District Health Profile Research Articles

Hubungan Kondisi Jamban dan Perilaku Sanitasi Lingkungan terhadap Kejadian Diare di Wilayah Belawan Sicanang


 
 One of the environment-based diseases is diarrhea. This disease is closely related to environmental sanitation conditions such as inadequate latrines and garbage. The World Health Organization (WHO) states that there are at least 2.2 million people who die from diarrhea, this is related to environmental conditions (sanitation/hygiene) and inadequate water (Moernanto, 2009). Judging from the district's health profile in 2018 it stated that in North Sumatra there were cases of diarrhea at all ages, namely 11,151 cases with service coverage reaching 10,280 cases (92.19%). Method: The design used in this study is descriptive quantitative with a cross sectional approach, and the research location is the Belawan Sicanang area. The number of research samples is 69 respondents using a non-probably sampling technique, namely the accidental sampling technique. Results: Based on the results of the SPSS analysis research based on the chi-square test with α=5%, it can be stated that there is a relationship between the location of the existence of latrines, the use of clean water, and the behavior of disposing of garbage to the TPA with the incidence of diarrhea in Belawan Sicanang with the acquisition of a Pvalue of each 0.03, 0.015, and 0.02 (p<0.05).
 Keyword: Diarrhea, healthy latrines, environmental sanitation

Supply-side readiness to deliver HIV testing and treatment services in Indonesia: Going the last mile to eliminate mother-to-child transmission of HIV.

Despite national efforts to integrate Prevention of Mother-to-Child Transmission (PMTCT) of HIV services into antenatal care in Indonesia, the rate of mother-to-child transmission of HIV remains the highest in the world. A range of barriers to uptake and long-term engagement in care have been identified, but far less is known about health system preparedness to deliver PMTCT of HIV services. This study explored supply-side barriers to the delivery of PMTCT services in Indonesia and whether these factors are associated with the uptake of antenatal HIV testing. An ecological analysis was undertaken, linking data from the World Bank Quality Service and Delivery Survey (2016) with routine data from Indonesia's HIV and AIDS case surveillance system and district health profile reports (2016). Supply-side readiness scores-generated from a readiness index that measures overall structural capacity and is often used as proxy for quality of care-were adapted from the WHO Service Availability and Readiness Assessment and presented by sector and geographic area. Univariate and multivariate regression analysis was used to explore factors associated with the uptake of antenatal HIV testing in public facilities. In general, public facilities scored more highly in most inputs compared to private facilities. Facilities located in urban areas also scored more highly in the majority of inputs compared to ones in rural areas. Readiness scores were lowest for PMTCT services compared to Antenatal Care and HIV Care and Support services, especially for the availability of medicines such as zidovudine and nevirapine. The national composite readiness score for PMTCT was only 0.13 (based on a maximum score of 1) with a composite score of 0.21 for public facilities and 0.06 for private facilities. The multivariate analysis shows that the proportion of pregnant women tested for HIV was more likely to be greater than or equal to 10% in facilities with a higher readiness score and a higher number of trained counsellors available, and less likely in facilities located outside of Java-Bali and in facilities supporting a higher number of village midwives. Despite targeted efforts by the Indonesian government and multinational agencies, significant gaps exist in the delivery of PMTCT that compromise the standard of care delivered in Indonesia. Future strategies should focus on improving the availability of tests and treatment, especially in the private sector and in rural areas.

Factors Related to the Achievement of the Target of the Maternal and Child Health Program at the Konawe District Health Center

Introduction: Based on the Konawe District Health Profile, it is known that in general the trend of delivery assistance coverage by health workers is known to be 91.20% in 2014, in 2015 there was no increase, namely 91.20%, for 2016 it decreased to 72.80%, for 2017 also increased to 75.70% but in 2018 it decreased drastically to 61.10%.
 Methods: This type of research is quantitative using a cross-sectional design, the research was conducted at the Konawe district health center, with a population of 29 health centers and a sample of 27 health centers and there were 5 people representing 1 health center so that the total sample of the study was 135 respondents.
 Result: It is known from the results of data analysis and obtained the value of X2Count or Chi- Square 66,849 > from 3.841 or X2table and a Phi value of 0.587 which means it has a moderate relationship between ability and the achievement of the MCH program. It is known from the results of data analysis and obtained the value of X2Count or Chi-Square 72.824 > from 3,841 or X2table and the value of Phi 0.603 which means it has a strong relationship between motivation and the achievement of the MCH program.
 Conclusion: There is a moderate relationship between the ability of health workers and the Maternal Health Program and a strong relationship between the motivation of health workers and the Maternal and Child Health Program.

