Perilaku Konsumsi Tembakau Pelajar SMP Usia 13–15 Tahun di Sumatra dan Jawa (Analisis Indonesia–Gyts 2009) (Behavior Tobacco Consumption Of Junior High School Student Aged 13–15 Years In Sumatra And Java (Analysis Of Indonesia–Gyts 2009))

Background: adolescence is a crucial period that must be maintained properly, because it has a direct and long-termimpact of the act he/she was doing. Baseline Health Research (RISKESDAS) 2007 showed that 59.5% of the causes ofdeath in Indonesia were due non communicable diseases (NCD), and tobacco consumption contributed as trigger of majority of NCD cases. Information related to the behavior of youth tobacco consumption is required to formulate strategicplan to reduce the incidence. Method: standard questionnaires were fi lled by students of 40 junior high schools from 33 districts and cities in Sumatra and Java, with a total sample of 142 classes (covering grades 7 to 9). Results: a total of 3,319 junior high school students aged 13–15 years were covered with a 94.0% response rate. About 20.3% of students was active smokers and 11.5% non-smoker students planned to smoke in 2010. There was 4.2% of active smoker students showed symptoms of addiction to the nicotine in cigarettes. Eight out of 10 active smokers need help to quit smoking. The main factors that motivate junior high school students in Sumatra and Java to smoke were 15.7% of all/most of his close friends smoking and 7 out of 10 junior high school students have at least one parent as smoker. Recommendations: Efforts to prevent children from smoking should be conducted together with support of national tobacco control policies, and the local policies with support from non-governmental organizations, community leaders, health workers, educators, school personnel and families

Sikap & Pandangan Perkumpulan (Asosiasi) Fasilitas Pelayanan Kesehatan terhadap Pasal 24 UU Sjsn Pemetakan dan Telaah Kritis Penyelenggaraan dan Pembiayaan Pelayanan Kesehatan Perorangan Sebelum UU No. 40 Tahun 2004 Tentang Sjsn

Background: Article 19 The National Social Security Act to set personal health service delivery in a Public Health Insurance System is applicable throughout lndonesia. Its implementation is further regulated by Presidential Decree as mandated by Article 24 paragraph 1 of the National Social Security Act. Purpose of the study to determine perception and the role of association which representing health care facilities about article 24. It is predictable to find out who can representing the health facilities in negotiating with the Social Security Administering Bodies (BPJS) and how the implementation mechanisms. Methods: Research design was cross-sectional, the qualitative data collection study involving 22 institutions and consisting of nine associations of health facilities in the central and localy (the city of Jakarta and Semarang, Districs Klaten and Purbalingga), includes: 1 GP Pharmacy, 5 health authorities, 5 health Army directorates/Police and the Armed Forces Headquarters and 2 the directorate in the Department of Health. This study was supported by various study literature and related documents extensively Results: There were some skepticism of the association on the effectiveness of the Association of National Health Insurance program. Terms region restriction should be defined further and Article 24 paragraph (1) can be implemented, whether an administrative area or boundaries refers to the work area of BPJS. Associations health facilities need to look at and comply with provisions of Act Book of the Civil Code if wish to engaged contracts with BPJS. Mechanism of the contract between BPJS and associations of health care facilities explain only one provision, namely: the amount of payments that must be agreed. Need some further explanation to adjust provisions of three parties (BPJS, health facilities and associations of health facilities) within building contract services delivery to insurers. Highlyexpected the more detail provision can be arranged on PJKN Presidential Regulation (PerPres PJKN)

