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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 928 Documents
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Analisis Politik dan Kebijakan Pembiayaan Rumah Sakit Pemerintah DKI Jakarta Olivia, Sandra; Ayuningtyas, Dumilah
Kesmas Vol. 5, No. 3
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Telah diyakini bahwa untuk mencapai visi Indonesia Sehat 2010 pembiayaan rumah sakit merupakan salah satu faktor penting yang mempengaruhi kualitas kesehatan masyarakat. Namun, menurut indikator Indeks Pembangunan Manusia, Indonesia masih menempati posisi ke-110 dari 117 negara di dunia. Penelitian ini telah dilaksanakan untuk memahami politik dan kebijakan pembiayaan pengelolaan rumah sakit pemerintah DKI Jakarta. Dua rumah sakit milik Pemerintah DKI Jakarta, yaitu Rumah Sakit Pasar Rebo dan Rumah Sakit Duren Sawit dipilih sebagai sampel. Studi ini merupakan penelitian kualitatif dimana pengambilan data primer dilakukan dengan cara wawancara mendalam. Pada kedua rumah sakit ini dikumpulkan data mengenai peraturan dan regulasi serta keuangan rumah sakit selama tahun 2004-2008. Hasil analisis aktor, konten, konteks, dan proses menunjukkan bahwa kebijakan pembiayaan rumah sakit terdiri dari penentuan tarif, subsidi anggaran pendapatan dan belanja daerah (APBD), keluarga miskin (gakin), dan surat keterangan tidak mampu (SKTM) serta pola pembiayaan yang terkait dengan status kelembagaan. Dalam penetapan kebijakan ini, anggota dewan perwakilan rakyat daerah (DPRD) merupakan aktor utama. Proses pengambilan keputusan untuk menetapkan agenda dan rumusan keuangan masih belum sempurna sehingga menghambat pelaksanaannya. Selain itu, proses evaluasi dan adaptasi kebijakan pembiayaan belum dilaksanakan dengan baik. Dibutuhkan diskusi dan kerja sama antara berbagai aktor kebijakan untuk menghasilkan kebijakan. Administrator rumah sakit berfungsi strategis untuk melakukan upaya peningkatan secara internal menuju kemandirian rumah sakit dan kemandirian eksternal dengan cara advokasi pihak legislatif untuk perbaikan kebijakan selanjutnya. It is believed that to achieve Healthy Indonesia 2010 vision health financing is a significant factor that affects the quality public health. However, according to Human Development Index’s indicators, Indonesia is at 110th position of 177 countries in the world. The present study has been carried out to understand the politic and financing policy in the management of government hospitals own by DKI Jakarta. Two DKI Jakarta own hospitals i.e. Pasar Rebo Hospital and Duren Sawit Hospital were selected as samples. This study is qualitative research with using indepth interviews. To collect primery data deal with relevan roles from which the data on hospital rules and regulations as well as finance were collected during 2004-2008 period. The results of actor, content, context, and process analyses showed that financing policy consists of tariff, local revenue and expenditure budget (APBD) subsidy, poor households (gakin), notification letter for the poor (SKTM) as well as financial pattern related to hospital status. In deciding this policy, legislators of local people representative (DPRD) are the main actors. Decision making process of financing agenda and formulation was imperfect which in turn causes implementation constraint. In addition, financing policy evaluation, and adaptation processes are not implemented properly. It takes discussions and cooperation between various policy actors to produce policy. Hospital administrator who has a stategic funtion should make effort to improve internal hospital toward independence as well as external hospital by advocates legislative to correct next policy.
