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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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Factors Shaping Uptake of Antenatal Care in Surabaya Municipality, Indonesia: A Qualitative Study Jones, Lisa; Damayanti, Nyoman Anita; Wiseman, Nicola; Harris, Neil
Kesmas Vol. 16, No. 3
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Abstract

Five focus group discussions (FGDs) with 61 pregnant women were conducted in June and July 2019 at primary health care (PHC) services within five urban areas of Surabaya, Indonesia. In addition, five semi-structured interviews with five midwives were carried out to explore the experiences of pregnant women accessing Antenatal Care (ANC) and the factors shaping uptake of ANC services. Data were audio-recorded, transcribed, and translated into English, and analyzed using thematic analysis. Findings from focus group discussions suggested that fears of negative diagnosis before initial ANC appointment and personal beliefs and myths surrounding pregnancy may delay uptake of ANC. Further, the influence of husbands, family, and friends and long waiting times with overcrowding leading to limited seating shaped timely access and return visits. In addition, feeling comfortable with the quality of the service and receiving a friendly service from the practitioners assisted women in feeling comfortable to return. Finally, midwives acknowledged feeling afraid of being referred to a hospital if deemed a high-risk pregnancy-shaped return ANC visits. The findings highlighted several factors needing to be addressed to increase the promptness of first ANC visits and ensure return visits to achieve great ANC coverage.
Reasons for Unwanted Pregnancy among Women of Childbearing Age (15-19 Years) in Jambi Province Kalsum, Ummi; Listiawaty, Renny; Mohd Awal, Dato Noor Aziah
Kesmas Vol. 16, No. 3
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Abstract

The occurrence of unwanted pregnancy (UP) among women of childbearing age (WCA) has been reported to be increasing in various regions, however, this incidence has not been assessed among the adolescents of 15-19 years age group, in Jambi City. The factors influencing this occurrence includes individual, family, and environmental determinants. This study aimed to determine the prevalence of UP among WCA (15-19 years) in Jambi Province. A cross-sectional design was used, while the participants (307 women aged 15-19 years) were selected in Jambi City and West Tanjung Jabung District, using the Multistage Random Sampling. The analytical method used was the Multiple Logistic Regression of alpha 5%. The results showed that the prevalence of UP among WCA (age 15-19 years) was 1.6%, compared to 50% of those that were married. The dominant factor of UP includes the use of contraceptives with an adjusted-odds ratio of 74.5 (95% CI = 3.58-1,549.02), while the control used were the job of WCA, knowledge, dating behaviour, accesses to information media and health facilities, as well as family education. Therefore, it is suggested that creative, innovative, informative promotions, and education were needed via the social media. Besides, the optimization and strengthening of the Gen-Re go to school program should be carried out, as well as synergizing the cross-sectoral activities, government, private sector, and the community (especially parents).
Characteristics of Cognitive Status in Sub-Population of Sub-Acute Stage of Ischemic Stroke Patients in West Nusa Tenggara, Indonesia Harahap, Herpan Syafii; Akbar, Muhammad; Tammasse, Jumraini; Bintang, Andi Kurnia; Zainuddin, Andi Alfian
Kesmas Vol. 16, No. 3
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Cognitive decline is a significant complication that affects most stroke survivors. Early detection of cognitive decline in ischemic stroke patients and identification of risk factors improves their clinical outcomes. This study aimed to determine the characteristics of cognitive status in the sub-acute phase of ischemic stroke. A cross-sectional study was conducted on 89 sub-acute ischemic stroke patients in three hospitals in West Nusa Tenggara recruited consecutively from August 2019 to April 2020. The data collected were demographic and clinical characteristics, cognitive status, and functional outcome. The association between clinical and demographic characteristics and cognitive decline was analyzed using logistic regression. In addition, the relationship between cognitive status and functional outcomes of these patients was examined using the chi-square test. This study revealed that the prevalence of cognitive decline in these subjects was 71.9%. Multiple logistic regression showed that age was the only characteristic associated with cognitive decline in the subjects (OR = 5.12,95% CI = 1.08-24.28). Furthermore, the frequency of cognitive decline in these subjects was significantly associated with functional outcomes (p-value =0.014). Thus, there was a high prevalence of cognitive decline in sub-acute ischemic stroke patients associated with increasing age and poor functional outcomes.
