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Health System and Medical Journal
Published by CV. MEDINSIGHT PUBLISHING
ISSN : 30904013     EISSN : 30903998     DOI : -
Core Subject :
Focus and Scope of Health System and Medical Journal The Health System and Medical Journal is a peer-reviewed academic journal that publishes high-quality research and scholarly articles on healthcare systems, medical sciences, and health policies. The journal serves as a platform for researchers, healthcare professionals, policymakers, and academicians to explore advancements, challenges, and innovations in the field of health systems and medical sciences. Scope of the Journal: covers a broad range of topics, including but not limited to: Health System Management and Policy Health governance and administration Healthcare policy development and implementation Universal health coverage and health financing strategies Quality improvement and patient safety in healthcare services Medical Sciences and Clinical Research Advances in diagnostics, treatment, and therapeutics Translational medicine and personalized healthcare Disease prevention and management strategies Integrative and alternative medicine approaches Health Economics and Healthcare Financing Economic evaluation of healthcare programs Cost-effectiveness analysis in medical treatment Public-private partnerships in healthcare delivery Health insurance and financial protection mechanisms Epidemiology and Public Health Disease surveillance and outbreak management Epidemiological studies on infectious and non-communicable diseases Environmental and occupational health policies Social determinants of health and health equity Digital Health and Medical Technology Artificial intelligence and machine learning in healthcare Electronic health records and telemedicine Big data and health informatics applications Digital interventions for disease prevention and health promotion Global and Regional Health Issues International comparisons of health systems Global health security and pandemic preparedness Health workforce planning and capacity building Ethical and legal issues in global health policy Health Promotion and Behavioral Science Community-based health promotion initiatives Behavioral change interventions and health literacy Nutrition, lifestyle, and chronic disease prevention Mental health and psychosocial interventions Target Audience: Researchers and academicians in health and medical sciences Healthcare professionals and practitioners Policymakers and government health officials Health administrators and hospital managers Non-governmental organizations (NGOs) and public health advocates
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Articles 20 Documents
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Histological and Oxidative Stress Toxicity of Dolutegravir-Based Antiretroviral Therapy on the Placenta of Adult Wistar Rats Ogbe, O.C; Ataman, J.E; Ezeuko, V.C
Health System and Medical Journal Vol. 1 No. 1 (2025): May : Health System and Medical Journal
Publisher : CV.MEDINSIGHT PUBLISHING

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Abstract

Tenofovir Disoproxil Fumurate/Lamivudine/Dolutegravir (TLD) is a fixed dose combination antiretroviral therapy recommended by World Health Organization (WHO) as preferred first and second-line antiretroviral therapy for people living with HIV. However, a relationship between placenta histology and oxidative toxicity of TLD is unknown. This study was designed to investigate the histological and oxidative stress toxicity of TLD on the placenta of adult Wistar rats. Ten rats weighing between 154-194g were randomly assigned into two groups; a control and TLD-treated. After pregnancy was achieved, the treated group was still administered combination drugs of Tenofovir Disoproxil Fumurate in 5mg/kg, Lamivudine in 5mg/kg and Dolutegravir in 0.8mg/kg body weight daily for 90 days. Dams were weighed on gestational day (GD) 0, 7, 14 and 21. At GD21, the dams were sacrificed, and placenta were harvested, counted, weighed, measured, and submitted for biochemical oxidative stress assessments and a section taken for histological evaluation. The findings revealed significant decrease in the body weight, placenta weight, diameter, and thickness of the treated group. Also, there was a significant decreased in placenta tissue reduced glutathione, glutathione peroxidase, superoxide dismutase, and catalase was decreased with insignificant difference, the concentration of malondialdehyde increased with insignificant difference in the treated compared to the control group. There was no significant difference in the number of number of placenta between the control and treated groups. The placenta histology of the TLD treated revealed vacuolation, congestion, and dilatation of the fetal-maternal vascular bed. These findings suggest TLD administration during pregnancy have negative effects on the placenta and could lead to abortion or cause serious negative consequences for the developing foetus. Concerns over long-term usage; especially during pregnancy, cannot be overemphasized.
