Impact of Baby-Friendly Hospital Initiative for Improving Exclusive Breastfeeding: A Systemic Review of Ten Steps to Successful Breastfeeding

طThe Baby−Friendly Hospital Initiative (BFHI) launched by WHO / UNICEF has proven to be a powerful tool for raising breastfeeding rates. Breastfeeding is a protective factor for health, and breastfeeding promotion continues to be an important measure to improve child and maternal health in both developed and developing countries. A systematic review of the effect of BFHI worldwide found that the BFHI was the most effective intervention for improving breastfeeding rates at health system level and adherence to the Ten Steps positively affected short-, medium-, and long-term breastfeeding outcomes. This study therefore examines the impact of baby-friendly hospital initiatives for improving exclusive breastfeeding. This study used systematic review which performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The published literature was identified using relevant keywords. The initial screening was conducted by year of publication (8 years) and free full text, then reading the titles and abstracts. Nine articles were included in this review. The studies showed there were positive impacts in enhancement of exclusive breastfeeding after applied baby-friendly hospital initiative program. Rates of exclusive breastfeeding were demonstrably improved by applying BFHI with Ten Steps to Successful Breastfeeding at health care facilities to all mothers from pregnancy until postpartum.   Keywords: Baby-Friendly Hospital Initiative, breastfeeding, exclusive breastfeeding, Ten Steps, Ten Steps to Successful Breastfeedin

Pengaruh Rejimen terhadap Ketidakpatuhan Berobat Tuberkulosis

Beban tuberkulosis di Indonesia termasuk lima tertinggi di dunia. Temuan kasus dan pengobatan adalah pilar utama program penanggulangan tuberkulosis. Survei nasional menunjukkan peningkatan penggunaan rejimen tidak standar dari 16,8% (2010) menjadi 55,6% (2013). Peningkatan penggunaan rejimen tidak standar diduga berpengaruh terhadap ketidakpatuhan berobat. Penelitian ini bertujuan untuk mempelajari ketidakpatuhan berobat pada orang dengan tuberkulosis yang menerima rejimen tidak standar dan rejimen standar. Penelitian menggunakan data sekunder Riset Kesehatan Dasar 2010. Analisis logistik multivariabel dilakukan pada sampel 971 orang dengan tuberkulosis yang selesai mendapatkan pengobatan. Hasil penelitian menunjukkan ada kecenderungan orang dengan tuberkulosis yang menerima rejimen tidak standar memiliki ketidakpatuhan berobat lebih tinggi. Hasil penelitian juga menunjukkan odds untuk tidak menyelesaikan pengobatan lebih tinggi pada orang yang menerima rejimen tidak standar dibandingkan orang yang menerima rejimen standar, yaitu odds ratio terkontrol 2,4 (95% CI odds ratio: 1,7-3,5). Dalam upaya menjamin kepatuhan berobat tuberkulosis, mutu program pengobatan perlu ditingkatkan; di antaranya adalah ketersediaan rejimen standar, penyetaraan standar pengobatan antara fasilitas pelayanan kesehatan swasta dan publik, serta sistem pemantauan minum obat.The influence of Regimen on Poor Adherence of Tuberculosis TreatmentIndonesia is one of five highest tuberculosis burden countries. Case finding and treatment are the main pillars of tuberculosis control program. National survey reported that the USAge of nonstandarized regimen is increased from 16,8% (2010) to 55,6% (2013). Increase use of nonstandarized regimen is associated with poor adherence tuberculosis treatment. This study purposed to compare the poor adherence of tuberculosis treatment among people who received standarized regimen and people who received nonstandarized regimen. The study used secondary data of National Health Survey 2010. Analysis used multivariable logistic through 971 people who completed tuberculosis treatment. This study found that people who received nonstandarized regimen had higher poor adherence of tuberculosis treatment than people who received standarized regimen. The result also showed that the odds of not to complete the treatment was higher in people who received nonstandarized regimen than who received standarized regimen, adjusted OR was 2,4 (95% CI OR: 1,7-3,5). To assure the adherence to tuberculosis treatment is to strengthen tuberculosis treatment program; such as the availability of standarized regimen, the equality of standard tuberculosis treatment among public and private health services, and the system of observed treatment

