PERAN JAMINAN KESEHATAN TERHADAP PEMANFAATAN TENAGA KESEHATAN SEBAGAI PENOLONG PERSALINAN DI INDONESIA (ANALISIS DATA SUSENAS 2017)

Background: The global maternal mortality ratio in 2015 was 216 deaths per 100,000 live births due to complications during pregnancy and delivery. The utilization of birth attendants is one of the important indicators that play a role for increasing safe delivery so that it can prevent maternal and child mortality. Objective: Knowing the role of health insurance and other related factors towards the utilization of skilled birth attendants in Indonesia. Method: This study uses Susenas data in 2017 with the sample size of 38,485 reproductive age women. The analysis uses logistic regression with the Logit model. Result: The logit test results show that the model is able to explain the data of 9.93 percent. Prob> Chi2 significance value of 0,000 means that all independent variables have a significant effect on the dependent variable. Women who had health insurance were 1,351 times higher to use skilled birth attendant at delivery. Conclusion: The Ownership of health insurance has a significant role towards the utilization of skilled birth attendants in Indonesia in 2017. Likewise with other related factors including increasing age, education ≥ SLTA, urban living areas, parity ≤ 3 people, and economic status in quintiles 2, 3, 4 and 5

EFISIENSI PENYISIHAN ORGANIK AIR SODETAN SUNGAI CITARUM MENGGUNAKAN CONSTRUCTED WETLAND DENGAN TANAMAN Typha sp. DAN Scirpus grossus (STUDI KASUS : DESA DARAULIN, KABUPATEN BANDUNG

Abstrak: Sungai Citarum adalah sungai terpanjang dan terbesar di Provinsi Jawa Barat, Indonesia. Setiap musim hujan di sepanjang Sungai Citarum di wilayah Bandung Selatan selalu dilanda banjir, oleh karena itu pemerintah membuat proyek normalisasi Sungai Citarum. Tetapi hasil proyek itu sia-sia karena tidak ada sosialisasi terhadap masyarakat sekitar sehingga sungai tetap menjadi tempat pembuangan sampah dan limbah pabrik. Kampung Daraulin dikelilingi oleh Sungai Citarum yang sudah tercemar yang diperkirakan mengandung beberapa parameter tercemar seperti BOD, COD, Total Nitrogen, Total Fosfat, serta TSS. Salah satu konsep yang dapat digunakan untuk menjadi solusi yaitu menggunakan constructed wetland dengan tanaman Typha sp. dan Scirpus grossus. Penelitian dilakukan sebanyak 2 kali running dengan media ijuk, kerikil, dan tanah lembang. Efisiensi penyisihan rata-rata pada constructed wetland untuk parameter COD adalah 89,7%  untuk reaktor I dan 87.6% untuk reaktor II;  untuk parameter NTK sebesar 31,4% untuk reaktor I dan sebesar 26,4 untuk reaktor II; untuk parameter nitrit adalah sebesar 90,5%  untuk reaktor I dan sebesar 94,1% untuk reaktor II; untuk parameter nitrat sebesar  94,9% untuk reaktor I dan sebesar 84.6% untuk reaktor II; untuk parameter ammonium mengalami kenaikan sebesar  142,4% untuk reaktor I dan sebesar 121,9% untuk reaktor II ; untuk parameter total fosfat sebesar  72,7% untuk reaktor I dan sebesar 62,04% untuk reaktor II; untuk parameter TSS sebesar  95,5% untuk reaktor I dan sebesar 92,4% untuk reaktor II; untuk parameter BOD sebesar  86,9% untuk reaktor I dan sebesar 69,9 untuk reaktor II. Nilai efluen reaktor memenuhi  baku mutu PP No. 82 Tahun 2001 kelas II.Kata kunci: constructed wetland, Desa Daraulin, Scirpus Grossus, Sungai Citarum, Typha sp. Abstract : The Citarum River is the longest and largest river in West Java province, Indonesia. Every rainy season along the Citarum River in South Bandung area is always flooded, therefore the government makes the normalization of the Citarum River project. But the project was in vain because there is no socialization of the surrounding community so that the river remains in landfills and sewage plants. Daraulin village surrounded by the already polluted Citarum River is estimated to contain several parameters such as polluted BOD, COD, Total Nitrogen, Total Phosphate, as well as TSS. One concept that can be used to be a solution that uses a constructed wetland plants Typha sp. and Scirpus Grossus. The research was conducted two times running with the fiber media, gravel, and bare soil. Elimination of average efficiency in constructed wetland to 89.7% COD parameter for reactor I and 87.6% for reactor II; to NTK parameters of 31.4% for reactors I and II at 26.4 for the reactor, because nitrite parameters amounting to 90.5% for reactors I and 94.1% for reactor II; parameters for nitrate 94.9% for reactors I and at 84.6% for reactor II; to the parameters of ammonium increased by 142.4% to the reactor I and 121.9% with the reactor II; to the parameters of the total phosphate 72.7% for reactors I and at 62.04% for reactors II; to 95.5% TSS parameters for reactors I and at 92.4% for reactor II; for the parameter BOD of 86.9% for reactors I and II at 69.9 for the reactors. The reactor effluent meets the standards of quality PP. 82 of 2001 class II. Key words: Citarum River, constructed wetlands, Daraulin Village, Scirpus grossus,Typha sp.

