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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 14 Documents
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Efek Samping Obat terhadap Kepatuhan Pengobatan Antiretroviral Orang dengan HIV/AIDS Latif, Fachri; Maria, Ida Leida; Syafar, Muhammad
Kesmas Vol. 9, No. 2
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Tingkat kepatuhan pengobatan antiretroviral di Indonesia sangat rendah, yaitu 40 - 70%, yang masih di bawah target nasional dengan tingkat kepatuhan 95%. Berbeda dengan rata-rata nasional, Puskesmas Jumpandang Baru justru memiliki tingkat kepatuhan pengobatan antiretroviral pasien HIV/AIDS di atas 95%. Penelitian ini bertujuan untuk menganalisis faktor yang paling berpengaruh terhadap kepatuhan pengobatan antiretroviral orang dengan HIV/AIDS (ODHA). Jenis penelitian bersifat observasional analitik dengan pendekatan potong lintang. Populasi penelitian adalah 121 ODHA yang aktif menjalani pengobatan antiretroviral di Puskesmas Jumpandang Baru yang dipilih dengan menggunakan teknik exhaustive sampling. Sampel dalam penelitian ini adalah 121 sampel. Penelitian dilakukan pada 22 April hingga 28 Juni 2014 di klinik Voluntary Counseling and Test Puskesmas Jumpandang Baru Makassar. Analisis data menggunakan uji kai kuadrat dan regresi logistik. Hasil uji kai kuadrat menunjukkan ada hubungan antara pengetahuan, persepsi, riwayat efek samping obat, dukungan keluarga dan teman, serta interaksi antara pasien dengan petugas layanan antiretroviral terhadap kepatuhan pengobatan antiretroviral ODHA. Analisis regresi logistik menunjukan bahwa pengetahuan yang baik, persepsi positif terhadap pengobatan, serta efek samping obat yang tidak dirasakan adalah faktor yang berhubungan dengan kepatuhan pengobatan antiretroviral. Penelitian ini menunjukkan ODHA yang tidak merasakan efek samping obat memiliki kecenderungan terbesar untuk patuh terhadap pengobatan antiretroviral dengan OR sebesar 13,452. The rate of adherence to antiretroviral treatment in Indonesia is very low, at 40 - 70%, which is still below our national target (95%). Different phenomena happens at Jumpandang Baru Primary Health Care, whose level of antiretroviral treatment adherence above 95%. This study aimed to analyze factors that influence the adherence to antiretroviral treatment of people li- Efek Samping Obat terhadap Kepatuhan Pengobatan Antiretroviral Orang dengan HIV/AIDS Drug Side Effects on Adherence to Antiretroviral Treatment among People Living with HIV/AIDS Fachri Latif, Ida Leida Maria, Muhammad Syafar ving with HIV/AIDS (PLWH). This study used observational analytic with cross-sectional approach. The population, 121 PLWH are people who actively undergoing antiretroviral treatment in Jumpandang Baru Primary Health Care. By exhaustive sampling technique, the sample size of the study was counted 121 people. The research was conducted on April 22 until June 28 2014 at Voluntary Counseling and Test Clinic of Jumpandang Baru Primary Health Care, Makassar. Data was analyzed using chi square and logistic regression test. Chi square test showed the relationship between knowledge, perception, drug side effects, family and friends support, and well interaction between PLWH with antiretroviral providers to antiretroviral treatment adherence among PLWH. The logistic regression analysis indicated that high level of knowledge, positive perceived to treatment, and no drug’s side effects were the related factors influenced antiretroviral adherence. This result showed that PLWH who do not feel the drug side effects has the greatest propensity to adherence to antiretroviral treatment with an OR of 13.452.
