Peran Indikator Pelayanan Kesehatan untuk Meningkatkan Nilai Sub Indeks Kesehatan Reproduksi dalam Indeks Pembangunan Kesehatan Masyarakat (IPKM)

In Indonesia, measuring the success of development of a region is increasingly needed with the enactment of the Regional Autonomy System (OTDA). There are many methods or indicators that can be used as a measuring tool. The Public Health Development Index (IPKM) is one of the indicators that can be used to measure the success of community health development. This study aims to explore the correlation between several indicators of sub-index of Health Service (Yankes) and sub-index of Reproductive Health (Kespro) which become part of IPKM. Another purpose of this analysis is to find out which indicators are most leveraging for the Kespro sub-index. The method to analyse the data used Multiple Linear Regression with the district as the unit of analysis. According to the RISKESDAS 2013 data, there are 497 districts/cities in 33 provinces in Indonesia. RISKESDAS 2013 and Podes 2011 data are used by IPKM 2013. The results of the analysis show that the largest indicator giving the leverage of Kespro sub-index. That are the coverage of birth delivery by health worker in health facilities after controlled by the proportion of physicians per sub-district, the proportion of adequate posyandu per region and the health service coverage ownership (Jaminan Pelayanan Kesehatan/JPK) in each district. Abstrak Pengukuran keberhasilan pembangunan suatu daerah semakin dibutuhkan dengan berlakunya sistim Otonomi Daerah (Otda) di Indonesia.  Banyak metode atau indikator yang dijadikan alat ukurnya. Untuk mengukur keberhasilan pembangunan kesehatan masyarakat, Indeks Pembangunan Kesehatan Masyarakat (IPKM) menjadi salah satu indikator yang digunakan.  Penelitian ini bertujuan menggali hubungan beberapa indikator pembentuk sub indeks Pelayanan Kesehatan (Yankes) terhadap sub indeks Kesehatan Reproduksi (Kespro) yang menjadi bagian dari IPKM. Tujuan lain dari analisa ini yakni menggali indikator mana yang paling memberi efek ungkit bagi sub indeks Kespro. Metode analisa yang digunakan adalah Regresi Linier Berganda dengan kabupaten sebagai unit analisanya. Terdapat 497 kabupaten di 33 provinsi di Indonesia sesuai dengan jumlah kabupaten pada saat Riset Kesehatan Dasar (Riskesdas) dikumpulkan pada tahun 2013. Riskesdas 2013 dan Podes 2011 menjadi sumber data yang digunakan IPKM 2013. Hasil dari analisa didapat indikator yang paling besar memberikan daya ungkit sub indeks Kespro yakni cakupan persalinan ditolong oleh tenaga kesehatan di fasilitas kesehatan setelah dikontrol proporsi jumlah dokter per kecamatan, proporsi jumlah posyandu per desa dan kepemilikan Jaminan Pelayanan Kesehatan (JPK) di setiap kabupaten