Relationship Between Knowledge and Parctice of Mothers With Basic Immunization Completeness in Infant Aged 0-12

Background: Based on the Health Profile of Kediri Regency, immunization coverage in 2015, Kediri Regency has not reached the predetermined terget because the coverage is still below 90%. According to the reporting that has been collected in the Kediri District Health Profile, the Papar District is one of the three sub district that has the lowest proportion of immunization coverage, which is below 80%. Aim: This study is conducted to determine the relation between mothers’ knowledge and practices and basic immunization completeness coverage on babies aged 0-12 months in Papar District Health Center, Kediri Regency. Method: This study uses observational analytical study with cross sectional approach. The population were all mothers who have babies aged 0-12 months in the Papar District, Kediri Regency, amounting to 416. Moreover, this study uses total sampling technique to gather the data. The instrument used for this study cinsisted of two questionnaires, a questionnaire for knowledge and practice. Results: The sample size was 150 respondents with the inclusion criteria including mothers that have babies aged 0-12 months, are at the location at the time of this study, and are willing to be respondents. Meanwhile, the exclusion criteria are mothers who do not have MCH Handbook (Kartu Ibu dan Anak/KIA) or growth chart (Kartu Menuju Sehat/KMS) and mothers who are out of town when the data collection is conducted. It is shown that 48% of mothers have good knowledge, 93.3% of mothers have good practices towards immunization, and 92% of infants had complete immunization coverage. The results of the Chi-square test of knowledge on immunization completeness coverage p = 0.527 (p>0.05), practice on immunization completeness coverage p = 0.001 (p <0.05). Conclusion: The data shows that there is no relationship between knowledge and immunization completeness coverage. Meanwhile, it is found that there is a relationship between practice and immunization completeness coverage in Papar District Health Center, Kediri Regency.

Analysis of HIV/AIDS Health Problems in Pacitan District East Java 2020

The implementation of health problem analysis is carried out to increase the eff ectiveness and effi ciency of solving health problems through the selection of health problems that become priority problems in a region. The purpose of this study was to analyze the problem and determine the priority of health problems in the work area of the Pacitan District Health Office, East Java Province. This research is a descriptive observational study conducted at the Pacitan District Health Office in January 2020. The type of data used is secondary data obtained from the 2016-2019 Pacitan District Health Profile and primary data obtained through interviews with related parties, namely the head of the fi eld. , section head and program holder. Prioritization of health problems is carried out using the USG method based on the criteria of Urgency, Seriousness, Growth and fi nding the root of the problem using the fi shbone diagram method. The increase in HIV/AIDS cases with an USG score of 128 has become a top priority health problem in Pacitan District. An increase over the last 4 years with the highest number of cases in 2019, which was 39 cases. The fishbine diagram shows the root of the HIV/AIDS problem, namely the lack of public knowledge about HIV/AIDS, the lack of public knowledge about HIV/AIDS, the lack of awareness of people at risk for conducting an HIV test, this makes the community less aware of information about HIV/AIDS, causing public stigma. which results in people being closed / unwilling to check themselves at the puskesmas orhospital. The increase in HIV/AIDS cases is one of the problems in Pacitan district. To reduce the incidence, health workers need to optimize the dissemination of information about HIV/AIDS, especially risk factors, causes, prevention, symptoms and treatment. Increase the understanding of health workers and public awareness in conducting early detection.