The Effect of Health Education on Mothers’ Knowledge and Attitudes Toward Exclusive Breastfeeding Firsta Ninenty Fife Bertha; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 1 (2025): May : Health System and Medical Journal
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Background : Exclusive breastfeeding during the first six months of life is a proven intervention to improve infant health, reduce morbidity and mortality, and support optimal growth and development. Nevertheless, the rate of exclusive breastfeeding remains below national and global targets. Inadequate maternal knowledge and unfavorable attitudes are recognized as important barriers to successful breastfeeding practices. Health education is considered an effective health promotion strategy to enhance maternal knowledge and foster positive attitudes toward exclusive breastfeeding. This study aimed to determine the effect of health education on mothers' knowledge and attitudes regarding exclusive breastfeeding. Methods : A quantitative study employing a quasi-experimental pretest–posttest control group design was conducted among 60 mothers selected using consecutive sampling. Participants were assigned to an intervention group (n = 30) and a control group (n = 30). The intervention group received structured health education through interactive lectures, group discussions, breastfeeding demonstrations, educational videos, and printed leaflets, whereas the control group received routine health education. Data were collected using validated and reliable questionnaires measuring knowledge and attitudes toward exclusive breastfeeding. Statistical analyses included descriptive statistics, paired t-test, independent t-test, and multiple linear regression with a significance level of p < 0.05. Results : The mean knowledge score in the intervention group increased from 61.8 ± 8.4 to 87.6 ± 6.3, while the mean attitude score improved from 65.4 ± 7.1 to 88.2 ± 5.8. Improvements in the control group were comparatively lower.
Omega-3-Enriched Fish Nugget Innovation to Enhance Appetite in Toddlers Ariska Dewi; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 1 (2025): May : Health System and Medical Journal
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Background: Poor appetite is a common nutritional problem among children under five and may lead to inadequate dietary intake, impaired growth and development, and an increased risk of undernutrition and stunting. Developing nutritious, acceptable, and child-friendly local food products is one strategy to address this issue. Fish nuggets enriched with omega-3 fatty acids provide high-quality  protein and essential fatty acids that may improve children's appetite while supporting optimal nutritional status. This study aimed to determine the effect of omega-3-rich fish nugget supplementation on appetite improvement  among children under five. Methods : A quantitative study with a quasi-experimental pretest–posttest control group design was conducted involving 60 children aged 24–59 months selected through consecutive sampling. Participants were assigned to an intervention group (n = 30) and a control group (n = 30). The intervention group received 50 g of omega-3-rich fish nuggets daily for 28 days, whereas the control group received routine supplementary food. Appetite was assessed using a modified  Children's Eating Behaviour Questionnaire (CEBQ) with satisfactory validity and reliability. Data were analyzed using descriptive statistics, paired t-test, independent t-test, and multiple linear regression at a significance level of p < 0.05. Results : The mean appetite score in the intervention group increased from 42.3 ± 5.6 to 58.6 ± 4.8, while the control group increased from 42.0 ± 5.3 to 47.4 ± 5.1. Independent t-test analysis demonstrated a statistically significant difference in appetite improvement between the two groups (p < 0.001). Multiple linear regression identified omega-3-rich  fish nugget supplementation as the strongest predictor of appetite improvement (β = 0.71; p < 0.001) after  adjustment for age, baseline nutritional status, and intervention adherence. Conclusion : Daily supplementation with omega-3-rich fish nuggets significantly improved appetite among children under five compared with standard supplementary feeding. This locally  based food innovation has the potential to serve as an effective complementary nutritional strategy to improve dietary intake, support child growth, and contribute to undernutrition and stunting prevention programs.  
Spinach Juice Supplementation Enhances Hemoglobin Concentrations in Pregnant Women: A Study at Yudha Wahana Abadi Clinic Mardiana Mardiana; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 1 (2025): May : Health System and Medical Journal
Publisher : CV.MEDINSIGHT PUBLISHING

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Abstract

Anemia during pregnancy remains a significant public health concern due to its association with adverse maternal and fetal outcomes, including premature birth, low birth weight, postpartum hemorrhage, and impaired fetal development. This study aimed to evaluate the effect of spinach juice supplementation on hemoglobin levels among pregnant women at Yudha Wahana Abadi Clinic. This research employed a quantitative quasi-experimental design with a pretest–posttest approach. A total of 60 pregnant women were selected using consecutive sampling and divided into an intervention group (n = 30) and a control group (n = 30). The intervention group received 250 mL of fresh spinach juice daily combined with standard iron supplementation for 28 days, while the control group received iron tablets only. Hemoglobin levels were measured before and after intervention using a HemoCue Hb 201+ analyzer. Data were analyzed using descriptive statistics, paired and independent sample t-tests, and multiple linear regression with a significance level of p < 0.05. The results showed an increase in mean hemoglobin levels in the intervention group from 9.71 ± 0.49 g/dL to 11.23 ± 0.58 g/dL, while the control group increased from 9.68 ± 0.52 g/dL to 10.34 ± 0.55 g/dL. The independent t-test revealed a significant difference between groups (p < 0.001). Regression analysis indicated that spinach juice supplementation was the strongest predictor of hemoglobin improvement (β = 0.67; p < 0.001). In conclusion, spinach juice combined with iron supplementation effectively improves hemoglobin levels and may serve as a complementary nutritional strategy in prenatal care to reduce anemia among pregnant women.  