PENGARUH KONDISI KESEHATAN LINGKUNGAN DAN SOSIAL EKONOMI TERHADAP KESEHATAN MENTAL DI INDONESIA

ABSTRACT  Conditions of housing and residential environment are one of the factors that cause mental emotional disorder. This is related to the quality of residential environment and socio-economic conditions of the community. Residential environment derived from variabels of healthy housing, overcrowding, and residence area. Social economy was a combination of economic quintile, housing ownership, subsidized rice for the poor programmed and healthcare for the poor. Family history of mental disorders and the search for medical treatment was also been studied.  The aim of this analysis was to find the relationship between residential environment and economic status as well as family history of mental emotional condition and the pursuit for medical treatment among population aged 15 years old and over. To measure mental emotional was Self Reporting Questioner (SRQ) consisted of 20 items in Riskesdas 2013 instrument. The results showed the relationship between residential environment and economic status of individual mental health. A history of mental disorders in the family also contributes to improving mental health disorders. Housing environment is a dominant factor associated with mental disorders. People who has a mental illness family member has a risk of 4,5 times experiencing mental disorders. Therefore, government support was needed to provide a decent, affordable and healthy housing for the poor.   Keywords: Residential, economic status, mental emotional   ABSTRAK  Kondisi perumahan dan lingkungan permukiman merupakan salah satu faktor yang menyebabkan gangguan kesehatan mental emosional. Hal ini terkait dengan kualitas lingkungan permukiman dan kondisi sosial ekonomi masyarakat. Kondisi permukiman meliputi variabel rumah sehat, kepadatan hunian dan wilayah tempat tinggal. Sosial ekonomi merupakan kombinasi dari indeks kepemilikan, kepemilikan rumah, pemberian beras miskin dan fasilitas kesehatan gratis. Selain itu, riwayat keluarga yang memiliki gangguan jiwa dan upaya pencarian pengobatan untuk mengobati gangguan kesehatan mental yang diderita juga dianalisis. Tujuan penelitian ini adalah untuk melihat hubungan antara kondisi lingkungan permukiman dan status sosial ekonomi serta riwayat keluarga dengan kesehatan mental emosional, dan upaya pencarian pengobatan gangguan mental penduduk usia 15 tahun ke atas  Pengukuran kesehatan mental menggunakan Self Reporting Questioner (SRQ) yang berisi 20 butir pertanyaan yang terdapat dalam kuesioner Riskesdas 2013. Hasil analisis menunjukkan bahwa adanya hubungan antara kondisi lingkungan permukiman dan status sosial ekonomi terhadap kesehatan mental individu. Lingkungan rumah merupakan faktor dominan yang berhubungan dengan gangguan kesehatan mental. Seseorang yang tinggal bersama anggota rumah tangga yang mengalami gangguan jiwa berat mempunyai risiko 4,5 kali mengalami gangguan mental emosional. Oleh karena itu, perlu dukungan pemerintah untuk menyediakan permukiman yang layak, terjangkau dan sehat bagi masyarakat menengah ke bawah. Kata kunci: Permukiman, status ekonomi, mental emosiona

PELAYANAN PEMERIKSAAN KEHAMILAN BERKUALITAS YANG DIMANFAATKAN IBU HAMIL UNTUK PERSIAPAN PERSALINAN DI INDONESIA

ABSTRACT Antenatal care (ANC) is a prevention healthcare for maternal health and their babies. In order to fulfill the needs of them, an accessible health facility that provides ANC with qualified services for the community is needed. This study aims to determine the utilization of maternal health services as preparation for safe delivery. Analysis of this study used the data from National Health Indicator Survey (Sirkesnas) 2016 and Village Potential Census (Podes) 2014. The analysis technique was multivariable logistic regression. The results showed that the use of qualified ANC tended to be used by mothers who were examined by midwives in health centers, highly educated mothers, those who were living in moderate and good neighborhoods, not living in slums (social environment) and residing in Java-Bali region.  It can be concluded that midwives and location of ANC provided important role to improve the utilization of ANC services as an ideal preparation for safe delivery. Keywords: Quality of ANC, maternal health, living environment, social environment   ABSTRAK Pemeriksaan kehamilan atau antenatal care (ANC) merupakan upaya untuk menjaga kesehatan ibu hamil dan bayinya. Dalam  memenuhi kebutuhan tersebut, diperlukan fasilitas kesehatan yang mudah diakses oleh masyarakat serta pelayanan pemeriksaan ANC yang berkualitas. Penelitian ini bertujuan untuk mengetahui pemanfaatan pelayanan kesehatan ibu hamil sebagai persiapan persalinan yang aman.  Analisis menggunakan data Survei Indikator Kesehatan Nasional (Sirkesnas) tahun  2016 dan Potensi Desa (Podes) tahun 2014. Teknik analisis yang digunakan adalah regresi logistik multivariabel. Hasil uji regresi logistik multivariabel menunjukkan bahwa pemanfaatan ANC berkualitas cenderung digunakan oleh ibu yang diperiksa bidan di puskesmas, ibu berpendidikan tinggi, tinggal di lingkungan permukiman sedang dan baik, tidak tinggal di wilayah kumuh (lingkungan sosial) serta bertempat tinggal di Regional Jawa-Bali. Dapat disimpulkan bahwa bidan dan tempat ANC mempunyai peran sangat penting untuk meningkatkan pemanfaatan pelayanan ANC ideal sebagai persiapan persalinan yang aman. Kata kunci: Pelayanan kehamilan  berkualitas, kesehatan ibu hamil, lingkungan permukiman, lingkungan sosia

