Agung Dwi Laksono

“Masalah kesehatan masyarakat merupakan resultante dari berbagai faktor, diantaranya Politik,  ekonomi, budaya, sosial dan demografi. Buku “Pemanfaatan Pelayanan Kesehatan di Daerah Tertinggal, Perbatasan, dan Kepulauan” yang ditulis oleh Agung Dwi Laksono, dkk adalah salah satu potret wajah layanan kesehatan terutama pemanfaatan rumah sakit di daerah tertinggal, perbatasan dan kepulauan. Data yg disajikan dalam buku ini sangat menarik karena bisa memotret berbagai aspek yang merupakan hambatan utama dalam pelayanan kesehatan khususnya pemanfaatan rumah sakit. Semoga para pengambil kebijakan bisa menjadikan buku ini sebagai salah satu referensi utk menyempurnakan kebijakan pelayan kesehatan di daerah 3 T.”

Prof. Dr. Aminuddin Syam, SKM., M.Kes., M.Med. Ed
Guru Besar Fakultas Kesehatan Masyarakat Universitas Hassanudin Makassar

Dengan sengaja pendekatan etnografi dipilih dalam studi ini, untuk menggali potensi kearifan lokal yang ada pada suku Tengger. Kearifan lokal yang mendorong masyarakat suku Tengger dalam memilih ukuran keluarga kecil. Kearifan lokal inilah yang terbukti membuat masyarakat suku Tengger bisa eksis dan bertahan di tengah arus modern pariwisata yang melingkupi kawasan wisata Gunung Bromo. Pendekatan etnografi lebih menekankan pandangan masyarakat setempat atas dunia yang melingkupinya (konsep emik), yang bisa jadi pandangan tersebut berbeda dengan perkembangan pada saat ini (konsep etik). Masyarakat Suku Tengger di Desa Wonokitri menganggap sama saja antara anak laki-laki atau perempuan. Kecenderungan untuk menyamakan kedudukan antara laki-laki dan perempuan dalam tatanan masyarakat Tengger di Desa Wonokitri tidak hanya sebatas pengakuan, tetapi juga tampak pada sistem budaya yang berlaku, pada sistem atau hukum waris misalnya dianggap memiliki kedudukan dan hak yang sama dalam soal pembagian warisan. Dua generasi terakhir keluarga Tengger seringkali ditemukan hanya memiliki satu-dua anak saja. Secara empiris jarang ditemukan keluarga inti yang memiliki anak lebih dari dua orang. Kalaupun ditemukan yang memiliki jumlah anak lebih dari dua, seringkali adalah keluarga senior (berumur di atas 50 tahun), atau keluarga muda yang mengaku kebrojolan. Kehamilan yang tidak direncanakan, atau tidak disengaja, karena ada sesuatu hal di luar prediksi. Selain alasan praktis dan jangka panjang yang berterkaitan dengan lahan pertanian, ada argumentasi lain juga dilontarkan masyarakat Suku Tengger untuk membatasi jumlah anak hanya dua orang saja. Alasan ini berkaitan dengan masa depan Suku Tengger secara keseluruhan. Alasan yang lebih mendasar dan filosofis dibanding alasan-alasan sebelumnya. Keyakinan yang dianut oleh masyarakat Tengger bersumber pada leluhur. Keluar dari wilayah seputar Bromo, maka artinya sama dengan meninggalkan tanah leluhur Tengger. Temuan baru dalam studi ini adalah konstruksi sosial dari multi faktor yang ikut menyusun ukuran keluarga kecil pada Suku Tengger di Desa Wonokitri. Sumber: Tengger Bertahan dalam Adat.

Program Desa Sehat Berdaya merupakan wujud keberanian berbuat dan mencoba hal yang baru. Berani menjadi terdepan dan hidup di tengah masyarakat. Berkoordinasi dengan lintas sektor yang menjadi sumber dukungan penuh terhadap apa yang dikerjakan. Program ini berjalan dengan cita-cita dapat mengisi ruang kosong di tengah keterbatasan masyarakat, menjadi penghubung masyarakat ke pelayanan publik setempat, menjadi sumber informasi bagi mereka yang membutuhkan. Meningkatkan derajat kesehatan masyarakat di desa adalah tujuan utama yang dicapai dengan kegigihan untuk saling belajar dan maju. Kalau bukan sekarang, kapan lagi?

Determinan sosial yang selama ini lebih sering dipinggirkan, menjadi salah satu menu pelengkap wajib bila memang peningkatan status kesehatan ibu dan anak benar-benar menjadi tujuan. Perlu membuka wawasan lebih luas untuk dapat memahami sekian banyak determinan sosial yang kebanyakan justru berlaku local specific.

Kebijakan pembangunan kesehatan ibu dan anak tidak bisa lagi hanya mengandalkan dalam format yang generik, berlaku umum untuk seluruh wilayah republik ini, yang dalam kenyataannya memiliki variabilitas yang sungguh benar-benar beragam. Para pengambil kebijakan di tingkat pusat tidak lagi bisa memaksakan pola yang sama untuk seluruh kabupaten/kota. Untuk itu, kebijakan yang disusun harus bisa memberikan peluang untuk pengembangan ataupun inovasi bagi daerah.

