PEMILIHAN FASILITAS KESEHATAN TEMPAT BERSALIN DI ERA JKN: ANALISA DATA SUSENAS 2019

Angka Kematian Ibu (AKI) tahun 2022 mencapai 207 per 100.000 kelahiran hidup. sedangkan Angka Kematian Bayi neonatal (usia 0-28 hari) mencapai 11,7 dari 1.000 bayi lahir hidup pada 2021. AKI ini berada di atas target Renstra yaitu 190 per 100.000 kelahiran hidup. Sebanyak 62% kedua kasus tersebut terjadi di fasilitas kesehatan rujukan tingkat lanjut (FKRTL). Meski masih memprihatikan namun ini menjadi penanda bahwa akses terhadap fasilitas kesehatan sudah lebih baik. Tujuan penelitian ini untuk mengetahui pengaruh status ekonomi keluarga, kepemilikan jaminan kesehatan dan faktor lainnya dalam keputusan keluarga menentukan tempat ibu bersalin. Sampel pada penelitian ini adalah wanita usia 10 – 54 tahun; berstatus kawin atau pernah kawin. Sebanyak 43.545 responden diambil dari data Susenas tahun 2019. Maximum Likelihood digunakan sebagai estimator dalam analisis yang dilakukan dengan model logit. Hasil penelitian menunjukkan secara bersama-sama variabel status ekonomi keluarga, kepemilikan jaminan kesehatan, usia, status kawin, pendidikan, lama pendidikan ibu, pekerjaan, wilayah tempat tinggal dan kepemilikan rumah signifikan berpengaruh terhadap pemilihan fasilitas kesehatan sebagai tempat bersalin dengan nilai p-value < 0,05 pada hasil uji logit. Pemilihan faskes sebagai tempat bersalin 1,728 kali lebih tinggi pada wanita yang memiliki jaminan kesehatan (? = 0,000; 95% CI 1,641 – 1,819). Keputusan memilih faskes untuk tempat bersalin dipengaruhi cukup signifikan oleh faktor ada tidaknya jaminan kesehatan yang dimiliki oleh ibu. Faktor lain yang ikut berpengaruh adalah usia, pendidikan, jumlah tahun menjalani pendidikan, wilayah tempat tinggal, status bekerja, kepemilikan rumah, status kawin dan status ekonomi keluarga yang dibagi menjadi 5 kuintil

Risk Factors for Anaemia in Pregnant Women who Take Iron Folic Acid Tablets in Locus Stunting Districts in Indonesia

Controlling anaemia in pregnant women is carried out through iron folic acid tablets (IFA) supplementation. The IFA supplementation for pregnant women in Indonesia has been carried out for a long time, but the prevalence of anaemia among pregnant women is still high. The results from the evaluation of anaemia management of pregnant women in Locus Stunting in 2021, showed that the proportion of anaemic pregnant women is higher in pregnant women who have taken IFA. Therefore, analysis was carried out to identify risk factors for anaemia in pregnant women who had taken IFA. Data analysis was carried out descriptively, along χ2 tests and logistic regression. The proportion of anaemic pregnant women who have taken IFA was 39.8% while the proportion of pregnant women who have never consumed IFA was 33.7% (p<0.05). The results of the bi-variate analysis of risk factors for anaemia in pregnant women who consume IFA were poor families, chronic energy malnutrition, and low consumption of meat, poultry, or fish. The results of the multivariate analysis showed that the risk factors for anaemia in pregnant women were those who have low family well-being, chronic energy malnutrition, second and third trimesters gestational age and low consumption of meat, poultry and fish. Keywords: anemia, pregnant women, iron folic aci

Challenges and Solutions in Implementing a Healthy Indonesia Program with a Family Approach

