Mortality In Indonesia Research Articles

Family empowerment in support of pregnancy examination: Scoping review

The maternal mortality rate (MMR) in the world in 2020 was 223 per 100,000 live births. The Maternal Mortality Rate in Indonesia (MMR) was 189 (BPS, 2020). The adequacy of K1 in 2022 in South Sumatra was 94%, an increase from 2021 with a coverage of 92%. The coverage of K4 in South Sumatra in 2022 was 91%, an increase compared to the previous year of 90%. The purpose of this scoping review is to review family empowerment in the context of supporting pregnancy examinations. This Scoping Review method uses the PEOS framework and article identification using inclusion and exclusion criteria. The results of this study found 6 articles and 6 themes. The themes are family empowerment, support for pregnant women, and examination of pregnant women. Suggestions for further researchers are to also provide special services only for pregnant women, health services for facilities with homes that are far away.

Hubungan Risiko Kehamilan Berdasarkan Kartu Skor Poedji Rochjati (KSPR) dengan Persalinan Sectio Caesarea dan Morbiditas Perinatal di Wilayah Puskesmas Mojo Kabupaten Kediri

Maternal Mortality Rate in Indonesia is still high, namely 177 per 100.000 live births. KSPR is a simple tool for early detection of risk factors in pregnant women. Pregnant women with high risk are more likely to experience complication during pregnancy and childbirth so that the possibility of caesarean delivery and perinata morbidity is igher. Complication during pregnancy and childbirth are also a factor in the high MMR. This study aims to determine the relationship between the risk of pregnant women based on the KSPR scoring results with caesarean section deliveries and perinatal morbidity. The research method uses observational analytic with retrospective data collection. The sample in this study were pregnant women who underwent ANC at the Mojo Health Center, Kediri Regency, from Januari to December 2021 who were included in the inclusion criteria and were determined using simple random sampling technique. Data collection trough secondary data in the form of register books, maternal cohorts, medical records, and data collection sheet. Research data were analyzed using the chi-square test. The results showed that the majority of respondents (54%) had high-risk pregnancies (KRT). The results of the statistical test between the risk of pregnancy and sectio caesarea delivery obtained p value = 0,022 and the results of the statistical test between the risk of pregnancy and perinatal morbidity obtained p value = 0,946. These data indicate that there is a significant relationship between the risk of pregnancy and caesarean delivery and there is no significant relationship between risk of pregnancy and perinatal morbidity.

Navigating the aftermath: Risk factors of recurrence following coronary bypass surgery in Indonesia

Coronary heart disease (CHD) remains a leading cause of mortality in Indonesia, and coronary artery bypass graft (CABG) surgery is frequently employed to manage arterial blockages. Despite its efficacy, the recurrence of heart disease post-surgery is a significant concern, highlighting the need for a deeper understanding of its influencing factors. The aim of this study was to examine the factors associated with the incidence of heart disease recurrence after coronary bypass surgery. This study employed a prospective observational design, analyzing hospital claim data from Indonesia's Social Security Agency for Health, known as Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, from 2017 to 2022. The analysis included 5,947 patients who survived CABG surgery. Multivariable logistic regression was utilized to assess the relationship between patient demographics, comorbidities, socioeconomic status, and compliance with follow-up visits, as well as their impact on the recurrence of cardiovascular disease. The study found that 24.1% of patients experienced hospitalization recurrence. Patients with irregular follow-ups were less likely to experience recurrence (adjusted odds ratio (AOR): 0.63; 95%CI: 0.51–0.78). Other significant risk factors for recurrence included being self-employed (AOR: 2.09; 95%CI: 1.72–2.55), having comorbid conditions such as disorders of fluid, electrolyte, and acid-base balance (AOR: 3.55; 95%CI: 2.97–4.24), and experiencing cerebral infarction or stroke (AOR: 10.85; 95%CI: 8.24–14.29). In contrast, older age (AOR: 0.89; 95%CI: 0.88–0.91) and the presence of non-insulin-dependent diabetes mellitus (AOR: 0.35; 95%CI: 0.29–0.42) were associated with a lower risk of recurrence. Sex did not significantly influence the risk of recurrence (AOR: 1.18; 95%CI: 0.86–1.62). In conclusion, the study indicates a considerable rate of cardiovascular disease recurrence post-CABG in Indonesia, highlighting several key risk factors. Tailored postoperative management and strict adherence to follow-up protocols are essential for mitigating recurrence. These findings offer crucial insights for improving post-CABG health management strategies in Indonesia.