A survey on HIV-related health-seeking behaviors among transgender individuals in Jakarta, based on the theory of planned behavior

BACKGROUND: Male-to-female transgender (waria) individuals are at high risk for HIV. This study aims at mapping the psychological determinants of four HIV-related health-seeking behaviors. This knowledge can be used to develop effective interventions to prevent the spread of HIV/AIDS. METHODS: The study involved 209 waria from five districts in Jakarta, selected with a cluster sampling procedure. Cross-sectional data were gathered through structured interviews. The four examined behaviors are, visiting sexually transmitted infections (STIs) services regularly, adherence to STI treatment, taking an HIV test and picking up the result of HIV test. For all four behaviors, specific measures of the psychological determinants as defined by the Theory of Planned Behavior were developed: attitudes, subjective norms and perceived behavioral control (PBC). Logistic regression analyses were conducted with these three psychological measures as independent variables and the behaviors as dependent variables. RESULTS: Of the 209 waria, 20.6 % had never visited STI services in the last 6 months, while 56.5 % had visited the services once or twice, and 23 % had visited the service three or more times. A HIV test had been taken by 90.4 % of the waria, and of those, 64.6 % had picked up the results. About 85 % of the waria who did a HIV test had been tested for HIV one or two times in the last 6 months and 10 % had been tested three to four times. The variance in behaviors that was explained by the concepts defined in the Theory of Planned Behavior ranged from 15 to 70 %; PBC was the most powerful predictor. Furthermore, the results showed that in several cases the relationships of attitudes or subjective norms with the dependent variable were mediated by one or both other independent variables. CONCLUSIONS: The results regarding the prominent role of PBC suggest that interventions should increase waria’s control over the behavior: Engaging in specific desired behaviors should be made easier for them. Besides, waria’s attitudes and subjective norms should be addressed, by education, but possibly also by providing waria with a positive experience with the behavior, for example, by designing a professional and friendly health care system

Pengaruh Status Kehamilan Tidak Diinginkan Terhadap Perilaku Ibu Selama Kehamilan Dan Setelah Kelahiran Di Indonesia (Analisis Data Sdki 2012)

Background: The status of unintended pregnancies is an important concern as unintended pregnancy can affect mother and infant health. Objective: This study aimed to determine the description and influence of unintended pregnancies towards mothers' behaviour during prenatal and postnatal within different economic status. Methods: An analysis of secondary data from Indonesian Demographic and Health Survey (IDHS) 2012 is conducted. A sample of 11.742 respondents qualified into inclusive criteria were women aged 15-49 years who had pregnant and gave birth to single births since January 2007 until the time of the survey. The analysis was performed with logistic regression and stratified multivariate logistic regression. Results: The results showed that mothers who experienced an unintended pregnancy were 1.79 more likely to not conduct prenatal care compared to those who didn't, and had the same opportunities of not having behaviour of exclusive breastfeeding and not giving complete basic immunization as those who didn't. The study also obtained results that behaviour of obstetric care, exclusive breastfeeding and complete basic immunization also influenced by economic status. Conclusion: Unintended pregnancy affected behaviour of antenatal care (ANC) visit whereas exclusive breastfeeding and complete basic imunization were not different compare to intended pregnancy. Effect unintended pregnanvy toward materna; behavior's mother are vary according economics status

Survival Analysis of Chronic Kidney Disease Patients with Hemodialysis in West Java. Indonesia, Year 2007 - 2018

