Factors Associated with Use of Intra-Uterine Device in Women of Reproductive Age in Boyolali, Central Java

Background: Family planning is a key strategy for reduction of maternal mortality. Family planning aims to control birth in order to control population growth. Long-acting reversible contraceptives (LARCs), which include intra-uterine device (IUD), are the most effective methods of birth control. Studies into factors affecting the uptake of IUD was lacking in Indonesia. This study aimed to investigate factors associated with use of IUD in women of reproductive age in Boyolali, Central Java, using multilevel analysis model and Theory of Planned Behavior.Subjects and Method: This was a case control study carried out in 25 posyandus (integrated community health posts) in Boyolali, Central Java, from April to June 2018. A sample of 200 women was selected by simple random sampling. The dependent variable was IUD use. The independent variables were education, family income, intention, attitude, subjective norm, perceived behaviour control, and husband support. The data were collected by questionnaire and analyzed by a multilevel logistic regression on Stata 13.Results: IUD use among women reproductive age increased with higher maternal education (b= 4.06; 95% CI= 0.68 to 7.44; p=0.019), higher family income (b= 3.90; 95% CI= 1.67to 7.64; p=0.041), positive attitude (b= 4.54; 95% CI= 0.52 to 8.55; p=0.027), positive subjective norm (b= 3.06; 95% CI= 0.01to 6.10; p= 0.049), strong perceived behaviour control (b= 3.40; 95% CI= -0.04to 6.85; p=0.053), strong intention (b= 3.18; 95% CI= -0.06to 6.41; p= 0.054), and strong husband support (b= 4.28; 95% CI= 0.01to 7.44; p= 0.050). Posyandu had a contextual effect on IUD use with ICC= 32.10%.Conclusion: IUD use among women reproductive age increases with higher maternal education, higher family income, positive attitude, positive subjective norm, strong perceived behaviour control, strong intention, and strong husband support. Posyandu has sizeable contextual effect on IUD use.Keywords: intra-uterine device, utilization, determinants, multilevel analysisCorrespondence:Bekti Susilowati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Central Java. Email: [email protected]. Mobile: +6281226808595.Journal of Maternal and Child Health (2018), 3(4): 252-260https://doi.org/10.26911/thejmch.2018.03.04.0

Association between Socio-demographic, Nutrition Intake, Cultural Belief, and Incidence of Anemia in Pregnant Women In Karanganyar, Central Java

Background: Anemia in pregnancy remains a major public health issue in developing countries. Studies in Indonesia examining the effects of socio-demographic factors, dietary pattern, and cultural belief on the risk of anemia in pregnancy are lacking. This study aimed to examine the effects of socio-demographic factors, dietary pattern, and cultural belief on the risk of anemia in pregnancy.Subjects and Method: An analytic cross-sectional study was conducted in 5 community health centers in Karanganyar, Central Java, from February to March 2018.A total of 200 trimesters I, II, and III pregnant mothers was selected for this study by fixed disease sampling, consisting of 50 mothers with anemia and 150 mothers without anemia. The dependent variable was anemia during pregnancy. The independent variables were nutrition intake, dietary pattern, consumption of iron tablet, family income, parity, family size, antenatal care visit, and cultural belief. The data were collected by questionnaire. The anemia status was obtained from the medical record. The data were analyzed by path analysis performed on Stata 13.Results: The risk of anemia during pregnancy directly decreased with better nutrition intake (b= -1.02; 95% CI= -1.73 to -0.31; p= 0.005) and regular consumption of iron tablet (b= -0.79; 95% CI= 1.48 to -0.10; p= 0.024). The risk of anemia during pregnancy was indirectly affected by better dietary pattern, higher family income, larger family size, cultural belief, parity, higher education, and antenatal care visit.Conclusion: Good nutrition intake and regular consumption of iron tablet decreased the risk of anemia during pregnancy. Dietary pattern, family income, family size, cultural belief, parity, and maternal education have indirect effects on the risk of anemia during pregnancy.Keywords: anemia, pregnancy, nutrition intake, iron tablet, dietary patternCorrespondence: Indah Permatasari Sinawangwulan. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: +6285655261261.Journal of Maternal and Child Health (2018), 3(2): 128-137https://doi.org/10.26911/thejmch.2018.03.02.0

