Resource Mobilization and Preparedness to Control Dengue Haemorrhagic Fever in Medan, North Sumatera

Background: Infectious diseases continuously emerge and/or reemerge, resulting in epidemics of varying sizes and scope. Infection preventionists undertake preparedness activities to ensure that the healthcare facilities and communities are well-prepared to recognize and respond to an infectious disease epidemic. Infectious disease epidemic preparedness is an ever evolving process that addresses the four principles of emergency management: mitigation, preparedness, response, and recovery. This study aimed to determine the relationship between resource mobilization within community and preparedness to control DHF. Subjects and Method: A cross sectional study was carried out in Medan, North Sumatera. A sample of 100 household heads was selected for this study by random sampling. The dependent variable was preparedness to control DHF. The independent variable was resource mobilization within the community. The data were collected by questionnaire and analyzed by chi-square with Odd Ratio (OR) as the measure of association. Results: Preparedness to control DHF was positively associated with resource mobilization within the community (OR= 3.22; 95% CI= 1.32 to 7.85; p= 0.001). Conclusion: Preparedness to control DHF is associated with resource mobilization within the community. Keywords: dengue haemorrhagic fever, control, preparedness, resource mobilization

Role of Human Resource, Facilities, and Infrastructure in Early Warning System of Dengue Haemorrhagic Fever in Dumai, Riau

Background: Dengue/dengue hemorrhagic fever (DF/DHF) has been one of the most important resurgent tropical diseases in the past 3 decades, with expanding geographical distribution of both the viruses and the mosquito vectors, increased frequency of epidemics, development of hyper-endemicity (co-circulation of multiple virus serotypes), and the emergence of DHF in new areas. Early warning systems (EWS) are in most instances, timely surveillance systems that collect information on epidemic-prone diseases in order to trigger prompt public health interventions. An EWS is an instrument for communicating information about impending risks to vulnerable people before a hazard event occurs, thereby enabling actions to be taken to mitigate potential harm, and sometimes, providing an opportunity to prevent the hazardous event from occurring. This study aimed to describe the role of human resource, facilities, and infrastructure in EWS of dengue haemorrhagic fever in Dumai, Riau. Subjects and Method: This was a qualitative study conducted in Dumai, Riau. A sample of informants was selected for this study, including personnel from Dumai City Health Office, health center doctors, and communicable disease control personnel. The study theme was adequacy of resources for DHF EWS. The data were collected by in-depth interview, observation, and document review. Results: The qualification, competence, and number of human resources for DHF surveillance and EWS at Dumai Municipality Health Office had not conformed with the standards. Facilities and infrastructure, including computing devices, were sufficient in number. However, Standard Operating Procedures (SOP) for DHF surveillance program and EWS was non-existent. Conclusion: Health personnel for DHF control and prevention are limited in number competence and qualification. SOP for DHF surveillance program and EWS is non-existent. Keywords: Dengue Haemorrhagic Fever, human resource, facilities, infrastructure, warning syste

The Relationships of Motivation and Sanction with Hand Hygiene Compliance among Health Workers at Dr. Pirngadi Hospital, Medan, North Sumatera

Background: Hand hygiene is described by many health care workers as the single most important tool in preventing the spread of health care-associated infections between patients. Washing hands before and after patient contact seems like a simple solution to prevent the spread of bacteria between patients. Most hospitals have hand hygiene policies in place that guide their employees to do just that. But this policy is not always complied with. This study aimed to determine the associations of presence of sanction and motivation with hand hygiene compliance among health workers at Dr. Pirngadi Hospital, Medan. Subjects and Method: A cross sectional study was conducted at Dr. Pirngadi Hospital, Medan, North Sumatera. A sample of 33 health workers were selected for this study by exhaustive sampling. The dependent variable was hand hygiene compliance. The independent variables were sanction and motivation. The data were collected by questionnaire and analyzed by a mulitiple logistic regression. Results: Hand hygiene compliance was associated with the presence of sanction (OR= 3.44; 95%CI= 1.22 to 4.95; p= 0.041) and motivation (OR= 4.77; 95%CI= 2.52 to 6.30; p= 0.029). Conclusion: Hand hygiene compliance is associated with sanction and motivation. Keywords: hand hygiene, compliance, sanction, motivatio

