District Health Centers Research Articles

GROWTH MONITORING TRAINING AND CHILD DEVELOPMENT FOR PRESCHOOL TEACHERS IN THE FRAMEWORK OF STUNTING OVERCOMING

The prevalence of stunting in Indonesia fell from 24.4% in 2021 to 21.6% in 2022. The stunting figure is still quite high compared to the government's target of 14% in 2024. Stunting is one of the government's priority programs, considering the impact of stunting on the quality of human resources is very large. PAUD/Kindergarten teachers academically have the potential intellectual abilities to provide input on the importance of children's growth, in addition to children's abilities or intelligence. The service activities aim to increase the capacity of PAUD/TK teachers in monitoring children's growth and development according to standards The activity method is training in monitoring the growth and development of early childhood. Activities in collaboration with partners, namely HIMPAUDI, Sunyaragi District and Sunyaragi Community Health Center, Cirebon City. Collaboration by sharing resources between study programs and partners. The measuring parameters use the pre-post knowledge and ability values ​​of participants in carrying out practical assignments to monitor growth and development in child cases. This activity is expected to increase the capacity of PAUD teachers in monitoring the growth and development of their students according to standards. This activity was carried out at the HIMPAUDI Secretariat, Cirebon City, attended by 25 PAUD teachers representing 5 (five) sub-districts in Cirebon City. As a result of this training activity, PAUD teachers understand better about anthropometric measurements, growth and development of early childhood based on the results of the pre and post test scores carried out. The teachers were very enthusiastic about participating in the training until it was finished. The outputs that have been created are training modules, activity videos, publication drafts in newspaper media and publication journals in the Community Service Journal in the process of being prepared.

EFEKTIVITAS SEDUHAN DAUN ASAM JAWA TERHADAP KADAR HOMA-IR DAN HOMA-β PADA PASIEN DIABETES MELLITUS TIPE 2

This study assessed the impact of tamarind leaf tea on HOMA-IR and HOMA-β levels in patients with Type 2 Diabetes Mellitus (DM). Thirty-two patients aged 20-50 years from Sungai Ambawang District Health Center, who were not using any DM medication, participated. They were divided into control (KN) and treatment (KP) groups, with KP receiving a tamarind leaf tea infusion for 7 days. HOMA-IR and HOMA-β levels were calculated using standardized formulas based on fasting insulin and glucose levels. The Wilcoxon signed-rank test revealed a significant decrease in HOMA-IR levels in the KP group (p<0.05), while no significant change was observed in the KN group. Although no significant difference in HOMA-β levels was found between the two groups, the KP group showed a notable increase by 4. These findings suggest that a 7-day tamarind leaf tea infusion effectively reduced HOMA-IR levels in patients with type 2 DM, although it did not significantly affect HOMA-β levels. This study highlights the potential of tamarind leaf tea as a complementary approach for managing insulin resistance in Type 2 DM patients. Further research is needed to explore the long-term effects and mechanisms of action for improving β-cell function. The conclusion of this study is that steeping tamarind leaves for seven days can reduce HOMA-I levels and slightly increase HOMA-β levels in patients with type 2 Diabetes Mellitus.

Influencing Factors Attitude Health Workers in Patients Mental Disorders

The negative view experienced by individuals with mental disorders will have an impact on the attitude of health workers in providing services at health service facilities. The aim of this research is to identify the factors that influence the attitude of health workers towards patients with mental disorders. This quantitative research was conducted at the District Health Center. Fakfak-West Papua at 127 workers using a purposive sampling technique. Data collection used a self-developed attitude scale, the MHKQ and GSES scales. Data analysis uses multivariate tests using regression. The results of the research obtained significant values for the relationship between various health worker attitude factors, including: There is an influence between mental health literacy (P 0.048<0.005), self-efficacy (P0.001<0.005), R2=0.335. The research conclusion is that there is a significant influence of mental health literacy and self-efficacy on the attitude of health workers in patients with mental disorders, with an influence of 33.5%. It is hoped that the Health Service and Community Health Centers can pay attention to the factors that influence the attitude of Health workers in serving patients with mental disorders so that they can provide better services.

