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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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Tingkat Pengetahuan dan Persepsi terhadap Shisha pada Mahasiswa Yudha, Dhimas Nirwana; Prabandari, Yayi Suryo; Purwanta, Purwanta
Kesmas Vol. 9, No. 1
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Isu yang berkembang terkait pengetahuan dan persepsi seorang calon tenaga kesehatan memengaruhi keberhasilan pelayanan kesehatan dalam menjawab tantangan di masyarakat nantinya. Shisha (rokok dari Timur Tengah) mulai marak di Yogyakarta. Tujuan penelitian ini untuk memperoleh gambaran tentang tingkat pengetahuan dan persepsi terhadap shisha pada mahasiswa reguler tahap akademik Fakultas Kedokteran Universitas Gadjah Mada. Penelitian ini merupakan penelitian deskriptif menggunakan rancangan potong lintang. Sampel penelitian adalah mahasiswa dari tiga program studi yang dilakukan pada bulan September - Oktober 2013. Jumlah responden sebanyak 72 mahasiswa ilmu keperawatan, 74 mahasiswa gizi dan kesehatan dan 258 mahasiswa pendidikan dokter. Pengumpulan data dilakukan dengan kuesioner. Analisis dilakukan dengan uji Mann-Whitney U dan uji-t. Hasil analisis statistik menunjukkan tingkat pengetahuan terhadap shisha pada mahasiswa dikategorikan kurang, sedangkan persepsi dikategorikan cukup. Hasil analisis uji beda menunjukkan tidak terdapat perbedaan tingkat pengetahuan dan persepsi terhadap shisha antar kelompok program studi (p=0,05). Knowledge and perception of medical student toward issue influence their health service to challenge in public. Shisha (cigarette from middle east) increasingly widespread in Yogyakarta. This study was aimed to assess the knowledge and perception of undergraduate students toward shisha at the Faculty of Medicine Gadjah Mada University. This study was descriptive and cross sectional study. It was undertaken in three study programs in September to October 2013. The respondents consisted of 72 of nursing students, 74 nutritionist student and 258 medicine students. The data were collected by questionnaires. Data was analysed by Mann-Whitney U-test and t-test. The result showed knowledge about shisha of the student was mostly rated as low, while perceptions toward shisha was rated as enough. The comparation analysis showed that there’s no difference of knowledge and perception toward shisha between study program groups (p=0.05).
Pattern of Household Drug Storage Gitawati, Retno
Kesmas Vol. 9, No. 1
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Household storage of pharmaceutical is world-widely practice, including in Indonesia. The purpose of this study was to obtain the pattern of medicine storage, the sources and reasons of medicine kept in households. Acrosssectional survey was conducted on October 2011, involving 250 adult household respondents, randomly selected from three subdistricts in North Jakarta, and have approved the written consents, and interviewed with structured questionnaire. Data were performed in univariate and bivariate analysis with chi square test. The majority of household (82%) stored drugs at home; analgesic-antipyretic nonsteroidal anti-inflammatory was the type of drugs kept by mostly (76.1%) of household. Out of 1001 stored drugs formulation encountered, about 31% were ethical drugs, mostly (64.8%) obtained from authorized pharmacies, purchased without prescription (71.9%), kept for future use (37.6%), and were leftover medicines (31.6%). Among the leftovers, 39.2% were ethical drugs including anti infective agents (31.5%). The leftover ethical medicines and anti infective agents could be indicated as inappropriate storage of pharmaceuticals and may lead to drug related problems. Penyimpanan obat di rumah tangga banyak dilakukan oleh masyarakat, namun tidak banyak informasi bagaimana obat disimpan dan digunakan oleh rumah tangga di Indonesia. Penelitian ini bertujuan memperoleh data pola obat di rumah tangga, sumber mendapatkannya, dan alasan obat disimpan. Survei potong-lintang dilakukan pada Oktober 2011, melibatkan secara acak 250 responden rumah tangga dewasa dari tiga kecamatan di Jakarta Utara yang dipilih purposif dan bersedia diwawancarai dengan menandatangani informed consent. Kuesioner terstruktur digunakan untuk memperoleh data obat. Dilakukan analisis data univariat dan bivariat dengan uji kai kuadrat. Mayoritas responden (82%) menyimpan obat, dengan jenis obat terbanyak analgesik-antipiretik dan anti-inflamasi nonsteroid (76,1%). Dari 1001 produk obat yang disimpan, 31% adalah obat etikal. Sebagian besar obat tersebut (64,8%) diperoleh dari apotek, dibeli tanpa resep dokter (71,9%), dan sengaja disimpan untuk persediaan jika sakit (37,6%) serta merupakan obat sisa resep (31,6%). Diantara obat sisa resep, sejumlah 39,2% adalah obat etikal, diantaranya termasuk anti-infeksi (31,5%). Adanya penyimpanan obat sisa resep berupa obat etikal dan anti-infeksi menggambarkan penyimpanan obat yang irasional dan dapat memicu masalah terkait obat termasuk risiko terjadinya medication error.
