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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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Determinan Asupan Makanan Usia Lanjut Amran, Yuli; Kusumawardani, Riastuti; Supriyatiningsih, Nita
Kesmas Vol. 6, No. 6
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Berdasarkan data Kementerian Sosial, jumlah usia lanjut (usila) di Indonesia tahun 2004 tercatat 16.522.311 jiwa dan 3.092.910 jiwa atau sekitar 20% adalah usila terlantar. Nutrisi yang kurang pada usila berdampak pada kesehatan sehingga relatif mudah terjangkit penyakit infeksi dan gangguan zat gizi. Selain itu, asupan makanan berhubungan dengan depresi, jumlah gigi, gangguan gigi, penggunaan obat, penyakit, dukungan sosial seperti kunjungan keluarga atau orang terdekat, dan rasa makanan. Tujuan penelitian ini adalah mengetahui berbagai faktor yang berhubungan dengan asupan makanan pada usila. Penelitian menggunakan desain studi cross sectional dilakukan terhadap 58 orang usila di Panti Sosial Tresna Werdha Budi Mulia 01 Cipayung pada periode bulan Mei-Juni tahun 2010. Metode analisis multivariat digunakan untuk melihat faktor dominan yang berpengaruh terhadap asupan makanan. Sekitar 62,1% usila di panti sosial yang diteliti mempunyai asupan makanan yang kurang. Berdasarkan hasil analisis multivariat, makanan, penyakit, dan jumlah gigi merupakan faktor yang paling dominan memengaruhi asupan makanan pada usila. Ministry of Sosial Welfare, the number of elder in Indonesia 2004 was recorded 16.522.311 and 3.092.910 or about 20% were neglected elders. Poor nutrition will impact on the health of the elders that directly related the infectious disease and the level of food intake. Besides, food intake is also associated with depression, the number of theet, the dental disorders, drug use, diseases, social support include the visit of the family or the people around them, and the taste of the food. The objective of study is to describe the factors that associated with food intake on the elders. This study that was conducted in Mei-June 2010 used cross sectional design. The sample that was suitable with criteria used in this study is about 58 people. The study used multivariate analysis to know the dominant factors that affected food intake. The result showed that 62,1% of elders in Panti Sosial Tresna Werdha Budi Mulia 01 Cipayung has less food intake. Based on the results, the diseases, depression, number of the teeth, and taste of the food are associated with food intake of the elders.
Pengaruh Pengembangan Organisasi Kepemimpinan Jenjang Karir terhadap Kepuasan Kerja dan Kinerja Pegawai Puskesmas Djestawana, I Gusti Gede
Kesmas Vol. 6, No. 6
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Puskesmas harus mampu cepat tanggap terhadap kebutuhan pelanggan dengan konsekuensi organisasi memerlukan sumber daya manusia yang mempunyai keahlian dan kemampuan unik. Untuk mewujudkan hal tersebut, puskesmas harus berorientasi pada pembentukan kualitas sumber daya manusia yang mampu menjawab tuntutan perubahan. Tujuan dari penelitian adalah membuktikan pengaruh pengembangan organisasi, kepemimpinan, serta pengembangan karir secara parsial dan simultan terhadap kepuasan kerja dan kinerja pegawai Puskesmas Kota Denpasar. Penelitian dilakukan pada pegawai di 10 Puskesmas Kota Denpasar menggunakan 3 tahap teknis analisis multivariat dengan metode confirmatory factor analysis yang dilakukan dengan mengurangi satu demi satu indikator penyusun suatu variabel hingga tercapai suatu model pendugaan yang memenuhi persyaratan menggunakan program aplikasi structural equation model (SEM) berupa analysis of moment structures (AMOS). Berdasarkan model persamaan 1 terbukti bahwa hipotesis yang menyatakan pengembangan organisasi, kepemimpinan, serta pengembangan karir secara parsial dan simultan berpengaruh signifikan terhadap kepuasan kerja (nilai p < 0,05). Berdasarkan model persamaan 2, pengembangan organisasi, kepemimpinan, pengembangan karir, serta kepuasan kerja secara parsial dan simultan berpengaruh signifikan terhadap kinerja pegawai (nilai p < 0,05). Puskesmas should be able to quickly respond to costumer need with the consequences of human resource organizations require the expertise and unique capabilities. So, puskesmas should be oriented to the formation of human resources capable of answering the demands of change. The aims of the research to find out the implication of organizational development, leadership, career development, both partially and simultaneously towards work satisfaction and work performance of personnel in Puskesmas in Pengaruh Pengembangan Organisasi, Kepemimpinan, Jenjang Karir terhadap Kepuasan Kerja dan Kinerja Pegawai Puskesmas towards Employee Satisfaction and Performance of Puskesmas Workers Denpasar City. This research involved personnels of 10 Puskesmas in Denpasar City: The research takes total population number as the sample and total 324 people were involved in this research. Data analysis technique was carried out in 3 phases; univariat, bivariat dan multivariat analysis. Univariat analysis was carried out with backward confirmatory factor analysis, while bivariat analysis was carried out with canonical correlation technique, and multivariat analysis was carried out with structural equation model (SEM). The analysis used computer program od SEM application: analysis of moment structures (AMOS). The research results as follows; according to equation 1, it is proved that hypothesis stating that organizational development, leadership and career development, both partially and simultaneously, influences on work satisfaction significantly (p value < 0,05). Organizational development, leadership, career development and work satisfaction, both partially and simultaneously, influence work performance significantly (p value < 0,05).
