Actes du séminaire ajustement structurel et agriculture - Expériences de pays en développement

L'objectif de ce séminaire était de mettre en commun un certain nombre d'expériences de pays africains, méditerranéens et latino-américains ayant mis en oeuvre des programmes d'ajustement structurel, et de tirer de cette confrontation des conclusions sur la manière d'aborder le problème de l'ouverture des économies et sur son impact sur les différents secteurs productifs. Après une série d'étude de cas dans différents pays, la création de trois groupes de travail permettant d'approfondir certains thèmes de réflexion (rôle de l'Etat, dynamique de l'ajustement, besoins en informations pour l'évaluation ex ante de l'impact des PAS) est proposée. En annexe figurent les textes présentés lors de ce séminair

Women’s Decision to Become Commercial Sex Workers in Banjarsari, Surakarta, Central Java, and its Associated Factors

Background: Worldwide, an estimated 33 million people are living with Human Immuno Deficiency Virus (HIV). Sex workers are 10 times more at risk of HIV compared with the general population, due to an increased likelihood of being economically vulnerable, unable to negotiate consistent condom use, and experiencing violence, criminalisation and marginalisation. Little is known about factors associated with the decision to work as a female sex worker in Indonesia. This study aimed to examine factors associated with women’s decision to become commercial sex workers in Banjarsari, Surakarta, Central Java. Subjects and Method: This was a case control study conducted in Banjarsari, Surakarta, Central Java. A total sample of 200 study subjects consisting of 100 female commercial sex workers and 100 non sex workers. The dependent variable was women’s decision to become commercial sex worker. The independent variables were knowledge of sexually-transmitted disease (STDs), family income, pro-commercial sex worker family support, snobbish life style, and access to whore house. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Women’s decision to become commercial sex worker was negatively associated with good knowledge of STDs (OR= 0.03; 95% CI= 0.01 to 0.18; p<0.001), high family income (OR= 0.01; 95% CI<0.01 to 0.05; p<0.001). Women’s decision to become commercial sex worker was positively associated with strong pro-commercial sex worker family support (OR= 8.15; 95% CI= 2.63 to 25.23; p<0.001), snobbish life style (OR= 6.20; 95% CI= 1.81 to 21.24; p= 0.004), and access to whore house (OR= 8.52; 95% CI= 2 .49 to 29.17; p= 0.001). Conclusion: Women’s decision to become commercial sex workers decreases with good knowledge of the STDs and higher family income. Women’s decision to become commercial sex workers increases with strong pro-commercial sex worker family support, life style, and access to whore house. Keywords: Women’s decision, commercial sex worker, knowledge, family income, family support, life style, access to whore hous

Safe Sex Behavior among Commercial Sex Workers in Banjarsari, Surakarta, Central Java, and its Associated Factors

Background: Worldwide it is estimated that more than one million people in contract sexually-transmitted disease (STDs) everyday. Annually approximately 357 million new infections occur by one of four STDs: chlamidia, gonorrhea, syphilis, and mouth ulcer. The incidence of HIV/AIDS has been increasing year by year. HIV/AIDS has spread in 407 of 507 districts and municipalities in Indonesia, or equivalently covering 80% districts and municipalities of the country. In Surakarta, the cumulative incidence of HIV/AIDS from 2005 to 2017 was 561 cases, with 38 HIV cases and 46 AIDS cases in 2017 alone. Safe sex is important to prevent pregnancy, STDs, and most importantly HIV and AIDS. This study aimed to examine factors associated with safe sex behavior among commercial sex workers in Banjarsari, Surakarta, Central Java. Subjects and Method: This was a cross-sectional study conducted in Banjarsari Sub-district, Surakarta, Central Java. A total sample of 100 commercial sex workers was selected by stratified random sampling. The dependent variable was safe sex behavior. The independent variables were knowledge of STDs and HIV/AIDS, self efficacy, condom availability, access to health care service, health personnel support, and peer support. The data were collected by questionnaire and analyzed by a multiple linear regression. Results: Safe sex behavior was associated with good knowledge of STDs and HIV/AIDS (b= 0.19; 95% CI= 0.01 to 0.30; p= 0.032), strong self efficacy (b= 0.18; 95% CI= 0.01 to 0.38; p= 0.047), condom availability (b= 0.30; 95% CI= 0.36 to 1.20; p<0.001), good access to health care service (b= 0.19; 95% CI= 0.02 to 0.52; p= 0.035), strong health personnel support (b= 0.18; 95% CI= 0.01 to 0.57; p= 0.041), strong peer support (b=0.17; 95% CI= 0.01 to 0.50; p= 0.046). Conclusion: Safe sex behavior is associated with good knowledge of STDs and HIV/AIDS, strong self efficacy, condom availability, access to health care service, strong health personnel support, and strong peer support. Keywords: safe sex behavior, knowledge, self efficacy, condom availability, access to health service, health personnel support, peer suppor