Support from midwives and spouse on antenatal care visit adherence in health centers among primigravida pregnant women

Background: The maternal mortality rate in Indonesia remains high. A strategy to reduce this number is through the implementation of antenatal care (ANC) programs, which are essential for pregnant women. The issue at hand is the low number of ANC visits at the Sragen Community Health Center, where out of 1,022 targets, 896 pregnant women did not meet the minimum service standard target in 2022. ANC visits are closely related to various factors, such as knowledge, attitude, access, and external support factors. This study focuses on external support factors that influence pregnant women to attend ANC visits, including support from husbands and midwives. Purpose: To determine the relationship between husband and midwife support and antenatal care visits among primigravida pregnant women. Method: This quantitative research with a cross-sectional design was conducted in October 2023 at the Sragen Community Health Center. The study population consisted of 100 primigravida women who had ANC visits from January to August 2023, with a sample size of 84 pregnant women selected using total sampling techniques based on the Lemeshow formula. The research instrument used was a questionnaire. Data were analyzed using bivariate Chi-Square tests processed with SPSS version 20. Results: There is a significant relationship between husband support and ANC visits among primigravida women, with a P-value of <0.001. Similarly, statistical tests showed a significant relationship between midwife support and ANC visits among primigravida women, with a p-value of <0.001. Conclusion: Both husband and midwife support are highly beneficial, with average support levels above 80%. The highest percentage of husband support was in the emotional aspect (83%), and the highest percentage of midwife support was in the instrumental aspect (83.3%). High levels of husband and midwife support can promote pregnant women to attend ANC visits regularly, while low support can result in reluctance to do so.

Hubungan Perdarahan dan Partus Lama pada Ibu Post Partum dengan Kejadian Infeksi pada Masa Nifas

Postpartum infection is an infection occurring after childbirth up to 42 days postpartum, characterized by fever, pelvic pain, foul-smelling lochia, and subinvolution of the uterus (delayed return of the uterus to its pre-pregnancy state). The leading causes of maternal mortality in Indonesia include hemorrhage, hypertensive disorders during pregnancy, infections, and metabolic disorders, with 25-50% of maternal deaths related to pregnancy, childbirth, and the postpartum period. This study aims to determine the relationship between hemorrhage and prolonged labor in postpartum mothers with the incidence of postpartum infections. The research used an analytical method with a retrospective approach. The population consisted of all postpartum women with infections, totaling 30 respondents in 2022. The sampling technique used total sampling with 30 respondents. Data analysis was performed using the chi-square test. The results showed a significant relationship between hemorrhage (p=0.03) and prolonged labor (p=0.04) with the incidence of postpartum infections at H. Abdul Manap Hospital, Jambi City, in 2023. The conclusion of this study is that there is a relationship between hemorrhage and prolonged labor with the incidence of postpartum infections at H. Abdul Manap Hospital, Jambi City.

Prediction model for composite adverse pregnancy outcomes: Indonesia demographic health survey analysis

