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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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The Effect of Health Insurance on Institutional Delivery in Indonesia Mukhlisa, Mazda Novi; Pujiyanto, Pujiyanto
Kesmas Vol. 12, No. 3
Publisher : UI Scholars Hub

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Abstract

Pemanfaatan pelayanan persalinan di fasilitas kesehatan berdampak pada menurunnya angka kematian ibu (AKI). Di Indonesia, persalinan di fasilitas kesehatan mengalami peningkatan setiap tahunnya, tetapi masih terdapat sekitar 30% ibu yang bersalin di rumah. Sayangnya, peningkatan pemanfaatan pelayanan persalinan di fasilitas kesehatan tersebut tidak diimbangi dengan penurunan AKI, sehingga Indonesia tidak berhasil mencapai target MDGs. Untuk mencapai Universal Health Coverage, Indonesia mengimplementasikan program Jaminan Kesehatan Nasional (JKN) yang mengintegrasikan empat jaminan kesehatan, yaitu Askes/ASABRI, Jamsostek, Jamkesmas, dan Jamkesda. Jaminan kesehatan dapat mengatasi kendala biaya pada persalinan di fasilitas kesehatan. Dengan menggunakan data Riset Kesehatan Dasar 2013 dan data Potensi Desa 2011 sebagai sumber data, penelitian ini bertujuan menganalisis bahwa kepemilikan jaminan kesehatan meningkatkan pemanfaatan pelayanan persalinan di fasilitas kesehatan di Indonesia. Sampel penelitian berjumlah 39.942 perempuan berusia 15-49 tahun yang melahirkan anak terakhir dalam periode waktu 2010-2013. Penelitian ini menggunakan pendekatan ekonometri dengan model estimasi probit dan bivariat probit untuk mengestimasi efek jaminan kesehatan dengan mempertimbangkan isu endogenitas pada jaminan kesehatan. Hasil penelitian menunjukkan bahwa kepemilikan jaminan kesehatan meningkatkan persalinan di fasilitas kesehatan sebesar 39,52%. Sebagai kesimpulan, ibu yang memiliki jaminan kesehatan akan lebih memanfaatkan fasilitas kesehatan saat persalinan dibandingkan dengan ibu yang tidak memiliki jaminan kesehatan. Institutional delivery has an impact on the decline in maternal mortality rate. In Indonesia, institutional delivery increases every year, but there are still 30%-37% mothers who deliver at home. Unfortunately, the increase is not in line with maternal mortality reduction, so that Indonesia does not achieve the fifth MDGs goal. To achieve Universal Health Coverage, Indonesia implements National Health Insurance (NHI). NHI integrates four types of health insurance, namely Askes/ASABRI, Jamsostek, Jamkesmas and Jamkesda. One of its benefits is maternal health services. Health insurance can address financial barriers on delivery in health facility. By using secondary data of National Basic Health Research 2013 and Village Potential 2011 data, this study aimed to analyze effect of health insurance on institutional delivery in Indonesia. Samples were 39,942 women aged 15-49 years old who gave birth to their last child during 2010-2013. The study used econometric approach by applying probit and bivariate probit as estimation model to estimate the effect with consideration to endogeneity issue of health insurance. The results found that health insurance was likely to increase institutional delivery by 39.52%. In conclusion, women who have health insurance prefer to deliver birth at health facility compared to those who do not have health insurance.
Determinants of Tourism and HIV/AIDS Incidence in West Java Heriana, Cecep; Suparman, Rossi; Rana, Sohel; Sukmanawati, Dera
Kesmas Vol. 12, No. 4
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Abstract

