Pengembangan Sistem Registrasi Kematian & Penyebab Kematian Di Indonesia: Evaluasi Sistem Registrasi Kematian Dilokasi Sentinel (Kabupaten Gorontalo & Kota Metro), 2007-2008

The aim of this article is to evaluate problem related to the development of the mortality system in sentinel mortality sites (Metro city and Gorontalo District 2007-2008). Since 2006, NIHRD has established sentinel site for special surveillance of mortality in some cities and districts in some provinces.The death data sources orisinaled from the trained personnel performing detail interviews (verbal autopsy-VA) with a responsible member of the household, respectively in order to ascertain the couse of illness and treatment of the diseases. The filled-in VA questionnaires were then scrutinized by a team of trained personnel for assigning the cause of death (COD) which was coded as per International Classification of Diseases (ICD-10). The deaths taking place in the hospital were certified by medical officers for cause of death and coded accordingly. In order to evaluate the completeness of vital registration, the mortality registration system data was been assessed through a dual record system. A sample of households was interviewed whether a hease hold member has died in the previous two years. These death data were then directly matched with death data derived from medical certificate cause of death from mortality registration system to analyze the mortality registration completeness. The level of Completeness rate in Metro City (33%) and Gorontalo District 2007-2008 (68,5%) are still low. The other issues is about sustainability of the system. In some districts and cities the system are not running properly, while in other districts and cities the system is not running at all since the project closed. It happens because operational budget is not allocated to maintain the system. Therefore there is a need of the local government to create the local government decree to assure allocated budget availability. Furthermore, in order the system to be continuous, permanent, compulsory and universal, and can cover whole Indonesia, it should be integrated in the Health Information System

Analisa Kesehatan Ibu Dan Neonatal Kabupaten Gianyar, 2010

Despite the tremendous overall improvement on maternal mortality and infant mortality still there is significant public health issue, commands and enormous amount of attention of these subjects in Indonesia. One of the main issues is how to provide high-quality services to the community in order toreduce maternal mortality and infant mortality including neonatal mortality. This article is to analyse problem related to issue on maternal and infant services in Gianyar District in 2010. The data sources are from the 2010 Health Profile of Gianyar, cause of death registration mechanism that have been implemented since 2010 in Gianyar and from the 1994, 1997, 2002-2003 and 2007 Indonesia Demographic and Health Survey. This study reveals that antenatal care and health provider birth attendance have been reaching the target, more than 90%. However, there are two high risk of maternal deaths; one is due to too young (age 19 years old) and the other one is due to too old (age 39 year old) of pregnancy. The direct causes of both are pre-eclampsia of the young mother and decompensasi cordis of the old mother. Finding also shows that the main cause of neonatal death is asphyxia and unfortunately the death mostly occured at the hospitals. It seems that health providers require knowledge and skills addressed primarily through training. Continued skills support through refresher training, magang and supervision can help strengthen skills in order to maintain competency and proficiency. Also the community need to be educated by introducing high risk factors related to the pregnancy and women right for avoiding unwanted pregnancy

Analisa Faktor Risiko dan Status Kesehatan Remaja Indonesia pada Dekade Mendatang

Adolescence is a life phase in which the future patterns of adult health are established. They are often thought of as a healthy group. However risky bevahior which will shape the adult health status starts as well in this period. A focus on adolescence is central to the success of many public health agendas. There are lots of researches containing information on Indonesian adolescent health status and risk behaviours, but they are not systematically arranged. This article aims to synthesize results from researches of adolescent health status and risk behavior to get complete picture to obtain pictures of health risk behavior dan health status of Indonesian adolescents. To achieve the objective, adolescent health information in the published reports with special attention to Riskesdas 2007 and Riskesdas 2010 reports accompanied by other adolescent health publications are analized and interpreted. The results showed almost 90% of Indonesian adolescents are in good health condition. But some of them already have NCD such as diabetes, heart diseases, hypertension and emotional distress. The alarming aspect is the high prevalence of smoking and poor diet which could lead to the high prevalence of NCD in their adult life. Therefore different approach of health intervention should be applied for adolescent who already has health problems and those without health problems but with risky behavior. Primary Health Center (PHC) should be prepared to provide for adolescent health service especially reproductive health and health related to traffic accidents for promotion, prevention and rehabilitation as adolescent will be referred to PHC.Key word : Indonesia, adolescent, health, service, riskAbstrakMasa remaja merupakan salah satu periode yang menentukan pola pembentukan status kesehatan di masa dewasa. Mereka sering dianggap sebagai kelompok dengan kesehatan prima. Namun perilaku berisiko umumnya dimulai pada periode ini. Perhatian pada remaja merupakan salah kunci sukses keberhasilan program kesehatan. Strategi yang menempatkan remaja sebagai pusat akan menguntungkan remaja dan kesehatan mereka di masa dewasa. Cukup banyak penelitian yang memuat informasi kesehatan remaja, namun belum disusun secara sistematis. Tulisan ini bertujuan merangkum penelitian kesehatan remaja yang tersebar untuk mendapatkan gambaran lebih lengkap mengenai kesehatan remaja dan faktor risiko berdasarkan bukti dengan fokus utama pada hasil Riskesdas 2007 dan 2010 dilengkapi dengan hasil penelitian lain. Dilakukan analisa dan interpretasi terhadap laporan dan hasil penelitian. Diperoleh hasil 90% remaja Indonesia mempunyai kesehatan yang baik, tidak bermasalah kesehatan. Hanya 10% remaja yang memiliki masalah kesehatan fisik atau emosional. Hal yang memprihatinkan adalah tingginya prevalensi merokok, pola makan kurang serat dan kurang akttivitas fisik yang merupakan kontributor PTM di masa dewasa. Diperlukan intervensi yang berbeda bagi remaja tanpa masalah kesehatan dan dengan masalah kesehata. Intervensi berupa kegiatan promosi dan promosi lebih ditujukan pada remaja tanpa masalah kesehatan namun berperilaku berisiko. Sedangkan pelayanan kesehatan bagi remaja dengan masalah kesehatan harus mulai menyediakan pelayanan mental emosional remaja, kesehatan reproduksi dan kesehatan lalu - lintas. Porgram modifikasi perilaku pro sehat dapat ditawarkan di pusat kesehatan.Kata kunci: Indonesia, remaja, kesehatan, pelayanan, risik

