Kunjungan Rumah Pasca Persalinan, sebuah Strategi Meningkatkan Kelangsungan Hidup Neonatal

The declining of children under five of age mortality has been seen over several decades. But the rate of neonatal death remains stagnant. Neonatal death is crucial if one want to decrease the under five mortality as it has been stated as the fourth goal of the Millennium Development Goals. At year 2000 there were 130 million births, among whom 4 million was died during neonatal period, which was 2/3 from the infant death. Two third of the neonatal death occurred at the first week of life and 99% happen in developing countries. The timing of maternal death mostly occurred at the end of pregnancy, at birth and within one week after delivery. Intervention of maternal and neonatal death should be done simultaneously. Evidence have showed that simple measures on communi-ty based approach are able to reduce neonatal and maternal mortality significantly. WHO and UNICEF in 2009 have made joint statement: “Home visits for the newborn child: a strategy to improve survival”. There were 7 points of recommendation that need to be addressed by countries who want to reduce neona-tal mortality. Each country should look at the existing program and make necessary changes accordingly

The Relationship between Exclusive Breastfeeding and Diarrhea in Under Six Months Infants in 2017 (Analysis of Indonesian Health Demography Data Survey 2017)

Background: Diarrhea is the main cause of malnutrition in underfive children. One of the efforts to prevent diarrhea in infants is exclusive breastfeeding. Exclusive breastfeeding is infant that receives only breast milk without any additional consumption from 0 to 6 months. Under six months infant who are not exclusively breastfed have a higher risk of developing diarrhea than those who are exclusively breastfed.Methods: This study aims to determine the relationship between exclusive breastfeeding and the incidence of diarrhea in under six months infants in Indonesia. This study analyze secondary data from the 2017 Indonesian Demographic and Health Survey. The sample in this study consist of all live infants aged 0-6 months born to women aged 15-49 years in Indonesia who were successfully interviewed and had a complete answer (no answer missing). After weighting, 1898 samples were obtained.Result: The result found that the proportion of diarrhea incidence in Indonesia is 9.1%. Meanwhile of all infants, 36% were not exclusively breastfed. The results showed that there was a significant relationship between infants who were not exclusively breastfed and diarrhea incidence in Indonesia after adjusted by mother's education level, maternal employment status, mother’s economic level, area of residence, and latrine ownership (PR = 2.12, 95% CI = 1.46-3.07).Conclusion : Infants who were not exclusively breastfed increase the risk for diarrhea. Therefore it is necessary to have a program to increase the coverage of exclusive breastfeeding. The program can take the form of counseling by health workers in health services

PENGGUNAAN KONTRASEPSI HORMONAL DAN OBESITAS PADA WANITA USIA SUBUR DI INDONESIA: ANALISIS DATA IFLS 5 TAHUN 2014

Abstract Background: Prevalence of obesity in adult females in Indonesia is 32,9% in 2013. Hormonal contraceptives (pills, injections and implants) are widely used by reproductive-age women in Indonesia, and the prevalence is 45%. Objective: The aim of this study is to identify whether reproductive-age women who use hormonal contraceptives are at risk of developing obesity compared to WUS who do not use hormonal contraceptives. Method: The design of this study is a cross sectional study using secondary data (5th Indonesia Family Life Survey, and the sample is reproductive-age women (15-49 years old) consisting of 6045 respondents. The variables of this study are obesity, hormonal contraceptive use, age, education, occupation, and duration of contraceptive use. Data were analysed by using Cox Regression. Result: The results of bivariate analysis showed that hormonal contaceptive use, age, education, occupation, and duration of contraceptive use were associated with obesity among reproductive-age womenand statistically significant (P-Value <0,05). Multivariate analysis showed that hormonal contraceptive use did not increase the risk of obesity among reproductive-age women in Indonesia (PR 0.939; CI 95% 0.869 - 1.013). Conclusion: The use of hormonal contraception did not increase the risk of obesity among reproductive-age women. Key words: Hormonal Contraception; Obesity; Reproductive Age-Women Abstrak Latar belakang : Prevalensi obesitas pada perempuan dewasa di Indonesia sebesar 32,9 persen pada tahun 2013. Kontrasepsi hormonal (pil, suntikan dan implan) merupakan jenis kontrasepsi yang paling banyak digunakan oleh wanita usia subur (WUS) di Indonesia, dengan prevalensi sebesar 45%. Tujuan : untuk mengetahui apakah wanita usia subur (WUS) yang menggunakan kontrasepsi hormonal berisiko mengalami obesitas dibandingkan WUS yang tidak menggunakan kontrasepsi hormonal.  Metode : Desain penelitian ini adalah studi cross- sectional dengan menggunakan data sekunder IFLS 5 tahun 2014. Sampel adalah WUS (15-49 tahun) sebanyak 6.045 responden. Variabel dalam penilitian ini adalah obesitas pada WUS, penggunaan kontrasepsi hormonal, umur, pendidikan, pekerjaan, serta lama penggunaan kontrasepsi. Analisis data yang digunakan adalah Cox Regression. Hasil : Hasil analisis bivariat menunjukkan bahwa variabel penggunaan kontrasepsi hormonal, umur, pendidikan dan status pekerjaan, serta  lama penggunaan kontrasepsi berhubungan dengan obesitas pada WUS (p-value <0,05). Analisis multivariat menunjukkan bahwa penggunaan kontrasepsi hormonal tidak meningkatkan risiko obesitas secara bermakna pada WUS di Indonesia (PR 0,939; CI 95% 0,869 – 1,013). Kesimpulan: Penggunaan kontrasepsi hormonal tidak meningkatkan risiko WUS untuk mengalami obesitas.   Kata kunci: Kontrasepsi Hormonal; Obesitas; Wanita Usia Subu

