Good Health Services Research Articles

Migrants’ health and Bulgarian health care system performance: experts’ and society point of view

Abstract Introduction Migrants often face serious inequities concerning their state of health and access to good quality health services. The aim of the study is to compare the experts' and society point of view on migrants' health and Bulgarian health care system performance in this field. Methods Within the TRAIN4M&H project, founded by EC, in March 2019th a work seminar was organized in Bulgaria. Data were collected through an unstructured interview. The focus group and facilitated discussion with 22 experts intended was performed. To elicit information about significant migrants' health problems the questionnaire among 388 people was applied. Data processing was performed by SPSS v.24. Results 22 frontline professionals and 388 people of the society were covered. 20% of the surveyed experts completely disagrees with the opinion that migrants are a threat to public health while nearly nine out of ten surveyed members of the public fully (38.0%) or partially agree (51%) with that statement (χ2=37,84;df=3;p<0,001). The majority (47.8%) of the respondents from the public express an opinion for greater needs for health care of migrants compared to the Bulgarian population while according to three quarters of the specialists there is no difference (χ2=24,07;df=2;р<0,001). About 40% of the representatives of the society claim that the health care system in Bulgaria is not prepared to provide adequate health care to migrants. Almost two thirds of the experts share the opinion that health care in the country can provide only some specific health care to migrants (χ2 = 15.11; df = 2; p < 0.001). The point of view of the groups compared coincided on the issues of restricting the access of migrants in the country and provision of health care, regardless of the legal status of migrants. Conclusions The society is not familiar with the health problems of the migrants, but accepts their health as worse than that of the Bulgarian population and threatening the public health in the country. Key messages The society is not familiar with the health problems of the migrants, but accepts their health as worse than that of the Bulgarian population and threatening the public health in the country. According to the experts working at local level with migrants Bulgarian health system is not well prepared and provides adequate health care for migrants only in some specific cases.

The Future Public Health Workforce in a Changing World: A Conceptual Framework for a European-Israeli Knowledge Transfer Project.

Health services quality and sustainability rely mainly on a qualified workforce. Adequately trained public health personnel protect and promote health, avert health disparities, and allow rapid response to health emergencies. Evaluations of the healthcare workforce typically focus on physicians and nurses in curative medical venues. Few have evaluated public health workforce capacity building or sought to identify gaps between the academic training of public health employees and the needs of the healthcare organizations in which they are employed. This project report describes the conceptual framework of “Sharing European Educational Experience in Public Health for Israel (SEEEPHI): harmonization, employability, leadership, and outreach”—a multinational Erasmus+ Capacity Building in Higher Education funded project. By sharing European educational experience and knowledge, the project aims to enhance professionalism and strengthen leadership aspects of the public health workforce in Israel to meet the needs of employers and the country. The project’s work packages, each jointly led by an Israeli and European institution, include field qualification analysis, mapping public health academic training programs, workforce adaptation, and building leadership capacity. In the era of global health changes, it is crucial to assess the capacity building of a well-qualified and competent workforce that enables providing good health services, reaching out to minorities, preventing health inequalities, and confronting emerging health challenges. We anticipate that the methods developed and the lessons learned within the Israeli context will be adaptable and adoptable by other countries through local and cultural adjustments.

Are the Poor Catching Up with the Rich in Utilising Maternal Health Care Services? Evidence from India

