Health Service Facilities Research Articles

Factors influencing antenatal care attendance in the eight contact era policy: a case of selected maternal health service facilities in Blantyre, Malawi

BackgroundMaternal mortality in sub-Saharan Africa and Malawi remains high. Effective antenatal care (ANC) services can reduce maternal morbidity and mortality. However, attendance to ANC clinics and the quality of services provided remain a challenge. Malawi adopted the 2016 WHO antenatal care model and there is a need to assess factors that influence antenatal care attendance. The main objective of this study was to assess factors influencing attendance in the era of the eight ANC contact policy in Blantyre.MethodsThis was an exploratory qualitative design in which 28 respondents participated using in-depth interviews and focus group discussions for the data collection process. The study sites included two healthcare facilities, namely Queen Elizabeth Central Hospital and Bangwe Health Centre, and a rural community (William Village Bangwe Rural) in Blantyre district. The 28 study participants included 11 ANC attendees, which comprised seven women in their final trimester and four postpartum women who attended ANC during their pregnancy, five midwives running the ANC clinics, and 12 non-users of ANC. The recordings were transcribed verbatim. The data were organized using Microsoft Excel and Microsoft word and analyzed using inductive content analysis.ResultsThe factors promoting ANC attendance in the context of the eight ANC contact policy include; motivation from health workers, family, and spouses and the women’s perceptions of ANC particularly the role it plays in preventing, detecting, and treating illness, but also preventing adverse pregnancy outcomes. On the other hand, the hindering factors to ANC attendance included lack of knowledge of the new ANC visit guidelines, financial constraints, quality of health services provided, attitude of healthcare workers, inadequate availability and training of healthcare workers, perceived poor quality of ANC services and personal beliefs.ConclusionIt is essential to provide comprehensive training to healthcare workers in the antenatal department regarding the new WHO ANC recommendations. This will help improve the quality of services at the antenatal clinics, including ensuring the availability of all necessary resources to encourage attendance. Additionally, promoting comprehensive spousal support, encouraging participation in activities, and adequately planning scheduled visits can help overcome financial barriers and further support antenatal attendance.

The Influence of Satisfaction on Service Quality and Intention to Recommend Mediated by Patient Loyalty

The purpose of this study is how the role of the Hospital as one of the health service facilities has a very strategic role in efforts to accelerate the improvement of the health of the Indonesian people. This strategic role is owned because the hospital is a technology-intensive health facility. This role is increasingly prominent considering the emergence of changes in disease epidemiology, changes in demographic structure, developments in science and technology, changes in the socio-economic structure of society, and services that are of better quality, friendly and able to meet the needs that demand changes in health service patterns in Indonesia. The analysis method is carried out through explanatory research, with the application of PLS / SEM. The concepts and problems studied look at the causal relationship, then explain the variables that cause the problems studied. The research sample was 384 respondents who had received services at a government tertiary hospital in Batam City. The findings of this study were patient satisfaction with the quality of service had a significant positive effect on patient loyalty. Patient satisfaction with the quality of service had a significant positive effect on the intention to recommend. Patient loyalty had a significant positive effect on the intention to recommend. Patient satisfaction with the quality of service had a significant positive effect on the intention to recommend with the mediation of patient loyalty

Pay for a free service, access to cesarean section in the slums of Dakar

BackgroundIn sub-Saharan Africa, equitable access to cesarean section remains a major challenge for reducing maternal and neonatal mortality, particularly among disadvantaged populations. This situation is further exacerbated in slums, where women face significant financial barriers to accessing expensive healthcare services, such as cesarean. Within this context, this paper aims to study access to emergency cesarean services among women living in the slums of Dakar, considering the free cesarean policy implemented in Senegal since 2005.MethodQuantitative data were collected using a cross-sectional retrospective approach, from 18 health facility managers and 260 women living in slums in Dakar who had undergone cesarean delivery between July and December 2022. The surveys aimed to collect socio-demographic data on women and the costs they paid to have a cesarean section, as well as on the application of the policy of free caesarean sections by public health facilities. The data were processed using Stata.ResultsThe results indicated that poor women residing in Dakar slums do have access to emergency cesarean section services in public health facilities. However, a significant portion of these women come from impoverished households and lack higher education, making them more vulnerable to financial constraints when seeking a C-section. Despite cesarean sections being performed primarily based on medical necessity, regardless of the woman's economic status, ethnicity, or educational background, women often find themselves having to pay substantial amounts to undergo the procedure. This is particularly concerning, as cesarean sections are intended to be entirely free in public health facilities in Senegal. Health facility managers attribute this financial burden to the State, which recurrently delays reimbursements for cesarean sections, forcing them to charge women higher prices for the procedure.ConclusionA more rigorous enforcement of the policy for free cesarean section could greatly enhance access to this obstetric practice for women living in the slums of Dakar.