Correlation between Dental Environment and Perceived Stress Scale among Dental Students during the COVID-19 Pandemic in Indonesia Astoeti, Tri Erri; Josephine, Howis; Widyarman, Armelia Sari; Sudhana, Widijanto
Kesmas Vol. 16, No. 3
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Academic stressors in a medical educational environment are related to two factors. This study was carried out in order to analyze the correlation between the dental environment and perceived stress among dental students during the COVID-19 pandemic. The respondents were 422 undergraduate dental students and the validated Modified Dental Environmental Stress (DES) and Perceived Stress Scale (PSS) questionnaires were used. Furthermore, the Spearman correlation analysis was used to measure the correlation between DES and PSS score. The result showed that five dental stressors were noted to have the strongest correlations with PSS (p-value >0.40). They include expectation towards dental school (p-value = 0.431), lack of confidence to be a successful dentist (p-value = 0.424), lack of confidence to become a successful dental student (p-value = 0.408), dental school regulations (p-value = 0.401) and criticism of school work (p-value = 0.400). In addition, all six DES categories showed a positive correlation with the PSS. Therefore, the dental students collectively displayed moderate perceived stress scores. The overall discoveries from this study showed a positive correlation between the DES and PSS among dental students during the COVID-19 pandemic.
Correlation between Care Burden and Mental Health with the Perceived Social Support of Patients Relatives in Turkey TAHTA, Mehtap ŞAHİNGÖZ; BALCI, Elçin
Kesmas Vol. 16, No. 3
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The people providing care for relatives always need support and accompaniment from their families and friends. This study aimed to evaluate the correlation among the care burden, mental health and social support perceptions of the patients’ relatives that provide long-term care for patients receiving service from the home care service (HCS) unit in one city. This descriptive study was carried out with the relatives of patients receiving service from home health units. Among the relatives providing care for a total of 859 patients, those that did not comply with the inclusion criteria were excluded, which made a total population of 309 people. Individual information form, burden interview, brief symptom inventory and multidimensional scale of perceived social support were used for the assessment of the data. Descriptive statistics and Spearman’s correlation coefficient were used for data analysis. The result showed a positive moderate significant correlation among the burden score, brief symptom inventory subscale and global index scores while, a negative moderate significant correlation was discovered between the family, significant other and multidimensional scale of perceived social support scores. Consequently, as the perceived social support level in the patients’ relatives providing care increased, their care burden and mental health problems decreased.
Strategy for Diagnosing Breast Cancer in Indonesia during the COVID-19 Pandemic: Switching to Ultrasound-Guided Percutaneous Core Needle Biopsy Sobri, Farida Briani; Bachtiar, Adang; Panigoro, Sonar Soni; Rahmaania, Juwita Cresti; Yuswar, Patria Wardana; Krisnuhoni, Ening; Tandiari, Nelly
Kesmas Vol. 16, No. 3
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Abstract

In this era of COVID-19, suspected breast cancer patients experience delay in diagnosis due to the fear of contracting the virus and reduction of non-COVID-19 health services. Furthermore, it may lead to potential increase in the incidence of advanced cancers in the future. Ultrasound-guided (US-guided) percutaneous core needle biopsy (CNB) is a great option for the diagnosis of cancer but it is poorly utilized. This study aimed to prove that the US-guided CNBis accurate when performed in a local setting and a potential solution for diagnosing breast cancer patients in this pandemic. In addition, it was a single health center cross-sectional study, and the participants were all breast cancer patients that had US-guided CNB from 2013-2019. The pathology results from US-guided CNB were compared to specimens from post-CNB surgeries. The data were collected from medical records and the immunohistochemistry (IHC) examinations were carried out for malignancy. There were 163 patients who were included in this study, 86 had malignancies and 77 had benign tumor reported in their CNB results. The US-guided CNB had 100% sensitivity and specificity compared to surgery. With its lower cost, time usage, and patient exposure to the hospital environment, US-guided CNB should replace open surgery biopsy for diagnosing suspicious breast cancers during the pandemic in Indonesia.
Understanding the Health-related Quality of Life of People Living with HIV Based on Sexual Orientation Sitorus, Rico Januar; Antara, Nyoman Yudi; Sangalang, Reymart; Panjaitan, Merry Natalia; Fauk, Nelsensius Klau
Kesmas Vol. 18, No. 1
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Human immunodeficiency virus (HIV) infection has detrimental impacts on the lives of different population groups living with HIV, including men who have sex with men (MSM). Using the World Health Organization Quality of Life questionnaire, this study aimed to assess the health-related quality of life of men living with HIV with different sexual orientations and to determine the dominant influential factors. This cross-sectional study involved 206 men living with HIV. They were recruited from the Sriwijaya Plus Foundation and a medical facility that provided antiretroviral therapy. The data were analyzed using Chi-square and binomial logistic regression. The analysis showed that the percentage of MSM patients was greater than that of non-MSM patients, accounting for 68.9% of the total population. The multivariate logistic regression revealed that the most dominant influential factor was depression status (PR = 5.417; 95% CI = 2.473–11.876), with the majority of the depressed patients being 5.417 times more at risk of a lower quality of life compared to others. These findings suggest that depression can lead to a low quality of life among HIV patients.