Pengaruh Tambahan Asupan Kalium dari Diet terhadap Penurunan Hipertensi Sistolik Tingkat Sedang pada Lanjut Usia Amran, Yuli; Febrianti, Febrianti; Irawanti, Lies
Kesmas Vol. 5, No. 3
Publisher : UI Scholars Hub

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Hipertensi adalah salah satu penyebab kematian utama di dunia dengan mortalitas akibat hipertensi sistolik 2,5 kali lipat lebih besar daripada mortalitas akibat hipertensi diastolik. Hipertensi yang tidak diobati menyebabkan komplikasi pada beberapa target organ seperti jantung, mata, ginjal, dan otak, sementara pengobatan hipertensi termasuk pengendalian diet harus dilakukan secara berkesinambungan sepanjang hidup. Guna menurunkan kasus-kasus hipertensi, suatu penelitian kuasi eksperimen dengan rancangan rangkaian waktu telah dilakukan di Panti Werdha Islamic Village Tangerang, Provinsi Banten, untuk mengamati pengaruh tambahan asupan kalium dalam diet terhadap penurunan tekanan darah sistolik. Buah-buahan yang lebih banyak ditambahkan ke dalam diet harian untuk 12 orang lanjut usia (lansia) dan tekanan darah mereka dipantau selama 14 hari. Uji t-independen dan t-dependen menunjukkan bahwa asupan tambahan kalium yang berasal dari buah-buahan dalam diet telah berhasil menurunkan tekanan darah sistolik. Sementara itu, tambahan buah-buahan juga telah meningkatkan asupan kalsium dan magnesium, tetapi peningkatan asupan kalsium dan magnesium serta lemak tidak berhubungan secara statistik dengan penurunan tekanan darah sistolik. Hypertension is one of the main causes of death in the world where the mortality from systolic is 2,5 fold higher than that from diastolic hypertension. Untreated hypertension can cause complications in target organs such as heart, eyes, kidneys, and brain, whereas the hypertension treatment including diet management must be conducted continuously along the life. In order to reduce hypertension cases, a time series design of quasi experiment research has been carried out at Islamic Village Elderly Nursing Home in Tangerang, Province of Banten, to observe the influence of additional potassium intake from diet. More fruits were added in the daily diet for 12 elderly and their blood pressures were monitored for 14 days. Statistic t-independent and t-dependent tests showed that additional potassium intake from fruits in the diet successfully decreased systolic blood pressure. Meanwhile, added fruits in the diet have significantly increased calcium and magnesium intakes, but additional calcium and magnesium as well as fat intakes were not statistically associated with decrease of systolic blood pressure.
Kualitas Hidup Anak Remaja pada Keluarga dengan HIV/AIDS di Indonesia Muhaimin, Toha
Kesmas Vol. 5, No. 3
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Epidemi HIV/AIDS mempunyai dampak pada sosial ekonomi keluarga, terutama terhadap kualitas hidup anak remaja (12-18 tahun). Untuk melihat dampak HIV/AIDS dalam keluarga terhadap kualitas hidup remaja dan untuk mengidentifikasi berbagai faktor yang mempengaruhi besar dampak itu, telah dilakukan penelitian dengan menggunakan data survei tentang AIDS yang dikumpulkan tahun 2007 oleh Pusat Penelitian Kesehatan Universitas Indonesia. Variabel komposit yang terdiri variabel pendidikan, lingkungan sosial, dan aktivitas fisik, yang dikategorikan menjadi kurang baik dan baik, digunakan untuk mengukur kualitas hidup. Variabel-variabel ini kemudian dianalisis dengan regresi logistik untuk melihat besar dampak HIV/AIDS dalam keluarga, rumah tangga, dan anak terhadap kualitas hidup remaja. Hasil studi menunjukkan bahwa keberadaan HIV/AIDS dalam keluarga berdampak buruk terhadap kualitas hidup remaja (OR = 1,6). Dampak buruk ini lebih parah apabila remaja mendapat pengasuhan kurang baik (OR = 1,7) terutama bila pengasuhnya laki-laki (OR = 2,8) dan pendidikannya rendah (OR = 2,4). Pengaruh buruk tersebut ditemukan sama pada remaja perempuan dan remaja laki-laki. HIV/AIDS epidemic has impacted the socioeconomy of the family, particularly the quality of life of adolescents (12 to 18 years of age). To assess the impact of HIV/AIDS in the family on the quality of life of adolescents and identify factors determining the extent of the impact, a research has been carried out using survey data on AIDS collected in 2007 by Center for Health Research, University of Indonesia. A composite variable consisting of education, social environment, and physical activity variables, which was categorized as less good and good, was employed to measure the quality of life. These variables were then subjected to multi-variable logistic regression analysis to examine the extent of impact of HIV/AIDS status in the family, household, and child towards the quality of life of adolescents. This analysis showed that HIV/AIDS in the family had adverse impact on the life of adolescents (OR = 1,6). The impact was worse on adolescents who lack of care (OR = 1,7), especially if the care givers were male (OR = 2,8) and had low level of education (OR = 2,4). The adverse impact was similar on both female and male adolescents.