Utilisation of maternal healthcare services and influencing factors in public health facilities in Addis Ababa, Ethiopia

Background: Ethiopian maternal mortality remains high, despite the implementation of extensive health programmes. This indicates that the full potential of maternal health services is not being effectively utilised.Aim: This study aimed to evaluate the utilisation and factors influencing maternal healthcare services in public health facilities in Addis Ababa.Setting: This study was conducted in five public hospitals and 10 public health centres of Addis Ababa city administration from 31st August 2023 to 13th October 2023.Methods: The study’s design utilised a cross-sectional quantitative technique, which involved interviewing 354 women from each group who received visits throughout their pregnancy, delivery and postpartum period. The data were analysed using SPSS version 26.Results: This study analysed maternal health service utilisation indicators, revealing a 70.8% overall utilisation of services, with antenatal care (ANC) at 85.5%, delivery at 71.58% and family planning services (PNC) at 55.4%. The study found that the length of time spent travelling to public health facilities significantly impacts the use of maternal health services. Pregnant women who travelled less than 30 min used services 2.29 times more than those over 2 h. The average client wait time also influenced service usage. Pregnant women with four or more prenatal care visits were more likely to use services.Conclusion: The study conducted in Addis Ababa’s capital city revealed that the utilisation of maternity health care services is not optimal, despite the concentrated resources.Contribution: The findings of the study could be beneficial for the Addis Ababa Health Bureau, Ministry of Health, legislators, and other stakeholders. It can help in the development of affordable intervention programmes, filling knowledge gaps and updating scientific understanding.

Penerapan Audit Lingkungan Dalam Menilai Efektivitas Pengelolaan Limbah Rumah Sakit di Rumah Sakit Gotong Royong Surabaya

Hospitals that provide health services also produce waste which will have negative impacts if not managed properly. Hospitals have a responsibility to the environment in conducting their business. Medical waste originating from health service facilities needs appropriate handling based on applicable regulations. This research was conducted to see how the Gotong Royong Hospital manages the waste it produces based on the Regulation of the Minister of Health of the Republic of Indonesia Number 2 of 2023 concerning Implementing Regulations of Government Regulation Number 66 of 2014 concerning Environmental Health.This research uses a qualitative method with a case study approach and collects primary data from the environmental health section of the Gotong Royong Hospital, Surabaya. Data analysis and processing methods use technical triangulation, reduction, data display, and drawing conclusions.Based on research, waste management at the Gotong Royong Hospital has been carried out in accordance with the Regulation of the Minister of Health of the Republic of Indonesia Number 2 of 2023.

Predictors of Birth Preparedness and Complication Readiness Practices Among Pregnant Women in Ethiopia, a Systematic Review and Meta-Analysis.

We conducted this review to identify factors associated with birth preparedness and complication readiness (BPCR) among pregnant women in Ethiopia. BPCR is a comprehensive approach that helps address delays in seeking care for obstetric problems. PRISMA was followed and different databases were used to find studies. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval was used to identify factors. The I2 statistic, funnel plot, and Egger test were used to assess the heterogeneity of studies and publication bias. Knowledge of BPCR, danger signs during pregnancy, labor, and postpartum (AOR = 1.99, 95% CI: 1.51, 2.64, AOR = 1.55; 95% CI: 1.35, 1.80; AOR = 1.45; 95% CI: 1.27, 1.63, and AOR = 1.4; 95% CI: 1.21, 1.63), respectively, residency (AOR = 1.49; 95% CI: 1.32, 1.68), antenatal care visit (AOR = 1.59; 95% CI: 1.43, 1.78), history of stillbirth (AOR = 1.58; 95% CI: 1.36, 1.86), and educational status (AOR = 1.62: 95% CI: 1.45, 1.78) were significantly associated with BPCR practice. This study identified some modifiable factors in the practice of BPCR. Integrating counseling and expanding ANC services in health facilities may improve BPCR practice.

