Meningkatkan Perhatian Siswa Kelas V SDN 2 Salakan Pada Mata Pelajaran PKn Melalui Metode Diskusi

Penelitian ini dilatarbelakangi oleh kurangnya perhatian siswa dalam proses pembelajaran PKn. Penelitian ini bertujuan untuk membuktikan bahwa metode diskusi dapat meningkatkan perhatian siswa pada pembelajaran PKn di kelas VB SDN 2 Salakan, dengan jumlah siswa sebanyak 29 siswa. Jenis penelitian ini adalah Penelitian Tindakan Kelas yang terdiri atas tiga siklus. Penelitian ini menggunakan model penelitian tindakan dari Kemmis dan Taggart (dalam Sugiarti, 1997: 6), yaitu berbentuk spiral dari siklus yang satu ke siklus yang berikutnya. Setiap siklus meliputi planning (rencana), action (tindakan), observation (pengamatan), dan reflection (refleksi). Teknik pengumpulan data yang digunakan adalah melalui lembar observasi, penilaian afektif dan psikomotor untuk mengetahui tingkat perhatian siswa dalam proses pembelajaran. Hasil analisis hasil penilaian akhir siklus I yang merupakan gabungan dari serangkaian penilaian mulai dari lembar observasi, penilaian afektif dan psikomotor menunjukkan hasil baik. Sementara hasil yang diperoleh pada siklus II jauh lebih baik daripada hasil yang diperoleh dari siklus I. Dari hasil analisis diketahui bahwa pada siklus II tingkat perhatian siswa sangat baik. Dengan demikian, dapat ditarik sebuah kesimpulan bahwa melalui metode diskusi dapat meningkatkan perhatian siswa kelas V SDN 2 Salakan pada mata pelajaran PKn. Saran peneliti siswa dapat lebih aktif lagi dalam proses pembelajaran dan guru dapat menemukan ide – ide baru dalam proses pembelajaran yang memungkinkan siswa lebih mudah memahami materi yang disampaikan

Mixed effects analysis of factors associated with health insurance coverage among women in sub-Saharan Africa

Introduction In the pursuit of achieving the Sustainable Development Goal targets of universal health coverage and reducing maternal mortality, many countries in sub-Saharan Africa have implemented health insurance policies over the last two decades. Given that there is a paucity of empirical literature at the sub-regional level, we examined the prevalence and factors associated with health insurance coverage among women in in sub-Saharan Africa. Materials and methods We analysed cross-sectional data of 307,611 reproductive-aged women from the most recent demographic and health surveys of 24 sub-Saharan African countries. Bivariable and multivariable analyses were performed using chi-square test of independence and multi-level logistic regression respectively. Results are presented as adjusted Odds Ratios (aOR) for the multilevel logistic regression analysis. Statistical significance was set at p<0.05. Results The overall coverage of health insurance was 8.5%, with cross-country variations. The lowest coverage was recorded in Chad (0.9%) and the highest in Ghana (62.4%). Individual-level factors significantly associated with health insurance coverage included age, place of residence, level of formal education, frequency of reading newspaper/magazine and watching television. Wealth status and place of residence were the contextual factors significantly associated with health insurance coverage. Women with no formal education were 78% less likely to be covered by health insurance (aOR = 0.22, 95% CI = 0.21–0.24), compared with those who had higher education. Urban women, however, had higher odds of being covered by health insurance, compared with those in the rural areas [aOR = 1.20, 95%CI = 1.15–1.25]. Conclusion We found an overall relatively low prevalence of health insurance coverage among women of reproductive age in sub-Saharan Africa. As sub-Saharan African countries work toward achieving the Sustainable Development Goal targets of universal health coverage and lowering maternal mortality to less than 70 deaths per 100,000 live births, it is important that countries with low coverage of health insurance among women of reproductive age integrate measures such as free maternal healthcare into their respective development plans. Interventions aimed at expanding health insurance coverage should be directed at younger women of reproductive age, rural women, and women who do not read newspapers/magazines or watch television

Suicidal behaviours among in-school adolescents in Mozambique: Cross-sectional evidence of the prevalence and predictors using the Global School-Based Health Survey data.