Hubungan Pemberian ASI dan Tingkat Pendidikan Ibu dengan Status Gizi 1000 Hari Pertama Kehidupan

The period of the first 1000 days of life is a very important period for the improvement of nutrition and growth and development of children. The 2018 Kebumen District Health Profile states that 8% of toddlers with malnutrition, 33.05% of toddlers who do not get exclusive breastfeeding, and mothers of toddlers with malnutrition are mostly 60% primary school education, 20% junior high school and 20% high school education. . To analyze the relationship between exclusive breastfeeding and mother's education with the nutritional status of children under five in the first 1000 days of life. This research is an analytic observational study with a case control design. The instrument used in this study is secondary data by taking samples using purposive sampling technique as many as 117 samples at the Petanahan Health Center. In the bivariate analysis of Chi Square test, it was found that the ASI variable showed p value = 0.000 with OR = 21.991 and mother's education showed p = 0.000 with OR = 6.279. There is a relationship between exclusive breastfeeding and mother's education with the nutritional status of toddlers in the first 1000 days of life.

Ecological Analysis of Preeclampsia/Eclampsia Case in Sidoarjo Regency, Indonesia, 2015-2019

Preeclampsia is hypertension that arises after 20 weeks of pregnancy accompanied by proteinuria, thesymptoms are divided into mild and severe preeclampsia. Preeclampsia with a coma is called eclampsia.Globally 80% of maternal deaths are classified as direct death. Hypertension is directly responsible forapproximately 20% of maternal deaths in the United States. Supas in 2015 showed maternal mortality ratein Indonesia 305/100,000 live births and the highest in Southeast Asian countries which only 40-60/100,000live births. One of the main causes is preeclampsia/eclampsia. In Sidoarjo Regency in the last 5 years, themost common cause of maternal death was preeclampsia/eclampsia by 58%. The purpose of this study wasto determine the description of the incidence of preeclampsia/eclampsia in the last 5 years in the SidoarjoRegency. This research is a descriptive study with a quantitative approach using secondary data from theSidoarjo District Health Profile in 2015-2019. The results found that the highest incidence of preeclampsia/eclampsia in the Sidoarjo Regency was Temple Health Center and Taman Health Center (5.74%), andBuduran Health Center (4.10%). The trend in the incidence of preeclampsia/eclampsia in the SidoarjoRegency over the past 5 years has fluctuated and has not shown a better change. It could be concludedthat there are 3 Health Centers that have the highest percentage of preeclampsia/eclampsia due to lack ofknowledge about maternal health. This shows that the program carried out by the Government to reduce theincidence of preeclampsia/eclampsia in the Sidoarjo Regency has not been effective so further interventionis needed.

PATH ANALYSIS FAKTOR YANG MEMENGARUHI KETEPATAN PEMAKAIAN KONTRASEPSI SUNTIK DMPA BERDASARKAN REASONED ACTION THEORY (RAT)

Background:In Indonesia birth control by injection is the main choice for family planning acceptors (BKKBN, 2015). The highest percentage of new family planning participants in Central Java in 2016 was injection contraception of 5.4% (Health Profile of Central Java Province, 2016). Active KB participants in Magelang Regency in 2015 used the most non-long-term contraception method type injections, by 50.5%. (Magelang District Health Profile, 2015).
 Objective:Analyzing factors that influence the accuracy of DMPA injection KB acceptors based on reasoned action theory in PMB Dhiaulhaq Magelang Regency, with variable attitudes, subjective norm, intentions and behavior.
 Methods:Analytic survey research using a cross sectional approach. The population were all DMPA injection KB acceptors, sampling technique uses a case group and a control group that is fixied diseases sampling.
 Results:Perception directly affects the norm with a p value of 0.007. Norm directly affects attitude with a p value of 0.007. Attitude directly influences intention with a p value of <0.001. Intention directly affects the accuracy / usage with a p value of 0.012.
 Conclusion:The intention directly influences the behavior of the accuracy of visits in the use of DMPA injection KB. Perception of control has an indirect effect through subjectifve norms, attitudes, and intentions.

