Integrated Health Center Research Articles

PHYSICOCHEMICAL AND MICROBIOLOGICAL EVALUATION OF HONEYS CONSUMED BY THE ELDERLY

Objective: to analyze physicochemical, microbiological and dirt parameters in marketed honeys, consumed by the elderly cared for at Integrated Health Center in Teresina, Piauí, Brazil. Method: the following analyses were performed: color, water activity, humidity, ash, pH, acidity, reducing sugars, total sugars, apparent sucrose and insoluble solids. Contamination indicator bacteria, mesophilic microorganisms, filamentous fungi and yeasts, as well as dirt and foreign matter, performed in the period from April to June 2016. Results: analyses of ash, pH, acidity and insoluble solids were outside current standards. Microbiological analyses did not present significant contamination. Also, analyses of dirt showed insect fragments, foreign matter in almost all the samples. Conclusion: parameters of ash, pH, acidity and insoluble solids, as well as dirt and foreign matter, indicated that the samples were not in accordance with current legislation.

Informing the Model of Care for an Academic Integrative Health Care Center: A Qualitative Study of Primary Care Stakeholder Views.

Objectives: To engage with local primary care stakeholders to inform the model of care for a proposed academic integrative health care center incorporating evidence-informed traditional, complementary, and integrative medicine (TCIM) in Sydney, Australia. Design: In-depth semistructured interviews, informed by community-based participatory research principles, were conducted to explore primary care stakeholder preferences and service requirements regarding the proposed Western Sydney Integrative Health (WSIH) center in their local district. Setting: Telephone and face-to-face interviews at primary care clinics in Sydney. Subjects: Thirteen participants took part in the study: eight general practitioners (GPs) and five primary care practice managers (PMs). Methods: GPs were recruited through local GP newsletters, closed GP Facebook groups, and snowballing. PMs were recruited through a national PM newsletter. The semistructured interviews were audiorecorded and transcribed verbatim before conducting a thematic analysis. Results: Three main themes emerged: (1) the rationale for "why" the WSIH center should be established, (2) "what" was most important to provide, and (3) "how" the center could achieve these goals. Participants were willing to refer to the service, acknowledging the demand for TCIM, current gaps in chronic disease care, and negligible Government funding for TCIM. They endorsed a model of care that minimizes out-of-pocket costs for the underserved, incorporates medical oversight, integrates evidence-informed TCIM with conventional health care, builds trust through interprofessional communication and education, and provides sound clinical governance with a strong focus on credentialing and risk management. It was proposed that safety and quality standards are best met by a GP-led approach and evidence-based practice. Conclusions: Our findings demonstrate that participants acknowledged the need for a model of care that fits into the local landscape through integrating conventional health care with TCIM in a team-based environment, with medical/GP oversight to ensure sound clinical governance. Findings will be used with input from other stakeholder groups to refine the WSIH model of care.

Evaluating implementation and impact of a provincial quality improvement collaborative for the management of chronic diseases in primary care: the COMPAS+ study protocol

BackgroundChronic conditions such as diabetes and chronic obstructive pulmonary disease (COPD) are common and burdensome diseases primarily managed in primary care. Yet, evidence points to suboptimal quality of care for these conditions in primary care settings. Quality improvement collaboratives (QICs) are organized, multifaceted interventions that can be effective in improving chronic disease care processes and outcomes. In Quebec, Canada, the Institut national d’excellence en santé et en services sociaux (INESSS) has developed a large-scale QIC province-wide program called COMPAS+ that aims to improve the prevention and management of chronic diseases in primary care. This paper describes the protocol for our study, which aims to evaluate implementation and impact of COMPAS+ QICs on the prevention and management of targeted chronic diseases like diabetes and COPD.MethodsThis is a mixed-methods, integrated knowledge translation study. The quantitative component involves a controlled interrupted time series involving nine large integrated health centres in the province. Study sites will receive one of two interventions: the multifaceted COMPAS+ intervention (experimental condition) or a feedback only intervention (control condition). For the qualitative component, a multiple case study approach will be used to achieve an in-depth understanding of individual, team, organizational and contextual factors influencing implementation and effectiveness of the COMPAS+ QICs.DiscussionCOMPAS+ is a QI program that is unique in Canada due to its integration within the governance of the Quebec healthcare system and its capacity to reach many primary care providers and people living with chronic diseases across the province. We anticipate that this study will address several important gaps in knowledge related to large-scale QIC projects and generate strong and useful evidence (e.g., on leadership, organizational capacity, patient involvement, and implementation) having the potential to influence the design and optimisation of future QICs in Canada and internationally.