Pengaruh Rejimen terhadap Ketidakpatuhan Berobat Tuberkulosis Fadila, Rizka Nur; Riono, Pandu
Kesmas Vol. 9, No. 2
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Beban tuberkulosis di Indonesia termasuk lima tertinggi di dunia. Temuan kasus dan pengobatan adalah pilar utama program penanggulangan tuberkulosis. Survei nasional menunjukkan peningkatan penggunaan rejimen tidak standar dari 16,8% (2010) menjadi 55,6% (2013). Peningkatan penggunaan rejimen tidak standar diduga berpengaruh terhadap ketidakpatuhan berobat. Penelitian ini bertujuan untuk mempelajari ketidakpatuhan berobat pada orang dengan tuberkulosis yang menerima rejimen tidak standar dan rejimen standar. Penelitian menggunakan data sekunder Riset Kesehatan Dasar 2010. Analisis logistik multivariabel dilakukan pada sampel 971 orang dengan tuberkulosis yang selesai mendapatkan pengobatan. Hasil penelitian menunjukkan ada kecenderungan orang dengan tuberkulosis yang menerima rejimen tidak standar memiliki ketidakpatuhan berobat lebih tinggi. Hasil penelitian juga menunjukkan odds untuk tidak menyelesaikan pengobatan lebih tinggi pada orang yang menerima rejimen tidak standar dibandingkan orang yang menerima rejimen standar, yaitu odds ratio terkontrol 2,4 (95% CI odds ratio: 1,7-3,5). Dalam upaya menjamin kepatuhan berobat tuberkulosis, mutu program pengobatan perlu ditingkatkan; di antaranya adalah ketersediaan rejimen standar, penyetaraan standar pengobatan antara fasilitas pelayanan kesehatan swasta dan publik, serta sistem pemantauan minum obat. Indonesia is one of five highest tuberculosis burden countries. Case finding and treatment are the main pillars of tuberculosis control program. National survey reported that the usage of nonstandarized regimen is increased from 16,8% (2010) to 55,6% (2013). Increase use of nonstandarized regimen is associated with poor adherence tuberculosis treatment. This study purposed to compare the poor adherence of tuberculosis treatment among people who received standarized regimen and people who received nonstandarized regimen. The study used secondary data of National Health Survey 2010. Analysis used multivariable logistic through 971 people who completed tuberculosis treatment. This study found that people who received nonstandarized regimen had higher poor adherence of tuberculosis treatment than people who received standarized regimen. The result also showed that the odds of not to complete the treatment was higher in people who received nonstandarized regimen than who received standarized regimen, adjusted OR was 2,4 (95% CI OR: 1,7-3,5). To assure the adherence to tuberculosis treatment is to strengthen tuberculosis treatment program; such as the availability of standarized regimen, the equality of standard tuberculosis treatment among public and private health services, and the system of observed treatment.
Prevalensi Sindrom Metabolik pada Pekerja Perusahaan Zahtamal, Zahtamal; Prabandari, Yayi Suryo; Setyawati, Lientje
Kesmas Vol. 9, No. 2
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Sindrom metabolik adalah masalah kesehatan yang prevalensinya cenderung meningkat pada pekerja. Penelitian ini bertujuan memaparkan prevalensi kasus sindrom metabolik yang terjadi pada pekerja perusahaan. Penelitian ini dilakukan pada tahun 2014 pada dua perusahaan di Provinsi Riau dengan rancangan potong lintang. Sumber data adalah rekam medis pekerja yang melakukan medical check up periode Oktober 2013 hingga Februari 2014. Populasi adalah pekerja yang menderita sindrom metabolik sebanyak 131 orang. Sampel penelitian dipilih dengan cara total sampling yakni 131 orang. Instrumen adalah kuesioner, international physical activity questionnaire, tabel 24 hours food recall, dan tabel bantu pencatatan komponen sindrom metabolik. Pengelolaan data dilakukan secara kuantitatif menggunakan analisis univariat dan bivariat, dengan uji korelasi Spearman’s Rho dan kai kuadrat. Hasil penelitian mendapatkan prevalensi sindrom metabolik sebanyak 21,58%, dengan jenis kelamin terbanyak adalah laki-laki, kelompok usia terbanyak adalah > 50 tahun. Sebagian besar kasus sindrom metabolik memiliki tiga komponen, dengan