Indonesia defined as tourist destination where the international and domestic tourists enjoy the tourist attractions. Prostitution existing in tourism place may increase the prevalence of HIV/AIDS. The incidence and spread of AIDS in many areas in West Java is a problem for tourism industry. These issues become acute in locations where sexual attraction is used as a determinant of tourist portability. The aim of this study was to determine relation between tourism and the incidence of HIV/AIDS in West Java. Non-reactive research design was used to collect secondary data from the Central Bureau of Statistics in 2016 from 26 districts/cities in West Java. This study was conducted in January - October 2016. Univariate and bivariate analysis methods with Spearman’s statistical test and multivariate analysis (multiple logistic) were applied. Bivariate analysis results showed the number of star hotels had p value = 0.003, r = -0.552), visit to accommodation had p value = 0.009, r = 0.499) and average guest per day had p value = 0.022, r = 0.447. Results of multivariate analysis showed that accommodation visits had p value = 0.000). In conclusion, tourism determinants associated with the incidence of HIV/AIDS are the number of star hotels, visits to hotel, and the average guest per day.
Implementation of Prevention of Mother to Child Transmission of HIV Program in South Jakarta Badriah, Fase; Tahangnacca, Minsarnawati; Alkaff, Raihana; Abe, Takeru; Hanifah, Laily
Kesmas Vol. 12, No. 4
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Abstract

Even though Prevention of Mother to Child Transmission (PMTCT) program has been running in Indonesia since 2006, the proportion of human immunodeficiency virus (HIV)-infected pregnant women remains high in some districts in Indonesia. The PMTCT program aims to reduce transmission of HIV from mother to child. Thus it requires an examination of the PMTCT program implementation. The study was a qualitative study on PMTCT program implementation in South Jakarta, Indonesia, whereas the proportion of children with HIV positive in the area was quite high. The analysis used domain analysis by looking the implementation of PMTCT as a system consisting of input, process and output. PMTCT strategy is based on a comprehensive four-pronged strategy. This study found that scaling-up communication and education about PMTCT program from health provider to community was needed. In the first prong, there was no specific health provider for PMTCT program, it was still integrated with the MCH staff. PMTCT program did not disseminate information to the community. Therefore, it seemed that it was underutilized. In the second prong, implementation of HIV testing and counseling for couples of women living with HIV remained a bottleneck because women living with HIV felt fear to inform their HIV status to their partners. Thus, counseling and HIV testing for couples have not benefited at all. These women were unsatisfied with the quality of counseling, and the failure to provide antiretroviral treatments. This study found the low coverage and less responsiveness of PMTCT program to build a network of partners with various elements of government.
Effect of Personal Protective Equipment during Pesticide Application to Neurological Symptoms in Farmers in Purworejo District, Indonesia Nurcandra, Fajaria; Mahkota, Renti; Shivalli, Siddharudha
Kesmas Vol. 12, No. 4
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Abstract

Agriculture is one of major sectors of Indonesia economic source with the high volume of pesticide used. Unfortunately, adverse health effect of neurotoxic pesticide has never been reported in Indonesia. This study aimed to determine effectiveness of personal protective equipment (PPE) during applied pesticides to neurological symptoms in farmers. This study was cross-sectionally conducted from April to May 2016 in Purworejo District. About 125 farmers were selected using purposive sampling, and restriction was applied in male farmers due to the high proportion of male sprayer. Data was collected by observation and interview. Logistic regression showed protective result of PPE used during preparing (POR=0.402; 95% CI 0.114-1.423) and spraying (POR = 0.382; 95% CI 0.110-1.320), also following wind direction (POR = 0.882; 95% CI 0.271-2.872) and bathing after spraying (POR=0.328; 95% CI 0.036-3.006) after controlled by confounders. Proper PPE used during preparing and spraying pesticide, following wind direction during spraying, and bathing after spraying can decrease risk of neurological symptoms because of pesticide exposure.
The Influence of Exclusive Breastfeeding to Emotional Development of Children Aged 48-60 Months Kusmiyati, Yuni; Sumarah, Sumarah; Dwiawati, Nurul; Widyasih, Hesty; Widyastuti, Yani; Haji Abdul Mumin, Khadizah
Kesmas Vol. 12, No. 4
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Abstract