Faktor-faktor yang Berhubungan dengan Kejadian Stroke pada Penduduk Usia ≥15 Tahun di Provinsi Daerah Istimewa Yogyakarta (Analisis Data Riskesdas 2018)

Menurut Riset Kesehatan Dasar (Riskesdas) 2013, prevalensi stroke pada penduduk usia ≥ 15 tahun di Indonesia sebesar 7 permil dan mengalami kenaikan dari tahun 2007 yang sebesar 6 permil. Provinsi Daerah Istimewa Yogyakarta (DIY) menjadi provinsi dengan prevalensi stroke tertinggi kedua di Indonesia dan prevalensinya melebihi angka nasional yakni sebesar 10,3 permil pada tahun 2013. Tujuan studi ini untuk mengetahui faktor-faktor yang berhubungan dengan kejadian stroke pada penduduk usia ≥15 tahun di Provinsi DIY. Penelitian ini menggunakan desain cross-sectional, dengan menganalisis data Riskesdas 2018 Provinsi DIY sebanyak 6695 responden. Chi square dan regresi logistik ganda digunakan sebagai uji statistik pada penelitian ini. Hasil penenlitian menyatakan prevalensi stroke pada penduduk usia ≥ 15 tahun di Provinsi DIY tahun 2018 sebesar 1,7%. Faktor yang memiliki hubungan statistik signifikan dengan kejadian stroke antara lain usia (POR=3,23; 95% CI=2,03-5,13), aktivitas fisik (POR=2,86; 95% CI=1,90-4,31), hipertensi (POR=5,69; 95% CI=3,68-8,79), penyakit jantung (POR=2,57; 95% CI=1,47-4,48), dan diabetes melitus (POR=2,44; 95% CI=1,49-3,40). Dari penelitian ini, disimpulkan bahwa ada hubungan antara usia, aktivitas fisik, hipertensi, penyakit jantung, dan diabetes melitus dengan kejadian stroke pada penduduk usia ≥ 15 tahun di Provinsi DIY

Determinan Konsistensi Penggunaan Kondom pada Laki-Laki Seks dengan Laki-Laki (LSL) Non-Pekerja Seks: Studi Potong Lintang

