Analisis Program Pemberian Air Susu Ibu (ASI) Eksklusif di Puskesmas Wilayah Kabupaten Purbalingga

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan 2016 ABSTRAK Rismawati Analisis Program Pemberian Air Susu Ibu (ASI) Eksklusif di Puskesmas Wilayah Kabupaten Purbalingga xv + 99 halaman + 6 tabel + 3 gambar + 13 lampiran Penyebab kematian anak di Indonesia salah satunya disebabkan masalah gizi yang erat kaitannya dengan pemberian ASI Eksklusif. Pada tahun 2014 kasus gizi buruk di Kabupaten Purbalingga terdapat 80 kasus. Keberhasilan program ASI Eksklusif tidak terlepas dari peran dari sistem manajemen program. Data cakupan ASI Eksklusif di Kabupaten Purbalingga pada tahun 2014 sebesar 63,40%. Masih dibawah target yang diharapkan yaitu sebesar 80%. Tujuan penelitian untuk menganalisis aspek input, proses, output dari program pemberian ASI Eksklusif di Puskesmas wilayah Kabupaten Purbalingga. Jenis penelitian kualitatif yang disajikan secara deskriptif eksploratif melalui wawancara mendalam terhadap 4 informan utama; petugas gizi dan 8 informan triangulasi; 4 Kepala Puskesmas dan 4 bidan koordinator. Pengolahan dan analisis data menggunakan metode content analysis. Hasil penelitian menunjukkan bahwa aspek input pada Puskesmas cakupan ASI Eksklusif rendah; SDM kurang dan terbatas, tidak pernah mengikuti pelatihan, tidak ada dana khusus, sarana prasarana belum memadai, tidak ada SOP, dan Perda sepenuhnya belum diketahui oleh pelaksana program. Aspek proses pada Puskesmas cakupan ASI Eksklusif tinggi; perencanaan ditentukan melalui alur kerja, supervisi, pengarahan dan sosialisasi rutin dilaksanakan, dan masih terdapat kendala-kendala didalam pelaksanaan program baik pada Puskesmas cakupan tinggi maupun rendah. Aspek output menunjukkan tidak ada KP-ASI pada Puskesmas cakupan rendah, berbeda dengan Puskesmas cakupan tinggi bahwa telah ada KP-ASI yang dibentuk. Disarankan untuk advokasi berulang kepada pemerintah daerah agar formulasi Peraturan Daerah segera disahkan dan dapat segera diterapkan. Mengadakan dan menyediakan ruang laktasi. Memprioritaskan program pemberian ASI dan alokasi dana khusus. Menyusun perencanaan dan pelatihan untuk memenuhi kebutuhan SDM kesehatan dan menambah jumlah konselor sebagai tenaga terlatih ASI di instansi pemerintah dan swasta. Kata kunci :Sistem Kesehatan, ASI Eksklusif, Program Kepustakaan :52 (1968 – 2015) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Administration and Health Policy 2016 ABSTRACT Rismawati Analysis of Exclusive Breastfeeding Program at Health Centres in District of Purbalingga xv + 99 pages + 6 tables + 3 figures + 13 appendices One of the causes of mortality among children in Indonesia was nutritional problems in which it was related to exclusive breastfeeding. In 2014, number of malnutrition cases in Purbalingga District were 80 cases. The success of exclusive breastfeeding program could not be separated with a role of management system of the program. Coverage of exclusive breastfeeding in Purbalingga District in 2014 was 63.40% (below the target of 80%). The aim of this study was to analyse aspects of input, process, and output of the exclusive breastfeeding program at health centres in Purbalingga District. This was a qualitative study presented using descriptive and explorative methods. Data were collected by conducting indepth interview to four main informants working as nutritionist and to 8 informants for triangulation purpose, namely 4 heads of health centres and 4 coordinator midwives. Data were analysed using content analysis. The results of this research showed that input aspects at health centres with low coverage of exclusive breastfeeding were as follows; number of human resource was insufficient; there was no training followed; there was no specific budget allocated; facilities were insufficient; there was no SOP; and not all implementers of the program knew an available regional regulation. Process aspects at health centres with high coverage of exclusive breastfeeding were as follows; a planning was determined by work steps; supervision, guidance, and socialisation were routinely conducted; there were some obstacles in the implementation of the program in both kinds of health centres. Output aspects demonstrated that there was no KP-ASI at health centres with low coverage of exclusive breastfeeding, otherwise KP-ASI was available at health centres with high coverage of exclusive breastfeeding. Advocacy needs to do to the local government in order to approve a draft of the regional regulation and to implement it. A lactation room needs to be provided. The program of exclusive breastfeeding and allocation of specific budget needs to be prioritised. There needs to arrange planning and training to fulfil human resource of health and to add number of counsellor as a trained worker for exclusive breastfeeding at public and private institutions. Keywords : Health System, Exclusive Breastfeeding, Program Bibliography: 52 (1968-2015