Konsumsi Jamu Ibu Hamil sebagai Faktor Risiko AsfiksiaBayi Baru Lahir Purnamawati, Dewi; Ariawan, Iwan
Kesmas Vol. 6, No. 6
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Jamu merupakan obat tradisional yang dibuat dengan cara mengolah bahan alamiah yang mempunyai khasiat obat dengan beberapa bahan campuran. Efektivitas dan efek samping pengobatan tradisional sebagai upaya pelayanan kesehatan masih perlu dibuktikan, khususnya jika digunakan oleh ibu yang sedang hamil. Penelitian ini bertujuan untuk mengetahui pengaruh konsumsi jamu pada ibu hamil terhadap kejadian asfiksia pada bayi baru lahir di Bekasi tahun 2008. Desain penelitian adalah kasus kontrol dengan metode kuantitatif dan kualitatif. Hasil penelitian menunjukkan hubungan yang signifikan antara konsumsi jamu terhadap kejadian asfiksia pada bayi baru lahir (nilai p = 0,005; odds ratio (OR) = 7,1; 95% CI = 4,23 – 11,9; (AFE) = 0,85; dan (AFP) = 0,43). Terdapat hubungan antara jumlah antenatal care (ANC) dan asfiksia pada bayi baru lahir dengan jumlah ANC = 4-8 kali (nilai p = 0,052; OR = 1,68; dan 95% CI = 0,99 – 2,83) sedangkan jumlah ANC kurang dari 4 kali (nilai p = 0,019; OR = 3,02; dan 95% CI = 1,2 – 7,58). Berdasarkan hasil wawancara mendalam diketahui bahwa mayoritas ibu hamil belum paham tentang perilaku sehat selama hamil dan tidak mendapatkan penjelasan yang cukup dari petugas kesehatan. Oleh karena itu, perlu ada peningkatan kualitas pelayanan kesehatan pada saat kehamilan dan persalinan serta perlu standardisasi penggunaan jamu untuk ibu hamil. Jamu are traditional medicine which is made by natural ingredience which has medicational effect combining with several ingrediences. The successful of traditional medicine as self medication in health care still need to prove for its efectiveness and the side effect especially if it used by pregnant women. The goal of this study is to know how the effect of consuming jamu for pregnant women with birth asphyxia in Bekasi in 2008. Quantitaive and qualitative study designs were used in this study. Case control design used to see how the odds ratio of the mother who have experience to take jamu during pregnancy. The result showed that there are relation and risk of consume jamu with birth asphyxia (p value = 0,000; odds ratio (OR) = 7,1; 95% CI = 4,23 – 11,9) and frequencies of antenatal care (ANC) with birth asphyxia (4 – 8 times during pregnancy, p value = 0,052; OR = 1,68; and less than 4 times during pregnancy, p value = 0,019; OR = 3,02). The result of indepth interview tells us that majority of mother doesn’t know about the health attitude during pregnancy and doesn’t have enough information from providers about it. Therefore increase the quality of health services during pregnancy and birth delivery and standart for using jamu for pregnant women are needed.