The Healthy Indonesia Program with a Family Approach (PISPK) is conducted bypuskesmas by integrating existing resources, with the family’s target. All familieswill get access to comprehensive health services. The implementation of PISPKsince 2016 has not been optimal because it has many obstacles. The analysis aimsto identify the obstacles, and to find solutions to implemented PISPK optimally.Implementation research was carried out using Participatory Action Research(PAR). The team (researcher and subject) implemented PISPK together based onstages that integrated into puskesmas management, at 4 puskesmas in SouthLampung. Researchers assisted and recorded data collected qualitatively (self-assessment, in-depth interviews, Focus Group Discussion), and quantitatively.There are any obstacles occurred in the implementation of PISPK such as theabsence of regulations and cross-sectoral supports; lack of knowledge andsupport from village officials, community leaders, and the public; limitedresources; lack of understanding of the substantive; application; lack of dataanalysis capabilities. These obstac-les can be minimized by making somebreakthroughs, such as advocacy and issuance of local government regulations onPISPK involving cross-sectors; increase socialization; periodic coordination,monitoring, and evaluation; making innovations (On Job Training, collaborationwith universities and health volunteer, Healthy Family Coverage Pocket Book,developing data analysis methods). The implementation of PISPK has manyobstacles that can be minimized by optimizing existing potentials and supportfrom stakeholders. Puskesmas need to increase socialization; team organizing;data analysis; coordination, and routine monitoring evaluation. Pusdatin needs toimprove KS applications to be more user-friendly

Pengelolaan Dan Pemanfaatan Data Program Indonesia Sehat Dengan Pendekatan Keluarga (PISPK) Di Puskesmas

The Healthy Indonesia Program with a Family Approach (PISPK) is conducted by the health center (puskesmas), which addressed to closer the public access to health services with a family target. Puskesmas would accept data and information from family health profiles (Prokesga) based on evidence, that needs to manage adequately so can be utilized as a document of drafting the action plan. Evaluation of the PISPK implementation in 2019 shows that the majority of puskesmas do not conduct and utilize PISPK Data. This study aims to describe how to manage, analyze, and utilization PISPK Data at puskesmas. The analysis is part of the PISPK implementation research conducted by the Center for Research and Development of Health Resources and Services through Participatory Action Research (PAR) approach in 8 puskesmas in Indonesia (2017-2018) using mixed methods. We had performed a Focus Group Discussion for the surveyor and an in-depth interview with the Head of Health Centers. PISPK Data analysed using Excel and SPSS. Results showed that still not proficient in data management and utilization at puskesmas sites. It is caused by several obstacles involve an administrative change of city or district; update of the healthy family application; restricted access of raw data, internet connection, and Prokesga storage, including limitations of data analysis skill also. Barriers can be minimalized use manual analysis and special training for management and data analysis. Results of data analysis for PISPK can also be used to determine program targets, to make a map of the individual problem, family, and area, which is utilized to arrange a draft of the Action Plan. Abstrak Program Indonesia Sehat dengan Pendekatan Keluarga (PISPK) dilaksanakan oleh puskesmas untuk mendekatkan akses pelayanan kesehatan dengan target keluarga. Puskesmas akan mendapatkan data dan informasi dari profil kesehatan keluarga (Prokesga) berdasar evidence yang perlu dikelola dengan baik sehingga dapat dimanfaatkan sebagai bahan penyusunan rencana usulan kegiatan. Evaluasi pelaksanaan PISPK 2019 menunjukkan mayoritas puskesmas belum melakukan analisis dan pemanfaatan data PISPK. Untuk itu, tulisan ini bertujuan menggambarkan bagaimana pengelolaan, analisis, dan pemanfaatan data PISPK di puskesmas. Analisis merupakan bagian dari riset implementasi PISPK yang dilakukan oleh Puslitbang Sumber Daya dan Pelayanan Kesehatan melalui pendekatan Parcipatory Action Research (PAR) di 8 puskesmas di Indonesia pada tahun 2017-2018 dengan metode kualitatif dan kuantitatif. Dilakukan Focus Group Discussion (FGD) terhadap petugas puskesmas dan wawancara mendalam kepada kepala puskesmas. Data PISPK diolah dengan menggunakan excel dan SPSS. Hasil menunjukkan bahwa pengelolaan dan pemanfaatan data PISPK di puskesmas lokus belum optimal. Hal ini terkendala, antara lain: perubahan administratif kota/kabupaten, perubahan versi aplikasi KS; tidak ada akses terhadap raw data; terbatasnya sinyal internet dan tempat penyimpanan Prokesga, termasuk juga keterbatasan kemampuan analisis data. Kendala dapat diminimalisir dengan analisis manual, dan pelatihan khusus manajemen dan analisis data. Hasil analisis data PISPK dapat digunakan dalam menentukan sasaran program, membuat peta masalah individu, keluarga dan wilayah yang dapat dimanfaatkan untuk penyusunan rencana usulan kegiatan