Diagnosis Dini Tuberkulosis pada Kontak Serumah dengan Penderita Tuberkulosis Paru melalui Deteksi Kadar IFN-γ Indreswari, Sri Andarini; Suharyo, Suharyo
Kesmas Vol. 9, No. 1
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Tuberkulosis paru masih merupakan masalah dunia. Indonesia menempati peringkat ke tiga di dunia pada tahun 2012. Target nasional Case Detection Rate tahun 2012 adalah 70%, sedangkan pencapaian Jawa Tengah sebesar 58,48%. Penelitian ini bertujuan untuk memperoleh batas kadar interferon (IFN) γ pada orang kontak serumah dengan penderita tuberkulosis paru sebagai dasar diagnosis dini penyakit tuberkulosis. Penelitian dilakukan secara kohort selama dua tahun (2011 - 2013) di Balai Kesehatan Masyarakat Paru Semarang. Pada akhir penelitian, terdapat 12 responden kontak dan 13 tidak kontak serumah. Uji Wilcoxon menunjukkan perbedaan bermakna rerata kadar IFN-γ antara kelompok kontak dengan kelompok tidak kontak serumah (nilai p = 0,004). Rerata kadar IFN-γ pada kontak serumah mengalami penurunan pada sebagian besar kasus (75%). Pada kelompok kontak serumah, 25% menunjukkan gejala klinis suspek tuberkulosis paru. Pemeriksaan mikrobiologis menunjukkan 100% negatif pada kedua kelompok. Hasil reciever operating characteristic kadar IFN-γ terhadap status klinis, diperoleh nilai area under the curve sebesar 70,4% (95% CI= 40,8% - 99,9%). Nilai cut off point IFN-γ yang optimal secara statistik yaitu pada nilai ≥3,277. Diperoleh hasil sensitivitas dan spesifisitas sebesar 67,7%. Pemeriksaan kadar IFN-γ dapat digunakan dalam kegiatan skrining untuk mendeteksi secara dini penularan pada kontak serumah dengan penderita tuberkulosis paru, sebagai pilot project pada daerah dengan prevalensi tuberkulosis paru yang tinggi. Tuberculosis remains a global problem. In 2012, Indonesia has the third biggest tuberculosis cases in the world. The national target in Case Detection Rate for tuberculosis in 2012 was 70%, whereas Jawa Tengah reached only 58.48%. This research aimed to find interferon (IFN) g level among households contact with tuberculosis patient that used a new screening method of finding tuberculosis cases. The research design was a two-year cohort study (2011 - 2013) took place in pulmonary community health centers Semarang. In the end of research, found 12 participants household contact and 13 participants nonhousehold contact. Wilcoxon test result showed significant differences IFN-g level between contact group and noncontact group (p value= 0.004). IFN-g among household contact group decreased in most cases (75%). Among household contact group showed 25% had a clinical symptom of tuberculosis. Microbiology diagnostic showed 100% had negative result in both group. Result of receiver operating characteristic IFN-g level toward clinical status, had value area under curve 70.4% (95% CI= 40.8%-99.9%). Cut off point of IFN-g value have optimal result in ³3.277, with sensitivity and specificity value 67.7%. IFN-g level test can be used in screening program to early detection of infected among household contact with new tuberculosis cases, as a pilot project in high prevalence of new tuberculosis cases.
