Revolusi Kesehatan Ibu Dan Anak (Kia) Dalam Meningkatkan Persalinan Oleh Tenaga Kesehatan Di Fasilitas Kesehatan Kabupaten Kupang

Basic Health Research 2007 shows that Kupang district is one of Regional Health Problems among 154 districts in Indonesia. In 2009 the Provincial Government of NTT launched the Mother and Child Health (MCH) Revolution Movement through Governor Regulation No. 42 in 2009, and followed by declaring Regulation of Head of Kupang District No.16 of 2010 on the Acceleration of MCH. The aim of this study is to describe the MCH achievement and the implementation of MCH Revolution Policy in Kupang District. This is a qualitative research which was conducted in 2012. Of the 25 health centers in Kupang District, there were 6 health center set in clusters. Data were collected by in-depth interviews, focus group discussion, and document review. Results showed that the MCH Revolution Movement had succeeded in increasing the delivery by health workers, especially in health facilities by involving the community. This increase is relevant to the growing number of health centers, Basic Emergency Obstetric and Newborn Care (BEmONC) facilities , and midwives in Kupang. The situation was supported by the facts that there were no competition between midwives and TBAs, active cadres who accompanied pregnant women very cooperative TBAs, supportive village regulation, and health centers and village midwives which always ready for delivery. Conclusions, the supporting factors of the MCH Revolution movement are the implementation of rewards and punishments system, community empowerment that has been running well, and also midwives-TBAs partnership

Coronary Heart Disease [CHD] with Obesity in Kebon Kalapa Village, Bogor [Baseline Cohort Study of Non-communicable Diseases Risk Factors]

Background: Obesity has become global pandemic problem in the world as WHO said that it is the largest chronic health problems in adults. Riskesdas 2007 shown that national obesity prevalence in adult based on BMI in 15 years age groups were 10.3%. The aim of this study was to determine risk factors of obesity on CHD i. e socio demography, behavior risk factors and blood test results. Methods: Cross sectional design with a deep analysis on the data evaluation subset of Risk Factors Cohort Study of Non Communicable Diseases research in Kebon Kalapa village, Bogor. The samples took were 1079 respondents CHD patients with obesity. CHD patients were determined based on ECG examination in 2013 and had obesity (BMI > 25 cm and hip ratio > 80 cm on women, and > 90 cm on men). Analysis Chi-square test and logistic regression. Results:The research shows that hypertension gives 1.8 of risk compared to obese CHD respondents with no hypertension with 95% of CI 1.312.53; LDL gives 1.6 of risk compared to respondents with no risk LDL in obese CHD group with 95% CI 1,182,32; HDL give 1.66 higher risk to respondents with risky HDL in obese CHD group with 95% CI 1,232,23 while Triglycerides gives 1.5 risk to obese CHD respondents with 95% CI 1,072,22. Conclusion: People of old ages, females, divorced, housewifes, well educated and high socioeconomic status would have CHD risk. Suggestion: Required further study of obese CHD on the quality of the food intake, especially in fat of the oil used for frying in order to know more detail the types of saturated fatty acids that affect the deterioration of the blood lipid profile

Faktor Risiko Penyakit Jantung Koroner (Pjk) Pada Perempuan (Baseline Studi Kohor Faktor Risiko Ptm) (Risk Factors for Coronary Heart Disease (Chd) in Women [Baseline Cohort Study of Risk Factors for Non Communicable Disease])

Background: Cardiovascular disease was claimed as a leading cause of death in women > 65 years old in Europe. Coronary Heart Disease (CHD) was major cause of death in women in the USA, a half of million women dead because of cardiovascular disease every year. Riskesdas 2007 shows that prevalence of cardiovascular disease in women was higher than man based on diagnosis (1.0% versus 0.8%) or diagnosis and symptoms (8.1% versus 6.2%). The aim of this study was to explore determinants risk factors of CHD in women (sociodemography, behavior risk factors, and blood examination). Methods: Cross sectional with in depth analysis The sample took from sub set data of cohort study of non-communicable disease in sub district Kebon Kalapa, Central Bogor in Bogor City by Center of Intervention Technology of Public Health. Dependent variable was CHD in women with independent variables were socio demography factors, behavior risk factors, and biomedical risk factors. Samples were 1042 respondents, women who had CHD. The criteria of CHD based on examination of ECG with abnormal results. Data analysis conducted by Chi square and logistic regression. Result: The result of this study shows that determinant factors of CHD in women were menopause OR = 1.5 (95% CI 1.215–2.081); waist circumstances OR = 1.5 (95% CI 1.147–2.221); and triglyceride level OR = 1 (95% CI 1.010–1.253). Conclusion: The women with menopause and central obesity had high risk on CHD. Recommendation: Health promotion should have done to decrease CHD prevalence