FACTORS ASSOCIATED WITH STUNTING AND WASTING IN CHILDREN AGED 12-48 MONTHS: AN EVIDENCE FROM LAMPUNG

Background: Stunting and wasting are a growth disorder in children under five. Stunting impedes human development, globally affecting 162 million children under five. Stunting is generally caused by recurrent acute malnutrition, whereas wasting occurs due to short-term malnutrition. Wasting indicates a recent and severe process of weight loss, which is often associated with acute starvation and/or severe disease. The prevalence of wasting is usually below 5% even in poor countries. Wasting is caused by the same factors that contribute to stunting. If untreated properly, stunting and wasting may cause low intelligence in adult life. This study aimed to determine factors associated with stunting and wasting in children aged 12-48 months. Subjects and Method: This was a case-control study conducted at Mulya Asri, Panaragan, and Da­ya­mur­ni community health centers, Lampung, from January to February 2018. A sample of 150 children under-five was selected for this study by fixed disease sampling. The dependent variables were stunting and wasting. The independent variables were birthweight, maternal knowledge, maternal education, maternal nutritional status (mid-upper arm circumference/ MUAC), exclusive breastfeeding (EBF), upper respiratory tract infection (URTI), diarrhea, lack of clean water, poor sanitation. The data were collected by questionnaire and maternal and child health monitoring book. The data were analyzed by a logistic regression. Results: The risk of stunting increased with poor maternal knowledge (OR= 5.29; 95% CI= 1.30 to 21.54; p=0.002), low maternal education (OR=10.25; 95%CI= 2.26 to 46.79; p=0.003), poor maternal nutritional status (OR= 8.87; 95%CI= 2.14 to 36.74; p=0.003), low birthweight (OR= 9.86; 95%CI=2.60 to 37.47; p=0.001), no EBF (OR= 5.70; 95%CI= 1.59 to 20.46; p=0.008). The risk of wasting increased with poor knowledge (OR= 10.95; 95%CI= 2.14 to 56.91; p= 0.004), low family income (OR= 7.04; 95%CI= 5.51 to 32.78; p=0.013), low birthweight (OR= 14.71; 95%CI= 2.74 to 79.06; p=0.002), URTI history (OR= 4.87; 95%CI= 1.23 to 19.38; p=0.024), diarrhea (OR= 6.09; 95%CI= 1.42 to 26.20; p=0.015), a lack of clean water (OR= 9.78; 95%CI= 2.26 to 42.36; p=0.002), and poor sanitation (OR= 7.67; 95%CI= 1.85 to 31.75; p=0.004). Conclusion: The risk of stunting and wasting are affected by birthweight, URTI history, diarrhea, EBF, maternal nutritional status, maternal knowledge, maternal education, family income, lack of clean water, and poor sanitation. Keywords: stunting, wasting, biopsychosocial, determinant

The Psychosocial Impact of Obesity or Overweight in Adolescents: A Path Analysis Evidence from Surakarta, Central Java