India launched the National Rural Health Mission (NRHM) in 2005 to improve maternal and child health by providing good quality health services to all, especially deprived sections of society, to reduce inequality in access to health services. With the backdrop of NRHM, we analysed the extent to which the utilisation of maternal health care services (MHCSs) in the three stages of the continuum of care—antenatal care (ANC), care during child delivery and postnatal care (PNC)—–has improved among the poor vis-à-vis the rich in India, and the corresponding narrowing down in inequality in the period 2006–2016. Data from the 3rd round of the National Family Health Survey (NFHS) in 2005–2006, capturing the pre-NRHM period and the 4th round of NFHS 2015–2016, capturing the post-NRHM era ten years after the implementation of the flagship programme, are used for the analysis. We estimated absolute as well as relative measures of inequality, absolute gap and coverage ratio between the poor and rich, slope index of inequality and concentration index. Our findings show that maternal health care coverage increased significantly among the poor for all components of MHCSs. Even so, the extent of utilisation of services remains significantly lower among the poor in 2015–2016 compared to the coverage among the rich in 2005–2006. Although inequality declined at the national level over the decade, it still persists. High equity has been achieved in using skilled birth attendance during child delivery and institutional delivery during 2015–2016, however, inequality continues to be higher for ANC indicators including consumption of iron and folic acid supplements for at least 100 days, receipt of four or more antenatal check-ups and comprehensive health check-ups at least once during antenatal visits and receipt of first check-up in the first trimester.

MENELISIK KESIAPAN SUMBER DAYA MANUSIA NON KESEHATAN DALAM MENDUKUNG PELAYANAN RUMAH SAKIT DI ERA NEW NORMAL

The readiness of Human Resources is an important element of the success of the Hospital organization in providing good health services to Covid-19 patients. Non-Health Workers are competent workers who must be ready to face the Services in the New Era. The purpose of this study is to see how the readiness of non-health human resources in supporting hospital services in the New Era is normal. The type of research used is a case study using a qualitative descriptive research approach with data collection techniques: in-depth interviews and documentation. Data processing in this study uses thematic analysis. The results of the study indicate that socialization or fair information about the Covid-19 disease intensively, carrying out continuous evaluations and ensuring the implementation of the Director's policy regarding the application of health protocols at work and the budgeting policy for the provision of Personal Protective Equipment greatly affect the Readiness of Non-Health Human Resources in supporting services. Hospitals in the New Era are normal. This is in accordance with the technical guidelines for hospital services during the adaptation period of new habits issued by the Indonesian Ministry of Health in 2020 that hospital administrators prepare service management according to national health protocol standards by prioritizing health and safety by preventing and controlling the transmission of COVID-19 so that can provide protection for human resources in hospitals. It is recommended that regularly socialize the application of health protocols on an ongoing basis, carry out monitoring and evaluation in stages.

Pelaksanaan Penyimpanan Rekam Medis Berdasarkan Unsur Manjemen 5M di Puskesmas Medan Johor

The implementation of medical records carried out at the puskesmas requires management in managing all existing activities with the aim of creating good health services, in accordance with procedures and guidelines. To achieve the goal of processing medical records, 5 elements of management are needed, namely man, money, material, machine, and method. The purpose of this study was to determine the management elements of man, money, material, machine, and method in the implementation of medical records carried out at the Medan Johor Health Center. This type of research uses qualitative research methods with a phenomenological approach. The study was conducted from May to July 2020. The population was all medical record officers at the Medan Johor Health Center. The research sample amounted to 5 people who were taken by saturated sampling. The research instrument is an interview guide and recorded using an audio recorder and a check list sheet for observation. The results showed that the man element was 5 people and none of them had a medical record background and had never received training, the money element was the funding obtained from JKN and APBD, the material element was that a family folder was used to store all patient forms, while the use of tracers and register books has not been used to control the borrowed files out of the storage rack, and the filling cabinet is used as a tool to store medical record files, the machine element is a primary care application to register patients, the SIMPUS application is used for reporting, the method element is Not all SOPs in medical records exist. The advice given is to provide training to medical record officers so that their officers better understand the importance of medical records.

