HIV Patients Drop Out in Indonesia: Associated Factors and Potential Productivity Loss

Aim: this study reported various factors associated with a higher probability of HIV patients drop out, and potential productivity loss due to HIV patients drop out. Methods: we analyzed data of 658 HIV patients from a database in a main referral hospital in Bandung city, West Java, Indonesia from 2007 to 2013. First, we utilized probit regression analysis and included, among others, the following variables: patients’ status (active or drop out), CD4 cell count, TB and opportunistic infection (OI), work status, sex, history of injecting drugs, and support from family and peers. Second, we used the drop out data from our database and CD 4 cell count decline rate from another study to estimate the productivity loss due to HIV patients drop out. Results: lower CD4 cell count was associated with a higher probability of drop out. Support from family/peers, living with family, and diagnosed with TB were associated with lower probability of drop out. The productivity loss at national level due to treatment drop out (consequently, due to CD4 cell count decline) can reach US$365 million (using average wage). Conclusion: first, as lower CD 4 cell count was associated with higher probability of drop out, we recommend (to optimize) early ARV initiation at a higher CD 4 cell count, involving scaling up HIV service at the community level. Second, family/peer support should be further emphasized to further ensure treatment success. Third, dropping out from ART will result in a relatively large productivity loss

Determinan Pengeluaran Rokok Elektrik di Kota Bandung

AbstrakPenelitian ini bertujuan untuk menganalisis faktor yang mempengaruhi pengeluaran rokok elektrik di Kota Bandung. Penelitian ini menggunakan Convenience Sampling dan formula Slovin, melakukan wawancara terhadap 200 pengguna rokok elektrik di Kota Bandung. Penelitian ini menggunakan metode Regresi Linear Berganda dengan STATA 12. Variabel yang digunakan adalah total pengeluaran rokok elektrik per bulan, harga alat mesin isap rokok elektrik, motivasi penggunaan rokok elektrik, jumlah rasa cairan rokok elektrik, pengetahuan mengenai resiko penggunaan rokok elektrik, dan status penggunaan ganda rokok konvensional dan rokok elektrik. Hasil regresi menunjukkan bahwa harga alat mesin isap rokok elektrik, motivasi penggunaan rokok elektrik, jumlah rasa cairan rokok elektrik berpengaruh positif dan signifikan pada peningkatan pengeluaran rokok elektrik di Kota Bandung. Sedangkan pengetahuan mengenai resiko penggunaan rokok elektrik tidak signifikan mengurangi tingkat pengeluaran rokok elektrik di kota Bandung. Penelitian ini juga menemukan bahwa status pengguna ganda rokok elektrik dan rokok konvensional berpengaruh negatif tetapi tidak signifikan pada pengeluaran rokok elektrik. Untuk mengurangi penggunaan rokok elektrik di Kota Bandung, pemerintah perlu meningkatkan kampanye kesehatan mengenai bahaya penggunaan rokok elektrik. Bahkan pemerintah seharusnya melarang penggunaan rokok elektrik karena pengaruh pengetahuan rokok elektrik yang tidak signifikan mengurangi konsumsi rokok elektrik.AbstractThis research aims to analyze the factors that affect expenditure decision on electronic cigarettes in Bandung. This research uses the Convenience Sampling and Slovin formula, interviews 200 users of e-cigarettes in Bandung. This paper uses Multiple Linear Regression (MLR) with STATA 12. Total expenditure per month in electronic cigarettes, the price of electronic cigarette suction machine tools, motivation in using electronic cigarettes, the amount of electronic cigarettes liquid taste, knowledge about the risk of using electronic cigarettes, and the status dual user of conventional cigarettes and electronic cigarettes are has been used as variables in this research. The regression result shows that the price of electronic cigarettes, motivation to use electronic cigarettes, the amount of electronic cigarettes liquid taste are positively and significantly correlated with the total expenditure per month for electronic cigarettes in Bandung. In the other hand, knowledge about the risk of using electronic cigarettes not significantly reduces electronic cigarette expenditure. This study also finds that the status of dual users of electronic cigarettes and conventional cigarettes has a negative but not significant effect on electronic cigarette expenditure. To reduce the use of electronic cigarettes, the government needs to increase health campaigns regarding the dangers of electronic cigarettes.Even the government must bans the use of electronic cigarettes because knowledge about electronic cigarettes risk has insignificant effect to reduce consumption of electronic cigarettes

The financial need of feeding infants for the first six months of life in West Java Province of Indonesia and the implications of socioeconomic and mental health factors

Abstract Background In Indonesia, nearly half of all children aged less than six months were not exclusively breastfed in 2017. This study aimed to compare the cost of providing direct or indirect exclusive breastfeeding 0–6 months, partial exclusive breastfeeding and commercial milk formula only. This study also assessed the maternal socioeconomic and mental health factors to providing exclusive breastfeeding. Methods Data were collected in 2018 via a cross-sectional survey of 456 mothers in Bandung City and Purwakarta District, West Java Province, Indonesia, who had children aged less than six months. We used micro-costing to calculate the cost of productivity, equipment, supplies, and training of mothers when providing direct exclusive breastfeeding, indirect exclusive breastfeeding, partial exclusive breastfeeding (a mix of breastfeed and commercial milk formula), and infant formula/commercial milk formula only. Logistic regression was used to determine the impact of several independent variables, including mother’s level of depression, on exclusive breastfeeding. Results To provide direct exclusive breastfeeding, the cost per mother in the first six months is US$81.08, which is less expensive than indirect exclusive breastfeeding (US$171.15), partial exclusive breastfeeding (US$487.8) and commercial milk formula (US$494.9). We also found that education and age are associated with the decision to provide direct exclusive breastfeeding. Mothers who work will most likely provide indirect exclusive breastfeeding, commercial milk formula, or partial breastfeeding as opposed to direct exclusive breastfeeding. Finally, although severe depression symptoms have a positive relationship with the decision to provide commercial milk formula over direct exclusive breastfeeding, the evidence here is not strong. Conclusions The total cost of providing only commercial milk formula is 6-times higher than the cost of direct exclusive breastfeeding. The presence of severe depression symptoms is positively related to mothers opting for other feeding methods aside of direct exclusive breastfeeding and indirect exclusive breastfeeding. This study shows that direct exclusive breastfeeding is economically preferable to other methods, supports policies to reduce the time cost of exclusive breastfeeding (e.g., paid maternity leave and maternal cash transfers), and addresses the importance of mother’s mental health to ensure successful breastfeeding