The coronavirus disease 2019 (COVID-19) pandemic has put a great burden on countries as a result of the demand for laboratory diagnostic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This paper reports our experiences in rapidly assessing Indonesia's COVID-19 laboratory testing capacity in the early phase of the pandemic response. Through a questionnaire-based survey carried out between 23 March and 2 April, we estimated the daily tests that could be done by the 44 facilities, excluding the national referral laboratory, first assigned to be COVID-19 diagnostic laboratories. The capacity constraints were lack of reagents and equipment, and limited human resources; because of these constraints, most of the laboratories were not yet operational. A major hindrance was reliance on imported supplies and the associated procurement time. Expanding real-time polymerase chain reaction testing capacity, through increased numbers of laboratories and optimization of existing facilities, was clearly the main priority. We also assessed the potential yield from using rapid molecular testing machines in the country's referral hospitals. Even assuming this potential could be tapped, several provinces would still be poorly served by diagnostic services in the event of a surge in cases. Since this rapid assessment, the number of designated COVID-19 laboratories has increased and, by 1 July 2020, was 163. On 29 July 2020, for the first time, the number of specimens examined in a day reached more than 30 000, achieving the WHO testing capacity target of 1 in 1000 inhabitants per week.
Background: Iodine Deficiency Disorder (100) reduction program has been implemented since 1976. According to the National Economic Survey 2002, the average consumption of iodized salt was 6. 26 grams. The results of Iodine Salt Survey (SGY) 2003 showed that the consumption of iodine salt at the household level was 73.2%, meanwhile, the baseline health survey (Riskesdas) 2007 showed there was reduction of iodine salt consumption towards 60.2%. Methods: Type of study was secondary data analysis with cross-sectional design utilizing the Riskesdas 2007's data. Sample was selected purposively according to the previous SGY's survey based on the endemically criteria namely highly endemic, mediocre and non endemic. Results: The results of the analysis were there was discrepancy of iodine salt consumption among urban and rural areas as well as mother's education level. The iodine salt consumption was higher in the urban area (65.5%) compare to the rural area (52.9%). The higher the education of mothers the better the iodine salt consumed. The usage of iodine salt in the households based on salt quick test was 60.2%, meanwhile, according to the salt titration it was only 23.4%. The results of Excretion Iodine Urine showed that the iodine intake among the school children (age of 6-12 years old) was 12.8% and was still below the cut-off point prevalence, which is greater than 50%. The conclusion of this analysisis that there was evidence of iodine salt reduction consumed at the household level. Conversely, there was inclination of the percentage of iodine urine level among the school children in Indonesia in the year 2007. It is recommended that policy analysis need to be conducted due to the achievement of the Universal Salt iodization target, especially in the endemic areas to asses the existence of the IDO prevalence.
Latar belakang: Tingkat kecacingan pada anak di Indonesia masih tinggi, untuk itu diperlukan pendekatan intervensi kesehatan masyarakat yang tepat. Tulisan ini bertujuan untuk meningkatkan pengetahuan, sikap dan perilaku (PSP) ibu dalam hal mengobati sendiri penyakit kecacingan dengan menggunakan Curcuma aeruginosa Roxb., bahan alam yang mudah ditemukan di Indonesia. Metode: Studi intervensi yang terdiri dari pengukuran terhadap tingkat PSP ibu (77) yang memiliki anak (80) usia 3 sampai 10 tahun, dimana dilakukan pemeriksaan kecacingan pada tinja anak-anak tersebut. Kemudian pada anak-anak yang terbukti menderita kecacingan diobati dengan minuman Curcuma dengan melibatkan ibu. Terhadap ibu juga diberi penyuluhan dan diukur kembali PSP nya terkait kecacingan dan pengobatan kecacingan dengan Curcuma. Tempat pengambilan sampel di Posyandu, desa Cibungbulang kabupaten Bogor. Hasil: PSP ibu meningkat setelah mereka diberikan penyuluhan kecacingan dan pengobatannya a.l pengetahuan bahwa kecacingan adalah penyakit menular (42,90% menjadi 84.40%) dan makanan yang kurang matang dan kotor menjadi jalan masauk bagi cacing kedalam tubuh (67,50% ke 92.20%), dan tanaman obat dapat digunakan untuk mengobati kecacingan (45.50% menjadi 79.20%). Kesimpulan: Edukasi kesehatan yang langsung melibatkan ibu untuk melakukan