Background: Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health. People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight by the square of the person’s height, is over 30 kg/m2, with the range 25–30 kg/m2 defined as overweight. Some East Asian countries use lower values. Obesity increases the likelihood of various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, osteoarthritis and depression. Little is known about the psychosocial impact of obesity or overweight in adolescents in Indonesia. This study aimed to determine the psychosocial impact of obesity or overweight in adolescents using path analysis. Subjects and Method: This was a cross-sectional study conducted at 6 junior high schools in Banjarsari and Jebres, Surakarta, Central Java, from October to November, 2017. A total sample of 160 junior high school students was selected for this study by purposive sampling. The dependent variables were depression, self-assessment, body image, eating disorder, and quality of life. The independent variables were obesity or overweight. Body mass index (BMI) was measured by body weight scale and microtoise. Data of other study variables were collected by questionnaire. The data were analyzed by path analysis. Results: Obesity or overweight was associated with an increased risk of depression (b= 1.04; 95% CI=0.32 to 1.77; p= 0.005) and bad body image (b= -2.35; 95% CI= -3.20 to 1.49; p<0.001). Depression was associated with an increased risk of eating disorder (b= 0.55; CI 95%= -0.87 to 1.18; p=0.091) and poor quality of life (b= -0.64; 95% CI= -1.34 to 0.69; p= 0.077). Good body image was asssociated with positive self-assessment (b= 2.71; 95% CI= 1.89 to 3.52; p<0.001). Conclusion: Obesity or overweight in adolescents is directly associated with depression and bad body image. Obesity or overweight is indirectly associated with negative self-assessment, eating disorder, and poorer quality of life. Keywords: overweight, obesity, psychosocial, path analysi

Life Course Perspective of the Factors Affecting Overweight and Obesity in Children Under Five: A Path Analysis Evidence from Surakarta

Background: Obesity is a public health problem that has raised concern worldwide. According to the World Health Organization, there will be about 2.3 billion overweight people aged 15 years and above, and over 700 million obese people worldwide in 2015. Being overweight or obese in childhood can contributes to numerous health conditions in adulthood including: hypertension, high LDL cholesterol, low HDL cholesterol or high levels of triglycerides, type 2 diabetes, coronary heart disease, and stroke. This study aimed to analyze the life course factors affecting overweight and obesity in children aged 2 to 5 years old in Surakarta, Central Java. Subjects and Method: This was a case control study was conducted in 5 community health centers, Surakarta, Central Java, from September to October 2017. A sample of 150 children aged 2 to 5 years old was selected for this study by fixed disease sampling. The dependent variable was overweight or obesity. The independent variables were nutrition intake, exclusive breastfeeding, starting age of complementary feeding, physical activity, birthweight, age of gestation, sectio cesarea labor, maternal body mass index, and maternal job. Physical activity data was measured using Pre PAQ questionnaire. Other data were collected using a set of questionnaire and maternal and child health monitoring book. The data were analyzed by path analysis. Results: Overweight and obesity in children aged 2 to 5 years old were positively affected by over nutrition intake (b= 1.9; 95% CI= 0.15 to 3.60; p= 0.033), high maternal body mass index (b= 2.0; 95% CI= 0.51 to 3.42; p= 0.008), and sectio cesarean birth (b= 2.1; 95% CI= 0.56 to 3.73; p= 0.008). Overweight and obesity in children aged 2 to 5 years old were negatively affected by normal birthweight (b= -2.2; 95% CI= -4.28 to -0.19; p= 0.032), exclusive breastfeeding (b= -2.0; 95% CI= -3.60 to -0.39; p=0.015), timely starting age of complementary feeding (b= -1.3; 95% CI= -2.80 to 0.11; p=0.072), and high physical activity (b= -3.0; 95% CI= -4.63 to -1.37; p= 0.001). Overweight and obesity in children aged 2 to 5 years old were indirectly affected by age of gestation and working outside the house. Conclusion: Overweight and obesity in children aged 2 to 5 years old are positively affected by over nutrition intake, high maternal body mass index, and sectio cesarean birth. Overweight and obesity in children aged 2 to 5 years old are negatively affected by normal birthweight, exclusive breastfeeding, timely starting age of complementary feeding, and high physical activity. Keywords: life course factors, overweight, obesity, path analysis

IMPLEMENTASI BAHASA ISYARAT DALAM AKTIVITAS PELAYANAN BARISTA KAFE SUNYI GRAND GALAXY CITY

The purposes of this research is to visualize a communication activity inside Sunyi Café barista of implementing sign language . Sunyi Café is a coffee shop that precisely located in Bekasi, Grand Galaxy City, that empowers people with disabilities especially those who are deaf to works as a barista. The conceptual communication in this research is using Symbolis Interactionism Theories. This research is using a descriptive qualitative with collecting data sources are method from observation and documentation techniques to perceive a service activity. The results of this research showed that difabel friends has the social activity that are generated causes of forums for them to bring an awareness to society that they has the skills that equivalent with non difabel friends in business activity by implementing sign language as an access to interact in sevice activity