Adverse Pregnancy Outcome (APO) is the leading cause of infant mortality, particularly in low and middle-income countries. Despite no significant change in neonatal mortality rates in Indonesia over the past fifteen years, identifying the risk factors for APO can help healthcare professionals provide personalized interventions and support. This study aims to determine the determinants of APO risk in Indonesia. The cross-sectional study utilized the 2017 Indonesian Health Demographic Survey (IDHS), which included 9,752 women of reproductive age. APO, including low birth weight, early birth, and stillbirth, was the outcome of the study. The demographic characteristics and other risk factors were evaluated. To identify APO-risk-associated factors, we performed multiple logistic regression analysis. The results showed that low economic status (Adj. OR= 1.407; 1.153-1.716; p= 0.001)), living in rural areas (Adj. OR= 0.804; 0.663-0.976; p= 0.027), having a history of pregnancy or childbirth complications (Adj. OR= 4.563; 3.617-5.756; p= 0.0001), premature rupture of the membrane during pregnancy or after giving birth (Adj. OR= 1.351; 1.069-1.708; p= 0.012), antenatal visits <4 times (Adj. OR= 1.603; 1.123-2.288; p= 0.009), consumption of iron supplement tablets <90 days (Adj. OR= 1.275; 1.063-1.529; p= 0.009), and twin pregnancy (Adj. OR= 33.715; 18.587-61.153; p= 0.0001) significantly influenced the APO prevalence. The study concluded that APO risk is significantly impacted by poor obstetric history features, multiple births, low health service utilization, and sociodemographic factors. Early detection of these risk factors is essential for reducing neonatal death caused by APO.

Risk factors for hypertension in pregnant women in Indonesia: A cross-sectional study

Objective: To determine the risk factors for hypertension in pregnant women, which is a significant cause of maternal and newborn morbidity and mortality in Indonesia. Methods: This was a cross-sectional study used secondary data from the 2018 Indonesian Basic Health Research. Pregnant women aged 15-54 years in the second and third trimesters were eligible. The history of hypertension in pregnant women was the dependent variable. The independent variables consisted of the demographic characteristics of pregnant women including pregnancy age, gestational age, education, occupation, place of residence, and region of residence. This study used multivariate logistic regression to determine the risk factors for hypertension in pregnant women in Indonesia. Results: Among 6479 respondents included in this study, 11 (7.0%) had a history of diabetes mellitus (DM) and hypertension compared to pregnant women who did not have a history of DM (0.1%). The dominant risk factors for hypertension in pregnant women in Indonesia include maternal age above 35 years (OR 3.67, 95% CI 2.54-5.32), third-trimester pregnancy (OR 2.40, 95% CI 1.72-3.35), primigravida (OR 1.78, 95% CI 1.19-2.68), excessive consumption of salty foods (OR 1.44, 95% CI 1.03-2.03), and diabetes mellitus (OR 10.20, 95% CI 3.04-32.23). Conclusions: Great efforts must be made to increase public awareness about the dangers of hypertension in pregnant women through early diagnosis and treatment, education on sodium intake, and appropriate care for pregnant women with DM.

Dietary Sodium-Potassium Intake and Risk of Hypertension: A Literature Review

Hypertension is a disease with a high mortality rate in Indonesia. Hypertension is an increase in systolic blood pressure >140 mmHg and diastolic blood pressure >90 mmHg. The prevalence of hypertension has increased significantly in patients aged 60 years and over. Many factors cause hypertension, one of which is a poor diet. The purpose of this study was to determine the effect of sodium and potassium intake on the incidence of hypertension in the elderly. The data or sources related to the relationship between potassium and potassium intake with hypertension in the elderly was used as a method in this research. The influence of sodium and potassium intake on the incidence of hypertension in the elderly is the result of research

Hubungan antara Karakteristik Calon Pengantin Wanita dengan Pengetahuan tentang Kesehatan Reproduksi di Puskesmas Tunjung Kecamatan Randuagung Kabupaten Lumajang Jawa Timur

