An Ethnography Study of Nutritional Conditions of Pregnant Women in Banten Indonesia

Maternal mortality in childbirth in developing countries is still high. The study describes the qualitative methods used to examine the knowledge, attitude, beliefs and behaviour related to nutrition and nutritional supplementation of pregnant women. The role of village midwives and cadres’ in relation to nutrition education resulted in improving nutritional behaviour of pregnant women to some extent, but poverty and culture restricted the ability of pregnant women to access better food. The study shows that the position of pregnant woman is low within the hierarchy of both the health care system and the power structures of the broader community. Husbands, mothers-in-law, village midwives, cadres and village leaders all have more power in determining nutrition during pregnancy. However, some women tried to eat better and more nutritious food in secret, thereby subverting culture and the authority of husbands and mothers-in-law

Artikel Isna Fitria - Society Reception on the Marine Ecotourism in Minneapolitan Region of Sidoarjo District

Desa Balongtani Jabon Sidoarjo memiliki potensi yang besar namun perlu mendapatkan dukungan dari semua pihak. Dalam bidang kesehatan Desa Balong Tani memiliki beberapa Posyandu aktif dengan kader yang handal dan berkomitmen baik dalam meningkatkan kesehatan ibu dan anak. Permasalahan yang terdapat di Desa Balongtani antara lain kebiasaan warga menggunakan MP-ASI (Makanan Pendamping ASI) instan, pembinaan kader kurang inovatif dan masih terdapat bayi balita dengan gizi kurang dan BGM (Bawah Garis Merah). Pengabdian Masyarakat PPDM (Program Pengembangan Desa Mitra) ini mengoptimalisasi 1000 HPK di desa Balongtani Jabon Sidoarjo melalui kegiatan sosialisasi dan pemahaman terhadap 1000 HPK kepada kader dan kelompok sasaran, pendampingan pembuatan MP-ASI untuk bayi balita usia 6 – 24 bulan dan pembuatan produk makanan kaya gizi bagi ibu hamil. Selain itu dilakukan revitalisasi Posyandu dan strategi pemasaran produk MP-ASI. Program ini melakukan pendekatan penyelesaikan masalah melalui pemberdayaan kader dan kelompok sasaran dengan target meningkatkan tata kelola masyarakat, sumber daya manusia, serta perbaikan sumber daya alam melalui tata kelola layanan Posyandu Kata kunci : Gizi, 1000 HPK, kader Posyandu,, MP-ASI Balongtani Village Jabon Sidoarjo has great potential but needs to get support from all parties. In the health field Balong Tani village has several active Posyandu with cadres who are reliable and committed both in improving the health of mothers and children. The problems in the Balong Tani Village include the habit of residents using instant MP-ASI (Breast Milk Complementary Food), the cadre coaching less innovative and there are still under nutrition toddlers and BGM (Below the Red Line). This Community Service PPDM optimizes 1000 HPK in the village of Balongtani Jabon Sidoarjo through socialization activities and understanding of 1000 HPK to cadres and target groups, mentoring to make MP-ASI (Breast Milk Complementary Food) for infants aged 6-24 months and the manufacture of nutrient-rich food products for pregnant women. In addition, the Posyandu revitalization and marketing strategies for MP-ASI (Breast Milk Complementary Food) products were carried out. This program approaches the problem solving through empowering cadres and target groups with the target of improving community governance, human resources, and improving natural resources through the management of Posyandu services. Keywords: Nutrition, the first thousand days of life, Posyandu cadres, MP-AS

Perception of Community Health Workers in Indonesia Toward Patients with Mental Disorders

In Indonesia, there are any community health volunteers called Kader. Although Kaders are members of mental health volunteer, they sometimes show negative attitude to psychotic persons, even they have already got some training about mental health. The aims of this study were to investigate 1) how is Kader's perception compare to the other countries, 2) how will they consult compare to the other countries 3) how is comparison of Kaders' perception to mental disorder person between trained and untrained. The method of this research is a descriptive explorative using survey study. This study was held on June to September 2013. It was conducted in five districts of Yogyakarta area with 619 respondents. The Questionnaires used contained three sections are follows; Part A is about Demographic Data, Part B two case vignettes (taken from MacArthur Health Module of the 1996 general Social Survey) and Part C about Kaders experiences. The perception of Kader as part of the community is lower than the general residence in the United States and Japan. The comparison between trained and untrained Kaders shown that trained Kaders has better perception toward patient with mental disorder. These results suggest that actual experiences in meeting the cases contributed to the improvement of Kaders' perception better than the previous mental health training did. It might be Kaders with short experience are explored information Kaders should be trained with more structured curriculum and recruiting Kader is recommended to recruit the young generation

