The Role of Facility - Based Data for Effective Control of Dengue Hemorrhagic Fever in Yogyakarta

Background: Data collected in community health centers and hospitals are not properly used to strengthen Dengue Hemorrhagic Fever (DHF) surveillance system due to their fragmented reporting. Objective: The purpose of this study is to integrate facility-based data from puskesmas (community health center) and hospitals for early warning and effective control of DHF. Methods: Data on reported cases diagnosed as DHF were obtained from community health centers (Kraton, Yogyakarta municipality and Depok I, Sleman district) and computerized discharged summaries at Dr. Sardjito Hospital. Interviews were conducted to describe how DHF cases were diagnosed, and how community interventions were implemented based on the reports of DHF cases. Result: The findings of this study suggested that virtually all DHF cases were diagnosed in hospitals, yet investigations of possible DHF transmissions in the community were carried out by epidemiologists at the community health centers based on reports by community members. The decision to do fogging and other DHF control measures was made in the district health office. Conclusions: Fragmented DHF information system slows down effective DHF control. It is therefore suggested that facility-based data should be integrated and evaluated at least weekly so that proactive DHF control program can be planned and implemented based on epidemiology evidence. Keywords: dengue hemorrhagic fever, information system, facility-base

From Clinical Epidemiology And Clinical Economics

Epidemiolog

Kebijakan Kesehatan Masyarakat Berbasis Bukti

Evidence-based public health policy is not a linear extrapolationof evidence-based medicine to the public health arena. Relevanttypologies, rather than hierarchies, of evidence, should beapplied to support public health policy. There are multipledimensions of evidence used for health policy formulation in aspecific political, social and cultural context. Typologies ofevidence for public health policy are broader than clinicalpractices. Methods for evidence production, appraisal andsystematic reviews for public health policy need to bedeveloped and applied to solve major public health issues,such as tobacco use and exposure to environmental tobaccosmoke.Keywords: evidence, public health, polic

Ubahan Indlkator Dan Regresi Linter

Kedoktera

Faktor-faktor yang mempengaruhi kepuasan kerja dan motivasi dokterkeluarga PT Askes dalam memberikan pelayanan kesehatan kepada pesertawajib PT Askes dl kodya Malang, Madiun dan Kediri, Jawa Timur=Factors Influencing...

ABSTRACT The aims of this study were to find out factors influencing satisfaction and motivation of family doctors of PT. Askes in providing comprehensive health services for PT. Askes membersto find out the level of satisfaction and work motivationand to find out the family doctor\u27s opinion concerning preventive and promotional health service. The aims of the study were chosen due to the poor work achievement, especially in terms of preventive and promotional health service as part of comprehensive services based on Health Project Evaluation IV1998. This was a cross-sectional study with 37 family doctors as the subjects and who were in contractual agreements with PT. Askes in Malang, Kediri, and Madiun. The measurement tools were closed questionnaires using Likert Scale and Osgood\u27s multi-semantic model. Data were processed using descriptive analysis, using statistical analysis with regression correlation, and t-test, and using qualitative analysis for open answers. The results showed that the levels of work satisfaction among family doctors were 4,97% very satisfied40,9% satisfied34,6% rather satisfied12,7% rather dissatisfied5,66% dissatisfied1,29% very dissatisfied. The biggest contribution on very dissatisfied, dissatisfied, ana rather dissatisfied feeling was the sub variabel of salary which was 27,17% and the administrative policy 21,63%. The result of work motivation analysis showed that the levels of work motivation were very high 4,79%high 40,9%rather high 34,6%rather low 12,7%low 5,66%and very low 5,7%. The regression analysis showed that there was no significant relationship between motivator (satisfier) and job satisfactionbut there was significant relationship between hygiene (dissatisfier) and job satisfactionwhile there was no significant relationship between job satisfaction and work motivation and there was significant relationship between motivator (satisfier) and work motivation. There was significant relationship between factors of hygiene (dissatisfier) and job satisfaction. The qualitative analysis showed that respondents focused more on salary, administrative policy, and facilities. Sixty two point eighty six percent of all 25 activities of the promotional and preventive health services had not been conducted. The family doctors agreed to conduct preventive and promotional health services. Keywords: family medicine, job satisfaction, work motivation, preventive and promotional health services

