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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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Access to Information on Toddler Family Development Program and Family Participation in Child Growth and Development Dhammayanti, Dita; Simbolon, Demsa; Ervina, Lissa; Fauzi, Yusran
Kesmas Vol. 20, No. 3
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The comprehension of the Toddler Family Development (TFD) Program among families in Indonesia remains limited, likely due to insufficient access to information and low participation rates. Limited participation can negatively affect a family’s ability to support optimal child growth and development. This study examined the relationship between access to information on the TFD Program and family participation in child growth and development. Using secondary data from the 2019 Program Performance and Accountability Survey in Indonesia, the cross-sectional analysis included 21,497 respondents. The results revealed an association between access to information on the TFD Program and family participation in child growth and development (OR: 1.53; 95% CI: 1.34–1.75). Families with limited access to TFD program information were 1.5 times more likely not to engage in child growth and development and parenting activities. Engaging in the TFD Program can help parents with the better growth and development of their children under the age of five.
Has Regional Hospital Autonomy Achieved Its Goals? Lessons Learned from Indonesia: A Systematic Review Basabih, Masyitoh; Widhakuswara, Indriaswari
Kesmas Vol. 20, No. 3
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This study examined the impact of hospital autonomy implementation on the performance of regional public hospitals in Indonesia, particularly in terms of efficiency, effectiveness, and governance. A systematic review of 32 peer-reviewed studies published between June 12 and September 6, 2023, was conducted using Garba Rujukan Digital and Google Scholar, following PRISMA guidelines. Studies addressing financial performance, service outcomes, and challenges related to implementing autonomy were included. The findings indicated that while autonomy led to improvements in infrastructure, service types, visit volumes, and hospital revenues, it had only a marginal impact on improving key health performance outcomes, such as service efficiency, effectiveness, and overall quality, suggesting the core goals of autonomy had not yet been fully achieved. Key barriers included weak policy capacity, inadequate governance structures, and limited human resources. Unlike centrally managed hospitals, the success of regional hospital autonomy is significantly shaped by local institutional arrangements and the broader decentralization framework, which together influence hospitals’ capacity to manage their operations effectively.
Low Economic Level and the Risk of Overweight Among Indonesian Junior and Senior High School Students Nugroho, Ariyanto; Setiyo Nugroho, Purwo; Yudhana, Amarin; Sunarti, Sri
Kesmas Vol. 20, No. 3
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Overweight and obesity among Indonesian adolescents have emerged as a pressing public health issue, reflecting global trends. This study examines the relationship between economic status and overweight prevalence among junior and senior high school students in Indonesia, using secondary data from the Global School-based Health Survey (GSHS). This study analyzed data from 9,977 students aged 11–18 years through a cross-sectional design and binary logistic regression, adjusting for dietary habits, physical activity, and sedentary behavior. Overall, 14.7% of students were overweight; the prevalence was notably higher among low-income students (27.4%) compared to high-income groups (14.2%). Students from lower economic backgrounds were 1.374 times more likely to be overweight (95% confidence Interval (CI): 1.011–1.867). Although many reported healthy behaviors, including regular fruit and vegetable consumption and participation in physical education, sedentary lifestyles and limited access to nutritious food remained significant challenges for low-income adolescents. These results highlight the complex interplay between economic status, health behaviors, and environmental factors, highlighting the need for targeted, equity-focused interventions to address disparities and curb obesity in Indonesia’s youth.
Barriers to Implementing Comprehensive Sexuality Education as a Strategy to Prevent Adolescent Pregnancy in Indramayu District, Indonesia Kurnaesih, Een; Herbawani, Chahya Kharin; Febriani, Nelly
Kesmas Vol. 20, No. 3
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The implementation of comprehensive sexuality education (CSE) is not optimal. This qualitative study aimed to identify and contextualize barriers to CSE implementation, specifically in Indramayu District, Indonesia. Conventional content analysis procedures were used. Seven participants, consisting of relevant authorities, were interviewed. A purposive sampling technique was employed to select participants. Data were collected through in-depth, semi-structured interviews. All interviews were recorded and transcribed verbatim. Data were analyzed using conventional qualitative content analysis. The barriers to CSE implementation in Indramayu District were identified across five themes: advocacy, technical considerations, coordination and collaboration, integration with other sexual and reproductive health projects, and access beyond school, highlighting the need for improved coordination, targeted outreach, and curriculum development to address these challenges and enhance program effectiveness.
