Factors Associated with Women\u27s Decision to Become Commercial Sex Workers in Banjarsari, Surakarta, Central Java

Background: In Indonesia, the number of new HIV cases in 2016 was 41.250, and AIDS cases was 7,491. HIV infection predominantly (67.6%) occur heterosexually. In Central Java, the number of Di Indonesia, new HIV cases in 2016 was 4.032, and AIDS cases was 1.402. Surakarta City has the second highest cases of HIV in Central Java after Semarang District with 38 HIV cases and 46 AIDS cases in September 2017. This study aimed to analyze factors associated with women\u27s decision to become commercial sex workers in Banjarsari.Subjects and Method: This was an analytical observational study with case control design. The study was conducted in Banjarsari, Surakarta, Central Java. A total sample of 200 study subjects consisting of 100 female commercial sex workers and 100 non sex workers. The dependent variable was women\u27s decision to become commercial sex worker. The independent variables were knowledge of sexually-transmitted disease, family income, pro-commercial sex worker family support, snobbish life style, and access to whore house. The data were collected by questionnaire and analyzed by multiple logistic regression.Results: Women\u27s decision to become commercial sex worker was negatively associated with good knowledge of sexually-transmitted disease (OR= 0.03; 95% CI= 0.01 to 0.18; p<0.001), high family income (OR= 0.01; 95% CI<0.01 to 0.05; p<0.001). Women\u27s decision to become commercial sex worker was positively associated with strong pro-commercial sex worker family support (OR=8.15; 95% CI= 2.63 to 25.23; p<0.001), snobbish life style (OR= 6.20; 95% CI= 1.81 to 21.24; p= 0.004), and access to whore house (OR= 8.52; 95% CI=2.49 to 29.17; p= 0.001).Conclusion: Women\u27s decision to become commercial sex worker has negative association with good knowledge of sexually-transmitted disease, high family income. Women\u27s decision to become commercial sex worker has positive association with strong pro-commercial sex worker family support, life style, and access to whore house.Keyword: Women\u27s decision, commercial sex worker, knowledge, family income, family support, life style, access to whore houseCorrespondence: Syefira Ayudia Johar. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6282136422448.Journal of Epidemiology and Publich Health (2018), 3(1): 72-82https://doi.org/10.26911/jepublichealth.2018.03.01.0

Life Course Perspective of the Factors Affecting Overweight and Obesity in Children Under Five: A Path Analysis Evidence from Surakarta

Background: Obesity is a public health problem that has raised concern worldwide. According to the World Health Organization, there will be about 2.3 billion overweight people aged 15 years and above, and over 700 million obese people worldwide in 2015. Being overweight or obese in childhood can contributes to numerous health conditions in adulthood including: hypertension, high LDL cholesterol, low HDL cholesterol or high levels of triglycerides, type 2 diabetes, coronary heart disease, and stroke. This study aimed to analyze the life course factors affecting overweight and obesity in children aged 2 to 5 years old in Surakarta, Central Java. Subjects and Method: This was a case control study was conducted in 5 community health centers, Surakarta, Central Java, from September to October 2017. A sample of 150 children aged 2 to 5 years old was selected for this study by fixed disease sampling. The dependent variable was overweight or obesity. The independent variables were nutrition intake, exclusive breastfeeding, starting age of complementary feeding, physical activity, birthweight, age of gestation, sectio cesarea labor, maternal body mass index, and maternal job. Physical activity data was measured using Pre PAQ questionnaire. Other data were collected using a set of questionnaire and maternal and child health monitoring book. The data were analyzed by path analysis. Results: Overweight and obesity in children aged 2 to 5 years old were positively affected by over nutrition intake (b= 1.9; 95% CI= 0.15 to 3.60; p= 0.033), high maternal body mass index (b= 2.0; 95% CI= 0.51 to 3.42; p= 0.008), and sectio cesarean birth (b= 2.1; 95% CI= 0.56 to 3.73; p= 0.008). Overweight and obesity in children aged 2 to 5 years old were negatively affected by normal birthweight (b= -2.2; 95% CI= -4.28 to -0.19; p= 0.032), exclusive breastfeeding (b= -2.0; 95% CI= -3.60 to -0.39; p=0.015), timely starting age of complementary feeding (b= -1.3; 95% CI= -2.80 to 0.11; p=0.072), and high physical activity (b= -3.0; 95% CI= -4.63 to -1.37; p= 0.001). Overweight and obesity in children aged 2 to 5 years old were indirectly affected by age of gestation and working outside the house. Conclusion: Overweight and obesity in children aged 2 to 5 years old are positively affected by over nutrition intake, high maternal body mass index, and sectio cesarean birth. Overweight and obesity in children aged 2 to 5 years old are negatively affected by normal birthweight, exclusive breastfeeding, timely starting age of complementary feeding, and high physical activity. Keywords: life course factors, overweight, obesity, path analysis