Pelaksanaan Penyimpanan Rekam Medis Berdasarkan Unsur Manjemen 5M di Puskesmas Medan Johor

The implementation of medical records carried out at the puskesmas requires management in managing all existing activities with the aim of creating good health services, in accordance with procedures and guidelines. To achieve the goal of processing medical records, 5 elements of management are needed, namely man, money, material, machine, and method. The purpose of this study was to determine the management elements of man, money, material, machine, and method in the implementation of medical records carried out at the Medan Johor Health Center. This type of research uses qualitative research methods with a phenomenological approach. The study was conducted from May to July 2020. The population was all medical record officers at the Medan Johor Health Center. The research sample amounted to 5 people who were taken by saturated sampling. The research instrument is an interview guide and recorded using an audio recorder and a check list sheet for observation. The results showed that the man element was 5 people and none of them had a medical record background and had never received training, the money element was the funding obtained from JKN and APBD, the material element was that a family folder was used to store all patient forms, while the use of tracers and register books has not been used to control the borrowed files out of the storage rack, and the filling cabinet is used as a tool to store medical record files, the machine element is a primary care application to register patients, the SIMPUS application is used for reporting, the method element is Not all SOPs in medical records exist. The advice given is to provide training to medical record officers so that their officers better understand the importance of medical records.

ANALYSIS OF FACTORS THAT INFLUENCE THE LOW UTILIZATION OF HEALTH SERVICES IN INPATIENT ROOMS IN THE COMMUNITY IN RSUD TUAN RONDAHAIM PEMATANG RAYA KABUPATENSIMALUNGUN IN 2019

The hospital is a center for public health services in an effort to prevent, restore and cure diseases and improve health status. The increasing level of community life is the increasing also the demands of the community on quality of health. To find out factors that effect the low utilization of health services in the hospitalization of community in RSUD Tuan Rondahaim Pamatang Raya. The number of sampel was 97 responden who get 2.777 hospitalization in that hospital in 2017.The type of research used is analytic survey research with cross secsional design,namely research conducted at the same time but with different subject. The results showed that there was a significant influence between sex and service utilization, The level of education has a significant effect on service utilization. Income has a significant influence with the utilization of health services. Hospital facilities had a significant influence with the utilization of health services. The distance to the service location had a significant influence with the utilization of health services, trust with the utilization of health services. Types of illness with utilization of health services. Trust is the most dominant factor in the utilization of health services with a value of RP = 25,260 (95% CI: 4,022-158,645), it means that the tendency of respondents to believe in a good health service place is 25,260 times greater than those who do not believe in a health service in a hospital. There was no significant influence between age, occupation and service costs with the utilization of health services (p> 0.05).It is expected that hospitals will maintain and provide the best services, and continue to make improvements regarding the availability of more complete facilities, types or variations of health services.

Enhance of Legal Protection the Health Outsourcing Workers in Health Law Number 36 of 2009

This research is to find out and analyze the legal regulation of health services for outsourcing workers, to find out and analyze the legal protection of health for outsourcing workers and to examine and analyze the law regarding sanctions for doctors and hospitals that make mistakes in health services for workers. The writing of this thesis research methodology uses normative juridical research methods using an empirical juridical approach, with qualitative analysis. Qualitative analysis means that research results do not depend on the amount of data based on numbers, but data analyzed is carried out in-depth and holistically. The normative juridical method means that research data is analyzed according to legal norms and court decisions relating to health services for outsourced workers. Legal materials or materials used to analyze are obtained from library materials that include primary, secondary and tertiary legal materials, secondary data used as references in this study, especially those relating to the legal protection of the health of outsourced workers in the health law. Data processing is carried out by editing and making data after the data is sorted and analyzed and then interpreted logically against the applicable provisions. After that, it is presented in the form of sentence descriptions. Based on the results of the study, it is known that health services for outsourcing workers. In-Law no. 13 of 2003 concerning Manpower, which becomes the primary reference in the world of Manpower, does not find the term outsourcing. In practice, a corporate liability that violates the labour law can be legally prosecuted for companies that do not provide health insurance for workers. Hospitals and doctors who check the health conditions of workers must provide good health services for outsourced workers.