Peningkatan Determinan Sosial dalam Menurunkan Kejadian Tuberkulosis Paru Wardani, Dyah Wulan Sumekar Rengganis
Kesmas Vol. 9, No. 1
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Upaya pengendalian tuberkulosis paru oleh World Health Organization telah meningkatkan angka kesembuhan dan menyelamatkan banyak jiwa, tetapi kurang berhasil dalam menurunkan insiden tuberkulosis. Oleh karena itu, pengendalian tuberkulosis akan lebih menekankan pada kebijakan determinan sosial karena determinan sosial secara langsung maupun melalui faktor risiko tuberkulosis berpengaruh terhadap tuberkulosis. Di Bandar Lampung, angka notifikasi tuberkulosis dari tahun 2009 – 2010 mengalami peningkatan walaupun angka kesembuhan sudah lebih dari 85%. Bandar Lampung juga merupakan bagian dari salah satu provinsi termiskin di Indonesia. Penelitian ini bertujuan untuk mempelajari pengaruh determinan sosial (yang diukur melalui indikator pendidikan, pendapatan dan kelas sosial) terhadap kejadian tuberkulosis. Penelitian dilakukan pada bulan Juli – Oktober 2012 di seluruh pelayanan kesehatan di Bandar Lampung yang telah melaksanakan strategi Directly Observed Treatment Shortcourse. Responden penelitian ini adalah 238 penderita tuberkulosis basil tahan asam positif dan 238 suspek yang tidak menderita tuberkulosis. Hasil penelitian menunjukkan bahwa determinan sosial yang rendah akan meningkatkan risiko untuk terkena tuberkulosis. Oleh karena itu, pengendalian tuberkulosis perlu disertai dengan peningkatan determinan sosial untuk menurunkan kejadian tuberkulosis. Tuberculosis control program conducted by World Health Organization, has increased tuberculosis cure rate and saved million people, but has less success in reducing tuberculosis incidence. Therefore, tuberculosis control program needs to put more emphasis on social determinants. It is obvious, since social determinants, directly or through its tuberculosis-risk factors, affect tuberculosis. In Bandar Lampung, notification rate during the period of 2009 - 2010 has increased although the cure rate of the period was more than 85%. Moreover, Bandar Lampung is located in Lampung, one of the poorest provinces in Indonesia. This research aimed to study the influence of social determinants (measured by indicators of education, income and social class) affecting tuberculosis incidence. The study was conducted during July - October 2012 at all health services, which has been implementing Directly Observed Treatment Shortcourse strategy, across the Bandar Lampung City. Respondents of this research consisted of 238 smear-positive tuberculosis patients and 238 suspects without tuberculosis. The result showed that the lower social determinants, the higher risk of suffering from tuberculosis. It can be learned that tuberculosis control should be accompanied by an effort of improving social determinants in order to reduce the incidence of tuberculosis.
Pertumbuhan dan Perkembangan Anak Usia 3-24 Bulan di Daerah Konflik Usman, Hastuti; Sukandar, Hadyana; Sutisna, Ma’mun
Kesmas Vol. 9, No. 1
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Lima tahun pertama adalah masa penting dalam proses tumbuh kembang anak. Anak lahir dan tinggal di daerah rawan bencana (bencana alam, perang, atau konflik bersenjata) berisiko mengalami kegagalan pertumbuhan dan keterlambatan perkembangan. Penelitian ini bertujuan mengukur perbedaan pertumbuhan dan perkembangan anak usia 3 - 24 bulan antara yang tinggal di daerah konflik dan bukan konflik dan menganalisis korelasi tempat tinggal daerah konflik dengan pertumbuhan serta perkembangan anak usia 3 - 24 bulan. Metode penelitian secara potong lintang dilakukan di Kabupaten Poso periode Februari - Maret 2014 terhadap 40 anak usia 3 - 24 bulan di daerah konflik dan bukan konflik. Data dianalisis menggunakan kai kuadrat dan korelasi point biseral. Hasil pertumbuhan berdasarkan berat badan/panjang badan di daerah konflik dan bukan konflik, kurus berturut-turut 32% dan 2% (p0,05), tetapi jenis kelamin memengaruhi perkembangan (p=0,010). Pertumbuhan dan perkembangan anak usia 3-24 bulan yang tinggal di daerah konflik lebih terganggu dibandingkan dengan yang tinggal di daerah bukan konflik. Terdapat korelasi antara tempat tinggal daerah konflik dan jenis kelamin anak dengan pertumbuhan dan perkembangan anak usia 3-24 bulan. The first five years are an important period in the development of the child. Children born and living in areas prone to disasters (natural disasters, war or armed conflict), risk of growth failure and developmental delay. This study aimed to measure the difference in the growth and development of children aged between 3 - 24 months who live in areas of conflict and not conflict and analyze correlations residential areas of conflict with the growth and development of children aged 3 - 24 months. Method of cross-sectional studies conducted in Poso regency February - March 2014 to children aged 3 - 24 months in areas of conflict and not conflict. Data were analyzed using chisquare and correlation point biseral.The results based on the growth of weight /height in conflict areas and not conflict, successive thin 32% and 2% (p0.05), but influence the development of gender (p=0.010). Conclusions growth and development of children aged 3 - 24 months who live in areas of conflict more disturbed than those living in areas not conflict. There is a correlation residential areas of conflict and gender of children with the growth and development of children 3-24 months of age.