Oral Health Educational Intervention for Primary Healthcare Providers Using the Flipped Approach.

Objectives: This study evaluated the effect of a flipped oral health educational program for primary healthcare providers (PHCPs) on their knowledge, attitude, and practice. Materials and Methods: This field trial was conducted on PHCPs (N=118; 61 cases and 57 controls) in District Health Centers (DHCs) of Tehran, Iran in 2012. The participants filled out a self-report questionnaire with questions on knowledge (N=34), attitude (N=8), and oral health practice (N=14). The intervention included an educational booklet delivered to the staff followed by a brief educational session using the flipped approach and a reminder pamphlet after 1 month. After 4 months, the questionnaire was completed again by the participants. Statistical analysis included paired sample t-test, ANCOVA, and linear and logistic regression. Results: Most participants were females (N=114), and the mean age was 37±8 years. The scores of the three domains of knowledge and also the total knowledge score, the attitude score, and the practice score significantly improved in the intervention group compared to the control group (P<0.001). Knowledge about the oral health of children (P=0.001) and the total knowledge score (P<0.05) significantly increased in the control group, but the increase in other domains was not statistically significant (P>0.05). Conclusion: The oral health knowledge of PHCPs was insufficient, and their practice and attitude were not desirable. The oral health educational program with the flipped approach had a positive impact on the PHCPs' knowledge, attitude and practice, and may be utilized in the academic curriculum or continuing medical education (CME) courses.

Readiness to provide comprehensive emergency obstetric and neonatal care: a cross-sectional study in 30 health facilities in Tanzania

BackgroundDespite the global progress in bringing health services closer to the population, mothers and their newborns still receive substandard care leading to morbidity and mortality. Health facilities’ capacity to deliver the service is a prerequisite for quality health care. This study aimed to assess health facilities’ readiness to provide comprehensive emergency obstetric and newborn care (CEmONC), comprising of blood transfusion, caesarean section and basic services, and hence to inform improvement in the quality of care interventions in Tanzania.MethodsA cross-sectional assessment of 30 CEmONC health facilities implementing the Safer Births Bundle of Care package in five regions of Tanzania was carried out between December 2020 and January 2021. We adapted the World Health Organization’s Service Availability and Readiness Assessment tool to assess amenities, equipment, trained staff, guidelines, medicines, and diagnostic facilities. Composite readiness scores were calculated for each category and results were compared at the health facility level. For categorical variables, we tested for differences by Fisher’s exact test; for readiness scores, differences were tested by a linear mixed model analysis, taking into account dependencies within the regions. We used p < 0.05 as our level of significance.ResultsThe overall readiness to provide CEmONC was 69.0% and significantly higher for regional hospitals followed by district hospitals. Average readiness was 78.9% for basic amenities, 76.7% for medical equipment, 76.0% for diagnosis and treatment commodities, 63.6% for staffing and 50.0% for guidelines. There was a variation in the availability of items at the individual health facility level and across levels of facilities. We found a significant difference in the availability of basic amenities, equipment, staffing, and guidelines between regional, and district hospitals and health centres (p = 0.05). Regional hospitals had significantly higher scores of medical equipment than district hospitals and health centers (p = 0.02). There was no significant difference in the availability of commodities for diagnosis and treatment between different facility levels.ConclusionFacilities’ readiness was inadequate and varied across different levels of the facility. There is room to improve the facilities’ readiness to deliver quality maternal and newborn care. The responsible authorities should take immediate actions to address the observed deficiencies while carefully choosing the most effective and feasible interventions and monitoring progress in readiness.