A toolkit with nine district types to support municipalities in taking an integrated approach to prevention

BackgroundNot only do people differ in their health, so do districts within municipalities. For example, city centres have different characteristics and health issues than villages or post-war neighbourhoods. This is why the Dutch National Institute for Public Health and the Environment has developed a toolkit, ‘Prevention in the district’, based on nine different types of district.MethodsThe aim of the toolkit is to help municipalities implement an integrated approach to prevention by providing tailored, practical information. We therefore looked at the best way to improve the connection between the available knowledge and local needs. Based on data analysis, expert opinion and working sessions with professionals and local policymakers, we developed a toolkit with three related tools.ResultsThe following tools were developed: 1) nine district types with their prominent characteristics and 14 themes for prevention (ranging from loneliness to overweight); 2) a data guide containing a set of indicators to assess the district health profile; 3) a prevention guide containing a mix of evidence-based interventions for the 14 themes. The tools are presented in a toolkit (a clickable PDF) to emphasise the fact that they form a coherent whole. The link between data and interventions is considered to be particularly innovative.ConclusionThe three tools support the improvement of the health and well-being of residents in a district. The first indications are that the toolkit empowers municipalities and lets them work towards an integrated approach. An integrated approach in both district health profiles and district plans could also serve as an example for other countries.

RELATIONSHIP BETWEEN HUSBAND SUPPORT AND PREGNANCY CONTROL IN PREGNANT WOMEN SUKAWENING PUSKESMAS GARUT

Data from the Garut District Health Office in 2016 showed that the number of pregnant women was 62,514. 62,818 pregnant women had 1 pregnancy check-up (K1), and only 58,594 pregnant women had 4 pregnancy check-up (K4) (Garut District Health Profile 2016). In the Health profile of Garut Regency, K4 coverage in the Sukawening Health Center area was 92.3%, public health center in Garut with the lowest K4 coverage, and 40% of pregnant women coming to health services alone, not accompanied by their husbands. Husband's support is one of the reinforcing factors and influences the pregnancy process, but information about the husband's support and its relationship with pregnancy control is still limited. The aim of the study was to determine the relationship of the husband's support to pregnant women with antenatal care (ANC) visits at Sukawening Health Center in 2016. The research method used in this study was descriptive correlational using a cross-sectional approach. Samples were selected using purposive sampling technique, 75 pregnant women were the respondents. Data collection used primary and secondary data with a measuring instrument was a note in the KIA book to find out the ANC frequency, and for husband's support used a questionnaire. Analysis of univariate data in the form of percentage and bivariate analysis with the chi-square test. The results showed that husband's support was 66.7% support and antenatal care visits were 60% completed. The analysis result of the relationship between the husband's support to pregnant women with antenatal care visits (ANC) obtained p-value = 0.012 and OR = 3.5. The conclusion is that there is a significant relationship between the husband's support for pregnant women and antenatal care (ANC) visits. Suggestions, health workers at Sukawening Health Center improve health services, especially antenatal care and involve husbands at each visit.Keywords: Antenatal care, husband’s support, ANC visit.

District Health Service Management

District Health System Management is a comprehensive study of the health system of the district as a unit of national health system. The report of District Health System Management has been prepared as per the MBBS 4th year (Third phase) curriculum of Tribhuvan University (TU), Institute of Medicine (IOM), Nepal after the field placement of our group in Gorkha and Kaski districts.
 We prepared regional health directorate profile, regional tuberculosis center profile, district profile, district health profile of Kaski, hospital profile of Western Regional Hospital, Kaski, and critical analysis on human resources of the Aampipal hospital. We prepared five year plan on ICU services of Gorkha District Hospital and conducted epidemiological study on COPD in WRH, Pokhara.
 The techniques used in this study were observation, interviews, interactions, participation, secondary data retrieval, analysis and presentation using specific tools and guidelines devised for the same.
 The field practice proved to be a milestone in enabling the students to develop aptitude in the fields of management, administration and communication in different health set-ups of the country. It is in fact once-in-a lifetime opportunity for the medical students to imbibe the practicality of management skills at various levels.