Theoretical Aspects and Features of the Tourism Industry in the Context of its Information Support and Financial Design

Tourism is a promising and important sector of the national economy that improves and diversifies people's lives by providing them with good recreational, educational, cultural, religious, economic, educational, environmental, humanitarian, communication, holistic and health services as well as meeting the relevant needs. The article thoroughly describes the theoretical aspects and reveals the features of the functioning of tourism companies, in particular, and the tourism industry in general. Demand for a tourist product is the number of ordered services that tourists want and can pay for at a certain price level. The offer of tourist products is the number of offered tourist services that the travel agency wants and can provide. The average costs of a travel agency — is the cost of a particular type of travel service, which depends on the average and marginal productivity of investment in tourism. These arguments are intended to help practitioners take real and effective steps to improve the development of the tourism business, expand its sphere of influence, effective financial design and information support. Information technologies and software in the modern information society and knowledge economy are an important key driver of the progress of science, technology and current economic practice from the microeconomic environment to the megaeconomic level. The tourism industry must participate in this progressive trend. The versatility of information technology and software allows you to calculate, forecast and analyze demand, supply, pricing, optimal allocation of available resources, structure and dynamics of average and marginal costs, as well as average and marginal return on investment, development of financing projects and more. Information technologies and software contribute to the significant facilitation of the choice of tourist routes, modeling of various situations both for tourist companies and for tourists themselves. It is proved that financial design in the tourism business is a very important element of its development and largely depends on the level of implementation and application of information technology and software. It has been found that programming and information processing technologies allow to develop optimal financial projects with minimal errors. Thus, the dynamics of average and marginal costs, the trend of marginal and average productivity, unexpected losses are prevented, funds for the development of intellectual capital, expansion and improvement of production capacities, efficient, careful and rational use of tourist and recreational tourism are calculated with approximate real accuracy.

Local wisdom and archipelago agriculture: Poverty in Maluku

Maluku is an archipelago province where its inhabitants mostly settle on small islands and conduct agricultural activities on very limited land with relatively low fertility rates. In such conditions, islanders’ local wisdom in Maluku is one of the cultural values that are still manifested in their life order, which is the social capital of archipelago communities. Local wisdom is derived from society’s knowledge and has a high social value in sustaining their lives when faced with all limitations and challenges. Islanders often face difficulties in marketing their agricultural products and limited transportation access to get a good education and health services. This has contributed to poverty among people living on small islands, as indicated by a poverty rate of 18.5%. Interestingly, local wisdom has been practised by communities for a long time when undertaking their agricultural activities. It is anticipated that global climate change also impacts agricultural practices undertaken by the islanders in Maluku. Therefore, this article’s objectives were to (1) analyze the form of local wisdom of islanders and its impact on sustainable archipelago agriculture development, (2) suggest ways to alleviate poverty in Maluku using local wisdom as social capital. The finding suggests that local wisdom’s value cannot be separated from the interactions between humans and their environment. This is a driving factor in the advancement of economic and socio-cultural aspects. Responsible marketing is another aspect that should be taken into account.

An Empirical Study on Citizen Perception, and Satisfaction Towards Ayushman Bharat Yojna (PM-JAY)

Good health service is the right of every citizen in India. But due to being expensive, the poor used to stay away from it. India, the world’s largest democracy and sixth-biggest economy, has been steadily humanizing its health services for the last few years. On 1- Feb-2018, the central government launched a health protection scheme named “Ayushman Bharat Yojna” by hon’ble prime minister Mr. Narendra Modi. In this scheme, approximately 10 corers of poor families are availing the free health service up to 5 lakhs rupees per annum per family. The objective of this research paper is to find the awareness, perception, and satiation of the citizens who are availing of this service. The success of this scheme depends on how many people can take advantage of this scheme and it is possible only through monitoring.

Implementation of Customer Communication to Maintain the Hospital Image from the Issues of Coviding Patients

Accusations of hospitals that have taken Indiscipline’s actions on Covid-19 cases have many comments that’s appeared on social media like Twitter with the hashtag #BongkarMafiaCovidRS which reached 5,700 tweets. This study aims to examine the accusations of this issue, how the issue started and how to dismiss it. This research is a qualitative research using literature method. To complement the results of this study, the researcher also conducted interviews with several informants from medical personnel who worked in the hospital. Does the issue of coviding patients make the hospital's image worse? How is the hospital able to maintain the image of the hospital as a good health service facility amid accusations of coviding patients? The results of this study indicate that the developing issue is not based on facts, the hospital has clear SOPs and guidelines in carrying out covid-19 patient care. The hospital also conducts and implements customer communication to patients and patients' families before the procedure so that patients and families are well educated. Implementation of customer communication is one of the strategies that are believed to be able to maintain the hospital image and ward off accusations of the issue of coviding patients.