Relationship Between Multiple Micronutrient Supplement (MMS) Tablet Supplementation and Gestational Weight Gain Among Pregnant Women with Chronic Energy Deficiency (CED) at UPTD Pancakarsa 2 Primary Health Center Yolipia Muliku; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 2 (2025): November : Health System and Medical Journal
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Abstract

Background : Chronic Energy Deficiency (CED) during pregnancy remains a major nutritional problem associated with increased maternal and fetal health risks, including pregnancy complications, low birth weight, and impaired fetal growth. One of the nutritional interventions currently promoted is Multiple Micronutrient Supplementation (MMS), which provides a combination of essential vitamins and minerals to improve maternal nutritional status. However, evidence regarding the relationship between MMS supplementation and gestational weight gain among pregnant women with CED at the primary healthcare level remains limited. This study aimed to determine the association between MMS supplementation and gestational weight gain among pregnant women with CED at UPTD Pancakarsa 2 Primary Health Center. Methods : A quantitative study with an analytical cross-sectional design was conducted involving 60 pregnant women with CED selected through consecutive sampling. Data were collected from maternal and child health records, medical records, structured questionnaires assessing MMS adherence, and body weight measurements using a calibrated digital scale. Statistical analyses included descriptive analysis, Chi-square test, and multiple linear regression with a significance level of p < 0.05. Results : The findings showed that 70.0% of participants adhered to MMS supplementation, while 65.0% achieved recommended gestational weight gain. Chi-square analysis demonstrated a significant association between MMS adherence and gestational weight gain (p = 0.001). Multiple linear regression identified adherence to MMS supplementation as the strongest factor associated with gestational weight gain (β = 0.58; p < 0.001) after adjustment for maternal age, gestational age, and parity. Conclusion : Adequate adherence to Multiple Micronutrient Supplementation is significantly associated with improved gestational weight gain among pregnant women with Chronic Energy Deficiency. Strengthening nutritional counseling, improving adherence monitoring, and optimizing MMS implementation within antenatal care services may contribute to better maternal nutritional status and improved pregnancy outcomes.
Effectiveness of Complementary Counseling in Controlling Weight Gain among Hormonal Contraceptive Users Srimicha Pasa; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 2 (2025): November : Health System and Medical Journal
Publisher : CV.MEDINSIGHT PUBLISHING

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Background : Hormonal contraception is one of the most widely used family planning methods because of its high effectiveness in preventing pregnancy. However, weight gain remains one of the most frequently reported side effects and often contributes to dissatisfaction, poor adherence, and discontinuation of contraceptive use. Complementary counseling, which integrates education on hormonal contraception with nutritional guidance, physical activity promotion, weight monitoring, and motivational support, has the potential to minimize these adverse effects. This study aimed to evaluate the effectiveness of complementary counseling in controlling weight gain among hormonal contraceptive users. Methods : This study employed a quantitative quasi-experimental design using a pretest–posttest control group approach. A total of 60 hormonal contraceptive users were recruited through consecutive sampling and equally assigned to an intervention group (n=30) and a control group (n=30). Participants in the intervention group received complementary counseling for eight weeks, whereas the control group received routine family planning counseling. Data were collected using structured questionnaires, observation forms, and calibrated digital weight scales. Statistical analyses included descriptive statistics, paired t-test, independent t-test, and multiple linear regression, with a significance level of p < 0.05. Results : Participants who received complementary counseling experienced a mean weight reduction of 0.70 ± 0.48 kg, whereas the control group demonstrated a mean weight increase of 0.90 ± 0.55 kg. The independent t-test indicated a statistically significant difference between the two groups (p < 0.001). Multiple linear regression analysis identified complementary counseling as the strongest predictor of weight change (β = -0.61; p < 0.001) after adjustment for age, baseline body mass index, and contraceptive type. Conclusion : Complementary counseling is effective in controlling weight gain among hormonal contraceptive users. Integrating contraceptive education with nutritional counseling, physical activity guidance, regular weight monitoring, and motivational reinforcement may improve the quality of family planning services and enhance continuation of hormonal contraceptive use. These findings provide evidence to support the implementation of comprehensive counseling programs in primary healthcare settings.