komponen terbanyak adalah lingkar perut dan tekanan darah. Sebanyak 23,50% kasus memiliki riwayat keluarga obesitas dan diabetes melitus. Sebagian besar kategori aktivitas adalah sedang. Jenis asupan makanan dengan kategori tidak sesuai dengan diet adalah serat pangan dan lemak jenuh. Variabel lingkar perut berhubungan bermakna secara statistik dengan tekanan darah sistolik dan diastolik serta kadar kolesterol high density lipoprotein (p < 0,05). Metabolic syndrome is a health problem that often occurs among workers. The objective of this research was to reveal prevalence of metabolic syndrome in company workers. This research was conducted in 2014 at two Prevalensi Sindrom Metabolik pada Pekerja Perusahaan The Prevalence of Metabolic Syndrome among Company Workers Zahtamal*, Wasilah Rochmah**, Yayi Suryo Prabandari***, Lientje K. Setyawati**** companies in Riau Province with cross sectional design. Data source is the medical records of workers who have been doing medical check up between October 2013 through February 2014. The population is 131 workers who suffer from metabolic syndrome. The study sample is 131 workers, counted by total sampling. The instruments are self-reported questionnaire, international physical activity questionnaire, 24 hours food recall form and recording auxiliary table for components of of metabolic syndrome. Quantitative data management conducted with descriptive analysis and bivariate analysis, by Spearman’s Rho correlation test and chi square. Prevalence of metabolic syndrome is 21.58%, with the highest gender is male, and the largest age group is > 50 years. Most cases of metabolic syndrome has three components, with the largest component is the abdominal circumference and blood pressure. A total of 23.50% of cases have a family history of obesity and diabetes mellitus. Most categories of activity is moderate. Most types of food intake in the category “out of dietary guidelines” are dietary fiber and saturated fat. Abdominal circumference variable has a statistically significant relationship with systolic and diastolic blood pressure and high density lipoprotein (p <0.05).
Perubahan Pola Konsumsi Pangan Sumber Zat Goitrogenik Sianida dan Cara Pengolahannya Melalui Penyuluhan Gizi Ningtyias, Farida Wahyu; Asdie, Ahmad Husain; Julia, Madarina; Prabandari, Yayi Suryo
Kesmas Vol. 9, No. 2
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Kabupaten Jember masih menghadapi masalah gizi gangguan akibat kekurangan iodium (GAKI), sebagian besar kecamatannya termasuk dalam kategori daerah endemik GAKI. Salah satu penyebabnya adalah faktor goitrogenik sianida yang mengganggu pembentukan hormon tiroid. Keberadaannya pada beberapa sayuran yang biasa dikonsumsi masyarakat menyebabkan diperlukannya pola konsumsi dan proses pengolahan yang baik agar aman dikonsumsi. Penelitian ini bertujuan mengubah pola konsumsi goitrogenik sianida dan cara pengolahannya melalui penyuluhan gizi dan demonstrasi cara pengolahan pangan sumber goitrogenik sianida yang benar. Penelitian ini adalah sebuah penelitian kuasi eksperimental dengan rancangan pretest-posttest control design. Jumlah sampel sebanyak 196 ibu rumah tangga, terdiri dari 98 orang di setiap kelompok perlakuan dan kontrol. Penelitian dilakukan di Kecamatan Arjasa Kabupaten Jember pada bulan Maret hingga Mei 2013. Hasil penelitian menunjukkan adanya peningkatan konsumsi bahan mentah sumber goitrogenik sebesar 25,98 gram. Namun, tidak terjadi peningkatan konsumsi sianida, justru menurun sebesar 9,09 miligram pada kelompok perlakuan. Hal ini terjadi karena pemilihan cara pengolahan yang tepat sesuai materi intervensi, yaitu beralih ke kulub dan rebus berkuah. Namun penurunan ini tidak signifikan (p = 0,56). Materi tentang GAKI dan cara mereduksi kadar sianida pada bahan pangan sumber goitrogenik sianida bisa dijadikan materi penyuluhan dalam program pencegahan GAKI di Kabupaten Jember. Jember still encounter the problem of nutrition iodine deficiency disorders (IDD), most of the district are included in the category of endemic areas. One reason is the cyanide goitrogenic factors that can interfere with the function of the thyroid hormone. Its