HUMAN IMMUNODEFICIENCY VIRUS (HIV) PREVENTION PROGRAM AMONG MEN WHO HAVE SEX WITH MEN (MSM) IN SEMARANG CITY

Background: The prevalence of Human Immunodeficiency Virus (HIV) among Men who have Sex with Men (MSM) in Indonesia continues to increase. The HIV cases among MSM in Semarang increased by 43 cases in 2013 to 147 cases in 2017. The prevalence of syphilis among MSM increased by 5.20% in 2011 to 11.38% in 2015. The use of condoms among MSM does not reach 50%. The Prevention of Sexual Transmission of HIV Program or Pencegahan HIV melalui Transmisi Seksual (PMTS) that focuses on sexual transmission risk factors did not provide optimal results.Aim: This study aimed to analyze aspects affecting the PMTS Program on MSM in Semarang City, including standard and objectives, resources, inter-organizational communication and enforcement activities, characteristics of the implementing agencies, economic, social, and political conditions, and the disposition of implementors.Method: This study was a descriptive study using a qualitative approach. Primary data were obtained through in-depth interviews with 14 informants, while secondary data were obtained from observation and document analysis. The data were analyzed using content analysis. The research was conducted from July to October 2019 in Semarang City.Results: The implemetation of the PMTS Program among MSM has some gaps. For example, these included (1) unclear standards of PMTS Program, (2) limited funding and infrastructures, (3) lack of  communication, (4) stigma and discrimination at the stakeholder level, implementing agencies level, and community level.Conclusion: The implementation of PMTS Program among MSM has not worked appropriately. Eliminating stigma and discrimination against MSM needs to be taken into account. All health workers in primary healthcare centers must be introduced to the diminish of stigma and discrimination against MSM. Communication and coordination as well as resources among the program implementers have to be more well-established. Keywords:  Human Immunodeficiency Virus, Men who have Sex with Men, prevention program

HUBUNGAN KARAKTERISTIK DEMOGRAFI, FAKTOR K3 (KESELAMATAN DAN KESEHATAN KERJA) DAN LINGKUNGAN TERHADAP KEJADIAN LEPTOSPIROSIS: Sebuah Studi Pada Pekerja Sektor Informal di Kota Semarang Tahun 2013-2016