IntroductionDespite interventions by low and middle-income countries toward the achievement of the global Sustainable Development Goal (SDG) on promoting mental health and well-being of their populace by the year 2030, suicidal behaviours continue to be major causes of premature mortality, especially among young people. This study examined the prevalence and predictors of suicidal behaviours among in-school adolescents in Mozambique.Materials and methodsThis was a cross-sectional study of 1918 in-school adolescents using data from the 2015 Global School-based Health Survey (GSHS) of Mozambique. The outcome variables (suicidal ideation, suicidal plan, and suicidal attempt) were measured with single items in the survey. Both bivariate and multivariate analyses were performed using chi-square test of independence and binary logistic regression respectively. Results are presented as Adjusted Odds Ratios for the binary logistic regression analysis. Statistical significance was set at pResultsThe prevalence of suicidal behaviours 12 months prior to the survey were 17.7%, 19.6% and 18.5% for suicidal ideation, suicidal plan, and suicidal attempt respectively. Adolescents who experienced anxiety had higher odds of suicidal ideation [AOR = 1.616, 95%CI = 1.148-2.275], suicidal plan [AOR = 1.507, 95%CI = 1.077-2.108], and suicidal attempt [AOR = 1.740, 95%CI = 1.228-2.467]. Adolescents who were physically attacked in school were also more likely to ideate [AOR = 1.463, 95%CI = 1.115-1.921], plan [AOR = 1.328, 95%CI = 1.020-1.728], and attempt [AOR = 1.701, 95%CI = 1.306-2.215] suicide. Having close friends was, however, an important protective factor against suicidal ideation [AOR = 0.694, 95%CI = 0.496-0.971], plan [AOR = 0.625, 95%CI = 0.455-0.860], and attempt [AOR = 0.529, 95%CI = 0.384-0.729]. Peer support also reduced the risk of suicidal ideation [AOR = 0.704, 95%CI = 0.538,0.920] and plan [AOR = 0.743, 95%CI = 0.572,0.966] among the in-school adolescents.ConclusionSuicidal behaviours constitute major public health challenges among in-school adolescents in Mozambique. The behaviours are predominant among adolescents who are physically attacked and those who experience anxiety. Conversely, having close friends serves as a protective factor against suicidal behaviours. To ensure that Mozambique meets the SDG target of promoting the mental health of all by the year 2030, the Government of Mozambique and educational authorities should urgently design and implement innovative interventions and strengthen existing ones that seek to address physical attacks and anxiety among in-school adolescents. School administrations should also incorporate programmes that seek to congregate students and offer platforms for social interaction and cohesion

Prevalence and Factors Associated with Interpersonal Violence among In-School Adolescents in Ghana: Analysis of the Global School-Based Health Survey Data

Interpersonal violence is a critical public health concern that is linked with many negative consequences, including mortality. It is the second most predominant cause of death among male adolescents aged 15–19. This study used a nationally representative data from the recent Ghana Global School-based Health Survey to examine the prevalence and factors associated with interpersonal violence among Ghanaian in-school adolescents. A total of 2214 in-school adolescents were included in the final analysis. Multivariable binomial logistic regression analysis was performed to determine the factors assciated with interpersonal violence. The results of the regression analysis were presented as adjusted odds ratios (aOR) with 95% confidence level (CI) in all the analyses. Statistical significance was set at p &lt; 0.05. The overall prevalence of interpersonal violence was 55.7%, of which the prevalences of physical fighting and attack were 38.2% and 41.5%, respectively. In-school adolescents who had an injury were more likely to experience interpersonal violence (aOR = 2.29, 95% CI = 1.71–3.06) compared with those who did not have an injury. The odds of interpersonal violence were higher among in-school adolescents who were bullied (aOR = 2.48, 95% CI = 1.84–3.34) compared with those who were not bullied. In addition, in-school adolescents who attempted suicide (aOR = 1.56, 95% CI = 1.22–2.47), consumed alcohol at the time of the survey (aOR = 1.88, 95% CI = 1.15–3.06), and were truant (aOR = 1.58, 95% CI = 1.29–1.99) had higher odds of experiencing interpersonal violence. These factors provide education directors and school heads/teachers with the relevant information to guide them in designing specific interventions to prevent interpersonal violence, particularly physical fights and attacks in the school settings. School authorities should organize parent–teacher meetings or programs to help parents improve their relationships with in-school adolescents to prevent or minimize their risky behaviors, including physical fights.</jats:p

Prevalence and Factors Associated with Hygiene Behaviours among In-School Adolescents in Ghana

