FACTORS AFFECTING INDONESIAN PUBLIC HEALTH CENTERS' HEALTH WORKERS' INCOME ADEQUACY

Background: Dissatisfaction, additional work, and desired compensation are related to the needs and perceptions of civil servant health workers to increase their income. However, the probability and influencing factors regarding the income adequacy of civil servant health workers in Indonesia are still unknown. Aims: to find out the factors related to the income adequacy of health workers. Methods: This observational study with a cross-sectional design uses data from the Employment Research in the Health Sector (RISNAKES) 2017 in Public Health Centers in Indonesia. Probit analysis was conducted to assess the probability of income adequacy. Results: A total of 963 respondents were analyzed. The study found that changes in each variable, including income, official residence facilities, training facilities/ seminars/ training, motivation, and job satisfaction of a unit, would increase the probability of income adequacy ranging from 2% - 81%, except for the age variable. By referring to high job satisfaction of > 75% and taking into account the probability of 80%, the presumed adequate income is no less than IDR 28,800,000. Conclusion: The probability of the monthly income adequacy of civil servants in the health sector is influenced by job satisfaction, ability to save, official residence facilities, facilities to attend seminars, age, and income. Increasing and reformulating the amount of income must be done to optimize the performance and productivity of health workers. Keywords: health workers, income adequacy, public health center, savin

EARLY STRESS DETECTION DURING PREGNANCY USING E-HEALTH IN THE PANDEMIC

Background: Women are more prone to stress during pregnancy than during the postpartum period. Stress during pregnancy is correlated with pregnancy and birth outcomes. Early detection using the e-health system is an alternative to health services during the pandemic. Aims: The research objective was to produce innovation in early stress detection using an information system based on the e-Health system. Methods: This study was conducted in the Ngaliyan Primary Healthcare Centre with 34 pregnant women. This study utilized both qualitative and quantitative research. Qualitative research used the System Development Life Cycle (SDLC), while quantitative research used an experimental design with a one-shot case study approach. Results: The e-Health system could automatically identify stress during pregnancy, with the TAM questionnaire yielding a very effective result of 85.4%. The average time needed to detect pregnant women’s stress was 230.94 seconds. This system can analyze 374 pregnant women within one day (24 hours), provide services, and report pregnant women’s stress detection results. Conclusions: The e-Health system effectively conserves time and can be used to record and report early stress in pregnant women. Keywords: early detection, information system, pregnancy, smartphone, stres

PROBLEMATIC OF AUTONOMY REVIEW OF THE COVID-19 VACCINATION INFORMED CONSENT

Background: Not all public approval to receive COVID-19 vaccination is based on understanding the right information, which is considered insufficient motivation. It is also related to inadequate government policies. Aims: This study was to identify the implementation of informed consent in COVID-19 vaccination, in terms of the autonomy of the vaccine recipients, so that the necessary policy could be recommended. Methods: The research was conducted at Surabaya in June-December 2021 with descriptive qualitative methods through in-depth interviews with five vaccinators and five vaccine recipients using purposive sampling. Data were analyzed from interview transcripts by coding, making categories and themes, and then compared to relevant references. Results: The results showed that 60% of the implementation of the COVID-19 vaccination informed consent was inadequate. It was found that incomplete information disclosure is often not even given information, and vaccinations are carried out without a signature of informed consent. These findings suggest that respect for the autonomy of COVID-19 vaccine recipients has not been made. Conclusion: Inadequate respect for the autonomy of vaccine recipients risks causing a medical conflict in the future if there are unexpected effects. Thus, the government must make standard informed consent procedures for COVID-19 vaccination and collaborate with the local government. Keywords: Covid-19 vaccination, informed consent, information disclosure, respect for autonom

FACTORS INFLUENCING PATIENTS’ REVISIT INTENTION TO PUBLIC HEALTH CENTER DURING COVID-19 PANDEMIC

Background: COVID-19 was declared a community health emergency, prompting the Indonesian government to implement a large-scale social restriction policy on March 2022. As a result, the number of patient visits to the Public Health Center (PHC) decreased. Aims: This study aimed to analyze the factors affecting the revisit intention of patients at PHC during the COVID-19 pandemic. Methods: This observational study was conducted at PHC XYZ in West Jakarta in September and October 2022 using a cross-sectional approach. Inclusion and exclusion criteria were employed to select 244 samples. The data collected through a questionnaire with 37 questions were analyzed using PLS-SEM. Results: Government trust and trust in healthcare facilities positively affect revisit intention, with t-statistics of 4.816 and 0.003 as well as a p-value of 0.000. Meanwhile, perceived crowding and health risk, reputation, self-confidence, familiarity, and brand image did not significantly influence revisit intention at the PHC during the COVID-19 pandemic. Conclusion: This study showed that trust in government and healthcare facilities affects the revisit intention of patients. Patients trust that the Government can overcome COVID-19 and that PHC can be trusted during COVID-19 has a positive influence on patients' intention to revisit. It is important to identify the factors influencing revisit intention at PHC during the pandemic because PHC has a role as a primary healthcare service. Keywords: COVID-19, government trust, Public Health Center, revisit Intention, trus

DO ANTI-SMOKING ADVERTISEMENTS INFLUENCE STUDENTS TO QUIT SMOKING?