Sistem Anggaran Rumah Sakit yang Berorientasi Kinerja untuk Meningkatkan Kualitas Keuangan Publik Sulistiadi, Wahyu
Kesmas Vol. 2, No. 5
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Upaya meningkatkan mutu pelayanan terbaik dan untuk memperbaiki standar pelayanan, manajemen di rumah sakit perlu memperhatikan kinerja pencapaian unit-unit pelaksana pelayanan kesehatan tersebut. Salah satu upaya mengalokasikan sumber daya rumah sakit dalam pengendalian kinerja pelayanan rumah sakit adalah sistem anggaran. Kebanyakan rumah sakit yang merupakan keuangan publik masih mengandalkan sistem anggaran tradisional dalam perencanaan anggarannya. Sistem anggaran rumah sakit berorientasi pada kinerja (performance budgeting) merupakan upaya terobosan prinsip anggaran tradisional yang kerap dilakukan. Walaupun ada kesulitan dalam menentukan output measurement, sistem anggaran ini dapat diandalkan dalam reformasi keuangan rumah sakit karena memiliki banyak kelebihan dalam akuntabilitas keuangan rumah sakit. In order to increase service quality and to improve service standard, hospital management should give attention to performance achievement of each unit within hospital system. One way of allocating hospital resources in controlling hospital service performance is budgeting system. Most government hospitals still use traditional budgeting system in planning the budget. Performance budgeting system is a breakthrough compared to traditional budgeting system. Although there are still difficulties in determining the output measurement, the performance budgeting system can be counted on hospital financial reform due to its accountability.
Faktor Kesehatan Reproduksi Ibu Hamil dan Hubungannya dengan Kejadian Bayi Berat Lahir Rendah di Kota Sukabumi Tahun 2005-2006 Saraswati, Etna
Kesmas Vol. 1, No. 3
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Di Indonesia, bayi berat badan rendah (BBLR) merupakan salah satu faktor utama yang berpengaruh terhadap kematian perinatal dan neonatal. Di Propinsi Jawa Barat dilaporkan 6,4% bayi lahir dengan berat badan kurang dari 2,5 Kg. Tujuan penelitian adalah mengetahui berbagai faktor kesehatan reproduksi yang berhubungan dengan kejadian. Penelitian yang menggunakan disain kasus kontrol ini dengan menggunakan formulir kohort ibu hamil di Dinas Kesehatan Kota Sukabumi. Kasus adalah bayi dengan BBLR yang lahir pada tahun 2005 sampai Juni 2006, sedangkan kontrol adalah bayi bukan BBLR yang lahir pada periode yang sama. Pengambilan variabel independen dilakukan melalui wawancara dengan ibu bayi pada kunjungan rumah dan telaah dokumen melalui kohort ibu, kartu pemeriksaan kehamilan atau KMS ibu hamil. Hasil penelitian memperlihatkan bahwa jarak kelahiran, status anemia, ukuran LILA, kenaikan berat badan <10 >kg, status ibu bekerja, dan proporsi pengeluaran konsumsi non pangan berhubungan secara bermakna dengan kejadian BBLR. Penelitian ini juga menemukan interaksi antara variabel jarak kelahiran dengan status anemia. In Indonesia, Low Birth Weight (LBW) is main factor related to perinatal and neonatal mortalities. In West Java province, it was reported that the proportion of LBW (less than 2,500 grams) was 6.4%. The objective of this study is to understand reproductive health factors related to LBW. The study was conducted in Sukabumi City with case-control design using pregnant mothers cohort data available at Sukabumi City Health Office. Cases are LBW infants born in the period of January 2005-June 2006, while controls were non-LBW infants born in the same period. Data on independent variables were collected through interview with mothers at their homes and document review including mother cohort data, pregnancy card or pregnant mothers healthy card (Kartu Menuju Sehat). The study shows that birth spacing, anemia status, upper arm circumference, weight gain more less 10 kilograms, working status, and proportion of non food expenditure significantly associated with LBW. The study also find an interaction between birth spacing and anemia status.