Kasus baru HIV di Indonesia cenderung terus mengalami peningkatan. Sedangkan, tren kasus baru di dunia sudah mengalami penurunan. Laki-laki Seks dengan laki-laki (LSL) merupakan kelompok risiko tinggi HIV. Upaya pencegahan penularan HIV erat kaitannya dengan perilaku seks. Studi ini menggunakan 1.161 sampel Survei Terpadu Biologi dan Perilaku (STBP) 2015 pada kelompok LSL yang termasuk bukan pekerja seks. Studi cross sectional ini bertujuan untuk menganalisis determinan perilaku seks konsistensi penggunaan kondom dengan analisis hingga bivariat dengan menggunakan chi-square dan prevalence ratio. Data didapatkan dengan metode respondent driven sampling (RDS) yang kemudian mengeksklusi LSL pekerja seks. Hasil menunjukkan bahwa faktor-faktor yang berhubungan dengan perilaku penggunaan kondom yang tidak konsisten yaitu pengetahuan status HIV dengan prevalence ratio (PR) 1,14 (95% CI 1,02-1,28), pelayanan pencegahan dan penularan HIV dengan PR 1,18 (95% CI 1,06-1,33), serta akses terhadap internet tentang pencegahan dan penularan HIV dengan PR 1,16 (95 % CI 1,02-1,31). Sehingga, LSL yang tidak mengetahui status HIV diri sendiri, tidak mendapatkan pelayanan pencegahan dan penularan HIV, dan tidak mengakses internet mengenai pencegahan dan penularan HIV berisiko lebih tinggi untuk berperilaku tidak konsisten dalam menggunakan kondom setiap kali melakukan hubungan seks. Maka dari itu, perlu program-program yang berfungsi untuk meningkatkan pengetahuan LSL tentang status HIV dirinya sendiri, dan informasi mengenai pencegahan penularan HIV baik melalui program pelayanan maupun internet untuk meningkatkan konsistensi penggunaan kondom pada LSL non-pekerja seks.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KUALITAS HIDUP LANSIA DI DESA CIPASUNG KABUPATEN KUNINGAN TAHUN 2017

  Latar belakang: Peningkatan populasi lansia berdampak pada berbagai aspek kehidupan baik sosial, ekonomi dan terutama kesehatan. Pada masa lanjut usia terjadi berbagai perubahan fisik, kognitif maupun psikologis. Harapan hidup dan kualitas hidup merupakan hal yang sangat penting bagi lansia. Terdapat banyak faktor yang mempengaruhi kualitas hidup lansia. Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kualitas hidup lansia. Metode: Desain penelitian adalah cross-sectional. Subjek penelitian berjumlah 242 orang lansia yang diperoleh dengan cara random dari populasi yang berjumlah 349 lansia. Variabel dependen adalah kualitas hidup, variabel independen adalah karakteristik, dukungan keluarga dan fungsi keluarga. Pengumpulan data dengan wawancara menggunakan kuesioner WHOQOL-BREF, kuesioner dukungan keluarga dan fungsi keluarga. Analisis data dilakukan dengan uji Chi-square dan uji Regresi Logistik. Hasil: Variabel yang memiliki hubungan yang signifikan dengan kualitas hidup lansia adalah pendidikan (OR=4,9, p-value=0,022), pekerjaan (OR=3,5, p-value=0,000) dan dukungan keluarga (OR=5,7, p-value=0,000). Kesimpulan: Faktor yang paling dominan berhubungan dengan kualitas hidup lansia adalah dukungan keluarga dengan nilai OR 5,7

Hubungan Kehamilan Tidak Diinginkan dengan Kejadian Berat Bayi Lahir Rendah di Pedesaan Pulau Jawa (Analisis Data SDKI 2017)

Background: There was an increase in the proportion of birth weight less than 2500 grams from 5.7 in 2013 to 6.2 in 2018. Several provinces in Java Island also still have the proportion of LBW above the average proportion of LBW in Indonesia (> 6.2 %) such as Banten, West Java, Yogyakarta Special Region, and East Java. Maternal characteristics such as rural residence and unwanted pregnancy status are related to low birth weight. This study aims to determine the relationship between unwanted pregnancy and LBW events in rural areas in Java Island.Methods: This study was conducted by analysing secondary data from the results of the 2017 Indonesian Demographic and Health Survey (IDHS). The sample in this study consists of all live births in the last 5 years prior to the survey with reports of birth weight less than 2500 grams born to women aged 15- 49 years in rural Java Island when the survey took place and was successfully interviewed, and has a complete answer (no answer missing).Result: After weighting, 1821 samples were obtained. The result found that the proportion of LBW events in rural areas in Java Island is 6.3%. Meanwhile, of all pregnancies during the study period, 13.5% were unwanted pregnancies. The results of the multivariate analysis showed that there was no significant relationship between unwanted pregnancy status and LBW in rural areas in Java Island after adjusted by maternal age, mother's education level, maternal employment status, economic level, problems in getting health care/treatment, ANC, and parity (POR = 1.31, 95% CI = 0.72-2.38).Conclusion: It is necessary to measure variables more accurately in the questionnaire and carry out further research by including other risk factors