Analysis of Partnership of Private Practice Midwife in The National Health Insurance Program in District Bungo Jambi Province

On January 1, 2014, the government began to implement the National Health Insurance (NHI) program to realize social welfare for the whole community. Midwifery and neonatal care in the NHI program involves Puskesmas/family doctors and Private Practice Midwife (PPM) as its network. PPM participation in the NHI program in Bungo District was still lacking, only 12 (54.5%) PPM have cooperated with family doctors from 22 existing PPM. This study aimed to get an overview of PPM participation in the NHI program in Bungo District, Jambi Province. The study used qualitative research approach with Rapid Assessment Prosedur design, purposive sampling, and conducted in-depth interview to 10 PPM, Head of Health Office, MPKP BPJS Health Manager, and Chairman of Bungo Regency Section of Indonesian Midwife Organization (IMO). The study was conducted from January to July 2017. The study found that the knowledge, perceptions and attitude towards NHI program were good, but the perceived toward the claim and predetermined tariff procedures were not so good. PPM motivated to join the NHI program as many patients had become NHI participants. Support from the Government, NHI, and IMO were low, either in the form of socialization, or policies. Therefore, the study suggest an improvement in claims procedures, tariffs, and an increase of socialization from government, NHI and IMO on NHI program related to obstetric and neonatal care

PENYISIHAN ZAT WARNA NAPHTHOL PADA LIMBAH CAIR BATIK DENGAN METODE ADSORPSI MENGGUNAKAN ADSORBEN TANAH LIAT DAN REGENERASINYA

