Pengaruh Pemeriksaan Kehamilan terhadap Pemilihan Penolong Persalinan

Di Indonesia, Angka pertolongan persalinan oleh tenaga kesehatan masih tergolong rendah. Pemeriksaan kehamilan (Antenatal Care = ANC) dapat dijadikan sebagai sarana untuk memotivasi ibu hamil agar bersalin ke tenaga kesehatan. Penelitian ini bertujuan mengetahui peranan ANC terhadap pemilihan tenaga penolong persalinan. Penelitian dengan rancangan potong lintang ini menggunakan data sekunder Survei Evaluasi Manfaat Proyek KKG (Kesehatan Keluarga dan Gizi), analisisnya menggunakan ukuran asosiasi Odds Ratio. Hasil penelitian ini memperlihatkan bahwa setelah dikontrol oleh variabel karakteristik responden, ibu hamil yang melakukan ANC minimal empat kali memiliki peluang 2 kali lebih besar untuk melahirkan pada tenaga kesehatan daripada ibu hamil dengan ANC kurang dari empat kali (ORadj = 2.1, 95%CI: 1.4—3.0). Ibu hamil yang mendapat konseling berpeluang 3.7 kali lebih besar untuk bersalin pada tenaga kesehatan daripada yang tidak mendapat konseling (ORadj=3.7, 95%CI: 2.4—5.7). Untuk meningkatkan angka persali- nan oleh tenaga kesehatan, ANC saja belumlah cukup tanpa diiringi dengan konseling. Konseling yang harus diberikan meliputi nasehat tentang kehamilan, melahirkan, dan pemberian ASI, serta anjuran yang tegas kepada ibu hamil agar melahirkan pada tenaga kesehatan.Kata kunci:Pemeriksaan kehamilan, kualitas pemeriksaan, penolong persalinanIn Indonesia, the proportion of mother who delivered by professional birth attendant is still low. The Antenatal Care ( ANC) can be used to motivate moth- ers to have delivery assisted by health personnel birth attendant. The objective of this study is to know the role of ANC and counselling on birth delivery choice. This study used a secondary data from the Evaluation on Benefit of Family Health Nutrition (FHN) Project, which was conducted in five provinces in Indonesia. Data were analyzed using multiple logistic regressions method. The effect of ANC on birth attendant choice was measured using association measurement of odd ratio. The study showed that mothers who had four times or more ANC had 2.0 times higher chance to have delivery assisted by professional birth attendant than mothers who had less than 4 times ANC, after adjusted for mother\u27s characteristics (family income, education and occupation of household\u27s head), (ORadj=2.1, 95%CI: 1.4—3.0). Mothers who got counselling were delivered by professional birth attendant 3.7 times higher than non counselled mother (OR adj=3.7, 95%CI: 2.4—5.7). The ANC alone was not sufficient to increase the number of mother who delivered by professional birth attendant, the ANC should be complemented by counselling about pregnancy, birth attendance, breast feeding, and suggestion to have delivery assisted by professional birth attendant

HIV Prevalence Among Pregnant Women in Eight Provincial Capitals in Indonesia in 2003-2010

This study has aims to determine the prevalence of Human Immunodeficiency Virus (HIV) among pregnant women in the community and to estimate the number of babies born with HIV, using secondary data of 11.693 pregnant women from Prevention of Mother-to-Child Transmission of HIV (PMTCT) program conducted the Pelita Ilmu Foundation during 2003-2010 in eight provincial capitals in Indonesia. The HIV diagnosis was based on  Enzyme-Linked Immunosorbent Assay (ELISA). The HIV prevalence was calculated from those who participated in the post-test counseling. Mantel Haenszel Chi-square test was performed to see the trend. Of all pregnant women, 98% expressed their desire for HIV testing. The women, then, were given pre-test counseling. Of the pre-test counseled respondents, 95% were willing to do HIV test and of the HIV tested respondents 88% followed the post-test counseling to get the test result, and as much as 0.41% are HIV positive. HIV prevalence quite vary and there is an increasing trend from 2003 to 2009, from 0.36% in 2003-2006, rose to 0.52% in 2008, rose to 0.54% in 2009, then fell to 0.25% in 2010. An estimated 8.604 infants were born with HIV every year. However, if PMTCT program was implemented there will be 8.112 babies averted with HIV and will save around 42 billion rupiah per year. It is concluded that the prevalence of HIV among pregnant women in the community were still low and vary in five-time observations.  It is recommended that the government should implement a PMTCT program and integrated it with maternal & child health and family planning program