Women’s Decision to Become Commercial Sex Workers in Banjarsari, Surakarta, Central Java, and its Associated Factors

Background: Worldwide, an estimated 33 million people are living with Human Immuno Deficiency Virus (HIV). Sex workers are 10 times more at risk of HIV compared with the general population, due to an increased likelihood of being economically vulnerable, unable to negotiate consistent condom use, and experiencing violence, criminalisation and marginalisation. Little is known about factors associated with the decision to work as a female sex worker in Indonesia. This study aimed to examine factors associated with women’s decision to become commercial sex workers in Banjarsari, Surakarta, Central Java. Subjects and Method: This was a case control study conducted in Banjarsari, Surakarta, Central Java. A total sample of 200 study subjects consisting of 100 female commercial sex workers and 100 non sex workers. The dependent variable was women’s decision to become commercial sex worker. The independent variables were knowledge of sexually-transmitted disease (STDs), family income, pro-commercial sex worker family support, snobbish life style, and access to whore house. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Women’s decision to become commercial sex worker was negatively associated with good knowledge of STDs (OR= 0.03; 95% CI= 0.01 to 0.18; p<0.001), high family income (OR= 0.01; 95% CI<0.01 to 0.05; p<0.001). Women’s decision to become commercial sex worker was positively associated with strong pro-commercial sex worker family support (OR= 8.15; 95% CI= 2.63 to 25.23; p<0.001), snobbish life style (OR= 6.20; 95% CI= 1.81 to 21.24; p= 0.004), and access to whore house (OR= 8.52; 95% CI= 2 .49 to 29.17; p= 0.001). Conclusion: Women’s decision to become commercial sex workers decreases with good knowledge of the STDs and higher family income. Women’s decision to become commercial sex workers increases with strong pro-commercial sex worker family support, life style, and access to whore house. Keywords: Women’s decision, commercial sex worker, knowledge, family income, family support, life style, access to whore hous

Path Analysis on Life Course Factors Affecting Overweight and Obesity in Children Aged 2 to 5 Years Old in Surakarta

Background: Globally, prevalence of obesity in children under 5 years old has been increasing from 32 million in 1990 to 42 million in 2014. Indonesia ranks highest in the number of obesity cases in South East Asia with prevalence of 11.5% in 2013. However, child overweight and obesity have not been the focus of health problems in Indonesia. Early intervention and prevention of child obesity can reduce long-term risk of chronic diseases in adulthood. This study aimed to analyze the life course factors affecting overweight and obesity in children aged 2 to 5 years old in Surakarta.Subjects and Method: This was an analytic observational study with case control design. The study was conducted in 5 community health centers, Surakarta, from September to October, 2017. A total sample of 150 children aged 2 to 5 years old was selected using fixed disease sampling. The dependent variable was overweight or obesity. The independent variables were nutrition intake, exclusive breastfeeding, starting age of complementary feeding, physical activity, birthweight, age of gestation, sectio cesarea labor, maternal body mass index, and maternal job. Physical activity data was measured using Pre PAQ questionnaire. Other data were collected using a set of questionnaire and maternal and child health monitoring book. The data were analyzed by path analysis.Results: Overweight and obesity in children aged 2 to 5 years old were positively affected by over nutrition intake (b= 1.9; 95% CI= 0.15 to 3.60; p=0.033), high maternal body mass index (b= 2.0; 95% CI= 0.51 to 3.42; p=0.008), and sectio cesarean birth (b= 2.1; 95% CI= 0.56 to 3.73; p=0.008). Overweight and obesity in children aged 2 to 5 years old were negatively affected by normal birthweight (b= -2.2; 95% CI= -4.28 to -0.19; p=0.032), exclusive breastfeeding (b= -2.0; 95% CI= -3.60 to -0.39; p=0.015), timely starting age of complementary feeding (b= -1.3; 95% CI= -2.80 to 0.11; p=0.072), and high physical activity (b= -3.0; 95% CI= -4.63 to -1.37; p=0.001). Birthweight was positively affected by age of gestation (b= 4.2; 95% CI= 1.99 to 6.32; p=0.001) and was negatively affected by maternal body mass index (b= -1.1; 95% CI= -2.11 to -0.13; p=0.025). Exclusive breastfeeding was negatively affected by working outside the house (b= -1.4; 95% CI= -2.10 to -0.72; p= 0.001).Conclusion: Overweight and obesity in children aged 2 to 5 years old are positively affected by over nutrition intake, high maternal body mass index, and sectio cesarean birth. Overweight and obesity in children aged 2 to 5 years old are negatively affected by normal birthweight, exclusive breastfeeding, timely starting age of complementary feeding, and high physical activity.Keyword: life course factors, overweight, obesity, path analysis.Correspondence: Uyunun Nudhira. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285253781714Journal of Epidemiology and Public Health (2017), 2(3): 267-283https://doi.org/10.26911/jepublichealth.2017.02.03.0