Latar Belakang: Leptospirosis adalah penyakit yang disebabkan oleh bakteri patogen Leptospira, yang ditularkan baik secara langsung maupun tidak langsung. Kasus Leptospirosis menunjukkan tren yang semakin meningkat dan persebaran di Kota Semarang semakin meluas. Penelitian mengenai Leptospirosis sudah banyak dilakukan, tetapi hubungan antara karakteristik demografi, faktor K3 dan lingkungan yang terfokus pada pekerja sektor informal sejauh ini masih belum jelas dan sangat jarang dilakukan. Sehingga penulis tertarik untuk meneliti hubungan antara karakteristik demografi, faktor K3 dan lingkungan terhadap kejadian Leptospirosis pada pekerja sektor informal di Kota Semarang. Metode: jenis penelitian observasional dengan rancangan kasus kontrol. Populasi penelitian ini adalah seluruh pekerja sektor informal di Kota Semarang, yang dibatasi pada petani, petugas kebersihan, buruh (tani, serabutan, bangunan) dan pedagang tradisional. Jumlah sampel 41 kasus dan 41 kontrol. Analisis data dilakukan secara univariat, bivariat dan multivariat dengan metode regresi logistik backward LR. Hasil: Faktor risiko yang berhubungan dengan kejadian Leptospirosis pada pekerja sektor informal adalah umur (18-40 tahun) p=0,017; aOR=42,22; 95%CI=1,9-906,5, jenis kelamin (laki-laki) p=0,017; aOR=37,01, 95%CI=1,9-718,6; riwayat luka pada saat bekerja p=0,042; aOR=10,85; 95%CI=1,8-108,24; kondisi sanitasi rumah (buruk, skor <60%) p=0,025; aOR=25,25; 95%C=1,5-423,3; dan Riwayat kontak dengan sumber infeksi p=0,003; aOR=56,98; 95%CI=3,8-849,2. Simpulan: Faktor risiko yang berhubungan dengan kejadian Leptospirosis pada pekerja sektor informal adalah faktor karakteristik demografi, K3 dan Lingkungan. Saran: menjaga kondisi sanitasi dan melakukan pengendalian tikus di rumah serta di tempat kerja, penggunaan APD, dan perawatan luka terbuka. Kata kunci: Leptospirosis, Faktor risiko, K3, Lingkungan, Pekerja Sektor Informal Background: Leptospirosis is a disease caused by pathogenic bacteria called Leptospira, which is transmitted directly or indirectly. Leptospirosis occurrences have tended to increased with widespread distribution. There were many of Leptospirosis study. However, the relation between demographic characteristic, occupational health and safety (OHS), and environmental factors foccusing on the workers of informal sectors was unclear. The objectives of study were to measure the association between demographic characteristics, OHS and environmental factors with Leptospirosis in the workers of informal sectors. Methods: an observational study with case-control design. Popupation of the study were all of workers of the informal sectors in Semarang City, it is including, but not limited to farmers, cleaning worker, laborers (farming, construction, handyman) and traditional market worker. There are 41 cases and 41 controls. Analysing data was perform by univariant, bivariant, and multivariant. Results: The main risk factors were age (18–40 years old) p=0,017; aOR=42,22; 95%CI=1,96-906,55; Gender (male) p=0,017; aOR=37,01, 95%CI=1,9-718,6; history of open wound during working p=0,042; aOR=10,85; 95%CI=1,08-108,24; home sanitation (poor, with score <60%) p=0,025; aOR=25,25; 95%CI=1,5-423,3; and history of contact with the source of infection p=0,003; aOR=56,98; 95%CI=3,8-849,2. Conclusion: Demographic characteristics, OHS, and environmental factors were associated with Leptospirosis. Suggestion: keeping sanitation in good condition, controlling the population of mice both in the home and in the working place, applying PPE (personal protective equipment), and treating open wounds carefully. Keywords: Leptospirosis, occupational health and safety, environmental, workers of informal sectors

Faktor Faktor yang Berhubungan dengan Implementasi Program Pengendalian Tuberkulosis di Puskesmas Wilayah Kabupaten Magelang