Promosi Kesehatan dengan Buku KIA Terhadap Peningkatan Pengetahuan Ibu Hamil dan Ante Natal Care Di Puskesmas Ceper Klaten Tahun 2011

Abstract: Health Promotion, Book KIA, Pengetahuan Antenatal Care. Mother and child health in Indonesia is still a major problem. It can be seen from the maternal mortality rate (MMR) that is still high. According to the extrapolation Central Statistics Agency (BPS) in 2007 MMR at 248 per 100,000 live births, while the MDG's target of 2015 was 102/100.000 KH (Department of Health, 2008). In Klaten district from 2005 to 2008 maternal mortality rate has decreased. In 2005 AKI showed 0.61, by 2006 MMR decreased by 0.47, in 2007, maternal mortality was 1.31, while in 2008 rose to 1.33 in 2009 and decreased to 0.98 (Klaten District Health Profile , 2009). Kesehatan Ibu dan Anak (KIA) is a book containing instruments to record the mother and child health condition, and consists of the guide for health promotion for mothers and their families, as well as a means of communication between health professionals and families. Research Objective is to know the impact of health promotion using books KIA t the increased knowledge and antenatal care to pregnant women in the health centers Ceper. The study was experiment with a survey approach. The study design is one group pre test - post test. Result shows the knowledge level of pregnant women about the Maternal and Child Book in Health Center Ceper Klaten area in 2011 was moderate level before being given a book MCH 28 (56%).After reading the book, the majority of pregnant mother which is 45 (90%) have a high level of knowledge with significance of 0001 and the r value correlation is low (0.389). The knowledge of antenatal care before being given the book at moderate level account 29 (58%) and after being given KIA book, the majority of pregnant mother, 39 (70%) have a high level of knowledge with significance 0:00 and r value 0,441 that means the correlation was moderate.

Geographical Satellite and Survey Data for Prediction of Dengue Cases in Sukoharjo, Indonesia

Background: Dengue fever is a disease based on environment and still a health problem. Problems related to the dengue fever vector distribution factor in terms of the spread of vector space with the use of geographic data and survey data in order to predict the incidence of dengue in the region. Subjects and Methods: This study used analytic observational with cross sectional approach using modeling Geographical Information Systems (GIS). The sampling technique in this research is saturated sampling of secondary data Sukoharjo District Health Profile in 2011-2014, population data and data Geographic, then all the data were analyzed using multiple linear regression. Results: There is a positive relationship between the area per Km2 with the number of new cases of dengue fever, although the relationship was not statistically significant. (B = <0:01; CI -0.01 - 0:02; p = 0.310). There is a positive relationship between population density per soul / Km2dengan number of new cases of dengue fever, a significant relationship between population density with DHF cases. (B = <0:01; CI <0:01 to 0:01; p = 0.013). There is a negative relationship between topography per masl by the number of new cases of dengue fever, although the relationship was not statistically significant. (B = <0:01; CI -0.02 - 0:01; p = 0.335). There is a positive correlation between rainfall per mm / yr with the number of new cases of dengue fever, although the relationship was not statistically significant. (B = <0:01; CI <0:01 to 0:01; p = 0101). There is a positive relationship between river flow per ha by the number of new cases of dengue fever, although the relationship was not statistically significant. (B = 0:02; CI -0.01 - 0:03; p = 0318). There is a negative correlation between% Non Flick figure by the number of new cases of dengue fever, although the relationship was not statistically significant. (B = <0:01; CI -0.02 - 0:01; p = 0764). Conclusions: The increase in land area, population density, rainfall, river flow is predicted to affect the increase in dengue cases, whereas the increase ABJ predicted topography and affecting the decline of dengue cases in the district of Sukoharjo in 2011-2014. Keywords: geographical data and survey data, prediction of dengue cases Correspondence: Dyah Kusumawati. Academy of Health Analyst 17 Agustus 1945, Semarang, Indonesia. Email: dyahkusumawatiwinarno@yahoo.co.id. Mobile: 085876563978 Journal of Epidemiology and Public Health (2016), 1(1): 11-17 https://doi.org/10.26911/jepublichealth.2016.01.01.02

How can collaboration be strengthened between public health and primary care? A Dutch multiple case study in seven neighbourhoods.