Antenatal Care Provider and Cesarean Section in Urban Areas in Indonesia Pristya, Terry Yuliana Rahadian; Herdayati, Milla; Besral, Besral; Fika, Dheni Fidyah
Kesmas Vol. 12, No. 3
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Tren persalinan sesar di Indonesia (2007-2012) mengalami peningkatan dua kali lipat berisiko pada munculnya masalah kesehatan jangka panjang maupun pendek. Penelitian ini bertujuan mengetahui hubungan tenaga kesehatan pemeriksa kehamilan dengan persalinan sesar. Penelitian kuantitatif ini menggunakan desain potong lintang dengan sampel penelitian 5143 wanita usia subur berusia 15-49 tahun yang melahirkan anak terakhirnya, baik melahirkan sesar maupun tidak di wilayah perkotaan yang terpilih dalam sampel Survei Demografi Kesehatan Indonesia tahun 2012. Analisis multivariat regresi logistik digunakan untuk mengetahui hubungan tenaga pemeriksa kehamilan dengan persalinan sesar, dikontrol oleh usia ibu, tempat periksa kehamilan, paritas, dan tempat melahirkan. Hasil penelitian menunjukkan bahwa pemeriksaan kehamilan pada spesialis kandungan 6,6 kali lebih tinggi, sedangkan pemeriksaan kehamilan pada spesialis kandungan dan bidan 2,1 kali lebih tinggi untuk melakukan persalinan sesar dibandingkan dengan ibu yang melakukan pemeriksaan kehamilannya di bidan setelah dikontrol usia ibu, tempat periksa kehamilan, paritas, dan tempat melahirkan. Terdapat interaksi antara spesialis kandungan dengan status sosial ekonomi untuk persalinan sesar. Implementasi peraturan dilakukannya persalinan sesar oleh institusi kesehatan, serta melakukan upaya protektif dan preventif persalinan pada kelompok masyarakat ekonomi tinggi dapat mengurangi terjadinya persalinan sesar yang tidak perlu. Trends of cesarean section trend in Indonesia (2007-2012) have doubled the risk of long-term and short-term health problems. This study was aimed to determine relation between antenatal care provider and cesarean section. This quantitative study used cross-sectional design with a total sample of 5,143 women aged 15-49 years who gave birth to the last child through cesarean section or not as in urban areas selected in samples of 2012 Indonesia Demographic and Health Survey. Logistic regression multivariate analysis was used to determine relation between antenatal care provider and section cesarean, which was controlled by maternal age, antenatal care facility, parity, and place of birth. Results showed that antenatal care at obstetrician was 6.6 times higher, while antenatal care at obstetrician and midwife was 2.1 times higher for cesarean section compared to women who had antenatal care at midwife after controlled by maternal age, antenatal care facility, parity, and place of birth. There is interaction between socioeconomic status and obstetrician for a cesarean section. Regulation on cesarean section by health authority, as well as protective and preventive labor applied towards on the high economic class community may reduce unnecessary cesarean section.
Early Inititation of Breastfeeding and Vitamin A Supplementation with Nutritional Status of Children Aged 6-59 Months Simanjuntak, Betty Yosephin; Haya, Miratul; Suryani, Desri; Ahmad, Che An
Kesmas Vol. 12, No. 3
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Masa balita, khususnya dua tahun pertama kehidupan merupakan usia emas bagi anak karena pertumbuhan dan perkembangannya yang cepat. Oleh karena itu, terjadinya gangguan nutrisi pada masa itu bisa bersifat permanen dan tidak dapat diubah. Penelitian ini mengkaji hubungan antara inisiasi dini pemberian air susu ibu dan vitamin A dengan status gizi. Total sampel yang dianalisis dalam penelitian ini adalah 1.592 anak di bawah lima tahun (balita) berusia 6-59 bulan yang diambil dari Pemantauan Status Gizi Indonesia 2015 di Bengkulu. Data termasuk usia, jenis kelamin, inisiasi menyusui dini, panjang kelahiran, berat lahir, suplementasi vitamin Adikumpulkan dengan menggunakan kuesioner. Berat dan tinggi anak diperoleh melalui pengukuran antropometri. Lebih dari setengah balita (54,6%) tidak mendapat inisiasi menyusui dini. Berdasarkan hasil analisis multivariat, variabel yang paling dominan terkait dengan indikator weight/age, height/age dan weight/height adalah inisiasi menyusui dini dan suplemen vitamin A. Balita yang tidak mendapat inisiasi menyusui dini berisiko 1,555 kali me-ngalami stunting dibanding balita yang mendapat inisiasi menyusui dini. Variabel yang paling dominan terkait dengan height/age adalah suplementasi vitamin A. Anak yang tidak mendapatkan suplemen vitamin A berisiko mengalami stunting 2,402 kali dibandingkan anak yang mendapat