pengobatan kecacingan dengan Curcuma terbukti efektif untuk meningkatkan PSP sekaligus menyembuhkan kecacingan pada anak. Hasil studi menyarankan bahwa program pengobatan kecacingan pada anak dengan Curcuma dapat dilakukan pada program pengentasan kecacingan dan tidak perlu didahului dengan test pengujian kecacingan pada feces karena Curcuma terbukti efektif untuk pengobatan kecacingan, aman dan meningkatkan nafsu makan anak. Kata kunci: pengentasan kecacingan, Curcuma aeruginosa Roxb., anthelmintic, ibu dan anakAbstract Backgrounds: Worm infections in Indonesia are still high, it needs an appropriate public health intervention. This study aims to improve the knowledge, attitude and practice (KAP) of mothers about self-medication of worm infections using Curcuma aeruginosa Roxb., a natural plant easily found in Indonesia Methods: Study intervention involving the assessment of knowledge, attitude and practice of mothers (77) whose children (80) were feces tested to find out worm infections on their children. The children who confirmed suffering from worm infection were joined Curcuma treatment. Health education related to worm infections and its treatment with Curcuma were delivered to mothers. Then PSP of mothers were assessed again using the same questionnaires as before. Samples were collected from two Village Integrated Health Post in Cibungbulang village Bogor Municipality Results: Before-after intervention showed, the KAP of mothers increased after they got health education & information i.e. mothers knew that worm infections was a contagious disease 42.90% to 84.40%, mothers knew that dirty or poor cooked food is the way of worm get inside into the body 67.50% to 92.20%) and mothers knew that medicinal plant is one of kind treatment for worm infections 45.50% to 79.20%. Conclusions: Health education together with Curcuma’s treatment improved mother’s KAP and it was also cured children from worm infections. It is recommended that deworming program for children with Curcuma should be appropriate without examination of stools since Curcuma effective, safe and may stimulate children’s appetite. Keywords: deworming, Curcuma aeruginosa Roxb., anthelmintic, mothers and children.
Latar belakang: Penyakit Diabetes Mellitus (DM) yang disertai dengan Hipertensi dapat meningkatkan risiko terjadinya disabilitas dan kematian premature. Data besaran masalah DM yang disertai Hipertensi masih terbatas pada data dari fasilitas kesehatan sementara data berbasis populasi merupakan informasi penting untuk memberikan gambaran besaran masalah secara nasional di masyarakat. Studi ini bertujuan untuk mendapatkan gambaran besaran masalah DM dengan disertai Hipertensi serta hubungannya dengan faktor risiko PTM lainnya berdasarkan data RISKESDAS 2013 yang mencakup 34 Provinsi di Indonesia. Metode: Studi Ini merupakan analisis data sekunder dari RISKESDAS 2013. Data dikumpulkan menggunakan kuesioner terstruktur dan pengukuran tekanan darah dan pemeriksaan darah. Jumlah sampel yang dianalisis adalah 35, 931 individu usia 18 tahun ke atas. Pemilihan sampel dengan cara “four stages stratified sampling method”. Hasil: Hasil analisis menunjukkan bahwa prevalensi DM dengan disertai Hipertensi adalah sebesar 3,0%, dengan prevalensi tertinggi sebesar 14% pada laki-laki dan 8% pada perempuan. DM dan hipertensi mempunyai hubungan yang bermakna dengan indeks merokok (OR:2,94) pada laki-laki, dengan obesitas (OR: 2,35 pada laki-laki dan 2,19 pada perempuan), dan dengan kolesterol darah (OR: 1,86 pada laki-laki dan 3,45 pada perempuan). Kesimpulan: Beberapa faktor risiko seperti indeks masa tubuh, profil lemak, konsumsi buah dan sayuran serta merokok dapat dijadikan indikator untuk pencegahan penyakit komplikasi DM dan hipertensi, risiko disabilitas dan kematian prematur. (Health Science Journal of Indonesia 2016;7(2):97-106) Kata Kunci: diabetes mellitus, hipertensi, faktor risiko perilaku Abstract Background: Diabetes mellitus (DM) with hypertension increases risk of disability and premature death. Data on DM with hypertension is limited to hospital based data, while population-based data is important to provide problem magnitude in the population setting. This study aimed to describe issues magnitude of diabetes mellitus with hypertension and relationship with other NCD risk factors in Indonesia based on national population based survey. Method: This is a data analysis from a cross sectional national health survey (RISKESDAS) in 2013 that covered 34 provinces in Indonesia. Data was collected using structured questionnaire and measurement. Sample was 35,931 people aged 18+ years. Sampling method used four stages stratified sampling method. Results: This study showed prevalence of diabetes mellitus with hypertension was 3.0%, the highest prevalence was 14% for male and 8% in female. Diabetes mellitus with hypertension had significant relationship to smoking index in male (OR:2.94), obesity in male (OR: 2.35) and female (OR: 2.19) and blood cholesterol (OR: 3.45 in female and OR:1.86 in male). Conclusion: Health risk monitoring on body mass index, lipid profile, fruits and vegetables consumption, and smoking, will be crucial as a secondary prevention among DM and Hypertension case towards further complication, and risk of disability and premature death. (Health Science Journal of Indonesia 2016;7(2):97-106) Keywords : diabetes mellitus, hypertension, behaviour risk factors