The Effectiveness of Early Detection of Heart Disease and Health Promotion on Attitude and Lifestyle Changes of Residents At Risk Of Heart Disease Post-Covid-19 Pandemic

During the Covid-19 pandemic, heart disease patients were at very high risk of experiencing severe complications if exposed to the virus. One important effort in preventing cardiovascular diseases is to identify the cardiovascular risk factors in each individual. There are several models for detecting risk, one of which is the Jakarta Cardiovascular Score. Health promotion is also an effort to manage modifiable risk factors for heart disease. Health promotion is expected to prevent risky behaviors that lead to an increase in heart disease incidence in the long term. This study aims to assess the effectiveness of early detection and health promotion in changing the attitudes and lifestyles of residents at risk of heart disease post-Covid-19 pandemic. The research method used in this study is a quasi-experimental design with one group of 30 respondents. The study was conducted in the working area of the Pasar Minggu District Health Center in Jakarta. The results showed that after the intervention, which included early detection and health promotion, there was a change in attitude by 0.8 points, from 88.13 (before intervention) to 88.95 (after intervention). The T-test results showed a p-value of 0.004, indicating a statistically significant difference between before and after the intervention. The respondents' lifestyle also changed by 5.5 points, from 66.03 (before intervention) to 71.62 (after intervention), with a p-value of 0.004, indicating a statistically significant difference between before and after the intervention.

Audit Sistem Informasi Monitoring dan Evaluasi (Monev) Pada Puskesmas Kecamatan Ciracas Menggunakan COBIT 2019

This research starts from the framework of thinking that auditing information technology governance in monitoring and evaluation (monev) information systems using COBIT 2019 is an important thing to do. In the present and future, it is necessary to align information technology investments with the aim of community services in public health centers. The COBIT 2019 framework provides the benefits of implementing information systems, minimizing risks, and optimizing resources according to needs at the Ciracas District Health Center. In implementing monitoring and evaluation (monev), the factor design from COBIT 2019 can determine which domains must be assessed for their maturity level, so that agencies can know what needs to be improved. In this case, the EDM02 domain focuses on the process of optimizing the contribution of business value, services and IT assets resulting from investment at a cost that is acceptable to the company, while MEA03 ensures that the agency has complied with all applicable external requirements. Based on the results of the inspection, EDM02 has a current maturity value of 4.23 with a maturity level of 5-Optimized, which means that the implementation of monitoring and evaluation (monev) at the Ciracas District Health Center has run according to its objectives, while MEA03 has a current maturity value of 3.98 with a maturity level of 4- Manged and Measureable, which means monitoring and evaluation (monev) at the Ciracas District Health Center has been running well, even data or information has been integrated

Healthcare workers’ views on decentralized primary health care management in Lesotho: a qualitative study

BackgroundLesotho experienced high rates of maternal (566/100,000 live births) and under-five mortality (72.9/1000 live births). A 2013 national assessment found centralized healthcare management in Ministry of Health led to fragmented, ineffective district health team management. Launched in 2014 through collaboration between the Ministry of Health and Partners In Health, Lesotho’s Primary Health Care Reform (LPHCR) aimed to improve service quality and quantity by decentralizing healthcare management to the district level. We conducted a qualitative study to explore health workers’ perceptions regarding the effectiveness of LPHCR in enhancing the primary health care system.MethodsWe conducted 21 semi-structured key informant interviews (KII) with healthcare workers and Ministry of Health officials purposively sampled from various levels of Lesotho’s health system, including the central Ministry of Health, district health management teams, health centers, and community health worker programs in four pilot districts of the LPHCR initiative. The World Health Organization’s health systems building blocks framework was used to guide data collection and analysis. Interviews assessed health care workers’ perspectives on the impact of the LPHCR initiative on the six-health system building blocks: service delivery, health information systems, access to essential medicines, health workforce, financing, and leadership/governance. Data were analyzed using directed content analysis.ResultsParticipants described benefits of decentralization, including improved efficiency in service delivery, enhanced accountability and responsiveness, increased community participation, improved data availability, and better resource allocation. Participants highlighted how the reform resulted in more efficient procurement and distribution processes and increased recognition and status in part due to the empowerment of district health management teams. However, participants also identified limited decentralization of financial decision-making and encountered barriers to successful implementation, such as staff shortages, inadequate management of the village health worker program, and a lack of clear communication regarding autonomy in utilizing and mobilizing donor funds.ConclusionOur study findings indicate that the implementation of decentralized primary health care management in Lesotho was associated a positive impact on health system building blocks related to primary health care. However, it is crucial to address the implementation challenges identified by healthcare workers to optimize the benefits of decentralized healthcare management.