Malnutrisi Akut Berat dan Determinannya pada Balita di Wilayah Rural dan Urban Huriah, Titih; Trisnantoro, Laksono; Haryanti, Fitri; Julia, Madarina
Kesmas Vol. 9, No. 1
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Malnutrisi akut berat merupakan malnutrisi yang paling serius yang memengaruhi balita dan merupakan masalah kesehatan utama di negara-negara berkembang. Malnutrisi telah meluas baik di perkotaan maupun perdesaan. Akar permasalahan malnutrisi di negara berkembang salah satunya adalah faktor sosial demografi. Tujuan penelitian untuk melihat perbedaan kejadian malnutrisi dan determinannya di area perkotaan dan pedesaan di Yogyakarta. Penelitian menggunakan desain potong lintang dengan responden adalah semua balita malnutrisi akut berat di Kabupaten Sleman (23 balita) dan Kota Yogyakarta (33 balita). Analisis data menggunakan statistik deskriptif dan inferensial. Penelitian dilaksanakan pada Bulan Desember 2012 - Februari 2013. Prevalensi balita malnutrisi akut lebih banyak di perkotaan daripada di pedesaan (59% vs. 41%). Persentase faktor risiko kejadian malnutrisi pada kelompok urban dan rural adalah jumlah balita dalam keluarga satu orang (60,7%), jenis kelamin laki-laki (58,9%), riwayat pemberian ASI tidak eksklusif (60,7%), usia ibu kurang dari 35 tahun (62,5%), pekerjaan non-PNS (98,2%), penghasilan orang tua lebih dari UMR (58,9%), tingkat pendidikan ayah dan ibu tinggi (71,4% dan 64,3% ) dan pengasuh balita di rumah adalah ibu (82,1%). Perbedaan yang signifikan (p<0,05) pada variabel pekerjaan dan penghasilan orang tua, tingkat pendidikan orang tua dan pengasuh balita, sedangkan hasil pengukuran antropometri tidak menunjukkan adanya perbedaan. Determinan kejadian malnutrisi pada kelompok urban dan rural adalah jumlah balita dalam keluarga. Severe acute malnutrition is the most serious form of malnutrition affecting children under-five and widely recognized as a major health problem in developing countries. It is wide spread in rural and urban areas. Social demographic factor is one of the main causes of severe acute malnutrition. This study was conducted to determine the prevalence of severe acute malnutrition and determinants of children in urban and rural area in Yogyakarta. A cross-sectional study was used in this study, where the respondents were all children with severe acute malnutrition in Sleman and Yogyakarta (23 and 33 children respectively). Descriptive and inferencial statistic were used to analyze the data. The study was carried out in December 2012-February 2013. The prevalence of severe acute malnutrition children was higher in urban than rural communities (59% vs. 41%). Risk factors percentage of malnourished were number of children in family was one person (60.7%), male gender (58.9%), the history of not exclusive breastfeeding (60.7%), mother age less than 35 years old (62.5%), lower class job (98.2%), monthly income was high (58.9%), higher education of father and mother (71.4% and 64.3% respectively), and children caregiver was mother (82.1%). There were a significant diference (p<0.05) in father profession, parents’ education, household economic status, and caregiver of children, whereas anthropometric measurement did not show any difference between two groups. Determinants of malnutrition in urban and rural groups is the number of children in the family.