The prevalence of chronic kidney disease on dialysis or CKD5D is increasing with a significant impact on disease burden in many countries. Patients are usually listed in the national renal registries, which report demographic data, incidence, prevalence, and outcome. The survival rate is an important outcome measure to characterize the impact of treatment in the CKD5 patient population in the national and international renal registries. Indonesian Society of Nephrology (InaSN) has the Indonesian Renal Registry program to collect data that was endorsed to monitor dialysis treatment quality in Indonesia.  IRR releases an annual report, but there is no survival analysis yet.   This study aimed to discover the five-year survival rate of CKD5D patients in West Java between 2007–2018 and its factor based on the IRR database. A retrospective cohort study was performed by gaining all patients' data from the IRR database, then data on all of the patients from West Java province who completed a 5-year follow-up on December 31, 2018.  Kaplan-Meier analysis and Cox proportional hazard's model were used to analyze the risk factors. There were 3,199 data included in this study. In total, the 1, 2, 3, 4, and 5 year survival rates are 82%, 70%, 62%, 58%, and 55 %, respectively.  Patients whose age is above 55 years and with unknown underlying kidney disease have a worse survival rate with a hazard ratio of 1.28 and 1.50, respectively. Further exploration of IRR data will provide better information on dialysis treatment in Indonesia. Ketahanan Hidup Pasien Penyakit Ginjal Kronis dengan Hemodialisis di Jawa Barat Indonesia tahun 2007-2018Prevalensi penyakit ginjal kronis pada dialisis atau PGK5D meningkat dan memberi beban penanganan penyakit di banyak negara. Pasien biasanya terdaftar dalam register ginjal nasional yang melaporkan data demografis, insiden, prevalensi dan luaran klisis. Tingkat ketahanan hidup merupakan parameter penting dalam registrasi ginjal untuk menggambarkan kualitas terapi pada  populasi pasien PGK stadium 5. Perhimpunan Nefrologi Indonesia (Pernefri) memiliki program Registri Ginjal Indonesia yang disebut Indonesian Renal Registry (IRR) untuk mengumpulkan data pasien PGK5D untuk  memantau kualitas pengobatan dialisis di Indonesia. IRR merilis laporan tahunan tetapi belum dilengkapi dengan  analisis ketahanan hidup. Tujuan penelitian ini adalah mengetahui angka ketahanan hidup lima tahun pasien PGK5D di Jawa Barat antara tahun 2007-2018 dan faktor risikonya berdasarkan basis data dari IRR. Studi kohort retrospektif dengan mengambil semua data pasien dari basis data IRR kemudian ditentukan data pasien Jawa Barat yang lengkap dan di follow up selama 5 tahun pada 31 Desember 2018.   Analisis Kaplan-Meier dan model proporsional hazard Cox digunakan untuk menganalisis faktor risiko. Subjek berjumlah 3199 data yang dimasukkan dalam penelitian ini. Kesimpulannya, angka harapan hidup satu, 2, 3, 4, dan 5 tahun berturut-turut adalah 82%, 70%, 62%, 58%, dan 55%. Usia lebih dari 55 tahun dan penyakit ginjal yang mendasari memiliki kelangsungan hidup yang lebih buruk dengan hazard ratio 1,28 dan 1,50. Eksplorasi lebih lanjut dari data IRR akan memberikan informasi yang lebih baik tentang perawatan dialisis di Indonesia

Pengaruh Tahu Status HIV terhadap Penggunaan Kondom Konsisten pada Lelaki yang Seks dengan Lelaki di YOGYAKARTA dan Makassar (Analisis Data Surveilans Terpadu Biologi dan Perilaku Tahun 2013)