Impaired emotional development is a problem faced by children and this can negatively impact on function, development and readiness of their school. Exclusive breastfeeding is able to meet brain development needs that affect child development. This study aimed to determine correlation between exclusive breastfeeding and emotional development of children aged 48-60 months. This study used historical cohort.The subjects of this study were 7-12-month old infants living in area of Borobudur Primary Health Care Primary Health Care, Central Java Province, Indonesia in 2011-2012. Independent variable of exclusive breastfeeding was when infants received only breast milk without any supplementary food or drink including water since birth until the age of 6 months. Data were obtained from medical records of children. The emotional development was assessed directly by using questionnaires on emotional and mental problems. Data analysis used cox regression. This study found that provision of exclusive breast milk was evidently correlated with child’s emotional development. Infants who did not receive exclusive breastfeeding had 2.96 higher risk of having abnormal emotional development than infants who received exclusive breastfeeding. Exclusive breastfeeding greatly influences emotional development of the child.
Larvicidal Effect of Mixture of Beauveria bassiana Crude Metabolite and Chitinase Enzyme against Aedes aegypti Larvae Widiastuti, Dyah; Ikawati, Bina; Hadi, Upik Kesumawati
Kesmas Vol. 12, No. 4
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Aedes aegypti is a major vector of dengue, a deadly disease causing deaths of millions of people in developing countries, both in urban and rural populations. Aedes aegypti control with chemical insecticide is widely used, and affects on a widespread insecticide resistance. Mosquito biological control was needed to replace the use of chemical insecticide. This study aimed to evaluate larvicidal effect of mixture of Beauveria bassiana crude metabolite and chitinase enzyme against Aedes aegypti larvae. An experimental study using completely Randomized Design was conducted in March-April 2016 at Banjarnegara Research and Development Unit for Zoonosis Control. Biolarvacide formula was made of mixture with 2 : 1 ratio between Beauveria bassiana crude metabolite and chitinase isolated from chitinolytic bacteria, which was propagated by the Agency’s Bacteriology Laboratory. In experimental method, 120 Aedes aegypti larvae (3rd instar) were exposed with four concentrations of biolarvacide formula (4%, 8%, 16%, and 32%) in 3 replicates. Results showed that exposure of biolarvacide formula caused the third instar larval mortality which started on the first day of exposure. Probit analysis showed LC50 value was obtained at concentration of 53.2 ppm. This shows that larvacide formula of Beauveria bassiana and chitinase enzyme compounds are effective to be used as larvacides against Aedes aegypti larvae.
Perceived Stigma in People Affected by Leprosy in Leprosy Village of Sinatala, Tangerang District, Banten Province, Indonesia Astutik, Erni; Gayatri, Dwi
Kesmas Vol. 12, No. 4
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Abstract

Leprosy is a disease of neglected tropical diseases (NTDs) which becomes a global problem and causes the perceived stigma in people affected by leprosy. This study aimed to determine most dominant factors affecting perceived stigma in people affected by leprosy in leprosy village of Sitanala, Tangerang District, Banten Province, Indonesia. The data used was secondary data taken from cross-sectional survey of a thesis which determined factors related to perceived stigma of leprosy in leprosy village of Sitanala, Tangerang, Indonesia. Samples were selected by purposive sampling. The results of the study showed that factors related to perceived stigma were level of education, perception of knowledge about leprosy, level of disability, and cultural values. There was modification effect between the level of disability and perception of knowledge about leprosy, OR1=4.82 (95% CI 1.26-18,34) and OR2=1.18 (95% CI 0.2-6.98). The dominant factor is level of education with PAR% = 38.8%.
Food Hygiene and Sanitation in Six Food Providers at University X, South Sumatra Isnadi, Yul; Malaka, Tan; Dahlan, Hatta; Novrikasari, Novrikasari
Kesmas Vol. 12, No. 4
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Abstract