Benefit Monitoring and Evaluation (Bme): a Case Study

Theoretically, the ultimate benefits of health development projects are reflected as increased incomes or tangible improvements in quality of life. They will only be forth coming if services provided by project have more direct effect for those who use the services. However the effects of health programs might be direct or indirect so that they are difficult to be measured comparing with other sectors. The study team conducted a study on Benefit Monitoring and Evaluation (BME) by using The Rural Health and Population Project (ADB Ill-Loan No.1299-lno) as objective of the study. The study was conducted in the year 2000, however, the results of this study is relevant to be published due to it is difficult to find the references, which showed the experiences of the BME study in the health sector. The prime objective of the Rural Health and Population Project was to assist the Government in raising the health status of the population and reducing total fertility rates through the improvement of quality, relevance, efficiency and effectiveness of community-based rural health and family planning (FP) delivery system. The Project adopted the following three strategic initiatives: (1) to change the role and orientation of the district hospital; (2) to improve community-based rural health, nutrition and FP service delivery and capabilities; and (3) to strengthen the organization and management at district level. To examine the extent, to which these reforms through the project implementation have intended benefits and effects, both individually and collectively, the evaluation team conducted a study to evaluate the progress on the field implementation of these reforms in the area of the project. The evaluation of benefits of projects will be conducted, whether or not the benchmarks of benefit monitoring was adequately documented when the project is prepared. The study team using a conceptual model called a Logical Framework (LF) a set of cause-and-effect relationship through which resources provided through the project are transformed so they contribute to achieving the objective of the intervention, and assumptions about external factors which affect these relationships. ALF enables one to describe a project in terms of three sequential relationships: inputs to outputs, outputs to effects and effects to impact. Assessment was used benchmark that information available in the project documents. Addition primary and secondary data needed was collected in the locations of the project. The study identified three group or stakeholders which have benefits of the projects; (1) the local authority; (2) The health provider; (3) the community or recipients. By using the benchmark which available in the regularly reporting and recording system the benefits of the project was assessed as; (1) no benefit; (2} minimal benefit; (3) and optimal benefit. Results of the study showed that (1) the local authority in general have optimal benefit, however several activities have minimal benefits; (2) the health providers have minimal benefit, some showed have no benefit, it is only improvement of medical services have an optimal benefit; (3) the community or recipients almost have optimal benefit

Tinjauan Implementasi Kartu Berobat yang Dijamin Pemerintah di Puskesmas Tahun 2005 (dalam Program Jaminan Kesehatan Masyarakat Miskin)

Implementation of the social health insurance based on the National Social Security Acf/SJSN (Law No. 4012004) was delegated to PT ASKES by the Ministry of Health, to manage health care program for the poor since January 2005. There were 36 million poor people covered by the program at the first semester. The study design was cross-sectional with collection of qualitative and quantitative data to describe the implementation program at Puskesmas. The total samples were 800 respondents with health cards chosen randomly from 4 districts/city in 4 provinces with different level of development (based on Indonesian Human Development Index). There were Karangasem District, Bali; Padang City, West Sumatra; Ende District, East Nusa Tenggara and Lebak District, Banten. Total samples analyzed were 796 household/respondents. About 69% respondents, used askeskin cards at Puskesmas, which increased utilization of the card after 2nd period of the program (after July 2005). About 15% respondents visited health centres without health cards, 15% did not visit the health centres because lack of transportation budget. About 94% of health cards were distributed appropriately to the poor: 74% classified as very poor. 13% classified as poor and 7% classified as nearly poor. About 80% respondents had general clinic services and 30% had MCH services and only 7% visited dentist. They were served 50% by doctor. 45% by midwives and 20% by the nurses. About 20% respondents with health cards still shared budget for medicines. About 85% respondents were satisfied with Puskesmas services. We recommend that safe guarding mechanism should be Implementing with all stakeholders, and socialization to health providers to the poor should be provided much more. Besides the standard implementation program should have several revisions

