Increasing HIV Prevalence among Female Sex Workers in Indonesia: How is it Presented in the Media and in Scholarly Journals?

Within different target audiences, the media and scholarly journals have significant roles in enhancing the awareness and influencing the development of HIV prevention-related policies. However, particularly in developing and poor countries, the media seem to affect policy development in contradictory ways. Thus, it is interesting to investigate how the increasing prevalence of HIV among female sex workers (FSWs) in Indonesia is represented in the media and to compare this representation with those in scholarly articles.Using three types of newspaper and peer-reviewed scholarly articles, this paper found that the media tend to frame the problem and its risk factors as merely a health problem produced by unsafe behaviours that are inappropriate to the local culture and belief. Efforts to challenge dominant values through the involvement of local media should encourage local journalists to be aware of the consequences of their chosen media template. Furthermore, given the fact that the majority of scholarly articles included in the analysis focused more on the biological and behavioural factors of HIV infection, more social research is needed. Keywords: media, HIV, and polic

PERSEPSI STAKEHOLDERS TERHADAP LATAR BELAKANG SUBSIDI PREMI, SISTEM KAPITASI DAN PEMBAYARAN PREMI PROGRAM JAMINAN KESEHATAN JEMBRANA

Background: Premium subsidy of Jaminan KesehatanJembrana or Jembrana Health Insurance (JKJ) in JembranaDistrict has a rising trend since it began and needs toredistribute, it’s critical to apply the cost containment programsby introducing capitation system to primary health careproviders and premium payment to the member of JKJ.Purpose: To examine perceptions of policy makers towardbackground of premium subsidy, capitation system and premiumpayment of JKJ and perceptions of providers toward capitationsystem.Method: Research was using cross sectional design anddata was taken by qualitative method. The subject was policymakers and primary health care providers of JKJ. Instrumentbeing use was deep interview guidance.Result and Conclusion: Generally policy makers of JKJ hadmisinterpretation about the concept of basic needs and equityegaliter in health, that causing resistance on premium payment.Generally policy makers and providers of JKJ had badperception about capitation system.Keywords: health insurance, capitation, premium paymen

SIMULASI PENGHITUNGAN TARIF PREMI SEBAGAI UPAYA ADVOKASI REALOKASI SUBSIDI PREMI PPK I JAMINAN KESEHATAN JEMBRANA

Background: Program of Jembrana Health Insurance (JHI) isintended to provide health insurance at first level (PPK I) forinhabitants of Jembrana District. Up till now, financing of JHIdepends on subsidy in which it is growing up and has a trendto be out of the target. Therefore, it needs to increase themember participants by implementing the premium payment.Aim of this research was to analyze premium of JHIcomprehensively to advocate the reallocation of premiumsubsidy of JHI.Methods: Type of this research was case study throughanalyzing secondary data. Data on members, utilization,operational cost and claim cost data was collected using format Bapel JKJ, Jembrana District Health Office and NegaraHospital.Results: The first Premium tariff scheme of JHI is free for 40 %inhabitants who earn low income, Rp48.171,00 for 40%inhabitants who earn medium income, and Rp96.341,00 for20% inhabitants who earn high income. The second Premiumtariff scheme of JHI is free for 40% inhabitants who earn lowincome, Rp89.595 for 40 % inhabitants who earn mediumincome, and Rp96.341,00 for 20% inhabitants who earn highincome.Conclusions: Local government could develop JHIcomprehensively by relocating premium subsidy of PPK I for40% inhabitants who earn low income, besides that localgovernment should apply principles of managed care bycontrolling cost and quality in terms of comprehensive healthinsurance.Keywords: health insurance, premiu

ANALISIS BIAYA PER KAPITA SEBAGAI UPAYA ADVOKASI PENGENDALIAN BIAYA PROGRAM JAMINAN KESEHATAN JEMBRANA

Introductions: Jembrana Health Insurance (JHI) program isintended to provide health insurance at first level (PPK I) forinhabitants of Jembrana District. Up till now, financing of JHIdepends on subsidy in which it is growing up and has a trendto be out of target. Therefore, it needs to manage cost byimplementing capitation payment system. Aim of this researchwas to analyze cost per capita and to identify perceptions ofJHI stakeholders towards capitation system.Methods: This research was case study through analyzingsecondary data and performing in-depth interview. Data onmember’s utilization and claim cost were collected using forms.Results: Result of cost per capita calculation based on realutilization of PPK I namely Rp5.262,- per month per member is63 % higher than cost per capita based on normal utilization ofPPK I namely Rp1.949,- per month per member. Furthermore,result of in-depth interview shows that both policy makersand providers have a bad perception towards capitationsystem and results of cost per capita calculation.Conclusions: Local government could apply principles ofmanaged care by controlling cost and quality by developingcapitation payment system for PPK I based on normal utilization.Keywords: health insurance, cost per capita, capitatio