The Effect of Family Development Session through Family Hope Program on Visit to Integrated Healthcare Center and Child Nutritional Status: A Multilevel Evidence

Background: The Family Development Session through the Family Hope Program (FHP) uses the nutritional status of toddlers as an indicator of the quality of life that reflects the welfare of the community. This study aimed to analyze the effect of the Family Development Session (FDS) through the Family Hope Program on the child nutritional status. Subjects and Method: This was an analytic observational study with a retrospective cohort design. This study was conducted in Ponorogo, East Java, from December to February 2020. A sample of 200 children was selected by simple random sampling. The dependent variable was child nutritional status. The independent variables were FDS (FHP), maternal education, family income, social support, maternal know­ledge, self-efficacy, complementary food, inte­grated community health center. The data were collected by questionnaire and analyzed by a multiple multilevel logistic regression. Results: Child nutritional status was positively associated with FDS (b= 1.24; 95% CI= 0.26 to 2.22; p= 0.014), high maternal education (b= 1.18; 95% CI= 0.16 to 2.19; p= 0.023), family income (b= 1.11; 95% CI= 0.11 to 2.11; p= 0.030), social support (b= 1.57; 95% CI= 0.46 to 2.67; p= 0.006), maternal knowledge (b= 1.24; 95% CI= 0.26 to 2.23; p=0.013), self effi­cacy (b= 1.38; 95% CI= 0.32 to 2.44; p= 0.011), complementary feeding (b= 1.35; 95% CI= 0.33 to 2.37; p= 0.010), and regular visit to inte­grated community health center (b=1.42; 95% CI= 0.28 to 2.56; p=0.015). Integrated health center had strong contextual effects on the child nutritional status with intra-class corre­lation (ICC) = 33.97%. Conclusion: Child nutritional status is posi­tively associated with FDS, high maternal education, family income, social support, maternal knowledge, self effi­cacy, comple­men­tary feeding, and regular visit to inte­grated community health center. Integrated health center has strong contextual effects on the child nutritional status. Keyword s : child nutritional status, integrated healthcare center Correspondence: Nisaus Zakiyah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email:nizakiyaah@gmail.com. Mobile: +628­5235948995. Journal of Health Policy and Management (2020), 05(03): 224-234 https://doi.org/10.26911/thejhpm.2020.05.03.08

Stigma and Family Knowledge of Tuberculosis Patients at Naibonat and Oesao Health Center

Stigma in tuberculosis can cause delays in treatment and hurt the continuity of treatment so that treatment is not completed. Knowledge about tuberculosis that is known by the family will increase efforts to prevent or spread tuberculosis to other families in the house and the environment around the house. The purpose of this study was to determine the stigma and knowledge of the family of tuberculosis patients. This study is a descriptive study with an approach cross-sectional. The sample in this study amounted to 61 people representing patients who were being treated at the Oesao Health Center and the Naibonat Health Center. The results of the study show that the stigma that occurs in the families of tuberculosis patients is a lack of knowledge about tuberculosis, the causes of tuberculosis, how it can be infected, and how to treat it, where people still think that tuberculosis is a man-made disease so that if there is one family who is sick they will be sick first. In the past, they looked for people to pray instead of checking themselves into health facilities such as health centers. Family knowledge about tuberculosis is good, where family knowledge is obtained from counseling health workers at the health center and at the Integrated Health Center so that families can prevent the transmission of tuberculosis in the family and the environment around the tuberculosis patient's home. It is recommended to improve counseling, personal hygiene, and Clean and Healthy Life Behavior to prevent the spread of tuberculosis to families and other people around the home environment.

