Contraceptive Services Available to Unmarried Sexually Active Adolescents

Background: Low contraceptive use amongst unmarried sexually active young men and women presents an ethical dilemma in Indonesia, particularly in realising reproductive rights as a fundamental human right. This study aims to address the difficulties in extending access to family planning for unmarried sexually active youths. Methods: A review of the laws relating to the provision of family planning was combined with a secondary data analysis of the 2012 Indonesian Demographic Health Survey throughout 6 provinces on the island of Java. The sample population included 5,150 unmarried adolescents, aged 15 to 24 years. The 2012 Indonesian Demographic Health Survey was the first and only survey that included unmarried young women in Indonesia. The association between subjects who had \u27ever had sex\u27 and three groups of predictors (demographic characteristics, peer influences, and knowledge of contraceptive methods) were examined using multivariate logistic regressions. Results:Results of the study found that subjects who were unmarried but had engaged in sexual activity were more likely to be those aged 19 to 21 years (OR = 2.36) and 22 to 24 years (OR = 6.81), of low education status (OR = 2.1), with a boyfriend or girlfriend (OR = 2.38), and those who approved of pre-marital sex (OR = 8.5). Conclusions: Results from this research suggest that new interpretations of the Law 52/2009 regarding family planning and Law 36/2009 that prohibits health services to unmarried sexually active youths are required in order to address the issues faced by Indonesia\u27s yout

Risk Differences between Elderly Men and Women toward Doctor-Diagnosed Diabetes Mellitus in Urban Areas in Indonesia: 2013 National Basic Health Research Data

AbstractDiabetes mellitus (DM) is one of the most common non-communicable diseases (NCDs) in Indonesia. Reportedly that DM is associated with various risk factors. Notably, it seems that the rising prevalence rates reflect changes in urban lifestyle. This study aimed to examine risk differences in the prevalence of DM among men and women aged 15 years and older that lived in urban areas in Indonesia. Analysis used secondary data of 2013 National Basic Health Research, which applied a cross- sectional study design. The total of sample was 333,731 respondents. Data processing and analysis used multiple logistic regression method. In general, findings showed that doctor-diagnosed diabetes mellitus (DDDM) among urban men and women aged 15-39 years did not differ. However, the odds ratio of DDDM among older women aged 50-64 years was 30 times higher than women aged 15-39 years, while among the same age men was 21 times higher than younger men aged 15-39 years (p value < 0.001). In conclusion, entering the age of 50 years, women show a much higher risk of contracting DDDM than women with younger age, also much higher than older men towards younger men. AbstrakDiabetes melitus (DM) adalah salah satu penyakit tidak menular yang paling umum di Indonesia. DM disebabkan berbagai faktor risiko. Peningkatan prevalensi DM salah satunya disebabkan oleh perubahan gaya hidup di perkotaan. Penelitian ini bertujuan untuk menguji perbedaan prevalensi DM yang didiagnosis dokter pada laki-laki dan perempuan usia 15 tahun keatas yang tinggal di daerah perkotaan di Indonesia. Analisis menggunakan data sekunder Riset Kesehatan Dasar (Riskesdas) 2013 dengan desain studi potong lintang. Total sampel sebanyak 333.731 responden. Metode analisis menggunakan regresi logistik ganda. Hasil menunjukkan bahwa DM yang didiagnosis dokter pada laki-laki dan perempuan usia 15-39 tahun di perkotaan tidak berbeda. Meski demikan, memasuki kurun usia 50-64 tahun, responden perempuan menunjukkan risiko terdiagnosis DM 30 kali lebih tinggi dibandingkan perempuan berusia 15-39 tahun, sementara laki-laki berusia 50-64 tahun berisiko 21 kali lebih tinggi dari laki-laki berusia 15-39 tahun (nilai p < 0,001). Penelitian ini menyimpulkan perempuan dan laki-laki berusia lanjut jauh lebih berisiko didiagnosa DM dibandingkan berusia lebih muda

Increasing Use of Research Findings in Improving Evidence-Based Health Policy at the National Level