Peran Media Massa terhadap Perilaku Ibu dalam Upaya Pencegahan Demam Berdarah pada Rumah Tangga di Kota YOGYAKARTA

Background: The incidence of dengue hemorrhagic fever (DHF) is increasing dramatically especially in tropical areas. DHF can cause death. It is predicted that 25 thousand people die every year because of DHF. Control of DHF through fogging and use of abate can reduce population of Aedes aegypti mosquitos but it is costly and use in improper dosage can cause resistance to insecticide. The best way to prevent the disease is eradicating vector larvae through 3 activities (draining, burying and covering). Such efforts can be done by mothers in their household. Meanwhile in doing these efforts mothers may be influenced by some factors, i.e. mass media, knowledge and attitude of mothers about DHF.Objective: The objective of the study was to identify factors related to mothers\u27 behavior in preventing hemorrhagic fever in the household.Method: This was an observational study with cross sectional design. The sample of the study was as many as 100 mothers. Data were collected through questionnaires and analyzed using univariate, bivariate and multivariate techniques.Result: Variable of role of mass media was statistically significant as predictor of DHF prevention behavior (p<0.05) with moderate relationship level (r=0.352). Variables of knowledge and attitude were statistically significant with p<0.05 but they had negative relationship.Conclusion: Mass media can significantly affect mothers\u27 behavior in preventing DHF in the household

Pemanfaatan Jaminan Pemeliharaan Kesehatan Masyarakat (JPKM) oleh Keluarga Miskin di Kabupaten Klaten: Utilization of Managed Care by Poor Family in Klaten District

Managed care for poor families was a program performed by Government of Klaten to improve health status of poor families and to enhance the coverage of insured population in Klaten district. The purpose of the study is to explore the related factors to utilization of managed care for poor familes, reasons for not utilizing the services by poor families, the level of satisfaction to health care package, the level of willingness to pay their own premium and relationship between the level of satisfaction to health care package and the level of willingness to pay their own premium. This study combined quantitative and qualitatif methods with cross sectional survey design. The sample size was 251 persons. Standardized questionnaire, tested for their validity and reliability questionnare was used to collect the data. Descriptive statistics, logistic regression and Chi-Square were use in SPSS 10.0 for windows program to analyze the data. Statistical results showed that there were no relationships between age, sex, marital status, religion, education, expenditure, distance to health service, transportation facility, time to acces health service and the utilization of managed care for poor families. There was relationship between knowledge toward the benefit of managed care and the utilization of managed care. Factors influencing the utilization of managed care for poor families were perception of good health by respondents, lack of knowledge about benefit of managed care, failure to bring the required card when visited health care, visiting private health care when sick, buying drug on drug store when sick, having JPS-BK card, or Askes card, afraid of complex bureaucracy, embarrassed of pay nothing when visiting PPKKS, forgot having managed care for poor family card, had to leave job when visiting at morning, loosing managed care for poor family card and managed care for poor family card had not received yet. 67,57% of the communities had high satisfaction toward managed care utilization and 64,86% of the communities had high level of willingness to pay their own premium. It was concluded that Knowledge toward benefit of managed care influenced utilization and the level of previous satisfaction to health care package related to willingness to pay their own premium. Keywords: managed care âutilization â satisfaction âwillingness to pa

KEBIJAKAN KESEHATAN MASYARAKAT BERBASIS BUKTI

Evidence-based public health policy is not a linear extrapolationof evidence-based medicine to the public health arena. Relevanttypologies,  rather  than  hierarchies,  of  evidence,  should  beapplied  to  support  public  health  policy.  There  are  multipledimensions of evidence used for health policy formulation in aspecific  political,  social  and  cultural  context. Typologies  ofevidence  for  public  health  policy  are  broader  than  clinicalpractices.  Methods  for  evidence  production,  appraisal  andsystematic  reviews  for  public  health  policy  need  to  bedeveloped  and  applied  to  solve  major  public  health  issues,such as tobacco use and exposure to environmental tobaccosmoke.Keywords: evidence, public health, polic