STUNTING AND DEVELOPMENTAL DELAYS AMONG CHILDREN AGED 6–59 MO

Objective: This study aimed to investigate the association between stunting and suspected developmental delay status in Kabupaten Bogor. Methods: An observational cross-sectional study was conducted in Puskesmas Kecamatan Ciampea, Kabupaten Bogor, Indonesia, from February to April 2019. We included children aged 6–59 mo who visited outpatient clinics. All eligible children underwent standardized anthropometric examinations and developmental milestone assessments using the Denver II tool. Both bivariate and multivariate analyses were conducted to investigate any associations. Results: From 184 children, 76 (41.3%) were stunted and 82 (44.57%) had suspected developmental delays, both relatively higher than the national prevalence. Overall, developmental delays were associated with stunting (64.5% vs. 30.6%; adjusted odds ratio (AOR): 3.45; 95% CI: 1.76–6.76; p = 0.000). In subgroup analyses, stunting was independently associated with suspected delays in fine motor skills (26.3% vs. 12.9%; AOR: 2.49; 95% CI: 1.00–6.18; p = 0.049), personal‑social development (35.5% vs. 12.0%; AOR: 2.75; 95% CI: 1.24–6.12; p = 0.013) and language skills (27.6% vs. 12.9%; AOR: 2.95; 95% CI: 1.28–6.77; p = 0.011) after multivariate analyses with sex, age and undernutrition as confounding factors in the final model. Conclusion: Stunting had a strong association with developmental delays among children visiting primary healthcare clinics. Stakeholders should focus on both the detection and prevention of stunting and developmental delays in primary healthcare facilities

Effectiveness of Comic as Learning Media to Enhance Knowledge of Menarche and Menstruation among Female Students in Yogyakarta

Background: Menarche and menstruation are physiological process but can cause physical, emotional discomfort, and anxiety. Menarche age tends to decline. Ignorance about menarche and menstruation may increase the risk of early pregnancy or unwanted pregnancy. This study aimed to determine the effectiveness of comic as learning media to enhance knowledge on menarche and menstruation among female primary school students in Yogyakarta. Subjects and Method: This was a quasi-experiment with before and after study with control group design conducted at Muhammadiyah primary schools in Sagan and Kauman, Yogyakarta, from October to November 2016. A sample 90 female primary school students was selected for this study. The dependent variable was knowledge of menarche and menstruation. The independent variable was learning media (comic versus leaflet). The data were collected by questionnaire. The data were analyzed by Mann-Whitney test. Results: The increase in knowledge scores before and after intervention in the comic group was higher than in the leaflet group, and it was statistically significant (p= 0.005). Conclusion: Comic is more effective as learning media than leaflet in enhancing knowledge of menarche and menstruation among primary school students. Keywords: menarche, menstruation, comic, leaflet, learning medi

Hubungan Makrosomia dengan Perdarahan Postpartum di Indonesia Tahun 2012

Makrosomia merupakan salah satu faktor risiko terjadinya perdarahan postpartum. Peneliti ini bertujuan untuk mengetahui hubungan antara makrosomia dengan perdarahan postpartum di Indonesia tahun 2012. Penelitian ini menggunakan desain studi kasus kontrol dengan bersumber dari data survey demografi dan kesehatan Indonesia (SDKI) tahun 2012. Semua kasus yaitu sebanyak 497 dianalisis dalam penelitian ini sedangkan kontrol dirandom dari seluruh eligible kontrol sehingga didapatkan besar sampel yaitu 994 dengan perbandingan kasus dan kontrol adalah 1:1. Hasil penelitian menunjukkan bahwa makromia merupakan faktor risiko kejadian perdarahan postpartum dengan nilai ORadjusted=1,525 (95%CI 1,031-2,255) setelah dikontrol oleh variabel kunjungan anc dan penolong persalinan. Penelitian ini menyarankan kepada wanita hamil untuk meningkatan kesadaran akan pentingnya pemeriksaan antenatal care dan penolong persalinan oleh tenaga kesehatan.Kata kunci: Perdarahan Postpartum, Makrosomia, SDKI 201