Evaluation Of Quality And Patient Expectations Of Health Services For The Universal Health Coverage Program At Puskesmas Ketapang Sampang District

The purpose of this study was to analyze the satisfaction of universal health coverage (UHC) program patients with health services at the Ketapang health center in Sampang district. Puskesmas Ketapang is one of the puskesmas in sampang district which includes the largest number of people registered in the universal health coverage program. This research method is descriptive with a qualitative approach where data collection techniques are carried out through direct interviews with medical personnel and also patients who come to visit the Puskesmas, documentation, observation, and data analysis. The results showed that patients (UHC) were very satisfied with the services provided from the puskesmas seen from reliability, responsiveness, assurance, empathy, but there were still patients who were less satisfied with the physical evidence or facilities provided at the Puskesmas. The results of the study seen from the dimension 5 gap there are no triggers for the gap, this shows that the quality of service that has been provided from the health center is good and in accordance with patient expectations.

Frequency of Antenatal Care: Does It Affect Pregnant Women's Anxiety in the Third Trimester?: A Cross-Sectional Study

Background: Antenatal Care (ANC) is a visit carried out by pregnant women to check the health status of their pregnancy. In Indonesia, 11 provinces have still not achieved the ANC visit target based on the Ministry of Health's 2017 Strategic Plan. The impact for pregnant women who do not make ANC visits is increased mortality and morbidity rates, undetected abnormalities, lack of information, and even anxiety. Method: This research uses a cross-sectional method. Spearman rank analysis was used to analyze data on 42 respondents at the Jatiasih District Health Center, Bekasi. Results: This study shows that there is a relationship between the frequency of ANC visits and anxiety of pregnant women in the third trimester with a p-value of 0.002 and r = 0.474. Conclusion: Pregnant women need to make ANC visits according to the regulations recommended by the government to protect their babies and their health status.

Effectiveness of Awareness Training on Birth Preparedness and Complication Readiness among Community Health Workers of New Delhi, India.

In India, current maternal mortality ratio is 97/100,000 livebirths, and still more efforts are needed to achieve Sustainable Development Goal 3, target 1 of 70/100,000 livebirths. Women die because of complications during and following pregnancy and childbirth. Skilled care during and immediately after delivery has been identified as one of the key strategies in reducing maternal mortality. Birth preparedness and complication readiness (BPCR) has been implemented as a comprehensive strategy to fill this gap. BPCR is one of the key interventions to reduce the maternal mortality. This was a community-based before and after interventional study (quasi-experimental study) and was conducted in two randomly selected primary health centers of South West district of Delhi. A total of 152 community health workers (CHWs) took part in the study. About one fourth (22.03%) had knowledge regarding water breakage without labor, which increased to 85.53% after training and was statistically significant (P < 0.0001). Mean knowledge score preintervention was 4.35 (1.82), whereas the postintervention mean knowledge score was 8.98 (0.99) and was statistically significant (P < 0.0001). Though awareness of CHWs on some aspects of the BPCR components was good before the training program, marked improvement was seen in most of the domains after the training session.

Peningkatan Fungsi Kognitif Lansia Dengan Terapi Modalitas Senam Otak (Brain Gym) Pada Lansia Kelompok Prolanis