A Cluster Analysis with Complete Linkage and Ward's Method for Health Service Data in Makassar City

Health care facilities are a place used to organize health efforts. Health service data in Makassar City has not shown which sub-districts have excellent service criteria, good enough, and not good. Therefore, it is necessary to group sub-districts with cluster analysis using hierarchy method. The hierarchy method used in this study is only 2, namely complete linkage and ward's method. Complete linkage method is the opposite of the approach to the minimum distance principle that is the furthest distance between objects while Ward's Method is a method that aims to minimize variance between objects in one cluster. There are four health services used, namely Hospitals, Health Centers, Home Care and Telemedicine with 15 sub-districts. This study also used a validity test namely Index Davies Bouldin (IDB) to determine the criteria of health services. The results of the analysis on complete linkage formed 3 clusters, namely cluster 1 with good health services, cluster 2 with excellent health services, and cluster 3 with poor health services. In addition, ward's Method also formed 3 clusters, namely cluster 1 with good health services, clusters 2 with poor service, and cluster 3 with excellent health services.

Analysis of Factors that Influence the Participation of Women of Childbearing Age in the Examination of Visual Acetic Acid Inspection (IVA) in Kanor Public Health Center, Bojonegoro Regency

Cervical cancer is the most common case and almost 70% of it is found in an advanced stage condition (> stage IIB). This is because the screening implementation is still low, which is <5%. In fact, the ideal screening implementation is 80%. Actually, early-stage cervical cancer can be diagnosed by performing a cytological examination through IVA. Nearly 50% of people with cervical cancer do not do IVA. The purpose of this study was to determine the effect of health services, maternal motivation, level of knowledge, and husband's support for the participation of women of childbearing age in the IVA examination at the Kanor Health Center. This research method is analytic research with cross sectional approach. The study population was all women of childbearing age between 30 and 50 years in the Kanor Health Center area. Proportional random sampling technique with a total sample of 300 people. Data analysis techniques using multiple logistic regression. The results showed that the variables that influenced participation in the IVA examination were health services (p = 0,000 and beta = 0.050) and maternal motivation (p = 0,000 and beta 0.037). While the variables that did not affect the participation of IVA examination were knowledge and husband support. The results of data analysis showed that the most dominant variable affecting the participation of women of childbearing age in the IVA examination was health services with a p value of 0.000 and an Odd Ratio of 0.050, which means that good health services will have a greater influence on the participation of women of childbearing age in IVA examinations by 0.050 times compared to poor health services. Therefore, it is necessary to have health promoter staff to provide information about health services as well as education or health education about early detection of cervical cancer through examinations.

Motivasi Perawat Dalam Pelaksanaan Timbang Terima Pasien Sesuai SOP

<p><strong><em>Backgroud: </em></strong><em>Nursing is one of a profession front for health workers in this effort to ensure the quality of health center in community. Handover is good quality health services to offer a service nursing on a patient care, To optimize the role and function of nurse especially function to independence nurse. This research aims to know the the relations motivation of a nurse with patient handover implementation as Standard Operational Procedure. <strong>Methods</strong>: The kind of research used is descriptive analytic with the approach cross sectional. A population that used is nurse who were 101 people from 101 a person who uses technique total of sampling. The analysis in use is analysis univariat and bivariat. <strong>Results: </strong>The results of the study was obtained between motivation meaningful a nurse with the implementation of these stations received patients (p = 0,000; OR = 9,389). <strong>Conclusion: </strong>Based on the research done can be concluded that there was a correlation meaningful of the incentives a nurse with the implementation of the weigh received patients appropriate with the Standard Operational Procedure. It was recommended to researchers , the hospital to continue to motivate nurse in the implementation of the weigh received patients appropriate with the Standard Operational Procedure. </em></p><p><em><br /></em></p><p><strong>Keywords</strong>: <em>Motivation, The Implementation of Handover</em></p><p><em><br /></em></p>

Global economic productivity losses from vision impairment and blindness.

