Analisis Faktor Socioeconomic Status (SES) Terhadap Kesehatan Mental: Gejala Depresi di Indonesia

AbstrakMenurut World Federation Mental Health, 1 dari 5 orang di dunia mengalami gangguan mental. Menurut beberapa studi yang sudah dilakukan, salah satu faktor penyebabnya adalah faktor status sosial ekonomi yang masih rendah di negara-negara berkembang. Oleh karena itu, penelitian ini dilakukan untuk mengetahui bagaimana pengaruh faktor status sosial ekonomi terhadap gangguan mental gejala depresi yang ada di salah satu negara berkembang yaitu Indonesia. Penelitian ini menggunakan metode kuantitatif berbasis data sekunder yang diambil dari data Indonesia Family Life Survey (IFLS) gelombang 5 menggunakan kuesioner CESD-R 10 untuk variabel gejala depresi. Variabel Gejala Depresi yang didapat dari IFLS 5 terlebih dahulu diolah menggunakan rasch model lalu seluruh variabel diolah menggunakan metode regresi logistik. Hasilnya, faktor status sosial ekonomi berkorelasi negatif dan memiliki pengaruh secara signifikan terhadap gangguan mental gejala depresi di Indonesia. Artinya status sosial ekonomi yang dimiliki dalam hal ini mencangkup pendidikan, kekayaan, dan status pekerjaan, memiliki pengaruh terhadap seseorang tersebut mengalami gejala depresi. AbstractAccording to the World Federation of Mental Health, 1 of 5 people in the world experiences a mental disorder. Several studies have mentioned that one of the primary factors that cause mental disorders is the low of socioeconomic status in developing countries. Therefore, this study was conducted to determine the influence of socioeconomic status factors on depressive symptoms as a mental disorder, in one of the developing countries, Indonesia. This study uses a quantitative method based on secondary data taken from the Indonesia Family Life Survey (IFLS) wave 5 using the CESD-R 10 questionnaire for depressive symptom variables. Depression symptom variables obtained from IFLS 5 were first processed using the Rasch Model, then all variables were processed using the logistic regression method. As a result, the socioeconomic status factors are negatively correlated and have a significant influence on depressive symptoms in Indonesia, which means that socioeconomic status, in this case including the education, wealth, and work status, affects a person experiencing depressive symptoms.

The analysis of tuberculosis funds efficiency on high burden countries

Tuberculosis remains a major global health problem and ranks as the second leading cause of death from infectious disease worldwide. Countries devote their budgets to overcome the tuberculosis problem. An efficient use of these budgets will arguably reduce the number of tuberculosis cases and eventually give a positive impact to the economy. This paper aims it aims to estimate the technical efficiency scores of tuberculosis funds on high-burden countries by using Data Envelopment Analysis (DEA) method. Further, this study analyzes other environmental factors that are crucial to increase the efficiency scores by using Tobit method. DEA shows that some countries exhibit high efficiency scores while others exhibit low efficiency scores. It also informs how countries use funds to maximize their results. Meanwhile, the Tobit estimation shows that taxing cigarettes and committing budgets to control tobaccos have positive marginal effects on technical efficiency scores

Government or Donor: The Budget for HIV/AIDS Control and Financial Commitment in Bandung City, Indonesia

The number of HIV/AIDS cases in Indonesia has steadily increased since 1987. West Java Province, especially Bandung City, had the highest HIV/AIDS cases among other districts/cities in 2016. Some stakeholders' interventions overlap with others, leading to inefficient use of the limited government budget and flattening international donor funding. This study aimed to estimate the HIV/AIDS budget in Bandung City and then segregate the share of the budget by funding source and objectives. This study was a part of the Priority Setting Involving Stakeholder Using Multiple Criteria (PRISMA) project in 2017 to prioritize HIV/AIDS interventions knowing that Bandung City had the highest HIV/AIDS cases. Data from several institutions and relevant budget allocations were obtained before (2016) and after (2018-2019) the PRISMA project. HIV/AIDS control programs in Bandung City largely depend on international funding: 49% in 2016 (~USD208,898), 85% in 2018 (~USD386,132), and 71% in 2019 (~USD389,943) for a total of ~USD1,433,216. The largest budget was allocated to core interventions, with prevention dominating the budget since 2018. The budget allocated for prevention increased significantly from 2016-2019, most likely under the influence of the PRISMA project