Introduction: The elderly population is increasing in number. This is a reality that cannot be avoided. The higher the elderly population, the more elderly people will need care. The increase in the prevalence of dementia follows an increase in the elderly population. Cognitive disorders in the elderly, if not treated properly, will affect daily living activities and the overall health of the elderly. One effort to prevent cognitive decline due to aging is by doing sports or physical exercise. Objective: The purpose of this service was to increase the knowledge and empowerment of the elderly in the application of Brain Gym Modality Therapy as an effort to improve the cognitive function of the elderly in the Prolanis Group of the Tajinan Health Center, Malang Regency Method: Community service was carried out in the form of training for the Prolanis Group at the Tajinan Health Center, Malang Regency with material related to brain exercise modality therapy to improve the cognitive function of the elderly during 3 meetings Result: From the results of measuring the knowledge of the elderly in the prolanis group at the Tajinan District Health Center. In Malang, data was obtained that there was an increase in the average pretest and posttest scores, the average pretest knowledge results of respondents were in the poor category. At the end of the evaluation activity, the average posttest results of respondents' knowledge were in the sufficient category. The ability of the elderly in the prolanis group at the Tajinan District Health Center. Malang, to demonstrate brain exercise modality therapy to improve the cognitive function of the elderly, obtained the average value of the results of the respondents' ability to re-demonstrate in the sufficient category Conclusion: It can be concluded that the aim of the training is to increase the knowledge and understanding of the elderly in the prolanis group regarding Brain Gym exercises to improve the cognitive function of the elderly can be achieved.

Determinants of Hypertension in Outpatients: A Cross-Sectional Study at Kramat Jati Health Center, East Jakarta

Aims: This research aims to determine the factors that most cause the incidence of hypertension in outpatients at the Kramat Jati District Health Center, East Jakarta in 2024. Study design: Cross-Sectional Design Place and Duration of Study: This research was carried out at the Non-Communicable Diseases Polyclinic or Hypertension Polyclinic, Kramat Jati District Health Center, East Jakarta. Data collection took place for 2 weeks in February 2024. Methodology: The selected population is outpatients who have hypertension and are active as controls and non-hypertensive outpatients who visit the Kramat Jati District Health Center, East Jakarta. The selected samples were outpatients, specifically hypertensive patients at the Kramat Jati District Health Center, East Jakarta. Samples were collected using non-random accidental sampling technique and 101 research samples were obtained. Data Processing and Analysis using SPSS (Statistical Package for the Social Sciences) 29th version was used to view research results using univariate and bivariate analysis. Results: The results obtained showed that 81 respondents (80.2%) experienced hypertension. The dominant characteristics of hypertensive patients were found to be women (65.3%), aged 56-65 years (28.7%), patients who had a family history of hypertension (52.5%), patients who consumed ≥ 5 grams of sodium (70 .3%), patients who did physical activity (76.2%), and patients who did smoke (31.7%). The factors of age (p-value = 0.0001), history of hypertension (p-value = 0.046), sodium diet (p-value = 0.0001), and smoking (p-value = 0.039) are significantly related and most dominantly influence the incidence. Hypertension. The factors of gender (p-value = 0.410) and physical activity (p-value = 0.454) were not significantly related to increasing blood pressure. Conclusion: There is a significant relationship between factors that unmodified factors, namely age and family history of hypertension, with the incidence of hypertension at the Kramat Jati District Health Center, East Jakarta, and there is also a significant relationship between factors that can be changed, namely dietary sodium patterns and smoking activities, and the incidence of hypertension in Kramat Jati District Health Center, East Jakarta.

Knowledge and Awareness of Spinal Muscular Atrophy in Pre-Marital Health Screenings: A Cross-Sectional Study

Background and Purpose: Early diagnosis of Spinal Muscular Atrophy (SMA) is crucial. This study assesses the awareness and attitudes toward SMA screening among individuals preparing for marriage. Methods: This cross-sectional study was conducted in three family health centers in the central district of XXX from June to September 2023. A researcher-designed 15-item instrument was utilized to collect demographic data and assess knowledge and attitudes regarding SMA among participants aged 18-65, excluding those with a diagnosis of mental retardation. Results: The study was participated in by 197 individuals, with an average age determined to be 29.45±7.48. The proportion of those supporting the implementation of SMA screening was 84.8% (n=167), while the intention to undergo the test was identified at 72.6% (n=143). A significant relationship was found between the willingness to be tested and variables such as the level of education, absence of disabled close relatives, not considering SMA to be genetically inherited, finding screenings appropriate, the perceived impact of test results on marriage, and the belief that screening could not be conducted after marriage. Conclusion: While most recognized SMA's severity, there's a notable deficit in understanding its preventability, suggesting the need for targeted educational interventions to enhance genetic screening uptake.

