Profil Kesehatan Gigi Penduduk Usia 12 Tahun Ke Atas Di Indonesia Tahun 2007

Background: The general objective of this study is to describe dental health condition of Indonesian aged 12 years or over using Basic Health Research 2007 data. The specific objective is (1) to determine the prevalence of dental caries among the study population based on their socio-demographic characteristics (2) to determine determinants of their dental health, (3) to determine magnitude of each determinant in term of Odds ratio and (4) to determine their DMFT - index. Methods: This is a combination of descriptive (estimatian and prevalence) study and analytic (using Odds ratio to describe relation between independent and dependent variable). In the year 2007, the provinces of highest prevalence of dental caries in lndonesia are Jambi, Bangka Belitung, Kalimantan Barat, Kalimantan Selatan, dan Sulawesi Utara. Results: Dental caries prevalence in urban (38%) is not far different from that in rural (35%). The same is true between men (37.4%) and women (35%). Rural community have caries risk 1,329 times more than urban community Woman have dental caries risk 2,186 times more than man. Non regular tooth brusher have caries risk 1,66 times more than the regular tooth brush er. Non filtered cigarette use increasing dental caries risk. Non filtered cigarette use increasing dental caries risk have caries risk 1,461 times more than non smoker. The last determinant that causing the level of caries after multivariate analysis test are the type of area, all the level of age, 26-44 years old, <::: 45 years old, education in senior high school and university, the habit use tobacco without filter, and man communit

Studi Kualitatif Pelayanan Kesehatan untuk Kelompok Adat Terpencil (Kat) di Kabupaten Kepulauan Mentawai

Background: The Government has some intentions to increase the social welfare of Remote Indigenous Communities. Firstly, prevented the disintegration of social vulnerability Secondly, protected from economic and social exploitation. Finally, ensuring the rights and obligations as othercitizens outside the Remote Indigenous Communities. The research objectives are to know the operational policies which is applied to improve health services to Remote Indigenous Communities in Mentawai IsIan ds District; to determine targets and priorities of health programs for Remote Indigenous Communities; to determine the pattern of empowerment in health to Remote Indigenous Communities; to determine the constraints in carrying out the pattern of empowerment in health to Remote Indigenous Communities; to determine the mechanism of cooperation with relevant inter-sector; to determine patterns of health services to Remote Indigenous Communities. Methods: The research, which was designed as across-sectional, conducted in April-November 2009. The research was implemented in the Sub-District of North Siberut and South Siberut, Mentawai IsIan ds District. In each sub-disrict which was selected purposively, has 4 villages research area with criteria coastal habitat. Data were collected through in-depth interviews of several informants, namely Director of Remote Indigenous Communities (Ministry of Social Affairs); Head of Sub Directorate of the backward area, borderland, and the island; Head of District Health Office of the Mentawai Islands; Head of Social Services of the Mentawai Islands District; Head of North Siberut and South Siberut Sub Districts; Head of Community Health Center of North Siberut and South Siberut; midwifes of North Siberut and South Siberut; Head of selected villages; and one who responsible of auxiliary community health center. Results: The results shown as follow: firstly, operation al policies in remote areas are the same as non remote areas, but non remote areas receive more attention; secondly, health program priority is malaria eradication, patients treatment, immunization, monthly weighing (in posyandu), health and sanitazion, diarrhea, check up and services for pregnant women, expanding of auxiliary community health center programs, maternal and child health, mother delivery, treatment baby and children under five years, clean and safe drinking water; thirdly, most comm on diseases that encountered in Remote Indigenous Communities are fever, malaria, gastritis, diarrhea, headache, chikungunya, acute respiratory infection. Conclusion: Indeed, health services of the Remote Indigenous Communities have specificity in the Mentawai IsIan ds District. First of all, mapping problem is conducted by community health center. Then, the constraints are frequent earthquakes, bad weather, transportation, difficulty to carry out activities based on community empowerment. Finally, there are several NGOs working with government agencies. Suggestions, ln addition to fulfil! human resources needs for short term objective, health care should pay attention at posyandu program and other related activities

Identifikasi Wilayah dengan Permasalahan Kesehatan Anak Balita di Provinsi Jawa Timur