Bugis Tukak, adalah sebutan penulis untuk masyarakat etnik Bugis yang tinggal di Desa Tukak, Kecamatan Tukak Sadai, Kabupaten Bangka Selatan. Sebuah koloni masyarakat Bugis yang tinggal jauh dari wilayah aslinya di Daratan Sulawesi.

Orang Bugis yang tinggal di Desa Tukak pada umumnya adalah nelayan. Tidak hanya mencari ikan, justru Desa Tukak dikenal sebagai penghasil ketam yang sudah sampai dieksport ke negara tetangga.

Seperti umumnya kampung nelayan di wilayah lain, perkampungan nelayan di Desa Tukak yang dihuni etnik Bugis juga terlihat kumuh, terutama dalam urusan sampah dan MCK. Kekumuhan ini, bukannya tidak disadari sebagai sesuatu yang salah, mereka berusaha untuk bisa menjadi lebih baik.

Apa saja yang bisa dilakukan untuk berubah? Upaya apa saja yang bisa ditempuh? Semuanya terangkum di dalam buku ini.

Analisis kebijakan, sebuah ilmu gado-gado yang memadukan banyak disiplin ilmu untuk meramu sebuah kebijakan dengan harapan menjadi applicable. Dengan membuka mata selebar mungkin terhadap isu kebijakan, menganalisis keterkaitan kebijakan yang sudah ada sebelumnya, strategi meminimalisir resistensi, merangkul sebanyak mungkin aktor kebijakan, menyediakan alternatif kebijakan, serta mampu memprediksikan tingkat keberhasilannya di masa mendatang,
membuat analisis kebijakan menjadi sedemikian kompleks.

Bagi Suku Muyu, anyiman, atau makanan dalam Bahasa Muyu, menempati posisi yang demikian tinggi. Makanan bagi Suku Muyu tidak bisa dilepaskan begitu saja hanya sebagai sumber energi atau zat gizi, atau sekedar memenuhi kebutuhan hidup. Makanan bagi Suku Muyu memiliki nilai yang sangat penting, yang juga merupakan sebuah aktualisasi pada kehidupan keseharian atas keyakinan pada dimensi religi yang dianut dan dijalaninya.

Short Communication intrOductiOn A pregnancy that occurs in unmarried women is much more likely to happen accidentally, and this accident is due to financial insufficiency and lack of support system support. The adverse effects of unintended pregnancy can be associated with pregnancy, delayed antenatal care, adverse birth outcomes, psychosocial stress, and poor mental health. [1] The child's low development score threatens babies from an unintended pregnancy. [2] The phenomenon indicates that unintended pregnancy has a double burden because of pregnancy's physiological changes and the absence of a conception plan. In Indonesia, pregnancies in unmarried women get the wrong value from the community. The incidence of marriage due to unintended pregnancy in 2013 was 84.12% of 143 unions; then, in 2014, it grew to 85.9% of 140 marriages. In 2015, the increase continued, 87.5% of 160 wedding events. [3] At the global level, the abortion incidence in the 1990-1995 period reached 55 million per year and increased to 73 million per year in 2015-2019. [4] Unintended pregnancy that ends in abortion is rising, especially in countries where abortion is restricted. [5] Since unintended pregnancy in unmarried women in Indonesia has a complex impact, it requires more comprehensive attention. The study analyzes the factors influencing unintended pregnancies among unmarried women in Indonesia. methOds The research used secondary data from 2017 Indonesian Demographic and Health Survey (IDHS). This study's population is unmarried women of childbearing age (15-49 years old) who had given birth in the last five years in Indonesia. Unmarried women mean never in a union, widowed, or divorced. The study gets 1,050 respondents. The dependent variable was unintended pregnancy. Unintended pregnancy was defined and calculated as a pregnancy that is Background: Indonesia has moral norms consider pregnancy among unmarried women a disgrace. The study analyzes the factors influencing unintended pregnancies among unmarried women in Indonesia. Material and Methods: The study examined 1,050 women. The author analyzed unintended pregnancy and six other variables (residence, age, education, employment, wealth, and parity). Multivariate analysis used binary logistic regression. Results: 15.5% of unmarried women in Indonesia have experienced an unintended pregnancy. Women living in urban areas are more likely to experience unintended pregnancies than women in rural areas. The 15-19 have the highest chance of experiencing an unintended pregnancy. Education is a protective factor from unintended pregnancy. Employed women are 1.938 times more likely than unemployed. Poverty is a risk factor for experiencing an unintended pregnancy. Multiparous is 4.095 times more likely than primiparous. Conclusion: The study identified six variables that affect unintended pregnancy among unmarried women in Indonesia: residence, age, education, employment, wealth, and parity.

Background: To care for their health needs, women in Indonesia who live with their parents or inlaws frequently lose their independence, including the choice of delivery place. Aim: The study aimed to analyze the effect of home residential status on the choice of delivery place in Indonesia. Methods: The study design was a cross-sectional study. The study employed secondary data from 2017 Indonesian Demographic and Health Survey (IDHS). The research included 15,357 women aged 15-49 with live births in the last five years. Meanwhile, the study used place of delivery as an outcome variable and home residential status as an exposure variable. Moreover, the research employed nine control variables: type of residence, age group, education level, employment status, marital status, parity, wealth status, health insurance, and antenatal care visits-the final analysis using binary logistic regression. Findings: The result shows that women with home residential status in the alone category were 1.248 times more likely than those in the joint category to choose to give birth to healthcare facilities (AOR 1.248; 95% CI 1.143-1.361). In addition to home residential status, the study also found seven control variables to have a relationship with the choice of place of delivery. The seven control variables were the type of residence, age group, education level, parity, wealth status, health insurance, and antenatal care. Conclusion: The study concluded that home residential status affects the choice of delivery place in Indonesia.