Analisis Demand dan Supply Konsumsi Garam Beryodium Tingkat Rumah Tangga Darmawan, Nadia Irina; Darmawan, Ede Surya
Kesmas Vol. 6, No. 6
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Secara nasional, konsumsi garam beryodium cukup adalah 62,3% dan di Provinsi Jawa Barat adalah 58,3%. Cakupan konsumsi garam beryodium tingkat rumah tangga di Kota Bekasi hanya sekitar 62,14%. Pemantauan garam beryodium di tingkat rumah tangga oleh Dinas Kesehatan Kota Bekasi tahun 2004 menunjukkan bahwa garam yang mengandung yodium cukup adalah 51%. Penelitian ini dilakukan untuk mengetahui analisis faktor demand dan supply terhadap konsumsi garam beryodium tingkat rumah tangga di wilayah kerja Puskesmas Kecamatan Bekasi Barat Kota Bekasi dengan menggunakan desain cross sectional. Populasi yang diteliti yaitu 110 orang ibu dengan menggunakan uji chi square. Pada faktor demand didapatkan hasil bahwa ada hubungan pengetahuan dengan konsumsi garam beryodium tingkat rumah tangga. Namun, tidak ada hubungan antara pendapatan dengan konsumsi garam beryodium tingkat rumah tangga. Pada faktor supply didapatkan hasil bahwa tidak ada hubungan antara ketersediaan di pasar dan harga dengan konsumsi garam beryodium tingkat rumah tangga. Untuk meningkatkan cakupan konsumsi garam beryodium tingkat rumah tangga diperlukan kerja sama dari berbagai pihak. Nationaly, the consumption of iodized salt is 62,3% and in Province of West Jawa is 58,3%. The coverage consumption of iodezed in household level in Bekasi city only about 62,14%. The monitoring iodezed salt in household level by district health departemen in 2004 showed that the enough iodezed salt is 51%.This research was conducted to determine the factor analysis of demand and supply of iodized salt consumption at household level in the District of West Bekasi. This iodesed salt udy used cross sectional design. The population that was studied was 110 mothers using chi square test. On the demand factor, the result shows that there is a relationship between knowledge and the consumption of iodized salt at household level. However, there is no relationship between the revenue and the consumption of iodized salt at household level. While in the supply factor, shows that there is no relationship between availability and price in the market and the consumption of iodized salt at household level. To improve the coverage of iodized salt consumption at household level, it is required cooperation from various parties.
Konfirmasi Pemeriksaan Mikroskopik terhadap Diagnosis Klinis Malaria Arsin, A. Arsunan; Paerunan, Heri; Syatriani, Sri
Kesmas Vol. 6, No. 6
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Penyakit malaria masih menjadi salah satu masalah kesehatan masyarakat yang penting di dunia. Di Indonesia, terutama di luar daerah Jawa dan Bali, sampai kini angka kesakitan malaria masih tergolong tinggi. Di Puskesmas Bunta Kabupaten Banggai, pada tahun 2008 Annual Malaria Incidence (AMI) dilaporkan mencapai 109,9‰. Penelitian ini bertujuan untuk membandingkan serta mengetahui hubungan gejala, tanda klinis, dan hasil pemeriksaan mikroskopik malaria. Desain studi yang digunakan adalah cross sectional. Pengumpulan data wawancara dan mengambil sediaan darah dilakukan pada 150 penderita suspect malaria di puskesmas dan rumah penduduk. Penderita malaria klinis dengan pemeriksaan mikroskopik malaria positif ditemukan sekitar 52%. Gejala dan tanda klinis malaria yang berhubungan bermakna dengan pemeriksaan mikroskopik meliputi menggigil (nilai p = 0,000); sakit kepala (nilai p = 0,007); nyeri otot/ tulang (nilai p = 0,001); pusing (nilai p = 0,000); demam (nilai p = 0,003); anemia (nilai p = 0,000); dan splenomegali (nilai p = 0,000). Berdasarkan analisis multivariat ditemukan gejala dan tanda klinis yang paling dominan berhubungan dengan pemeriksaan mikroskopik adalah menggigil (nilai p = 0,002; CI 95% = 1,593 - 7,797) dan anemia (nilai p = 0,000; CI 95% = 2,265 - 11,191) yang merupakan faktor prediksi terbaik untuk diagnosis dini, skrining, dan surveilans malaria. Malaria which morbidity still high is one of health problems in the world including in Indonesia, mainly in outside Java and Bali island. In Bunta Public Health Center Banggai Regency in 2008, the AMI was 109,9‰ still high. The objective of this research is to compare and to know the relationship between clinical malaria diagnosis and microscophic examination. The methods used in research were observasional study with cross sectional study by interviewing and taking blood stoke of malaria suspected among 150 respondents in Public Health Center and people residents. The data was analyzed by SPSS program according to univariate, bivariat, and multivariate. The result showed that positive mycroscopic cases among clinical malaria cases is 52%. The sign and symptomps of malaria is corelated to positif microscophic examinated cases such as shiver (p value = 0,000); headache (p value = 0,007); muscle/bones pain (p value = 0,001); dizzyness (p value = 0,000); fever >37,5°C (p value = 0,003); anemia (p value = 0,000); and splenomegaly (p value = 0,000). Based on the multivariate test, indicated that the sign and symptoms that related dominantly to microscophic examination includes shiver symptom (p value = 0,002; CI 95% = 1,593 - 7,797) and anemia (p value = 0,000; CI 95% = 2,265 - 11,191). Malaria clinical signs and symtomps is the alternative diagnosis of malaria in endemic areas that have microscophic examination restictiveness.