Artificial Intelligence-Based Chronic Disease Detection Application Among Hypertension and Diabetes Mellitus Risk Group in Indonesian Primary Healthcare: A Usability and User Experience Evaluation

This study aims to considering the assessment of the usability and user experience of applications based on artificial intelligence (AI) for early detection of chronic diseases. Health data is recorded and chronic disease risk is classified using an AI-based early detection of chronic disease application. The study was conducted in Semarang city/regency health service facilities, using quantitative research methodology. The study's inclusion criteria were individuals with a history of diabetes mellitus and hypertension. Using the System Usability Scale (SUS) and User Experience Question (UEQ) surveys, 131 respondents were studied in May–July 2023. The study's findings showed that respondents who were older than 60, female, had not completed their education, worked for a living or were self-employed, did not use a mobile phone, and had never used health applications scored poorly for usability and user experience. The system satisfation aspect receives the lowest grade in terms of system usability, while the memorability aspect has the best score. The efficiency aspect of the system receives the greatest score in terms of user experience, while the novelty aspect receives the lowest. It is known that the AI-based early detection of chronic disease application has a reasonably acceptable usability and user experience based on the findings of the SUS and UEQ questionnaires for patients at risk of hypertension and diabetes mellitus. It is necessary to design an AI-based chronic disease detection application that is easier to learn and more innovative so that it can be used by the wider community.

Pelayanan Pendaftaran Pasien Rawat Jalan di Rumah Sakit Elisabeth Medan

Abstract Hospital outpatient registration services are a phenomenon that refers to the actions or activities of a system within a hospital or health service facility which aims to maintain and improve health, prevent and cure disease and restore health. Outpatient care is a medical service provided to patients not in the form of inpatient care. This study aims to see an overview of outpatient registration services at Santa Elisabeth Hospital, Medan. This research uses a descriptive design with a quantitative approach. The sample in this study consisted of 30 patients. In this research, researchers collected data using a questionnaire. This research was conducted in June 2024. The data was analyzed univariably. The research results showed that there were 15 patients who received good and good service (50%), 10 patients received adequate service (33.33%) and 5 patients received poor service (16.66%). In this case, Santa Elisabeth Hospital Medan must continue to maintain good and friendly services and improve poor services.

Kebijakan Pemerintah Daerah Bali dalam Mewujudkan Penyelenggaraan Pelayanan Kesehatan Tradisional Integrasi

Progress and changing ages have an impact on changes in various areas of life, one of which is health. A variety of cutting-edge discoveries related to medical methods and medicines led to advances in both conventional and traditional health care. This development has led to various policies made by countries including Indonesia. Indonesia sheds health-related policy as a constitutional right of the people as set forth in the rules of enforcement. The guarantee of good health care gives the public the right to use the kind of medical or traditional health care. There are three types of traditional health care within the rules of enforcement: empirical, complementary, and integrated. This paper highlights the integration of traditional health services which, based on the authority of the Indonesian Government Regulations, mandate local governments to make regional policies that are in line with national policies. This writing uses normative methods with a legislative and conceptual approach. The results showed that the policy of the regional government of Bali in the maintenance of traditional health services integration implemented by issuing the regulation of the governor of Bali No. 55 Year 2019 on the traditional health service of Bali which provides guarantees on the implementation of health services traditional integration of bali as a collaboration carried out between the traditional complementary health services with conventional health services in health services facilities such as Puskesmas and hospitals. Progress and changes of the era have an impact on related types of traditional health services the integration given in its organization is established on the basis of the Decision of the Governor of Bali of the results of the analysis of the study team which is further established by the respective heads of the health service facilities.

Assessing ventilation through ambient carbon dioxide concentrations across multiple healthcare levels in Ghana.