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan 2017 ABSTRAK Ita Puji Lestari Faktor Faktor yang Berhubungan dengan Implementasi Program Pengendalian Tuberkulosis di Puskesmas Wilayah Kabupaten Magelang xxii + 130 halaman + 31 tabel + 4 gambar + 21 lampiran Prevalensi TB di Provinsi Jawa Tengah pada tahun 2012 adalah sebesar 106,42 per 100.000 penduduk. Penemuan kasus dan Case Detection Rate di bawah standar 70%, pada level kota/ kabupaten maupun level puskesmas dan untuk CDR terendah di Kabupaten Magelang yaitu 21,82%. Kabupaten Magelang pada tahun 2013 perkiraan kasus baru TB Paru BTA positif sebanyak 1285 orang dengan cakupan penemuan kasus TB Paru BTA positif pada tahun 2013 mencapai 17,98%. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan implementasi program pengendalian TB di Puskesmas Kabupaten Magelang. Jenis penelitian adalah observasional analitik dengan pendekatan Cross Sectional. Responden dalam penelitian ini adalah seluruh petugas pelaksana yang terdiri satu perawat koordinator program, seorang tenaga laboratorium, dan serang dokter sebanyak 87 orang. Analisis data dilakukan secara multivariat. Hasil penelitian dengan uji statistik menunjukkan ada hubungan antara faktor komunikasi dengan implementasi (p=0,001), ada hubungan antara faktor disposisi dengan implementasi (p=0,001),ada hubungan antara faktor karakteristik badan pelaksana dengan implementasi (p=0,001), ada hubungan antara pemahaman standar dengan implementasi (p=0013),tidak ada hubungan antara faktor sumber daya dengan implementasi (p=0,240), dan tidak ada hubungan yang bermakna antara faktor lingkungan dengan implementasi program TB (p=0,057). Disarankan Puskesmas untuk menyusun instrumen yang mengukur efektifitas koordinasi dalam program,membuat kegiatan pendidikan dan pelatihan kaderisasi penyakit TB secara berkala. Puskesmas menjalin jejaring kerja sama dengan stakeholder dan masyarakat, menyusun pengembangan sistem reward bagi petugas maupun kader TB yang memiliki peran yang aktif ,menyusun suatu task force khusus untuk program pengendalian TB yang dilegalkan dengan Surat Keputusan dari Kepala Puskesmas. Kata Kunci : Implementasi Program, Tuberkulosis\ud Kepustakaan : 52 (1980-2016)Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Administration and Health Policy 2017 ABSTRACT Ita Puji Lestari Factors Relating to the Implementation of Tuberculosis Intervention Program at Health Centres in Magelang Regency xxii + 130 pages + 31 tables + 4 figures + 21 appendices A prevalence of Tuberculosis (TB) in Central Java Province in 2012 was 106.42 per 100,000 people. Case finding and case detection rate (CDR) were lower than the standard (< 70%) either at a level of regency or a level of health centre. CDR in Magelang Regency was the lowest (21.82%). In 2013 in Magelang Regency, estimation of new TB cases with positive Acid Resistant Bacteria (ARB) was approximately 1285 persons and coverage of case finding was about 17.98%. This study aimed at identifying factors relating to the implementation of the TB intervention program at health centres in Magelang Regency. This was an observational-analytic study using a cross-sectional approach. Number of respondents was 87 persons who were all implementers consisted of a coordinator of nurse, laboratory assistant, and a physician. Data were analysed using a multivariate method. The results of this research showed that factors of communication (p=0.001), disposition (p=0.001), characteristics of implementers (p=0.001), and understanding of the standard (p=0.013) had significant relationship with the implementation of the TB intervention program. In contrast, factors of source (p=0.240) and environment (p=0.057) did not relate to the implementation of the TB intervention program. Health centres need to arrange an instrument to measure effectiveness of coordination in implementing the program, and to conduct educational activities and training of TB cadres regularly. In addition, health centres need to build network with stakeholders and community, to arrange reward system development for health workers and TB cadres who have important roles, to arrange a specific task force for the TB intervention program that was legalised by issuing Decree from heads of health centres. Keywords: Program Implementation, Tuberculosis Bibliography: 52 (1980-2016