Factors Associated with K4 Antenatal Care Coverage at Wanggarasi Primary Health Center Yasri Aluna Rumampuk; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 2 (2025): November : Health System and Medical Journal
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Background : Completion of at least four antenatal care visits (K4) is an important indicator of maternal health service performance, contributing to the early detection of pregnancy complications and the reduction of maternal and neonatal morbidity and mortality. Despite continuous improvements in antenatal care programs, K4 coverage remains suboptimal in several regions. Multiple factors are believed to influence pregnant women's adherence to the recommended antenatal visit schedule. Methods : A quantitative cross-sectional analytical study was conducted involving 60 pregnant women selected through proportional random sampling. Primary data were collected using a structured questionnaire, while K4 status was verified through Maternal and Child Health (MCH) books and medical records. Data were analyzed using descriptive statistics, Chi-square tests, and binary logistic regression, with statistical significance set at p < 0.05. Results : Of the participants, 70.0% completed the recommended K4 visits. Bivariate analysis revealed significant associations between K4 coverage and maternal knowledge (p=0.001), education (p=0.028), husband's support (p<0.001), access to health services (p=0.011), and quality of antenatal care (p=0.003). Multivariate analysis identified husband's support as the strongest predictor of K4 completion (OR=6.73; 95% CI=2.11–21.44; p=0.001). Conclusion : K4 coverage is influenced by the interaction of maternal characteristics, family support, and health service quality. Strengthening maternal health education, promoting husband involvement, and improving access to and quality of antenatal services are essential strategies for increasing K4 compliance. These findings provide evidence that may assist primary healthcare providers and policymakers in developing more effective maternal health interventions.
Effect of a Combination of a Low-Salt Diet and Coconut Water on Blood Pressure Reduction Among Pregnant Women at Tapa Primary Health Center Indriwati Pakaya; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 2 (2025): November : Health System and Medical Journal
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Background : Hypertension during pregnancy remains one of the leading causes of maternal and fetal morbidity and mortality worldwide. In addition to pharmacological treatment, non-pharmacological interventions through dietary modification have been recommended to assist in blood pressure control. A low-salt diet may reduce sodium retention, while coconut water is rich in potassium and essential minerals that may contribute to blood pressure regulation. This study aimed to determine the effect of a combination of a low-salt diet and coconut water consumption on blood pressure reduction among pregnant women at Tapa Primary Health Center. Methods : This study employed a quantitative quasi-experimental design with a pretest–posttest control group approach. A total of 60 pregnant women were recruited through consecutive sampling and allocated into an intervention group (n = 30) and a control group (n = 30). The intervention group received education regarding a low-salt diet and consumed 250 mL of fresh coconut water daily for 14 days, whereas the control group received routine antenatal care. Blood pressure was measured before and after the intervention using a calibrated digital sphygmomanometer. Data were analyzed using descriptive statistics, paired t-test, independent t-test, and multiple linear regression, with a significance level of p < 0.05. Results : The intervention group demonstrated a significant reduction in mean systolic blood pressure from 148.7 ± 6.8 mmHg to 132.4 ± 5.6 mmHg, while mean diastolic blood pressure decreased from 95.8 ± 4.5 mmHg to 84.6 ± 4.2 mmHg (p < 0.001). The magnitude of blood pressure reduction was significantly greater than that observed in the control group. Multiple linear regression identified the combined low-salt diet and coconut water intervention as the strongest predictor of blood pressure reduction (β = -0.62; p < 0.001). Conclusion : The combination of a low-salt diet and coconut water consumption was effective in reducing blood pressure among pregnant women. This intervention may serve as a safe and practical complementary non-pharmacological strategy in antenatal care to support hypertension management during pregnancy. Further multicenter studies with larger sample sizes and longer intervention periods are recommended to confirm the long-term effectiveness of this approach.
