VILLAGE FUNDS IMPLEMENTATION FOR BIRTH AND DEATH CERTIFICATE INTEGRATED

This paper describes local government innovations that are part of the Civil Service and Civil Registry (Dukcapil) reform. Arrangement of birth certificate and death certificate integrated village fund is an innovation policy in West Aceh Regency which is abbreviated as Aklamasi Dansa. The issue of legal identity is still a problem in Indonesia, many people do not have a legal identity so it impacts all services provided by the government to the community. The policy of integrating birth certificates and death certificates is an innovation that brings government and society closer together. The Aklamasi Dansa has been running since 2017 and operates in the assisted village. This study uses a qualitative method with a case study approach. The informant of this research is the community as the recipient of services, the government of West Aceh as an innovator. The results showed that the Aklamasi Dansa policy have shown that they are capable of significantly increasing the percentage of ownership, as can be seen from the percentage of birth certificates in 2016, only 86% after the Aklamasi Dansa was implemented to be 94% in 2019. The same thing happened with the death certificate issued by Disdukcapil in West Aceh in 2016 only 86 death certificates after the aklamasi dansa went on to 1629 in 2019. The Aklamasi Dansa as one of the innovations in service to the community went very well in improving village data administration and making it easier for citizens to receive services in taking care of birth certificates and death certificates

STEADY-STATE PHARMACOKINETICS OF METFORMIN IN OBESE PATIENTS WITH TYPE 2 DIABETES MELLITUS: A PRELIMINARY STUDY

Objective: This study aimed to determine the metformin plasma steady-state concentration (PSSC) either trough and peak level in Type 2 diabetesmellitus patients with obesity and the impact of SLC22A1 gene organic cation transporter 1 (OCT) rs628031 A>G on PSSC of metformin.Methods: Validated reversed-phase high-performance liquid chromatography method with ultraviolet detector was used to determine the metforminPSSC, as well as genotype variation was performed using the restriction fragment length polymorphisms-polymerase chain reaction method.Results: A total of 13 patients were recruited from five Primary Health Centers in Yogyakarta Province of Indonesia. The results showed that themeans of their trough and peak PSSC were 0.285±0.192 and 1.175±0.814 μg/ml, respectively. Only 10 patients (77%) had peak PSSC within theplasma therapeutic level (PTL) of metformin, and 14-fold variability was observed for the peak PSSC. None of the patients achieved the PTL ofmetformin with regard to their trough PSSC. The PSSC of metformin was independent of the OCT1 genotype in rs628031 (A>G) 408M/V SLC22A1.Conclusion: This study found a huge variability in the trough concentration of metformin (>100-fold) and 14-fold for the peak PSSC, and no impactof a variant of rs628013 SLC22A1 OCT1 on metformin PSSC was revealed.Keywords: Metformin, Steady-state pharmacokinetics, Obesity, Type 2 diabetes mellitus

Evidence on the magnitude of the economic, health and population effects of palm cooking oil consumption: an integrated modelling approach with Thailand as a case study

BACKGROUND: Palm oil’s high yields, consequent low cost and highly versatile properties as a cooking oil and food ingredient have resulted in its thorough infiltration of the food sector in some countries. Longitudinal studies have associated palm oil’s high saturated fatty acid content with non-communicable disease, but neither the economic or disease burdens have been assessed previously. // METHODS: This novel palm oil-focussed disease burden assessment employs a fully integrated health, macroeconomic and demographic Computable General Equilibrium Model for Thailand with nine regional (urban/rural) households. Nutritional changes from food consumption are endogenously translated into health (myocardial infarction (MI) and stroke) and population outcomes and are fed back into the macroeconomic model as health and caregiver-related productive labour supply effects and healthcare costs to generate holistic 2016–2035 burden estimates. Model scenarios mirror the replacement of palm cooking oil with other dietary oils and are compared with simulated total Thai health and macroeconomic burdens for MI and stroke. // RESULTS: Replacing consumption of palm cooking oil with other dietary oils could reduce MI/stroke incident cases by 8280/2639 and cumulative deaths by 4683/894 over 20 years, removing approximately 0.5% of the total Thai burden of MI/stroke. This palm cooking oil replacement would reduce consumption shares of saturated/monounsaturated fatty acids in Thai household consumption by 6.5%/3% and increase polyunsaturated fatty acid consumption shares by 14%, yielding a 1.74% decrease in the population-wide total-to-HDL cholesterol ratio after 20 years. The macroeconomic burden that would be removed is US$308mn, approximately 0.44% of the total burden of MI/stroke on Thailand’s economy or 0.003% of cumulative 20-year GDP. Bangkok and Central region households benefit most from removal of disease burdens. // CONCLUSIONS: Simulations indicate that consumption of palm cooking oil, rather than other dietary oils, imposes a negative health burden (MI and stroke) and associated economic burden on a high consuming country, such as Thailand. Integrated sectoral model frameworks to assess these burdens are possible, and burden estimates from our simulated direct replacement of palm cooking oil indicate that using these frameworks both for broader analyses of dietary palm oil use and total burden analyses of other diseases may also be beneficial