BEBERAPA FAKTOR RISIKO KEMATIAN NEONATAL DINI DI KABUPATEN KENDAL

Latar Belakang: Menurut WHO dua pertiga kematian neonatal terjadi pada masa neonatal dini (0-6 hari). Hasil Riskesdas 2007 menunjukkan 78,5% kematian neonatal terjadi pada umur 0-6 hari. Di Kabupaten Kendal tahun 2012-2015 prosentase kematian neonatal dini dari seluruh kasus kematian neonatal masih cukup tinggi.Tujuan penelitian ini untuk membuktikan faktor ibu, faktor bayi, faktor pelayanan kesehatan dan faktor sosial ekonomi merupakan faktor risiko kematian neonatal dini. Metode : Penelitian ini menggunakan desain studi case control didukung indepth interview. Populasi studi adalah bayi yang tercatat di puskesmas wilayah Kabupaten Kendal. Sampel penelitian sebanyak 114 orang terdiri dari 57 kasus dan 57 kontrol. Pengambilan sampel dengan consecutive sampling pada kasus dan random sampling pada kontrol.Variabel yang diteliti meliputi umur ibu, paritas, anemia ibu, status gizi ibu, komplikasi kehamilan, komplikasi persalinan, pendidikan ibu, berat lahir bayi, asfiksia, praktek ANC, penolong persalinan, tempat persalinan, pelayanan neonatal, rujukan dan tingkat pendapatan keluarga. Pengolahan data menggunakan SPSS, analisis data secara univariat, bivariat (chi square) dan multivariat ( regresi logistik). Hasil : Faktor yang terbukti merupakan faktor risiko kematian neonatal dini di Kabupaten Kendal adalah berat lahir bayi < 2500 gram/BBLR (p=0,024; aOR=6,983; 95%CI=1,290-37,804), asfiksia (p=<0,001; aOR=47,342; 95%CI=11,090-202,095) dan rujukan terlambat (p=0,002; aOR=17,831; 95%CI= 2,838-112,029) Simpulan : BBLR, asfiksia dan rujukan terlambat merupakan faktor risiko kematian neonatal dini dengan probabilitas sebesar 99,8% . Kata Kunci : Kematian Neonatal Dini, BBLR, asfiksia, rujukan terlambat Background : According to WHO two-thirds of neonatal deaths occur in the early neonatal period (0-6 days). The result of Riskesdas 2007 showed 78.5% of neonatal deaths occur at the age of 0-6 days. In Kendal Regency during the years of 2012-2015 the percentage of early neonatal mortality of all cases of neonatal mortality is still high. This research aims to prove that maternal factors, infant factors, health service factors and socioeconomic factors are the risk factors for early neonatal mortality. Methods: This research used case control design which was supported by indepth interviews. The study population was all babies recorded in community health centers in Kendal Regency. The research sample consisting of 57 cases and 57 controls. Samples were collected by a consecutive sampling technique. Variabel included maternal age, parity, maternal anemia, nutritional status of the mother, complications of pregnancy, childbirth complications, maternal education, infant birth weight, asphyxia, antenatal care, birth attendance, birth setting, neonatal care, referral and family income level. The data analysis used univariate, bivariat and multivariat. Results: Factors proven to be risk factors of early neonatal mortality were birth weight of neonates< 2,500 grams (p = 0.024; aOR = 6.983; 95% CI = 1.290-37.804), asphyxia (p = <0.001; aOR = 47.342; 95% CI = 11.090-202.095) and late referral (p = 0.002; aOR = 17.831; 95% CI = 2.838-112.029). Conclusion: Risk factors for early neonatal mortality are low birth weight, asphyxia and late referral with the probability of 99.8%. Keywords: Early neonatal mortality, low birth weight, asphyxia and late referra