The maternal mortality rate in Indonesia is still high at 4,400/100,000 births, likewise in Lumajang Regency at 97/100,000 live births. Various factors that influence the high maternal mortality rate include knowledge about reproductive health. In Lumajang Regency there is a regent's regulation about prospective bride and groom must report to the Puskesmas to obtain reproductive health information. Until now, in the coverage area of Tunjung Health Center, Lumajang Regency are not known about the connection between characteristics of the prospective bride and groom with knowledge about reproductive health, this research was conducted to find out. An observational analytic survey with cross sectional approach are used in this research. Fifty research samples were determined by the Lemeshow formula and total sampling technique. Data were collected using questionnaire that was created and validated. The results showed that most of the prospective brides were aged 20 to 35 years (63.64%), while the risk group in terms of age <20 years was 36.36%. Most of education of the bride-to-be is in junior high school (52.73%) and 12.73% are elementary school. The highest income for prospective brides is under 2 million (69.09%) with 14.55% of them earning below 1 million. Sourcemost reproductive health information from teachers (47.27%) and parents (21.82%), the respondent group of prospective brides with less knowledge are only 5.45%. The results of statistical analysis with Pearson chi-square test showed there is a significant relationship between age and the level of knowledge of reproductive health. Keywords: age, education, income, reproductive health

High Protein Milk Effective to Increase the Hb Levels of Third Trimester of Pregnancy with Anemia

The high maternal mortality rate in Indonesia is still plagued by three main causes, one of which is anemia caused by iron deficiency. This weakness is related to protein deficiency, so the way to overcome it is by giving blood supplement tablets with additional protein intake to pregnant women. The aim of this study was to determine the effect of giving high protein milk intake on increasing hemaglobin levels in third trimester pregnant women with iron deficiency. This test plan was a pre-try one collection pretest-posttest. The population in this study was all third trimester pregnant women with pale faces in the work room of the Gondanglegi Welfare Center Malang Regime, with a sample of 33 people using total sampling. The measured test used was Wilcoxon Marked Rank Test. The examination results showed that the average hemaglobin level before treatment was 10.1 gr/dl, and after treatment was 11.1 gr/dl. The results showed that there was an effect of giving high protein milk on increasing hemaglobin levels in third period pregnant women with pale skin in the Gondanglegi Health Center Working Area (p-value = 0.000). The conclusion of this study is that milk protein consumption basically affects the increase in hemaglobin levels in pregnant women. It is recommended for pregnant women who get anemia to focus on their food intake, especially protein consumption.

Burden of unintentional drowning in Indonesia: insights from the Global Burden of Disease Study 2019

IntroductionA high burden of unintentional fatal drowning has been reported in low- and middle-income countries. However, little is known about unintentional drowning in Indonesia.MethodsThis population-based retrospective cohort study analysed unintentional...

COMPARATIVE METHODS OF SNOWBALL AND BRAINSTORMING ON MATERNAL KNOWLEDGE ABOUT DANGEROUS SIGNS OF PREGNANCY

Introduction. Maternal and infant mortality in Indonesia is still quite persistent. Maternal knowledge of danger signs in pregnancy is one of the factors that can affect expectant mothers at high risk of pregnancy risk signs. Snowball is a multilevel discussion which eventually leads to consensus responses, while brainstorming begins with the group leader presenting a particular problem and then each participant responds with an opinion or feedback. The aim of this research is to find out the comparison of snowball and brainstorming methods on maternal knowledge about the danger signs of pregnant women. Method. This research uses a quasi-experimental design with a one-group design that is pre-tested and post-tested using the Snowball method and Brain Storming group. The population was 45 expectant mothers who made antenatal visits. The samples consisted of 26 expectant mothers who were selected by purposive sampling. Data was collected using a questionnaire and analyzed by Marginal Homogeneity test. Result & Analysis. Before the health promotion, most respondents in the brainstorming group had sufficient knowledge (61.5%) and those with insufficient knowledge amounted to 38.5%. After being trained with the brainstorming method, respondents' knowledge increased to 53.8% with good knowledge, 38.5% with fair knowledge, and 7.7% with insufficient knowledge (p value 0.008). Meanwhile, 92.3% of the respondents' knowledge was insufficient and 7.7% of the respondents' knowledge was adequate (p value 0.008). However, after the health promotion, the respondents' knowledge changed to 46.1% moderately knowledgeable, 38.5% less knowledgeable, and 15.4% well knowledgeable (p value 0.013). Discussion. There is a significant difference in the knowledge of pregnant women before and after being promoted with the brainstorming and snowball methods. It is expected that the brainstorming health promotion method can be applied as one of the methods in improving the knowledge of pregnant women.