The Effect of Decision-Making Aid (ABPK) Education on the Selection of Long-Acting Contraceptive Methods Putri Yulia Taenggi Puasa; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 2 (2025): November : Health System and Medical Journal
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Background : The low utilization of Long-Acting Reversible and Permanent Contraceptive Methods (LAPMs) remains a major challenge in family planning programs. Limited knowledge and misconceptions regarding the effectiveness, benefits, and safety of long-term contraceptive methods often influence clients' decisions. The Decision-Making Aid (ABPK) is an educational counseling tool designed to facilitate informed contraceptive choices. This study aimed to determine the effect of ABPK-based education on the selection of Long-Acting Contraceptive Methods among prospective family planning acceptors. Methods : A quantitative quasi-experimental study with a pretest–posttest control group design was conducted involving 60 couples of reproductive age, consisting of 30 participants in the intervention group and 30 participants in the control group, selected through consecutive sampling. The intervention group received family planning counseling using the ABPK, whereas the control group received routine counseling. Data were collected using a validated knowledge questionnaire, contraceptive choice observation sheets, and respondent characteristic forms. Statistical analyses included descriptive analysis, paired t-test, Chi-square test, and binary logistic regression, with a significance level of p < 0.05. Results : The mean knowledge score in the intervention group increased significantly from 60.53 ± 9.82 to 84.70 ± 6.45 (p < 0.001). Following the intervention, 73.3% of participants in the intervention group selected long-acting contraceptive methods compared with 36.7% in the control group (p = 0.004). Binary logistic regression demonstrated that participants receiving ABPK-based education were 4.96 times more likely to choose long-acting contraceptive methods than those receiving routine counseling (OR = 4.96; 95% CI = 1.74–14.15; p = 0.002). Conclusion : Education using the Decision-Making Aid (ABPK) significantly improved participants' knowledge and increased the selection of Long-Acting Contraceptive Methods. Integrating ABPK into routine family planning counseling is recommended to strengthen informed decision-making, improve counseling quality, and increase the utilization of long-acting contraceptive methods in primary healthcare settings.
Association Between Maternal Knowledge Regarding Pregnancy Danger Signs and Antenatal Care (ANC) Visit Adherence at Papusungan Primary Health Center Merlis Ladaun; Retno Dewi Prisusanti
Health System and Medical Journal Vol. 1 No. 2 (2025): November : Health System and Medical Journal
Publisher : CV.MEDINSIGHT PUBLISHING

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Background : Maternal knowledge regarding pregnancy danger signs is an important determinant of health-seeking behavior during pregnancy. Adequate knowledge enables pregnant women to recognize potential complications early and encourages compliance with recommended antenatal care (ANC) visits, thereby reducing delays in obtaining appropriate medical care. However, adherence to ANC visits remains a challenge in many primary healthcare settings. This study aimed to determine the relationship between maternal knowledge of pregnancy danger signs and compliance with antenatal care visits at Papusungan Primary Health Center. Methods : This quantitative analytic study employed a cross-sectional design. A total of 60 pregnant women were recruited using consecutive sampling based on predefined inclusion criteria. Maternal knowledge was assessed using a structured questionnaire that demonstrated satisfactory validity and reliability, while ANC compliance was determined through maternal health records and the Maternal and Child Health (MCH) Handbook. Data were analyzed using descriptive statistics, Chi-square tests, and binary logistic regression, with statistical significance established at p < 0.05. Results : Among the respondents, 46.7% demonstrated good knowledge regarding pregnancy danger signs, while 68.3% were compliant with the recommended ANC schedule. Chi-square analysis revealed a statistically significant association between maternal knowledge and ANC compliance (p = 0.001). Binary logistic regression further indicated that women with good knowledge were 5.84 times more likely to comply with ANC visits than those with poor knowledge (OR = 5.84; 95% CI = 1.82–18.71; p = 0.002). Conclusion : Maternal knowledge of pregnancy danger signs was significantly associated with compliance with antenatal care visits at Papusungan Primary Health Center. Strengthening health education through antenatal counseling, maternal education classes, and continuous health promotion is recommended to improve maternal awareness and ANC attendance. Future studies involving larger populations, multicenter settings, and longitudinal designs are recommended to provide stronger evidence regarding factors influencing ANC compliance.

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