Objectives Policymakers must ensure that the entire population has equal access to health services, and efforts to minimise inequalities are needed. This study aimed to analyse the regional disparities in hospital utilisation in Indonesia. Design A cross-sectional study analysing secondary data from the 2018 Indonesian Basic Health Survey. Setting National-level survey data from Indonesia. Participants A total of 629 370 participants were included in the study. Intervention We employed no intervention Primary and secondary outcome measures The primary outcome was hospital utilisation. Aside from region, we utilise residence type, age, gender, marital status, educational level, occupation, wealth, insurance and travel time as control variables. We used binary logistic regression in the final analysis Results The respondents in Sumatra were 1.079 times (95% CI 1.073 to 1.085) more likely than those in Papua to use the hospital. Furthermore, compared with the respondents in Papua, those in the Java-Bali region (1.075 times, 95% CI 1.069 to 1.081), Nusa Tenggara (1.106 times, 95% CI 1.099 to 1.113), Sulawesi (1.008 times, 95% CI 1.002 to 1.014) and Kalimantan (1.212 times, 95% CI 1.205 to 1.219) were more likely to use the hospital. However, those in Maluku were less likely than those in Papua to use the hospital (0.827 times, 95% CI 0.820 to 0.835). Six demographic variables (age, gender, marital status, educational level, occupation and wealth) and three other control variables (residence type, insurance and travel time to the hospital) were found to be associated with hospital utilisation. Conclusions Our findings highlight the existence of regional disparities in hospital utilisation in Indonesia.

Original Article intrOductiOn Poverty is a household economic condition with an average expenditure below the poverty line. [1] Poverty is a situation that encourages women to experience domestic violence. The World Health Organization noted that 30% of women experience violence from their partners globally. [2] One of the implications of women's poverty is the lack of knowledge due to dropping out of school so that women do not have bargaining power towards their partners. [3] Not only that, but the condition bound women by poverty will also voluntarily look for work and even experience woman trafficking. [4] The number of violence against women in Indonesia increases from year to year. However, this condition is like the iceberg phenomenon because we found many violence cases in women under-reported. After all, violence against women is in privacy. [5,6] Based on a national survey conducted by the Central Bureau of Statistics and the Ministry of Woman Empowerment and Child Protection, Indonesia in 2016 stated that women aged 15-64, as many as 12.3% experienced physical violence, and 10.6% experienced violence by spouses. [7] Other survey reports conducted in Indonesia explain that the number of violence cases against women in Indonesia in 2017 was 348,466 cases, in 2018 as many as 406,178 patients, and still increased in 2019 by 431,471. [8] Globally, violence against women is related to patriarchal social norms. The situation includes strict gender norms and cultural settings, which have an excellent opportunity to accept that torturing a woman is a form of fairness, as is the case in Background: Society placed women living in the men's world as inferior. Poverty as a stressor for men has the opportunity to make women victims of violence from their partners. The study aimed to analyze the effects of poverty on the risk of intimate partner violence among married women in Indonesia. Materials and Methods: The samples used were married women aged 15-49 years old. The weighted sample size was 34,086 women. Besides intimate partner violence as the dependent variable, other variables analyzed as independent variables were wealth status, residence, age, education, employment, living with in-laws, and recent sexual activity. The study employs binary logistic regression to determine intimate partner violence risk in the final stage. Results: The results show the poorest married women were 1.382 times more likely than the richest married women to experience intimate partner violence. Married women with wealthy status in the lower category were 1.320 times more likely than the richest married women to experience intimate partner violence. Married women with a wealthy group in the middle class were 1.262 times more likely than the richest married women to experience intimate partner violence. Married women with wealthy status in the more decadent category were 1.132 times more likely than the richest married women to experience intimate partner violence. Conclusion: The study concluded that poverty was a risk factor for intimate partner violence among married women in Indonesia. The lower the socioeconomic status, the greater the risk of intimate partner violence.

The health care system uses health care services for various objectives, including curing or treating disease and health conditions, preventing or delaying future health issues, reducing pain, and improving quality of life. A hospital, emergency department, doctor's and dentist offices, and other care facilities are examples of where health services are used. [1] The hospital provides referral services from lower health care, providing comprehensive curative and rehabilitative services. [2] Background: Maluku region is one of the vulnerable areas in Indonesia, and this region has extreme geographical conditions with thousands of islands. The study aims to analyze the role of travel time to a hospital in the Maluku region in Indonesia. Material and Methods: This cross-sectional study analyzed the 2018 Indonesian Basic Health Survey data. The research included 14,625 respondents by stratification and multistage random sampling. The study used hospital utilization as an outcome variable and the travel time to the hospital as an exposure variable. Moreover, the study employed nine control variables: province, residence, age, gender, marital status, education, employment, wealth, and health insurance. The study performed binary logistic regression to interpret the data in the final analysis. Results: The result shows a relationship between travel time and hospital utilization. Someone with a travel time of 30 min or less to the hospital has a 1.792 (95% CI 1.756-1.828) higher probability than those with a travel time of more than 30 min. The results of this analysis find that shorter travel time to the hospital has a better possibility of hospital utilization. In addition, the study also found eight control variables to have a significant relationship with hospital utilization. Conclusion: Shorter travel time to the hospital is more likely to be utilized in the Maluku region.