Hubungan Penggunaan Kontrasepsi Pil dengan Kejadian Hipertensi pada Wanita Usia 15-49 Tahun di Indonesia Tahun 2013 (Analisis Data Riskesdas 2013)

Prevalensi hipertensi pada wanita cenderung lebih tinggi dibanding laki-laki. Berdasarkan Riskesdas2013, prevalensi hipertensi pada perempuan sebesar 28,8% dan laki-laki 22,8%. Penggunaan kontrasepsipil pada wanita akan mempengaruhi keseimbangan hormonal di tubuh sehingga bisa mengakibatkanpeningkatan tekanan darah. Penelitian ini bertujuan mengetahui hubungan penggunaan kontrasepsi pildengan kejadian hipertensi pada wanita usia 15-49 tahun di Indonesia tahun 2013. Desain Riskesdas2013 adalah cross sectional. Kajian ini memilih sampel wanita usia 15-49 tahun yang menggunakankontrasepsi dengan jumlah 34.755. Data dianalisis dengan univariat, bivariat dan multivariat dengan ujicox regression. Hasil penelitian diperoleh hubungan yang bermakna antara penggunaan kontrasepsipil dengan kejadian hipertensi pada wanita usia 15-49 tahun dengan nilai PR 1,4 (95%CI: 1,31 1,45)setelah dikontrol umur dan IMT. Disimpulkan bahwa kontrasepsi pil merupakan faktor risiko terjadinyahipertensi. Wanita usia 15-49 tahun yang menggunakan kontrasepsi pil berisiko 1,4 kali untuk mengalamihipertensi dibanding mereka yang tidak menggunakan kontrasepsi pil. Sebaiknya tidak menggunakankontrasepsi pil jika pada awal pemeriksaan tekanan darah sudah tinggi dan wanita yang menggunakankontrasepsi pil harus mengontrol tekanan darah sekali tiap 6 bulan

Prevalensi Diabetes Melitus Pada Tuberkulosis Dan Masalah Terapi

The incidence and prevalence of diabetes mellitus (DM) is rapidly increasing across the world. DM has been known as one of the risk factors for tuberculosis (TB). DM was seen to have a negative effect on the outcome of TB treatment. This paper is a literature review based on articles about DM and TB taken from PubMed, Google, and Mendeley published ten years behind. Screening for DM in persons with TB demonstrated that DM prevalence in TB population is high. DM prevalence in TB was about 5,4 % – 44,0 %. Diabetes mellitus is a risk factor to develop active tuberculosis (OR: 1,5 – 8,9). DM impairs the immunity of the patients and therefore DM is an independent risk factor for infections such as TB. Lack control of diabetes predisposes the patient to tuberculosis. People with diabetes are more likely to fail TB treatment compared to those without diabetes. Effective management of both diseases require the same elements including early detection, providing guided standard treatment, and proper drug intak

Determinan Upaya Pengobatan Tuberkulosis Pada Anak Di Bawah Umur 15 Tahun

One of the WHO\u27s step of TB strategy reflects the importance of the need to improve care for children with TB. However, children with TB often are neglected to cure, even in the countries with high TB incidence. Around 20 percent children estimated with TB, caused by the spreading of adult TB, and many of them without specific symptom as adult. The aim of this study is to get information about the relation between demography, socio-economic, environmental factors, vaccination status, and contact with adult TB patient, and TB treatment practice of children aged <15 years. The sample was a cross-sectional data of TB Prevalence Survey 2004 and Susenas 2004, which had been merged. The method of analysis was multivariate. The result showed that the significant variable were Sumatera region, household expenditure, BCG scars, and contact with TB patients with log-likelihood < 0.05 (p=0.000). Final model for determinant factors of TB treatment practice for children aged < 15 years were children contact with adult TB patient in the household that had risk of 1.9 times (CI 95%: 1.26-2.89) and place of living classification (Sumatera region) that had risk of 2.6 times (CI 95%: 1.65-4.01). To handle child TB cases and their treatment, there are some actions could be applied, namely: to cure every adult TB until recovery, to conduct active case finding, to educate TB patients and their family to be discipline in taking the drug, to support financial transportation to go to health facility for TB patient in poor family, and to prevent from drop out by supervising them closely