Background: Government Regulation no. 38 year 2007 about the distribution of governmental power between central, provincial and district/town was one reference for government. Despite of decentralization was expected to remain the relevance from the administration. Meanwhile, to view the performance or measured the success of development held by local districts, especially in the field of health has issued the Ministerial Regulation Rl No. 741/Menkes/Per/VII/2008 on Minimum Service Standards (SPM) in the Health Sector which is an effort to accelerate the achievement of the MDGs in 2015. Child health problems focused on the decline in mortality because even the trend was declining but the achievement is still rae from target, particularly the MDGs in 2015, either RPJPM or Minimum Service Standards (SPM). When in handling found of resource limitation, it is necessary to scale the priority to handle with the regional approach or program. The objective of the study is to know distribution areas and offers an alternative method of diagnosing the area of Children under 5 health problems so that it shows children under 5 priority areas. Methods: The data for this analysis from a survey called RISKESDAS 2007 with sample unit is children under 5. Variables used are; state of poor and malnutrition, the completed Immunization coverage, posyandu utilization, morbidity (diarrhea, pneumonia and TB), clean and healthy lifestyle. lack of clean water, lack of sanitation in the districts of East in Java. Results: This result is several thematic maps when it is overlay; find the two districts in the eastern part is relatively problematic area among the districts and other towns in East Java. Key words: Spatial analysis, children under 5 health, East Jav

Studi Kualitatif Penyelenggaraan Pelayanan Kesehatan Ibu dan Bayi Setelah Penerapan Kw-spm di Kabupaten Badung, Tanah Datar, dan Kota Kupang

The Ministry of Health had set targets and obligatoried for minimum health standards that have to be Implemented in each district/municipality. The maternal and neonatal health (MNH) services is one of services in the district health system that has to be delivered by puskesmas to enhance the maternal and neonatal health towards reducing the maternal and neonatal mortality. It was a cross sectional study health policy. The study was conducted in three districts/municipality, namely district of Badung, Bali; District of Tanah Datar, West Sumatera and Kupang Municipality in East Nusa Tenggara. February to November 2006. Every area had to make special strategy and specified activity priority to execute the policy on mother and baby healthy program. The roles of other and private sectors need continuality. Attainment of mother and baby healthy program activity year 2005 in general were still under the goals. Constraints to execute the policy on mother and baby healthy program had limitation on the quality and quantity of human resources, availibility of equipments, knowledgeof community concerning health was still lower, attention of local government was very limited on budget allocation; and also the expectation of community to soothsayer was high, especially in Municipality of Kupang and District of Tanah Datar. The other limitation was of training on mother and baby healthy program. The access of community to public health services is good enough. Network with the other sectors in general worked well. There were some areas faced coverage goals so high, that difficult to achieve pregnant mother visit coverage (4) and high referral. Target of coverage that were achieved better were the coverage diving birth by midwifes or healthy staffed midwifery compentency. There were some coverage needs re-socializing as definition, because of the difference perception between the right definition and the perception of health staffs on the coverage of neonatus visit and baby with BBLR

Persepsi dan Tanggapan Masyarakat terhadap Sistem Kesehatan, Jangkauan dan Kualitas Pelayanan Kesehatan di Puskesmas Kabupaten Banyuasin

This cross sectional study was conducted in Banyuasin District, South Sumatera Province. The general objective of the study is to assess the community perceptions on the health system responsiveness, access to services and quality of health care in Puskesmas. Data collection was conducting by exit interviews using structured instruments on 242 outpatients in selected Puskesmas and Focus Group Discussion in Petaling village. Interview was carried out to assess respondent perception in 4 dimensions: Good Public Image; Access to Health Services; Personnel Performance; and Client Preference. In general, most of Respondent\u27s were not satisfied with the health services in Puskesmas. The aspects which assessed not good were on physical performance of Puskesmas building and personnel performance. The effort to improve and maintain patient \u27s satisfaction is should be continuously programmed in order to achieve good quality of health care in Puskesmas