Penyuluhan kepada Masyarakat tentang Pemberantasan Sarang Nyamuk (PSN) di Desa Bak Buloh, Aceh Besar.

Cases of Dengue Hemorrhagic Fever (DHF) in Aceh Province are currently increasing, and Aceh Besar is one of the districts that has experienced a drastic increase in the last two years. There is a need for empowerment activities to increase community knowledge so that they can carry out prevention and improve their health status independently and sustainably. The aim of this community service activity is to provide understanding to the people of Bak Buloh Village, Kuta Baro District, Aceh Besar Regency, Aceh Province, about how to effectively eradicate mosquito nests as an effort to prevent dengue fever. The methods used are lecture, discussion and question and answer methods. The results of the counseling showed that there was a significant improvement in the majority of the people of Bak Buloh Village, after being given the Mosquito Nest Eradication (PSN) counseling. It is hoped that the relevant agencies, the Kuta Baro District Health Center, the Village and Cadres, can carry out more frequent outreach regarding the Eradication of Mosquito Nests (PSN) and the impacts it causes.

Pregnant Women's Knowledge about Bleeding and The Adherence to Antenatal Visits

Physiological and psychological changes during pregnancy can run normally if the mother is able to adapt to these changes. If there is a failure to adapt or there are other factors that affect the health of the mother during pregnancy, complications will arise. One of the abnormal complications during pregnancy is bleeding. To determine the relationship between the knowledge of pregnant women in the third trimester of signs of bleeding during pregnancy with compliance with antenatal visits at the Cipayung District Health Center, East Jakarta. Using a quantitative study with a cross sectional approach to 30 third trimester pregnant women with a purposive sampling technique. Data analysis using Chi-Square. The study was conducted in October-November 2020. The research instrument used a questionnaire made by the researcher about signs of bleeding during pregnancy. The results showed that the characteristics of the respondents were mostly aged 20-35 years (93.3%), primigravida (56.7%), secondary education (60%), less knowledgeable (60%), and obedient to antenatal visits (76.7%). The results of the bivariate analysis obtained p-value=1,000. There is no significant relationship between the knowledge of pregnant women in the third trimester of signs of bleeding during pregnancy and compliance with antenatal visits at the Cipayung District Health Center, East Jakarta. With this research, it is hoped that health workers, especially nursing staff, can provide information on the importance of adherence to antenatal visits to prevent risks for pregnant women, especially related to bleeding.

Reproductive behaviors among school-based health center clients in New Mexico.

School-based health centers (SBHCs) are an evidence-based model for providing contraceptives to adolescents. SBHCs ability to provide reproductive health services is often limited by school district policies, state laws, and health center policies. We used data from the Teens Exploring and Managing Prevention (TEMPO) study to document demographic characteristics and birth control methods among patients at four SBHCs in New Mexico. A total of 264 teens were included in the baseline data collection at SBHCs in New Mexico. A baseline survey was administered via iPad, that specifically focused on questions related to sexual experiences and sexual health topics. Baseline questions included demographic questions, gender identity, sexual orientation, reasons for visits, reproductive practices, and birth control methods. Descriptive statistics were calculated, including means and standard deviations for continuous variables and categorical frequencies. Our findings present reproductive health behaviors among New Mexican patients attending schools with SBHCs. More than 74% of respondents were Hispanic or Latino. The most common reason teens went to the SBHC was for birth control, and just 62% of teens reported using birth control methods in the past. These behaviors are essential for policymakers to consider as they address policy gaps, the complex landscape of parental permission, reproductive rights, and health as a human right.