PENGARUH PEMBERIAN MAKANAN PENDAMPING AIR SUSU IBU DINI TERHADAP GANGGUAN PERTUMBUHAN PADA BAYI USIA 6-12 BULAN (Studi Kohort Prospektif di Wilayah Kerja Puskesmas Tongkuno, Kabupaten Muna, Provinsi Sulawesi Tenggara)

Latar Belakang: Cakupan ASI eksklusif di Provinsi Sulawesi Tenggara pada tahun 2016 yaitu 46,63% dimana angka ini belum mencapai target nasional (85%), sedangkan cakupan ASI eksklusif di Puskesmas Tongkuno yaitu 57,4%. Cakupan ASI eksklusif yang rendah menggambarkan tingginya pemberian makanan pendamping air susu ibu dini pada bayi. Penelitian ini bertujuan untuk membuktikan pengaruh pemberian MP-ASI dini terhadap gangguan pertumbuhan (growth faltering) pada bayi usia 6-12 bulan di wilayah kerja Puskesmas Tongkuno. Metode: Penelitian ini menggunakan desain cohort prospective yang dilakukan selama 2 bulan pada 79 bayi: 32 bayi yang diberi MP-ASI dini dan 47 bayi yang tidak diberi MP-ASI dini. Subyek dipilih secara consecutive sampling. Growth faltering ditentukan melalui kenaikan berat badan anak dalam 2 bulan yang kurang dari persentil ke-5 berdasarkan standar WHO weight increment. Analisis data menggunakan regresi logistik. Hasil: Dari 79 bayi yang diteliti, 30,4% mengalami gangguan pertumbuhan. Tidak ada perbedaan karakteristik (jenis kelamin, tingkat pendidikan orang tua, pekerjaan orang tua, umur dan berat badan bayi saat awal penelitian, serta umur orang tua) antara kelompok yang diberi MP-ASI dini dan kelompok yang tidak diberi MP-ASI dini. Hasil analisis multivariat menunjukkan bahwa ada pengaruh pemberian MP-ASI dini terhadap gangguan pertumbuhan pada bayi usia 6-12 bulan (OR= 3,429; 95%CI= 1,076-10,932) setelah dikontrol tingkat kecukupan energi, protein, dan zinc; riwayat berat lahir rendah; dan kejadian penyakit infeksi saluran pernapasan atas. Simpulan: Pemberian MP-ASI dini berpengaruh terhadap gangguan pertumbuhan pada bayi usia 6-12 bulan. Kata kunci: MP-ASI dini, gangguan pertumbuhan, bayi Background: The coverage of exclusive breastfeeding in Southeast Sulawesi in 2016 was 46.63% which had not reached the national target (85%), while the coverage in Tongkuno health center was 57.4%. The low coverage of exclusive breastfeeding illustrates that many infants got early complementary feeding. This study aimed to determine the effect of early complementary feeding on growth faltering on infants aged 6-12 months in Tongkuno health center. Methods: This cohort prospective study was held for 2 months in 79 infants: 32 infants who were given early complementary feeding and 47 infants who were not. The subjects were chosen by consecutive sampling technique. Growth faltering was defined as the baby weight increments within two months < 5th percentile of WHO weight increment standard. Data were analyzed by logistic regression method. Results: There were 79 of the infants who followed for 2 months, 30.4% of them had growth faltering. There were no differences on respondents’ characteristics (gender, parents education level, parents occupation, infant age and body weight at the beginning of the study, and parents age) between the early complementary feeding group and the timely complementary feeding group. Multivariate analysis showed that there was an effect of early complementary feeding on growth faltering on infants aged 6-12 months (OR=3.429; 95%CI: 1.076-10.932) after controlling for energy, protein, and zinc adequacy level; the history of low birth weight; and the incidence of upper respiratory tract infections. Conclusion: Early complementary feeding affect the growth faltering on infants aged 6-12 months. Keywords: Early complementari feeding, growth faltering, infan

