Faktor-faktor yang Berhubungan dengan Status Gizi Anak Umur 6-36 Bulan Sebelum dan Saat Krisis Ekonomi di Jawa Tengah

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN STATUS GIZI ANAK UMUR 6-36 BULAN SEBELUM DAN SAAT KRISIS EKONOMI DI JAWA TENGA

Perilaku Konsumsi Tembakau Pelajar SMP Usia 13–15 Tahun di Sumatra dan Jawa (Analisis Indonesia–Gyts 2009) (Behavior Tobacco Consumption Of Junior High School Student Aged 13–15 Years In Sumatra And Java (Analysis Of Indonesia–Gyts 2009))

Background: adolescence is a crucial period that must be maintained properly, because it has a direct and long-termimpact of the act he/she was doing. Baseline Health Research (RISKESDAS) 2007 showed that 59.5% of the causes ofdeath in Indonesia were due non communicable diseases (NCD), and tobacco consumption contributed as trigger of majority of NCD cases. Information related to the behavior of youth tobacco consumption is required to formulate strategicplan to reduce the incidence. Method: standard questionnaires were fi lled by students of 40 junior high schools from 33 districts and cities in Sumatra and Java, with a total sample of 142 classes (covering grades 7 to 9). Results: a total of 3,319 junior high school students aged 13–15 years were covered with a 94.0% response rate. About 20.3% of students was active smokers and 11.5% non-smoker students planned to smoke in 2010. There was 4.2% of active smoker students showed symptoms of addiction to the nicotine in cigarettes. Eight out of 10 active smokers need help to quit smoking. The main factors that motivate junior high school students in Sumatra and Java to smoke were 15.7% of all/most of his close friends smoking and 7 out of 10 junior high school students have at least one parent as smoker. Recommendations: Efforts to prevent children from smoking should be conducted together with support of national tobacco control policies, and the local policies with support from non-governmental organizations, community leaders, health workers, educators, school personnel and families

Analisis Kesesuaian Klaim dengan Realitas Pembayaran Ppk Rujukan dalam Jaminan Kesehatan Masyarakat Miskin

The main goal of health development in lndonesia is providing quality health care and assuring community access to equal health services for all citizen (universal coverage). In assuring the access to health services for the poor. Ministry of Health has launched special health insurance program for the poor (Askeskin). PT Askes was assigned by MOH to manage this program. Therefore, it is very important to improve facilities and management capabilities of health insurance administering bodies and health care providers. These include, improvement in case management, hospital accounting system, medical record, etc. This will be very useful for verification process and reducing the fraud and abuse. This study was conducted in order to provide valuable input for the Improvement of financing mechanism and payment system of referral providers in health insurance program for the poor (Askeskin). The objectives of this study are to calculate hospital claim on case management of Askeskin members and its real payment by PT Askes and to calculate the differences between claim and reimbursement (real payment) based on hospital components. The study design is cross-sectional. A Stratified Random Sampling method was conducted to select the study sites based on Human Development Index (HOI) and Fiscal Capacity (refers to Ministry of Finance Data) of district and city. Districts and cities were then classified into high, middle, or low level. The 3 selected study sites were: Kampar District (HPI 34,1) in Riau Province which represent high HOI; North Bengkulu District (HPI: 30.4) in Bengkulu province which represent middle HOI, and Pontianak City (HPI: 27.7) in West Kalimantan Province which represent low HOI. The results show that tariff agreement of case management for Askeskin members was not in accordance with local real condition. Therefore, clear operational and technical Askeskin guidelines are needed to gain similar perception between PT Askes and health care providers· beside Improvement of socialization activities to the community. The amount of differences between claim and reimbursement varied among study sites. The difference was influenced by following factors: (1) existed guidelines that were not suitable with local specific real demand and (2) disparity among hospital facilities. Hospital with limited facility has difficulty to refer patient to another closed hospital which doesn't have contract with PT Askes. Furthermore, in some cases hospital with good facility cannot optimalize using their advanced equipment for treatment, because not stated in the contract with PT Askes. Contract review, tariff adjustment, and re-negotiation between hospitals and PT Askes should be encouraged to provide better services for Askeskin members