Family Role towards Smoking Behaviour among Children in Jakarta Septiono, Wahyu; Meyrowitsch, Dan Wolf
Kesmas Vol. 9, No. 1
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In Indonesia, the prevalence of smoking among 5 – 9 years old children has increased from 0.4% in 2001 to 2% in 2007. Among present adults smokers (>20 years), 17% started to smoke before the age of 13 years. This study identified factors related to smoking behaviour among 8 – 12 years old children in Jakarta, Indonesia using a questionnaire based cross sectional survey to obtain smoking status and possible predictors towards smoking habit. The total sample size was 1,097 students among 3rd - 7th grade students from schools in Jakarta. Self-reported smoking status was defined as whether the child had smoked tobacco within the past two months prior to the interview. The prevalence of smoking was 13.4%. Logistic regression analysis showed that high parental approval on tobacco use (OR=13.4; CI 95%: 5.1 – 35.1) was the strongest predictor on children smoking status, followed by low parental control (OR=12.1; CI 95%: 6.9 – 21.2), being a male compared to a female (OR=10.7; CI 95%: 5.3 – 21.7), mother (OR=10.58; CI 95%: 3.96 – 28.28), father (OR=7.69; CI 95%: 3.59 – 16.47), sibling (OR=7.91; CI 95%: 4.41 – 14.17) smoking status. Smoking parents and siblings, low parental control, and high parental approval on smoking were related to higher odds of smoking among children. The results were used as a rationale for suggestions and recommendations of relevance for future intervention programs and tobacco related research with specific focus on children. Prevalensi anak perokok umur 5-9 tahun di Indonesia meningkat dari 0,4% di tahun 2001 menjadi 2% di tahun 2007. Tujuh belas persen perokok dewasa menyatakan mulai merokok ketika berumur di bawah 13 tahun. Penelitian ini bertujuan untuk menentukan faktor terkait perilaku merokok anak umur 8-12 tahun di Jakarta dengan menggunakan pendekatan potong lintang untuk menjaring perokok anak dan faktor yang mungkin menyebabkan perilaku tersebut. Kuesioner digunakan untuk menjaring status perilaku merokok anak dalam dua bulan terakhir sebelum survei. Total 1.097 murid kelas 3 sampai 7 di Jakarta menjadi sampel penelitian dengan 13,4% responden merokok dalam 2 bulan terakhir. Analisis regresi logistik menunjukkan bahwa pembolehan merokok di dalam rumah oleh orang tua (OR=13,4; CI 95%: 5,1 – 35,1) menjadi penyebab terkuat, diikuti dengan rendahnya kontrol orang tua (OR=12,1; CI 95%: 6,9 – 21,2), siswa laki-laki (OR=10,7; CI 95%: 5,3 – 21,7), ibu (OR=10.58; CI 95%: 3.96 – 28.28), ayah (OR=7,69; CI 95%: 3,59 – 16,47), dan saudara kandung yang perokok (OR=7,91; CI 95%: 4,41 – 14,17). Orang tua dan saudara kandung yang merokok, rendahnya pengawasan orang tua, dan tingginya pembolehan merokok di dalam rumah menjadi penyebab perilaku merokok anak umur 8- 12 tahun. Hasil penelitian dapat dimanfaatkan sebagai rekomendasi untuk program intervensi di masa depan dan penelitian terkait tembakau dengan fokus kepada anak-anak.
Pendapatan Daerah, Pembiayaan Kesehatan, dan Gizi Buruk pada Balita: Studi Korelasi Tingkat Kabupaten/Kota Choirunisa, Septyana; Adisasmita, Asri C.