Determinan yang Berhubungan dengan Ketahanan Hidup Bayi Neonatal di Indonesia

Background: Health care for children under five year in Indonesia was still a problem that should be cope with. Infant mortality (IMR), maternal mortality (MMR), and the IMR in Indonesia, ware still ranked the highest in Southeast Asia. According Soemantri (2004), infant mortality reached 46 per 1000 live births during the period 1998-2002. According SKRT 2001, the highest cause for infant mortality was perinatal disturbances (34%) and for neonatal mortality are premature and low birth weight babies (29%) and birth asphyxia (27%) (Soemantri S, et al: 2004). Baby's health is associated with several maternal factors during pregnancy and birth, infant factors, and environmental factors. The cause of death of a baby has two kinds, namely endogen and exogen. Endogen infant death or neonatal was death that happens at the first month after birth, and generally caused by factors that brought by the child since birth, obtained from the parents at the time of conception or during pregnancy. Exogen baby's death or post-neonatal mortality was happen after the age of one month until the age of one year that is affected by external environment. Obj ective: This analysis is to ascertam the probabtlity and detenninants related to the live endurance of neonatal infants. Methods: This research design was cross sectional, using data of Health Basic Research (Riskesdas) 2007. Data analysis was conducted univariate, bivariate, and multivariate with the life table method, Kaplan Meier and Cox regression. Results: The analysis indicate that premature variables and barier have relationships with the live endurance of neonatal infants, where babies those are born premature have risk 1.4 times higher for death compared with infants those ware not born premature. For a baby that is born with barier haverisk 1.5 times higher for death compared with infants born without barier. Babies born premature and have barier have risk 2.02 times higher than babies born premature, and not without barier

Analisis Biaya Obat untuk Penyakit Kebidanan Rawat Inap Rumah Sakit (Sebelum dan Selama Krisis)

An explorative survey on obstetrics drug cost had been conducted in three hospitals, in Jakarta. The three hospitals were type B governmental hospital, private hospital (I) has 200 beds hospital and private hospital (II) has 170 beds respectively. Medical record data were collected. They were collected purposively, 10% of population number, started from January-May1997 (before crisis) and January-May 1998 (during crisis). The sample size both at the Governmental hospital and at the private hospital were (I) before crisis 112, and during crisis 113, at the private hospital (II) both of before and dunng crisis 75 samples respectively. Results showed that the quality of medical records in 3 hospitals selected still have not clear, complete and correct yet. Drug services profile showed that there's no significant differences between before and during crisis at the governmental hospital. It was identified that drug supplied 1- 3 items, 4-6 items and more than 7 items. Meanwhile at the private hospital (I) showed that there's significant differences, especially when drug supplied 1- 3 items increase from 31,8% before crisis, up to 53,4% during crisis. Evenly, the private hospital (II) drug supplied 1-3 items increased from 47,4% before crisis, up to 63,7% during crisis. Obstetrics drug cost for 7 item drugs supplied increased from Rp. 74.000,- (before crisis) up to Rp. 152.000,- (during crisis). Similarly at the private hospital (II) the drug cost for obstetrics cases increased by two times for 7 item drug supplied, that was Rp.198.000,- to Rp.406.000,-. There's no difference between before and during crisis for generic drug utilization even at the Governmental Hospital or private hospitals. Since drug cost of some diseases might be compared by a different period, the samples must be in a sizeable for getting a responsible value

Prevalence and Risk Factors of the Ischemic Heart Diseases in Indonesia: A Data Analysis of Indonesia Basic Health Research (Riskesdas) 2013

Background: The Cardiovascular disease (CVDs) is leading in the world as a number one cause of death. Ischemic Heart Disease (IHD) part of CVDs which is often also called coronary artery disease.Objective: The purpose this study is to know the risk factors for ischemic heart disease in Indonesia, 2013.Methods: The risk assessment analyzes was used to exam the risk factor IHD around 721,427 people from data of Basic Health Research (RISKESDAS) 2013 in Indonesia.Results: The finding of this study was former smoker (Adj. OR= 4.09, 95% C.I=3.78-4.43), hypertension (Adj. OR= 3.80, 95% C.I=3.60-4.10), obesity (Adj. OR= 1.96, 95% C.I=1.84-2.08), low consumption of fruits and vegetables (Adj. OR= 0.70, 95% C.I=0.57-0.87), and low physical activity (Adj. OR= 1.14, 95% C.I=1.06-1.23) are risk factor of IHD in Indonesia, 2013.Conclusion: The central, regional, and even village level special attention have a need for reducing IHD. Cross-program and sector collaboration are also needed collaboration with NGOs and the private sector to control risk factors outside the health sector and improve the environment