PENGARUH PENGEMBANGAN JAMINAN KESEHATAN BALI MANDARA TERHADAP KEBERADAAN JAMINAN KESEHATAN TINGKAT KABUPATEN DI BALI DAN UPAYA PENCAPAIAN UNIVERSAL COVERAGE

Background: To conduct an analysis of the influence of theBali Mandara Health Insurance (JKBM) policy concerning theexistence of district level health insurance and its impact onachieving universal coverage.Method: Literature review to produce an analysis of JKBMpolicy and to produce appropriate policy alternatives forfinancing and health care issues which emerged from theimplementation of JKBM.Results: The aim of Bali Mandara Health Insurance is to providehealth services which are fully subsidized by the Provincialand Districts Government in Bali. JKBM is intended for peopleswho do not protected by health insurance programs. Theimplementation of JKBM has forced Tabanan to stop the AskesMandiri program while Jembrana District decided not to takepart in JKBM. Unlike JKJ and Askes Mandiri, JKBM is still managedby a coordination team under Bali Health Office Supervision.Furthermore another fundamental difference is regarding onhow they finance the program. JKBM is fully financed fromsharing subsidies while JKJ and Askes Mandiri are financedfrom member premium. Nevertheless JKBM policy is potentialto expand the efforts of achieving universal coverage, improveequity in health financing and fulfil a non-profit principle ofsocial health insurance. Along with the positives impact, thisprogram also has several weaknesses. One of theweaknesses is lack of consideration to the principles of socialsolidarity and mutual cooperation. Communities’ participation inhealth financing program which has been developed by JKJand Askes Mandiri is abandoned. In addition to theseweaknesses JKBM also less able to adopt the district healthinsurance who have first evolved. JKJ case shows of JKBMfailure to apply the principle of portability and benef itscoordination of the services thereby potentially harming thepeople of Bali.Conclusion: Bali provincial government should immediatelydevelop Implementing Agency (Badan Pelaksana) of JKBM toorganize and develop the program. In addition to this, memberparticipation throughout premium payment could be establishedgradually to ensure the sustainability of the program. JKJ andJKBM should operate in harmony by considering role distributionbetween member, Provincial Government of Bali, andGovernment of Jembrana.Keywords: health insurance and universal coverag

Status gizi, densitas zat gizi, dan keragaman pangan anak balita selama pandemi COVID-19 di Kabupatan Bangli, Bali

Nutritional status, nutrient density, and dietary diversity of children under five during the COVID-19 pandemic in Bangli Regency, BaliBackground: Stunting in children caused the lack of nutritionally balanced food intake in the first two years of life. During the COVID-19 pandemic, the fulfillment of balanced nutrition for children must still be considered to maintain body resistance to avoid COVID-19 infection.Objective: This study was conducted to find out the nutritional status of children and also the knowledge and attitudes of mothers regarding the practice of balanced nutrition based on local food in the COVID-19 pandemic situation. Methods: Cross-sectional study with 202 children aged 23-59 months located in Susut District, Bangli Regency, Bali Province. Data collection includes anthropometric measurements and food recall. Characteristics, knowledge, and attitudes of mothers were conducted by interview using a questionnaire. Results: The nutritional status of subjects showed that the average weight for height z-score (WHZ) was 0.29 ± 1.37, height for age z-score (HAZ) was 0.56 ± 2.38, and weight for age z-score (WAZ) which is -1.18 ± 2.03. The average density of energy intake in the adequate (1.66±0.456), as well as protein density (4.12±0.884 g/100 calories), vitamin B12 (0.225±0.457 mg/100 kcal), and vitamin A (71.7 ±104.6 mg/100 kcal). The majority (61.9%) of subjects consumed less than five food groups in the last 24 hours. The average knowledge of respondents is 69.5±15.3, which is 35.1% in well nutrition knowledge, while most respondent’s attitude has in the good category. Conclusions: Overall children are in normal nutritional status, but it is necessary to attention to the density of vitamins and minerals which are still low, and the lack of food diversity. Suggestion to increase education on balanced nutrition practices based on local food to mothers and families so that they can help grow and also maintain children's health during the COVID-19 pandemic

Impact of Budget Increase on Primary Health Care Performance in the Era of National Health Insurance: Case Study in Buleleng District

