ibu dan bayi baru lahir yang rendah serta akses dan kualitas pelayanan persalinan masih rendah. Tahun 2006, kematian neonatal di Kabupaten Solo adalah 47 dari 8.250 kelahiran hidup dan di Kecamatan Lembah Gumanti adalah 23 kematian neonatal dari 1,091 kelahiran hidup. Tujuan penelitian ini untuk mengetahui pengaruh praktek bidan di wilayah kerja Puskesmas Alahan Panjang terhadap pelayanan ibu bersalin dan bayi baru lahir pasca persalinan. Penelitian dilakukan dengan metode kualitatif diskusi kelompok terarah, wawancara mendalam dan observasi. Informan adalah seluruh bidan yang bertugas di wilayah kerja Puskesmas Alahan Panjang, ibu bersalin yang persalinannya ditolong oleh informan bidan tersebut. Informan kunci adalah pimpinan dan koordinator program Kesehatan Ibu dan Anak (KIA) Puskesmas Alahan Panjang. Masih ada praktek yang tidak sesuai dengan Standar pelayanan kebidanan, terutama penyuluhan pada ibu bersalin. Supervisi yang dilakukan Pimpinan dan Koordinator Program KIA Puskesmas Alahan Panjang masih kurang. Bidan yang pernah mengikuti pelatihan fungsi bidan dalam pelayananan KIA sarana mendukung atau tindakan bidan dalam pelayanan KIA kurang. In Indonesia both Maternal and Infant Mortality Rates (MMR & IMR) has been significantly reduced. However, those figures were still higher than those of other ASEAN countries. About a third of infant deaths took place in the neonatal period, while 80% of the neonatal deaths happened during the first week of life. This was partly caused by both low accessibility and quality of care. The objective of this study was to assess the midwives’ practice during the provision of services in the post partum and early neonatal period. In addition, this study at Puskesmas Alahan Panjang was also aimed to identify supporting factors in delivering the above services. The design of this study was qualitative research design. The methods of data collection were focus group discussions (FGD), in-depth interview and observation. Results of the study showed that there were many practices of the midwives during postpartum and early neonatal period which did not follow the standard midwifery care by the Ministry of Health. Health education was not properly implemented and oftenly did not even take place. Supervision from the Puskesmas chief or midwife responsible for Maternal and Child Health (MCH) services was insufficient. There were very few midwives who ever joined training in improving their midwifery skills. It is urged that both District Health Office (Dinkes) of Solok and Puskesmas Alahan Panjang improve the competency of the midwives through appropriate training, supervision and provision of equipment and facilities. In addition, strengthening midwives in conducting effective health education program is also strongly recommended. In line with this effort, socialization of recent MCH programs and support for the development of “jorong” (Desa Siaga) is also of outmost importance.
Membangun Bangsa yang Sehat Produktif Sampoerno, Does
Kesmas Vol. 3, No. 1
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Peran kesehatan yang dipahami pihak eksekutif dan legislatif di Indonesia masih terbatas pada pengobatan dan penyembuhan penyakit, bukan membangun sumber daya manusia yang berkualitas. Sejak masa penjajahan, kebijakan kesehatan tersebut didominasi oleh kebijakan kuratif dengan fasilitas kesehatan utama Rumah Sakit, Puskesmas dan Balai Pengobat. Upaya kesehatan tersebut melemahkan argumentasi peran penting kesehatan dalam pembangunan bangsa. Konsep tersebut berpengaruh terhadap tujuan upaya kesehatan mencapai keadaan sehat produktif untuk semua yang dapat mengantarkan penduduk mencapai tingkat sehat produktif. Definisi sehat yang baru tersebut berpengaruh terhadap perubahan paradigma penanganan kesehatan dari “Health Program for Survival” ke “Health Program for Human Development”. Tujuan akhir program kesehatan berubah menjadi sehat produktif yang bernilai ekonomis bagi sebagian besar penduduk. Hak azasi kesehatan menurut WHO mencakup hak informasi, privasi, menikmati kemajuan teknologi kesehatan, pendidikan kesehatan, ketersediaan makanan dan gizi, mencapai standard hidup optimal, dan jaminan sosial. Sudah saatnya upaya kesehatan tidak lagi bertumpu pada pengobatan penyakit, tetapi pada upaya peningkatan dan pemeliharaan kesehatan serta pencegahan penyakit dan penanguulangan risiko. Masyarakat perlu dilibatkan secara aktif dalam pemeliharaan kesehatan melalui pendekatan: (1) “health gain approach” (2) “creation and production of their own health” dan (3) upaya “people’s health empowerment”. The role of health as perceived and understood by executives and legislatives in Indonesia is limited to medication of illness and curative aspect and not perceived as development of quality human resources. Since the Dutch colonial era, health policy in Indonesia is dominated by curative policy emphasizing on health facilities such as hospital, community health center, and health clinic. Those perception, policy, and effort has weakened and suppressed arguments on important roles of health in the development of nation. Newer concept of health stated that the goal of health effort is the achievement of productive health status for all meaning leading most of population to the productive health level. New definition of “health” is influencing the paradigm shift from “Health Program for Survival” to “Health Program for Human Development”. The end objective of health program has changed to productive health with economic value for most of the people. WHO human rights on health includes rights of information, privacy, rights to enjoy the advancement of health technology, health education, adequate food and nutrition, optimal living standard, and social security. Therefore, health effort should not be based on illness medication but on the improvement and maintenance of health, disease prevention, and risk reduction. Communities should be involved actively in health preservation and promotion through (1) “health gain approach” (2) “creation and production of their own health” and (3) “people’s health empowerment”.