Analisis Ketahanan Hidup Lima Tahun Penderita Kanker Ovarium Epithelial di Rumah Sakit Kanker Dharmais Jakarta Trihandini, Indang; Nurrika, Dieta
Kesmas Vol. 5, No. 3
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Kanker ovarium merupakan salah satu penyebab utama kematian wanita. Dalam kasus kanker, jumlah serum albumin adalah indikator prognostik bertahan hidup yang penting, sementara probabilitas global pasien kanker ovarium dengan serum albumin ³ 3,6 g/dL dan ² 3,5 g/dL untuk bertahan hidup lima tahun masing-masing 23% and 10%. Namun di Indonesia, ketahanan hidup pasien-pasien kanker ovarium epithelial belum diteliti secara intensif. Penelitian yang dilaporkan ini bertujuan untuk menentukan probabilitas ketahanan hidup pasien-pasien kanker ovarium epithelial menurut tingkat serum albumin tertentu. Dengan menggunakan rancangan studi kohort retrospektif dan analisis ketahanan hidup, 48 orang pasien Rumah Sakit Kanker Dharmais Jakarta diamati sejak pertama kali mereka didiagnosis kanker ovarium epithelial sampai sembuh, meninggal atau tidak dapat ditindaklanjuti lagi. Ditemukan bahwa selama tahun 1996-2004, secara umum probabilitas pasien dengan bertahan hidup lima tahun adalah 26,2%. Secara spesifik, probabilitas pasien dengan serum albumin ³ 3,6 mg/dL dan < 3,6 mg/dL untuk bertahan hidup lima tahun masing-masing 36,1% dan 15,7%. Jika dikontrol dengan stadium kanker, kadar asite dan hemoglobin, risiko mati pasien karena kanker ovarium epithelial dengan kadar serum albumin < 3,6 mg/dL ternyata 2,077 kali lipat daripada pasien dengan serum albumin ³ 3,6 mg/dL. Disimpulkan bahwa di Indonesia ketahanan hidup lima tahun pasien-pasien kanker ovarium epithelial lebih tinggi daripada tingkat global. Ovarian cancer is one of the largest causes of death in women. In cancer, albumin serum level is an important prognostic indicator of survival, whereas globally the probability of ovarian cancer patient with serum albumin ³ 3,6 g/dL and ² 3,5 g/dL to survive for five years is 23% and 10%, respectively. In Indonesia, however, the survival of epithelial ovarian cancer patient with respect to serum albumin level has not been investigated intensively. The present study was to determine the probability of epithelial ovarian cancer patients to survive for five years at particular level of serum albumin. Using retrospective cohort design with survival analysis, 48 patients of the Dharmais Cancer Hospital Jakarta were observed from the time when the epithelial ovarian cancer was first diagnosed until they were cured, death, or lost to follow up. The results showed that during 1996-2004 the overall probability of five-year survival was 26,2%. Specifically, the probability of patients to survive for five years at serum albumin level ³ 3,6 mg/dL and < 3,6 mg/dL was 36,1% and 15,7%, respectively. When the cancer stages, ascites, and hemoglobin level were controlled, risk of death from epithelial ovarian cancer of the patients with an albumin level of < 3,6 mg/dL was 2,077 fold higher than those with an albumin level of ³ 3,6 mg/dL. It is concluded that in Indonesia the five-year survival probability of epithelial ovarian cancer patients is higher than that the global rate.
