Priorities and realities: addressing the rich-poor gaps in health status and service access in Indonesia

<p>Abstract</p> <p>Introduction</p> <p>Over the past four decades, the Indonesian health care system has greatly expanded and the health of Indonesian people has improved although the rich-poor gap in health status and service access remains an issue. The government has been trying to address these gaps and intensify efforts to improve the health of the poor following the economic crisis in 1998.</p> <p>Methods</p> <p>This paper examines trends and levels in socio-economic inequity of health and identifies critical factors constraining efforts to improve the health of the poor. Quantitative data were taken from the Indonesian Demographic Health Surveys and the National Socio-Economic Surveys, and qualitative data were obtained from interviews with individuals and groups representing relevant stakeholders.</p> <p>Results</p> <p>The health of the population has improved as indicated by child mortality decline and the increase in community access to health services. However, the continuing prevalence of malnourished children and the persisting socio-economic inequity of health suggest that efforts to improve the health of the poor have not yet been effective. Factors identified at institution and policy levels that have constrained improvements in health care access and outcomes for the poor include: the high cost of electing formal governance leaders; confused leadership roles in the health sector; lack of health inequity indicators; the generally weak capacity in the health care system, especially in planning and budgeting; and the leakage and limited coverage of programs for the poor.</p> <p>Conclusions</p> <p>Despite the government's efforts to improve the health of the poor, the rich-poor gap in health status and service access continues. Factors at institutional and policy levels are critical in contributing to the lack of efficiency and effectiveness for health programs that address the poor.</p

THE INFLUENCE OF OROGRAPHY DURING DEEP MEDITERRANEAN CYCLOGENESIS 11-15 NOVEMBER 2004

The deep cyclogenesis causing a range of severe weather events took place over the Mediterranean Sea from 11- 15 November 2004. The first phase of the event was analysed by a series of numerical experiments using the MM5 forecast model. Factor separation method was applied to investigate the cyclogenetic and cyclolytic influences of orography, upper-level potential vorticity and latent heat flux from the sea as well as their mutual synergies in the cyclone initiation and movement in the lee of Atlas Mountains. Results of model simulations show that pure orographic effect is responsible for generation of the low-level shallow vortex in the lee, while upper-level PV anomaly is a dominant effect in the later stage of lee formation. In addition, upperlevel PV anomaly is crucial for advection of the system to the Mediterranean Sea, where the cyclone experienced a severe deeping in the mature stage of its development

Hubungan antara Karakteristik Ibu dan Keluarga dengan Praktik Keluarga Sehat di Wilayah Kerja Puskesmas Lasem Kabupaten Rembang

Keluarga Sehat approach is a new program of Health Ministry that will be used to measure family health in 2017. Family health in work area of Puskesmas Lasem based on PHBS approach in 2015 is 34,1%, fewer than national target 80%. The aim of this research is to analyze the correlation between characteristic of housewife and family with practice of keluarga sehat in work area of Puskesmas Lasem. This analytic-survey research uses cross sectional study and combains quantitative method used quetionnair guide and qualitative method used in-depth interview. Population is 2.793 families that has toddler and sampel is 120 choosen propotional randomly. Bivariat analysis is counted by chi square test with 95% of significancy between characteristic of housewife and family with practice of keluarga sehat. The result showed that respondents are in healthy reproduction age (20-35 years old)(76,7%), elementary educated (75,8%), not employer (79,2%), having family member ≤4 (79,2%), and having revenue ≥ UMR (75,8%). Bivariat test showed that there is no correlation between housewife age, housewife education level, housewife occupation status, and total of family member with practice of keluarga sehat. There is correlation between family revenue with practice of keluarga sehat. It is recomended that Puskesmas Lasem analyze the need of resource that support Keluarga Sehat program and manage sosialization by associating with family characteristic

Analysis of the environments of seven Mediterranean tropical-like storms using an axisymmetric, nonhydrostatic, cloud resolving model

Tropical-like storms on the Mediterranean Sea are occasionally observed on satellite images, often with a clear eye surrounded by an axysimmetric cloud structure. These storms sometimes attain hurricane intensity and can severely affect coastal lands. A deep, cut-off, cold-core low is usually observed at mid-upper tropospheric levels in association with the development of these tropical-like systems. In this study we attempt to apply some tools previously used in studies of tropical hurricanes to characterise the environments in which seven known Mediterranean events developed. In particular, an axisymmetric, nonhydrostatic, cloud resolving model is applied to simulate the tropical-like storm genesis and evolution. Results are compared to surface observations when landfall occurred and with satellite microwave derived wind speed measurements over the sea. Finally, sensitivities of the numerical simulations to different factors (e.g. sea surface temperature, vertical humidity profile and size of the initial precursor of the storm) are examined

Substitution effect of Zn and Cu in MgB2 on Tc and structure

The investigation of Zn substitution in MgB2 polycrystalline samples shows that about 0.1 Zn can be substituted in the structure of Mg deficient samples while it can not be substituted in stoichiometric MgB2. As a result of the isovalent Zn substitution into the Mg position of Mg deficient samples the a and c lattice constants increase by about 0.17% and 0.2% respectively. Susceptibility measurements show a slight lowering of Tc by about 0.5 K for 0.05 Zn, which decreases to 0.2 K for 0.1 Zn substitution. Investigation of the pressure derivative of Tc shows dp/dTc = -0.15 K/kbar independent of Zn content. Substitution of Cu leads to multiphase samples without any changes of lattice constants, which indicates that Cu does not enter the structure of MgB2. The Cu substitution broadens the superconducting transition considerably, while the onset remains unchanged.Comment: 13 pages, 5 figure

Determination of hemihedral twinning and initial structural analysis of crystals of the procarboxypeptidase A ternary complex

The initial structural analysis of the ternary complex of procarboxypeptidase A from hemihedrally twinned crystals diffracting up to 2.8 Å is described. Detection of twinning by different techniques is presented, including biochemical and intensity statistics approaches. The structure was initially solved using Patterson-search techniques, and the three positioned search models were used to effectively deconvolute the twinned data