Background Policymakers must understand primary healthcare utilization disparity to minimize the gap because they must seek fair service for every citizen. The study analyzes regional differences in primary healthcare utilization in Java Region-Indonesia. Methods The cross-sectional research analyzes secondary data from the 2018 Indonesian Basic Health Survey. The study setting represented Java Region-Indonesia, and the participants were adults 15 years or more. The survey explores 629,370 respondents. The study used primary healthcare utilization as an outcome variable and province as the exposure variable. Moreover, the study employed eight control variables (residence, age, gender, education, marital, employment, wealth, and insurance). The study evaluated data using binary logistic regression in the final step. Results People in Jakarta are 1.472 times more likely to utilize primary healthcare than those in Banten (AOR 1.472; 95% CI 1.332-1.627). People in Yogyakarta are 1.267 times more likely to use primary healthcare than those in Banten (AOR 1.267; 95% CI 1.112-1.444). In addition, people in East Java are 15% less likely to utilize primary healthcare than those in Banten (AOR 0.851; 95% CI 0.783-0.924). Meanwhile, direct healthcare utilization was the same between West Java, Central Java, and Banten Province. They are sequentially starting from the minor primary healthcare utilization: East Java,

Background Indonesia has made significant progress in expanding universal health coverage (UHC) through its National Health Insurance (NHI) mechanism. However, in the context of NHI implementation in Indonesia, socioeconomic disparities caused its subpopulations to have different literacy of NHI concepts and procedures, increasing the risk of healthcare access inequities. Hence, the study aimed to analyse the predictors of NHI membership among the poor with different education levels in Indonesia.

The study aimed to analyze the target of the policy to decrease low birth weight (LBW) in Indonesia. This cross-sectional study used a sample of live births in last five years preceding the survey of birth weight. Data collection took place from July to September 2017. The weighted
sample size was 17,848 participants. The variables analyzed included residence, age, marital status, education, employment, parity, and wealth. The study employed binary logistic regression in the final stage to determine the target of policy regarding LBW. The results showed that women in urban areas were 1.200 times more likely to deliver babies with LBW than women in rural areas. All age groups were less likely to deliver babies with LBW than those aged 45–49. The study also found all marital statuses had a lower likelihood of providing babies with LBW than those who had never been in a marriage. Women of all education levels had a greater risk of giving birth to babies with LBW than women with higher education levels. Unemployed women had 1.033 times more chances
of delivering babies with LBW than employed women. Primiparous women were 1.132 times more
likely to give birth to babies with LBW than multiparous women. Overall, the women in all wealth
status categories had a higher probability of delivering babies with LBW than the wealthiest groups. The study concluded that policymakers should target women who live in urban areas, are old, have never been married, have low education, and are unemployed, primiparous, and poor to decrease LBW cases in Indonesia.

Background An urban poor is a vulnerable group that needs government financing support to access health services. Once they are sick, they will fall deeper into poverty. The study aims to analyze the effectiveness of governmentrun insurance in hospital utilization in urban poor in Indonesia. Methods The research analyzed the 2018 Indonesian Basic Health Survey data. This cross-sectional survey collected 75,970 participants through stratification and multistage random sampling. Meanwhile, the study employed hospital utilization as an outcome variable and health insurance ownership as an exposure variable. Moreover, the study looked at age, gender, marital status, education, and occupation as control factors. The research employed a binary logistic regression to evaluate the data in the final step. Results The results show that someone with government-run insurance is 4.261 times more likely than the uninsured to utilize the hospital (95% CI 4.238-4.285). Someone with private-run insurance is 4.866 times more likely than the uninsured to use the hospital (95% CI 4.802-4.931). Moreover, someone with government-run and private-run insurance has 11.974 times more likely than the uninsured to utilize the hospital (95% CI 11.752-12.200). Conclusion The study concluded that government-run insurance is more effective than the uninsured in improving hospital utilization among the urban poor in Indonesia. Meanwhile, private-run is more effective than governmentrun and uninsured in improving hospital utilization among the urban poor in Indonesia. Moreover, the most effective is to combine the kind of health insurance ownership (government-run and private-run).

The study aimed to analyze the most appropriate maternal characteristics for stunting prevention policies. The study employed secondary data from the 2017 Indonesia Nutritional Status Monitoring Survey. The study obtained weighted samples of 11,887 Papuan children under five years of age. On the other hand, the study used the nutritional status as an outcome variable and maternal characteristics as an exposure variable. The research employed the following four control variables: residence, region, under-five age, and gender. The study occupied the binary logistic regression. The results show that mothers who graduated from primary school and under were 1.263 times more likely than mothers with a college education to have stunted children. Mothers who graduated from junior high school are 1.222 times more likely than mothers with a college education to have stunted children. Mothers who graduated from senior high school were 1.122 times more likely than mothers with a college educati...