The Impact of Breastfeeding Duration to the Child Survival in Indonesia

Breastfeeding can decrease risk of infant death. But, it is not clear yet the effect of breastfeeding duration to the infant survival after controlled for the other determinant factors. This research is aimed to know the effect of duration of breastfeeding to infant survival in Indonesia after controlled for mother, infant, and environment factors. Data was analyzed by using multiple cox regression models. The result showed that duration of breastfeeding had a significant effect to infant survival in Indonesia. Infant who breastfeed for 6 months or more had 33.3 better survival than those who breastfeed less than 4 months. Infant who breastfeed for 4-5 months had 2.6 time better survival than those who breastfeed less than 4 months. Others determinant of infant survival in Indonesia are the number of under five year children in family and their residence. Its recommended to all party were expected to support the policy conducted by Department of Health to improve the duration of breastfeeding up to 24 months

Determinan Stres pada Pegawai Kementerian Kesehatan Republik Indonesia

Kejadian stres pada pelbagai kelompok di Indonesia cukup tinggi dan belum banyak diketahui determinannya. Penelitian ini bertujuan untuk mengetahui determinan stres pada pegawai Kementerian Kesehatan Republik Indonesia (Kemenkes RI). Penelitian potong lintang ini dilakukan pada tahun 2013 terhadap 230 pegawai sekretariat jenderal yang dipilih secara acak. Analisis statistik menggunakan regresi logistik ganda. Responden dikatakan stres jika memiliki skor 28 atau lebih dengan menggunakan 17 pertanyaan terkait personal stress inventory. Hasil penelitian menunjukkan prevalensi stres sebesar 79% dan determinan stres adalah obesitas, usia, jabatan, suku, pendidikan, dan aktivitas fisik. Risiko stres lebih tinggi pada pegawai yang obesitas (ORadj = 1,9), pegawai berusia di bawah 40 tahun (ORadj = 2,1), suku Sunda (ORadj = 3,1), menduduki jabatan struktural (ORadj = 2,3), pegawai yang berpendidikan SMA atau D3 (ORadj = 2,8), dan pegawai perempuan yang kurang aktivitas fisik (ORadj = 8,2). Disimpulkan bahwa determinan stres sangat bergantung pada beban kerja dan karakteristik individu, risiko stres sangat tinggi terdapat pada pegawai perempuan yang kurang aktivitas fisik. Disarankan agar Kemenkes melakukan promosi kesehatan tentang hidup sehat dan pencegahan stres kepada seluruh pegawai, melakukan rekreasi bersama secara berkala, melaksanakan olahraga rutin setiap hari Jumat pagi di pusat kebugaran Kemenkes untuk menurunkan obesitas dan stres. Determinants of Stress among Civil Servants at Health Ministry of IndonesiaThe prevalence of stress on various groups in Indonesia is quite high and has not been known their determinants. This study aimed to find out determinants of stress among civil servants at the Health Ministry of Republic of Indonesia. This cross sectional study was conducted in 2013 toward 230 secretariat general civil servants selected randomly. Analysis of statistic used multiple logistic regression. Respondents were considered stress if they got score 28 or more by using 17 questions personal stress inventory. Results showed that prevalence of stress related to and determinants of stress were obesity, age, position, tribe, education and physical activity was worth 79%. The risk of stress was higher among obese civil servants (ORadj = 1.9), age under 40 years old (ORadj = 2.1), tribe Sundanese (ORadj = 3.1), structural positions (ORadj = 2.0), senior high school or vocation level (ORadj = 2.8), women with lack of physical activity (ORadj = 8.2). To sum up, determinants of stress very depended on work loads and individual characteristics, the highest risk of stress among women who lack of physical activity. The Health Ministry should promote health public concerning healthy lifestyle and prevention of stress to all civil servants, periodically holding recreation together, conducting regular exercise on Friday morning in order to reduce obesity and stress

“Go Baby Go” Model Kelas Pengasuhan untuk Optimalisasi Tumbuh Kembang Anak Usia 0-3 Tahun

