Hubungan antara Pengetahuan dan Sikap Pengelola Vaksin dengan Skor Pengelolaan Vaksin di Daerah Kasus Difteri di Jawa Timur

Provinsi Jawa Timur merupakan daerah endemis penyakit difteri dari tahun 2000 sampai- 2012. Setiap tahunnya selalu terjadi kenaikan kasus (KLB), meskipun angka cakupan imunisasi tinggi. Kasus banyak terjadi pada anak-anak baik yang sudah diimunisasi maupun yang belum diimunisasi dengan angka kematian cukup tinggi.Tujuan penelitian ini adalah menilai pengetahuan dan sikap petugas pengelola vaksin dalam mengelola vaksin di tempat pelayanan kesehatan di daerah Jawa Timur. Metode penelitian menggunakan desain potong lintang, yang dilakukan di 6 Kabupaten/kota di Jawa Timur, dengan lama penelitian 11 bulan dari Januari sampai November 2011. Variabel dependen adalah kualitas vaksin dan variabel independen adalah cara kerja pengelola vaksin dan skor pengelolaan vaksin. Hasil penelitian menemukan bahwa pelatihan petugas dalam mengelola vaksin berpengaruh terhadap ketepatan dalam pengelolaan vaksin di tempat pelayanan kesehatan. Kata kunci : pengelolaan, vaksin , difteri. Abstract East Java Province is an area endemic diphtheria from 2000 to-2012., Every year is always an increase in cases (KLB), despite a high rate of immunization coverage. Common cases in both children who have been immunized or not immunized with mortality rate is quite high. The purpose of this study was to assess the knowledge and attitude of management personnel in managing vaccine vaccines in the health service in the area of East Java. The method used is a design study using cross-sectional design, which was done in the study in six districts / cities in East Java, with a long 11-month study period is the month of January to November 2011. The dependent variable is the quality of the vaccine used and the independent variable is how the Human Resources (HR) managers vaccines and vaccine observed score management. The results found that the training of administer vaccines officer was affecting the accuracy in vaccine management in the health service. Keywords: management, vaccines, diphtheria

The effect of health insurance and socioeconomic status on women’s choice in birth attendant and place of delivery across regions in Indonesia: a multinomial logit analysis

Background: Evidence suggests that women gave birth in diverse types of health facilities and were assisted by various types of health providers. This study examines how these choices are influenced by the Indonesia national health insurance programme (Jaminan Kesehatan Nasional (JKN)), which aimed to provide equitable access to health services, including maternal health. Methods: Using multinomial logit regression models, we examined patterns and determinants of women’s choice for childbirth, focusing on health insurance coverage, geographical location and socioeconomic disparities. We used the 2018 nationally representative household survey dataset consisting of 41 460 women (15–49 years) with a recent live birth. Results: JKN coverage was associated with increased use of higher-level health providers and facilities and reduced the likelihood of deliveries at primary health facilities and attendance by midwives/nurses. Women with JKN coverage were 13.1% and 17.0% (p<0.05) more likely to be attended by OBGYN/general practitioner (GP) and to deliver at hospitals, respectively, compared with uninsured women. We found notable synergistic effects of insurance status, place of residence and economic status on women’s choice of type of birth attendant and place of delivery. Insured women living in Java–Bali and in the richest wealth quintile were 6.4 times more likely to be attended by OBGYN/GP and 4.2 times more likely to deliver at a hospital compared with those without health insurance, living in Eastern Indonesia, and in the poorest income quantile. Conclusion: There are large variations in the choice of birth attendant and place of delivery by population groups in Indonesia. Evaluation of health systems reform initiatives, including the JKN programme and the primary healthcare strengthening, is essential to determine their impact on disparities in maternal health services

Gambaran Keamanan Cemaran Mikroba E. Sakazakii pada Susu Formula Bayi yang Beredar di Indonesia Tahun 2011