Infection prevention and control (IPC) measures safeguard primary healthcare systems, especially as the infectious disease landscape evolves due to climate and environmental change, increased global mobility, and vaccine hesitancy and inequity, which can introduce unexpected pathogens. This study explores the importance of an "always-on," low-cost IPC approach, focusing on the role of natural ventilation in health facilities, particularly in low-resource settings. Ambient carbon dioxide (CO2) levels are increasingly used as a measure of ventilation effectiveness allowing for spot checks and targeted ventilation improvements. Data were collected through purposive sampling in Northern Ghana over a three-month period. Levels of CO2 ppm (parts per million) were measured by a handheld device in various healthcare settings, including Community-Based Health Planning and Services (CHPS) facilities, municipal and teaching hospitals, and community settings to assess ventilation effectiveness. Analyses compared CO2 readings in community and hospital settings as well as in those settings with and without natural ventilation. A total of 40 facilities were evaluated in this study; 90% were healthcare facilities and 75% had natural ventilation (with an open window, door or wall). Facilities that relied on natural ventilation were mostly community health centers (60% vs 0%) and more commonly had patients present (83% vs 40%) compared with facilities without natural ventilation. Facilities with natural ventilation had significantly lower CO2 concentrations (CO2 ppm: 663 vs 1378, p = 0.0043) and were more likely to meet international thresholds of CO2 < 800 ppm (87% vs 10%, p = <0.0001) and CO2 < 1000 ppm (97% vs 20%, p = <0.0001). The adjusted odds ratio of low CO2 in the natural facilities compared with non-natural were: odds ratios, OR (95% CI): 21.7 (1.89, 247) for CO2 < 800 ppm, and 16.8 (1.55, 183) for CO2 < 1000 ppm. Natural ventilation in these facilities was consistently significantly associated with higher likelihood of low CO2 concentrations. Improved ventilation represents one cost-effective layer of IPC. This study highlights the continuing role natural ventilation can play in health facility design in community health care clinics. Most health facilities met standard CO2 thresholds, particularly in community health facilities. Further research is needed to optimize the use of natural ventilation. The use of a handheld devices to track a simple metric, CO2 levels, could improve appreciation of ventilation among healthcare workers and public health professionals and allow for them to target improvements. This study highlights potential lessons in the built environment of community primary health facilities as a blueprint for low-cost, integrated multi-layer IPC measures to mitigate respiratory illness and anticipate future outbreaks.

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&lt;0.005), self-efficacy (P0.001&lt;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.

Management Of Hazardous And Toxic Waste at PKU Muhammadiyah Hospital Surabaya in 2024

Hospitals, as healthcare service facilities, generate hazardous and toxic waste. Inadequate management can cause health problems both within the hospital environment and in the surrounding community. This study aims to examine the management of hazardous and toxic waste generated by PKU Muhammadiyah Hospital Surabaya.This research uses a descriptive method by collecting primary and secondary data. The subjects in this study are those responsible for the management of hazardous and toxic waste. The data obtained are then analyzed descriptively using the CIPP evaluation method.The context evaluation of hazardous and toxic waste management based on interviews and observations falls into the good category, while the input, process, and product evaluations based on interviews also fall into the good category. However, based on observations, they fall into the sufficient category. This is because several CIPP evaluation variables have not fully met the assessment criteria. It is hoped that the results of this evaluation can be used as feedback to improve the quality of hazardous and toxic waste management at PKU Muhammadiyah Hospital Surabaya.Based on the research results, it can be concluded that the management of hazardous and toxic waste at PKU Muhammadiyah Hospital Surabaya generally complies with Ministry of Health Regulation Number. 2 of 2023. However, its implementation is not yet optimal, as it is adjusted to the hospital's conditions and capabilities. It is recommended that the hospital improve and upgrade the facilities and infrastructure for hazardous and toxic waste management.