Kesmas Vol. 9, No. 1
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Pendanaan kesehatan merupakan salah satu faktor penting dalam memengaruhi derajat kesehatan, termasuk salah satu masalah gizi pada balita yang disebut gizi buruk. Oleh karena itu, penelitian ini bertujuan mendeskripsikan pendapatan daerah dan pembiayaan kesehatan serta korelasinya dengan gizi buruk pada balita di tingkat kabupaten/kota di Indonesia tahun 2007. Penelitian ini merupakan studi ekologi/korelasi. Data pendapatan daerah dan pembiayaan kesehatan didapat dari Kementerian Keuangan, sedangkan data gizi buruk menggunakan data Riset Kesehatan Nasional tahun 2007. Sebanyak 250 kabupaten/kota yang diteliti dengan tidak mengikutsertakan kabupaten/kota yang datanya tidak lengkap atau tidak valid. Secara nasional, hanya persentase pendapatan asli daerah (PAD) per total pendapatan yang berkorelasi dengan gizi buruk, meskipun korelasinya lemah (r = 0,22). Berdasarkan kawasan di Indonesia, Kawasan Indonesia Barat dan Kawasan Indonesia Timur menunjukkan persentase PAD per total pendapatan berkorelasi lemah dengan gizi buruk (r = 0,20 dan r = 0,53). Terlihat kecenderungan bahwa semakin tinggi persentase pendapatan daerah dan pembiayaan kesehatan, semakin rendah persentase gizi buruknya. Korelasi antara pendapatan daerah, pembiayaan kesehatan dan masalah status gizi tidak dapat diabaikan. Data yang lebih lengkap dan valid diperlukan untuk dikembangkan penelitian selanjutnya. Health financing is one of the factors which contribute important role in influencing health status, including nutritional problem among children under five, called severely wasted. Therefore, the aim of this study was to describe districts income and health financing and examine it correlations with the prevalence of severely wasted among children under 5 years at regencies/ municipalities level in Indonesia in 2007. This research was an ecological study. Data on revenue and health financing were obtained from Ministry of Finance, and severely wasted data were obtained from the Indonesian Basic Health Research (Riskesdas) 2007. There are 250 regencies/municipalities were being objects of this research, while the others were excluded due to incomplete/missing or invalid data. Result shows nationally, only the percentage of local revenue by total district income had correlation with severely wasted, although it is weak (r = 0,22). By regions, in the Western Region Indonesia and the Eastern Region Indonesia, those variable had weak correlation with severely wasted (r = 0,20 and r = 0,53). The graphics trend shows higher percentage of local revenue and health financing, related to lower number of the prevalence of severely wasted. The correlation between district income and health financing for poor nutritional status cannot be ruled out. More valid and complete data on district income and health financing is needed for further research.
Asupan Karbohidrat sebagai Faktor Dominan yang Berhubungan dengan Kadar Gula Darah Puasa Werdani, Aprilya Roza; Triyanti, Triyanti
Kesmas Vol. 9, No. 1
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Peningkatan kadar gula darah memicu peningkatan produksi hormon insulin yang erat hubungannya dengan diabetes melitus. Berdasarkan data Riskesdas, prevalensi diabetes melitus di Indonesia meningkat dari 1,1% (2007) menjadi 2,1% (2013). Penelitian ini bertujuan untuk mengetahui faktor dominan yang berhubungan dengan kadar gula darah puasa pegawai pemberdayaan masyarakat & keluarga dan pegawai sekretariat daerah Kota Depok. Desain penelitian yang digunakan adalah potong lintang dan melibatkan 105 sampel. Variabel independen penelitian meliputi karakteristik individu, asupan zat gizi, hipertensi, aktivitas fisik, status gizi dan pengetahuan gizi. Analisis data yang dilakukan adalah analisis univariat, analisis bivariat menggunakan uji korelasi dan uji beda dua mean, serta analisis multivariat menggunakan uji regresi linear ganda. Hasil penelitian menunjukkan bahwa rata-rata kadar gula darah puasa adalah 95,14±10,863 pada keseluruhan responden, sedangkan 94,07±11,55 mg/dl pada perempuan, dan 96,47±9,92 mg/dl pada laki-laki. Diabetes melitus (≥126 mg/dl) ditemukan sebesar 2,9% dan impaired fasting glucose (100-125 mg/dl) sebesar 22,9%. Berdasarkan hasil analisis bivariat, terdapat hubungan antara usia, asupan karbohidrat, dan aktivitas fisik dengan kadar gula darah puasa (p<0,05). Hasil analisis multivariat menunjukkan bahwa asupan karbohidrat merupakan faktor dominan yang berhubungan kadar gula darah puasa. Increased blood glucose levels lead to excess insulin secretion that is closely associated with diabetes mellitus. Based on Riskesdas, prevalence of diabetes mellitus in Indonesia has increased from 1,1% (2007) to 2,1% (2013). This study was aimed to find dominant factor associated with fasting blood glucose level. Cross sectional design were used to conduct this study and involved 105 samples. Independent variables in this study were individual characteristics, nutrients intake, history of hypertention, physical activities, nutritional status and nutritional knowledge. Bivariate analysis was performed by correlation test and two different test mean. Multivariate analysis was performed by multiple linear regression test. Result showed that the average of employees’ fasting blood glucose level is 95.14±10.863, 94.07 ± 11.55 mg/dL for woman and 96.47 ± 9.92 mg/dl for man. This study found 2.9% employees with diabetes mellitus (³126 mg/dl) and 22.9% employees with impaired fasting glucose (100-125 mg/dl). Result of bivariate analysis showed that associated between age, carbohydrate intake, physical activities with fasting blood glucose level. Result of multivariate analysis showed that carbohydrate intake was a dominant factor related to fasting blood glucose level.