Analisis Potensi Pasar dan Atribut Pelayanan Rumah Sakit Islam Depok Ayuningtyas, Dumilah; Fazriah, Hidayani
Kesmas Vol. 3, No. 1
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Di Kota Depok masyarakat muslim yang menjadi komunitas terbesar (91,94%) merupakan pasar potensial rumah sakit. Tujuan penelitian ini adalah mendapat gambaran potensi pasar dan atribut pelayanan rumah sakit yang diharapkan masyarakat muslim. Penelitian yang menggunakan model SERVQUAL ini dimodifikasi dengan 4 karakteristik syariah marketing dan dikelompokkan dalam people, place, symbols, equipment, dan price. Desain penelitian menggunakan metode survey self administered questionaire. Sampel berjumlah 120 diambil dari pasien yang berobat di rumah sakit di Kota Depok. Selain itu, dilakukan studi kualitatif dengan metode indepth interview kepada pakar terkait. Atribut pelayanan rumah sakit Islam pilihan responden yang bersifat universal berupa bentuk pelayanan yang diinginkan. Atribut spesifik tersebut meliputi cara berpakaian, tata ruang, petunjuk arah kiblat, petunjuk dan perlengkapan wudhu pasien, disain interior Islami, mushola di setiap lantai. Atribut fasilitas berupa bimbingan pasien kritis dan bimbingan ruhani. Atribut tarif meliputi komitmen melayani pasien tak mampu, pelayanan tidak terpengaruh tarif kelas dan tidak sepenuhnya profit oriented. Dari hasil indeph interview pakar diformulasikan atribut pelayanan rumah sakit Islam yang bersifat universal dan spesifik. Atribut pelayanan spesifik meliputi aspek fisik, aspek SDM, dan aspek fasilitas. Atribut pembiayaan yang tidak ada pembedaan tarif, tidak menerapkan uang muka. Atribut prosedur pelayanan medis berupa pelayanan bersalin dengan konsep pure gender dan adanya standar operasional prosedur yang memperhatikan aspek layanan gender. Manajemen rumah sakit Islam perlu mempertimbangkan potensi pasar dan merealisasikan atribut universal dan spesifik. Muslim community as the largest population in Indonesia as well as in the city of Depok with the percentage of 91.94%, has been considered as prospective market for Islamic-based business including hospital business. The objective of this study is to investigate the market potential and the service attributes of the Islamic hospitals. The design of study is analytic descriptive with quantitative approach using survey method through self administered questionnaires. The number of samples was 120 taken from the patients nursed in the hospitals in Depok. Qualitative approach was conducted using in-depth interview of related experts. The attributes of service of Islamic hospitals selected by the respondents were universal and specific. The universal attributes were the service models. The specific attribute which indicated Islamic services physically comprised of : Muslim costumes, availability of sign of the direction of kiblah, Islamic interior design, and availability of prayer room. The attributes of facilities including guide for critical patients by particular staff, and costumes for prayer for serious patients, and religious guide for the patients and their family. The attributes of price were to serve poor patients, the services are not influenced by the class tariff and not fully profit-oriented. The specific attributes of service including physical aspects, facility aspects, and human resources aspect. The attributes of costing comprise of: the absence of tariff differences, there is no deposit. The attributes of medical services consist of purely gender-based maternity services, and the existence standard operation procedures which considers the aspects gender-based services. The management of Islamic hospitals should consider their market potencies and implement the universal and specific attributes to enable them to perform Islamic high-quality services.