BEBERAPA FAKTOR RISIKO KEJADIAN DROP OUT PENGOBATAN PENDERITA KUSTA YANG DITEMUKAN SECARA AKTIF (Studi di Wilayah Kerja Puskesmas Kabupaten Brebes)

Latar Belakang: Menurut data Dinas Kesehatan Kabupaten Brebes tahun 2011 angka drop out pengobatan pada penderita yang ditemukan secara aktif lebih tinggi dibandingkan penderita yang ditemukan secara pasif. Penelitian ini bertujuan untuk membuktikan faktor predisposisi, enabling dan reinforcing sebagai faktor risiko kejadian dropout pengobatan penderita kusta yang ditemukan secara aktif. Metode: Jenis penelitian adalah observasional dengan rancangan kasus kontrol dengan perbandingan kasus : kontrol adalah 1:1. Populasi studi adalah semua penderita kusta yang ditemukan secara aktif di Kabupaten Brebes pada tahun 2011-2012. Jumlah sampel 102, terdiri dari 51 kasus dan 51 kontrol.Teknik pengambilan sampel menggunakan total sampling. Analisis data menggunakan chi square, Odd Ratio (OR) dan regresi logistik. Hasil: Analisa multivariat menunjukkan faktor risiko yang terbukti berpengaruh terhadap kejadian drop out pengobatan penderita kusta yang ditemukan secara aktif adalah penghasilan keluarga yang kurang (P=0,035; OR=2,72; 95%CI=1,071-6,914), dukungan keluarga yang kurang (P=0,005; OR=3,89; 95%CI=1,504-10,06), dan keterampilan petugas yang kurang (P=0,017; OR=3,20; 95%CI=1,227-8,392). Probabilitas penderita untuk mengalami kejadian drop out pengobatan jika terdapat tiga faktor di atas adalah sebesar 88,79%. Simpulan: Terdapat tiga faktor yang terbukti berpengaruh terhadap kejadian drop out pengobatan penderita kusta yang ditemukan secara aktif, yaitu penghasilan keluarga yang kurang, dukungan keluarga yang kurang, dan keterampilan petugas yang kurang. Saran: Melakukan refreshing pelatihan petugas dan meningkatkan Komunikasi, Informasi dan Edukasi (KIE) kepada keluarga. Kata Kunci: drop out, faktor risiko, penemuan kusta secara aktif, kasus kontrol. Background: According to data of Brebes District Health Office in 2011, the rate of dropped out treatment of leprosy patients detected actively was higher than that of detected passively. This study is conducted with the purpose to prove the predisposing, enabling and reinforcing factors as the risk factors of the occurrences of dropped out treatment of leprosy patients detected actively Methods: The type of study is observational research with case-control design. The ratio of case and control is 1:1. The population of the study is all of the leprosy patients detected actively in Brebes Regency during 2011-2012. There are 102 samples, consists of 51 cases and 51 control. The sampling technique is total sampling, while the data are analyzed with chi square, Odd Ratio (OR) and logistic regression. Results: Multivariate analyses show that the risk factors that evidently influent the occurrences of dropped out treatment of leprosy patients detected actively are lack of family incomes (p = 0.035; OR = 2.72; 95% CI = 1.071 to 6.914), lack of family support (p = 0.005; OR = 3.89; 95% CI = 1.504 to 10.06), and less skills of health care personnel (p = 0.017; OR = 3.20; 95% CI = 1.227 to 8.392). The rate of probability of leprosy patients having the above mentioned factors to drop out treatment is 88,79%. Conclusion: There are three factors evidently affect the occurrences of dropped out traetment of leprosy patients detected actively, namely the lack of family income, lack of family support and less skills of health care personnel. Suggestion: It is necessary to refresh the skill of health care personnels and increasing the communication, information and education (KIE) for the family. Keywords: drop out, risk factors, active case detection, case-control