presence in some commonly consumed vegetables society, causes the need for patterns of consumption and good processing in order to make it safe for consumption. Cyanide is a precursor thiocyanate which disrupt the formation of thyroid hormones through two pathways, active transport and interfere with the activity of thyroid peroxidase. This study aimed to change food pattern and way of processing goitrogenic cyanide food stuff through nutritional counseling and demonstration of food processing to reduce cyanide in goitrogenic food stuff. The research was a quasy-experimental study with pretest-posttest control design. The number of samples 196 housewives, consist of 98 people in the respective treatment groups and control. The study was conducted in the District Arjasa Jember between March and May 2013. The result showed presence of increased consumption of raw materials sources goitrogenic cyanide of 25.98 grams, was not followed by an increase in the consumption of cyanide, which has decreased by 9.09 miligram in the treatment group. This occurs because of the selection of appropriate food processing, switching to boil and blanching (kulub). However, this decrease was not significant (p = 0.56). The material on IDD and how to reduce levels of cyanide in the food source of cyanide can be used as material counseling in prevention programs IDD in Jember.
Upaya Peningkatan Status Gizi Balita Malnutrisi Akut Berat Melalui Program Home Care Huriah, Titih; Trisnantoro, Laksono; Haryanti, Fitri; Julia, Madarina
Kesmas Vol. 9, No. 2
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Malnutrisi pada balita masih merupakan permasalahan di Indonesia termasuk di Daerah Istimewa Yogyakarta. Berdasarkan indikator berat badan menurut tinggi badan, 2,6% balita mengalami malnutrisi akut berat. Pada beberapa dekade terakhir, telah terjadi pergeseran paradigma dalam penanganan balita malnutrisi, yang sebelumnya berbasis pendekatan fasilitas kesehatan bergeser menjadi pendekatan berbasis komunitas. Tujuan penelitian ini adalah untuk menganalisis pengaruh program home care terhadap peningkatan status gizi balita malnutrisi pada anak usia 6-60 bulan. Penelitian menggunakan desain kuasi eksperimen dengan pretest dan posttest control group melalui tiga tahap pendampingan yaitu intensif, mandiri, dan penguatan dengan pendekatan asuhan keperawatan. Sampel adalah 56 balita malnutrisi akut di dua wilayah, yaitu 33 balita di Kota Yogyakarta (eksperimen) dan 23 balita di Kabupaten Sleman (kontrol) dengan teknik pengambilan sampel yaitu purposive sampling. Intervensi home care diberikan selama tiga 3 bulan (Januari sampai Maret 2013). Hasil penelitian menunjukkan setelah program home care, terjadi peningkatan yang signifikan pada status gizi balita (p < 0,05). Pada akhir intervensi, terjadi penurunan kejadian malnutrisi akut berat dari 100% menjadi 56,7% (p < 0,05). Children undernutrition is still an issue in Indonesia, including in the Special Region of Yogyakarta. Based on weight for height indicator, 2.6% children experience severe acute malnutrition. In the last few decades, there has been a paradigm shift in the management of acute malnutrition from a facility- based to community-centered approach. The purpose of this study was to analyze the effect of home care intervention on the improvement of nutritional status of severe acute malnutrition children aged 6-60 months. This study was designed with quasi-experimental and pretest-posttest control group design, conducted in three phases; intensive, strengthening and independent with nursing approach (January until March 2013). Samples were 56 children with severe and moderate acute malnutrition for both study sites, 33 children in Yogyakarta city (experiment) and 23 children in Sleman district (control), selected using purposive sampling. Home care intervention is given for three months (January until March 2014). Results findings show there were significant increase in nutritional status (p < 0.05) after home care intervention. At end line evaluation, the proportion of severe acute malnutrition in the experimental groups reduced significantly from 100% to 56,7% (p < 0.05).