BackgroundAlthough public health and primary care share the goal of promoting the health and wellbeing of the public, the two health sectors find it difficult to develop mutually integrated plans and to collaborate with each other. The aim of this multiple case study was to compare seven neighbourhoods in which a stepwise approach based on two central tools (district health profile and policy dialogue) was used to develop integrated district plans and promote collaboration.MethodsThe stepwise approach involved the following steps: 1 Getting to know the neighbourhood, 2 Assembling the workgroup, 3 Analysing the neighbourhood, 4 Developing a district health profile, 5 Preparing policy dialogue, 6 Holding local dialogues, 7 Embedding integrated district plans and collaboration. To supervise this process, a core team was assembled for each neighbourhood, consisting of people drawn from both public health and primary care. Both the use of the two tools and the collaboration were studied by means of documentary analysis, interviews, questionnaires and observations.ResultsThe seven neighbourhoods differed in the way the two tools of the stepwise approach were used: general versus focused profiles, the actors involved, the aims of the dialogue or the intensity of the steps. There were also similarities: profile indicators (e.g., population prognosis, vulnerability) and dialogue themes (e.g., obesity, social cohesion). The local actors experienced that the combination of both tools facilitates the process of bringing public health and primary care closer together, and that it is essential to invest sufficiently in the integration of profile data and in involving appropriate actors in the dialogue (e.g., GPs, residents). Collaboration was perceived as positive (e.g., feels involved, focus on consensus), but a starting process. Local actors also believe that the stepwise approach supported the process.ConclusionA stepwise approach involving the combined use of district health profiles and policy dialogues promotes the integrated planning of health activities and facilitates collaboration between public health and primary care at the local level. Local differences may arise in the intensity and form of the various steps, but because they are practical and clearly defined, they remain transferrable to other neighbourhoods.

Impact of a decision-support tool on decision making at the district level in Kenya.

BackgroundIn many countries, the responsibility for planning and delivery of health services is devolved to the subnational level. Health programs, however, often fall short of efficient use of data to inform decisions. As a result, programs are not as effective as they can be at meeting the health needs of the populations they serve. In Kenya, a decision-support tool, the District Health Profile (DHP) tool was developed to integrate data from health programs, primarily HIV, at the district level and to enable district health management teams to review and monitor program progress for specific health issues to make informed service delivery decisions.MethodsThirteen in-depth interviews were conducted with ten tool users and three non-users in six districts to qualitatively assess the process of implementing the tool and its effect on data-informed decision making at the district level. The factors that affected use or non-use of the tool were also investigated. Respondents were selected via convenience sample from among those that had been trained to use the DHP tool except for one user who was self-taught to use the tool. Selection criteria also included respondents from urban districts with significant resources as well as respondents from more remote, under-resourced districts.ResultsFindings from the in-depth interviews suggest that among those who used it, the DHP tool had a positive effect on data analysis, review, interpretation, and sharing at the district level. The automated function of the tool allowed for faster data sharing and immediate observation of trends that facilitated data-informed decision making. All respondents stated that the DHP tool assisted them to better target existing services in need of improvement and to plan future services, thus positively influencing program improvement.ConclusionsThis paper stresses the central role that a targeted decision-support tool can play in making data aggregation, analysis, and presentation easier and faster. The visual synthesis of data facilitates the use of information in health decision making at the district level of a health system and promotes program improvement. The experience in Kenya can be applied to other countries that face challenges making district-level, data-informed decisions with data from fragmented information systems.

What is the status quo of South Africa's National Health Insurance pilot project?

This editorial was motivated by a colleague's recent criticism of the National Health Insurance (NHI) pilot project that was launched in April 2012. He claimed that patients have not experienced any tangible difference in health service delivery from the pilot NHI districts, compared to that from other non-NHI pilot districts. The selection of 13 pilot NHI districts was based on audit findings, which included the district's health profile, demographics, income levels and other social factors that impact on health, health delivery performance, management of health institutions and compliance with quality standards. I engaged my colleague by asking him if he knew the objectives of the NHI pilots, to which his response was: No. Obviously, from this short interaction I asked myself the question: How many other colleagues are ill- or uninformed about the objectives of the pilot sites and implementation plan of the NHI?