District Public Health Research Articles

Changes of Organizational Culture at the Public Health Center in Cilincing District, North Jakarta, Indonesia

The empirical problem in this research is that in the working area of the Cilincing District Public Health Center, they have never carried out health education or monitoring activities in fisheries areas, including how to make salted fish. The study aims (1) to measure responsive culture, awareness management, organizational commitment, and identification of formalin in salted fish before and after implementing responsive culture. Furthermore, the study analyzes the influence of awareness management and organizational commitment on responsive culture and formalization in salted fish. It also aims to determine the best influence path model. The design used is to provide a responsive culture module and pre-post observational. Descriptive analysis was used to determine the distribution of respondents regarding responsive culture; awareness management; organizational commitment; and identification of formalin in salted fish. SEM SmartPLS is used to test the influence between variables. The results showed that the best model of influence path is (1) awareness management has a direct effect on organizational commitment; (2) organizational commitment influences responsive culture and responsive culture influences formalin content in salted fish. It is proven that a responsive culture plays an important role in overcoming health center performance problems. After implementing the responsive culture module, and a formalin test was carried out on making salted fish, the results showed that there was no formaline in salted fish.

Abstract A147: A ten-year overview of cancer genetic family history screening in Georgia’s Latina population

Abstract Introduction: Population-based cancer genetic family history screening to identify families at high risk for BRCA-associated cancers has been endorsed by national public health policies. This report aimed to describe the utilization of family history screening services from 2013 to 2022 according to rurality and socioeconomic deprivation among the Latina community in the state of Georgia. Methods: Self-identified Latina women who attended a medical appointment at participating Georgia Public Health Clinics were invited to utilize the cancer genetic family history screening services. Screening results and participant zip code were reviewed. Area deprivation index (ADI) was measured at the census block group level and assessed as a dichotomous variable (more deprived and less deprived). Rurality was measured through Rural-Urban Commuting Area (RUCA) codes and was assessed dichotomously (urban and rural). The ADI and RUCA codes were linked to participant data by zip code to characterize genetic service access among the Latina community. Results: We found 9,330 (3.31%) adult Latinas in Georgia completed cancer genetic family history screening from 2013-2022. In this sample, 9,066 (97.17%) women screened negative, and 264 (2.83%) women screened positive (i.e., family history suggestive of higher risk for carrying BRCA1/2 mutations compared to the general population). The family history screening program reached Latinas in 16 of 18 public health districts in Georgia. However, family history screening completion varied significantly across the 16 districts (mean=327 women, range: 2 - 1,337). FH screening completion was higher among Latinas in urban areas (n=7,871) than Latinas in rural areas (n=1,459). Latinas who lived in more socially deprived areas appeared to have a higher number of screening completion (n=5,207) than those living in less socially deprived areas (n=4,123) due to interaction with urbanicity. Conclusions: Georgia’s family history screening program was able to reach Latina women across the state of Georgia, particularly those living in urban, socially deprived areas. To ensure equitable cancer genetic screening dissemination, future efforts should prioritize tailored outreach in rural regions and a comprehensive evaluation to identify key determinants of screening trends among Georgia’s Latina population. Citation Format: Dayanna A. Ramírez León, Lauren E. Barber, Sheryl Gabram-Mendola, Cindy Snyder, Susan Vadaparampil, Lindsay Fuzzell, Lauren E. McCullough, Lynn Durham, Yue Guan. A ten-year overview of cancer genetic family history screening in Georgia’s Latina population [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A147.

Impact of the Korea Early Childhood Home-visiting Intervention (KECHI) on child health and development and maternal health: a randomised controlled trial protocol

IntroductionRandomised controlled trials (RCTs) of early childhood home-visiting interventions led by nurses have been conducted mainly in Western countries, whereas such trials have been limited in non-Western cultures, including Asia....

