Under-Utilization of Community Health Centers in Purworejo Regency, Central Java

The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observation, in-depth interview and focus group discussion were done among different types of group. The study was done in Purworejo District on February and March 2000. The main problems related to under-utilization of community health centers are mostly on administration (less quality services, un-efficient, long hours waiting), strong bureaucratic system (physician has a dominant power, overlapping programs, poor coordination and integration with other divisions) and cultural behavior of the community (labeling/stigma, self-care dominant, lack of community participation). To overcome under-utilization of community health centers the administration and bureaucracy should be changed into more efficient, not bureaucratic management. In addition social changes of the community culture is needed. As a consequence through these changes the staff of the health centers will be more efficient and effective. &nbsp

Pengobatan Tradisional, Upaya Meminimalkan Biaya Kesehatan Masyarakat Desa di Jawa

Background: Traditional medicine is frequently perceived asnegative and even though many people still practice. It the useof traditional medicine is mainly due cause to tradition. Thevillager tends to use traditional medicine as primary healing.This article tried to identify frequent diseases among Javaneseand economic capability to afford health cost.Methods: Ethnography study using observation and in-depthinterviewamong 48 informants and 6 key informant of peasantcommunity in Sleman, DIY and fisherman in Rembang, CentralJava, during 2007-2008. Phenomenology approach used duringdata collection and analysis.Result: Masuk angin (wind illness) is a disease whichfrequently occur among the villager. Traditional medicine wasapplied because it is inexpensive, easy, effective and suitablewith the cognitive related to the harmony (equilibrium). Theprinciple of coining was binary opposition such as: hot x cold;loose x tight; angin masuk x angin keluar; better x awful andthe equilibrium is the basic rational of traditional medicine.Recommendation: Traditional medicine must be recognizedby the government and should be in equal position to modernmedicine in order to reduce negative opinion, so the rational ofit is recognized by others.Keywords: holistic, traditional, masuk angin, effective, chea

Acculturation in Javanese Traditional Medicine Practice in YOGYAKARTA

The rampant practice of traditional medicine in the big cities in Java can not be separated from the influence of globalization. The practice of traditional medicine advertised through flyers, pamphlets, signage, television and internet. In medical practice, it can not be separated from the mixture of elements of the local culture, external/ foreign as well as modern medical later adopted in order to enhance public interest in their treatment. The purpose of this article is to analyze the practice of acculturation in traditional medicine both related to methods, tools, how to advertise and meaning behind the ways the adoption of other culture into the traditional practice.An intergrative ethnographic study was conducted in Bantul and Sleman, Yogyakarta, on traditional healers such as gurah, bekham, metaphysical/ spiritual, herbal, traditional massage therapy, as well as traditional healers specifically hemorrhoids. Other information was obtained from interviews with their patients.Medical pluralism by wrapping traditional therapy combined with health culture from the outside to attract consumers with a dogmatic way in order to improve the clients made by Javanese traditional healers. They advertise with testimony on local television screen with the aim of introducing methods, tools, disease cure rates, fees, in order made populair so the number of patients increases. Acculturation appears that more and more people believe in business practices and its treatment

Dominasi Medis Modern Atas Medis Tradisional Suku Sumuri, Teluk Bintuni, Papua Barat

Declaration 1990-2015 MDG's 4 and 5 points in Indonesia fail due to a decrease in maternal and infant mortality rate is not reached until three quarters. Sumuri District, in West Papua is one of the area that maternal and infant mortality rates high, althought free health care for its residents. This paper wants to explore how the interaction between modern medicine and local medicine so the dominant health care in the community will be identified. Ethnographic study by living together with the local community to make the observation of the patient's health centers, community leader interviews, adult population, health workers and mini Focus Group Discussion among 4 mothers who has under 5 years old children conducted in June 2014. Government, oil and gas companies are aggressively introducing modern medical to the residents of SumuriDistrict, as a result communities have high interest to visit the health center for treatment and natural healing tends to disappear. New health institutions such as health centers, integrated health, midwives, nurses, physicians are able to shift the role of traditional birth attendants, traditional healer or traditional medicine. As a result of social relations within the extended family was replaced by a stronger role of midwives, nurses and doctors. However, the older generation tends to be more suitable with traditional healing compare to modern medicine

Smoking Cessation Therapy

Cigarettes are regarded as being highly addictive. Consequently, if the smoker quits their habit, they will feel physically and mentally stressed. The purpose of this research is to understand, successful methods of quitting smoking, and factors which ease quitting smoking. It is also hoped to be able to lay a base for and bring into reality every element of society to create a social etiquette in smoking. Research using qualitative method by case studies among 3 smokers was undertaken in 2004. The criteria of the informant was age more than 40 years old, married, successfully in smoking cessation, and 10 years more as a smoker. The interview to informants was hold by recorder. The principle model of successful quitting smoking was the strong will and determination of the smokers themselves. The reasons to stop smoking were also health, religious organisation, and, family factors. Health factors are related with disease suffered by the informants such as hypertension, fever, cough and headache. Religious organisation factors are related to religious organization that prohibit to smoke. Family factors were related to the family of the informants who followed in their footprints as smokers. Besides that, the informants also had young children who should not be exposed to cigarette smoke. The methods used by the informants to smoke cessation were therapy, changing behavior, and positive encouragement. All the above incidents resulted in a smoker quitting their habit. The wisdom behind all this is a smoker who has a strong will to quit smoking