Some tribes in Indonesia have a big family culture. The study aimed to analyze factors that correlate to family size in Indonesia. The study employed secondary data from the 2017 Indonesia’s Demographic and Health Survey. The samples used were 34,353 childbearing age couples. The variables analyzed included type of residence, wealth, marital, cohabitation duration, complete child gender, contraceptive, age of husband-wife, education of husband-wife, and occupation of husband-wife. Final test by binary logistic regression. The results show that couples in urban areas are less likely to have a family size ≤ 4 than couples who live in rural areas. The better the wealth status, the higher the possibility to have a family size ≤ 4. The longer the cohabitation period, the lower the possibility of having a family size ≤ 4. Couples who already have complete child gender were 0.148 times more likely to have a family size < 4 than couples with incomplete child gender. The contraceptives us...

Previous studies have informed that female workers are a vulnerable group that can affect the failure to achieve exclusive breastfeeding (EBF). This study aims to analyze the determinants of EBF among female workers in Indonesia. The research used secondary data from the 2017 Indonesian Nutritional Status Monitoring as a material analysis. Apart from EBF, other variables analyzed include the type of place of residence, age group, marital status, education level, under-five’s age, under-five’s gender. The study employed 13,042 female workers as analysis material. Binary Logistic Regression was employed in the final stage. The results show female workers who live in urban areas have 1,144 times the probability of achieving EBF than female workers who live in rural areas. Female workers with high school senior education have 0.891 times the chance of achieving EBF compared to female workers with a college education. Under-five’s age was found as a determinant of EBF among female worker...

Previous research has found that the cost of chronic kidney disease is relatively high. This study aims to ecologically analyze the factors relatedto the prevalence of chronic kidney disease in Indonesia.The research conduct ecological analysis using secondary data from the Ministry of Health of the Republic of Indonesia report in 2018. The study takes all provinces as samples. Apart from chronic kidney disease, four other variables analyzed as independent variables were the adherence to taking antihypertensive drugs, dedication to taking anti-diabetic drugs/injections, a habit of drinking soft drinks > 1 time/day, a habit of drinking energy drinks> 1 time/day. Data were analyzed usinga scatter plot.The results showed that the higher the percentage of adherence to taking antihypertensive drugs in a province, the higher the prevalence of chronic kidney disease. The higher the percentage of commitment to taking anti-diabetes medications/injections in a section, the lower the pre...

Eastern Indonesia is a region that is noted to often have a lower public health status than Western Indonesia. This study was aimed to analyze the demographic characteristics of a mother as a predictor of LBW in Eastern Indonesia. The study employed the 2017 Indonesian Demographic Health Survey data. The study population was women aged 15-49 years old who had given birth in the last 5 years in Eastern Indonesia. The analysis involved 6 independent variables, namely type of place of residence, age group, marital status, education level, employment status, and wealth status. The study employed 6,636 respondents. Binary Logistic Regression was used for the final stage. The results inform is getting older, the possibility of women in Eastern Indonesia is getting bigger to have LBW babies. Women with higher education levels are 0.400 times more likely than no education women to have LBW babies (OR 0.400; 95% 0.293-0.545). Category women in wealth poorer have a probability of 0.789 times ...

Health insurance ownership is one indicator of the readiness of pregnant women for the delivery process. The study aimed to analyze the determinants of health insurance ownership among pregnant women in Indonesia. The study population was pregnant women in Indonesia. The study involved 2542 pregnant women in Indonesia. The variables analyzed included type of place of residence, age group, education level, employment status, marital status, parity, wealth status, and know the danger signs of pregnancy. In the final step, the study employed binary logistic regression to explain the relationship between health insurance ownership and predictor variables. The results show that pregnant women with higher education were 3.349 times more likely than no education pregnant women to have health insurance. Pregnant women with wealth status in the middle category were 0.679 times the poorest pregnant women to have health insurance. Meanwhile, the richest pregnant women had 1.358 times more chan...

The elderly are one of the vulnerable groups. This study was aimed at analyzing descriptive statistics ofthe incidence of injury in the elderly in Indonesia.The data derived from the 2018 Indonesia Basic HealthSurvey. The analysis was performed statistically descriptive. The analysis was carried out with a sampleof85,358 elderly.The results show that in all types of characteristics the highest proportion of injuries waslower limb injury, followed by upper limb injury. The incidence of lower limb injury in the 60-69 age groupwas higher than in any other age group. Meanwhile, upper limb injuries were more common in the 70-79age group. The incidence of injury in various locations in males was higher than in female elderly, except atthe location of head and stomach injuries which have the same proportion. The proportions of abrasions andsprains were most common in the 70-79 age group, male, senior high school, and the middle wealth status.The proportion of blisters/bruises affects the e...

Background: If a child gives values that were considered positive or beneficial to parents, then parents will place high expectations on the child. The study was conducted to synthesize the value of children in the Aceh Tribe and the Lani Tribe. Objective: The research aim was to explore the value of children in the Lani and the Acehnese. Methods: Using the meta-synthesis method in two manuscripts resulting from health ethnographic research, namely "The Dilemma of the Family Planning Program" (Acehnese Tribe in East Aceh, Aceh) and "Portrait of Noken Child Care Patterns in Lani Culture" (Lani Tribe in Tolikara, Papua). Results: Economically the people of Aceh and Lani consider children to be investments. This applies to girls. Socially, the two tribes consider children to be a complement to a family's life and a source of happiness. In religion, the Acehnese consider the child to be the successor to the religion, multiplying children was an effort to multiply...