Since 2014, there has been an increase in funds for primary health care (PHC) coming from the National Health Insurance program capitation funds and the Health Operational Assistance Fund. This study aimed to explore the effect of this budget increase on the health care services at PHC. The case study used a qualitative approach and interviews from 19 PHC health workers with the highest and lowest budget. Data were analyzed using thematic analysis and supported by quantitative data. The positive impact of the increasing PHC budget was felt by PHC staff due to the addition of operational equipment and incentives provided. Nevertheless, there was also a negative impact such as feeling overwhelmed due to an increase in the quantity of PHC activities and additional administrative affairs. It also triggered a negative interaction between staff due to the number of incentives received. The regulation on the use of budget empowers PHC to better arrange the schedule of activities and manage human resources. However, these regulations are considered restrictive and the administrative flow of funds is too long that hinder the optimal use of the budget

RISK FACTOR OF ACTIVITY LEVEL AND NUTRITIONAL CONSUMTION PATTERN WITH INCIDENCE OF TYPE 2 DIABETES MELLITUS in Sanglah Hospital Denpasar

Diabetes mellitus is a degenerative disease that has an increasing prevalence worldwide and Indonesia. In Bali, the prevalence is 5.9% of the total population. This number will continue to increase as the change of lifestyle and eating pattern in the community. This study aims to prove the risk factors that related to the incident of type 2 diabetes mellitus in out clinic patient of Sanglah Hospital.This was an observational analytic study using unmatched case control study. The respondents in this study consisted of case and control with 1:2 ratio.  Case was type 2 DM  outpatients that matched diagnostic criteria or type 2 DM patients that had been treated and visited Sanglah hospital. Control was non diabetic outpatients that came to sanglah hospital. The number of respondents was  84 respondent  that were determined using consecutive sampling.The instruments   were questioners, medical records, and fasting blood sugar levels. Univariate, bivariate (chi-square) and multivariate (multiple logistic regression) analysis  were used in this study. The result of this study showed the OR value of activity levels   was   4.298 (95% CI = 1.646 – 11.226. The OR value of fat consumtion patterns was 7.171 (95% CI=1.986-11.226). The OR of karbohidrat consumtion was 0.224 (95% CI: 0.071-0.703).   The result also showed that fat consumtion pattern had a chance to cause diabetic by 6.7  compared to activity levconsumtion of carbohidrat to cure diabetes at Sanglah Hospital, Denpasar.The health institutions should improve promotive and preventive measures to diabetic and non diabetic patients

Influence of social media exposure on knowledge and behaviour of COVID-19 preventive measure:a cross sectional study

A lot of misinformation about COVID-19 on social media possibly hinder the practice of healthy behaviors that are essential to protect individuals. This situation is exacerbated by the lack of health literacy in Indonesia. This study aimed to determine the influence of social media information exposure on the knowledge and behavior of Indonesians in compliance with COVID-19 protocols. An online survey of 909 people was conducted from July 2nd to August 10th, 2020. The data collected were knowledge and behavior of preventing COVID-19, while independent variables were socio-demographic characteristics and exposure to social media information. Inclusion criteria were defined as follows: minimum age of 18 years and domiciled in the country during the data collection period. The analysis used for the data collected were univariate and multivariate. The result showed that gender, age, marital status, and social media presence significantly affect a person's knowledge about COVID-19 with a p-value of 0.05. Enforcement behavior of health and healthy living protocols is significantly influenced by the respondent’s gender, marital status, education level, the island of residence, and exposure to online information. The frequency of exposure to information affects people's knowledge and behavior to implement health protocols and healthy living in the COVID-19 era, and it is further influenced by socio-demographic characteristics

Infodemic, Health Promotion Efforts, and Preventive Behavior During the COVID-19 Pandemic in Indonesia: A Quantitative Analysis Study

The coronavirus disease 2019 (COVID-19) is the first pandemic in history where technologies and social media are used on a large scale to make people safe, informed, productive, and connected. At the same time, these technologies enabled the rise of the infodemic, which endangered pandemic control. This study aimed to assess COVID-19 information exposure in the community, the efforts to find related information in online media, and COVID-19 preventive behavior. A cross-sectional study was conducted with 909 participants in Indonesia using the consecutive sampling technique. Data were collected using a questionnaire distributed through social media (WhatsApp, Instagram, and Facebook) and analyzed using univariate analysis, bivariate analysis (Chi-square test), and multivariate analysis (multiple logistic regression). The results showed that about 838 (92.2%) participants said they often or always obtain information about COVID-19 online, 662 (72.8%) participants stated that information from online sources increased their knowledge of the disease, and 728 (80.1%) said that online information enabled them to make preventive efforts. Marital status (AOR: 1.81, p-value = 0.002) and perceived susceptibility (AOR: 1.42, p-value= 0.011) were the most influential factors for COVID-19 preventive behaviors. Information sources and channels frequently accessed by the community must be professionally managed by the government as valuable tools for mitigating an epidemic or pandemic