(1) Background: Despite a global call to act to resolve communicable diseases caused by lack of clean water, sanitation, and hygiene, many people in low- and middle-income countries continue to die each year. In this study, we looked at in-school adolescents’ oral and hand hygiene activities in Ghana, as well as the factors that influence them. (2) Methods: This was a cross-sectional study that utilised data on 1348 in-school adolescents from the 2012 global school-based health survey. Using Stata software version 14.2, descriptive and inferential statistics were used to analyze the data. All statistical analyses were considered significant at p-value &lt; 0.05. (3) Results: The prevalence of good hygiene behaviour was 62.6% and 79.9% for good oral hygiene and good hand hygiene, respectively. In-school adolescents who were truant were 31% (AOR = 0.69, 95% CI = 0.51–0.92) and 28% (AOR = 0.72, 95% CI = 0.54–0.87), respectively, less likely to practise good hand and oral hygiene compared to those who were not. Adolescents whose parents supervised their homework, however, had higher probabilities of practising good hand (AOR = 2.30, 95% CI = 1.64–2.31) and oral (AOR = 2.34, 95% CI = 1.80–3.04) hygiene respectively. Adolescents aged 18 years and above were 1.33 times more likely to practice good oral hygiene than younger adolescents (AOR=1.33, 95% CI = 1.07–1.66). Adolescents who were bullied had lower odds of practicing good hand hygiene (AOR = 0.70, 95% CI = 0.52–0.94). (4) Conclusions: While good hygiene behaviour remains a major strategy in decreasing the prevalence of communicable diseases, the less than 65% prevalence of hand hygiene we observed in the current study is indicative of the country’s inability to achieve water, hygiene and sanitation for all by the year 2030. To accelerate progress towards meeting the Sustainable Development Goal 6.2, there is a need for the implementation of innovative interventions which seek to promote good hygiene behaviours among adolescents and the expansion of existing interventions, such as the WASH initiative, in schools. Such interventions should focus more on younger adolescents, those who are truant, and adolescents who suffer from bullying in school.</jats:p

Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050

Background: The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods: We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings: In 2019, health spending globally reached$8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or $1132 (1119–1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40·4 billion (0·5%, 95% UI 0·5–0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0–25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this,$13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and$1·4 billion was repurposed from existing health projects. $3·1 billion (22·4$2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7$1519 (1448–1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation: Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Funding: Bill & Melinda Gates Foundation

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings: By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4–82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5–42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4–41·3] in 1980 to 83·6% [82·3–84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4–44·1) in 1980 to 79·8% (78·4–81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6–60·9) to 14·5 million (13·4–15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation: After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories : the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics

Social autopsy: INDEPTH Network experiences of utility, process, practices, and challenges in investigating causes and contributors to mortality

<p>Abstract</p> <p>Background</p> <p>Effective implementation of child survival interventions depends on improved understanding of cultural, social, and health system factors affecting utilization of health care. Never the less, no standardized instrument exists for collecting and interpreting information on how to avert death and improve the implementation of child survival interventions.</p> <p>Objective</p> <p>To describe the methodology, development, and first results of a standard social autopsy tool for the collection of information to understand common barriers to health care, risky behaviors, and missed opportunities for health intervention in deceased children under 5 years old.</p> <p>Methods</p> <p>Under the INDEPTH Network, a social autopsy working group was formed to reach consensus around a standard social autopsy tool for neonatal and child death. The details around 434 child deaths in Iganga/Mayuge Health and Demographic Surveillance Site (HDSS) in Uganda and 40 child deaths in Dodowa HDSS in Ghana were investigated over 12 to 18 months. Interviews with the caretakers of these children elicited information on what happened before death, including signs and symptoms, contact with health services, details on treatments, and details of doctors. These social autopsies were used to assess the contributions of delays in care seeking and case management to the childhood deaths.</p> <p>Results</p> <p>At least one severe symptom had been recognized prior to death in 96% of the children in Iganga/Mayuge HDSS and in 70% in Dodowa HDSS, yet 32% and 80% of children were first treated at home, respectively. Twenty percent of children in Iganga/Mayuge HDSS and 13% of children in Dodowa HDSS were never taken for care outside the home. In both countries most went to private providers. In Iganga/Mayuge HDSS the main delays were caused by inadequate case management by the health provider, while in Dodowa HDSS the main delays were in the home.</p> <p>Conclusion</p> <p>While delay at home was a main obstacle to prompt and appropriate treatment in Dodowa HDSS, there were severe challenges to prompt and adequate case management in the health system in both study sites in Ghana and Uganda. Meanwhile, caretaker awareness of danger signs needs to improve in both countries to promote early care seeking and to reduce the number of children needing referral. Social autopsy methods can improve this understanding, which can assist health planners to prioritize scarce resources appropriately.</p