Prevalensi Psikosis di Indonesia berdasarkan Riset Kesehatan Dasar 2018

Abstrak Psikosis adalah gangguan jiwa yang memiliki prevalensi kecil dibandingkan gangguan jiwa lainnya tetapi mempunyai beban penyakit yang cukup tinggi. Tujuan analisis ini adalah untuk memperoleh prevalensi psikosis pada penduduk Indonesia secara nasional, per provinsi dan melihat sebaran psikosis antara perkotaan, perdesaan berdasarkan Riset Kesehatan Dasar (Riskesdas) 2018. Analisis ini merupakan analisis lanjut Riskesdas dilaksanakan di 34 provinsi, 514 kabupaten/kota pada bulan Juli 2018. Jumlah blok sensus 29.824 dengan respon rate 99,41%, jumlah rumah tangga dikunjungi dan diwawancara 282.654 dengan respon rate 95,58%. Enumerator bertanya kepada kepala keluarga atau yang mewakilinya mengenai adakah anggota rumah tangga (ART) di rumah tersebut yang pernah atau sedang mengalami gangguan jiwa psikosis dan berapa banyak jumlahnya. Analisis dilakukan dengan perangkat statistik SPSS versi 22 dengan metode complex sample. Berdasarkan Riskesdas 2018, didapatkan estimasi prevalensi orang yang pernah menderita psikosis di Indonesia sebesar 1,8 per 1000 penduduk. Prevalensi antar provinsi berkisar 0.9 sampai 3.5 per 1000 penduduk. Prevalensi psikosis lebih tinggi di perdesaan dibandingkan di perkotaan (p=0,099). Kata kunci: Riskesdas 2018, psikosis, prevalensi Abstract Psychosis is a mental disorder that has a small prevalence compared to other mental disorders but it has a fairly high burden of disease. The purpose of this analysis is to obtain the national, provincial prevalence of psychosis and to compare the prevalence between urban and rural regions in Indonesia based on Basic Health Research (Riskesdas) 2018. This is an advance analysis. Riskesdas was implemented in July 2018 in 34 provinces and 514 regencies/cities. A total of 29,824 census blocks with a response rate of 99.41%, as many as 282.654 households visited and interviewed with a response rate of 95.58%. The enumerator interviewed the head of the family or his representative regarding the existence of household members (ART) in the house who had or were experiencing psychosis and how many of them. The analysis was carried out with SPSS version 22 using the complex sample method. Based on Riskesdas 2018, an estimated prevalence of people who have suffered psychosis in Indonesia is 1.8 per 1000 population. The prevalence between provinces ranges from 0.9 to 3.5 per 1000 population. The prevalence is higher in rural than urban area (p=0.099). Keywords: Riskesdas 2018, psychosis, prevalenc

Psychological distress and dyslipidemia in adult women: A 6-years follow up study in Bogor City, Indonesia

BACKGROUND Dyslipidemia is of global occurrence, with a prevalence 30% or higher in several countries, including Indonesia. One risk factor of dyslipidemia is physical or mental stress, that is more frequent in women. This study aimed at investigating the association between psychological distress and dyslipidemia in adult women. METHODS This observational longitudinal study involved 1850 women aged 25 years and older at baseline. Dyslipidemia was determined from the ratio of low- density lipoprotein to high-density lipoprotein. Psychological distress was determined using the 20-item self-reporting questionnaire. Data analysis was by Cox regression for calculating the hazard ratio of the incidence of dyslipidemia as predicted by the psychological distress. RESULTS Among the 1474 participants without dyslipidemia at baseline, 545 (36.9%) developed dyslipidemia during 6 years of monitoring, while 93 (6.3%) had a history of psychological distress. There was a significant association between psychological distress and dyslipidemia (HR = 3.08; 95% CI: 2.33- 4.07). Cox regression revealed that the association was still found to be significant after a further adjustment for the variables of age, BMI, menopause, smoking status, physical activity, and carbohydrate and fat intakes (HR=2.8; 95% CI: 2.10 - 3.77). CONCLUSIONS Dyslipidemia incidence was high among adult women in Bogor. Women with psychological distress had higher incidence rates of dyslipidemia than women without psychological distress. Psychological distress in women was statistically significantly associated with incidence rate of dyslipidemia. This finding highlights the importance of the need for a dyslipidemia- reduction program in women through prevention and control of psychological distress