Appendicectomy pathway: Insights from electronic medical records of a local health district in Australia

BackgroundThis study aims to identify the common pathways of appendicectomy, the most common emergency surgery in Australia’s public hospitals and any variations within a regional public health district in New South Wales, Australia. MethodsWe analyzed the electronic medical records of 3,943 patients who underwent appendicectomy between January 2014 and July 2020 at 2 hospitals in the Illawarra Shoalhaven Local Health District, New South Wales, Australia, using the PM2 approach for surgical pathway identification and subsequent statistical analyses. ResultsAmong 3,943 patients, 3,606 (91.5%) followed an 11-step main pathway: (1) emergency department admission, (2) surgery booking, (3) anesthesia start, (4) operating room entry, (5) surgery start, (6) surgery end, (7) anesthesia end, (8) operating room discharge, (9) postanesthesia care unit admission, (10) postanesthesia care unit discharge, and (11) hospital discharge. The median length of stay was 48.13 hours (interquartile range 32.74). The main pathway differed from either variation 1 (n = 246, 6.2%) or variation 2 (n = 30, 0.8%) only in the timing and location of anesthesia administration or conclusion. Variation 3 (n = 26, 0.7%) included patients who underwent appendicectomy twice, whereas variation 4 (n = 25, 0.6%) included patients booked for surgery before emergency department admission through community doctor referrals. Thirteen exceptional cases experienced combinations of the aforementioned pathways. The length of stay and phase durations varied between the main pathway and these variations. ConclusionThe appendicectomy pathway was largely standardized across the studied hospitals, with the location of anesthesia administration or conclusion affecting specific stages but not the overall length of stay. Only a complex 2-surgery pathway increased length of stay.

Introducing a digital emergency obstetric and newborn care register for indoor obstetric patient management: An implementation research in selected public health care facilities of Bangladesh.

Digital health records have emerged as vital tools for improving health care delivery and patient data management. Acknowledging the gaps in data recording by a paper-based register, the emergency obstetric and newborn care (EmONC) register used in the labour ward was digitised. In this study, we aimed to assess the implementation outcome of the digital register in selected public health care facilities in Bangladesh. Extensive collaboration with stakeholders facilitated the development of an android-based electronic register from the paper-based register in the labour rooms of the selected district and sub-district level public health facilities of Bangladesh. We conducted a study to assess the implementation outcome of introducing the digital EmONC register in the labour ward. The digital register demonstrated high usability with a score of 83.7 according to the system usability scale, and health care providers found it highly acceptable, with an average score exceeding 95% using the technology acceptance model. The adoption rate reached an impressive 98% (95% confidence interval (CI) = 98-99), and fidelity stood at 90% (95% CI = 88-91) in the digital register, encompassing more than 80% of data elements. Notably, fidelity increased significantly over the implementation period of six months. The digital system proved a high utility rate of 89% (95% CI = 88-91), and all outcome variables exceeded the predefined benchmark. The implementation outcome assessment underscores the potential of the digital register to enhance maternal and newborn health care in Bangladesh. Its user-friendliness, improved data completeness, and high adoption rates indicate its capacity to streamline health care data management and improve the quality of care.

Prenatal depression among pregnant women attending public health facilities in Babile district, Eastern Ethiopia: a cross-sectional study