Hubungan Berat Badan Lahir Bayi dan Infeksi Nosokomial di ruang Perinatologi Tambunan, Eviana S
Kesmas Vol. 1, No. 2
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Infeksi nosokomial masih merupakan masalah kesehatan di seluruh dunia karena meningkatkan angka kematian. Infeksi nosokomial paling tinggi ditemukan di ruang perawatan bayi dan angka infeksi tertinggi terjadi di ruang perawatan intensif neonatus. Penelitian ini bertujuan mengetahui hubungan antara berat badan lahir bayi dengan kejadian infeksi nosokomial. Penelitian ini menggunakan data sekunder rekam medik bayi yang dirawat di level III Perinatologi RSAB Harapan Kita. Desain studi yang digunakan adalah Kasus Kontro dengan metode analisis regresi logistik ganda. Penelitian ini menemukan jenis infeksi nosokomial terbanyak adalah sepsis (52,91%), bakteremia (35,48%) dan pneumonia (11,61%). Pola jenis kuman yang paling banyak ditemukan adalah bakteri gram negatif (0,3-53,9%). Jenis kuman terbanyak adalah Serratia sp. (2,3-38,1%), Klebsiella pneumonia (kisaran 3,2-6,8%) dan Candida sp. (1-4,2%). Penelitian ini menemukan kejadian infeksi nosokomial berhubungan dengan pemasangan long line intravenous catheter dan/atau kateter umbilikus. Neonatus dengan berat badan <2.500 gram yang menggunakan long line intravenous catheter dan/atau kateter umbilikus berisiko tinggi untuk menderita infeksi nosokomial. Risiko juga meningkat pada neonatus dengan berat badan lahir ≥ 2.500 gram, sementara neonatus dengan dengan berat badan < 2.500 gram yang hanya menggunakan infus, tidak berisiko mengalami infeksi nosokomial. Nosocomial infection is still a health problem on the world because of its increasing morbidity and mortality rates. Nosocomial infection is mostly occured among infant and the highest infection is in the neonatus intensive care unit. The objective of the study is to examine the relationship between birth weight and nosocomial infection of neonatus (pneumonia, bacteremia and septicemia) in level III, Perinatal Ward, Rumah Sakit Anak Bersalin Harapan Kita (RSAB Harapan Kita) in the period of 2002-2004. The data used was the medical record of infants under care in level III, Perinatal Ward, RSAB Harapan Kita. Major sites of infection were septicemia (52.91%), bacteremia (35.48%) and pneumonia (11.61%). The most commonly found pathogens were Gram-negative bacteria: Serratia sp. (range 2.3-38.10%), Klebsiella pneumonia (range 3.2-6.8%) and Candida sp. (1-4.2%). Neonatus with birth weight <2,500 gram using long line intravenous catheter and/or umbilical catheter faced high risk of nosocomial infection. Neonatus with birth weight <2,500 gram having intravenous catheter showed no case of nosocomial infection.
Determinan Indeks Massa Tubuh Remaja Putri di Kota Bukit Tinggi, Tahun 2006 Santy, Rini
Kesmas Vol. 1, No. 3
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Di Indonesia, pada 1999-2003, remaja putri yang mengalami Kekurangan EnergiKronis (KEK). akibat asupan energi yang kurang adalah 35–40% dan sekitar 50% remaja putri menderita status gizi kurang (IMT <18,5 kg/m² ). Tujuan penelitian adalah mengetahui gambaran epidemiologi. IMT remaja putri dan berbagai faktor yang berhubungan Rancangan studi yang digunakan adalah rancangan potong lintang (cross sectional). Populasi adalah remaja putri berusia 16-18 tahun yang tinggal di Buki Tinggi dan sampel adalah 156 siswi kelas III SLTA (SMA, MA, dan SMK) usia 16–18 tahun yang terpilih dari 11 sekola yang diamati. Analisis data dilakukan secara multivariate dengan metoda logistic regression ganda. Hasil penelitian (1) Rata-rata IMT remja putri adalah 20,69 kg/m²± 2,63. (2) Proporsi siswi dengan IMT<18,5 kg/m² adalah 19,9% yang meliputi 14,1% kekurangan gizi ringan dan 5,8% kekurangan gizi berat. (3) Rata-rata asupan energi remaja putri adalah 1,694 kalori dan rata-rata kontribusi terhadap total energi protein (11,8%), lemak (26,7%) dan karbohidrat (58,7%). (4) Rata-rata asupan energi dibanding AKG meliputi total energi (77%), protein (93,6%). Variabel yang berhubungan secara bermakna dengan IMP pada remaja meliputi total energi, kebiasaan makan dan citra tubuh dengan IMT remaja putri dengan variabel utama adalah total energi. In Indonesia, in period of 1999–2003, abot 35–40% women in productive age of 15–19 are at risk of Chronic Energy Deficiency (KEK) because of insufficient consumption of energy. This research is aimed at obtaining the description of nutritional status of girls