ABSTRACT
Background: Jampersal program was launched in Indonesia in January of 2011 by Permenkes No.631/Menkes PER/111/2011. The aim was to improve the coverage of antenatal care. delivery, postpartum care, postnatal, and Tamil; planning by health professionals free of charge. After over a year Jampersal program runs, The ANC figures of Jamperss utilization were still very low. Methods: Quantitative and qualitative research on socio- cultural factors in relation ti the selection of health personnel by utilizing Jampersal conducted in 2012 which was then followed by a round WM discussion to review the policy options related to the Jampersal utilization of the 6 rural districts.
Results: Policy option suggested in Jampersal socialization activities need intersectoral Commitment: The Ministry of Home Affairs. Mm/sir of Religious Affairs, and BKKBN, followed by a clear and decisive political commitment. They need active partnership of the midwives. TBAs and cadres in Jampersal socialization. Midmives in the health center level should be prohibited from private practice, but the total amount of compensation of midwife in helping delivery should be adjusted. Regulations are required and procedures should be set for Jamkesmas, Jamkesda, and Jampersal; They need regulation on cooperation between the health centers staffs and village chiefs to further reinforce ID requirement; the transportation cost to refferal unit; TBAs services (devision of task and cost); financial restriction; Financial restriction to cover by Jampersal on second or third delivery. Additioally nee d a regulation of reward and punishment for midwives, TBAs and cadres involvement in serving pregnancy and delivery. In village level, they need to establish regulation, that TBAs and cadres should write the pregnat women dat a at board office of village chiefts. Lastly, MoU between head of district health center and midwife assosiation related to midwife understanding of culture approaches and on the job training for midwife should be established.
Conclusion: Culture-Based Approach has important role to improve Delivery By Health Workers in Rural Areas. Recommendation: Shorterm and longterm and logterm priority of policy should be set up.
Keywords: Jaminan Persalinan, Policy Options, Cultural, Delivery, Midwives – TBAs
Stunting among toddlers is highly prevalent in Indonesia. As a chronic malnutrition problem, stunting is closely related to internal (maternal health) and external factors such as feeding practices, illness and socio-economics of the community. The purpose of this study was to analyze the relationship between low birth weight (LBW), child feeding practices and neonatal illness with stunting among Indonesian toddlers. For this study, we took data from the 2010 Indonesian National Basic Health Survey (RISKESDAS). Totally 3024 children aged of 12–23 months included in this analysis. Stunting was measured using standardized body length and was defined based on criteria from WHO AnthroII.PC2007. Data analysis was done through bivariate and multivariate logistic regressions. The results showed that the prevalence of stunting among Indonesian toddlers (12 23 months) was 40.4%. Early initiation of breast-feeding and exclusive breast feeding was experienced by 42.7% and 19.7% of the babies. More than half of the babies were given pre-lacteal feeds, while early complementary feeding was given to 68.5% of the subjects. Multivariate analysis showed infants born with LBW were 1.74 times more likely to be stunted (95% CI 1.38–2.19) than those born with normal weight. Boys were 1.27 times (95% CI 1.10–1.48) more likely to be stunted than girls. Infants with a history of neonatal illness, they were 1.23 times (95% CI 0.99–1.50) more susceptible to stunting. Being poor was another indirect variable that significantly associated with stunting (OR = 1.3, 95% CI 1.12–1.51). LBW, gender (boys), history of neonatal illness and poverty are factors related to stunting among children aged 12–23 months in Indonesia, with LBW being the major determinant of stunting.