Determinants of early neonatal mortality: secondary analysis of the 2012 and 2017 Indonesia Demographic and Health Survey

BackgroundMost neonatal deaths occur during the first week of life (i.e., early neonatal deaths). In this analysis, we aimed to investigate the determinants of early neonatal deaths in a nationally representative sample of births in Indonesia over the five years before each survey.MethodsData were obtained from the 2012 and 2017 Indonesia Demographic and Health Survey (IDHS), including information from 58,902 mothers of children aged <5 years of age. The outcome variable was early neonatal death (death of a newborn within the first six days of life). Explanatory variables were categorized into environmental, household, maternal, pregnancy, childbirth, and child characteristics. Multivariate regression methods were employed for analysis.ResultsIncreased odds of early neonatal deaths were associated with mothers who lacked formal education or had incomplete primary schooling (adjusted odd ratio [OR] = 2.43, 95% confidence interval [CI]: 1.18–5.01), worked outside the house in agricultural (aOR = 5.94, 95% CI: 3.09–11.45) or non-agricultural field (aOR = 2.98, 95% CI: 1.88–4.72), and were required to make a joint decision about health care with their partner or another household member (aOR = 1.79, 95% CI: 1.12–2.84). Increased odds were also observed in smaller-than-average infants, particularly those who received low-quality antenatal care services (aOR = 9.10, 95% CI: 5.04–16.41) and those whose mothers had delivery complications (aOR = 1.72, 95% CI: 1.10–2.68) or who were delivered by cesarean section (aOR = 1.74, 95% CI: 1.07–2.82). Furthermore, male infants showed higher odds than female infants (aOR = 1.85, 95% CI: 1.23–2.76).ConclusionsA multifaceted approach is essential for curtailing early neonatal mortality in Indonesia. Enabling workplace policies, promoting women's empowerment, strengthening the health system, and improving the uptake of high-quality antenatal care services are among the critical steps toward preventing early neonatal deaths in Indonesia

Chronic kidney disease in Indonesia: evidence from a national health survey

Objectives Several previous studies have stated that consuming certain foods and beverages might increase the risk of chronic kidney disease (CKD). This study aimed to examine the relationships of food and beverage consumption with other risk factors for CKD. Methods Data sources included the 2018 Basic Health Research (Riskesdas) and the National Socio-Economic Survey (Susenas), which were analyzed using a cross-sectional design. The study samples were households from 34 provinces in Indonesia, and the analysis was performed with provincial aggregates. Data were analyzed using risk factor analysis followed by linear regression to identify relationships with CKD. Results The prevalence of CKD in Indonesia was 0.38%. The province with the highest prevalence was North Kalimantan (0.64%), while the lowest was found in West Sulawesi (0.18%). Five major groups were formed from 15 identified risk factors using factor analysis. A linear regression model presented 1 significant selected factor (p=0.006, R2=31%). The final model of risk factors included water quality, consumption of fatty foods, and a history of diabetes. Conclusion Drinking water quality, fatty food consumption, and diabetes are associated with CKD. There is a need to monitor drinking water, as well as to promote health education and provide comprehensive services for people with diabetes, to prevent CKD