BackgroundDepression during pregnancy is a significant health concern that can lead to a variety of short and long-term complications for mothers. Unfortunately, there is a lack of information available on the prevalence and predictors of prenatal depression in rural eastern Ethiopia. This study assessed prenatal depression and associated factors among pregnant women attending public health facilities in the Babile district, Eastern Ethiopia.MethodAn institution-based cross-sectional study was conducted among 329 pregnant women attending Babile District Public Health Facilities from November 1 to December 30, 2021. Bivariable and multivariable logistic regression were used to identify factors associated with prenatal depression. The adjusted odds ratio (AOR) with a 95% confidence interval was used to report the association, and the significance was declared at a p-value < 0.05.ResultsThe prevalence of prenatal depression was 33.1% (95% CI = 28.0%, 38.2%). A lower income (AOR = 3.85, 95% CI = 2.08, 7.13), contraceptive use (AOR = 0.53, 95% CI = 0.28, 0.98), unintended pregnancy (AOR = 2.24, 95% CI = 1.27, 3.98), history of depression (AOR = 5.09, 95% CI = 2.77, 9.35), poor social support (AOR = 5.08, 95% CI = 2.15, 11.99), and dissatisfied marriage (AOR = 2.37, 95% CI = 1.30, 4.33) were the factors associated with increased prenatal depression among pregnant women.ConclusionsOne in every three pregnant women in rural eastern Ethiopia had prenatal depression. Monthly income, contraceptive use, pregnancy intention, history of depression, social support, and marriage satisfaction status were the determinants of prenatal depression. Preventing unintended pregnancies by encouraging women to utilize modern contraceptive methods is essential for mitigating and controlling the risks and burdens of prenatal depression and its negative consequences.

The lived experiences of providing nursing care in coastal areas: A qualitative study.

To explore nurses' experiences in providing care in coastal areas. The phenomenological study was conducted from July to September 2020 in two coastal areas located in the Riau province of Indonesia, and comprised nurses working in public health centers, hospitals and district health offices. Data was collected using in-depth interviews. Data was subjected to thematic analysis. Of the 13 nurses, 10(77%) were females and 3(23%) were males. The overall age range was 24-44 years. Four themes that emerged were health problems in coastal areas, obstacles in nursing care delivery, irrelevant duty, and procedures in delivering nursing care. There were a total of 10 sub-themes as well. Despite the challenged faced by the nurses, communities in coastal areas deserve to get due healthcare services.

Analyzing the Impact of Dissolved Organic Components on River Water Quality and Its Implications for Human Health: A Case Study from Banjar District

Introduction: Environmental contamination, especially water quality, is a global issue. The association between river water quality and human health is explored in Banjar Regency, rich in natural resources and essential rivers, utilizing dissolved organic components concentration as an indicator. Methods: A mixed-methods study in Banjar District, South Kalimantan, Indonesia, examined the impact of river water quality on human health, using dissolved forganic components as a primary indicator. Water quality assessments, nutrient content measurements, consumption surveys, and water-related disease epidemiology provided data. The statistical studies revealed key correlations and patterns. Results and Discussion: Water quality metrics varied among sampling locations. The dissolved fish feed negatively correlated with dissolved oxygen, while nutrient content weakly correlated with gastrointestinal disorders. High water temperatures increased respiratory illnesses. Drinking water from sources with high dissolved fish feed content caused digestive and respiratory problems. The study confirms previous research linking water quality parameters to health effects. The complex relationship between water quality and health is location-dependent, illustrating how environmental factors, especially water quality, shape illness trends. Conclusion: The study illuminates the complex links between river water quality, human health, and water usage in Banjar District. Dissolved fish feed content affects digestive and respiratory disorders, emphasizing the need of water quality management for regional health. These findings guide Banjar District water resource management and public health measures and help solve worldwide environmental pollution issues.

Side effects of CoronaVac® COVID-19 vaccination: Investigation in North Jakarta district public health center communities in Indonesia

BackgroundThe decreasing prevalence of COVID-19 has highlighted the value of vaccinations. CoronaVac® vaccine was one of the most widely used vaccines in Indonesia, in other Southeast Asian countries, as well as in Latin America. However, to date the safety and side effect profiles of CoronaVac® vaccine among the Indonesian population have not been reported. ObjectiveIn this study, the CoronaVac® safety profiles were determined in a community of a public health center in North Jakarta, Indonesia. MethodThis is a descriptive cross-sectional questionnaire-based study on vaccine side effects as recorded in the yellow form (MESO). Patients (n = 300) who received CoronaVac® vaccinations between July and August 2021 were enrolled. SPSS was used to analyze the descriptive data. ResultsMost respondents were women (72.7 %) between the ages of 17 and 21 years. A significantly (p = 0.009) positive correlation was established between the vaccine side effects (namely pain at the injection site) with the female gender. Other side effects such as fatigue (p = 0.034) and headache (p < 0.001) were also correlated with disease comorbidity. ConclusionOverall, the side effects following the first and the second doses were generally mild and included fever, pain in the injection area, fatigue, headache, drowsiness, diarrhea, cough, and nausea. Regarding vaccine efficacy, CoronaVac® confers better protection following the second dose administration where the percentage of respondents affected with COVID-19 (26.7 %) decreased to only 20.3 % following the second dose.