Factors Associated with Hemoglobin Level in Pregnant Women

Background: Anemia in pregnancy is defined as a hemoglobin concentration of less than 110 g/L (less than 11 g/dL) in venous blood. It affects more than 56 million women globally, two-thirds of them being from Asia. Anemia increases perinatal risks for mothers and neonates; and increases overall infant mortality. The odds for fetal growth restriction and low birth weight are tripled. The odds for preterm delivery are more than doubled. Even a moderate hemorrhage in an anemic pregnant woman can be fatal. Anemia is the major contributory or sole cause in 20–40% of maternal deaths. Many women go through the entire pregnancy without attaining the minimum required intake of iron. The purpose of this study was to investigate factors associated with hemoglobin level in pregnant women. Subjects and Method: This was a cross-sectional study carried out Karanganyar, Central Java, from February to March 2018. A sample of 200 pregnant women was selected for this study by fixed disease sampling, comprising 50 women with anemia and 150 women without anemia. The dependent variable was hemoglobin level. The independent variables were iron tablet consumption, nutrition intake, dietary culture, and family size. Data on hemoglobin level were taken from medical record. The other variables were measured by questionnaire. The data were analyzed by a multiple linear regression. Results: Hemoglobin level increased with adequate iron tablet consumption (b= 0.38; 95% CI= 10.79 to 11.37; p<0.001) and better nutrition intake (b= 0.46; 95% CI= 0.17 to 0.75; p= 0.002). Hemoglobin level decreased with inhibitory dietary culture (b= -0.28; 95% CI= -0.55 to <0.01; p= 0.050) and larger family size (b= -0.30; 95% CI= -0.63 to 0.03; p= 0.070). Conclusion: Adequate iron tablet consumption and better nutrition intake increase hemoglobin level. Inhibitory dietary culture and larger family size decrease hemoglobin level. Keywords: hemoglobin level, anemia, iron tablet consumption, nutrition intake, family size, pregnant wome

Pengaruh Program Promosi Intervensi Cuci Tangan Pakai Sabun Terhadap Pengetahuan Siswa di Sekolah Dasar Jakarta

Hand washing with soap is one of the sanitation measures by cleaning the hands and fingers using water and soap by humans to be clean and break the chain of germs. Washing hands with soap is also an effort to prevent disease.This study aims to analyze effect of hand washing with soap intervention promotion program on students' knowledge in jakarta elemntary schools. This type of research is quantitative using experimental research with one group pre-post test design. The sample in this study class V elementary Schools, amounting to 37 students. Data is collected by using a questionnaire. Counseling given by video and song washing media using hand soap. The statistical test used in this study is Wilcoxon. Based on the results it is known that there are significant differences between the value of prior knowledge and the value of knowledge after health promotion interventions. The difference in students' knowledge about washing hands with soap before and after the health promotion intervention was seen from an increase in score of 4.72 or an average difference of -4.714 with a p value of 0,000. There is an increase in the average number of respondents after receiving the educational instruction on washing hands with soap. Keywords : Hand washing, Knowledge, Health Promotion, Interventio