PERAN LINGKUNGAN DAN INDIVIDU TERHADAP MASALAH DIARE DI PULAU JAWA DAN BALI

ABSTRACT  Diarrhea is a major health problem in Indonesia with high morbidity and mortality rates. Unhealthy environment and unhygienic behavior are closely related to diarrhea disease. This study aims to identify the association between environmental conditions and behavior with the occurrence of diarrhea in Jawa and Bali. Data source used was the integration data of March’s Susenas and Riskesdas 2018. A logistic regression analysis was chosen to elicit the relationship between sanitation and drinking water facilities, open defecation practice, and other factors with the prevalence of diarrhea. The results showed that open defecation (OR = 1.2; 95% CI: 1.12 to 1.29; P<0.001, and improper of household sanitation and drinking water (OR = 1.11; 95% CI: 1.04 to 1.2; P = 0.003) had significant association with diarrhea. Other factors are age 0-5 years (OR = 1.56; 95% CI: 1.46 to 1.66; P <0,001) and low education (OR = 1.33; 95% CI: 1.21 to 1.47; P <0,001). This study shows the hygienic behavior is the essential factors to reduce the incidence of diarrhea. Therefore, it is recommended to to prioritize aspects of behavior and environmental health, namely changing people’s behavior to defecate in a latrine, and provide proper sanitation and sufficient drinking water. Keywords: Diarrhea; sanitation; drinking water; open defecation   ABSTRAK Penyakit diare merupakan masalah kesehatan utama di Indonesia dengan angka kesakitan dan kematian yang masih tinggi. Lingkungan yang tidak sehat dan perilaku tidak higienis sangat erat kaitannya dengan penyakit diare. Penelitian ini bertujuan untuk menganalisis hubungan antara kondisi lingkungan dan perilaku dengan penyakit diare di pulau Jawa dan Bali. Sumber data yang digunakan adalah data integrasi Susenas Maret dan Riskesdas 2018. Analisis dilakukan dengan menggunakan regresi logistik untuk melihat hubungan antara ketersediaan sanitasi dan air minum, perilaku buang air besar serta faktor lainnya terhadap kejadian diare. Hasil menunjukkan bahwa faktor perilaku buang air besar sembarangan (OR = 1,2; 95% CI: 1,12 - 1,29; P <0,001) serta akses sanitasi dan air minum rumah tangga tidak layak/tidak tersedia (OR = 1,11; 95% CI: 1,04 - 1,2; P = 0,003) memiliki hubungan dengan kejadian diare. Faktor lainnya yaitu: usia 0-5 tahun (OR = 1,56; 95% CI: 1,46 - 1,66; P <0,001) dan pendidikan rendah (OR = 1,33; 95% CI: 1,21 - 1,47; P <0,001).  Penelitian ini menunjukkan bahwa perilaku higienis sangat penting untuk menurunkan kejadian diare. Oleh karena itu direkomendasikan untuk mengutamakan aspek perilaku dan kesehatan lingkungan, yaitu merubah perilaku masyarakat untuk BAB di jamban, serta menyediakan sanitasi dan air minum yang layak. Kata kunci: Diare, sanitasi, sarana air minum, buang air besar sembaranga

IPKM (Indeks Pembangunan Kesehatan Masyarakat) 2018

Indeks Pembangunan Kesehatan Masyarakat tahun 2018 dihitung menggunakan model IPKM yang dikembangkan pada tahun 2013. Indeks ini mengikutsertakan 30 indikator kesehatan yang dikelompokkan menjadi 7 sub indeks :1).kesehatan balita, 2). kesehatan reproduksi, 3). pelayanan kesehatan, 4). perilaku kesehatan, 5). penyakit tidak menular, 6). penyakit menular, dan 7). kesehatan lingkungan. Sub indeks dapat digunakan untuk melihat masalah utama yang menyebabkan nilai IPKM membaik atau memburuk, sehingga intervensi atau penyelesaian masalah lebih tepat pada sasaran. Data indikator dianalisis secara agregat pada tingkat kabupaten/ kota dengan menggunakan data Riskesdas 2018, Podes 2018, Susenas Maret 2018 terintegrasi Riskesdas 2018 dan Proyeksi penduduk per kab/ kota tahun 2018. Penyempurnaan definisi operasional indikator dilakukan untuk menyesuaikan dengan perubahan definisi yang digunakan untuk menyesuaikan dengan perubahan definisi yang digunakan pelaksana program di unit utama Kementerian Kesehatan. Peringkat provinsi tertinggi dan terendah di tingkat nasional tidak mengalami perubahan antara tahun 2013 dan 2018. Peringkat paling adalah Provinsi Bali dan paling rendah adalah Provinsi Papua. Capaian maksimal oleh kabupaten/kota di Provinsi Papua Barat masih di bawah nilai minimal pada provinsi lainnya. Provinsi Papua juga perlu mendapat prioritas pembangunan kesehatan karena sepuluh peringkat terendah secara nasional didominasi kabupaten/ kota di Provinsi Papua.xix+380 hlm; 29,7 c