The Knowledge and Experience of Dengue Mosquitoes Among Housewives

Dengue Hemorrhagic Fever (DHF) prevention programs in Semarang, were focused through controlling mosquito breeding sites (PSN), but the implementation of PSN was not become a habit in every household. The objective of this study was to explore knowledge and experience of dengue mosquitoes among housewives in the endemic villages.The research was using qualitative methods. Subjects of the study were 17 housewives which selected by purposive sampling. The data collection was carried in Sendangmulyo village, Semarang, through observation, focus groups discussions, and indepth interviews. The techniques used to test data validity were triangulation and member checking method. Data were analyzed using content analysis approached. The results showed that housewives classifying mosquito based on time occurrence whether the presence of mosquito in environment was perceived naturally.  Unoptimalized PSN behavior was based on the lack of housewives knowledge on larvae development stages. Mosquito was not considered as a threatening because night mosquito biting was directly more disturbing rather than day mosquitoes’. Health promotion program could increase dasa wisma cadres knowledge and skill, particularly on mosquito life cycle and the correct stages of PSN behavior. This study did not distinguish the demographic characteristics of informants. Further reserch could explore it or develop media based on local knowledge and experience

Family Intervention in the Problem of Maternal Death

In 2015, the maternal mortality rate in Bima was recorded as 3 cases per 1,000 births, equivalent to 300 maternal deaths per 100,000 births. Although this number is low, it is much higher than the zero mortality rate set by the Sustainable Development Goals. This study discusses the family and community aspects of the maternal health framework, reading the gendered symbolic violence that affect maternal health in Jatibaru Village, Asakota, Bima, West Nusa Tenggara. Data was collected using an ethnographic approach, with techniques including Focus Group Discussions, participatory observation, interviews, and document study. The existence of gender inequities in the family can cause problems when women attempt to access healthcare. Furthermore, families and communities exert control over pregnant women, directing their behavior and attempts to access healthcare according to local customs and traditions. As such attitudes and behaviors are part of the digestive process of knowledge and experience, women often accept and do what is recommended by their families and communities. This social reality of maternal health thus becomes part of gender inequality in society

Jamu Cekok Components for Treating Children Have No Appetite: an Ethnomedicine Approach

Jamu is used in an effort to treat patiens with a traditional herbal medicine, which is well known among the community. The jamu is widely used for trating light health problems, preventing illness, increasing the endurance and the health of the body, besides for cosmetic reasons. Jamu cekok is a kind of jamu used in Yogyakarta, especially for children , given by forcing the mixture into the throat if children have no appetite. The aims of the article are to know the components of jamu cekok and also to know the jamu cekok use toward improving child health. The research took 5 Javanese families as informants. Additional informants is jamu cekok traditional shop and traditional herbalist. Data were obtained by interviews and observation during February to June 2003. Analysis data was descriptive using medical anthropology approach. The essential components of jamu cekok, called empon-empon are curcuma xanthorriza Robx (temulawak), Zingiber Americans l. (lempuyang emprit), Tinospora tuberculata Beume (brotowali), Curcuma aeruginaosa Robx (temu ireng) and Carica papaya L. (papaya). The main aims to drink jamu cekok is to increase the appetive of the children because parents worried about the children growth and development. The children were threatened that they will be forced to drink jamu, if they did not want to consume food. The belief and suggestion factors of jamu cekok having special characteristics cause consumers become satisfied after giving jamu cekok to their children. Beside that, traditional medicine using natural ingredients regarded more secure and the price can be reached by common society. Drinking jamu cekok indicated that there is trend back to nature, which had possessed by their anchestor

Tabu, Hambatan Budaya Pendidikan Seksualitas Dini pada Anak

Latar belakang: Selama tahun 2014, telah terjadi peningkatan kasus Kekerasan Seksual pada Anak (KSA) di Kota Dumai. Salah satu cara melindungi anak dari kekerasan seksual adalah dengan memberikan pendidikan seksualitas dini pada anak. Namun, pendidikan seks masih menjadi topik perbincangan tabu di dalam keluarga. Padahal keluarga merupakan agen sosialisasi pertama bagi anak. Menurut teori Health Belief Model, terdapat 4 hal penting yang mempengaruhi seseorang untuk mengubah perilakunya, yaitu apabila seseorang merasa rentan, merasa masalah tersebut serius, tidak ada yang menghalangi dan merasa diuntungkan dengan perilaku tersebut. Menggali persepsi orangtua terhadap pendidikan seks dini pada anak akan memberikan informasi tentang langkah intervensi yang terbaik melalui pendidikan seks.Metode: Penelitian ini adalah penelitian deskriptif eksploratif dengan pendekatan kualitatif. Pemilihan subjek penelitian dilakukan dengan purposive sampling. Pengambilan data dilakukan dengan focus group discussion (FGD) dan wawancara mendalam. Analisis yang digunakan adalah content analysis.Hasil: Pengetahuan orangtua terhadap kasus Kekerasan Seksual pada Anak (KSA) masih minim. Faktor penghambat utama yang menghalangi orangtua memberikan pendidikan seksualitas dini pada anak adalah ketidaknyamanan, persepsi ketidaksiapan anak dan ketidaktahuan cara menyampaikan pendidikan seksualitas pada anak. Ketersediaan informasi yang cukup tentang seksualitas, komunikasi yang baik dan adanya peran ayah dalam pendidikan seksualitas akan memudahkan orangtua dalam memberikan pendidikan seksualitas dini pada anak.Kesimpulan: Orangtua masih mengganggap pendidikan seksualitas sebagai topik pembicaraan yang tabu dalam keluarga. Tenaga promosi kesehatan hendaknya lebih dapat memanfaatkan forum-forum yang melibatkan orangtua, seperti posyandu atau pertemuaan komite sekolah, untuk mensosialisasikan pendidikan seksualitas dini yang tepat bagi anak