What influence mothers’ mental health and health care seeking behaviors for their malnourished children in Nepal: building evidence for a broader perspective

IntroductionImplementing research projects on community-based health care interventions in low-ressource settings is feasible with specific methods and applications. In order to critically understand all ins and outs of influencing factors involved in health care pathways for children and their mothers, we must consider to implement more than one research in the same context.ObjectivesThe objective of this presentation is to showcase the continuum of research projects starting from the assessment of the effectiveness of a combined nutrition and psychosocial intervention and its economic evaluation, and how that led to exploring social representations of malnutrition in order to better understand the link with health care seeking behaviours.MethodsThe FUSAM cluster randomized control trial included 427 were severe acutely malnourished (SAM) children and their mothers. They were divided in two groups receiving the standard nutrition treatment while the intervention group benefited from five psychosocial sessions. A battery of tests for child development and maternal mental health was administered pre and post intervention. For the economic evaluation, a data collection was conducted with 98 community members and District Public Health Office personnel in Saptari and 17 Action contre la Faim and government personnel in Kathmandu. Finally, a mixed-method study comparing social representations of malnutrition included 376 adults in Saptari and Nuwakot district. Data analysis was performed according to the study design: a multivariate model analysis for the CRCT, a micro-costing methodology to cost data collection and analysis was favored. For the mixed-method analysis, descriptive and inductive analysis were performed.ResultsRegarding the child development, children in the intervention group showed higher scores than children in the control group at all time points. And the economic evaluation showed that the costs of adding psychosocial counselling to an existing CMAM program was approximately EUR 28,788 for 6 centers per year. However, referrals of children through the community-based screening were not optimal. The findings related to health seeking behaviors showed that different meaning categories were simultaneously resorted to by community members leading to different representations of SAM children and that relevant health advises were neither systematically nor uniquely associated to medical categories but are linked to different meaning categories depending on the cultural context.ConclusionsMultiplying research projects is crucial to mitigate the limitations of the studies often facing numerous contextual challenges and ultimately to leverage further opportunities.Disclosure of InterestNone Declared

Factor Analysis Of Stunting In CIlincing Public Health Center North Jakarta

Background: According to the Ministry of Health announced the results of the Indonesian Nutrition Status Survey (SSGI) at the BKKBN National Work Meeting, where the prevalence of stunting in Indonesia fell from 24.4% in 2021 to 21.6% in 2022. Therefore, the Government of Indonesia has a target for 2024 for the stunting rate to fall by around 14%. So that the reduction in stunting rates is still far from the target set by the Government. Indonesia is still experiencing problems in nutrition and child development. UNICEF suggests that around 80% of stunted children are found in 24 developing countries in Asia and Africa. Objective: This study aims to determine the factors related to stunting in Cilincing Public Health Center, North Jakarta in 2024. Methodology: Descriptive correlation research with cross sectional research design. Population 74 respondents aged 24-59 months with purposive sampling technique. The instrument used to perform variable calculations uses a questionnaire. Variables include Immunization History, Clean and Healthy Living Behavior (PHBS), Exclusive Breastfeeding History, Parenting Patterns and Diarrhea History. This data was analyzed using descriptive statistics chi-square. Results: The research results showed that the number of health workers who experienced stunting was greater (68.9%) compared to normal ones (31.1%). There is an average value of stunted toddlers with a complete immunization history (56,%), good PHBS (66,2%), exclusive breastfeeding history (77%). ), less good parenting patterns (51.4%) and history of diarrhea with Diarrhea (60.8%). So there is a significant relationship between the factors history of immunization, PHBS, Parenting Patterns and History of Diarrhea (p value &lt;0.05). Conclusion and Suggestion: The availability of educational activities for the Cilincing Public Health Center in providing education on the knowledge of parents of toddlers about the factors of stunting incidence at the Cilincing District Public Health Center in 2024. The Puskesmas can provide education related to food diversity/variety, especially sources of animal protein.