FAKTOR LINGKUNGAN DAN PERILAKU PEMBERANTASAN SARANG NYAMUK TERHADAP STATUS TRANSMISI DEMAM BERDARAH DENGUE DI KECAMATAN MUSTIKAJAYA, KOTA BEKASI

Bekasi City is one of the dengue-endemic areas in West Java province which has fluctuated the number of cases annually. Dengue transmission was influenced by the interaction between humans, virus, vector, and environmental factors. This study was conducted to analyze environmental factors and source reduction practices related to the status of dengue hemorrhagic fever (DHF) transmission in Bekasi. This study was an observational study with a cross-sectional design that was carried out in Mustikajaya Sub-district, Bekasi City. Total samples were 280 households from two villages. The obtained data were analyzed using chi-square and multivariate logistic regression with a p-value of 0.05. Bivariate analysis results showed that plants were taller than five meters (OR=7,98 95% CI=2,83-22,45), uneven growing vegetation (OR = 2.14 95% CI = 1.21-3, 78), even growing vegetation (OR = 8.84 95% CI-2.84-27.54), frequency of cleaning water containers at least once a week (OR = 2.9 95% CI = 1.77-4.78), and the use of anti-mosquito  (OR = 2.2 95% CI = 1.37-3.61) related to DHF transmission in Mustikajaya Sub-district. Dominant variables that contributed to the high dengue transmission in Mustikajaya District were the frequency of cleaning water containers and the use of household anti-mosquitoes. The socialization and evaluation of source reduction at the community level need to be improved so that the DHF control will be more effective Abstrak Kota Bekasi merupakan salah satu wilayah endemis Demam Berdarah Dengue (DBD) di Provinsi Jawa Barat dengan jumlah kasus fluktuatif setiap tahun. Transmisi DBD dipengaruhi oleh interakasi antara manusia, virus, nyamuk vektor, dan faktor lingkungan. Tujuan penelitian adalah menganalisis faktor lingkungan dan perilaku Pemberantasan Sarang Nyamuk (PSN) yang berhubungan dengan status transmisi DBD di Kota Bekasi. Penelitian ini merupakan studi observasional dengan desain cross sectional yang dilaksanakan di Kecamatan Mustikaya, Kota Bekasi. Jumlah sampel sebanyak 280 rumah tangga di dua kelurahan. Data dianalisis menggunakan chi square dan regresi logistik berganda dengan nilai P sebesar 0,05%. Hasil analisis bivariat menunjukkan bahwa tinggi tanaman lebih dari lima meter (OR=7,98 95% CI=2,83–22,45), rimbunan tanaman tidak merata (OR=2,14 95% CI=1,21-3,78) dan vegetasi tersebar merata (OR=8,84 95% CI-2,84-27,54), frekuensi membersihkan Tempat Penampungan Air (TPA) minimal satu minggu sekali (OR=2,9 95% CI=1,77-4,78), serta penggunaan obat anti nyamuk (OR=2,2 95% CI=1,37-3,61) berhubungan dengan transmisi DBD di Kecamatan Mustikajaya. Variabel dominan yang berkontribusi pada tingginya transmisi kasus DBD di Kecamatan Mustikajaya yaitu frekuensi membersihkan TPA dan penggunaan obat anti nyamuk. Sosialisasi dan evaluasi PSN di tingkat masyarakat perlu ditingkatkan agar pelaksanaannya lebih efektif dalam pengendalian DBD di Kota Bekasi

KEPEMILIKAN KELAMBU DAN FAKTOR SOSIODEMOGRAFI YANG BERHUBUNGAN DENGAN PENGGUNAAN KELAMBU ANTI NYAMUK DI WILAYAH ENDEMIS MALARIA PASCA PENDISTRIBUSIAN TAHUN 2017-2018