The yearly financing need of providing paid maternity leave in the informal sector in Indonesia

Background: The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia. Method: The costing methodology used is the adapted version of the World Bank methodology by Vilar-Compte et al, following pre-set steps to estimate costs using national secondary data. We used the 2018 Indonesian National Socio-Economic Survey to estimate the number of women working informally who gave birth within the last year. The population covered, potential cash transfer’s unitary cost, the incremental coverage of the policy in terms of time and coverage, and the administrative costs were used to estimate the cost of MCT for the informal sector. Result: At 100$175million (US$152/woman) to US$669million (US$583/woman). The share of the yearly financing need did not exceed 0.5% of Indonesian Gross Domestic Product (GDP). Conclusions: The yearly financing need of providing MCT for eligible WRA working in the informal sector is economically attractive as it amounts to less than 0.5% of GDP nominal of Indonesia. While such a program would be perceived as a marked increase from current public health spending at the onset, such an investment could substantially contribute to the success of breastfeeding and substantial corresponding public health savings given that more than half of working Indonesian WRA are employed in the informal sector. Such policies should be further explored while taking into consideration realistic budget constraints and implementation capacity

Breastfeeding and infant care as ‘sexed’ care work: reconsideration of the three Rs to enable women’s rights, economic empowerment, nutrition and health

Women’s1 lifelong health and nutrition status is intricately related to their reproductive history, including the number and spacing of their pregnancies and births, and for how long and how intensively they breastfeed their children. In turn, women’s reproductive biology is closely linked to their social roles and situation, including regarding economic disadvantage and disproportionate unpaid work. Recognizing, as well as reducing and redistributing women’s care and domestic work (known as the ‘Three Rs’), is an established framework for addressing women’s inequitable unpaid care work. However, the care work of breastfeeding presents a dilemma, and is even a divisive issue, for advocates of women’s empowerment, because reducing breastfeeding and replacing it with commercial milk formula risks harming women’s and children’s health. It is therefore necessary for the interaction between women’s reproductive biology and infant care role to be recognized in order to support women’s human rights and enable governments to implement economic, employment and other policies to empower women. In this paper, we argue that breastfeeding–like childbirth–is reproductive work that should not be reduced and cannot sensibly be directly redistributed to fathers or others. Rather, we contend that the Three Rs agenda should be reconceptualized to isolate breastfeeding as ‘sexed’ care work that should be supported rather than reduced with action taken to avoid undermining breastfeeding. This means that initiatives toward gender equality should be assessed against their impact on women’s ability to breastfeed. With this reconceptualization, adjustments are also needed to key global economic institutions and national statistical systems to appropriately recognize the value of this work. Additional structural supports such as maternity protection and childcare are needed to ensure that childbearing and breastfeeding do not disadvantage women amidst efforts to reduce gender pay gaps and gender economic inequality. Distinct policy interventions are also required to facilitate fathers’ engagement in enabling and supporting breastfeeding through sharing the other unpaid care work associated with parents’ time-consuming care responsibilities, for both infants and young children and related household work

The annual cost of not breastfeeding in Indonesia: the economic burden of treating diarrhea and respiratory disease among children (< 24mo) due to not breastfeeding according to recommendation