In February 2016, the Minister of Health decided to increase the use of research findings in improving the quality of the national health policy and planning. The Ministry of Health has instructed the National Institute of Health Research and Development or NIHRD to play a stronger role of monitoring and evaluating all health programs, because “their opinion and research findings should be the basis for changes in national health policies and planning”. Compared to the past, the Ministry of Health has increased the research budget for evidence-based research tremendously. However, there is a gap between the information needs of program and policy-makers and the information offered by researchers. A close dialogue is needed between the users (program managers, policy makers and planners) and the suppliers (researchers and evaluators) to ensure that the evidence-based supplied by research is useful for programs, planning and health policy

Risk Differences Between Elderly Men and Women Toward Doctor-Diagnosed Diabetes Mellitus in Urban Areas in Indonesia: 2013 National Basic Health Research Data

Diabetes mellitus (DM) is one of the most common non-communicable diseases (NCDs) in Indonesia. Reportedly that DM is associated with various risk factors. Notably, it seems that the rising prevalence rates reflect changes in urban lifestyle. This study aimed to examine risk differences in the prevalence of DM among men and women aged 15 years and older that lived in urban areas in Indonesia. Analysis used secondary data of 2013 National Basic Health Research, which applied a cross- sectional study design. The total of sample was 333,731 respondents. Data processing and analysis used multiple logistic regression method. In general, findings showed that doctor-diagnosed diabetes mellitus (DDDM) among urban men and women aged 15-39 years did not differ. However, the odds ratio of DDDM among older women aged 50-64 years was 30 times higher than women aged 15-39 years, while among the same age men was 21 times higher than younger men aged 15-39 years (p value < 0.001). In conclusion, entering the age of 50 years, women show a much higher risk of contracting DDDM than women with younger age, also much higher than older men towards younger men

Rendahnya Skor Methods Information Index (MII) dan Faktor-Faktor Terkait: Analisis Survei Demografi dan Kesehatan Indonesia (SDKI) 2012 dan 2017

Informed choice memastikan bahwa pilihan kontrasepsi modern diputuskan perempuan setelah menerima informasi lengkap tentang metode kontrasepsi yang tersedia. Indeks informasi yang disebut Methods Information Index (MII) mengukur tiga elemen, yaitu efek samping masing-masing metode, kemana harus berobat jika efek samping muncul, dan perlu berganti ke kontrasepsi mana. Pemberian informasi lengkap tentang ketiga elemen MII merupakan pemenuhan etika dan hak-hak reproduksi perempuan. Penelitian ini menyajikan temuan rendahnya skoring MII di Indonesia, cermin dari tinggginya persentase perempuan pengguna kontrasepsi yang tidak menerima informasi lengkap dan faktor-faktor terkait. Sebanyak 45.607 dan 49.627 perempuan usia 15-49 tahun yang tercakup dalam Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2012 dan 2017 yang menjadi sampel. Data dianalisis menggunakan statistik regresi logistik yang memperlihatkan korelasi antara skoring MII dengan variabel bebas. Variabel bebas terdiri dari usia perempuan menikah 25 tahun ke atas, tingkat pendidikan menengah ke atas, akses pelayanan KB di bidan dan fasilitas kesehatan, serta pengguna metode IUD terkait dengan peluang lebih besar untuk menerima informasi MII lengkap. Proporsi perempuan penerima informasi MII lengkap adalah 24,60% (2012) dan 28,65% (2017). Lebih dari 70% perempuan pengguna kontrasepsi modern belum mendapatkan informasi MII lengkap. Perlu diupayakan agar program keluarga berencana memonitor peningkatan skoring indeks MII untuk memastikan perempuan pengguna kontrasepsi Indonesia terpenuhi haknya untuk mendapatkan informasi MII lengkap

Improving the health care response to gender-based violence: Phase II

In 2009, the Population Council/Vietnam in collaboration with the Hanoi Health Service carried out an evaluation survey among Duc Giang Hospital staff to assess the extent to which awareness and perceptions of gender-based violence (GBV) had changed since the project commenced in 2005. The survey also assessed the extent to which the response of the hospital and Women’s Center for Counseling and Health had been strengthened, and made recommendations on changes to improve the situation. Overall, this project has been effective in raising awareness and willingness to integrate GBV screening into health services. The project conducted its training program at a time when the community was also becoming increasingly aware, with the result that younger health practitioners are more sensitive to GBV issues. These two actions were complementary and reinforced one another. The result is that health staff are more willing to screen and help GBV victims. This final project evaluation report states that to map out where GBV is most prevalent, who is most vulnerable, and how can it be most effectively addressed, high-quality population-based GBV surveys should be a priority for Vietnam

