Dadih and Zinc Supplementation during Pregnancy Benefits Pregnancy Outcomes and Humoral Immune Response in West Sumatera, Indonesia

Keywords Dadih · Zinc supplementation · Pregnancy outcome · sIgA Background/Aims: Dadih is a dairy product obtained from fermented buffalo milk in West Sumatra Indonesia. It contains various nutrients for human body, and source of probiotics that are beneficial for prenatal supplementation and pregnancy outcomes. Methods: We conducted randomized control trial in which 138 pregnant mothers at second trimester were randomly assigned to three groups 1). Control groups, 2). Dadih groups, and 3), Dadih and zinc groups. The mothers in dadih and zinc group received dadih tube (100 gram) six times a week and one packed of 20 mg zinc tablet weekly for six months of intervention. Mother’s weight gain was measured every month. After six month of intervention, fecal secretary immunoglobulin A (sIgA) and anthropometric of newborn infants were measured in all groups. Results: The average maternal weight gain was 8.9 + 3.7 kg, the lowest was in the control group and the highest was in dadih and zinc groups (9.2+3.8 kg). We found significant difference on infant’s birth weight compared to control, i.e. 163.9 (95% CI:-43.8 - 371.8) gram in dadih group and 236.5 (95%CI:-13.4 - 459.7) in dadih and zinc group after adjusted for ideal maternal weight gain (p<0.05). There were no significant differences reduction of sIgA in mothers and in infants at the beginning and after six month of intervention among three groups (p>0.05). Conclusion: Dadih and zinc supplementation were beneficial for improving maternal weight gain and pregnancy outcomes, but have no effect on immune response both for mothers and infants

Evaluasi Kebijakan Jaminan Persalinan (Jampersal) dalam Penurunan Angka Kematian Ibu dan Bayi di Indonesia

Adanya Kenyataan bahwa AKI meningkat progresif, walaupun telah dibentuk suatu kebijakan jampersal. Sehingga penelitian ini bertujuan untuk mengkaji kebijakan dan menganalisis evaluasi implementasi kebijakan Jampersal ditingkat pelayanan kesehatan ibu hamil dan melahirkan dan dukungan pemerintah daerah kabupaten-kota serta stake holder lainnya. Analisis evaluasi kebijakan menggunakan metode observasional prospektif, dengan pendekatan analisis semi kuantitatif kualitatif. Hasil analisis dari beberapa aspek kebijakan meliputi pengambil atau pembuat keputusan, pelaksana kebijakan, lingkungan kebijakan, penerima kebijakan, dan dampak kebijakan. Dari hasil analisis dapat disimpulkan bahwa kebijakan Jampernal belum mampu mencapai hasil yang diharapkan dalam penurunan Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB), bahkan Kenyataan yang dihadapi saat ini menunjukan hasil yang negatif terhadap tujuan yang hendak dicapai. Perlunya peningkatan payung hukum kebijakan Jampersal dalam bentuk Instruksi Presiden (INPRES), sehingga akan mengikat para pelaku kebijakan yang terkait di kabupaten-kota. The fact maternal mortality rate increased progressively although the system has been established of universal delivery coverage (Jampersal) policy, so that the purpose of this study was analyze evaluation of the policy implementation of universal delivery coverage (Jampersal) in health maternal pregnancy and implication supporting from government and other stakeholders in city-district level. Evaluation analysis of the implementation of Jampersal policy used prospective observational method and used qualitative and quantitative analysis. The results of the analysis showed that some aspects of the policy include making or policy-makers, policy implementers, policy environment, recipient policies, and the impact of policies. The result of analysis can be concluded that the policy Jampersal not been able to achieve the expected results in decrease mother mortality rate (MMR) and infant mortality rate, even the current reality was showed the negative results from objectives to be achieved. The needed for increased legal protection in the form of policy Jampersal such as Presidential Instruction (INPRES) , so it will be binding on the relevant stakeholders in districts and cities