Pengetahuan, Sikap dan Perilaku Ibu Bayi terhadap Pemberian Asi Eksklusif

Latar Belakang: Survei Sosial Ekonomi Nasional (Susenas) menunjukkan grafi k ibu menyusui yang mengalamipenurunan selama tiga tahun terakhir. Tahun 2006, 64,1% ibu memberikan ASI eksklusif kepada bayinya, kemudian tahun2007 turun menjadi 62,2%, dan tahun 2008 menjadi 56,2%. Faktor yang menyebabkan pemberian ASI eksklusif tidakoptimal, antara lain karena faktor si ibu sendiri, tenaga kesehatan, dan produsen susu formula. Metode: Penelitian inimerupakan penelitian kualitatif dengan disain studi kasus, di mana peneliti menggali secara natural tentang pengetahuan,sikap, dan perilaku ibu bayi dalam pemberian ASI Eksklusif. Faktor pemicu (predisposing), faktor pemungkin (enabling)dan faktor penguat (reinforcing) untuk menggambarkan dan memberikan informasi rinci tentang menyusui eksklusif padabayi. Hasil: Hasil penelitian antara lain faktor pemicu dalam pemberian ASI Eksklusif kepada bayi adalah pengetahuan,sikap, dan perilaku ibu, di mana sebagian besar ibu masih belum paham tentang manfaat pemberian ASI Eksklusif. Faktorpekerjaan, pendidikan, dan Balita juga sebagai pemicu untuk terjadinya pemberian ASI Eksklusif kepada bayinya. Faktorpemungkin dalam pemberian ASI Eksklusif adalah Inisiasi Menyusu Dini, tempat melahirkan, dan ketersediaan ruanganuntuk menyusui. Status kesehatan ibu, dukungan keluarga dan petugas yang menolong persalinan sebagai faktor penguatuntuk pemberian ASI Eksklusif kepada bayi. Saran penelitian ini antara lain meningkatkan pengetahuan, sikap, dan perilakuibu dalam pemberian ASI Eksklusif kepada bayi, Kementerian Kesehatan harus mempromosikan tentang ASI Eksklusiflebih intensif, dan membuat pesan dan informasi yang sederhana namun mudah dicerna dan dipahami oleh masyarakat awam; memonitor fasilitas kesehatan dalam mendukung program ASI Eksklusif dan menegakkan disiplin kepada petugaskesehatan yang terlibat mempromosikan susu formula atau makanan padat lainnya dengan sangsi yang tegas. Saran:Kementerian Kesehatan harus menindak tegas Perusahaan yang memproduksi susu formula dan makanan tambahanlainnya yang melanggar peraturan yang sudah ditetapkan; pemerintah menegakkan peraturan tentang penyediaan ruangmenyusui di tempat kerja dan memfasilitasi ketersediaan ruangan menyusui di tempat umum

Penentuan Jumlah Produksi Optimal Cpo Dengan Menggunakan Metode Goal Programming Pada Pabrik Kelapa Sawit PT. Xyz

Dalam manajemen Perusahaan yang baik perencanaan produksi mempunyai peranan penting. Perencanaan produksi pada pabrik dilakukan berdasarkan taksiran permintaan dari pabrik yang membutuhkan Crude Palm Oil (CPO) dan Palm Kernel Oil (PKO) untuk tiap periode. Namun pada Kenyataannya, Perusahaan sering dihadapkan dengan keadaan dimana adanya ketidaksesuaian produksi dengan volume permintaan. Pada periode-periode tertentu karena permintaan produksi yang besar pabrik tidak dapat mencukupi permintaan para konsumennya. Produksi yang tidak dapat dipenuhi adalah pada periode Februari 1304,056 ton, April 2530,185 ton, Agustus 2238,947 ton, Oktober 2271,422 ton, dan Desember 1654,846 ton didalam tahun fiscal 2011. Sedangkan jumlah produksinya bulan Februari 1285,813 ton, April 2524,047 ton, Agustus 2198,283 ton, Oktober 2269,422 ton dan Desember 1646,869 ton. Metode yang dilakukan sebagai solusi optimal untuk menentukan produksi CPO adalah metode Goal Programming. Pengolahan data yang dilakukan dengan meramalkan permintaan dan kemudian diolah dengan program (Linear Interactive Discrete Optimizer) LINDO. Variabel keputusan diambil berdasarkan pada kegiatan yang ada di pabrik yaitu kegiatan produksi CPO dan kegiatan pengadaan TBS. Sasaran yang ingin dicapai dari penelitian ini adalah untuk memperoleh rencana produksi yang optimal sebagai alternatif pemecahan masalah dalam pengoptimalan kapasitas produksi yang masih menganggur. Hasil produksi yang optimal diperoleh dengan pendekatan goal programming untuk periode 2012 adalah Januari 1274,041 ton, Februari 1304,056 ton, Maret 1884,732 ton, April 2491,604 ton, Mei 2358,086 ton, Juni 2210,374 ton, Juli 2048,557 ton, Agustus 2119,203 ton, September 2314,591 ton, Oktober 2234,631 ton, November 2046,007 ton dan Desember 1627,766 ton. Dari hasil perbandingan peramalan permintaan dan pengolahan data dengan metode goal programming maka produksi dinyatakan optimal karena produksi dapat dipenuhi

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