Analisis Upaya Pemberdayaan Masyarakat oleh Bidan Desa melalui Pendekatan Positive Deviance pada Perbaikan Gizi Balita di Kabupaten Bojonegoro Tahun 2013

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Maya Primayanti Analisis Upaya Pemberdayaan Masyarakat oleh Bidan Desa melalui Pendekatan Positive Deviance pada Perbaikan Gizi Balita di Kabupaten Bojonegoro Tahun 2013 xvii + 257 halaman + 9 tabel + 4 gambar + 16 lampiran Pada akhir tahun 2012, 56,27% desa di Kabupaten Bojonegoro melakukan pemberdayaan melalui positive deviance (PD). Namun, penurunan presentase balita gizi kurang dan gizi buruk tidak dapat dipertahankan. Tujuan penelitian menganalisis upaya pemberdayaan masyarakat oleh bidan desa melalui pendekatan positive deviance pada perbaikan gizi balita di Kabupaten Bojonegoro. Penelitian dilakukan secara kualitatif. Informan utama 8 bidan desa (4 bidan desa PD kriteria baik dan 4 bidan desa PD kriteria kurang baik) dan informan triangulasi 28 orang (8 kader PD, 8 perangkat desa, 8 ibu balita dan 4 petugas gizi). Data dikumpulkan dengan teknik wawancara mendalam. Pengolahan dan analisis data menggunakan analisis isi. Hasil penelitian menunjukkan upaya pemberdayaan masyarakat oleh bidan desa PD kriteria kurang baik belum optimal dibandingkan PD kriteria baik. Hal ini berkaitan dengan : 1) bidan belum mengupayakan kader meningkatkan partisipasi ibu balita sampai membawa kontribusi bahan makanan dan membantu memasak, 2) pemimpin desa kurang memotivasi dan menggerakkan partisipasi masyarakat, 3) bidan belum memanfaatkan organisasi masyarakat desa sepenuhnya untuk meningkatkan partisipasi masyarakat, 4) bidan belum mengupayakan kader melakukan penyelidikan PD untuk mencari role model sebagai dasar pembuatan menu dan pemberian pesan kesehatan, 5) mobilisasi sumberdaya kurang dalam hal dana swadaya masyarakat atau ADD, serta keaktifan semua kader, 6) kemitraan bidan dengan perangkat desa dan kader belum didukung SK PD dan kesepakatan yang saling menguntungkan, 7) bidan belum mengupayakan kader melakukan evaluasi PD sampai kunjungan rumah, serta tidak ada supervisi rutin dan penilaian/umpan balik pelaksanaan PD dari petugas gizi. Disimpulkan bahwa pelaksanaan PD belum berkelanjutan sesuai harapan. Diperlukan kerjasama semua pihak dalam mewujudkan program tersebut. Disarankan kepada Dinas Kesehatan untuk melakukan pelatihan PD bagi bidan dan kader, serta penempatan tenaga gizi sesuai kompetensi. Disarankan kepada puskesmas untuk meningkatkan komitmen perangkat desa dan pemberian insentif kader. Kata Kunci : Pemberdayaan Masyarakat, Positive Deviance, Perbaikan Gizi Balita Pustaka : 63 (1983-2013) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Maya Primayanti Effort Analysis of Community Empowerment by Village Midwife through Positive Deviance Approach in Improving Nutrition of Children under Five years old in Bojonegoro District in 2013 xvii + 257 pages + 9 tables + 4 figures + 16 enclosures In the end of 2012, 56.27% of villages in Bojonegoro District had empowered community using positive deviance (PD) approach. However, a decreasing percentage of severely and moderately malnourished children under five years old could not be maintained. The aim of this study was to analyse efforts of community empowerment by village midwife through PD approach in improving nutrition of children under five years old in Bojonegoro District. This was qualitative research. Main informants consisted of eight village midwives (4 midwives with good PD and 4 midwives with bad PD). Meanwhile, 28 persons (8 cadres of PD, 8 village officials, 8 mothers of children under five years old, and 4 nutritionists) were as informants for triangulation purpose. Data were collected using indepth interview method. Furthermore, data were analysed using content analysis. The results of this study showed that efforts of community empowerment conducted by village midwives with bad PD had not been optimal compared to those with good PD. Some reasons for this problem were as follows: 1) midwives had not empowered cadres to increase participation of mothers of children under five years old in order to bring groceries and help cooking; 2) head of villages had not motivated and actuated participation of communities; 3) midwives had not fully utilised villagers’ organisation to increase participation of community; 4) midwives had not empowered cadres to investigate PD for finding role model as a basis of making menu and providing health messages; 5) there was lack of resources mobilisation particularly in terms of self-funding or ADD and activeness of all cadres; 6) partnerships between midwives, village officials, and cadres had not been supported by decree of PD and mutual agreements; and 7) midwives had not empowered cadres in evaluating PD and visiting a house. In addition, there were no regular supervisions and feedback of PD implementation from nutritionists. In conclusion, the implementation of PD had not complied expectation. Therefore, cooperation with other sectors needs to be done to realise its program. District Health Office needs to conduct training of PD for midwives and cadres and place nutritionists in accordance with their competencies. Health centres need to improve commitment of village officials and provide incentive for cadres. Key Words : Community Empowerment, Positive Deviance, Improvement of Nutrition of Children under Five Years Bibliography : 63 (1983-2013