The Relationship between the Level of Satisfaction of Blood Delivery Workers with Five Dimensions of Service Quality at UDD PMI Bekasi Regency in 2023

(1) Hospital Blood Bank (BDRS) is one of the health service facilities to meet the needs of blood transfusions of patients but does not rule out the possibility that blood stocks in BDRS are not available so they require assistance from the Indonesian Red Cross Blood Donor Unit (UDD PMI) in meeting the blood needs of patients. UDD PMI Bekasi Regency is carried out almost every time, regardless of the time and weather at that time. Blood collection is usually done by special officers from the hospital. This officer is what connects the chain of blood requests BDRS to UDD PMI Bekasi Regency, where later the officer will carry out blood retention and memory. (2) This research aims to determine the level of ability to use five dimensions quality services to have reliability, response, empathy, and blood transmission in UDD PMI District Bekasii. (3) Methodology This study by distributing questionnaires to 52 blood delivery officer respondents, data processing using data analysis of satisfaction index and ordinal logistic regression, namely simultaneous tests, partial tests, and model conformity tests (Hosmer-Lemeshow Goodness-of-fit Test). (4) The results of this study show that the level of satisfaction of blood delivery officers is based on five dimensions of satisfaction with UDD PMI district services. Bekasi has very satisfactory criteria.

Use of Maternal and Reproductive Health Services During and After Donor Funding in Nzega District, Tanzania

One of the United Nations’ Sustainable Development Goals (SDG) is to ensure healthy lives and promote well-being for all at all ages. Therefore, maintenance of the application of maternal and reproductive health practices to Women of Reproductive Age (WRA) is crucial throughout women’s lifetime. To find out whether this was happening, the study on which this paper is based examined the socio-demographic characteristics of women who had received maternal and reproductive health services in public health facilities and the extent of application of the maternal and reproductive health practices. A clinic-based descriptive cross-sectional study was conducted on women attending reproductive and child health clinics. Data were collected in 2023 from 121 respondents, mainly using a questionnaire that included a 54-point index summated scale to determine the extent of application of various maternal and reproductive health practices during and after donor funding. The points scored on the scale were expressed as per cents and compared using a paired samples t-test. The results showed an increase in the application of maternal and reproductive health practices after donor funding (49.1% during donor funding and 52.7% after donor funding), but the extents did not differ significantly (p = 0.308; effect size, r = 0.093). Among other things, the results were influenced by the women’s socio-demographic characteristics. The increase shows that the application of the practices is likely to increase. Based on the findings and conclusion, it is recommended that the Government of Tanzania and other relevant stakeholders at all levels should take necessary measures to intervene with respect to various socio-demographic characteristics including age, gender, and marital roles, so that they cannot compromise the application of maternal and reproductive health practices in the research area

Water, sanitation and hygiene (WASH) index for primary healthcare facilities: Towards achieving WASH security

This study focused on designing a WASH Index for assessing the status of WASH in Primary Healthcare Facilities (PHCs) especially for low- and middle-income countries. To assess the effectiveness of the WASH Index in evaluating the WASH in PHCs, PHCs were selected from 70 Local Government Areas (LGA) across 3 Southwestern States in Nigeria. The WASH index comprises of the five Joint Monitoring Programme service ladders as outlined in the World Health Organization Global Baseline Report for monitoring basic WASH services in health care facilities: water, sanitation, hygiene, waste management and environmental cleaning. The 5 service elements (termed as components) assessed were based on 10 indicators and 30 sub-indicators. The results of the WASH Index of the PHCs were compared statistically on LGA and State basis with emphasis on the status of WASH facilities. The study concludes that the result would further provide baseline information on the status of WASH in PHCs in the selected States in the quest to achieve the Sustainable Development Goals (SDGs). This study recommends that the WASH Index could be adopted an assessment tool for evaluating WASH in PHCs in other to ensure communication of results to policy makers and other relevant stakeholders, for effective monitoring healthcare facilities.

The Influence of Leadership and Organizational Culture on the Performance of Health Personnel Mediated by Work Motivation (Study of Kendari City Hospital Health Workers)

