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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 15 Documents
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Search results for , issue "Vol. 9, No. 1" : 15 Documents clear
Pendapatan Daerah, Pembiayaan Kesehatan, dan Gizi Buruk pada Balita: Studi Korelasi Tingkat Kabupaten/Kota Choirunisa, Septyana; Adisasmita, Asri C.
Kesmas Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Pendanaan kesehatan merupakan salah satu faktor penting dalam memengaruhi derajat kesehatan, termasuk salah satu masalah gizi pada balita yang disebut gizi buruk. Oleh karena itu, penelitian ini bertujuan mendeskripsikan pendapatan daerah dan pembiayaan kesehatan serta korelasinya dengan gizi buruk pada balita di tingkat kabupaten/kota di Indonesia tahun 2007. Penelitian ini merupakan studi ekologi/korelasi. Data pendapatan daerah dan pembiayaan kesehatan didapat dari Kementerian Keuangan, sedangkan data gizi buruk menggunakan data Riset Kesehatan Nasional tahun 2007. Sebanyak 250 kabupaten/kota yang diteliti dengan tidak mengikutsertakan kabupaten/kota yang datanya tidak lengkap atau tidak valid. Secara nasional, hanya persentase pendapatan asli daerah (PAD) per total pendapatan yang berkorelasi dengan gizi buruk, meskipun korelasinya lemah (r = 0,22). Berdasarkan kawasan di Indonesia, Kawasan Indonesia Barat dan Kawasan Indonesia Timur menunjukkan persentase PAD per total pendapatan berkorelasi lemah dengan gizi buruk (r = 0,20 dan r = 0,53). Terlihat kecenderungan bahwa semakin tinggi persentase pendapatan daerah dan pembiayaan kesehatan, semakin rendah persentase gizi buruknya. Korelasi antara pendapatan daerah, pembiayaan kesehatan dan masalah status gizi tidak dapat diabaikan. Data yang lebih lengkap dan valid diperlukan untuk dikembangkan penelitian selanjutnya. Health financing is one of the factors which contribute important role in influencing health status, including nutritional problem among children under five, called severely wasted. Therefore, the aim of this study was to describe districts income and health financing and examine it correlations with the prevalence of severely wasted among children under 5 years at regencies/ municipalities level in Indonesia in 2007. This research was an ecological study. Data on revenue and health financing were obtained from Ministry of Finance, and severely wasted data were obtained from the Indonesian Basic Health Research (Riskesdas) 2007. There are 250 regencies/municipalities were being objects of this research, while the others were excluded due to incomplete/missing or invalid data. Result shows nationally, only the percentage of local revenue by total district income had correlation with severely wasted, although it is weak (r = 0,22). By regions, in the Western Region Indonesia and the Eastern Region Indonesia, those variable had weak correlation with severely wasted (r = 0,20 and r = 0,53). The graphics trend shows higher percentage of local revenue and health financing, related to lower number of the prevalence of severely wasted. The correlation between district income and health financing for poor nutritional status cannot be ruled out. More valid and complete data on district income and health financing is needed for further research.
Asupan Karbohidrat sebagai Faktor Dominan yang Berhubungan dengan Kadar Gula Darah Puasa Werdani, Aprilya Roza; Triyanti, Triyanti
Kesmas Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Peningkatan kadar gula darah memicu peningkatan produksi hormon insulin yang erat hubungannya dengan diabetes melitus. Berdasarkan data Riskesdas, prevalensi diabetes melitus di Indonesia meningkat dari 1,1% (2007) menjadi 2,1% (2013). Penelitian ini bertujuan untuk mengetahui faktor dominan yang berhubungan dengan kadar gula darah puasa pegawai pemberdayaan masyarakat & keluarga dan pegawai sekretariat daerah Kota Depok. Desain penelitian yang digunakan adalah potong lintang dan melibatkan 105 sampel. Variabel independen penelitian meliputi karakteristik individu, asupan zat gizi, hipertensi, aktivitas fisik, status gizi dan pengetahuan gizi. Analisis data yang dilakukan adalah analisis univariat, analisis bivariat menggunakan uji korelasi dan uji beda dua mean, serta analisis multivariat menggunakan uji regresi linear ganda. Hasil penelitian menunjukkan bahwa rata-rata kadar gula darah puasa adalah 95,14±10,863 pada keseluruhan responden, sedangkan 94,07±11,55 mg/dl pada perempuan, dan 96,47±9,92 mg/dl pada laki-laki. Diabetes melitus (≥126 mg/dl) ditemukan sebesar 2,9% dan impaired fasting glucose (100-125 mg/dl) sebesar 22,9%. Berdasarkan hasil analisis bivariat, terdapat hubungan antara usia, asupan karbohidrat, dan aktivitas fisik dengan kadar gula darah puasa (p<0,05). Hasil analisis multivariat menunjukkan bahwa asupan karbohidrat merupakan faktor dominan yang berhubungan kadar gula darah puasa. Increased blood glucose levels lead to excess insulin secretion that is closely associated with diabetes mellitus. Based on Riskesdas, prevalence of diabetes mellitus in Indonesia has increased from 1,1% (2007) to 2,1% (2013). This study was aimed to find dominant factor associated with fasting blood glucose level. Cross sectional design were used to conduct this study and involved 105 samples. Independent variables in this study were individual characteristics, nutrients intake, history of hypertention, physical activities, nutritional status and nutritional knowledge. Bivariate analysis was performed by correlation test and two different test mean. Multivariate analysis was performed by multiple linear regression test. Result showed that the average of employees’ fasting blood glucose level is 95.14±10.863, 94.07 ± 11.55 mg/dL for woman and 96.47 ± 9.92 mg/dl for man. This study found 2.9% employees with diabetes mellitus (³126 mg/dl) and 22.9% employees with impaired fasting glucose (100-125 mg/dl). Result of bivariate analysis showed that associated between age, carbohydrate intake, physical activities with fasting blood glucose level. Result of multivariate analysis showed that carbohydrate intake was a dominant factor related to fasting blood glucose level.