Experiences, Opportunities and Challenges of Implementing Task Shifting in Underserved Remote Settings: The Case of Kongwa District, Central Tanzania.

Tanzania is experiencing acute shortages of Health Workers (HWs), a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers' shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants' practical experiences of implementing task shifting in their respective health facilities (district level) and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy infrastructures are not in place before formalising tasks shifting. There was also a perception that implementation of task shifting has ensured access to services especially in underserved remote areas. Professional discontent and challenges related to the management of health personnel policies were also perceived as important issues to consider when implementing task shifting practices. Additional resources for additional training and supervisory tasks were also considered important in the implementation of task shifting in order to make it deliver much the same way as it is for conventional modalities of delivering care. Task shifting implementation occurs as an ad hoc coping mechanism to the existing shortages of health workers in many undeserved areas of the country, not just in the study site whose findings are reported in this paper. It is recommended that the most important thing to do now is not to determine whether task shifting is possible or effective but to define the limits of task shifting so as to reach a consensus on where it can have the strongest and most sustainable impact in the delivery of quality health services. Any action towards this end needs to be evidence-based

The Establishment of Child Health Cadre as Prevention for Foodborne Disease at Primary Schools

Personal health, including health on school-age children comes from food intake. But often, these foods can cause health problems, such as foodborne diseases. A quasi-experimental study was conducted to monitor the Clean and Healthy Lifestyle (CHL) of children at school through the establishment and evaluation of child health cadres. Phases of activities are the selection of child health cadres (10 children), training and determination of the child that will be monitored (40 children), preliminary assessment on the monitored CHL, two-month monitoring and final assessment. Monitored CHL are the CHL associated with foodborne diseases such as clean nails, snacks habit, habit of bringing lunch, and hand-washing habit in schools. Descriptive analysis showed that there were differences between the CHL school children before and after the monitoring conducted by child health cadres, however the results of the Chi-Square Test indicated that only the habit of bringing lunch that yield a significant change (p=0.01). Evaluation of the routine activity showed that the average cadre activity on monitoring is 75.7% and the average of completeness monitoring books is 91.9%. The activities of child health cadres can be applied on an ongoing basis with the school health program activities that have been established in schools

The radical left's turn towards civil society in Greece: One strategy, two paths

The Communist Party of Greece (KKE) and the Coalition of the Radical Left (SYRIZA) made remarkable ‘turns towards civil society’ over the last decade. It is argued that this was primarily a response aimed at strengthening their social legitimacy, which had reached its lowest point in the early 1990s. Differences in the way the two parties attempted to stabilise and engage their membership and re-establish links to trade unions and new social movements can be attributed to their distinct ideological and organisational legacies. Despite those differences, their respective linkage strategies were both successful until the game-changing 2012 Greek national elections, which brought about the remarkable rise of SYRIZA and the electoral demise of the KKE

The Implication of Cultural Revolution and Economic Reform on Rural Women’s Political Participation in Post-Mao China

Since the passage of the Organic Law of Village Committees in 1987, direct election of village leaders has been conducted in China, and eventually reached a national scale after ten years’ experiment. However, rural women’s political participation is discouraged by the social and economic reality in the countryside. Taking a historical retrospect, this research project attempts to analyze the impact of Cultural Revolution and Economic Reform on rural women’s voting rates and representation in local governments in post-Mao China. The results show that these two landmark political and social transformation in the 20th century have reinforced traditional gender roles, excluded rural women from power, and posed additional barriers to their political involvement by introducing new problems such as landlessness