Hubungan seks yang berisiko menularkan HIV adalah hubungan seks dengan banyak pasangan dan berganti-ganti pasangan yang sebagian besar didominasi dengan hubungan seks komersial, baik pada kelompok heteroseksual maupun pada kelompok homoseksual atau sejenis. Kelompok yang paling berisiko tertular HIV adalah kelompok homoseksual dan biseksual yang biasa dikategorikan sebagai lelaki seks lelaki atau disebut LSL. Di banyak bagian wilayah, HIV di kalangan LSL muncul dengan penularan HIV yang sangat cepat. Penelitian ini bertujuan untuk mengetahui pengaruh tahu status HIV terhadap penggunaan kondom konsisten pada LSL di Yogyakarta dan Makassar dan melihat adakah perbedaan hasil analisis dengan menggunakan metode RDS dan non RDS terhadap indikator program. Penelitian ini menggunakan data STBP 2013. Dari hasil analisis diperoleh bahwa di Yogyakarta ada pengaruh tahu status HIV terhadap penggunaan kondom konsisten dengan OR sebesar 6,6 dan 95% CI 2,1-20,9, sedangkan di Makassar belum dapat diketahui pengaruh tahu status HIV dengan penggunaan kondom konsisten dengan OR sebesar 1,6 dan 95% CI 0,6 - 4,4. Ada perbedaan hasil analisis dengan menggunakan metode RDS dan non RDS terhadap indikator program. Terdapat pengaruh tahu status HIV dengan penggunaan kondom konsisten pada lelaki yang seks dengan lelaki di Yogyakarta sedangkan di Makassar belum dapat diketahui pengaruh tahu status HIV dengan penggunaan kondom konsisten. Terdapat perbedaan hasil analisis dengan menggunakan metode RDS dan non RDS terhadap indikator program

PENGARUH TAHU STATUS HIV TERHADAP PENGGUNAAN KONDOM KONSISTEN PADA LELAKI YANG SEKS DENGAN LELAKI DI YOGYAKARTA DAN MAKASSAR (ANALISIS DATA SURVEILANS TERPADU BIOLOGI DAN PERILAKU TAHUN 2013)

Abstrak: Hubungan seks yang berisiko menularkan HIV adalah hubungan seks dengan banyak pasangan dan berganti-ganti pasangan yang sebagian besar didominasi dengan hubungan seks komersial, baik pada kelompok heteroseksual maupun pada kelompok homoseksual atau sejenis. Kelompok yang paling berisiko tertular HIV adalah kelompok homoseksual dan biseksual yang biasa dikategorikan sebagai lelaki seks lelaki atau disebut LSL. Di banyak bagian wilayah, HIV di kalangan LSL muncul dengan penularan HIV yang sangat cepat. Penelitian ini bertujuan untuk mengetahui pengaruh tahu status HIV terhadap penggunaan kondom konsisten pada LSL di Yogyakarta dan Makassar dan melihat adakah perbedaan hasil analisis dengan menggunakan metode RDS dan non RDS terhadap indikator program. Penelitian ini menggunakan data STBP 2013. Dari hasil analisis diperoleh bahwa di Yogyakarta ada pengaruh tahu status HIV terhadap penggunaan kondom konsisten dengan OR sebesar 6,6 dan 95% CI 2,1-20,9, sedangkan di Makassar belum dapat diketahui pengaruh tahu status HIV dengan penggunaan kondom konsisten dengan OR sebesar 1,6  dan 95% CI 0,6 - 4,4. Ada perbedaan hasil analisis dengan menggunakan metode RDS dan non RDS terhadap indikator program. Terdapat pengaruh tahu status HIV dengan penggunaan kondom konsisten pada lelaki yang seks dengan lelaki di Yogyakarta sedangkan di Makassar belum dapat diketahui pengaruh tahu status HIV dengan penggunaan kondom konsisten. Terdapat perbedaan hasil analisis dengan menggunakan metode RDS dan non RDS terhadap indikator program. Abstract:  Sex which higher risk of spreading HIV is sex with multiple partners and change partners that is largely dominated by commercial sex, either on the heterosexual and homosexual group, or similar sexual behaviour. Groups most at risk of contracting HIV is a group of homosexual and bisexual men are commonly categorized as men sex with men, or so-called MSM. In many parts of the region, HIV among MSM appears with HIV infection very quickly. This study aimed to determine the effect knowing their HIV status toward consistency condom use in MSM in Yogyakarta and Makassar and to see the differences between analysis using RDS and non RDS to indicator of program. This study uses data IBBS 2013. From the results of the analysis showed that in Yogyakarta there was an effect Yogyakarta of knowing HIV status toward consistency condom use with an OR of 6,6 and 95%CI 2,1-20,9, while in Makassar is unclear knowing HIV status toward consistent condom use with an OR of 1.6 and 95% CI 0,6 - 4,1. There is differences between analysis using RDS and non RDS to indicator of program. There is Influence of knowing HIV Status to consistent Condom use in Yogyakarta while in Makassar unclear knowing HIV status toward consistent condom use. There is differences between analysis using RDS and non RDS to indicator of program