Abtrak: Industri Kecil Menengah (IKM) batik merupakan salah satu penghasil limbah cair yang berasal dari proses pewarnaan dengan kandungan zat warna yang tinggi juga mengandung bahan-bahan kimia sintetis yang cukup stabil dan sukar untuk diuraikan/didegradasi secara alami, sehingga dapat membahayakan lingkungan sekitar. Apabila konsentrasi yang dibuang ke lingkungan cukup tinggi maka dapat menaikkan nilai COD (Chemical Oxygen Demand). Salah satu metode pengolahan limbah cair khususnya hasil proses pewarnaan batik, saat ini yang banyak dilakukan penelitian dan pengembangan adalah adsorpsi dengan menggunakan berbagai jenis adsorben yang berbeda beda. Alternatif lain jenis adsorben yang digunakan adalah tanah liat (clay), hal ini dilakukan mengingat keberadaan tanah liat melimpah di alam dan merupakan bahan alami yang dapat ditemukan hampir di semua wilayah Indonesia khususnya di Bandung, Jawa Barat. Zat warna naphthol merupakan salah satu pewarna sintetis yang digunakan dalam pembuatan batik. Pada penelitian ini dilakukan proses adsorpsi menggunakan limbah cair yang mengandung zat warna naphthol dari hasil proses pembuatan batik dengan adsorben tanah liat dan regenerasinya. Hasil penelitian menunjukkan efisiensi terbesar untuk adsorben tanpa modifikasi adalah 65,648% dengan dosis 1,5 gr dan waktu kontak 30 menit, sedangkan adsorben dengan modifikasi didapat efisiensi sebesar 82,809% untuk dosis 2 gr dan waktu kontak 60 menit. Kinetika yang menggambarkan proses adsorpsi adalah kinetika pseudo orde 2 untuk kedua adsorben dan isoterm adsorpsi adalah isotherm Freundlich. Kata kunci: adsorpsi, tanah liat, napthol, isoterm Abstract: Small and medium industry (IKM) batik is one of the producers of liquid waste that comes from the process of staining with substances of high color also contains synthetic chemicals that are fairly stable and difficult to untangle/degradation in naturally, so that can harm the environment. When the concentration of dumped into the environment high enough then it can raise the value of COD (Chemical Oxygen Demand). One of the liquid waste processing methods in particular results of batik coloring process, which is currently much research and development is carried out adsorption using various types of different adsorbents. Other alternative types of adsorbents used is clay, this is done considering the existence of clay abundant in nature and are the natural ingredients that can be found in almost all regions of Indonesia especially in Bandung, West Java. Naphthol color substances is one of the synthetic dyes are used in the making of Batik. On the research of the adsorption process was carried out using liquid waste containing the substance the color results from naphthol batik processing with adsorbent clay and its regeneration. The results showed the greatest efficiency for adsorbents without modification was 65.648% with a dose of 1.5 grams and a contact time of 30 minutes, while the adsorbent with modification obtained efficiency of 82.809% for a dose of 2 grams and 60 minutes contact time. Kinetics that describes the process of adsorption is a pseudo second-order kinetics for both the adsorbent and adsorption isotherm is Freundlich.Keywords: adsorption, clay, naphthol dyes, isother

Microplastic Removal from Road Stormwater Runoff using Lab-scale Bioretention Cell

Microplastic removal from stormwater runoff from roads is necessary to reduce the effect of microplastic pollution in water bodies. Bioretention is a potential technology to remove microplastics in stormwater runoff from roads. A lab-scale experiment was conducted to determine the efficiency, effect on vegetation and discharge variation, and the kinetics of microplastic removal from stormwater runoff from roads using a bioretention cell. The experiment was done using an artificial sample based on visual characterization of stormwater runoff from highways, commercial, and residential roads. The vegetations that were examined were Vetivera sp. and Hibiscus sp. The operational discharge was varied based on rainfall intensity categories. The result showed that the removal efficiency was in the range of 92.4 to 99.3% with a mean of 97.2%. Statistical analysis (α = 5%) showed that variation in vegetation and discharge had no significant effect on microplastic removal using bioretention. The first-order kinetic analysis showed that the kinetic removal constant of the bioretention with Vetivera sp., bioretention with Hibiscus sp., and bioretention without vegetation was 0.0356, 0.034, and 0.0327, respectively. These results indicate that bioretention with Hibiscus sp. removed more microplastics at greater depths than with Vetivera sp

ANALISIS MANAJEMEN ANGGARAN PADA RUMAH SAKIT RUJUKAN DI MASA PANDEMI COVID-19

Manajemen anggaran merupakan salah satu bentuk pertanggungjawaban pengelolaan anggaran kas yang didistribusikan oleh pemerintah kepada instansi rumah sakit sehingga anggaran yang diberikan oleh pemerintah pusat dapat dipergunakan secara efektif, efisien dan tepat sasaran.  Untuk mengkaji dan mengeksplorasi manajemen anggaran pada rumah sakit di Indonesia di masa pandemi COVID-19 berkaitan dengan anggaran pengadaan APD dan sarana prasarana di rumah sakit sebagai upaya penanggulangan pandemi COVID-19. APD merupakan salah satu instrumen krusial yang harus digunakan oleh seluruh tenaga medis dalam melaksanakan tugasnya, hal ini memicu peningkatan anggaran pengadaan APD. Literature review dengan mengkaji penelitian terdahulu yang relevan. Manajemen anggaran dalam rumah sakit belum terkategori efektif dan efisien sehingga diperlukan perencanaan dan manajemen anggaran yang lebih matang bagi rumah sakit untuk mengelola anggaran. Pengalokasian dana yang dilakukan pada beberapa rumah sakit di Indonesia direalisasikan dengan melakukan pembelian alat dan juga perlengkapan APD untuk menambahkan sarana dan prasarana yang digunakan dalam penanggulangan COVID-19