Spatial Analysis of Seven Islands in Indonesia to Determine Stunting Hotspots

Indonesia is a vast country struggling to reduce its stunting prevalence. Hence, identifying priority areas is urgent. In determining areas to prioritize, one needs to consider geographical issues, particularly correlations among areas. This study aimed to discover whether stunting prevalence in Indonesia occurs randomly or in clusters; and, if it occurs in clusters, which areas are the hotspots. This ecological study used aggregate data from the 2018 National Basic Health Research and Poverty Data and Information Report from the Statistics Indonesia. This study analyzed 514 districts/cities across 34 provinces on seven main islands in Indonesia. The method used was the Euclidean distance to define the spatial weight. Moran's index test was used to identify autocorrelation, while a Moran scatter plot was applied to identify stunting hotspots. Autocorrelation was found among districts/cities in Sumatra, Java, Sulawesi, and Bali East Nusa Tenggara West Nusa Tenggara Islands, resulting in 133 districts/cities identified as stunting hotspots on four major islands. Autocorrelation proves that stunting in Indonesia does not occur randomly

Identifying the Weak Foundation of Public Health Resilience forNational Disaster Policy in Indonesia’s Mid-term DevelopmentAgenda 2015–2019: A Policy Content Analysis

Indonesia is one of the most susceptible nations toward natural disasters in the world. Since 1992, approximately 37 tsunami incidents have occurred inIndonesia, with at least 1,244 cases of natural disasters during 2018. Despite the overwhelming impact of disasters on Indonesia, Public Health Resilience,as an approach to disaster countermeasures, has been poorly elaborated in Indonesia’s development agenda (National Mid-term Development Plan (NMDP),or Rencana Pembangunan Jangka Menengah Nasional (RPJMN), 2015 - 2019). By utilizing the method of policy content analysis, this study aimed to analyzethe policy background of Public Health Resilience against disasters in the NMDP 2015 - 2019 and National Disaster Management Authority (NDMA)’s, orBadan Nasional Penanggulangan Bencana (BNPB),Strategic Plan 2015 - 2019. The results showed that the NMDP 2015 - 2019 and NDMA‘s Strategic Plan2015 - 2019 lack the scientific background for Public Health Resilience building in Indonesia. Enhancing the scientific background in these plans will enhancefocus on evidence-based Public Health Resilience establishment

Improving the health care response to gender-based violence: Project evaluation report

Consistent with previous studies, this study provides evidence that gender-based violence (GBV) remains a problem in Viet Nam with indications that it may be on the increase. In 2009 the Population Council Viet Nam in collaboration with the Hanoi Health Department, carried out an evaluation among the staff of Duc Giang Hospital to assess the extent to which awareness and perceptions of GBV had changed since a pilot intervention project commenced in 2005. Overall the project has been very effective in raising awareness and willingness to integrate GBV screening in the health services. This report documents the results and lists a number of recommendations for moving forward. Implementing the recommendations will allow for an increased level of quality of services to be provided

Female circumcision in Indonesia. Extent, implications and possible interventions to uphold women\u27s health rights

In Indonesia, the practice of female circumcision (FC) has long existed, but information concerning where and how it is carried out has been limited. The specific aims of the study conducted by the Population Council Jakarta were to provide research-based information on FC customary practices and their socio-cultural determinants, and if possible, to assess any long-term physical and psychological consequences. Study findings indicate that in general Muslim communities support the continuation of FC practice, because they perceive it as both a societal custom and a religious duty. The report strongly recommends that key donor agencies pressure the Ministry of Health to protect girls and women\u27s sexual and reproductive rights. While policy and law enforcement can address the available supply of medical providers for the practice, mass communication should be used to reduce the demand for FC from the community, which can facilitate consensus-building and collective decisionmaking in support of abandoning the practice