BackgroundIn the absence of accessible, good quality eye health services and inclusive environments, vision loss can impact individuals, households and communities in many ways, including through increased poverty, reduced quality of life and reduced employment. We aimed to estimate the annual potential productivity losses associated with reduced employment due to blindness and moderate and severe vision impairment (MSVI) at a regional and global level.MethodsWe constructed a model using the most recent economic, demographic (2018) and prevalence (2020) data. Calculations were limited to the working age population (15–64 years) and presented in 2018 US Dollars purchasing power parity (ppp). Two separate models, using Gross Domestic Product (GDP) and Gross National Income (GNI), were calculated to maximise comparability with previous estimates.FindingsWe found that 160.7 million people with MSVI or blindness were within the working age and estimated that the overall relative reduction in employment by people with vision loss was 30.2%. Globally, using GDP we estimated that the annual cost of potential productivity losses of MSVI and blindness was $410.7 billion ppp (range $322.1 - $518.7 billion), or 0.3% of GDP. Using GNI, overall productivity losses were estimated at $408.5 billion ppp (range $320.4 - $515.9 billion), 0.5% lower than estimates using GDP.InterpretationThese findings support the view that blindness and MSVI are associated with a large economic impact worldwide. Reducing and preventing vision loss and developing and implementing strategies to help visually impaired people to find and keep employment may result in significant productivity gainsFundingMJB is supported by the Wellcome Trust (207472/Z/17/Z). JR's appointment at the University of Auckland is funded by the Buchanan Charitable Foundation, New Zealand. The Lancet Global Health Commission on Global Eye Health was supported by grants from The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity (GR001061), NIHR Moorfields Biomedical Research Centre, The Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The SEVA Foundation, The British Council for the Prevention of Blindness and Christian Blind Mission. The funders had no role in the design, conduct, data analysis of the study, or writing of the manuscript.

Health Literacy Co-Design in a Low Resource Setting: Harnessing Local Wisdom to Inform Interventions across Fishing Villages in Egypt to Improve Health and Equity.

Fishermen in low resource settings have limited access to health services and may have a range of health literacy-related difficulties that may lead to poor health outcomes. To provide solutions and interventions based on their needs, co-design is considered best practice in such settings. This study aimed to implement a co-design process as a step towards developing health literacy interventions to improve health and equity in the Borollos Lake region of northern Egypt, a low resource setting with a high prevalence of chronic diseases. This study was guided by the Ophelia (Optimising Health Literacy and Access) process, a widely used and flexible co-design process that seeks to create local and fit-for-purpose health literacy solutions through genuine engagement and participation of community members and relevant stakeholders. Following a health literacy survey using the Health Literacy Questionnaire (HLQ), cluster analysis was conducted to identify the diverse health literacy profiles among the fishing communities. Seven health literacy profiles were identified. Vignettes, representing these profiles, were presented and discussed in ideas generation/co-design workshops with fishermen and health workers to develop intervention ideas. Seventeen fishermen, 22 wives of fishermen, and 20 nurses participated in four workshops. Fifteen key strategies across five themes, including ‘Enhancing education among fishing communities’, ‘Provide good quality health services’, ‘Financial support for health’, ‘Social support for health’, and ‘Promote better health-related quality of life among fishermen’, were generated. The ideas did not only target the individuals but also required actions from the government, non-government organizations, and fishermen syndicates. By harnessing local wisdom, the Ophelia process has created meaningful engagement with the local communities, leading to a wide range of practical and feasible solutions that match the special needs and environment of a low resource setting.