Background/Objective: Although there has been a decline in the prevalence of stunting in Indonesia in the past decade, the figure is still the highest among countries in Southeast Asia. This figure varies in 34 provinces. The purpose of the study was to analyze the regional disparity of stunted toddlers in Indonesia.Materials and Methods: The analysis in this study uses data from the 2017 Indonesian Nutritional Status Monitoring (PSG 2017). Multi-stage cluster random sampling was used in the PSG 2017. The sample used in this study was 149,571 toddlers aged 0-59 months. Data were analyzed using the Binary Logistic Regression test.Results: Toddlers in the Sumatra region have the possibility of 0.921 times stunted compared to toddlers in the Papua region (OR 0.921; 95% CI 0.880-0.963). The Java-Bali region was 0.805 times more likely than toddlers in the Papua region to be stunted (OR 0.805; 95% CI 0.763-0.843). The Nusa Tenggara Region was 1.394 times more likely than toddlers in the ...

The subnational global hunger index (GHI-SN) is derived from the global hunger index as a simple indicator to compare hunger status at each subnational level and monitor health program achievement concerning the global target. The purpose of this objective study is to ensure the validity and reliability of the subnational global hunger index; to assess health inequality in children under the age of five in Indonesia. Method: We use secondary data analysis to determine malnutrition and child mortality prevalence using aggregate data from national basic health research survey reports (2007, 2010, 2013, 2018) and demographic survey reports from 2002, 2012, and 2017. The subnational hunger index was calculated using previously standardized undernutrition, stunting, wasting, and child mortality rates. Factor analysis and Pearson correlation with Alpha Cronbach coefficient were used to assess the validity and reliability. Further analysis using longitudinal panel data analysis with random...

Background: Equitable distribution of health services between areas is still a problem in various countries. Even in developed countries. This condition also applies to the utilization of healthcare facilities for childbirth.Objective: To analyze the urban-rural disparities of facilities-based childbirth in Indonesia.Methods: The analysis in this study uses raw data from the 2017 IDHS. With stratification and multistage random sampling, 17,769 women aged 15-49 years with live births in the last 5 years were sampled. Data were analyzed using a Binary Logistic Regression test.Results: Women in urban areas were probably 2.417 times more utilizing healthcare facilities for delivery than those in rural areas. Women with tertiary education were likely to be 1.709 times more utilizing healthcare facilities for delivery than those who don't. Richest women were probably 6.556 times more utilizing healthcare facilities for delivery than poorest women. Women who have health insurance maybe...

The antenatal treatment has been ineffective in reducing maternal mortality. Therefore, this study aimed to examine  health insurance effect on Indonesia's antenatal care quality. The 2017 Indonesian Demographic and Health Survey data were processed. Moreover, a sample size of 15,351 participants was selected using the analysis unit of study for women aged 15 to 49. In the final stage, Binary Logistic Regression was used, while other variables examined besides antenatal treatment included health insurance, residence, age, marital, education, parity, and wealth. Based on the complete category of antenatal care visits, women that did antenatal care visits were ≥ four, occupied by both types of health insurance ownership. The multivariable analysis indicated that health insurance ownership affects antenatal care completeness as insured women were 1.394 times higher than uninsured women (OR= 1.394; 95% CI= 1.257-1.546). Result showed other determinant variables, namely age, educatio...

Health insurance is an effort to transfer risks to increase public access to the use of health services. The study was aimed at analyzing factors related to health insurance ownership among Mollucans in Indonesia. The sample size was 788 respondents. The variables analyzed included health insurance ownership, age group, gender, education level, employment status. The final stage was employed multinomial logistic regression. The results show Mollucans in the ≤19 age group were 0.182 times more likely than Mollucans in the ≥ 50 age group to have government-run type health insurance. Mollucans in the 20-29 age group were 0.219 times more likely than Mollucans in the ≥ 50 age group to have government-run health insurance. On the other hand, Mollucans with primary education was 0.196 times more likely than Mollucans with higher education to have a government-run type of health insurance. Mollucans with secondary education was 0.415 times more likely than Mollucans with higher education t...

Background: Food for the Muyu tribe was an actualization of daily life over the belief in the religious dimension that is adopted and lived. This study aims to explore the food taboo among the Muyu tribe in Indonesia.Methods: The authors conducted the case study in Mindiptana, Boven Digoel, Papua. The study carried out data collection by participatory observation, in-depth interviews, and document searches. The authors carried out the report using an ethnographic approach an emically perspective.Results: Belief in the lord of wild animals, the lord of fruits and plants, and the lord of sago, was so thick that many spells appear to hunt and search for food in the forest, which was a form of recognition of the power of these. The Muyu tribe had restrictions on several types of food. Food can be taboo based on its physical form; meanwhile, because of Muyu people's belief that there was a bad quality inherent in these food ingredients. It was especially closely related to ritual pra...