ABSTRACT The distribution of LLINs (Long Lasting Insecticidal Nets) is one of the strategies implemented by health programs to control malaria in Indonesia. This study aims to determine the sociodemographic factors associated with the use of LLINs. The research is an observational  with a cross-sectional study design. Interviews using a structured questionnaire were carried out on household members from 4602 sample houses in selected villages with systematic random sampling that had been distributed malaria nets in 2017 - 2018 in 12 malaria endemic districts. The data collected were ownership of bed nets, sociodemographic data including gender, marital status, education, age, occupation, household status, and behavior of using bed nets. Data analysis used multivariate logistic regression. The results showed that 83.9% of respondents had mosquito nets and as much as 82.4% of them were obtained from the LLINs program, and the use of LLINs netting was obtained by 60.5%. Sociodemographic factors associated with the use of bed nets were gender (OR=1,12, 95%CI=1,08 – 1,20), marital status (OR=1,31, 95%CI=1,22-1,44), , educational status (OR=1,26, 95% 1,08-1,45), age (OR=1,58, 95% CI=1,40 – 1,77), occupation (OR=1,23, 95%CI=1,11 – 1,21) and status in the household (OR=1,09, 95%=1,00 – 1,19). The use of LLINs in the community is still low, so there is a need for more intensive socialization and education, so that the use of mosquito nets in the community increases. Keywords: Endemic, bed nets, LLINs, malaria, sociodemographic   ABSTRAK Distribusi kelambu anti nyamuk merupakan salah satu strategi yang dilakukan program kesehatan untuk mengendalikan kasus malaria di Indonesia. Penelitian ini bertujuan untuk mengetahui faktor-faktor sosiodemografi yang berhubungan dengan penggunaan kelambu anti nyamuk. Studi ini merupakan observasional dengan desain studi cross-sectional. Wawancara menggunakan kuisioner terstruktur dilakukan pada anggota rumah tangga,  dari 4602 sampel rumah di desa terpilih secara systematic random sampling yang telah didistribusikan kelambu malaria tahun 2017 – 2018 pada 12 kab/kota endemis malaria. Data yang dikumpulkan adalah kepemilikan kelambu, karakteristik sosiodemografi meliputi jenis kelamin, status pernikahan, pendidikan,  umur, pekerjaan, status di rumah tangga serta perilaku penggunaan kelambu. Analisis data digunakan regresi logistik multi variat. Hasil penelitian menunjukkan bahwa 83,9% responden memiliki kelambu dan sebanyak 82,4% kelambu tersebut diperoleh dari program (LLINs), dan penggunaan kelambu LLINs diperoleh sebesar 60,5%. Faktor sosiodemografi yang berhubungan dengan penggunaan kelambu adalah jenis kelamin (OR=1,12, 95%CI=1,08 – 1,20), status perkawinan (OR=1,31, 95%CI=1,22-1,44),  pendidikan (OR=1,26, 95% 1,08-1,45), usia (OR=1,58, 95% CI=1,40 – 1,77), status pekerjaan (OR=1,23, 95%CI=1,11 – 1,21), serta kedudukan responden (OR=1,09, 95%=1,00 – 1,19). Penggunaan kelambu LLINs di masyarakat masih rendah, sehingga perlu dilakukan sosialisasi dan edukasi yang lebih intensif lagi, agar penggunaan kelambu di masyarakat meningkat. Kata kunci: Endemis, kelambu anti nyamuk,  malaria, sosiodemograf

Investigating improved drinking water quality at the point of access: Evidence from four regions of Indonesia

To meet the Sustainable Development Goal (SDG) 6.1.1. indicator of the ‘proportion of the population using safely managed drinking water services (SMDWS)’, data on the state of drinking water quality in Indonesia is needed. Therefore, a cluster survey was conducted in 2019 to investigate the access to, availability of, and quality of drinking water from 870 improved drinking water sources (IDWS) in four regions. The methods involved sanitary inspection, assessment of household water management and water quality examination. Based on four levels of sanitary risks determined by World Health Organization (WHO), the IDWS in Sumatra had the highest percentage of sources categorised as `low-risk' among the four regions. The percentage of samples in compliance with the national standards for total coliforms and Escherichia coli was 21.49 and 42.64%, respectively. Moreover, the percentage of SMDWS was 35.9%, which was higher than the previous Indonesian surveys in 2015 and 2020. These findings indicate that bacteriological contamination was present in the IDWS and sanitary risk factors were a good predictor of drinking water quality. The study suggests that proper implementation of drinking water surveillance through sanitary inspection, water quality testing and remedial actions of non-piped water sources is imperative towards achieving SDG 6.1.1. HIGHLIGHTS This study focuses on the quality of improved drinking water sources at the point of access in four regions.; Sanitary inspection remains a useful tool to identify risks of drinking water supplies.; The proportion of bacteriological parameters that complied with the national standards was lower as opposed to physicochemical parameters.; The proportion of the population using safely managed drinking water services was 35.9%.