Faktor Risiko Kematian Neonatal Dini di Rumah Sakit Bersalin Abdullah, Andi Zulkifli; Naiem, M. Furqaan; Mahmud, Nurul Ulmy
Kesmas Vol. 6, No. 6
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Angka kematian bayi di Indonesia masih tergolong tinggi, kematian neonatal 50% terjadi pada bayi berat lahir rendah (BBLR) dan lebih dari 50% kematian bayi adalah kematian neonatal dini. Penelitian ini bertujuan untuk mengetahui faktor-faktor antenatal care (ANC), status imunisasi Tetanus Toxoid (TT) ibu hamil, anemia pada saat hamil, berat lahir, status paritas, dan status hipotermia terhadap kematian neonatal dini. Penelitian meng- gunakan desain penelitian case control di Rumah Sakit Bersalin Kota Makassar dengan sampel 40 kasus dan 120 kontrol. Data diperoleh melalui wawancara langsung dengan responden. Hasil penelitian menunjukkan bahwa faktor risiko kejadian kematian neonatal dini meliputi ANC (nilai p = 0,000; odds ratio, OR = 7,333; CI 95% = 2,966 - 18,129), status imunisasi TT (nilai p = 0,000; OR = 19,205; CI 95% = 7,902 - 46,678), anemia ibu hamil (nilai p = 0,000; OR = 32,818; CI 95% = 7,549 -142,674), berat lahir (nilai p = 0,000; OR = 122,212; CI 95% = 32,324 - 462,068), status paritas (nilai p = 0,000; OR = 5,537; CI 95% = 2,029 - 15,111), status asfiksia (nilai p = 0,000; OR = 8,197; CI 95% = 0,452 - 2,745). Status hipotermia bukan merupakan faktor risiko kematian neonatal dini (nilai p = 0,815; OR = 1,114; CI 95% = 3,646 - 18,428). Hasil uji regresi logistik ganda menemukan bahwa berat lahir bayi merupakan faktor yang paling berisiko terhadap kematian neonatal dini (nilai p = 0,000). Infant mortality rate in Indonesia is still high. Fifty percent of the neonatal mortality occurred among low birth weight infants (LBWI) and neonatal mortality within 7 days of life accounted for 50% of total infant mortalities. This study was aimed to examine the extent of early neonatal mortality risk by antenatal care (ANC), Tetanus Toxoid (TT) immunization status of pregnant women, anemia during pregnancy, birth weight of neonatal, parity status, and hypothermia status. This study was a case control study with direct interview to respondents, conducted in the Maternity Hospital of Makassar with 40 cases and 120 controls. Samples were selected by purposive sampling. Study results indicated that risk factor of early neonatal mortality were ANC (p value = 0,000; odds ratio, OR = 7,33; CI 95% = 2,966 - 18,129), TT immunization status (p value = 0,000; OR = 19,205; CI 95% = 7,902 - 46,678), pregnancy anemia (p value = 0,000; OR = 32,818; CI 95% = 7,549 - 142,674), birth weight (p value = 0,000; OR = 122,212; CI 95% = 32,324 - 462,068), parity status (p value = 0,000; OR = 5,537; CI 95% = 2,029 - 15,111), asphyxia status (p value = 0,000; OR = 8,197; CI 95% = 0,452 - 2,745), whereas hypothermia status (p value = 0,815; OR = 1,114; 0,452 - 2,745) was not a risk factor. Results of logistic regression multivariate analysis indicated that infant’s birth weight was the most risk factor of early neonatal mortality (p value = 0,000). Specific surveillance program for high risk neonatal needed to be arranged in all health centers.