Predictors of Intra-Uterine Device Uptake: Application of Theory of Planned Behavior and Path Analysis

Background: Promotion of family planning and ensuring access to preferred contraceptive methods for women and couples is essential to securing the well-being and autonomy of women, while supporting the health and development of communities.Contrary to popular misconception, intrauterine device (IUD) is a safe and highly effective contraceptive for women who have never been pregnant. IUDs are a great option for a woman who may want to become pregnant in the future but also desires long-term, highly effective pregnancy prevention. As many as 214 million women of reproductive age in developing countries who want to avoid pregnancy are not using a modern contraceptive method such as IUD. This study aimed to investigate predictors of intrauterine device uptake using Theory of Planned Behavior and path analysis. Subjects and Method: A case-control study was carried out in Boyolali, Central Java, from April to June 2018. A sample of 200 women was selected by sim¬ple random sampling. The dependent variable was IUD uptake. The independent variables were age, family income, intention, attitude, perceived behavior control, and husband support. The data were collected by questionnaire and analyzed by path analysis. Results:Strong intention (b= 1.14; 95%CI= 0.36 to 1.92; p= 0.004), strong perceived behaviour control (b= 2.16; 95%CI= 1.36 to 2.97; p<0.001), and higher family income (b= 2.59; 95%95%= 1.79 to 3.39; p<0.001), positively predicted IUD uptake. The use of IUD was indirectly affected by husband support, maternal education, and attitude. Conclusion: Strong intention, strong perceived behaviour control, and higher family income, positively predict IUD uptake. The use of IUD is indirectly affected by husband support, maternal education, and attitude. Keywords: intrauterine device uptake,Theory of Planned Behavior, path analysi

Safe Sex Behavior among Commercial Sex Workers in Banjarsari, Surakarta, Central Java, and its Associated Factors

Background: Worldwide it is estimated that more than one million people in contract sexually-transmitted disease (STDs) everyday. Annually approximately 357 million new infections occur by one of four STDs: chlamidia, gonorrhea, syphilis, and mouth ulcer. The incidence of HIV/AIDS has been increasing year by year. HIV/AIDS has spread in 407 of 507 districts and municipalities in Indonesia, or equivalently covering 80% districts and municipalities of the country. In Surakarta, the cumulative incidence of HIV/AIDS from 2005 to 2017 was 561 cases, with 38 HIV cases and 46 AIDS cases in 2017 alone. Safe sex is important to prevent pregnancy, STDs, and most importantly HIV and AIDS. This study aimed to examine factors associated with safe sex behavior among commercial sex workers in Banjarsari, Surakarta, Central Java. Subjects and Method: This was a cross-sectional study conducted in Banjarsari Sub-district, Surakarta, Central Java. A total sample of 100 commercial sex workers was selected by stratified random sampling. The dependent variable was safe sex behavior. The independent variables were knowledge of STDs and HIV/AIDS, self efficacy, condom availability, access to health care service, health personnel support, and peer support. The data were collected by questionnaire and analyzed by a multiple linear regression. Results: Safe sex behavior was associated with good knowledge of STDs and HIV/AIDS (b= 0.19; 95% CI= 0.01 to 0.30; p= 0.032), strong self efficacy (b= 0.18; 95% CI= 0.01 to 0.38; p= 0.047), condom availability (b= 0.30; 95% CI= 0.36 to 1.20; p<0.001), good access to health care service (b= 0.19; 95% CI= 0.02 to 0.52; p= 0.035), strong health personnel support (b= 0.18; 95% CI= 0.01 to 0.57; p= 0.041), strong peer support (b=0.17; 95% CI= 0.01 to 0.50; p= 0.046). Conclusion: Safe sex behavior is associated with good knowledge of STDs and HIV/AIDS, strong self efficacy, condom availability, access to health care service, strong health personnel support, and strong peer support. Keywords: safe sex behavior, knowledge, self efficacy, condom availability, access to health service, health personnel support, peer suppor