Program HIV/AIDS untuk Rakyat Kodim, Nasrin; Hiryani, Desy
Kesmas Vol. 5, No. 4
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Indonesia menghadapi epidemi HIV dan AIDS yang berkembang cepat dan sebagian besar menyerang kelompok usia muda. Epidemi HIV/AIDS muncul dan menyebar melalui perilaku, berupa praktik seks bebas dan penyalahgunaan narkoba menggunakan jarum suntik. Artikel ini bertujuan membahas masalah HIV/AIDS terkini di Indonesia dan berbagai upaya yang telah dan akan dilakukan untuk mencegah masyarakat dari bencana AIDS. Proporsi penderita AIDS perempuan di Indonesia meningkat pesat, kebanyakan ibu rumah tangga dan penularan terbesar terjadi melalui hubungan seksual. Obat Anti Retroviral yang tersedia mampu menurunkan kematian dan risiko penularan HIV/AIDS dari ibu ke bayi. Pemerintah menyediakan pelayanan, pengobatan, perawatan dan dukungan tanpa diskriminasi. Obat subsidi disediakan secara berkesinambungan dan diberikan secara penuh. PT Kimia Farma memproduksi obat antiretroviral dan menyalurkannya ke rumah sakit yang melayani penderita HIV/AIDS. Upaya pengendalian penularan HIV/AIDS dilakukan melalui peningkatan pengetahuan masyarakat tentang penularan secara komprehensif dan tindakan pencegahan. Indonesia faces HIV/AIDS epidemy that is now developing tremendously and attacking mostly the young generation. HIV-AIDS has emerged and spread through behavior such as practicing free sex lifestyle and using drugs by sharing needles. The objective of this article is to review the current HIV/AIDS problems and measures carried out in Indonesia to help protect the people from disaster. The proportion of Indonesian females suffering from HIV/ AIDS had been increasing sharply, whose mostly are household mothers and transmitted sexually. The existing anti retroviral treatment is able to reduce HIV/AIDS transmission from mother to infant. The Government of Indonesian provides health services, medical treatment, nursing care as well as support without discrimination. Subsidized drugs were provided fully and continuously. PT Kimia Farma produces antiviral and has it distributed to the hospitals that serve HIV/AIDS patients. Measures to control the spread of HIV/AIDS are carried out through strengthening the knowledge of the people about HIV/AIDS and preventive action.
Prevalensi dan Determinan Kelebihan Berat Badan dan Kegemukan pada Anak Berusia 5-15 Tahun Sartika, Ratu Ayu Dewi
Kesmas Vol. 5, No. 6
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Kelebihan berat badan dan kegemukan, suatu keadaan lemak tubuh yang berlebihan, merupakan masalah kesehatan di negara-negara maju dan negara-negara berkembang, termasuk Indonesia. Penelitian ini bertujuan untuk mengetahui prevalensi dan determinan kelebihan berat badan dan kegemukan anak usia 5-15 tahun menggunakan data Riset Kesehatan Dasar (Riskesdas) tahun 2007. Ditemukan bahwa prevalensi kelebihan berat badan dan kegemukan pada anak berusia usia 5-15 tahun masing-masing 7,4% dan 8,3%. Jika dikontrol oleh jenis kelamin, tingkat pendidikan, riwayat kegemukan ibu, kebiasaan konsumsi buah mingguan, kebiasaan merokok, dan asupan energi, faktor paling dominan yang berhubungan dengan kelebihan berat badan (> 85% persentil) anak adalah riwayat kegemukan ayah. Disimpulkan bahwa keturunan merupakan faktor penting kelebihan berat badan dan kegemukan pada anak-anak. Program intervensi kesehatan masyarakat sebaiknya ditujukan pada keluarga dan determinan sosial yang difokuskan pada perubahan gaya hidup seperti membiasakan untuk tidak terlalu banyak mengonsumsi makanan tinggi kalori dan gula serta orang tua sebaiknya mengembangkan suatu pola aktivitas fisik anak yang dapat merangsang gerakan olah tubuh. Overweight and obesity, a condition where the amount of body fat is in excess, are health problems in both developed and developing countries including Indonesia. The purpose of this study was to determine the prevalence and determinant of overweight and obesity in children using 2007 Basic Health Research data. It was found that the prevalence of overweight and obesity in children aged 5 to 15 years old are 7,4% and 8,3%, respectively. If controlled by sex, education level, history of mother’s obesity, weekly habit to consume fruit, smoking habit, and energy intake, the most dominant factor related to children overweight (> 85%) is the history of father’s obesity. It is concluded that genetics are important factors of overweight and obesity in children. Public health intervention should address family and social determinants with a focus on the change in life style i.e not too much eating high calories and sugar and parents should develop physical activity patterns to stimulate their activity.
Implementation of Digital Health in Addressing Global Threats: Lessons from the Use of Technology during COVID-19 Pandemic in Indonesia Shifa, Naili; Tiasari, Anisa; Siregar, Kemal N
Kesmas Vol. 19, No. 1
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This research conducted a systematic literature review to explore the implementation of digital health in Indonesia, focusing on the digital health policies, usage during the COVID-19 pandemic, benefits, and lessons learned. The study identified 10 relevant journals through database searches and analyzed the trends in publication, productive journals, and top institutions involved in digital health research. The findings revealed an increasing interest in digital health, with a growing number of published articles from 2021 to 2023. ScienceDirect emerged as the most productive journal, followed by PubMed and MDPI. The University of Indonesia and the University of Gajah Mada were the leading institutions in digital health research in Indonesia. The study discussed the implementation of digital health during the pandemic, highlighting its role in epidemic surveillance, telemedicine services, and data systems for COVID-19 management. The research also emphasized the challenges faced in the 3T regions (remote areas) of Indonesia due to limited internet access and infrastructure. Overall, the findings contribute to understanding the landscape of digital health in Indonesia and provide insights into its benefits and lessons learned.