suplemen vitamin A. Toddler period, especially the first two years of life is considered as golden age for children because of their rapid growth and development. Therefore, the occurrence of nutritional disorders in the period can be permanent and irreversible. This study tried to assess correlation between early initiation of breastfeeding and vitamin A with nutritional status. The total of samples analyzed in this study was 1,592 toddlers aged 6-59 months that were drawn from 2015 Indonesia Nutritional Status Monitoring Survey in Bengkulu. Data including age, sex, early initiation of breastfeeding, birth length, birth weight, vitamin A supplementation were collected by using questionnaire. Weight and height of children were obtained through anthropometric measurements. More than half of the toddlers (54.6%) did not get early initiation of breastfeeding. Based on multivariate analysis results, most dominant variables related to weight/age, height/age and weight/height indicators were early initiation of breastfeeding and Vitamin A supplementation. Toddlers who did not get early initiation of breastfeeding are at risk of 1.555 times stunting compared to toddlers who got early initiation of breastfeeding. The most dominant variable related to height/age is vitamin A supplementation. Children who do not get vitamin A supplementation are at risk of stunting 2.402 times compared to children who get vitamin A supplementation.
Family Support as a Factor Influencing the Provision of Exclusive Breastfeeding among Adolescent Mothers in Bantul, Yogyakarta Lailatussu’da, Maulida; Meilani, Niken; Setiyawati, Nanik; Barasa, Sammy Onyapidi
Kesmas Vol. 12, No. 3
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Kehamilan remaja di Indonesia cukup tinggi. Kecamatan Sewon memiliki angka persalinan remaja tertinggi di Kabupaten Bantul pada tahun 2015-2016. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang memengaruhi pemberian ASI eksklusif pada ibu usia remaja di Kecamatan Sewon, Kabupaten Bantul. Penelitian ini menggunakan desain potong lintang dan sampel penelitian berjumlah 45 orang ibu usia remaja yang mempunyai bayi usia 6-24 bulan. Pengumpulan data menggunakan kuesioner terstruktur. Analisis bivariat menggunakan kai kuadrat dan fisher’s exact test, sedangkan analisis multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan bahwa 53.3% ibu usia remaja tidak memberikan ASI eksklusif. Analisis bivariat menunjukkan faktor status kehamilan (nilai p = 0.029), persepsi pengalaman melahirkan (nilai p= 0.045), persepsi menyusui (nilai p= 0.005), dukungan suami (nilai p= 0.009), dukungan keluarga (nilai p = 0,000) berhubungan dengan pemberian ASI eksklusif. Hasil analisis multivariat menunjukkan persepsi menyusui (nilai p = 0.015; RP = 9.746) dan faktor dukungan keluarga (nilai p = 0,014; RP = 7,637) sebagai faktor yang paling berpengaruh terhadap pemberian ASI eksklusif dengan probabilitas sebesar 72.7%. Masih rendahnya pemberian ASI ekslusif pada ibu remaja di Bantul, Yogyakarta, dan dukungan keluarga merupakan faktor paling dominan yang memengaruhi pemberian ASI eksklusif pada ibu usia remaja. The number of adolescent pregnancies in Indonesia is still very high. Sewon Subdistrict had the highest number of adolescent deliveries in Bantul District in 2015-2016. This study aimed to determine factors influencing exclusive breastfeeding among adolescent mothers in Sewon Subdistrict, Bantul District. This study used cross-sectional study design and a sample size of 45 that were adolescent mothers of 6-24-month-old infants. Data was collected using a structured questionnaire. Data analysis involved bivariate analysis using chi-square test and fisher’s exact test, while multivariate analysis used logistic regression. Results showed that 53.3% of adolescent mothers did not practice exclusive breastfeeding. Bivariate analysis showed that pregnancy status (p value = 0.029), perception of childbirth experience (p value = 0.045), perception of breastfeeding (p value = 0.005), husband support (p value = 0.009) and family support (p value = 0.000) were correlated to exclusive breasfeeding. Multivariate analysis showed that perception of breastfeeding (p value = 0.015; OR = 9.746) and family support (p value = 0.014; OR = 7.637) as the most influential factors to exclusive breastfeeding among adolescent mothers with a probability of 72.7%. There is low practice of exclusive breastfeeding among adolescent mothers in Bantul, Yogyakarta and family support is the most dominant factors influencing exclusive breastfeeding.

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