Impact on the Quality of Life of Older Adults Who Use Inadequate Dental Prostheses: A Cross-Sectional Study

Objective: To investigate the impact of inadequate prostheses on older adult’s quality of life at the Integrated Health Center for Older Adults in the northeastern city of Brazil. Material and Methods: A cross-sectional study involving 147 older adults aged 60-90 years old in Joao Pessoa, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and gender) and clinical dental measures (use of inadequate upper and/or lower dental prosthesis) and Oral Health Impact Profile (OHIP-14 Questionnaire). The Pearson Chi-square and Fisher’s exact tests were used to evaluate the association between the OHIP-14 dimensions and the use of unsatisfactory prostheses (p<0.05) . Results: The sample consisted of 90.5% of women being a mean age of 69.86 (± 6.60) years. Individuals with inadequate prostheses had a higher impact on quality of life, with a predominant prevalence ratio for developing physical pain (PRR = 3.52; CI = 4.69-2.65), psychological discomfort (PRR = 5.0; CI = 5.85-4.26) and psychological inability (PRR = 1.71; CI = 2.56-1.14) . Conclusion: The use of inadequate prostheses had a negative impact on the quality of life of the older adult population. Therefore, services, which provide health care for older adults, should overcome this reality by providing broad access to oral rehabilitation that is appropriate to the needs of each individual.

The Role of Community Nurses in the Prevention of Complications on Hypertension Patients in Integrated Health Centers

Complications of hypertensive patients are expected to continue to increase. Integrated Health Center of Sikumana, Kupang City is one of the major health centers that have a high case of hypertension complications in Kupang City, NTT Province. The objective of this study is to determine the role of community nurses in the prevention of complications in hypertensive patients at the Integrated Health Center of Sikumana, Kupang City. The research method is descriptive with a survey design. The population in research is nurses in the Integrated Health Center of Sikumana, Kupang City comprising 21 people. The sample was taken from the total population with inclusion criteria of PNS (civil servant) and PTT (non-permanent employee) nurses from the government, minimum education of Nursing D-III, and working period ≥ 2 years. The results showed 52.4% of nurses assessed risk factors for complications in hypertensive patients, 81% formulated nursing diagnoses, 76.2% developed intervention plans, 76.2% implemented, 54.5% conducted community empowerment, 85.7% conducted health education, 95.5% conducted referral in prevention complications in hypertensive patients. It can be concluded that the role of community nurses in the prevention of complications in hypertensive patients in Integrated Health Center of Sikumana, Kupang City has largely been conducted well, and it is recommended that nurses at the Integrated Health Center have participated actively in following various training and work on the community nursing process to comply with the latest instructions and regulations.

Evaluation of Urine Reagent Strip as a Tool for Routine Diagnosis of Maternal Urogenital Schistosomiasis at Antenatal Clinic Visit in Munyenge, South West Region, Cameroon.

Urine reagent strip used in detecting microhaematuria has been recommended in pregnancy for diagnosis of urogenital schistosomiasis (UGS) during routine antenatal care (ANC). This study evaluated its sensitivity, specificity, and predictive values in the diagnosis of maternal UGS using filtration method as a reference test. We also assessed the variation in its performance in the diagnosis of UGS using multiple-sample collection. A total of 93 pregnant women reporting for first ANC clinic visit at any of the three functional health care centres (Munyenge Integrated Health Centre, Banga Annex Health Centre, and Trans African Health Centre) were enrolled and followed up for three consecutive monthly visits. Urine samples were observed microscopically for S. haematobium egg using urine filtration and screened for microhaematuria and proteinuria using urine reagent strips. Twenty-two (23.7%) out of the 93 women were diagnosed for UGS, all of whom showed S. haematobium egg excretion during all three visits. There was a significant difference (p < 0.001) between the prevalence of S. haematobium infection and the prevalence of microhaematuria. The intensity of infection was significantly higher in microhaematuria-positive women compared with microhaematuria-negative cases. Sensitivity of reagent strip ranged from 54.5 to 59.1%, while specificity was above 98.0% (range: 98.6–100%). The measure of agreement between urine filtration and reagent strip method was substantial (0.61–0.8) irrespective of different sampling periods. Urine reagent strip is a moderately sensitive method in the detection of UGS and will most likely identify women with high egg load burden. Proper diagnosis of schistosomiasis during pregnancy is recommended.