FACTORS ASSOCIATED WITH STUNTING AND WASTING IN CHILDREN AGED 12-48 MONTHS: AN EVIDENCE FROM LAMPUNG

Background: Stunting and wasting are a growth disorder in children under five. Stunting impedes human development, globally affecting 162 million children under five. Stunting is generally caused by recurrent acute malnutrition, whereas wasting occurs due to short-term malnutrition. Wasting indicates a recent and severe process of weight loss, which is often associated with acute starvation and/or severe disease. The prevalence of wasting is usually below 5% even in poor countries. Wasting is caused by the same factors that contribute to stunting. If untreated properly, stunting and wasting may cause low intelligence in adult life. This study aimed to determine factors associated with stunting and wasting in children aged 12-48 months. Subjects and Method: This was a case-control study conducted at Mulya Asri, Panaragan, and Da­ya­mur­ni community health centers, Lampung, from January to February 2018. A sample of 150 children under-five was selected for this study by fixed disease sampling. The dependent variables were stunting and wasting. The independent variables were birthweight, maternal knowledge, maternal education, maternal nutritional status (mid-upper arm circumference/ MUAC), exclusive breastfeeding (EBF), upper respiratory tract infection (URTI), diarrhea, lack of clean water, poor sanitation. The data were collected by questionnaire and maternal and child health monitoring book. The data were analyzed by a logistic regression. Results: The risk of stunting increased with poor maternal knowledge (OR= 5.29; 95% CI= 1.30 to 21.54; p=0.002), low maternal education (OR=10.25; 95%CI= 2.26 to 46.79; p=0.003), poor maternal nutritional status (OR= 8.87; 95%CI= 2.14 to 36.74; p=0.003), low birthweight (OR= 9.86; 95%CI=2.60 to 37.47; p=0.001), no EBF (OR= 5.70; 95%CI= 1.59 to 20.46; p=0.008). The risk of wasting increased with poor knowledge (OR= 10.95; 95%CI= 2.14 to 56.91; p= 0.004), low family income (OR= 7.04; 95%CI= 5.51 to 32.78; p=0.013), low birthweight (OR= 14.71; 95%CI= 2.74 to 79.06; p=0.002), URTI history (OR= 4.87; 95%CI= 1.23 to 19.38; p=0.024), diarrhea (OR= 6.09; 95%CI= 1.42 to 26.20; p=0.015), a lack of clean water (OR= 9.78; 95%CI= 2.26 to 42.36; p=0.002), and poor sanitation (OR= 7.67; 95%CI= 1.85 to 31.75; p=0.004). Conclusion: The risk of stunting and wasting are affected by birthweight, URTI history, diarrhea, EBF, maternal nutritional status, maternal knowledge, maternal education, family income, lack of clean water, and poor sanitation. Keywords: stunting, wasting, biopsychosocial, determinant

IMPLEMENTASI REKAM MEDIS ELEKTRONIK DI RUMAH SAKIT KELAS D, KABUPATEN SERANG, PROVINSI BANTEN: PENDEKATAN PATH ANALYSIS

Pendahuluan: Pandemi Covid-19 mendorong akses pelayanan kesehatan dengan pengembangan transformasi digital kesehatan. Sehingga, penting untuk penerapan sumber daya manusia dan digitalisasi kesehatan berkaitan dengan rekam medis elektronik (RME). Isu penelitian mengkaji kesiapan rumah sakit untuk transformasi rekam medis digital dengan implementasi RME. Metode: Penelitian ini menggunakan desain kausalitas eksplanatori dengan pendekatan survei, dan data primer dengan sampel berjumlah 76. Teknik pengambilan sampel menggunakan sampel jenuh. Horizon waktu dengan cross-sectional. Unit analisis adalah individu manajer dan karyawan rumah sakit yang menggunakan rekam medis. Analisis data menggunakan path analysis. Hasil dan Pembahasan: Hasil penelitian menunjukkan bahwa persepsi kegunaan, efikasi diri, dan kesadaran teknologi RME, melalui niat memiliki pengaruh yang signifikan terhadap kesiapan implementasi RME; persepsi kegunaan berpengaruh signifikan terhadap niat; persepsi kegunaan berpengaruh signifikan terhadap kesiapan implementasi RME; efikasi diri tidak berpengaruh terhadap niat; efikasi diri berpengaruh signifikan terhadap kesiapan implementasi RME; kesadaran teknologi tidak berpengaruh terhadap niat; kesadaran teknologi RME tidak berpengaruh terhadap kesiapan implementasi RME; niat berpengaruh signifikan terhadap kesiapan implementasi RME. Niat untuk menggunakan RME tidak memediasi variabel eksogen ke variabel endogen. Kesimpulan: Temuan penelitian menunjukkan bahwa manajemen rumah sakit melakukan penundaan implementasi RME meskipun memiliki kesiapan untuk mengimplementasikan RME, tidak sadar dalam proses penggunaan RME, meskipun memiliki keyakinan untuk dapat menggunakan RME