Evaluasi Pelaksanaan Konseling Menyusui Murtiyarini, Ika; Herawati, Dewi Marhaeni Diah; Afriandi, Irvan
Kesmas Vol. 9, No. 1
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Salah satu upaya pemerintah dalam meningkatkan pemberian ASI di Indonesia adalah dengan memberikan konseling menyusui di pelayanan kesehatan. Penelitian perlu dilakukan untuk mengevaluasi pelaksanaan konseling menyusui di Kota Jambi dengan mengeksplorasi komponen input, activity, output, dan outcome. Penelitian ini merupakan penelitian kualitatif menggunakan strategi studi kasus. Penelitian dilakukan di empat puskesmas Kota Jambi pada bulan Desember 2013 sampai dengan Februari 2014. Pengumpulan data dilakukan dengan studi dokumen, observasi pelaksanaan konseling menyusui dan sarana prasarana, wawancara mendalam, serta focus group discussion. Analisis data yang digunakan adalah analisis tematik. Hasil penelitian menunjukkan bahwa komponen input dan activity kurang optimal seperti kurangnya sumber daya manusia, keterbatasan sarana prasarana, belum ada petunjuk teknis pelaksanaan konseling menyusui, belum ada pemantauan pascapelatihan, kurangnya komitmen personal konselor, belum ada penegasan program, serta lemahnya pengawasan. Komponen output masih kurang baik, terlihat pada belum terdapat data jumlah klien yang diberi konseling menyusui dan jumlah monitoring/supervisi. Komponen outcome menunjukkan bahwa kepuasan klien konseling menyusui kurang. Pelaksanaan konseling menyusui di Kota Jambi masih kurang optimal. Terlihat dari komponen input masih kurang memadai, komponen activity belum berjalan optimal, sedangkan komponen output dan komponen outcome belum mencapai hasil yang diharapkan. The government’s efforts in improving breastfeeding in Indonesia is to provide breastfeeding counseling services in health care especially at primary health care centre. Therefore it is necessary to evaluate the implementation of breastfeeding counseling in the City of Jambi by exploring its input, activity, output, and outcomes components. This study was a qualitative research using case study strategy. The study was conducted in four health centers City of Jambi during December 2013 to February 2014. Data were collected through document study, breastfeeding counseling and execution infrastructure observation, in-depth interviews, and focus group discussion. Data analysis includes transcription, reduction, coding, categorizing, themes, and interpretation of research results. The results showed that the component inputs and activity were not done optimally due to a lack of human resources, infrastructure limitations, unavailability of technical guidelines, non-existence of post training monitoring or supervision, lack of counselor’s personal commitment, lack of program clarity, as well as poor management and supervision of the health department. Aservice output were not also good as indicated by data unavailability of clients served and none of monitoring has been conducted. Outcome component showed that there were still a lack of client satisfaction and resolved breastfeeding problems after acquiring breastfeeding counseling as an conclusion, implementation of breastfeeding counseling in the City of Jambi is still less than optimal, seen from the input components is still inadequate, activity components are not yet optimal, while the outputs and outcomes components not achieving the expected.