The aim of this research is to determine the influence of leadership and organizational culture on health performance performance mediated by work motivation. This research was carried out on health workers at the Kendari City Regional Hospital, with the consideration that the Kendari City Regional Hospital is one of the advanced level health service facilities belonging to the Kendari City Government which has the task of providing health services to the community. The population of this study is health workers who have the status of State Civil Apparatus, have worked for more than 2 (two) years and serve in the Kendari City Regional Hospital, totaling 267 people. To determine the sample size using the Slovin formula, at a precision level of 5%, from a total population of 267 health workers, a sample size (n) of 160 respondents was obtained. The type of inferential statistics used in this research is the t-test which is used to determine whether groups of scores have significant differences in the level of choice probability. To determine the value of the research t-test statistic, this research data was analyzed using SmartPLS software version 3.0. The results of this study found that Leadership had a positive and insignificant effect on the performance of health workers, Organizational Culture had a positive and significant effect on the Performance of health workers, Work Motivation had a positive and significant effect on the Performance of health workers, Leadership had a positive and significant effect on Work Motivation, Organizational Culture had an effect positive and significant towards Work Motivation, Work Motivation plays a role in mediating the influence of Leadership on the Performance of health workers, and Work Motivation plays a role in mediating the influence of Organizational Culture on the Performance of health workers.

Penyuluhan Perawatan Metode Kangguru terhadap Peningkatan Suhu Badan Rendah Bayi Baru Lahir di RSUD Sawerigading Kota Palopo Tahun 2024

Sawerigading Hospital is located in the middle of Palopo City where the location is very strategic and easy to reach by the community, so it is not surprising that Sawerigading Hospital is in great demand by the people of Palopo City to get health service facilities. The method used in this community service activity is a group discussion with an interactive question and answer session between helpers and mothers for 40 minutes. The mothers are all postpartum mothers at Sawerigading Hospital, Palopo City, with a total of 30 mothers. Before the educational activity, a pre-test was carried out and after the activity a post-test was carried out using a questionnaire containing 10 questions about the importance of the kangaroo method. This activity was carried out at Sawerigading Hospital, Palopo City. Kangaroo Method Treatment (FMD) is skin contact between mother and baby early, continuously and combined with exclusive breastfeeding. The purpose of this community service is to increase the knowledge of mothers and mothers of.

Prevalence and factors associated with depression and anxiety among patients recovered from COVID-19: a cross-sectional study in a tertiary care hospital in Nepal

IntroductionCOVID-19 has immensely affected the mental health of all people with prominent effects among the COVID-19 survivors who underwent hospitalisation. The evidence of the long-term mental health implications among the...

Proses Pengelolaan Limbah Medis Padat di Rumah Sakit Umum Mamami Kupang

Mamami Kupang General Hospital as a health service facility produces medical and non-medical waste. The results of surveys carried out by infectious solid medical waste at Mamami General Hospital are usually collected from waste producing places/rooms, including the Emergency Unit (ER), laboratory, nurse station, operating room, pharmacy installation, VK room, outpatient room/polyclinic. . For the process of burning/destroying medical waste, Mamami General Hospital collaborates with PT. Wastec Internasional (destroyer) and PT. Sagraha Satya Sawahita (Carrier). The average amount of solid infectious waste produced every day is around 7 kg. This research aims to determine the process of managing solid medical waste at the Mamami Kupang General Hospital. This type of research is quantitative research, with a descriptive research design. The population in this study was the solid medical waste producing unit at the Mamami Kupang General Hospital and health workers who handled the problem under study. The technique used in this research is nonprobability sampling, namely total sampling. The research results show that the medical waste management process at Mamami Kupang General Hospital, especially in temporary shelters, still requires attention. Transportation of solid medical waste from waste generating units is not encouraged using special trolleys and the accumulation of medical waste in temporary storage areas due to the unavailability of containers.

Upaya Pengelolaan Konka Hipertrofi dengan Pendekatan Pelayanan Kedokteran Keluarga

The patient came to the Tanah Pasir Health Center public poly with nasal complaints blockage that is aggravated in 1 month. This complaint of nasal congestion is felt until the patient has difficulty breathing. Nasal congestion does not improve after changes position. Headaches are felt occasionally. Fever (-), bad nose (-), and runny nose (-). The calculation of the body mass index was obtained 22.89 kg/m2 (normal). Primary data was obtained through anamnesis and physical examination at the Tanah Pasir Health Center and home visits. The assessment is carried out based on the initial holistic diagnosis, process, and end of the visit. The interventions carried out include education on the importance of avoiding triggering factors from complaints, taking medication and controlling regularly. Patients are also educated about diet and education about receiving treatment at health service facilities such as health centers and hospitals.