. Background. Infant formulain powdered form(powder) is not a sterile product. It is likely to contain pathogenic microorganisms, cause infectioning the infant. E.sakazakii (Cronobacter spp) is one of the pathogens as indicatorof the safety in infant formula. Method. This survey design is cross sectional and purpose of this survey is not to conclude lot a cceptance (safety assurance to a level of standard) or quality control of product.To ensure food security, the number of samples taken is one sample (n =1) per item from distributed products. Nevertheless, this survey uses 2 samples (n=2). Method used to detect E. Sakazakii in infant formula samples isbased onISO/TS 22964 : 2006 from Codex Alimentarius Commission (CAC) in July 2008.Method uses testing method validation. Samples are obtained from Indonesian regions which representing 7 Bappenas regions with a number of 88 samples, consist of 41samples (2 batch number) and 6 samples (1 batch number). Maximum Limit of microbial contaminants in food are set by the Head of National Agency of Drug and Food Control Regulations number HK.00.06.1.52.4011 based on Codex Alimentarius Commission (CAC) in July 2008. It determines the limit of E.Sakazakii on infant formula that is negativein 10 gram. This data is complemented with secondary data about GMP and HACCP implementation in industry which produces/imports infant formula milk. Result. The result showed that all of samples are negative in 10 g sample. In addition, all of the manufacturers have fulfilled the GMP requirements and have applied HACCP system in the production system. Imported baby milk formula products have to attach analysis certificate which declares that the products are negative from E. Sakazakii/10 gram. Keywords : E.sakazakii, infant formula, Cronobacter sp Abstrak. Latar Belakang. Susu formula bayi dalam bentuk bubuk (powder) bukan merupakan produk steril, kemungkinan bisa mengandung mikroorganisme sehingga harus dijamin ketiadaan patogen yang secara epidemiologis menjadi sumber dan pembawa infeksi pada bayi.E.sakazakii (Cronobacter spp)adalah salah satu patogen yang menjadi indikator keamanan susu formula bayi. Metode. Survei menggunakan desain potong lintang dan tujuan surveibukan untuk menyimpulkan lot acceptance (safety assurance to a level of standard)atau quality control yang dilakukan oleh produsen, tetapi bertujuan untuk menjamin keamanan pangan.Sehingga jumlah sampel yang diambil cukup satu sampel (n=1) per item produk yang beredar, namun dalam survei ini menggunakan lebih dari 1 per item (n=2). Metode deteksi E. Sakazakii pada sampel formula bayi dilakukan sesuai ISO/TS 22964 : 2006disertai validasi metode pengujian. Sampel diperoleh dari wilayah Indonesia yang mewakili 7 region Bappenas dengan jumlah 88 sampel terdiri dari 41 sampel ( 2 nomor bets ) dan 6 sampel ( 1 nomor bets ). Batas Maksimum Cemaran Mikroba dalam Pangan berdasarkan Peraturan Kepala Badan POM Nomor HK.00.06.1.52.4011 berlandaskanCodex Alimentarius Commission (CAC) pada Juli 2008 menetapkan E.sakazakii pada formula bayi negatif dalam 10 gram. Data di atas dilengkapi dengan data sekunder tentang penerapan GMP dan HACCP di industri yang memproduksi/melakukan impor susu formula. Hasil. Semua formula bayi negatif E.sakazakii dalam 10 g sampel.Disamping itu semua produsen telah memenuhi persyaratan GMP dan telah menerapkan sistem HACCP dalam proses produksi.Produk formula bayi impor wajib melampirkan sertifikat analisis yang menyatakan produk tersebut negatif E.sakazakii/10 gram Kata Kunci : E.sakazakii, susu formula, Cronobacter s

Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia

BACKGROUND: Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. METHODS: A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. FINDINGS: Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population, particularly numbers of births, infants and children and also key diseases with high cost/prevalence and variation, most notably the level of malnutrition. The approach to resource allocation was implemented using existing data sources and permitted the rapid construction of a needs based formula that is highly specific to the package mandated across the country. Refinement could focus more on resources required to finance demand side costs and expansion of the service package to include priority non-communicable services

Cost Analysis of Chronic Kidney Disease Patients in Indonesia

Endang Sunariyanti,1,2 Tri Murti Andayani,3 Dwi Endarti,4 Diah Ayu Puspandari5 1Doctoral Program in Pharmaceutical Science, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia; 2Universitas Muhammadiyah A.R.Fachruddin, Tangerang, Banten, Indonesia; 3Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia; 4Department of Pharmaceutics, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia; 5Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Yogyakarta, IndonesiaCorrespondence: Tri Murti Andayani, Department of Pharmacology and Clinic, Faculty of Pharmacy, Universitas Gadjah Mada, Sekip Utara, D. I., Yogyakarta, 55281, Indonesia, Email [email protected]: The cost of treating chronic kidney disease requires large funds. Chronic kidney disease financing ranks 2nd in BPJS as the highest financing. All cost components in the treatment of chronic kidney disease are considered high, so adjustments and efficiency are needed. This study aims to perform a cost analysis in chronic kidney patients. In this article, we will discuss the cost components in treatment and see whether there are differences in the cost of treatment in each hospital.Methods: The study used a cross-sectional design with a hospital perspective and was conducted in 6 hospitals selected based on class in different regions: Sardjito Central General Hospital (class A), Yogyakarta Regional General Hospital (class B) and PKU Muhammadiyah Hospital (private class) represent hospitals in regional 1. Meanwhile, Makassar Central General Hospital (class A), Labuang Hospital Baji (class B) and Faisal Islamic Hospital (private class) represent hospitals in regional 3. The study lasted for 14 months from October 2019-December 2020. The total sample involved in this study was 582 samples. The cost components analyzed include hemodialysis costs, serious procedures and operations, services, radiology, laboratories, blood transfusions, drugs, medical devices, hospitalization and supplies.Results: Chronic kidney patient profile data, calculations and cost components are presented descriptively. The Mann–Whitney test was used to see whether there were differences in costs between hospitals in each region. The results showed that the total cost of treating chronic kidney disease was higher in class A hospitals compared to class B and private class hospitals.Conclusion: The highest cost component is the cost of hemodialysis, followed by severe procedures and services. The highest total cost of hemodialysis reached Rp. Rp.840,132,546, heavy action Rp. 423,156,000 and services Rp. 792,155,000. The results of statistical tests showed that there were differences in the cost of treating chronic kidney disease in hospitals in regional 1 and regional 3 (p < 0.05).Keywords: cost of illness, chronic kidney, hemodialysi