in Bukittinggi and factors related to it. The research that was conductec in period of February tol March 2006 used the design of cross sectional. The study population is the girls studied are represented by the third-grade female students of senior high schools of 16–18 who are categorized as a late teenager who is very close to pregnant period. The sample consist of 156 female student that was selected by systematic random sampling at 11 schools. The results show that the BMI of the girls is 20.69 kg/m²± 2.63 on average. The proportion of students having BMI <18.5 kg/m2 is 19.9% all of which is distributed to 14.1% of light level of malnutrition and 5.8% for heavy level of malnutrition. Intake per day is 1,694 calorie on average with protein contributed to intake is 11.8%, fat 26.7% dan carbohydrat 58.7%. Intake energy compared with Recommended Dietary Allowence (RDA) are total energy consumption 77%, protein 93.6%, lemak 65.3% and carbohydrat 84.7%. There is a significant relation between energy consumption, eating habit, body image, by BMI. Variable energy consumption is the dominant variable influencing BMI.
Kelangsungan Hidup Bayi di Perkotaan dan Pedesaan Indonesia Simbolon, Demsa
Kesmas Vol. 1, No. 1
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Kelangsungan hidup bayi di Indonesia yang masih rendah terlihat pada angka kematian bayi (AKB) yang menempati posisi tertinggi di Asean, kondisi intermediate rock dan sangat bervariasi. Penelitian yang menggunakan sumber data sekunder SDKI 2002-2003 ini bertujuan mengetahui gambaran kelangsungan hidup bayi di wilayah perkotaan dan pedesaan di Indonesia serta berbagai faktor yang berpengaruh. Besar sampel yang digunakan adalah 11.588 terdiri dari 4.769 bayi di perko- taan dan 6.819 bayi di pedesaan. Metoda analisis yang digunakan meliputi metode life table dan regresi cox. Hasil penelitian memperlihatkan probabilitas kelangsungan hidup bayi di perkotaan (98,59%) lebih tinggi daripada bayi di pedesaan (97,54%) dan proporsi kematian bayi di pedesaan dua kali lebih besar daripada di perkotaan. Pada masa neonatal, kurva kelangsungan hidup bayi memperlihatkan kecenderungan yang menurun tajam dan post neonatal terlihat lebih landai. Penurunan probabilitas kelangsungan hidup bayi di wilayah perkotaan terlihat lebih landai daripada di wilayah pedesaan. Terdapat perbedaan faktor-faktor yang berhubungan dengan kelangsungan hidup bayi di perkotaan dan pedesaan. Di perkotaan, faktor-faktor yang berhubungan dengan kelangsungan hidup bayi meliputi berat badan lahir, waktu pemberian ASI dan penolong persalinan. Sedangkan di pedesaan, faktor tersebut adalah frekuensi pemeriksaan antenatal, berat badan lahir, penolong persalinan, nomor urut lahir, waktu pemberian ASI dan tempat persalinan. Keadaan saat lahir merupakan faktor penting yang berhubungan signifikan dengan kelangsungan hidup bayi, faktor waktu pemberian ASI pertama kali merupakan faktor dominan yang berhubungan dengan kelangsungan hidup bayi. Infant's survival in Indonesia is still low, as showed by the highest IMR level in ASEAN, intermediate rock condition and highly varied. This research's aim is to describe infant's survival in Indonesia's urban and rural area, also various factors related. This research is using SDKI 2002-2003 data. Sample's amount 11,588 infant, consist of 4,769 infant in urban and 6,819 infant in rural. Method of analysis used in this study is life table and cox regression. This research found probability infant's survival in urban (98.59%) higher than in rural (97.54%) and infant's mortality proportion in rural is twice higher than in urban. On first month age (neonatal mortality) infant's survival time probability was decline, and for higher age infant's survival time probability is still low, but not as low as the first month age. In urban area, infant's survival time probability is even lower than in rural. There are determinant factors which are related to infant's survival in rural and urban. In urban, factors which are related to infant's survival are birth weight, breast feeding period and birth assistance. Meanwhile in rural area, the factors of are antenatal care, birth weight, birth assistance, birth queue number, breast feeding period and bearing place. Infant condition when the baby born is determinant factors which is related significantly with infant's survival, first breast feeding period is dominant factor which is related with infant's survival.