Latar Belakang; Berdasarkan data Riskesdas tahun 2018 diketahui bahwa tingkat perkembangan anak usia 36-59 bulan secara literasi perkembangannya mencapai 64,6%, tingkat perkembangan sosial emosional sebanyak 69,9%, tingkat perkembangan fisik sebanyak 97,8%. Hal tersebut menunjukkan ketidakseimbangan pertumbuhan dan perkembangan pada anak. Idealnya, pertumbuhan dan perkembangan anak dapat dicapai anak dengan optimal dan seimbang antara perkembangan fisik, sosial emosional dan literasi (kognitif). Pemantauan dan stimulasi tumbuh kembang anak oleh pengasuh sangat diperlukan untuk optimalisasi tumbuh kembang anak dan mengenali masalah secara dini.Tujuan; Mengembangkan kelas pengasuhan Go Baby Go sebagai integrasi berbagai pendekatan untuk optimalisasi pertumbuhan dan perkembangan anak usia dini.Metode; Model kelas pendampingan Go Baby Go memberikan intervensi yang difasilitasi oleh kader terlatih di Kecamatan Cilincing Jakarta Utara pada pengasuh anak usia 0-3 tahun. Pertemuan dilakukan seminggu sekali selama sepuluh minggu, kemudian membandingkan hasil brigance score dan formulir KPSP antara baseline dengan endline. Intervensi yang diberikan adalah; praktik pemberian makan pada bayi dan anak yang tepat, praktik stimulasi dan deteksi dini tumbuh kembang anak serta praktik perlindungan anak.Hasil; Terdapat Perubahan pola pengasuhan yang dilakukan oleh pengasuh kepada anak berusia 0-3 tahun. Dari hasil baseline dan endline yang dilakukan, ditemukan bahwa terdapat peningkatan pola pengasuhan oleh pengasuh dalam melakukan stimulasi secara dini kepada anak, dari 72,0% menjadi 90,5%. Peningkatan pola interaksi pengasuh dengan anak meningkat dari 18,5% menjadi 32,3%. Kebiasaan mencuci tangan mengalami peningkatan dari 53,2% menjadi 79,0%. Konsumsi sumber protein hewani mengalami peningkatan dari 66,4% menjadi 84,3%. Status gizi normal berdasarkan TB/U meningkat dari 69,01% menjadi 72,4%. Anak yang mengalami penyimpangan perkembangan motorik, bahasa, dan kemandirian (skor KPSP < 6), berkurang dari 2,7% menjadi 0%. Kesimpulan; Model kelas pengasuhan Go Baby Go yang diberikan seminggu sekali selama sepuluh minggu efektif meningkatkan tumbuh kembang anak usia 0-3 bulan. Saran; Model kelas pengasuhan Go Baby Go dapat direplikasi sebagai inovasi program untuk mengoptimalkan perkembangan anak usia 0-3 tahun. Kolaborasi dan kerjasama antara pemerintah lokal, Dinas Kesehatan dan NGO perlu dilakukan untuk meningkatkan kapasitas kader dalam melakukan fasilitasi kelas dan memastikan keberlanjutan program

Pre-eklampsia Berat dan Kematian Ibu

Severe preeclampsia, one of main causes of maternal death in Indonesia and at Dr. H. Abdul Moeloek Lampung Public Hospital, is the leading cause of maternal death (47.25%). This study aimed to determine relation of severe preeclampsia predictor as assessed from systolic blood pressure, diastolic blood pressure, proteiunuria, eclampsia and HELLP syndrome with maternal death at Dr. H. Abdul Moeloek Public Hospital. This study used case control design with 60 cases and 120 control total of sample. Data was managed from hospital medical records during five years period (2010 – 2014). Results of study showed HELLP syndrome had risk of maternal death 12 times higher (95%CI 2.9 – 53.7) and eclampsia had the risk 12.1 times higher (95%CI 3.8 – 38.6). Then diastolic blood pressure 110 – 119 mmHg had the risk 7.4 times higher (95%CI 1.8 – 29.2), diastolic blood pressure ≥ 120 mmHg had the risk 5.5 times higher (95%CI 1.1 – 23.1), sistolic blood pressure > 190 mmHg had the risk 2.1 times higher (95%CI 0.5 – 7.4), sistolic blood pressure 170 – 190 mmHg had the risk 1.6 times higher (95%CI 0.5 – 4.5), proteinuria +3 had the risk 4.2 times higher (95%CI 0.3 – 27.4), proteinuria +4 had the risk 3.2 times higher (95%CI 0.5 – 31.7) after controlled by maternal age, gravida, pregnancy age, delivery method, diazepam provision, education, domicile and employment. Therefore, it needs to improve early detection of pregnancy complication and good management of preeclampsia case to prevent maternal death due to eclampsia and HELLP syndrome