Annual Parasite Incidence Malaria di Kabupaten Banyumas Rejeki, Dwi Sarwani Sri; Sari, Ruthi Armita; Nurhayati, Nunung
Kesmas Vol. 9, No. 2
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Kabupaten Banyumas merupakan kabupaten endemis malaria di Provinsi Jawa Tengah. Data Dinas Kesehatan Kabupaten Banyumas tahun 2008 - 2013 menunjukkan angka annual paracite incidence (API) yang selalu mengalami fluktuasi. Dari 27 kecamatan, 22 di antaranya termasuk dalam kategori medium case incidence (MCI) dan low case incidence (LCI). Faktor lingkungan, perilaku, sosial ekonomi, dan iklim berdampak pada tinggi rendahnya kejadian malaria. Tujuan penelitian adalah mengetahui faktor yang berhubungan dengan API di Kabupaten Banyumas. Data dikumpulkan dari Januari 2011 - Desember 2013 menggunakan penelitian analitik dengan rancangan penelitian potong lintang dan menggunakan data sekunder dari Dinas Kesehatan, Dinas Pertanian, dan Badan Pusat Statistik Kabupaten Banyumas. Populasi adalah seluruh kecamatan di Kabupaten Banyumas dan sampel diambil menggunakan teknik total sampling, sebanyak 27 kecamatan dengan pengamatan selama 3 tahun menjadi 81 sampel. Hasil penelitian menunjukkan 44,4% pengamatan termasuk kategori LCI dan MCI, 48,1% termasuk kategori curah hujan tinggi, 49,4% termasuk kategori wilayah yang luas, 49,4% termasuk kategori jumlah pendatang tinggi, 48,1% termasuk kategori kepadatan penduduk sedang. Sementara itu, dari 27 kecamatan, yang termasuk ketinggian rendah adalah 63,0%. Faktor yang terbukti berhubungan dengan API adalah luas wilayah, jumlah pendatang, kepadatan penduduk, sedangkan yang tidak berhubungan adalah curah hujan dan ketinggian. Banyumas is malaria endemic district in Central Java. Banyumas Health Office data of 2008 - 2013 showed that, the Annual Parasite Incidence (API) always fluctuated. From 27 subdistricts in Banyumas, there are 22 subdistricts which fall into the category of middle case incidence (MCI) and low case incidence (LCI). Malaria is a disease that closely associated with the enviroment, behaviour, social economy, and climate. The purpose of this study was to determine factors associated with API in Banyumas. Data were collected from Januari 2011 - Desember 2011 using an analytic crosssectional design using secondary data from Banyumas Health Office, Agriculture Office and Statistic Center. The population in this study were all subdistricts in Banyumas and samples were taken using total sampling technique. The sample of this study was 27 districts. The results showed that from 81 samples we obtained 44.4% of observations included in LCI and MCI category, 48.1% with high rainfall, 49.4% with large areas, 49.4% with high number of entrants, 48.1% with medium population density. Meanwhile, from 27 districts, 63.0% included in low altitude category. Factors associated with API in Banyumas were the extensive areas, the number of entrants, and population density. The factors that are not associated to the API were the rainfall and altitude regions.