The mixed effects of a package of multilevel interventions on the health and care of pregnant women in Zinder, Niger

BackgroundAnaemia is prevalent among pregnant women in rural Niger and antenatal care (ANC) attendance is suboptimal. We designed a programmatic intervention including community-based behaviour change communication, provision of essential drugs...

Hubungan Pemberian Asupan Makanan Pendamping Asi (MPASI) Dengan Pertumbuhan Bayi Atau Anak Usia 6-24 Bulan

Background: Relationship Of Complementary Food Intake Of Breast Milk (MPASI) With Baby / Children Growth Ages 6-24 Months The first two years of life is a period that lasts very short and cannot be repeated again, so it is referred to as a "golden period" or a window of opportunity. Inappropriate nutritional intake will also cause children to experience malnutrition, which ultimately increases the incidence of morbidity and mortality. According to a survey of micronutrients in 12 provinces in Indonesia shows that the age group 6-11 months consume nutrients lower than other age group. Purpose of this research is the relationship of Complementary Food Intake of Breast Milk (MPASI) with infants / children growth ages 6-24 months. This study was a descriptive analytic study with a cross-sectional approach. The population is mothers who have babies / children aged 6-24 months. Samples were taken by consecutive sampling method with 18 babies / children. Data analysis using Chi Square with a significance limit of α = 0.05. Respondents with Complementary Food Intake of Breast Milk giving, most of the growth was normal, namely 10 respondents (55.5%), respondents with sufficient Complementary Food Intake of Breast Milk giving, normal growth was 2 respondents (11.1%) and respondents with less Complementary Food Intake of Breast Milk giving were high growth (11.1 %). There was no significant relationship between the provision of complementary feeding and the growth of infants / children 6-24 months in the Gamping Wirastri Integrated Health Center in Sleman.

Prevalence and determinants of gestational weight gain among pregnant women in Niger.

Low gestational weight gain (GWG) and low mid‐upper arm circumference (MUAC) are associated with adverse pregnancy outcomes. We aimed to assess the prevalence and determinants of low GWG and low MUAC among pregnant women in rural Zinder, Niger. A community‐based survey was conducted among 1,384 pregnant women in the catchment areas of 18 integrated health centers in the region of Zinder, Niger. Weight and MUAC were measured during an in‐home visit and again 1 month later, when haemoglobin concentration and micronutrient status were also assessed. The prevalence of low GWG was defined based on the 2009 United States Institute of Medicine (U.S. IOM) guidelines (<0.35 kg/week) and less than the third centile of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH‐21st) standards. Factors associated with GWG and MUAC were identified using logistic regression models adjusting for season, village, and gestational age. The median (interquartile range) age was 25.0 (20.7, 30.0) years, and 16.4% were ≤19 years. The prevalence of low GWG were 62.9% and 27.5% according to 2009 IOM and less than the third INTERGROWTH‐21st centile, respectively; 24.9% had low MUAC. Higher α‐1‐acid glycoprotein (OR = 1.7, 95% CI [1.1, 2.8]) and C‐reactive protein (OR = 1.2, 95% CI [1.02, 1.50]) increased the odds of low GWG. Adolescents (OR = 2.7, 95% CI [1.8, 4.0]), housewives (OR = 1.97, 95% CI [1.36, 2.86]), and those who reported recent food assistance (OR = 1.80, 95% CI [1.04, 3.11]) had higher odds of low MUAC. Prevalence of low GWG and low MUAC was high among pregnant women. Determinants of GWG and MUAC included socio‐economic, demographic, and biological factors, although only markers of inflammation were consistent predictors across different definitions of low GWG.