Background: The prevalence of adolescent smoking in Indonesia increased from 2013 to 2018. Aims: This study examines the influence of pro and anti-cigarette advertising on students' smoking cessation. Methods: The study uses the Global Youth Tobacco Survey Indonesia 2019 data. The sample was students aged 13-15 years who had smoked. The dependent variable is quitting smoking, and the independent variables are pro-cigarette and anti-smoking ads: chi-square and logistic regression tests with a 95% confidence interval and a p-value of 0.05. Results: The total sample was 1023 students, and 79.32% wanted to quit smoking. In the anti-smoking ads variables: anti-smoking messages in various media (OR=1.63, 95% CI=1.14-2.34); pictorial health warnings (PHW) on cigarette packs (OR=3.46, 95% CI=2.40-4.97); feeling afraid when seeing health warnings on packaged cigarettes (OR=3.03, 95% CI=2.16-4.26); education about harmful of cigarette consumption (OR=1.40, 95% CI=1.00 – 1.96) had a significant association to quit smoking. The most dominant factor in multivariate analysis was pictorial health warnings on cigarette packs (OR=2.53, 95% CI=1.67-3.81). Conclusion: Most student smokers express a desire to quit smoking. Pictorial health warnings are significantly associated with quitting smoking among students. Keywords: cigarette ads, GYTS, pictorial health warning, student

HUMAN RIGHTS-BASED LEGAL PROTECTION FOR HEALTH WORKERS IN CONFLICT ZONES

Background: One of the human rights issues in the health sector is legal protection in conflict areas. The obstacles faced were the limited number of security personnel on guard and the long distance between the security post's location and the conflict's location. Aims: This study aims to determine how legal protection for health workers in conflict areas is. Methods: The method of this study is a literature review. The nature of this study is descriptive. The data collection method used is the literature study method, namely by collecting secondary data related to the issues raised. Results: The results of this study show that the central and regional governments have not been maximal in protecting health workers in conflict areas. Conclusion: Based on the results and discussion of this study, the recommendations are to make a grand design for health, security, and occupational safety for health workers, specifically in conflict areas, and to make standard operating procedures for handling cases of attacks on health workers in conflict areas. Keywords: Human Rights, Legal Protection. Health Workers

COST ANALYSIS OF HOME PHARMACY CARE PROGRAM AMONG DIABETES PATIENTS IN PHARMACY

Background: Home pharmacy care is expected to be able to provide a pharmaceutical service that not only reduces the incidence of drug interactions and side effects but also increases the effectiveness of therapy and patient compliance in using drugs. Aims: The study aimed to analyze the costs incurred for the home pharmacy care program for diabetic patients at the pharmacy. Methods: This analysis used the independent variable by providing a program of home pharmacy care. The dependent variable was the cost of running the program of home pharmacy care. The sample was the pharmacist in charge of the pharmacies in the Banyumas and Cilacap districts, which provide a home pharmacy care service program. The sample was conducted by purposive sampling method. Sampling was done by direct interviews with pharmacists who signed informed consent. Break Even Point (BEP) was calculated to determine the number of patients who must be served. The pharmacoeconomic analysis used is Cost Analysis using the activity-based costing (ABC) method. Results: The lowest rate for home pharmacy care services is Rp. 17,000, and the highest is Rp.31,000 without including home pharmacy care services. Conclusions: Pharmacies continue to benefit from the home pharmacy care program, and there is no provision for home pharmacy care service rates. Keywords:  Activity Based Costing (ABC), Diabetes Mellitus, Home pharmacy care (HPC

KNOWLEDGE AND ATTITUDES OF HEALTH WORKERS TOWARDS COVID-19 VACCINATION IN ACEH, INDONESIA

Introduction: Herd immunity through vaccination is one of the major strategies for overcoming the COVID-19 pandemic, but there are still doubts about vaccines among health workers. Aims: This study aims to assess the relationship between knowledge of the COVID-19 vaccine and the attitudes of health workers. Methods: This is a cross-sectional study, which involves the distribution of a validated online questionnaire through Google Forms to health workers at Zainoel Abidin General Hospital Banda Aceh. The data consist of general characteristics, 13 questions regarding knowledge, and nine inquiries related to attitudes. Results: There were 301 respondents, of which 87.4% were females and 48.8% were nurses. Only 27.9% of the health workers have a history of COVID-19 courses, 67.8% have good knowledge about the vaccine, and 70.8% with a positive attitude. There was a significant relationship between the knowledge of the vaccine and health workers' attitudes. Furthermore, gender, age, education level, and training history did not affect the knowledge of vaccination, while profession was the main influential factor. Conclusion: This study shows that there is a relationship between knowledge of the COVID-19 vaccine and health workers' attitudes. However, stakeholders must always focus on strategies that can increase understanding and practice of disease prevention Keywords: attitude, COVID-19 vaccine, knowledge, health worker

THE INFLUENCE OF INTERNAL FACTORS ON JOB SATISFACTION IN HEALTHCARE SETTINGS

Background: Job dissatisfaction in healthcare facilities can increase medical errors. In order to reduce the medical errors, hospitals must focus on employee job satisfaction. In this case, both stress and burnout can lower job satisfaction. Aims: This research was conducted to analyze the internal factors that affect the level of job satisfaction of employees in health facilities. Methods: The method applied is the PRISMA framework, which consists of five stages, namely eligibility criteria, information sources, study selection, data collection process, and data items. Results: Systematic review was done on 34 quantitative studies about the factors that influence job satisfaction. Based on the review, the internal factors known are demographic and personal factors. In this case, demographic factors mostly do not affect employee job satisfaction, one of which is salary. Meanwhile, the most researched personal factor and the biggest influence is burnout. Conclusion: Based on the systematic review, it is known that the internal factors affecting employees’ job satisfaction include demographic and personal factors. The demographic factor that has a significant effect is salary, while the most researched individual factor is burnout. Working in the health sector requires caution so as not to cause medical errors. Health workers who experience burnout are at risk of causing medical errors. For that we need a strategy to overcome burnout so as to increase job satisfaction. Keywords: burnout, healthcare, internal factor, job satisfaction, PRISM