Daily Income Targets and Passenger Pressure on Safety Risky Riding Behavior Among Online Motorcycle Taxi Riders in Jakarta, Indonesia Djunaidi, Zulkifli; Khaliwa, Agra Mohamad; Hafia, Azka; Putri, Nadya
Kesmas Vol. 19, No. 1
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Online motorcycle taxi riders, a vulnerable group on the road, are more susceptible to serious injury than non-motorcycle riders. This study analyzed a correlation between daily income targets, passenger pressure, risk perception, safety attitudes, and risky riding behavior. This cross-sectional study used a semi-quantitative approach by collecting online-based questionnaires from 500 online motorcycle taxi riders in Jakarta, and 50 of them were obtained through offline interviews. The findings revealed a significant relationship between daily income targets, passenger pressure, risk perception (danger level, stochastic evaluation, and safety priority), safety attitudes (pragmatic attitude to rule violations and dissatisfaction with traffic rules), and risky riding behavior, with a p-value of <0.05. In particular, a pragmatic attitude to rule violations was the most impactful on risky riding behavior. Online motorcycle taxi companies should provide regular training on traffic laws and safe riding practices to improve road safety. This holistic approach may enhance safety through education, passenger awareness, and rigorous management.
The Effects of Environmental Noise on Annoyance, Stress, and Urine Cortisol Levels Among Residents Living Near Industrial Sites in Bangkok, Thailand Onmek, Nutthajit; Bordeerat, Narisa Kengtrong; Wangwongwatana, Supat
Kesmas Vol. 19, No. 1
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People are exposed to environmental noise each day. It may be annoying, cause stress, induce hormonal changes, and negatively affect long-term health. This study aimed to determine the effects of environmental noise on annoyance, perceived stress, stress symptoms, and urine cortisol in people living in a selected area. This cross-sectional study was conducted from April to October 2022 on 142 participants. Urine samples were collected to determine cortisol levels, and perceived stress, stress symptoms, and environmental noise annoyance were evaluated using questionnaires. Stress symptoms correlated with traffic, industrial, and community noise, but not aircraft noise. Community noise correlated most strongly with all stress symptoms. Only community noise exposure was correlated with perceived stress. People reported that industrial and community noise affected their health and daily activities. Cortisol correlated with only traffic noise annoyance. Environmental noise was associated with stress symptoms and stress hormones. In brief, sound level is not the onlyindicator of stress or health impacts, but annoyance and concern over the effects of noise may negatively affect stress and health.
The Importance of Blood Pressure Control in the Survival of Peritoneal Dialysis Patients Using a Multistate Model Najafimehr, Hadis; Rahimi Foroushani, Abbas; Yekaninejad, Mir Saeed; Yousefifard, Mahmoud; Hosseini, Mostafa
Kesmas Vol. 19, No. 1
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Since less attention has been paid to the effect of passing blood pressure states on the survival of peritoneal dialysis (PD) patients, this study aimed to inves­tigate the survival of PD patients with and without hypertension, estimate the probability of hypertension and determine the influential factors. In this retro­spective cohort study, the data of 700 patients visiting dialysis centers from all provinces of Iran from 1997-2009 were analyzed. For data analysis, the multistate survival model was used. The median survival time (months) and five-year survival were 75% and 56%, respectively. Males had a higher probability of hypertension (63%) than females (52%). The risk of death in normotensive patients increased with age and fast blood sugar (FBS) (age: HR = 1.02, p-va­lue <0.001; FBS: HR = 1.03, p-value = 0.034) and decreased with increasing albumin (HR = 0.60, p-value = 0.015). When experiencing hypertension, the death risk increased with age (age: HR = 1.03, p-value<0.001); also, higher serum albumin and blood urea nitrogen (BUN) had a protective effect against mortality (albumin: HR = 0.66, p-value = 0.038; BUN: HR = 0.99, p-value = 0.014). Paying attention to age, obesity, and blood sugar in PD patients seems necessary.

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