Faktor Penentu Kontaminasi Bakteriologik pada Makanan Jajanan di Sekolah Dasar Wibawa, Anton
Kesmas Vol. 3, No. 1
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Makanan jajanan merupakan produk pengolahan makanan yang banyak dijumpai di sekitar sekolah dan dikonsumsi secara rutin oleh banyak anak usia sekolah. Selain bermanfaat makanan jajanan juga berisiko menimbulkan masalah kesehatan. Tujuan penelitian ini adalah mengetahui kontaminasi bakteriologi pada makanan jajanan serta faktor yang mempengaruhinya. Penelitian ini menggunakan disain potong lintang (Cross Sectional), dengan sumber data sekunder kegiatan pengawasan makanan dan minuman oleh Dinas Kesehatan Kabupaten Tangerang tahun 2006. Sampel diambil dari 159 Sekolah Dasar di kabupaten Tangerang. Variabel yang diamati adalah : pengetahuan, perilaku, peralatan sarana air bersih, sarana pembuangan limbah, tempat pembuangan sampah dan lokasi usaha, sedangkan variabel terikat adalah kontaminasi makanan oleh bakteri E.Coli. Hasil dari analisis pada penelitian ini menunjukan sampel makanan yang terkontaminasi sebanyak 37,1%. Sekitar (62,9%) berpengetahuan tidak baik, perilaku tidak baik (76,7%), lokasi usaha tidak memenuhi syarat (53,5%), peralatan yang digunakan tidak memenuhi syarat ( 57,2%). Fasilitas sanitasi, tempat sampah tidak memenuhi syarat (93,1%), sarana air bersih (75,5%) tidak memenuhi syarat, sarana pembuangan limbah (86,2%) tidak memenuhi syarat. Pada analisis multivariat diketahui bahwa perilaku merupakan variabel murni yang mempengaruhi terjadinya kontaminasi pada makanan jajanan (p = 0,011) dengan nilai OR 3,2 (95% : CI). Street food is a processed food that can be easily found around schools and consumed routinely by school children. Despite its benefit, street food pose a threatening risk toward health problems. The objective of this study is to investigate bacteriological contamination in street foods and its influencing factors. Design of this study was cross-sectional using secondary data from Health Office Tangerang District year 2006. Subjects were 159 Primary Schools in Tangerang District. Variables observed including knowledge, practice, clean water facilities, waste processing facilities, and location of vendor with E. coli contamination as dependent variable. Analysis of the study shows that 37.1% of street foods in the study was contaminated. Around 62.9% had poor knowledge, 76.7% had poor practice, 53.5% inappropriate location, 57.2% inappropriate utensils, inappropriate sanitation facilities (93.1%), inappropriate clean water facilities (75.5%), and inappropriate waste management facilities (86.2%). The multivariate analysis shows that behaviour was the single dominant variable influencing contamination of street foods (p=0.0011) with OR of 3.2 (95%CI).
Pengelolaan Sampah Berbasis Masyarakat di Kampung Rawajati Jakarta Selatan Puspawati, Catur; Besral, Besral
Kesmas Vol. 3, No. 1
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Kampung Rawajati di Jakarta yang menerapkan sistem pengelolaan sampah berbasis masyarakat merupakan alternatif upaya mengatasi sampah rumah tangga. Penelitian ini bertujuan mengetahui pengaruh sistem tersebut terhadap penurunan berat sampah rumah tangga. Dengan desain studi potong lintang, penelitian ini dilakukan pada sampel 175 ibu rumah tangga yang dipilih secara acak. Hasil penelitian ini menunjukan bahwa pengelolaan sampah berbasis masyarakat dapat menurunkan berat sampah sebesar 28,3%. Analisis regresi linier ganda memperlihatkan bahwa kegiatan pengelolaan yang berpengaruh terhadap penurunan berat sampah adalah kegiatan reuse, daur ulang, dan pembuatan kompos (nilai-p < 0,05). Pembuatan kompos merupakan variabel yang berkontribusi terhadap penurunan berat sampah 657,3 gram setelah dikontrol variabel perancu. Penurunan berat sampah ditemukan lebih besar pada rumah tangga yang mendapat pelatihan. Tidak ada perbedaan penurunan berat sampah menurut jumlah anggota keluarga, penghasilan rumah tangga, dan pengetahuan ibu. Disarankan agar Pemerintah DKI Jakarta dapat melakukan replikasi model pengelolaan sampah berbasis masyarakat kepada wilayah lainnya, dengan memberikan pelatihan pengelolaan sampah kepada masyarakat. Kampung Rawajati in Jakarta applies community-based solid waste management system as an alternative way to overcome household waste problem. The objective of the research is to assess the effect of community-based solid waste management on reduction of household waste weight. This study has crosssectional study design and was conducted on 175 housewife as respondent who were selected randomly. The data was collected by interview using structured questionnaire and weighing of household waste. The result shows that the community-based solid waste management can reduce 28.3% of household waste weight (weight before: 1.845 gram/house/day and after: 1.324 gram/house/day). Multiple linear regression analysis shows that variables affecting the reduction of solid waste including re-using activity, recycling, and composting (p-value <0.05). Composting represents the biggest effect to reduction (657.26 gram) after controlled by potential confounders. The reduction was higher among household with waste training and number of trained household member. It was found that number of family member, family income, and mother knowledge are not significant. It was recommended to the Government of DKI Jakarta to replicate this community-based waste management system to other regions by providing training facilities on solid waste management.

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