Obesity and Hypertension in Postmenopausal Women

Hypertension is a public health problem that has a high prevalence. The increase in prevalence with age, especially in women who have been entering menopause. Obesity is frequent in middle-aged women than men; this is the reason why weight often affects blood pressure. This study objective was to determine the association of obesity with hypertension in postmenopausal women using secondary data analysis: The Baseline Cohort Study of risk factors for non-communicable diseases in Kebon Kalapa, Central Bogor, Bogor City in 2011.The cross-sectional study was used in this study. Prevalence Ratios (PR) hypertension was 1.51 times greater in obesity (95 % CI: 1.12 to 2.04, p value = 0.003). Multivariate analysis used Cox Regression after controlled by confounding variables, they were: age, family income and a history of chronic disease, the prevalence rate of hypertension in obese respondents was 1.38 times higher compared with they who had normal weight (95 % CI is 0.92-2.07). Obesity in postmenopausal women may increase blood pressure, so it needs to be early anticipation by increasing healthy behavior and health education for the community. Keywords: Hypertension; obesity; postmenopausal; wome

The state of health in Indonesia's provinces, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Analysing trends and levels of the burden of disease at the national level can mask inequalities in health-related progress in lower administrative units such as provinces and districts. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to analyse health patterns in Indonesia at the provincial level between 1990 and 2019. Long-term analyses of disease burden provide insights on Indonesia's advance to universal health coverage and its ability to meet the United Nations Sustainable Development Goals by 2030. Methods We analysed GBD 2019 estimated cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 286 causes of death, 369 causes of non-fatal health loss, and 87 risk factors by year, age, and sex for Indonesia and its 34 provinces from 1990 to 2019. To generate estimates for Indonesia at the national level, we used 138 location-years of data to estimate Indonesia-specific demographic indicators, 317 location-years of data for Indonesia-specific causes of death, 689 location-years of data for Indonesia-specific non-fatal outcomes, 250 location-years of data for Indonesia-specific risk factors, and 1641 location-years of data for Indonesia-specific covariates. For subnational estimates, we used the following source counts: 138 location-years of data to estimate Indonesia-specific demographic indicators; 5848 location-years of data for Indonesia-specific causes of death; 1534 location-years of data for Indonesia-specific non-fatal outcomes; 650 location-years of data for Indonesia-specific risk factors; and 16 016 location-years of data for Indonesia-specific covariates. We generated our GBD 2019 estimates for Indonesia by including 1 915 207 total source metadata rows, and we used 821 total citations. Findings Life expectancy for males across Indonesia increased from 62·5 years (95% uncertainty interval 61·3–63·7) to 69·4 years (67·2–71·6) between 1990 and 2019, a positive change of 6·9 years. For females during the same period, life expectancy increased from 65·7 years (64·5–66·8) to 73·5 years (71·6–75·6), an increase of 7·8 years. There were large disparities in health outcomes among provinces. In 2019, Bali had the highest life expectancy at birth for males (74·4 years, 70·90–77·9) and North Kalimantan had the highest life expectancy at birth for females (77·7 years, 74·7–81·2), whereas Papua had the lowest life expectancy at birth for males (64·5 years, 60·9–68·2) and North Maluku had the lowest life expectancy at birth for females (64·0 years, 60·7–67·3). The difference in life expectancy for males between the highest-ranked and lowest-ranked provinces was 9·9 years and the difference in life expectacy for females between the highest-ranked and lowest-ranked provinces was 13·7 years. Age-standardised death, YLL, and YLD rates also varied widely among the provinces in 2019. High systolic blood pressure, tobacco, dietary risks, high fasting plasma glucose, and high BMI were the five leading risks contributing to health loss measured as DALYs in 2019. Interpretation Our findings highlight that Indonesia faces a double burden of communicable and non-communicable diseases that varies across provinces. From 1990 to 2019, Indonesia witnessed a decline in the infectious disease burden, although communicable diseases such as tuberculosis, diarrhoeal diseases, and lower respiratory infections have remained a main source of DALYs in Indonesia. During that same period, however, all-ages death and disability rates from non-communicable diseases and exposure to their risk factors accounted for larger shares of health loss. The differences in health outcomes between the highest-performing and lowest-performing provinces have also widened since 1990. Our findings support a comprehensive process to revisit current health policies, examine the root causes of variation in the burden of disease among provinces, and strengthen programmes and policies aimed at reducing disparities across the country. Funding The Bill & Melinda Gates Foundation and the Government of Indonesia. Translation For the Bahasa Indonesia translation of the abstract see Supplementary Materials section