Riwayat Pemberian Air Susu Ibu dengan Penyakit Infeksi pada Balita Nur, Abidah; Marissa, Nelly
Kesmas Vol. 9, No. 2
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Riset Kesehatan Dasar tahun 2013 menyebutkan angka insiden diare pada balita di Indonesia sebesar 6,7%. Aceh merupakan provinsi dengan insiden diare tertinggi, mencapai 10,2%. Profil Kesehatan Aceh menunjukkan bahwa secara umum terjadi peningkatan penyakit infeksi seperti influenza, tuberkulosis, dan diare dalam kurun waktu tujuh tahun (2006 - 2012). Penyakit tersebut dapat dicegah dengan pemberian ASI yang berperan dalam peningkatan kekebalan tubuh. Penelitian ini dilakukan untuk mengetahui hubungan riwayat pemberian ASI dengan penyakit infeksi pada balita. Penelitian ini menggunakan data sekunder dari Badan Pusat Statistik Provinsi Aceh, yaitu data Survei Sosial dan Ekonomi Nasional tahun 2012 dengan jumlah sampel 3.486 balita. Data penelitian dianalisis menggunakan uji regresi logistik. Hasil penelitian menunjukkan secara umum ada hubungan yang signifikan antara riwayat pemberian ASI dengan penyakit infeksi. Terdapat hubungan yang signifikan antara lama pemberian ASI, ASI eksklusif, dan pemberian makanan pendamping ASI dengan penyakit infeksi pada balita di Provinsi Aceh. Basic Health Research in 2013 mentions the incidence of diarrhea in toddlers in Indonesia amounted to 6.7%. Aceh Province has the highest incidence of diarrhea reached 10.2%. Aceh’s Health Profile indicates that in general there is an increase in infectious diseases such as influenza, tuberculosis, and diarrhea within a period of seven years (2006 - 2012). The disease can be prevented by breastfeeding to increase immune system. This study used secondary data from the Central Statistics Agency of Aceh Province, The National Socio-Economic Survey 2012 using 3,486 toddlers as samples. Data were analyzed using logistic regression. Results showed in general no significant relationship between a history of breastfeeding with infectious diseases. There is a significant relationship between duration of breastfeeding, exclusive breastfeeding, and complementary feeding with infectious disease in toddlers in the Aceh province.
Analisis Risiko Karakteristik, Sosial Ekonomi, Perilaku dan Kondisi Lingkungan Rumah terhadap Kejadian Malaria Sukiswo, Susy Sriwahyuni; Rinidar, Rinidar; Sugito, Sugito
Kesmas Vol. 9, No. 2
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Malaria merupakan penyakit menular yang menjadi perhatian global. Kecamatan Arongan Lambalek merupakan daerah rawan malaria di Kabupaten Aceh Barat dengan kategori Medium Incidence Area dengan nilai Annual Parasite Incidence (API) 3,67 per 1000 penduduk masih di atas target API Nasional pada fase eliminasi API kurang dari 1 per 1000 penduduk tahun 2013. Penelitian ini bertujuan menganalisis karakteristik, sosial ekonomi, perilaku, dan kondisi lingkungan rumah yang berpengaruh terhadap kejadian malaria di Kecamatan Arongan Lambalek, Kabupaten Aceh Barat. Jenis penelitian ini adalah observasional analitik dengan pendekatan kasus kontrol dengan metode penarikan sampel yaitu purposive sampling. Jumlah sampel dalam penelitian ini terdiri 33 kasus dan 33 kontrol, kelompok kasus adalah orang yang dinyatakan positif malaria sedangkan kelompok kontrol orang yang dinyatakan negatif berdasarkan pemeriksaan mikroskopis/rapid diagnostic test tahun 2014. Analisis statistik yang digunakan analisis univariat, bivariat (kai kuadrat), dan multivariat (regresi logistik). Hasil analisis bivariat diketahui ada lima variabel yang berpengaruh, yaitu pekerjaan (p = 0,000, OR = 0,05), pengetahuan (p = 0,000; OR = 17,5), sikap (p = 0,001; OR = 7,43), tindakan (p = 0,000; OR = 9,8), dan lingkungan (p = 0,000; OR = 9,0). Berdasarkan hasil analisis multivariat, pengetahuan adalah determinan yang paling berpengaruh (p = 0,006; OR = 12,783, CI 95% = 2,045–79,893). Penyuluhan yang intensif mengenai malaria perlu dilakukan untuk lebih menambah pengetahuan dan informasi masyarakat. Malaria is an infectious disease of global concern. The Subdistrict of Arongan Lambalek in West Aceh which belongs to the Medium Incidence Area category was a malaria endemic area with Annual Parasite Incidence (API) 3,67 at 1000 population in 2013. The API was higher than national