Analisis Pembiayaan Program Kesehatan Ibu dan Bayi di Kabupaten/kota

The Ministry of Health had set target it and obligatory for minimum health standard (KW-SPM) that has to be implemented in each district/municipality. Maternal and neonatal health (MNH) services is one of the services in district health system that has to be delivered by puskesmas to improve the maternal and neonatal health towards reducing the maternal and neonatal mortality. It was a cross sectional study on health policy and financing. The study was conducted in three districts/municipality, namely Badung District, Bali; Tanah Datar District, West Sumatera and Kupang Municipality in East NusaTenggara. Time of the study was February to November 2006. Results showed that the highest allocation of budgetting according to the district health competency was for basic health services, the preventions of communicable diseases, and nutrition program. Budget allocation for investation in maternal and neonatal health was relatively low, only 2-7%. except for Badung District that was 47.2%. The allocated budget for the basic health services has a similar pattern among theareas under study, except for Tanah Datar District, the proportion of operational costs for immunization seem lower than two other districts. There gap between budget allocation and budget necessity. The budget was hardly used to serve the community. Indirect budget, most of provided for staff trainings, building capacity, as well as facility improvements. Per capita allocation for MNH varied among the districts/municapality. Badung District got the lowest (Rp. 20,000) per capita allocation, albeit it had the highest fiscal capacity; meanwhile Tanah Datar District, the middle fiscal capacity had the highest (Rp. 47,000). Kupang Municipality. the lowest fiscal capacity had the middle per capita allocation, which was Rp. 40,000. According to the health services function, the proportion allocating for training was the highest, more than 70% (Kupang and Tanah Datar Districts), and basic health services achieving 50% of the budget was in Badung. In conclusion, budget allocation was varied among the districts, the proportion was burden to public administration and only small part for the operational. Of the total health budget, the highest proportion or 30-35% was financing to the MNH programs. Unfortunately, the allocalton was not so specified, distributed to other programs and tended for routine activites

Determinan Penyakit Diare Pada Anak Balita Di Provinsi Nanggro Aceh Darussalam, Jawa Barat, Nusa Tenggara Barat, Nusa Tenggara Timur, Gorontalo Dan Papua

Background: Diarrhoeal diseases become the second caused of death of the under-fives, the third in infant, and the fifth at all people in Indonesia. WHO indicated that every year an average of 100.000 children in Indonesia dead because of diarrhoea and Sub directorate of Diarrhoea, MOH indicated that about 301-347 per 1000 people still infected by diarrhoea from year 2000 up to 2003. Methods: This study analyzed the Basic Health Research data collected in 2007 to determine the prevalence, characteristic determinants including its Odd Ratio (behavioral, environmental sanitation, household characteristic, and specific condition of child), of the 20245 under-fives children in 6 provinces having diarrhoea prevalence above the 2007 national diarrhea prevalence rates (16.7%). (NAD: 27%, Gorontalo: 24%, NTB: 23%, NTT: 22%, Papua: 21%, and West Java: 18%). Results: The result showed that the highest prevalence of diarrhoea rates was found at the family with having lower level of percapita expenditure (kuintil 1 and 2); in mother who worked as a farmer/fisherwoman/labour and did not used latrine as well as lack of control for contamination of water available at home. The specific conditions of the under-fives that related to the increase prevalence of diarrhea are the existence of typhoid and measles, frequency of OPT immunization and over weight condition. The Odds of having diarrehea occurred in the under-fives having measles 1 month earlier (OR. 2.61) followed by the lack of control of the quality of the water condition available at home (OR 2.19), open water tank (OR 1.40), Defecate not in WC (OR1.36), Not receiving meales immunization (OR 1.37) and OPT immunization less than 3 times (OR 1. 19). It is concluded that to prevent diarrhea, it is important for children to have full coverage of immunization, to improve health behavior of mothers and children especially to wash hand before eating or preparing meals, and to improve housing condition and sanitation. For the next Basic Health Research data collection, it is recommended to improve quality of questions in order to get more specific information related to the child's habits and practices to prevent diarrhoea