Faktor-faktor yang Berhubungan dengan Pemberian Asi Satu Jam Pertama Setelah Melahirkan Rahardjo, Setiyowati
Kesmas Vol. 1, No. 1
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Di Indonesia, Angka Kematian Bayi (AKB) masih yang tertinggi di negara-negara ASEAN. Penyebab utama kematian anak balita tersebut adalah penyakit infeksi saluran nafas dan diare yang dapat dicegah antara lain dengan pemberian ASI secara benar dan tepat. Pada periode 2002-2003, sekitar 95,9% balita sudah mendapat ASI, tetapi hanya 38,7 % balita mendapat ASI pertama satu jam setelah lahir. Tujuan penelitian ini adalah untuk mengetahui berbagai faktor yang berhubungan dengan pemberian ASI dalam satu jam pertama setelah melahirkan. Penelitian ini menggunakan sumber data sekunder SDKI 2002-2003 dengan desain cross sectional. Sampel berjumlah 6.018 terdiri dari ibu yang memiliki anak berusia 0 – 24 bulan terakhir yang masih hidup dan dilahirkan tanpa operasi dan mendapat ASI. Analisis data dilakukan dengan model regresi logistik multivariat. Ditemukan proporsi pemberian ASI satu jam pertama setelah melahirkan adalah 38,3%. Faktor dominan yang berhubungan dengan pemberian ASI dalam satu jam pertama adalah tenaga periksa hamil. Faktor lain adalah daerah tempat tinggal, kehamilan diinginkan, tenaga periksa hamil, penolong persalinan, akses terhadap radio, dan berat lahir. Terdapat interaksi antara daerah dengan tenaga periksa, kehamilan diinginkan dengan tenaga periksa, dan berat lahir dengan penolong persalinan. Perlu upaya meningkatkan pengetahuan dan motivasi petugas kesehatan mengenai pentingnya ASI segera dan ASI eksklusif, upaya peningkatan pengetahuan ibu dan calon ibu mengenai tata laksana pemberian ASI yang benar serta program keluarga berencana. Infant Mortality Rate (IMR) in Indonesia is still the highest among the other ASEAN countries. The major cause for infant and children mortality is infections, especially the upper respiratory tracts infection and diarrhea. The prevention efforts for reducing the infections are a good nutrition management for infant and children such as adequate and appropriate breastfeeding. A good start for breastfeeding is about 30 minutes after delivery. The Indonesia DHS 2002-2003 showed that 95.5% children under five have already have breast-milk, but only 38.7% of them are having the first breast-milk within one hour after delivery. The Objective of this study is to know the factors related to the breastfeeding given within one hour after delivery. The study uses secondary source of data of the Indonesia DHS 2002-2003 with a cross-sectional design. The number of sample is 6.018, which are mothers who have the latest life child aged 0 to 24 months and still having breastfed and delivered without surgery. Data are analyzed using the application multivariate logistic regression. The study has found that the proportion of breastfeeding given within one hour after delivery as high as 38.28%. The dominant factor related to the breastfeeding given within one hour after delivery is the antenatal care provider. Other factor are: the residential location, wanted pregnancy, the antenatal care provider, birth attendance, accessibility on radio, and newborn’s weight. There is an interaction between residential location and the antenatal care provider, wanted pregnancy and the antenatal care provider, and newborn’s weight and the birth attendance. There is a need to make an effort on: increasing the knowledge and motivation for the health provider about the importance of the immediate administration of breastfeeding to the newborn and the exclusive breastfeeding. The efforts should be supported by government policy.

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