API on elimination phage less than 1 at 1000 population. The objective of this research was to analyze the characteristic, socioeconomic, behavioral, home environment conditions to determine of malaria incidence in Arongan Lambalek Subdistrict, of West Aceh District. This research was analytic observational case control approach with purposive sampling method. The number of samples in this study comprised 33 cases and 33 controls, the cases are people who tested positive for malaria, while the control group of people who tested negative by examination microscopic/rapid diagnostic test in 2014. The statistical analysis used univariate, bivariate (chi-square), and multivariate (logistic regression). The results of the bivariate analysis are five variables known to affect malaria, they are job (p = 0.000, OR = 0.05), knowledge (p = 0.000; OR = 17.5), attitude (p = 0.001; OR = 7.43 ), action (p = 0.000; OR = 9.8), and the environment (p = 0.000; OR = 9.0). Based on the results of the multivariate analysis (logistic regression) knowledge is the most dominan determinan (p = 0.006; OR = 12.783, 95% CI = 2.045 to 79.893). Intensive counseling regarding malaria is needed, to make people know more knowledge and information about malaria.
Perbedaan Pendidikan Kelompok Sebaya tentang Pendewasaan Usia Perkawinan di Perkotaan dan Perdesaan Follona, Willa; Raksanagara, Ardini S.; Purwara, Benny Hasan
Kesmas Vol. 9, No. 2
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Remaja berisiko terhadap pernikahan usia dini namun informasi tentang pendewasaan usia perkawinan masih kurang. Pendidikan kelompok sebaya merupakan metode pendidikan kesehatan yang sesuai untuk remaja, namun belum terlaksana di lingkungan masyarakat baik perkotaan maupun perdesaan. Selain itu, belum terfokus pada pendewasaan usia perkawinan, sehingga perlu diketahui perbedaan pengetahuan dan sikap tentang pendewasaan usia perkawinan setelah pendidikan kelompok sebaya pada remaja di perkotaan dan perdesaan. Tujuan penelitian ini adalah untuk menganalisis perbedaan pendidikan kelompok sebaya tentang pengetahuan dan sikap mengenai pendewasaan usia perkawinan antara remaja di wilayah perkotaan dan perdesaan. Penelitian ini merupakan eksperimen semu dengan desain pretest-posttest pada 60 remaja yang dipilih secara acak sederhana di Desa Cileungsi (perkotaan) dan Desa Mampir (perdesaan) Kecamatan Cileungsi pada bulan Maret 2014. Hasil penelitian menunjukkan bahwa pendidikan kelompok sebaya dapat meningkatkan pengetahuan dan sikap remaja perkotaan serta perdesaan dengan p < 0,001. Namun tidak terdapat perbedaan bermakna pada peningkatan pengetahuan maupun sikap dengan p > 0,05. Pendidikan kelompok sebaya dapat dilaksanakan di berbagai wilayah sehingga diperlukan dukungan berbagai pihak untuk pelatihan pendidik sebaya bagi remaja dan pengembangan di lingkungan masyarakat. Adolescents are at risk of having early marriage, but they still lack of information about maturation age of marriage. Peer education is a suitable method to provide adolescents with health education. However, health education given to adolescents both in urban society and rural society has never used this method, and has not been focused on maturation age of marriage. Therefore, it is necessary to find out the difference between knowledge and attitude of urban adolescents and those of rural adolescents about maturation age of marriage after peer education method is used. This study was aimed to analyze the difference impacts of peer education on maturation age of marriage among urban and rural adolescents. This is a quasi experimental study using pre-test and post-test design on 60 adolescents who are selected using a simple random sampling, from Cileungsi Village (urban area) and Mampir Village (rural area) in Cileungsi Sub-district in March 2014. The results show that peer education is able to improve the knowledge and attitude about maturation age of marriage of adolescents with p < 0.001. However, it does not show any significant difference with p > 0.05 in both knowledge and attitude. Peer education can be implemented in all regions. Therefore, supports from all stakeholders is necessary to make some training for trainers in peer education for teenagers and its development in society.