Abstract Background In Indonesia, 96% of children (< 24mo) are breastfed. However, only 42% of children (< 6mo) are exclusively breastfed, as per World Health Organization recommendations. Breastfeeding provides protective benefits such as reducing the risk of morbidity and mortality associated with diarrhea and pneumonia/respiratory disease (PRD). This study estimates the potential economic impact of not breastfeeding according to recommendation in Indonesia based on infants suffering from attributable diarrhea and PRD. Methods A cost analysis examined both the healthcare system costs and non-medical costs for children (< 24mo) with diarrhea and PRD. Data collection took place between 2015 and 2016 and healthcare expenditures were assessed in 13 facilities, in five sites including Bandung and Tomohon City. Costs from a provider perspective were estimated using healthcare records and 26 interviews with healthcare workers. A discount rate of 3% was used. A cross-sectional survey with caregiver-child pairs (n = 615) collected data related to out of pocket costs such transportation and opportunity costs such as wage loss. These figures were combined with the national disease prevalence rates from Indonesia Demographic and Health Survey 2012, and the relative risk of disease of not breastfeeding according to recommendation from literatures to extrapolate the financial burden of treatment. Results The healthcare system cost due to not breastfeeding according to recommendation was estimated at US$118 million annually. The mean healthcare system cost and out of pocket costs was US$11.37 and US$3.85 respectively. This cost consists of US$88.64 million of provider costs and US$29.98 million of non-medical patient costs. Conclusions The cost of not breastfeeding according to recommendation is potentially high, therefore the Indonesian government needs to invest in breastfeeding protection, promotion and support as the potential healthcare system cost savings are significant. As suggested by other studies, the long term cost due to cognitive losses of providing not breastfeeding according to recommendation should also be taken into account to provide a complete understanding of the economic impact of not breastfeeding according to recommendation

Prioritizing HIV/AIDS prevention strategies in Bandung, Indonesia: A cost analysis of three different HIV/AIDS interventions.

BackgroundIndonesia has one of the fastest growing HIV epidemics in Asia, which mainly concentrates within risk groups. Several strategies are available to combat this epidemic, like outreach to Men who have Sex with Men (MSM) and transgender, Harm Reduction Community Meetings (HRCMs) for Injecting Drug Users (IDUs), and Information, Education and Communication (IEC) programs at Maternal & Child Health Posts (MCHPs). Reliable cost data are currently not present, hampering HIV/AIDS priority setting. The aim of this study thus is to assess the societal costs of outreach programs to MSM and transgender, HRCMs for IDUs and IEC at MCHPs in Bandung, Indonesia in 2016.MethodsThe societal costs were collected in Bandung from April until May 2017. Health care costs were collected by interviewing stakeholders, using a micro-costing approach. Non-health care costs were determined by conducting surveys within the target groups of the interventions.ResultsThe societal costs of the outreach program were US$347,199.03 in 2016 and US$ 73.72 per reached individual. Moreover, the cost of HRCM for IDUs were US$48,618.31 in 2016 and US$ 365.55 per community meeting. For the IEC program at MCHPs, US$337.13 was paid in 2016 and the cost per visitor were US$ 0.51.ConclusionThis study provides valuable insights in the costs of outreach to MSM and transgender, HRCMs for IDUs and IEC at MCHPs. Policy makers can use these results in setting priorities within Indonesia. Data on effectiveness of interventions is necessary to make conclusive statements regarding cost-effectiveness and priority of interventions

Feasibility study of strengthening the public–private partnership for tuberculosis case detection in Bandung City, Indonesia

Abstract Objective Private practitioner’s (PPs) collaboration for detection, diagnosis and treatment of tuberculosis (TB) is recommended by the World Health Organization and encouraged by the Indonesian National TB control programme. TB case management by PPs, however, are mostly not in line with current guidelines. Therefore, we developed an intervention package for PPs comprising of TB training, implementation of a mobile phone application for notification of TB cases and a 6-month regular follow-up with PPs. This study aimed to evaluate the feasibility of the intervention package to increase TB case detection and notification rates among PPs in five community health centre areas in Bandung City, Indonesia. Results A total of 87 PPs were registered within the study area of whom 17 attended the training and 12 had the mobile phone application successfully installed. The remaining five PPs had phones that did not support the application. During the follow-up period, five PPs registered patients with TB symptoms and cases into the application. A total of 36 patients with TB symptoms were identified and 17 were confirmed TB positive