Analisis Faktor-Faktor yang Memengaruhi Penggunaan IUD Pasca Plasenta

High maternal mortality rate and infant mortality rate in Indonesia can be suppressed by increased coverage of MKJP methods. The aim of the research was to analyze the factors that influence the use of post-placental contraceptives with IUD methods in Praya RSUD. Research design used analytical observation with case control study. The results of the research obtained the level of knowledge of the WUS and the promotion or KIE activities given by the health personnel are significantly related to the use of post-placental IUDs in RSUD Praya with a P-value of 0,000. However, the health care competence factor is not related to the use of post-placental IUDs in Praya RSUD with a P-value of 0.715. Conclusion The level of knowledge and promotional activities/KIE by health care personnel has been linked to the use of post placental IUD in RSUD Praya. Whereas health care competence has nothing to do with it.

The Correlation between the knowledge and attitudes of mothers of toddlers about immunization with compliance to complete routine immunization in Wage Village, Taman Subdistrict, Sidoarjo Regency, East Java, Indonesia

Introduction: The under-five mortality rate in Indonesia and East Java in 2021 shows a downward trend from 2020, with the main cause of under-five mortality being infectious diseases such as pneumonia and diarrhea. One of the factors that contributed to this was the increase in complete immunization coverage for babies in previous years; however, in the 2021 and 2022 periods in Indonesia and East Java, there was a significant decline in the number of complete immunization coverage. Community behaviour regarding improving health, in this case, immunization, is determined by many factors, one of which is the knowledge and attitudes of the mothers of toddlers themselves. Objective: Analyzing the correlation between the knowledge and attitudes of mothers of toddlers regarding immunization and compliance with providing complete routine immunization in Wage Village, Taman District, Sidoarjo Regency, East Java, Indonesia. Method: This research used quantitative methods with a cross-sectional approach. Data was collected through questionnaires given to 90 mothers of toddlers aged 24-59 months in Wage Village who had a Healthy Way Card (KMS) or Maternal and Child Health Book (KIA); the sample size was calculated using the Compare Two Proportions formula, sampling techniques using Purposive Consecutive Sampling, and Fisher's Exact test was used to see the correlation between the two variables. Results: The results of this study show that there is no significant correlation between the knowledge of mothers of toddlers about immunization and compliance with providing complete routine immunization (p=0.434), and there is no significant correlation between the attitude of mothers of toddlers about immunization and compliance with providing complete routine immunization (p=1.000). Conclusion: The results of this study indicate that neither the knowledge nor attitudes of mothers of toddlers regarding immunization have a significant correlation with compliance in providing complete routine immunization in Wage Village, Taman District, Sidoarjo Regency. Efforts to increase immunization compliance need to focus on other aspects, such as cross-sectoral cooperation, accessibility of health services and more comprehensive education programs for mothers of toddlers, families and the community.

Maternal factors associated with the occurrence of Low Birth Weight (LBW) Infants at the Haji Hospital, East Java Province

Introduction: Low birth weight infants are an indicator of public health problems. They are also included in the 100 core health conditions the World Health Organization (WHO) compiled. LBW Infants are still the cause of infant mortality in Indonesia. The infant mortality rate in Indonesia is still not reaching the SDGS target. Objective: This study aims to examine maternal factors associated with the occurrence of LBW Infants at the Haji Hospital, East Java Province Method: This study used a retrospective method with a case-control study design. This study took a sample of 258 infants with inclusion and exclusion criteria. Data collection uses secondary data in the form of collection carried out in the delivery and medical records room. Result: Bivariate analysis obtained the results of gestational age (p < 0.001), history of LBW infants (p = 0.03), anemia (p = 0.641), hypertension in pregnancy (p < 0.001), maternal illness (p < 0.001) with the occurrence of LBW infants. Based on multivariate analysis, mothers with gestational age <37 weeks had OR 8.667 (95%CI 4.509-16.659), a history of LBW infant had OR 10.736 (95%CI 1.895-60.809), hypertension in pregnancy OR 2.468 (95%CI 1.250-4.869), and maternal illness OR 3.212 (95%CI 1.301-7.932) times to experience LBW infants. Conclusion: This study highlights the burden of caring for LBW infants in the Haji Hospital in East Java province. Maternal factors need to be given special attention during pregnancy. Health promotion measures, early detection screening, and intervention of related factors need to be done so that the occurrence of LBW infants can be prevented.