Cornwall Foundation Trust’s capacity to implement the government’s children and young people’s mental health strategy

PurposeThe purpose of this paper evaluates the capacity of the Cornwall Foundation Trust (CFT) of the National Health Service (NHS) to implement the UK Government’s children and young people’s mental health strategy through its school-based integrated health centre (SBIHC) delivery model.Design/methodology/approachThis evaluation uses six case studies of SBIHCs to indicate the general effectiveness of this delivery model and its capacity to implement the three core proposals of the Government’s strategy. The core proposals are: to encourage all schools and colleges to identify and train a designated senior lead (DSL) for mental health; to fund new mental health support teams (MHSTs); and to develop strategies to meet the proposed four-week waiting time for access to specialist NHS mental health services.FindingsThis evaluation found that the Duchy Health Charity and CFT piloted a new delivery model in three SBIHCs from 2009 that successfully integrated health and educational services to children and adolescents, including general health and well-being and sexual and mental health and, more recently, integrated welfare services.Research limitations/implicationsThe main research implication is that longitudinal case studies of organisational innovations can reveal the subtleties of educational management in context and potentially inform advances elsewhere consistent with national policy developments.Practical implicationsThe main practical implication is that the SBIHCs at Penair Community School, Budehaven Community School, Hayle Community School, Looe Community Academy, Treviglas Community Academy and Wadebridge Community School should each be recognised as a “trailblazer site” in the implementation of the Government’s children and young people’s mental health strategy.Social implicationsMandatory secondary education is the last opportunity that the UK society has to embed knowledge, skills and attitudes needed for the life-long self-management of health. The CFT’s SBIHC model trialled since 2009 has successfully integrated health and educational services to children and adolescents, including general health and well-being and sexual and mental health and, more recently, integrated welfare services.Originality/valueThis evaluation research is unique. It reports that the CFT’s SBIHC model is the first and only organisational innovation at a system level in the UK that has successfully integrated health and education services to children and adolescents.

EVALUASI IMPLEMENTASI PROGRAM SISTEM PENCATATAN DAN PELAPORAN TERPADU PUSKESMAS

&lt;p&gt;&lt;em&gt;P&lt;/em&gt;&lt;em&gt;rogram implementation in Koto Type the health center includes&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;several phases of activity, starting from the data collection phase, perekapan, inputting and sending to the Department of Health Kota.dari terms of delivery of the reports is still timely and charging an incomplete report. The purpose of this study to evaluate the implementation of the program recording and reporting system of integrated health centers in health centers katik koto long field,research design is qualitative research with phenomenological. With the number of informen of 7 people, results showed on the input source human resources are lacking, the process of the implementation of the SP2TP not running optimally because still many shortcomings in the planning, recording and reporting so that the effect on the incompleteness and delays in the delivery of the Monthly Report.The conclusion of the research is the implementation of the PHC Koto SP2TP Katik not been implemented optimally. The need for increased availability, power that the implementation processes SP2TP no constraints as well as reports submitted complete and timely.&lt;/em&gt;&lt;/p&gt;

Grand multiparity in rural Cameroon: prevalence and adverse maternal and fetal delivery outcomes

BackgroundGrand multiparity is a major public health concern especially among developing countries and has been associated with higher risk of adverse maternal and fetal outcomes compared with women of lesser parity. There is a dearth of evidence on this subject in Cameroon, especially in the rural areas. We therefore carried out this study to document the prevalence and maternal and fetal delivery outcomes of grand multiparity in a rural Cameroonian setting.MethodsWe conducted a retrospective chart review of delivery records from two health facilities (the Oku District Hospital and Kevu Integrated Health Centre) in the Oku Health District over a period of eight years. Data was entered into and analyzed using Epi-Info version 7.0.8.3. The Chi-squared or Fisher’s exact test was used to compare categorical variables. The threshold of statistical significance was set at 5%.ResultsA total of 1755 delivery records met our inclusion criteria. The overall prevalence of grand multiparity was 27.0%. We found no significant difference in the rate of selected maternal and fetal delivery outcomes between grand multiparous women and those with lesser parity (p-value> 0.05). However, grand multiparous women were less likely to develop second-fourth degree perineal tears compared to their counterparts with lesser parity (odds ratio = 0.3, 95% confidence interval = 0.2–0.7, p = 0.001).ConclusionOur study depicts a high prevalence of grand multiparous delivery in this rural community. With the exception of severe perineal tear, grand multipara and their babies are as likely to develop adverse delivery outcomes as their counterparts with lesser parity. There is also the need to enhance existing government policies on reproductive health in rural areas.