Determinants of perineal wound healing in 2023

Normal labour can result in a perineal laceration due to pressure from the baby's bottom during delivery or from an episiotomy operation to open the birth canal. Perineal injuries will have an impact on the muscles in the pelvic floor. In the East Jakarta region, there will be numerous cases of perineal rupture in 2022, both spontaneous and due to episiotomy. Many postpartum women suffer from perineal lacerations that take longer than seven days to heal. This study aims to identify the factors that influence perineal wound healing in the Kramat Jati District Health Center's operational setting. This study used a cross-sectional design. Based on the sample formula, the research sample of 110 postpartum women with perineal wounds was chosen to test the hypothesis with a different percentage. Purposive sampling was used as the sample method. Chi-Square test study of a correlation test. A questionnaire and a checklist were employed as the data collection tools to track the healing of the perineum wound, which was assessed during the respondent's postpartum visit. The results showed that there was a significant association between age (P-value 0.003; OR 3.354), parity (P-value 0.001; OR 4.028), mobilization (P-value 0.007), personal hygiene (P-value 0.001; OR 3.611), body mass index (BMI) (P-value 0.012; OR 2.682), type of perineal injury (P-value 0.001; OR 0.251), treatment (P-value 0.0001; OR 5.262) on perineal wound healing. Postpartum mothers are advised to practice good hygiene, non-pharmacological therapies, engage in active mobilization, and maintain a normal BMI. Perineal wounds might heal more quickly depending on BMI. Health services require education for health workers and perineal wound care recommendations for postpartum women.

KESETARAAN JENDER DALAM KEPUTUSAN BER KB DI PUSKESMAS KECAMATAN PALMERAH JAKARTA BARAT TAHUN 2022

Decision-making relatewith reproductive health is not fully in the hands of women sometimes it based on husband or family especially when problems with termination of pregnancy arise. This condition can lead women to death. The aim is to explore gender equality in family planning decisions were in Palmerah in West Jakarta District Health Center in 2009. The benefits of this research is to understand gender equality in family planning decisions were expected to prevent the occurrence of an unwanted pregnancy that led to the decline in maternal mortality. This research is quantitative descriptive design with cross sectional correlation. By involving 131 mothers as the respondent. Data were analyzed by univariate, bivariate and multivariate. Results showed gender equality in family planning decisions were the most are those that have gender equality in family planning decisions were numbered 68 women (51.9%) and independent variables that have significant knowledge (p = 0.000), P-value attitudes (p = 0.000) P-value perception (p = 0.000) and for the characteristics of the mother and the father of P-value for Age Mr (p = 0049), P-value for Mother Works (p = 0.000), P-value for family income (p = 0021). Statistical tests can be performed because of logistic regression analysis results bivariatnya to determine the candidates all have the value p value &lt;0.25. Of the six variables are independent variables age of the father of the P-Wald 0.016 most related to gender equality in family planning decisions were once controlled by the Income Families P-Wald 0.025. The results of this study recommends to the Head of Puskesmas Kec. Palmerah to improve the promotion of gender equality. Recommendations are also given to other researchers who intend to conduct research on gender equality to involve more variables that were assessed with different design and use instruments that have validity and reliability of raw value.

Service quality attributes on customers’ perceived value and behavioral intention of district health centres: a moderating effect of health-care subsidy

PurposeThis study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district health centres (DHCs) in Hong Kong. This research also intends to assess customers’ perception of the subsidy scheme and its influence on the relationships amongst the aforementioned constructs.Design/methodology/approachThe convenience and snowball sampling approaches were adopted, and the self-administered questionnaire was sent to 309 customers of DHCs.FindingsService quality attributes in terms of staffing and procedures positively increased customers’ perceived value and staffing, procedures and operations. Physical facilities positively promoted customers’ satisfaction, consequently improving DHCs’ effectiveness and behavioural intention. However, core treatments and services of DHCs did not impact customers’ perceived value and satisfaction. Furthermore, customers receiving subsidies exhibited a more positive perception than those without subsidies.Practical implicationsHealth-care organisations are advised to strategically allocate resources (staffing, facilities and procedures and operations management) to optimise overall performance outcomes. DHC operators could reinforce the core services of DHCs and health-care voucher subsidies to local citizens so as to enhance the effectiveness of DHCs and behavioural intention of customers.Originality/valueThis study integrates the input–process–output approach in measuring the effectiveness of and customers’ behavioural intention towards newly established DHCs.