Utilization of Reproductive Health Services and Associated Factors among Secondary School Students in Woldia Town, Northeast Ethiopia.

Background Reproductive health is a universal concern but it has special importance for women particularly during the reproductive year. Although policy actions and strategic efforts made reproductive health service uptake of youths in Ethiopia, still its utilization remains low. Adolescence is not quite capable of understanding complex concepts. This makes them vulnerable to sexual exploitation and high-risk sexual behaviors and reproductive health problems. Objective The aim of this study was to assess the utilization of reproductive health services and associated factors among adolescents in Woldia town secondary schools, Amhara, Ethiopia, 2019. Methods An institutional-based descriptive cross-sectional study was conducted on 420 secondary school students in Woldia Town from January to June 2019. A self-administered, structured questionnaire was used to collect the data. The samples were distributed proportionally, and participants in each school were selected by the systematic sampling technique. Bivariable and multivariable logistic regression was carried out to assess the association between dependent and independent variables. Result Out of 420 students participated in this study, 270 (64.3%) of the respondents utilize reproductive health service. Residence (AOR = 4.40, 95%CI (1.23, 9.362)), educational status of the partner (AOR = 2.66, 95%CI (2.35, 5.24)), presence of RHS facility in school (AOR = 2.53, 95%CI (1.57, 4.06)), and good knowledge level on reproductive health services (AOR = 1.77, 95%CI (1.14, 2.75)) were significantly associated with reproductive health service utilization. Conclusion and Recommendations. Knowledge of respondents on reproductive health utilization in the study area was found to be low. Students who were from rural families have low utilization of reproductive health services. This low service utilization in these students might be disposed to different reproductive health risks such as sexually transmitted infections, HIV/AIDS, and unwanted pregnancy, which in turn can increase the school dropout rate and have an impact on an individual's future life. However, students who have good knowledge and were encouraged by their friends have good reproductive health service utilization. Therefore, it needs a great effort and attention of all concerned bodies including parents, school staff, and health professionals to improve service utilization in schools.

THE ROLE OF POSYANDU CADRES IN EFFORTS TO IMPROVE THE NUTRITIONAL STATUS OF TODDLERS IN SUKA MAKMUR VILLAGE, PATILANGGIO DISTRICT

THE ROLE OF POSYANDU CADRES IN EFFORTS TO IMPROVE THE NUTRITIONAL STATUS OF TODDLERS IN SUKA MAKMUR VILLAGE, PATILANGGIO DISTRICT

LEGAL RESPONSIBILITY ANESTHESIA ADMINISTRATOR IN THE HEALTH SERVICE

Good, quality and quality health services are one of the basic needs that everyone needs. Therefore, in the health world, the authority of anesthetist administrators within the scope of anesthesia services is direct, mandated, and collaborative where the mandate obtained from anesthetist administrators is not only from specialist doctors but also from the Government, as regulated in Article 14 Paragraph (1) and Paragraph (2) Ministry of Health Regulation No. 18 of 2016 concerning Licensing and Implementation of Anesthesia Administrator Practices. Now the delegation based on government assignments is carried out if there is no anesthetist in an area. The authority falls to the anesthetist in that area who has received training. This study aims to determine how the legal responsibility of anesthesia administrators in health services. The method used in this research is juridical normative, which examines legislation (statute approach) by examining all relevant regulations or statutory regulations and looking at the facts in the field. The research approach used is qualitative. This study's results indicate that anaesthesia services' general responsibility lies with anaesthetists in the practice of anesthesia services. What needs to be considered in the delegation of tasks from doctors to nurses is that the primary responsibility remains with the doctor who gives the assignment, nurses also have executive responsibility, delegation can only be carried out after the nurse has received sufficient education and competence to receive the delegation, delegation for the long term or continuously given to health nurses with special skills (specialist nurses), which are regulated by separate rules (standing orders). Anaesthetist administrators' role when carrying out health services to delegate authority according to these norms can only be performed by anaesthetist administrators who have received training.