Real-World Evidence from the Integrative Medicine Primary Care Trial (IMPACT): Assessing Patient-Reported Outcomes at Baseline and 12-Month Follow-Up.

Purpose The University of Arizona Integrative Health Center (UAIHC) was an innovative membership-supported integrative medicine (IM) adult primary care clinic in Phoenix, Arizona. UAIHC delivered healthcare using an integrative medicine model that combined conventional and complementary medical treatments, including nutrition, mind-body medicine, acupuncture, manual medicine, health coaching, educational classes, and groups. Results from pre-post evaluation of patient-reported outcomes on several standardized measures are presented here. Methods UAIHC patients completed surveys at baseline and after 12 months of continuous integrative primary care. Patients reported on perceived changes in health outcomes as measured by Short-Form Health Survey (SF-12 general, mental, and physical health), Perceived Stress Scale (PSS4), Work Productivity and Activity Impairment Questionnaire (WPAI), World Health Organization Well-Being Index (WHO-5), Pain Visual Analog Scale (VAS), Fatigue Severity Scale (VAS; FSS), Generalized Anxiety Disorder Scale (GAD2), Patient Health Questionnaire for depression (PHQ2), Pittsburgh Sleep Quality Index (PSQI) global rating of sleep quality, and the Behavioral Risk Factor Surveillance System (BRFSS; nutrition, exercise, and physical activity). Overall differences between time points were assessed for statistical significance. Patient demographics are also described. Results 177 patients completed baseline and follow-up outcome measures. Patients were predominantly white, female, college-educated, and employed. Baseline to one-year follow-up results indicate statistically significant improvements (p <.05) on all but perceived stress (PSS-4) and work absenteeism (WPAI). Clinical impact and/or practical effects are reported as percent change or standardized effect sizes whenever possible. Other demographic and descriptive information is summarized. Conclusions Following one year of IM primary care at UAIHC, patient-reported outcomes indicated positive impacts in several areas of patients' lives: mental, physical, and overall health; work productivity; sleep quality; pain; fatigue; overall well-being; and physical activity.

Promoting Children Growth and Development: A community-based cluster randomized controlled trial in rural areas of Indonesia.

This study examined the influence of the Promote Children's Growth and Development (PCGD) intervention on children's growth and development in rural areas in Indonesia. A community-based nonblinded cluster randomized controlled trial was conducted. Twelve clusters of villages were matched based on population and randomly assigned to intervention group (six clusters and 72 caregivers dyads) or control group (six clusters and 72 caregivers dyads) with inclusion criteria age 0-72months and attending integrated health centers (Posyandu). The intervention was conducted for 14weeks with caregivers. The weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), weight-for-height Z-score (WHZ), and body mass index-for-age Z-score (BAZ) were calculated using World Health Organization Anthro-Plus version 1.0.3. A prescreening developmental questionnaire (PSDQ) measured the development of children before and after the intervention. The proportion of stunting of HAZ, wasting of WHZ, and deviation development of PSDQ were higher in the control group compared to the intervention group, respectively (22.2% vs. 37.5%), (9.7% vs. 4.2%), and (12.5% vs. 2.8%). Caregivers were more confident promoting children's growth and development after attending 12 sessions of the PCGD intervention. The 12 session PCGD intervention is effective for promoting the growth and development of children of 0-72months. The PCGD could be considered for implementation in community health centers.