SO2 Concentration and the Occurrence of Acute Respiratory Infection in Children Under Five Lestari, Puji Amrih; Haryanto, Budi
Kesmas Vol. 17, No. 4
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Jakarta is the capital city of Indonesia, with 10.7 million inhabitants with poor air quality as of 2020. Higher levels of pollution often come with an increase in the number of health risks and pneumonia cases. This study aimed to determine the association between SO2 concentration and the occurrence of acute respiratory infection (ARI) in children under five. An ecological time series design was implemented during the study by utilizing secondary data of SO2 concentrations and ARI from the Indonesian Agency for Meteorological, Climatological, and Geophysics, the Special Capital Region of Jakarta Environmental, and Health Office. Statistical correlation tests were performed to analyze the association between SO2 concentration and ARI prevalence in five municipalities cities in Jakarta from 2018-2021 based on the rainy and dry seasons. The average concentration of SO2 was 18.06–20.89 μg/m3. The SO2 concentration and the occurrence of ARI in children under five in Jakarta from 2018 to 2021 showed a weak relationship (r = 0.24). It seems that children under five in Jakarta spent their time indoors rather than outdoors; therefore, they were exposed to fewer transportation emissions.
The Potential of Private Health Insurance Ownership Based on the 2018-2020 National Socioeconomic Survey Data Hasan, Arief Rosyid; Bachtiar, Adang; Candi, Cicilya
Kesmas Vol. 17, No. 4
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In 2014, the Indonesian Government introduced a social security program in the health sector. However, Indonesia’s out-of-pocket expenses remain high due to a lack of public interest in National Health Insurance services. Financing expensive health services with high out-of-pocket expenses has the potential to cause poverty. Private health insurance is considered a solution to this problem. This study aimed to determine the socioeconomic factors of private health insurance ownership and its potential in Indonesia. This study used secondary data from the 2018, 2019, and 2020 National Socioeconomic Surveys. Logistic regression analysis showed that the variables related to private health insurance ownership were age, sex, education, economic status, employment status, marital status, household status, and location of residence. The most dominant variable in 2018 was per capita expenditure (economic status), while education was the most dominant variable in 2019 and 2020. The result of this study can be used to formulate a strategy for increasing participation in private health insurance. The socioeconomic health sector should use this information to target specific markets for private health insurance.
Medication Adherence and Self-Management Practices among Type 2 Diabetes Mellitus Patients in Jeli District, Kelantan, Malaysia Muhammad, Marzuki bin; Yasmin, Farzana; Alabed, Alabed Ali A.; Abdullah, Bibi Florina; Poddar, Sandeep
Kesmas Vol. 17, No. 4
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This study was carried out to investigate the level of medication adherence and diabetic knowledge among type 2 diabetes mellitus patients in Jeli District, Kelantan, Malaysia. This cross-sectional study was done from February to July 2019 by giving a questionnaire to 150 type 2 diabetes mellitus patients aged 40-80 years at three primary health cares in Jeli District, Kelantan, Malaysia. The quantitative descriptive method was used in this study. The findings of this study revealed that knowledge was significantly related to poor adherence. When sex, history of diabetes, and education were accounted for, patients with low diabetic knowledge had an odds ratio of 4.53 for poor adherence compared to those with high knowledge (adj 95% CI (1.92-10.69), p-value = 0.001). To achieve the goal of regulating diabetes management in primary health care, a clinical supervision program should be implemented to improve staff competence in diabetes management and to empower patients through self-management.
Cognitive Function in Type 2 Diabetes Mellitus Patients Taking Metformin and Metformin-Sulfonylurea Rachman, Abu; Sauriasari, Rani; Syafhan, Nadia Farhanah; Prawiroharjo, Pukovisa; Risni, Hindun Wilda
Kesmas Vol. 17, No. 4
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The most prescribed antidiabetic drugs in Indonesian primary health care are metformin or a combination of metformin and sulfonylurea. Studies on metformin have shown various impacts on cognitive decline in patients with type 2 diabetes mellitus, whereas sulfonylurea has been shown to reduce this impact. This study aimed to compare the impacts of metformin and metformin-sulfonylurea on cognitive function and determine what factors affected it. This cross-sectional study was conducted at Pasar Minggu Primary Health Care involving 142 type 2 diabetes mellitus patients taking metformin or metformin-sulfonylurea for > 6 months and aged > 36 years. Cognitive function was assessed using the validated Montreal Cognitive Assessment Indonesian version. The effects of metformin and metformin-sulfonylurea on cognitive decline showed no significant difference, even after controlling for covariates (aOR = 1.096; 95% CI = 0.523–2.297; p-value = 0.808). Multivariate analysis showed age (OR = 4.131; 95% CI = 1.271–13.428; p-value = 0.018) and education (OR = 2.746; 95% CI = 1.196–6.305; p-value = 0.017) affected cognitive function. Since a lower education and older age are likely to cause cognitive decline, health professionals are encouraged to work with public health experts to address these risk factors for cognitive function.

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