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

Factors Associated with Stunting in Children Under Five in Karawang, West Java

Background: Despite global efforts, stunting remains a public health problem in several developing countries. It is estimated that globally in 2016, 24% of children under age five were still stunted. Stunting during childhood can lead to reduced immunity, increased susceptibility to non-communicable diseases, impaired physical and mental development, and reduced productivity. This study aimed to analyze factors associated with stunting in children under five in Karawang, West Java. Subjects and Method: A case control study was conducted in 5 community health centers in Karawang, West Java, from April to May 2018. A sample 225 children under five consisting of 75 stunted children and 150 normal children was selected by fixed disease sampling. The dependent variable was stunting. The independent variables were maternal height, low birthweight, exclusive breast¬feeding, complementary feeding, and history of infectious disease. Data on children body height were measured by infantometer or microtoise. The other data were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of stunting increased with low birth weight (OR= 4.61; 95% CI= 1.73 to 12.24; p<0.001) and history of infectious illness (OR= 4.77; 95% CI= 1.95 to 11.69; p= 0.001). The risk of stunting reduced with maternal height ≥150 cm(OR= 0.20; 95% CI= 0.08 to 0.49; p<0.001), exclusive breastfeeding (OR= 0.39; 95% CI= 0.17 to 0.88; p= 0.024), and appropriate complementary feeding (OR= 0.24; 95% CI= 0.11 to 0.54; p= 0.001). Conclusion: The risk of stunting increases with low birth weight and history of infectious illness, but reduces with maternal height ≥150 cm, exclusive breastfeeding, and appropriate complementary feeding. Keywords: stunting, low birth weight, exclusive breastfeeding, complementary feeding, infectious illnes

Path Analysis on the Life-Course Biopsychosocial Determinants of Stunting in Children Under Five Years of Age in Karawang, West Java

Background: Studies have shown that stunted children are more likely to start school later, perform more poorly on cognitive functioning tests, and are more likely to drop out of school. In future, adults who are stunted as children earn 20% less than comparable adults who were not stunted and are 30% more likely to live in poverty and less likely to work in skilled labor. This study aimed to examine the life-course biopsychosocial determinantsof stunting in children under five years of agein Karawang, West Java, using a path analysis model.Subjects and Method: This was a case control study carried out inTunggakjati, Rengasdengklok, Kutawaluya, Pedes, and Medangasem community health centers, Karawang, West Java, from April to May 2018. A sample of 225 children under five was selected for this study by fixed disease sampling, consisting of 75 stunted children and 150 normal children. The dependent variable was stunting. The independent variables were maternal height, maternal middle upper arm circumference (MUAC), low birthweight (LBW), history of infection illness, maternal education, exclusive breastfeeding, complementary feeding, and family support. Child height was measured by infantometer or microtoice. The other variables were measured by questionnaire. The data were analyzed by path analysis run on Stata 13.Results: Stunting increased with LBW (b=1.64; 95% CI=0.69 to 2.59; p=0.001) and history of infection illness (b=1.80; 95% CI=0.94 to 2.67; p<0.001). Stunting decreased with maternal height ?150 cm (b=-1.57; 95% CI=-2.43 to -0.71; p<0.001) and appropriate complementary feeding (b=-1.80; 95% CI=-2.53 to -1.08; p<0.001). Stunting was indirectly affected by maternal MUAC, maternal education, exclusive breastfeeding, and family support.Conclusion: Stunting increases with LBW and history of infection illness, but decreases with maternal height ?150 cm and appropriate complementary feeding. Stunting is indirectly affected by maternal MUAC, maternal education, exclusive breastfeeding, and family support.Keywords: stunting, life-course, biopsychosocial, children under fiveCorrespondence:Rona Luthfi Fauziyyah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6281316970696.Journal of Maternal and Child Health (2019), 4(1): 25-35https://doi.org/10.26911/thejmch.2019.04.01.0

The Effect of Parenting Style, Bilingual School, Social Environment, on Speech and Language Development in Preschool Children in Surakarta, Central Java