The elderly are one of the most vulnerable groups with very high dependency rates. This condition has the potential to cause other problems for the caregiver or his family. The elderly also has the potential to suffer from catastrophic diseases that have costly consequences. This research is a further analysis of Riskesdas 2013 data, that presented in descriptive quantitative. The results showed that elderly people living in urban as well as rural areas have a tendency of moderate access barrier to Puskesmas. There are still 15% of very poor elderly people who have major access barrier to Puskesmas. This study concludes that although elderly access to Puskesmas is quite good, but the access of very poor elderly is still need more attention. The government needs to provide basic health care facilities in more rural areas. The government also needs to realize a National Health Insurance with tax-based funding, to ensure universal coverage regardless of the ability to pay the community...

Background: Early marriage practice in Indonesia is more often found in rural than in urban areas. Objective: The aim of this study is to examine the relationship of socioeconomic status and early marriage in rural areas in Indonesia. Method: This study used data from the 2017 Indonesian Demographic Health Survey. The sample was 2,252 of women aged 19 – 24 living in rural Indonesia. The variables included in the analysis were early marriage status, socioeconomic status, educational level, and working status. Analysis of collinearity, chi-square, and multiple logistic regressions were conducted in this study. Results: The socioeconomic status and educational level were significantly associated with early marriage among women aged 19 – 24 in rural Indonesia. The poorest socioeconomic women were 2.23 times more likely to experience early marriage than the richest women. Poorer women were 1.68 times more likely to experience early marriage than the richest women. Women who did not go to...

Background: Health insurance is one indicator of the readiness of pregnant women for the delivery process. The study was aimed at analyzing the determinants of health insurance ownership among pregnant women in Indonesia.Methods: The study involved 2,542 pregnant women in Indonesia. The variables analyzed included type of place of residence, age group, education level, employment status, marital status, parity, wealth status, and know the danger signs of pregnancy. Determination of determinant by binary logistic regression.Results: The results show that pregnant women with higher education were 3.349 times more likely than no education pregnant women to have health insurance. Pregnant women with wealth status in the middle category were 0.679 times more likely than the poorest pregnant women to have health insurance. Meanwhile, the richest pregnant women had 1.358 times more chances than the poorest pregnant women to have health insurance. Grande multiparous pregnant women were 1.54...

Background: Eastern is one of the regions that have a higher prevalence rate of stunted children than other regions in Indonesia. The study aims to analyze the risk factors for stunted toddlers in Eastern Indonesia.Methods: The study employed secondary data from the 2017 Indonesia Nutritional Status Monitoring. With the multi-stage cluster random sampling method, 24,103 toddlers in eastern Indonesia were sampled. Data were analyzed using a multinomial logistic regression test.Results: The results of the study found that toddlers living in urban areas had a 0.798 times chance compared to toddlers living in rural areas to experience severe stunted (OR 0.798; 95% CI 0.719-0.885). A toddler with a married mother is 0.706 times more likely than a toddler with a divorced/widowed mother to experience severe stunted (OR 0.706; 95% CI 0.547-0.911). The results of this multivariate analysis indicate that the better the level of education of a mother, the less likely it is to have stunted and ...

Background: The prevalence of stunted toddler in Indonesia is very high. The study was aimed at analyzing ecologically the factors related to the prevalence of stunted toddler in Indonesia.Methods: Ecological analysis was conducted using secondary data from the Ministry of Health of the Republic of Indonesia report in 2018. Apart from the stunted toddler, 6 other variables analyzed as independent variables were the percentage of households with access to safe drinking water sources, percentage of households with access to proper sanitation, percentage of households that occupy livable houses, percentage of the population who smoke, percentage of poor people, and percentage of the population completing basic education. Data were analyzed using a scatter plot.Results: The results of the study found that 4 variables (the percentage of household with access to a safe drinking water source, the percentage of household with access to proper sanitation, the percentage of the household that...

Latar Belakang: Stunting dalam kehidupan awal akan mempunyai konsekuensi fungsional yang merugikan, termasuk kognisi yang buruk dan tingkat pendidikan yang rendah. Penelitian ditujukan untuk menentukan determinan balita stunting di Jawa Timur.Metode: Penelitian menggunakan data sekunder survei Pemantauan Status Gizi tahun 2017 (PSG 2017). Dengan metode multi-stage cluster random sampling, diambil sampel 10.814 balita berusia 0-59 bulan. Varibel yang dianalisi terdiri dari variabel dependen status gizi balita, 7 variabel independen: tempat tinggal, umur balita, umur ibu balita, status perkawinan ibu balita, tingkat pendidikan ibu balita, dan status bekerja ibu balita. Penentuan determinan dengan menggunakan uji Regresi Logistik Biner.Hasil: Balita yang tinggal di daerah perkotaan 0,855 kali lebih memiliki risiko stunting dibandingkan dengan balita yang tinggal di daerah pedesaan (OR 0,885; 95% CI 0,798-0,980). Balita yang memiliki ibu dengan pendidikan SD ke bawah 2,206 kali lebih me...