Retention of health care workers at health facility, trends in the retention of knowledge and correlates at 3rd year following training of health care workers on the prevention of mother-to-child transmission (PMTCT) of HIV\u2013National Assessment

BackgroundKnowledgeable Health Care Workers (HCWs) are indispensable for the proper management of clients. We investigated retention of HCWs at health facility and retention of knowledge at 18, 24 and 36 months after training and correlates for retention of knowledge at 3rd year.MethodsA cross-sectional study was conducted among 1000 HCWs, 710 were trained and 290 untrained working at the PMTCT of HIV services in health facilities of the ten regions of Cameroon. A Multiple Choice Questionnaire (MCQ) on HIV management with focus on PMTCT of HIV was used to assess retention of HCWs at the health facility and retention of knowledge. Summary statistics described mean scores for retention of HCWs and retention of knowledge. One-way Analysis of Variance summarized the differences in retention of knowledge over time after training. Correlates for retention of knowledge were investigated by logistic regression analysis.ResultsThe retention of HCWs at health facilities in PMTCT of HIV services was 85%. Trained HCWs had higher mean scores for retention of knowledge than untrained HCWs, p < 0.001. Knowledge attrition was observed from 18, 24 to 36 months following training. Differences in the mean scores for retention of knowledge were observed between state-owned with private and confessionary health facilities but not among trained HCWs at 18, 24 or 36 months. Highest mean scores for retention of knowledge were observed in District Hospitals, Sub-Divisional Hospitals, and Integrated Health Centres. Correlates for retention of knowledge were: gender, type of health facility, location, longevity at PMTCT services, trained others and had means to apply what was trained to do.ConclusionRetention of trained HCWs at health facilities was high, mean scores for retention of knowledge was average and knowledge attrition was observed over time. This research is critical to understand where interventions may be most effective.

Interprofessional Collaboration Practices: Case Study of the Handling of Malnutrition in Three Public Health Centers in South Sulawesi

The results of this research revealed various definitions of malnutrition by the health officials, including the characteristics and causes of malnutrition. Various actual activities were performed as joint efforts in handling nutrition problems and a good understanding of interprofessional collaborations was indicated by the health officers. Many activities showed a form of interprofessional collaboration in the daily healthcare services. One of these activities was the integrated health center activity. However, at the time of implementation of the activities, there was not yet an interprofessional collaboration as a whole. Supporting documents showed that the implementation of interprofessional collaborations in the form of written rules was also not available. Conclusion: It can be concluded that the implementation of interprofessional collaborations in South Sulawesi has not been optimized

PENGETAHUAN DAN SIKAP IBU YANG MEMILIKI BALITA DALAM PEMBERIAN OBAT PENURUN PANAS DI WILAYAH KERJA PUSKESMAS BETUNGAN KOTA BENGKULU

Fever on children is one of those cases that cannot be ignored. Based on data from a health center from January to September 2016 there were 211 febrile children with fever. One of fever treatment is to give fever-reducing medicine, which has antipyretic effect. In this case, of course knowledge and attitudes of mothers about delivering fever medications to children is very important, because of the impact that can be caused if the fever is not handled will cause brain damage, hyperpyrexia which would cause shock, epilepsy, mental retardation or learning disabilities can even endanger the safety of life.This study was to determine the relationship and attitude of mothers who have children in delivering fever medication in Betungan health center in the city.This study was an analytical study using cross-sectional design. The study population were mothers who have children with a history of fever last 3 months in Betungan health center, with the sample size of 68 people, using accidental sampling technique. Data collection was done by direct interview using a questionnaire. Data were analyzed using univariate and bivariate analysis with chi-square test at α 5%.The results showed that almost half of respondents (36.8%) had less knowledge about medication for fever, almost half of respondents (48.5%) had unfavorable attitude in granting febrifuge, and almost half of respondents (26.5%) whose toddlers who were not given medicine for fever. There was a relationship between knowledge of mothers who have children in drug delivery for fever in Betungan health center in Bengkulu City (ρ = 0.001), and there was a correlation between the attitudes of mothers who have children in drug delivery for fever in Betungan health center in Bengkulu City 2016 (ρ = 0.009).It is expected that Betungan health center to be more intensive to provide counseling and health promotion and provision of febrile febrifuge, such as in The Integrated Health Center, at village programs, as well as providing leaflets / brochures on granting fever medications appropriately.

A Comparison Study of Alcohol Use by Community College Students Receiving Care at an Integrated Health Center

A Comparison Study of Alcohol Use by Community College Students Receiving Care at an Integrated Health Center