Background: Childhood speech and language development is considered an important predictor of their future achievement. This study aimed to analyze the effect of parenting style, bilingual school, social environment, on speech and language development in preschool children in Surakarta, Central Java. Subjects and Method: This was an analytic and observational study with a cross-sectional design. The study was conducted at 25 preschools in Surakarta, Central Java, from February March 2018. A sample of 200 preschool children was selected by simple random sampling from 25 preschools selected by stratified random sampling. The dependent variable was speech and language develop-ment. The independent variables were sex, nutritional status, parental education, parenting style, family income, bilingual school, and social environment. The data of speech and language development were measured by pre-screening development questionnaire. Other variables were collected by questionnaire. The data were analyzed by a multilevel logistic regression using Stata 13. Results: Speech and language development increased with age (b= 2.03; 95% CI= 0.38 to 3.68; p= 0.016), nutritional status (b= 2.44; 95% CI= 0.38 to 4.08; p= 0.003), maternal education (b= 1.50; 95% CI= 0.14 to 2.86; p= 0.031), democratic parenting style (b= 2.76; 95% CI= 1.16 to 4.08; p<0.001), family income (b= 1.69; 95% CI= 0.15 to 3.23; p= 0.031), bilingual school(b= -4.46; CI= -6.53 to -2.39; p= 0.001), and social environment (b= 1.80; 95% CI= 0.10 to 3.50; p= 0.038). Intra-class correlation= 28.06% indicating considerable contextual effect of preschool. Conclusion: Speech and language development increases with age, nutritional status, maternal education, parenting style, family income, bilingual school, and social environment

Pengaruh Motivasi, Self Efficacy, dan Komitmen Karyawan terhadap Kinerja Perawat di Rumah Sakit Hermina Depok

Employee performance is one of the factors that play an important role in achieving company goals and individual goals. Performance is an ability that a person has to complete a task given by superiors so that it is completed with one's abilities, willpower and skills. The high low performance of an employee is determined by factors that affect him directly or indirectly. This research aims to test the influence of motivation, self-efficacy, and employee commitment to the performance of nurses at Hermina Depok Hospital. The data used is the result of the spread of questionnaires directly from September to November 2020 at Hermina Depok Hospital.The sampling technique uses proportional systematic sampling where there are 200 samples from two different staffing statuses, namely permanent employees and contracts. There are four variables in this study, namely motivation, self-efficacy, and employee commitment and performance. The research instrument uses a questionnaire and is measured using the likert scale. The data is analyzed using the Structural Equation Model (SEM). The results showed that employee motivation, self-efficacy, and commitment had a positive and significant effect on the performance of nurses, both partially and simultaneouslyKinerja karyawan merupakan salah satu faktor yang memegang peranan penting dalam mencapai tujuan perusahaan dan tujuan individu. Kinerja adalah suatu kemampuan yang dimiliki seseorang untuk menyelesaikan tugas yang diberikan oleh atasan sehingga diselesaikan dengan kemampuan, kemauan dan keterampilan seseorang. Tinggi rendahnya kinerja seorang pegawai ditentukan oleh faktor-faktor yang mempengaruhinya secara langsung maupun tidak langsung. Penelitian ini bertujuan untuk menguji pengaruh motivasi, efikasi diri, dan komitmen karyawan terhadap kinerja perawat di RS Hermina Depok. Data yang digunakan adalah hasil penyebaran kuesioner secara langsung pada bulan September sampai November 2020 di RS Hermina Depok. Teknik pengambilan sampel menggunakan proportional systematic sampling dimana terdapat 200 sampel dari dua status kepegawaian yang berbeda yaitu pegawai tetap dan kontrak. Ada empat variabel dalam penelitian ini, yaitu motivasi, efikasi diri, serta komitmen dan kinerja karyawan. Instrumen penelitian menggunakan angket dan diukur menggunakan skala likert. Data dianalisis menggunakan Structural Equation Model (SEM). Hasil penelitian menunjukkan bahwa motivasi, efikasi diri, dan komitmen karyawan berpengaruh positif dan signifikan terhadap kinerja perawat, baik secara parsial maupun simulta