Factors Associated with Work Performance of Midwives at Langsa Hospital, Aceh

Background: Recently, in some countries a framework for quality maternal and newborn care was developed, which encourages a system-level shift to provide skilled care for all. This care includes preventive and supportive care that works to strengthen women’s capabilities and focuses on promotion of normal reproductive processes while ensuring access to emergency treatment when needed. Midwives with high work performance have an important role in this new system. This study aimed to determine factors associated with work performance among midwives at Langsa Hospital, Aceh, with special attention to the effect of motivation. Subjects and Method: This was a cross sectional study conducted at General Hospital in Langsa, Aceh. A sample of 47 midwives was selected for this study. The dependent variable was work performance. The independent variables were employment status, skill, motivation, supervision, and training. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: High motivation improved work performance of midwives (OR= 2.35; p= 0.037), after controlling for the effects of employment status, skill, training, and supervision. Conclusion: High motivation improves work performance of midwives. Keywords: work performance, motivation, employment status, supervision, training, skill, midwife

Physical, Social, and Cultural Environment Determinants Of Filariasis In Tapanuli Tengah, North Sumatera

Background: Lymphatic filariasis impairs the lymphatic system and can lead to the abnormal enlargement of body parts, causing pain, severe disability and social stigma. According to World Health Organization, in 2000 over 120 million people were infected, with about 40 million disfigured and incapacitated by the disease. Lymphatic filariasis can be eliminated by stopping the spread of infection through preventive chemotherapy with safe medicine combinations repeated annually for at least 5 years. More than 6.7 billion treatments have been delivered to stop the spread of infection since 2000. Tapanuli Tengah district ranked third in the incidence of filariasis in North Sumatera. The total number of filariasis cases was 22 cases. This study aimed to examine the physical, social, economic, and cultural environment determinants of filariasis in Tapanuli Tengah, North Sumatera. Subjects and Method: This was a qualitative study carried out in Lumut Maju village, Tapanuli Tengah, North Sumatera. A total of 23 informants were selected for this study, consisting of filariasis patients, family members, and personnel from the health and related sectors. The dependent variable was filariasis incidence. The independent variables were physical, social, economic, and cultural environments, and the local goverment. The data were collected by indepth interview, direct observation, focus group discussion, and document review. The data were analyzed by thematic analysis. Results: The incidence of filariasis is determined by the interaction of host agent environment conditions favorable for the transsmition of filariasis. The physical environment conditions in Lumut Maju village could be described as follows: (1) Several swamps; (2) Several rivers and bushes (3) Some plantations; (4) High humidity of climate. The social, economic, and cultural environment conditions could be described as follows: (1) Common habit of people to go out at night; (2) Rare use of protective work clothes; (3) Low household income; (4) Local belief in mystical things. The local government involvement was as follows: (1) Non existence of regent regulation on infectious diseases control and prevention, including filariasis; (2) Uneven distribution of health workers and health facilities. Conclusion: The incidence of filariasis in Lumut Maju village, Tapanuli Tengah, North Sumatera, is closely related to the conditions of physical, social, economical, and cultural environments, as well as the local goverment policy. Keywords: filariasis, physical, social, economical, cultural environment, local goverment policy

The Effects of National Health Insurance Perception and Information Access on The Utilization of Health Service in Pematang Siantar, North Sumatera

Background: Financial protection is at the core of the national health insurance (NHI). Financial protection is achieved when direct payments made to obtain health services needed do not expose people to financial hardship. This study aimed to examine the effects of NHI perception and information access on the utilization of health service in Pematang Siantar, North Sumatera. Subjects and Method: This was a cross sectional study conducted at Pematang Siantar, North Sumatera. A sample of 140 people was selected for this study. The dependent variable was ulilization of health service. The independent variables were perception of NHI, and information access. The data were collected by questionnaire. Associations between variables were tested by chi-square with OR as the measure of association. Results: Utilization of health service increased with positive perception of NHI (OR= 2.34; p= 0.001) and good information access (OR= 1.73; p= 0.002). Conclusion: Utilization of health service increases with positive perception of NHI and good information access. Keywords: utilization of health service, national health insurance, perception, information access