EFFECTIVENESS OF CTL-BASED STUDENT WORKSHEET IN MEMBRANE TRANSPORT MATTER TO FACILITATE STUDENT’S CRITICAL THINKING ABILITY

Abstract The purpose of the research is to know the effectiveness of CTL-based worksheet that facilited the student’s critical thinking ability in membrane transport matter. This research is done by limited trial implementation of valid CTL-based worksheet that developed before and involved 20 students of MIA 2 of Senior High School 2 Kediri on April 2019. Technique of data analysis in this research is descriptive quantitatively. The result of enhancement of student critical thinking ability was shown by improvement of every indicators critical thinking ability after learning by CTL-based worksheet. The pre-test percentage of interpretation, inference, analysis, explanation and evaluation succesively was 62.50%; 57.91%; 57.00%; 51.25% dan 41.25%. Then the post-test percentage was 78.75%; 82.91%; 86.00%; 76.25% dan 63.75%. Besides the percentage of every indicators, the improvement of student’s critical thinking ability was shown by gain score that was 0.53 with middle category. Then efectiveness was based on the student’s postitive responses that reach about 91.60% including the very good category. Keywords : student worksheet, CTL, critical thinking ability, membrane transpor

PENGARUH KADAR AIR PADA PENGOLAHAN LUMPUR TINJA TANGKI SEPTIK BERBASIS TERRA PRETA SANITATION

Abstrak: Ekskreta manusia (feces dan urin) berkontribusi kecil dalam volume tetapi merupakan penyebab utama dari pencemaran air. Pendekatan sanitasi berbasis ekologi (ecological sanitation) mempertimbangkan limbah (kotoran) manusia sebagai sumber daya dibandingkan dengan limbah. Salah satu konsep ecological sanitation yang sedang dikembangkan adalah Terra Preta Sanitation (TPS). Terra Preta Sanitation merupakan suatu konsep sanitasi dengan tujuan akhir untuk meningkatkan kesuburan tanah, tetapi mampu mengatasi masalah bau yang tidak enak dengan adanya proses laktofermentasi dan vermikompos. Saat  ini,  konsep  Terra  Preta  diadopsi  dan  dikembangkan menjadi  konsep  alternatif pengolahan limbah cair dan limbah padat domestik/rumah tangga. Tujuan utama dari penelitian ini adalah optimaisasi proses laktofermentasi pada pengolahan lumpur tinja tangki septic. Pada penelitian ini dilakukan pengolahan lumpur tinja yang berasal dari 3 tangki septik dengan variasi kadar air untuk mengetahui  pengaruh  kadar  air  pada  proses  laktofermentasi. Variasi  kadar  air  dilakukan  dengan pengurangan 10% air sampel dan penambahan 0%, 10% dan 20% air pencampur. Reaktor yang digunakan merupakan reaktor batch anaerob dengan kapasitas 2,5 liter. Bakteri yang digunakan berasal dari bakteri kultur campuran jenis EM4  (Effective Microorganism 4) sebanyak 20% dari volume efektif reaktor, sedangkan untuk co-substrat digunakan larutan glukosa dan air keran sebagai air pencampur. Penelitian ini dilakukan selama 21 hari pada suhu ruang. Parameter yang dianalisa seperti pH, kadar air, kadar volatile, Total Organic Carbon (TOC), Total Kjedahl Nitrogen (TKN), Total phosphate, Total Asam Volatile (TAV), amonium, dan H2S. Karakteristik awal sampel tinja memiliki nilai organik tinggi dengan angka TOC sekitar 25000 mg/L. Pada akhir pengolahan, hasil menunjukkan sampel dengan pengurangan10% air sampel memberikan degradasi organic yang lebih baik, konsentrasi H2S dan produksi asam laktat lebih besar. Efisiensi penyisihan karbon organik sekitar 50%, penyisihan NTK sekitar 60%, penyisihan posphat total sekitar 70% dan penyisihan indikator bau yaitu H2S mencapai 90%. Pembentukan asam laktat pada akhir reaksi mencapai 3,9%.  