Mutu Pelayanan Puskesmas Perawatan yang Berstatus Badan Layanan Umum Daerah Indrayathi, Putu Ayu; Listyowati, Rina; Nopiyani, Ni Made Sri; Ulandari, Luh Putu Sinthya
Kesmas Vol. 9, No. 2
Publisher : UI Scholars Hub

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Abstract

Kebijakan pusat pelayanan kesehatan masyarakat (puskesmas) sebagai Badan Layanan Umum Daerah (BLUD) diimplentasikan untuk meningkatkan kualitas pelayanan kesehatan dasar. Kebijakan BLUD puskesmas telah diterapkan di Kabupaten Gianyar sejak tahun 2010 dan berlaku pada puskesmas perawatan maupun nonperawatan. Pelaksanaan BLUD puskesmas tidak selalu meningkatkan mutu layanan. Penelitian ini bertujuan mengetahui gambaran mutu pelayanan puskesmas perawatan yang berstatus BLUD di Kabupaten Gianyar. Penelitian ini merupakan penelitian potong lintang dengan pendekatan kuantitatif dan kualitatif. Tempat dan waktu penelitian ini dilakukan di Kabupaten Gianyar, Agustus hingga Desember 2013. Data kuantitatif dikumpulkan melalui penyebaran kuesioner kepada 105 pengguna layanan di empat puskesmas yang dipilih dengan cara multistage random sampling. Data kualitatif dikumpulkan melalui wawancara mendalam kepada 13 penyedia pelayanan kesehatan yang dipilih secara purposive sampling. Data kuantitatif dianalisis secara deskriptif dan data kualitatif dianalisis dengan analisis tematik. Dari hasil penelitian, pelayanan di puskesmas perawatan berstatus BLUD di Gianyar dinilai kurang memuaskan karena keterbatasan peralatan medis dan kurangnya tenaga yang kompeten dalam pengelolaan keuangan. Pelatihan pengelolaan keuangan pada staf puskesmas dan perekrutan tenaga berlatar belakang akuntansi penting untuk dilakukan. The policy of primary health care as local public service agencies (BLUD) was established to improve the quality of basic health care services. The public service agencies primary health care policy has been implemented to all primary health care in Gianyar district since 2010. The implementation does not always improving health service quality. This research was aimed to overview the quality of services in primary health care with general services agency status in Gianyar district. This research was a crosssectional study with mixed of quantitative and qualitative approaches.This research was conducted in Gianyar between August and December 2013. The quantitative data was collected through questionaire survey to 105 patients in four primary health care who were chosen with multistage random sampling technique. The qualitative data was collected through in-depth interviews to 13 health care providers in primary health care who were chosen with pusposive sampling. The quantitative data was analysed descriptively and the qualitative data was analysed using thematic analysis. The result of the study was primary health care quality in BLUD puskesmas with inpatient services was perceived as poor due to the limited availability of medical equipment and lack of staff who major in financial management. Training on financial management and recruitment of staff with accounting background should be conducted.

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