The state of health in Indonesia's provinces, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Analysing trends and levels of the burden of disease at the national level can mask inequalities in health-related progress in lower administrative units such as provinces and districts. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to analyse health patterns in Indonesia at the provincial level between 1990 and 2019. Long-term analyses of disease burden provide insights on Indonesia's advance to universal health coverage and its ability to meet the United Nations Sustainable Development Goals by 2030. Methods We analysed GBD 2019 estimated cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 286 causes of death, 369 causes of non-fatal health loss, and 87 risk factors by year, age, and sex for Indonesia and its 34 provinces from 1990 to 2019. To generate estimates for Indonesia at the national level, we used 138 location-years of data to estimate Indonesia-specific demographic indicators, 317 location-years of data for Indonesia-specific causes of death, 689 location-years of data for Indonesia-specific non-fatal outcomes, 250 location-years of data for Indonesia-specific risk factors, and 1641 location-years of data for Indonesia-specific covariates. For subnational estimates, we used the following source counts: 138 location-years of data to estimate Indonesia-specific demographic indicators; 5848 location-years of data for Indonesia-specific causes of death; 1534 location-years of data for Indonesia-specific non-fatal outcomes; 650 location-years of data for Indonesia-specific risk factors; and 16 016 location-years of data for Indonesia-specific covariates. We generated our GBD 2019 estimates for Indonesia by including 1 915 207 total source metadata rows, and we used 821 total citations. Findings Life expectancy for males across Indonesia increased from 62·5 years (95% uncertainty interval 61·3–63·7) to 69·4 years (67·2–71·6) between 1990 and 2019, a positive change of 6·9 years. For females during the same period, life expectancy increased from 65·7 years (64·5–66·8) to 73·5 years (71·6–75·6), an increase of 7·8 years. There were large disparities in health outcomes among provinces. In 2019, Bali had the highest life expectancy at birth for males (74·4 years, 70·90–77·9) and North Kalimantan had the highest life expectancy at birth for females (77·7 years, 74·7–81·2), whereas Papua had the lowest life expectancy at birth for males (64·5 years, 60·9–68·2) and North Maluku had the lowest life expectancy at birth for females (64·0 years, 60·7–67·3). The difference in life expectancy for males between the highest-ranked and lowest-ranked provinces was 9·9 years and the difference in life expectacy for females between the highest-ranked and lowest-ranked provinces was 13·7 years. Age-standardised death, YLL, and YLD rates also varied widely among the provinces in 2019. High systolic blood pressure, tobacco, dietary risks, high fasting plasma glucose, and high BMI were the five leading risks contributing to health loss measured as DALYs in 2019. Interpretation Our findings highlight that Indonesia faces a double burden of communicable and non-communicable diseases that varies across provinces. From 1990 to 2019, Indonesia witnessed a decline in the infectious disease burden, although communicable diseases such as tuberculosis, diarrhoeal diseases, and lower respiratory infections have remained a main source of DALYs in Indonesia. During that same period, however, all-ages death and disability rates from non-communicable diseases and exposure to their risk factors accounted for larger shares of health loss. The differences in health outcomes between the highest-performing and lowest-performing provinces have also widened since 1990. Our findings support a comprehensive process to revisit current health policies, examine the root causes of variation in the burden of disease among provinces, and strengthen programmes and policies aimed at reducing disparities across the country. Funding The Bill & Melinda Gates Foundation and the Government of Indonesia. Translation For the Bahasa Indonesia translation of the abstract see Supplementary Materials section

Studi Kualitatif Penyelenggaraan Pelayanan Kesehatan Ibu dan Bayi Setelah Penerapan Kw-spm di Kabupaten Badung, Tanah Datar, dan Kota Kupang

The Ministry of Health had set targets and obligatoried for minimum health standards that have to be Implemented in each district/municipality. The maternal and neonatal health (MNH) services is one of services in the district health system that has to be delivered by puskesmas to enhance the maternal and neonatal health towards reducing the maternal and neonatal mortality. It was a cross sectional study health policy. The study was conducted in three districts/municipality, namely district of Badung, Bali; District of Tanah Datar, West Sumatera and Kupang Municipality in East Nusa Tenggara. February to November 2006. Every area had to make special strategy and specified activity priority to execute the policy on mother and baby healthy program. The roles of other and private sectors need continuality. Attainment of mother and baby healthy program activity year 2005 in general were still under the goals. Constraints to execute the policy on mother and baby healthy program had limitation on the quality and quantity of human resources, availibility of equipments, knowledgeof community concerning health was still lower, attention of local government was very limited on budget allocation; and also the expectation of community to soothsayer was high, especially in Municipality of Kupang and District of Tanah Datar. The other limitation was of training on mother and baby healthy program. The access of community to public health services is good enough. Network with the other sectors in general worked well. There were some areas faced coverage goals so high, that difficult to achieve pregnant mother visit coverage (4) and high referral. Target of coverage that were achieved better were the coverage diving birth by midwifes or healthy staffed midwifery compentency. There were some coverage needs re-socializing as definition, because of the difference perception between the right definition and the perception of health staffs on the coverage of neonatus visit and baby with BBLR. Key words: mother and baby healthy program, maternal and child health, district office