Kata kunci: terra preta sanitation, laktofermentasi, Effective Microorganism 4, tangki septik Abstract : Human excrement (faeces and urine) have small in volume of domestic wastewater but it is the main causes of water pollution. Ecological sanitation considers human wastes as resources rather than waste. A new emerging concept in ecological sanitation is Terra Preta Sanitation (TPS). Terra Preta Sanitation is sanitation concept with final purpose for improve soil fertility, but able to overcome odor problem with lactic acid fermentation and vermicomposting process. Today, TPS concept is adopted and developed to be alternative concept for domestic waste treatment. The main objective of this research is optimizing lactic acid fermentation process in sludge of septic tank treatment. This research conducted with black water treatment from three septic tanks with variation of water content. Water content variations are with 10% sample water reduction, 0%, 10%, and 20% mixing water addition Reactor that used is anaerobic reactor with 2.5 liter capacity. Effective Microorganism 4 (EM4) is used as source of lactic acid bacteria for treat sludge from septic tank. Glucose is used as co-substrate and tap water as mixing water. The study was conducted in 21 days at room temperature. pH, water content, volatile content, Total Organic Carbon (TOC), Total Kjedahl Nitrogen (TKN), Total phosphate, Total Volatile Acid (TVA), ammonium, and H2S are analyzed.  Characteristic of sample have organic content approximately 25000 mg/L. In the end of treatment, the result show, that the sample with 10% sample water reduction had better degradation, lower H2S and greater lactic acid production. Organic carbon removal efficiency about 50%, TKN removal efficiency about 60%, total phosphate efficiency about 70%, and H2S removal efficiency about 90%. Production of lactic acid in the end of reaction time about 3.9%  Key words: terra preta sanitation, lactic acid fermentation, Effective Microorganism 4, septic tank

Optimizing Faecal Sludge Treatment Plant (FSTP) Management through Implementation of Scheduled Faecal Sludge Services (SFSS) (Case Study: Suwung FSTP and Kuta District, Bali)

Indonesia have achieved 79,53% access to improved and safely managed sanitation in 2020. The government has mandated an improvement in sanitation access to 90% through National Mid-Term Development Plan in order to fulfill 100% access to water and sanitation as stated in Sustainable Development Goals (SDGs). The province of Bali was able to achieve improved sanitation access up to 89%, but it is not yet safely managed. One of the government's efforts to achieve safely managed sanitation is through the implementation of septic tank regular desludging program named the Scheduled Faecal Sludge Service (SFSS) system. This research aims to formulate SFSS implementation strategy by assessing user aspect (Willingness to Pay/WTP and Ability to Pay/ATP), financial aspect, and technology aspect. The research methodology used are interview using questionnaires for user aspect; Interactive Septage Management toolkit for financial aspect; and technology audit method combined with pairwise comparison method for technology aspect. Strength-Weakness-opportunity-Threat (SWOT) analysis was used to provide recommendation for implementation strategy. Questionnaires were given to 100 respondents who live in Kuta District and it was found that 87.13% strongly agree with SFSS program, WTP is Rp. 9.110,- and ATP is Rp. 30.050,-. Financial aspect analysis result shows service rate of Rp. 9.722,- per month and 37 desludging trucks are needed to serve Badung Regency and Denpasar City. Technology audit consist of technoware, humanware, infoware and orgaware (THIO) variables and involved 13 key informants. The overall performance of Suwung FSTP was 81.46%, which indicates good performance with the performance of the THIO variables is 72.22%, 86.67%, 90.28%, and 76.67% consecutively. Scenario analysis shows that should SFSS has been implemented in the study area, the FSTP performance can be increased to 89.79%. SWOT analysis result shows that implementation strategy include establishing partnerships with the private sector, combining data management with a centralized system, improving services and making regulations that support the SFSS program