Asupan Vitamin D Rendah dan Keparahan Demam Berdarah Dengue pada Anak Usia 1-14 Tahun Siyam, Nur; Wilopo, Siswanto Agus; Hakimi, Mohammad
Kesmas Vol. 9, No. 1
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Abstract

Demam berdarah dengue (DBD) menimbulkan syok dan kematian. Penderita DBD di Yogyakarta sebagian besar usia 1 - 12 tahun dengan DBD parah. Asupan vitamin D rendah diasumsikan penyebab DBD parah. Asumsi ini perlu dibuktikan dengan menganalisis pengaruh asupan Vitamin D dan keparahan DBD. Rancangan penelitian adalah studi kasus kontrol. Penelitian di bangsal rawat inap anak dan instalasi catatan medik RS Jogja dan RSUP Dr. Sardjito. Kasus adalah anak usia 1 - 14 tahun dengan DBD grade III & IV, kontrolnya DBD grade I & II. Data asupan vitamin D diambil dengan food frequency questionnaire (FFQ). Variabel luar adalah indeks massa tubuh (IMT), usia, status penyakit kronis dan intensitas terpapar matahari pagi. Analisis dengan uji-t dan regresi logistik. Hasil penelitian didapatkan 60 kasus dan 60 kontrol tanpa matching. Cut-off point asupan vitamin D berdasarkan ROC curve adalah 2,7 µg/hari. Penderita DBD parah rata-rata asupan vitamin D 1,10 kali lebih sedikit dibandingkan DBD tidak parah. Rata-rata asupan vitamin D lebih rendah 1 µg/day bersama IMT ≥18,75 kg/m2, penyakit kronis, dan kurang terpapar matahari pagi berpengaruh pada DBD parah (OR=0,47; 95% CI: 0,32-0,71). Cukup Asupan vitamin D disarankan untuk menghindari keparahan DBD. Penyakit kronis dan berat badan lebih perlu menjadi perhatian tenaga medis sebagai kewaspadaan dini terjadinya shock. Dengue hemorrhagic fever (DHF) lead to shock and death. Patient in Yogyakarta mostly aged 1 - 12 years old with severe dengue. A low vitamin D intake is assumed to be the cause of severe dengue. This assumption needs to be proved by analyzing the effect of vitamin D intake and severity of DHF. Study design was a case control study. Research on children’s wards and medical record installation in hospital. Cases were children with DHF grade III and IV, the control of DHF grade I & II. Data vitamin D intake was obtained by FFQ. Outer variables: BMI, age, chronic diseases and intensity morning sun exposure. Analysis by t-test and logistic regression. The results showed 60 cases and 60 controls without matching. Cut-off point vitamin D intake based ROC curve was 2.7 µg/day. Patients with severe dengue average vitamin D intake of 1.10 times less than not severe dengue. The average vitamin D intake lower 1 µg/day with a BMI ³ 18.75 kg/m2, chronic disease, and less exposed to the morning sun effect on severe dengue (OR = 0.47, 95% CI: 0.32 to 0.71). Sufficient vitamin D intake is recommended to avoid the dengue severity. Chronic diseases and more weight should be a concern of medical personnel as early warning shock occurrence.
Optimalisasi Sistem Pelayanan Kesehatan Berjenjang pada Program Kartu Jakarta Sehat Idris, Fachmi
Kesmas Vol. 9, No. 1
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Peningkatan jumlah kunjungan pasien ke rumah sakit pada awal masa pemberlakuan program Kartu Jakarta Sehat (KJS) disebabkan belum optimalnya sistem pelayanan kesehatan berjenjang. PT Asuransi Kesehatan (PT Askes) bersama Dinas Kesehatan DKI Jakarta melakukan berbagai upaya dalam bentuk paket intervensi untuk mengoptimalkan sistem tersebut. Penelitian ini bertujuan untuk mengevaluasi efektivitas paket intervensi PT Askes dan Dinas Kesehatan DKI Jakarta dalam meningkatkan optimilisasi sistem rujukan pelayanan kesehatan. Penelitian ini menggunakan survei potong lintang dengan metode pengambilan sampel acak pada puskesmas di DKI Jakarta terhadap hasil intervensi PT Askes. Hasil intervensi diukur melalui wawancara pada kepala puskesmas atau petugas yang mewakili. Data dianalisis menggunakan tes statistik nonparametrik, yaitu uji Wilcoxon dan regresi Generalized Linear Model. Penelitian dilakukan pada bulan Oktober 2013 hingga Februari 2014. Terdapat perbedaan bermakna pada keempat indikator, terjadinya peningkatan kunjungan peserta KJS dipengaruhi oleh ketersediaan tempat tidur, jumlah peserta KJS terdaftar, intervensi dalam bentuk regulasi, serta persentase pengangguran terbuka. Meskipun ada perbedaan signifikan setelah dikelola PT Askes, hal ini belum cukup membentuk persepsi puskesmas untuk berpendapat bahwa PT Askes memiliki andil dalam mengoptimalkan sistem pelayanan kesehatan berjenjang pada program KJS. Increasing the number of patient visits to the hospital at the beginning of the implementation Healthy Jakarta Card (KJS) program was claimed to be associated with optimization of health care referral system. PT Asuransi Kesehatan (PT Askes) with the DKI Jakarta Department of Health Service made efforts to improve the optimalization that system. This study aimed to evaluate the effectiveness of intervention PT Askes’s and DKI Jakarta Departement Of Health’s packages in improving the optimization of health care referral system. This study used a cross sectional survey with a random sampling method in primary health centers in Jakarta related with the result of PT Askes’s intervention package. The result of intervention were conducted by interview to the head of the primary health center or officer representing. Data were analyzed with nonparametric statistical tests, using the Wilcoxon test and Generalized Linear Regression Model. The study was conducted in October 2013 until February 2014. There were significant differences between the four indicators, an increase in visits KJS participants are influenced by the availability of beds, number of participants registered KJS, intervention in the regulation, and the percentage of open unemployment. Although there were significant differences after managed by PT Askes, these efforts were not enough to make primary health centers perception that PT Askes has contributed to the optimization of health care referral system in KJS program.

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