Trends and causes of maternal mortality in Indonesia: a systematic review

BackgroundThe maternal mortality ratio (MMR) in Indonesia is among the highest in Southeast Asia. We aim to describe trends in the MMR and causes of maternal deaths in Indonesia over the past decades, regionally and nationally.MethodsWe performed a systematic review and conducted a search using PubMed, Embase, Global Health, CINAHL, Cochrane, Portal Garuda, and Google Scholar from the inception of the database to April 2023. We included all studies on the incidence and/or the causes of maternal deaths in Indonesia. The MMR was defined as the number of maternal deaths per 100,000 live births. Maternal death causes were assessed and reclassified according to the WHO International Classification of Disease Maternal Mortality (ICD-MM).ResultsWe included 63 studies that reported the MMR (54 studies) and/or the causes of maternal deaths (44 studies) in Indonesia from 1970 to 2022, with a total of 254,796 maternal deaths. The national MMR declined from 450 to 249 (45%) between 1990 and 2020. Great differences in MMR exist across the country, with the lowest in Java-Bali and the highest (more than twice the national MMR) in Sulawesi and Eastern Indonesia. Between 1990 and 2022, the proportion of deaths due to hemorrhage and sepsis decreased, respectively from 48 to 18% and 15–5%, while the share of deaths due to hypertensive disorders and non-obstetric causes increased, respectively from 8 to 19% and 10–49%.ConclusionDespite the steady decline of maternal deaths in Indonesia, it remains one of the highest in Southeast Asia, with enormous disparities within the country. Hypertensive disorders and non-communicable diseases make up a growing share of maternal deaths, making maternal death reduction strategies increasingly challenging. National Maternal Death Surveillance and Response needs to be prioritized to eliminate preventable maternal deaths in Indonesia.Registration of systematic reviewsPROSPERO, CRD42022320213.

“Lansia Berdaya” Program Penguatan Posyandu Lansia Dusun 2 Desa Karangwuni Sebagai Upaya Peningkatan Pengetahuan dan Pencegahan Hipertensi

Hypertension, a non-communicable disease, exhibits significant death and suffering rates worldwide, including in Indonesia. Hypertension ranks as the third leading cause of mortality in Indonesia, following strokes and tuberculosis, primarily impacting the older population. Dusun 2 Karangwuni is a region that experiences a high mortality rate due to hypertension. The hypertension screening findings revealed that out of the 49 elderly visitors to Posyandu, 41 of them were found to have hypertension. The team's objective is to implement the dedication of Lansia Berdaya's activities in managing hypertension in Dusun Two village, Karangwuni, Weru district. The Lansia activities occur in Dukuh Ngampas, Dusun 2, Village KarangWuni, district Weru, Sukoharjo. Activities encompass kader upgrading training, hypertension assessment, rehabilitation, and elderly gymnastics. The sequence of events will occur in February 2023. The intended recipients are 17 healthcare professionals, whereas the intended recipients are 47 individuals. Activities are evaluated by examining the level of knowledge, which is determined using pre-test and post-test values. Heath cadre training was conducted with 17 audiences. Hypertension screening, senior gymnastics, and health education activities were conducted and attended by 47 seniors. The hypertension exercise video has been distributed to the health cadre. The video is anticipated to serve as a comprehensive manual for gymnastics exercises at Posyandu Lansia to establish a long-lasting and sustainable devotion program.