OPTIMASI PENURUNAN WARNA PADA LIMBAH TEKSTIL MELALUI PENGOLAHAN KOAGULASI DUA TAHAP

Abstrak : Limbah tekstil sebagian besar terdiri dari zat warna  yang digunakan untuk proses pencelupan dan pencapan pada kain. Jenis zat warna yang paling sering digunakan  dalam kegiatan industri adalah zat warna reaktif  azo seperti Remazol Red RB 133 yang digunakan dalam penelitian kali ini. Limbah zat warna ini akan sulit  terurai dan menyebabkan pencemaran bila dibuang tanpa melalui pengolahan terlebih dahulu. Penelitian ini bertujuan untuk mengolah limbah warna melalui koagulasi dua tahap (Two Stages Coagulation) yang merupakan proses koagulasi dengan dua kali pembubuhan koagulan disertai dua kali pengadukan cepat dan dilanjutkan satu kali proses flokulasi (Dewi.2008). Proses ini merupakan salah satu alternatif pengolahan air secara koagulasi untuk air dengan warna dan zat organik tinggi (Carlson et al, 2000) dan diperlukan karena proses koagulasi secara konvensional seringkali tidak berhasil pada beberapa kondisi air. Hal ini disebabkan jenis material dalam air berbeda-beda, setiap jenis material membutuhkan kondisi proses koagulasi yang bermacam-macam. Dosis optimum didapat melalui percobaab Jartest, pada pengolahan One Stage Coagulation didapatkan pada 0,2 mg/L Poly Aluminium Chloryde (PAC) dengan kondisi basa (pH 9), efisiensi penurunan konsentrasi warna mencapai 98,11%. Pada Two Stage Coagulation didapatkan dosis optimum yang lebih rendah yaitu 0,16 mg/L sehingga pemakaian PAC menjadi lebih ekonomis. Efisiensi penurunan konsentrasi warna mencapai 100% dengan membagi dosis koagulan secara merata (50:50) untuk setiap tahap diikuti pengaturan pH pada kondisi asam untuk tahap pertama dan kondisi basa untuk  tahap kedua. Namun secara garis besar, kondisi pH netral (pH 7) untuk kedua tahap juga memberikan hasil yang cukup maksimal.Abstract : Wastewater from textile industries consist of dye which is used for dyeing and printing the fabrics. Most of dye types commonly used are reactive azo such as Remazol Red RB 133 which is used in this research. It was undegradable and can caused pollution if  it was disposed without a treatment. This research done to treat dyes wastewater with Two Stages Coagulation. It is a kind of process which coagulant added and rapid mixing were done two times and followed with a flocculation process (Dewi, 2008)  . Two stages coagulation is one of water treatment alternatives by coagulation especially for water treatment with high color and organic matter (Carlson et al,2000). Because of mineral variaty in the water, some conventional coagulation are often not success to remove them, so it necessary to get an optimum condition of coagulation.The efficiency of Poly Aluminium Chloryde (PAC) in discoloration of dying wastewater has been investigated with the Jartest methode.The results show that  optimum dosage of one stage coagulation was 0,2 mg/L at pH 9, the efficiency of removal color reaches 98,11%. While the optimum dosage of Two Stages Coagulation is 0,16mg/L,  lower than One Stage Coagulation so that the consumption of PAC can be minimazed. The color removal efficiency reaches 100% by dividing coagulant added 50% of dosage for the first stage and the 50% other for the second stage, The pH adjustmet for the first stage before coagullant added was 5 (acid condition) and then pH should be incresed till 9 for the second stage. But, for overall the neutral condition (pH 7) give the optimum performance for color removal. But initially, when the initial pHis neutral for both stages, the two stages coagulation gives the best performance to color removal.Key words:  One Stage Coagulation,  pH, Poly Aluminium Chloryde (PAC), Two Stages Coagulatio