Sejak diberlakukannya kebijakan Jaminan Kesehatan Nasional (JKN), seluruh puskesmas di Indonesia wajib mengikuti akreditasi. Melalui akreditasi, diharapkan kualitas pelayanan puskesmas semakin meningkat, salah satu diantaranya dapat dilihat dari peningkatan kepuasan pasien. Penelitian ini dilakukan untuk menganalisis pengaruh akreditasi terhadap kepuasan pasien. Penelitian ini merupakan penelitian observasional dengan rancang bangun cross-sectional, yang dilakukan kepada 90 pasien puskesmas yang pernah berkunjung ke puskesmas sebelum dan sesudah akreditasi. Sampel diambil secara accidental sampai memenuhi kuota yang ditetapkan untuk tiap puskesmas. Uji Paired-Sample T Test dilakukan untuk melihat signifikansi perbedaan skor kepuasan sebelum dengan sesudah akreditasi. Hasil penelitian menunjukkan terdapat perbedaan skor kepuasan yang signifkan antara sebelum dengan sesudah akreditasi untuk dimensi mutu responsiveness, credibility, competence, communication, security, access, courtesy...

Introduction: The main strategy for decreasing maternal morbidity and mortality with antenatal care (ANC). ANC aims to monitor and maintain the health and safety of the mother and fetus, detect all complications of pregnancy and take the necessary actions, respond to complaints, prepare for birth, and promote healthy living behavior. The study aims to analyze inter-regional disparities in ≥4 ANC visits during pregnancy in Indonesia. Methods: Data sources from 2017 Indonesian Demographic and Health Survey (IDHS). With an analysis unit of women aged 15-49 years old, a sample of 15,351 women was obtained. Besides ANC as the dependent variable, other variables analyzed were place of residence, age, husband/partner, education, parity, wealth status, and health insurance. Analysis using Binary Logistic Regression for the final test to determine disparity. Results: All regions show a gap with the Papua region as a reference, except the Maluku region which was not significant shows differen...

Background: In Indonesia, only 74% of women give birth in health care facilities. This study was conducted to analyze the socioeconomic disparities of facilities-based childbirth in Indonesia.Methods: The analysis in this study uses raw data from the 2017 Indonesia Demographic and Health Survey (IDHS). With stratification and multistage random sampling, 17,769 women aged 15-49 years with live births in the last 5 years were sampled. Data were analyzed using a Binary Logistic Regression test.Results: Poorer women were 1.898 times more likely to use healthcare facilities for delivery than poorest women. Middle women were 2.669 times more likely to use healthcare facilities for delivery than poorest women. Richer women have 3.163 times more opportunities to use healthcare facilities for delivery than poorest women. The richest women were 6.566 times more likely to use healthcare facilities for delivery than the poorest women. Women who live in urban areas were 2.412 times more likely t...

Introduction: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output. Aim: This study was intended to analyze urban-rural disparity in the utilization of primary health care or puskesmas use by the elderly.Methods: This study was used the 2013 Riskesdas (Indonesian Basic Health Survey) raw data. The 2013 Riskesdas was designed a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province were obtained. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). Th...

Riset Aksi Partisipatif Desa Sehat Berdaya yang telah dideskripsikan seluruh prosesnya secara mendetail mulai dari Bab 1 sampai Bab 8, merupakan program purwarupa yang menginisiasi suatu kegiatan pemberdayaan bidang kesehatan. Pada Bab 9 ini tim peneliti mencoba menarik butir-butir untuk meringkas secara garis besar apa yang telah diuraikan pada bab-bab sebelumnya. Riset aksi partisipatif ini didedikasikan untuk dapat dicobaterapkan sebagai sebuah program yang lebih mengutamakan pendekatan promotif dan preventif yang berbasis komunitas (community based) pada suatu wilayah desa.

Upaya pembangunan kesehatan merupakan tanggung jawab pemerintah, sektor swasta, maupun masyarakat. Teori dasar yang dikemukakan oleh Hendrik L. Blum (1974) menyebutkan bahwa status kesehatan seseorang ditentukan oleh genetik, sistem pelayanan kesehatan, perilaku, dan lingkungan. Pada konteks peran pemerintah hanya merupakan bagian kecil saja. Bagian terbesar justru ada pada sisi masyarakat, yaitu perilaku kesehatan dan lingkungan yang melingkupi kehidupan seseorang. Perubahan perilaku kesehatan merupakan tantangan yang cukup berat, yang membutuhkan perhatian secara intens, kontinyu dan membutuhkan waktu yang panjang. Perubahan perilaku dimulai dari keadaan tidak sadar menjadi sadar kemudian termotivasi untuk mencoba sesuatu yang baru, dilanjutkan dengan mengadopsi perilaku baru, mempertahankan, menghayati perilaku baru sehingga menjadi bagian dari perilaku dan kebiasaan sehari-hari.

Desa Sehat Berdaya merupakan program purwarupa berbasis komunitas yang bertujuan untuk meningkatkan status kesehatan masyarakat desa, yang diharapkan dapat berdampak pada peningkatan kesejahteraan. Program ini menempatkan fasilitator Desa Sehat Berdaya, atau yang dinamai Sahabat Desa, yang berperan memberikan motivasi, stimulasi, dan mendampingi masyarakat. Pola pendekatan yang dipakai dalam program Desa Sedaya adalah community based. Sahabat Desa akan menjadi fasilitator yang hidup berbaur dengan masyarakat (lived in) untuk membumikan strategi pendekatan promotif-preventif di masyarakat.