Efek Penyakit Kronis terhadap Gangguan Mental Emosional

Hasil Riset Kesehatan Dasar tahun 2007 menunjukkan 11,6% penduduk Indonesia berumur 15 tahun ke atas mengalami gangguan mental emosional. Penelitian ini bertujuan untuk mengetahui efek penyakit kronis terhadap gangguan mental emosional. Desain penelitian ini adalah potong lintang mengggunakan data Riskesdas tahun 2007. Sebanyak 660.452 responden berusia di atas 15 tahun yang tidak mengalami gangguan jiwa dijadikan sampel. Gangguan mental emosional dinyatakan ada jika responden mem-punyai paling tidak enam dari 20 gangguan. Penyakit kronis seperti tuberculosis (TB) paru, hepatitis, jantung, diabetes, kanker, dan stroke diukur melalui wawancara yang didasarkan pada diagnosis petugas kesehatan. Hasil penelitian menunjukkan bahwa dari sepuluh penderita penyakit kronis, dua sampai lima penderita akan mengalami gangguan mental emosional. Analisis regresi logistik multivariat memperlihatkan bahwa risiko gangguan mental emosional semakin tinggi bersamaan dengan semakin banyak jumlah penyakit kronis yang diderita oleh responden. Responden yang menderita satu penyakit kronis berisiko 2,6 kali lebih besar untuk mengalami gangguan mental emosional, yang menderita dua penyakit kronis berisiko 4,6 kali, yang menderita tiga penyakit kronis atau lebih berisiko 11 kali. Kementerian Kesehatan disarankan untuk mengembangkan standar pelayanan penyakit kronis terkait dengan pengurangan dampak pada gangguan mental emosional dan dibentuknya tim bimbingan teknis pelayanan penyakit kronis.Basic Health Research (Riskesdas) year 2007 showed that 11.6 percent of Indonesia's population aged 15 years and above suffering from mental emotional disorder. This study aimed to examine the effects of chronic illness to the mental emotional disorders. A cross-sectional study was performed that used Riskesdas 2007 data. Atotal of 660,452 respondents aged 15 years and over who are mentally health become sample of this study. Mental emotional disorders exist if they have at least six of the 20 disorder. Chronic diseases such as pulmonary tuberculosis, hepatitis, heart disease, diabetes, cancer, and stroke were measured based on diagnosis by health pro-fesional. The results showed that out of ten respondents with chronic illness, aproximately two to five will suffering from mental emotional disorder. Multivariat logistic regression analysis shows that the risk of developing mental emotional disorders higher as more number of chronic illnesses suffered by the respondent. Respondents suffering from one chronic disease were 2.6 times greater risk for emotional mental disorder, suffering from two chronic dis-ease have risk 4.6 times, which had three or more chronic disease risk have risk 11 times. It is suggested that the Ministry of Health to develop a standard of care of chronic diseases associated with reducing impact on the mental emotional disorders and establishment of teams for technical guidance chronic disease care

The Effect of Drinking Tea to the Anemia Among Elderly in Bandung

The objective of this study is to know the effect of tea to anemia iron deficiency among elderly people. The study population is the elderly people in Bandung City. The sampling was 132 elderly that were selected randomly in Sub District of Cicendo year 2005. Method of measuring hemoglobin is the sianmethemoglobin and the drinking tea was measured by 1 x 24 hours food record for seven days. The data was analysis using multiple logistic regression. The results of this study shows that rate of anemia among elderly people in Bandung is 47,7% (95%CI = 39%&mdash;56%) and&nbsp; about half of the elderly (49%) drinking tea every day (95%CI = 40%&mdash;58%). The elderly who drink tea every day have risk for anemia 92 times higher compared than those who did not drink tea (ORadj = 91.8, 95% CI = 8&mdash;221) after controlled for protein intake.&nbsp; If the drinking tea habit among elderly could be changed, the anemia could be reduced by 85% i.e. from 47.7% become 7.3%. In order to decrease anemia, it&rsquo;s suggested to reduce their drinking tea habit or increase their protein intake. However, due to lack of their teeth&rsquo;s functioning and low of their economic status, reducing their drinking tea habit is the best choice to decrease anemia among elderly.&nbsp

Antenatal Care Provider and Cesarean Section in Urban Areas in Indonesia

Trends of cesarean section trend in Indonesia (2007-2012) have doubled the risk of long-term and short-term health problems. This study was aimed to determine relation between antenatal care provider and cesarean section. This quantitative study used cross-sectional design with a total sample of 5,143 women aged 15-49 years who gave birth to the last child through cesarean section or not as in urban areas selected in samples of 2012 Indonesia Demographic and Health Survey. Logistic regression multivariate analysis was used to determine relation between antenatal care provider and section cesarean, which was controlled by maternal age, antenatal care facility, parity, and place of birth. Results showed that antenatal care at obstetrician was 6.6 times higher, while antenatal care at obstetrician and midwife was 2.1 times higher for cesarean section compared to women who had antenatal care at midwifeafter controlled by maternal age, antenatal care facility, parity, and place of birth. There is interaction between socioeconomic status and obstetrician for a cesarean section. Regulation on cesarean section by health authority, as well as protective and preventive labor applied towards on the high economic class community may reduce unnecessary cesarean section