Evaluasi Pelaksanaan Konseling Menyusui Murtiyarini, Ika; Herawati, Dewi Marhaeni Diah; Afriandi, Irvan
Kesmas Vol. 9, No. 1
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Abstract

Salah satu upaya pemerintah dalam meningkatkan pemberian ASI di Indonesia adalah dengan memberikan konseling menyusui di pelayanan kesehatan. Penelitian perlu dilakukan untuk mengevaluasi pelaksanaan konseling menyusui di Kota Jambi dengan mengeksplorasi komponen input, activity, output, dan outcome. Penelitian ini merupakan penelitian kualitatif menggunakan strategi studi kasus. Penelitian dilakukan di empat puskesmas Kota Jambi pada bulan Desember 2013 sampai dengan Februari 2014. Pengumpulan data dilakukan dengan studi dokumen, observasi pelaksanaan konseling menyusui dan sarana prasarana, wawancara mendalam, serta focus group discussion. Analisis data yang digunakan adalah analisis tematik. Hasil penelitian menunjukkan bahwa komponen input dan activity kurang optimal seperti kurangnya sumber daya manusia, keterbatasan sarana prasarana, belum ada petunjuk teknis pelaksanaan konseling menyusui, belum ada pemantauan pascapelatihan, kurangnya komitmen personal konselor, belum ada penegasan program, serta lemahnya pengawasan. Komponen output masih kurang baik, terlihat pada belum terdapat data jumlah klien yang diberi konseling menyusui dan jumlah monitoring/supervisi. Komponen outcome menunjukkan bahwa kepuasan klien konseling menyusui kurang. Pelaksanaan konseling menyusui di Kota Jambi masih kurang optimal. Terlihat dari komponen input masih kurang memadai, komponen activity belum berjalan optimal, sedangkan komponen output dan komponen outcome belum mencapai hasil yang diharapkan. The government’s efforts in improving breastfeeding in Indonesia is to provide breastfeeding counseling services in health care especially at primary health care centre. Therefore it is necessary to evaluate the implementation of breastfeeding counseling in the City of Jambi by exploring its input, activity, output, and outcomes components. This study was a qualitative research using case study strategy. The study was conducted in four health centers City of Jambi during December 2013 to February 2014. Data were collected through document study, breastfeeding counseling and execution infrastructure observation, in-depth interviews, and focus group discussion. Data analysis includes transcription, reduction, coding, categorizing, themes, and interpretation of research results. The results showed that the component inputs and activity were not done optimally due to a lack of human resources, infrastructure limitations, unavailability of technical guidelines, non-existence of post training monitoring or supervision, lack of counselor’s personal commitment, lack of program clarity, as well as poor management and supervision of the health department. Aservice output were not also good as indicated by data unavailability of clients served and none of monitoring has been conducted. Outcome component showed that there were still a lack of client satisfaction and resolved breastfeeding problems after acquiring breastfeeding counseling as an conclusion, implementation of breastfeeding counseling in the City of Jambi is still less than optimal, seen from the input components is still inadequate, activity components are not yet optimal, while the outputs and outcomes components not achieving the expected.

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