Asuhan Kebidanan Komprehensif Pada Ny. M Umur 44 Tahun G4P2A1 Faktor Resiko Umur Ibu Lebih Dari 35 Tahun Dan Pre-Eklamsia Di Wilayah Kerja Puskesmas Paguyangan Tahun 2023

The Program Registration at the Ministry of Health in 2020 shows a figure of 5,125 deaths. AKI is caused by bleeding, pre-eclampsia/eclampsia, infection, late arrival of the mother to a health facility and mothers with positive PCR/Antigen. The aim of this research is to be able to implement comprehensive midwifery care for Mrs. M, 44 years oldhe maternal mortality rate in Indonesia compiled from the Family Health. This research method used quantitative descriptive with a case study approach. The case study carried out was in the form of Comprehensive Midwifery Care which examined women during pregnancy, childbirth, newborns, postpartum and family planning with Varney's seven-step midwifery management and SOAP. Comprehensive Midwifery Care for Mrs. M, namely during pregnancy, pre-eclampsia was discovered. Delivery by Sectio Caesarea and the baby was born normally. During the postnatal period, no problems were found in the baby. During the postpartum period, no problems were found. Mother uses MOW birth control. Based on the care, it is concluded that the care has been implemented according to Midwifery Service standards.

Role of digital education through smartphones in improving knowledge among asthma patients: A preliminary study.

Asthma is a chronic inflammatory airway disorder and is among the top ten causes of morbidity and mortality in Indonesia, highlighting the need for effective management strategies. This study aimed to evaluate changes in asthma knowledge levels before and after using the "Paru Sehat" smartphone application for digital education. A quasi-experimental study using a pre- and post-test design was conducted over three months at the outpatient clinic of Universitas Sumatera Utara Hospital, Medan, Indonesia, among asthma patients aged over 18 years. The patients completed the Patient Asthma Knowledge Questionnaire (PAKQ) before installing the "Paru Sehat" application to establish baseline knowledge. Once a week, patients received reminders to access materials covering an asthma overview, peak flow meter use, medication differences, and management techniques. After four weeks of intervention, the participants' knowledge was reassessed using the PAKQ. Data were analyzed using either paired Student's t-test or Wilcoxon test to assess the improvement in knowledge. The results showed increases in knowledge about asthma in general, asthma triggers, and asthma diagnosis domains, with the median score in each domain rising by one point (p=0.003, p=0.001, and p=0.002, respectively). The asthma management domain exhibited the largest change, with a median increase of two points (p<0.001). The total scores increased by an average of five points (p<0.001), indicating an overall improvement in patient knowledge about asthma. The "Paru Sehat" application demonstrated significant potential in enhancing asthma knowledge across multiple domains. Further research is warranted to explore the long-term effectiveness of the application in diverse populations and settings, ultimately contributing to improved asthma management and patient outcomes.

The Relationship Between Knowledge and Motivation of Pregnant Women with the Implementation of Integrated ANC at UPTD Plaosan Health Center

Antenatal care (ANC) is an important component in maternal health services to reduce maternal and infant mortality rates in Indonesia, which are still high. Every pregnancy in its development has a risk of complications, therefore ANC services must be carried out routinely, integrated, and according to quality antenatal service standards. In fact, not all pregnant women make regular ANC visits, so the coverage of K1, K4 and K6 is low, including at the Plaosan Health Center. The general objective of this study was to determine the relationship between knowledge and motivation of pregnant women with the implementation of Integrated ANC at UPTD Puskesmas Plaosan in 2024. The type of research used in this study was an analytic survey with a cross sectional design. Data analysis using primary data. The number of samples used was 37 pregnant women using purposive sampling technique. The independent variables in this study were knowledge and motivation while the dependent variable in this study was the implementation of integrated ANC. Data analysis was performed with chi-square test. The results showed that the variable of knowledge with the implementation of integrated ANC obtained significance with a p value = 0.014 while the motivation variable obtained a p value = 0.001 so that there is a significant relationship between knowledge and motivation with the implementation of integrated ANC. Therefore, knowledge and motivation need to be considered to be a reference in the implementation of integrated ANC..