Pregnancy Care Application Mobile Android Based

Pregnancy is a major concern of the world in current health issues. The maternal mortality rate (MMR) is still quite large in almost all countries in the world due to pregnancycomplications.Pregnancycomplicationscanbepreventedbyimprovingthe healthstatusofpregnant women.However,the lack ofknowledgeof pregnantwomen about pregnancy care and inadequate pregnancy care practices causes mothers to be less aware of what is experienced so that there are delays in decision making to seek help, delays in getting transportation to bring to health facilities, and delay in gettinghelpfromofficershealth.Thehighestnumberofcellularphoneuserstoaccess the internet comes from internet users from Java and Bali (92 percent). The purpose of using the internet is 68.7 percent to search for information and browsing. The purpose of the research is to create a pregnancy guide application for the expectant mother to get the information and knowledge about pregnancy care. The method is used in the research is SDLC (System Development Life Circle) method is the method that describes the system development life cycle in the design and development of information system. The results of the research showed that application has been completed design and has been tested by taking a sample of 55 pregnant women, which is named Pregnancy Care Application Mobile Android Based. Based on the Function Point relationship, this application gets a score of 9,638 (scale 1-10) which shows the usability of use to the user. Thus, this application is very feasible to use becauseallthefeaturesthatarepreparedarethingsthatarereallyneededbypregnant women in the care of daily pregnancy. &nbsp; &nbsp; Keywords: Pregnancy Care, Application Mobile Android

PERBEDAAN KADAR PLUMBUM (Pb) DARAH DAN PROFIL DARAH PADA IBU MENYUSUI DI DAERAH PEGUNUNGAN (SUMOWONO) DAN PESISIR PANTAI (BANDARHARJO) SEMARANG

Latar Belakang: Timbal merupakan logam beracun yang berada dilingkungan dan sifat toksiknya mengganggu metabolisme tubuh yang dapat merusak kesehatan neonatal dan anak-anak. Ibu menyusui merupakan kelompok yang rentan terpapar oleh timbal. Tujuan: Mengetahui perbedaan kadar Pb darah dan profil darah pada ibu menyusui di daerah pegunungan dan pesisir pantai. Metode: Penelitian ini observasional analitik dengan pendekatan cross sectional, jumlah sampel 33 responden di pegunungan dan 22 responden dipesisir pantai. Pengumpulan data dilakukan melalui observasi, wawancara dengan kuesioner, pemeriksaan laboratorium. Analisis data menggunakan uji Indpendent T-test. Hasil: Hasil uji statistik menunjukkan bahwa ada beda kadar Pb darah, trombosit, MCV, MCH, dan MCHC (p0,05) pada ibu menyusui antara pegunungan dan pesisir pantai. Saran: Bagi ibu menyusui perlu mempelajari asupan makanan yang aman dari logam berat sehingga dapat meminimalisir dampak buruk bagi anak-anak dan bagi petugas kesehatan sebaiknya melakukan penyuluhan secara rutin. Kata kunci : Kadar Pb darah, Profil darah, Ibu menyusui Background: Lead is a toxic metal in the environment and its toxic properties disrupt the body's metabolism which can damage the health of neonates and children. Nursing mothers are a group that is vulnerable to exposure to lead. The purpose:Knowing the difference in blood Pb levels and blood profile in breastfeeding mothers in mountainous and coastal areas. Method: This research was analytic observational with cross sectional approach, the number of samples was 33 respondents in the mountains and 22 respondents on the coast. Data collection is done through observation, interviews with questionnaires, laboratory examinations. Data analysis using Independent Test T-test.. Results: Statistical test results showed that there were different levels of blood Pb, platelets, MCV, MCH, and MCHC (p 0.05) in nursing mothers between mountains and coastal areas. Suggestion: For breastfeeding mothers, it is necessary to study food intake that is safe from heavy metals so as to minimize adverse effects on children and for health workers should do regular counseling. Keywords: Blood Pb Levels, Blood Profile, Breastfeeding Mother