Hubungan Antara Pembesaran Kelenjar Gondok Yang Tampak Dengan Gangguan Pertumbuhan Anak Sekolah Dasar Di Daerah Gondok Endemik

Salah satu spektrum gangguan akibat iodium (GAKI) adalah gangguan pertumbuhan ragawi. Pembesaran kelenjar gondok, disatu pihak merupakan salah satu manifestasi kekurangan iodium, sementara di lain pihak, defisit tinggi badan merupakan petunjuk gangguan pertumbuhan. Hasil penelitian Bautista et.al. dan Koutras et.al. tidak menunjukkan hubungan antara pembesaran kelenjar gondok dengan postur tubuh. Penelitian untuk konfirmasi hasil penelitian tersebut dengan keadaan di Indonesia telah dilakukan di daerah gondok endemik di Kecamatan Salaman, Kabupaten Magelang, Jawa Tengah. Sebanyak 1110 siswa sekolah dasar (7 SD) diperiksa pembesaran gondoknya dengan palpasi dan diukur tinggi badannya secara antropometri. Data yang diperoleh dianalisis secara kasus-kontrol dan distratifikasi menurut jenis kelamin dan umur. Kasus adalah anak penderita gangguan pertumbuhan pada nilai Z-skor 2.51 dari sebaran tinggi badan NCHS/WHO. Hasil penelitian ini menunjukkan bahwa resiko anak yang terganggu pertumbuhannya karena menderita kekurangan iodium sama besar dengan resiko anak yang pertumbuhannya normal (rasio odd, OR=0.84); demikian pula resiko pertumbuhan, pada anak perempuan (OR=0.90) hampir sama besar dengan pada anak laki-laki (OR=0.81). Efek umur, tampaknya, juga tidak menunjukkan perbedaan resiko. Disimpulkan bahwa hasil penelitian ini menegaskan hasil penelitian Bautista et.al. dan Koutras et.al

Preparatory behaviours and condom use during receptive and insertive anal sex among male-to-female transgenders (Waria) in Jakarta, Indonesia

Introduction: The male-to-female transgender (waria) is part of a key population at higher risk for HIV. This study aims to test whether psychosocial determinants as defined by the theory of planned behaviour (TPB) can explain behaviours related to condom use among waria. Three preparatory behaviours (getting, carrying, and offering a condom) and two condom use behaviours (during receptive and insertive anal sex) were assessed. Methods: The study involved 209 waria, recruited from five districts in Jakarta and interviewed by using structured questionnaires. Specific measures were developed to study attitudes, subjective norms and perceived behavioural control (PBC) in order to predict intentions and behaviours. Results: The explained variance between intentions with regard to three preparatory behaviours and two condom uses ranged between 30 and 57%, and the variance between the actual preparatory behaviours of three preparatory and two condom uses ranged between 21 and 42%. In our study, as with several previous studies of the TPB on HIV protection behaviours, the TPB variables differed in their predictive power. With regard to intention, attitude and PBC were consistently significant predictors; attitude was the strongest predictor of intention for all three preparatory behaviours, and PBC was the strongest predictor of intention for condom use, both during receptive and insertive anal sex. TPB variables were also significantly related to the second parameter of future behaviour: actual (past) behaviour. TPB variables were differentially related to the five behaviours. Attitude was predictive in three behaviours, PBC in three behaviours and subjective norms in two behaviours. Conclusions: Our results have implications for the development of interventions to target preparatory behaviours and condom use behaviours. Five behaviours and three psychological factors as defined in the TPB are to be targeted