Food provider at university is one of places that needs to implement standards of food hygiene and sanitation (FHS). This study aimed to evaluate and analyze practices of FHS based on Regulation of Health Minister No. 1098 of 2003 and best practices in six food providers at University X. This study used mixed method evaluation with sequential explanatory design through two stages. Stage I was in forms of assessment on six food providers, food handlers and laboratory examination on food and beverage samples as well as on eating utensils. Stage II was in form of focus group discussion (FGD) to deepen findings at stage I. Results of this study showed that 100% of food providers had not yet met the government’s regulation. As much as 67% of eating utensils and 83% of food were contaminated with bacteria. Based on food handler examination results, 100% of food handlers were not yet to get medical checkups and training. FGD results indicated that findings at stage I were associated with a lack of knowledge among food handlers and the absence of special unit to oversee FHS at campus. In conclusion, six food providers in the study area have not met the regulation.
Factors Causing Contraceptive Acceptors Drop Out mufdlilah, mufdlilah; Aryekti, Kanthi
Kesmas Vol. 12, No. 4
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Family planning program has a very strategic, comprehensive and fundamental meaning in creating a healthy and prosperous Indonesian human being. However, recently the incidence of drop out is quite high for several reasons. This study was conducted to determine the influential factors that cause acceptors to drop out. It is descriptive research. The populations in the study were contraceptive acceptors who dropped out for 3 consecutive months, and not being pregnant. The numbers of sample were 100 people. The data collection employed closed and open questionnaires; data presented in descriptive form. Influential factors of drop out contraceptive acceptors due to side effects were 38%, wanting children 18%, others (changing the method/ expired) 14%, without husband support in using contraception 22%, and others 22%. The period of using contraception after dropout 34% (3-10 years); express unlimited time (one day later) and unwilling to use contraception anymore after dropping out 23%. It is suggested that health professionals can increase the handling of family planning side effects, improve counseling, information and education related to the choice of short term non hormonal contraceptive devices related to the selection of contraceptives for pre-menopausal age so that the decision making can be taken more appropriately, increase the competence of health professionals, increasing husband support, improving mentoring and monitoring acceptors who have dropped put to use contraceptives again willingly.
The Impact of National Health Insurance Policy to the Implementation of Health Promotion Program on Public Health Center in Indonesia Nurmansyah, Mochamad Iqbal; Kilic, Bulent
Kesmas Vol. 11, No. 3
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Abstract

Jaminan Kesehatan Nasional (JKN) telah diimplementasikan di Indonesia pada 1 Januari 2014. Hal tersebut membawa beberapa perubahan pada aspek manajerial pada pusat kesehatan masyarakat (puskesmas). Penelitian ini bertujuan untuk mengidentifikasi dampak dari kebijakan JKN terhadap implementasi program promosi kesehatan di puskesmas di Kota Tangerang Selatan, Indonesia. Penelitian menggunakan metode kualitatif. Data dikumpulkan pada Februari – Maret 2016. Dampak program dilihat dalam hal kebijakan, pendanaan, fasilitas, sumber daya manusia dan pelaksanaan program promosi kesehatan. Dengan menggunakan metode purposive sampling, enam pengambil kebijakan, delapan pemberi layanan dan delapan penerima layanan diambil sebagai informan dalam penelitian ini. Pada analisis dokumen, 17 dokumen telah dianalisis. Observasi dilakukan dengan melihat kegiatan yang dilakukan di empat puskesmas. Analisis data menggunakan analisis konten tematik. Tidak terdapat perbedaan dari fungsi puskesmas sebelum dan setelah adanya JKN. Dana yang digunakan untuk kegiatan promosi kesehatan telah mengalami peningkatan setelah implementasi kebijakan JKN dimana dana tersebut dapat digunakan untuk berinovasi, memberi peralatan dan melakukan promosi kesehatan dengan lebih baik. Dana kapitasi yang dapat digunakan untuk melaksanakan program promosi kesehatan dan beberapa kegiatan promosi kesehatan yang baru dilaksanakan pada saat era JKN menjadi bukti bahwa kebijakan JKN memiliki dampak positif terhadap pelaksanaan program promosi kesehatan di puskesmas. National Health Insurance (NHI) Program has been implemented in Indonesia on January 2014. That program definitely brings some changes into managerial aspect in public health center (PHC). This study aimed to determine an impact of NHI policy in the implementation of health promotion programs at PHC in South Tangerang City, Indonesia. This study was conducted using qualitative method during February and March 2016. The impact of NHI is seen on policy, budget, equipment, human resource and implementation of health promotion program. With purposive sampling method, six policy makers, eight service providers and eight service users were selected for in-depth interview. As many as 17 documents were analyzed. Observation conducted at four selected PHC. Data analysis used thematic content analysis. There was no difference of PHC’s functions before and after NHI period. Budget expended for health promotion programs had increased after NHI implemented which it could be opportunity for PHC to make innovations, procure materials and implement better health promotion programs. Capitation budget which could be used for executing health promotion program and some recently implemented health promotion programs in NHI era becomes an evidence that NHI policy has a positive impact in the implementation of health promotion program at PHC

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