So far, limited research has been done on inequity and inequality in health care utilisation in Indonesia. As anywhere else in the world, wealth and education are unequally distributed over the population. Need of health care is a major determinant which should affect use to health services. Using data from the 1997 Indonesia Demographic and Health Survey and the concentration index approach, models of access to preventive care in children age 12-23 months, pregnancy related care for mothers as well as curative care for children five years old or less is estimated. Asset scores are used to analyse whether health care utilisation of children and mothers is correlated to household wealth. Significant inequity has been found in the utilisation of health care by wealth. Access to preventive care for children immunisation and pregnancy related care (tetanus injection, first visit for antenatal care, place for antenatal care, place for delivery, professional assistance for delivery) as well as curative care (medical treatment for diarrhoea and ARJ) tend to be significantly different by household wealth. Wealthier mothers use more health services than poorer mothers do. An exception to this rule is treatment for diarrhoea and ARI. This may be explained by measurement error. Need (health care), urban-rural residence and education are confounding that are found to reduce the concentration indices for use. Horizontal equity principle is violated, in the sense that mothers in equal need are found to be treated unequally.
Tuberculosis (TB) is the world's major public health problem. We assessed the proportion, reasons, and associated factors for anti-TB treatment nonadherence in the communities in Indonesia.This national coverage cross-sectional survey was conducted from 2013 to 2014 with stratified multi-stage cluster sampling. Based on the region and rural-urban location. The 156 clusters were distributed in 136 districts/cities throughout 33 provinces, divided into three areas. An eligible population of age ≥15 was interviewed to find TB symptoms and screened with a thorax x-ray. Those whose filtered result detected positive followed an assessment of Sputum microscopy, LJ culture, and Xpert MTB/RIF. Census officers asked all participants about their history of TB and their treatment-defined Nonadherence as discontinuation of anti-tuberculosis treatment for <6 months. Data were analyzed using STATA 14.0 (College Station, TX, USA).Nonadherence to anti-TB treatment proportion was 27.24%. Multivariate analysis identified behavioral factors significantly associated with anti-TB treatment nonadherence, such as smoking (OR = 1.78, 95% CI (1.47-2.16)); place of first treatment received: government hospital (OR = 1.45, 95% CI:1.06-1.99); private hospital (OR = 1.93, 95% CI: 1.38-2.72); private practitioner (OR = 2.24, 95% CI: 1.56-3.23); socio-demographic and TB status included region: Sumatera (OR = 1.44, 95% CI: 1.05-1.98); other areas (OR = 1.84, 95% CI: 1.30-2.61); low level of education (OR = 1.60, 95% CI: 1.27-2.03); and current TB positive status (OR = 2.17, 95% CI: 1.26-3.73).Nonadherence to anti-TB drugs was highly related to the personal perception of the respondents, despite smoking, current TB status, a place for the first treatment, education, and region. The position of the first TB treatment at the private practitioner was significantly associated with the risk of Nonadherence to treatment.
Berdasarkan penelitian yang telah dilakukan diketahui bahwa alokasi anggaran kesehatan berbeda antar kabupaten, proporsi anggaran terbeban untuk kegiatan administrasi umum dan hanya sebagian kecil anggaran dialokasikan untuk kegiatan operasional. Dari total anggaran, proporsi terbesar tampaknya untuk kegiatan Kesehatan Ibu dan Bayi. Sayangnya, tidak ada perincian secara jelas, terpecah-pecah ke dalam program (misal: Gizi, Imunisasi, dan lain-lain), dan cenderung untuk kegiatan rutin. Alokasi untuk kegiatan investasi juga sangat rendah (2-7%), kecuali untuk Kabupaten Badung 47,2%.
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