An analysis of Nepal's federal health system in the context of the COVID-19 pandemic and the Sustainable Development Goals

Nepal's public health slogan was 'Health for All' with integrated community health services in 1991. The female community health volunteer network was created. District Public health offices (DPHO) managed these programs in their districts. After 2008 federalism, 2017 brought federal, provincial, and local governments. The federal health system substituted the administrative District Public / Health Offices in districts. The local governments or health institutions now oversee the Sustainable Development Goals (SDGs). The federal and provincial authorities should have employed qualified professionals to oversee public health at local health facilities. Healthcare efficacy and goal attainment are concerns today. This study did a microscopic investigation using health system studies. The researcher conducted field observations and stakeholder interviews and participated in public discussions. Data from Nepal's federal health system's community status was compared using SWOT analysis. The study delved into specific research gaps thoroughly. According to previous research, health infrastructure could be more effective with financial expenditures. A hypothesis was formed after comparing further information to domestic and international situations. The researcher emphasizes the need for good governance and suggests allocating 6% of national GDP to health spending, in line with WHO recommendations. To fulfil the needs of the healthcare sector, deliver quality medical services, and attain SDGs, it is imperative to ensure the presence of adequately trained health professionals at the local government level. The head of the local health institution must conduct administrative work connected to public health. Hence, public health-trained health staff are needed there.

Analysis Adequate Between Vitamin D Intake and Dementia in the Elderly in Community Health Center Work Areas

Based on population projection data, it is estimated that in 2017 there will be 23.66 million elderly people in Indonesia (9.03%). The number of elderly people is predicted in 2020 (27.08 million), 2025 (33.69 million), 2030 (40.95 million) and 2035 (48.19 million) (Ministry of Health RI, 2017). The prevalence of dementia (per 1000 people) in Indonesia in 2005 was 191.4 incidents, in 2020 it is estimated to be 314.1 incidents, and will increase in 2050 to around 932 incidents. The data obtained in the work area of the Telaga District Public Health Center were 134 elderly , of which 38 had dementia. From the results of interviews obtained from health workers at the puskesmas and families, they said that often the elderly forgot many activities such as bathing, taking medicine and others, so the family had to remind them to take a bath, take medicine and so on . Further interviews conducted by researchers on the elderly, some said that they rarely consume vitamins, especially vitamin D, are lazy to exercise, do light activities or sunbathe every morning which can increase the risk of developing dementia.

PENGARUH DISIPLIN KERJA, KOORDINASI DAN PENGAWASAN TERHADAP KINERJA KARYAWAN PUSKESMAS SURUH KABUPATEN SEMARANG

The aim of this research is to find out whether there is an influence between work discipline, coordination and supervision on the performance of employees at the Suruh Community Health Center, Semarang Regency.&#x0D; The research method used is a quantitative approach. Data collection was carried out by distributing questionnaires directly to respondents. The respondents in this study were all employees of the Semarang District Public Health Center with a total population of 76 people.&#x0D; The results obtained from the research show that the variables of work discipline, coordination and supervision simultaneously have a positive and significant effect on employee performance. The performance of employees at the Suruh Community Health Center, Semarang Regency.

Racial disparities in the relationship of regional socioeconomic status and colorectal cancer survival in the five regions of Georgia.

The study's purpose was to examine 5-year colorectal cancer (CRC) survival rates between White and Black patients. We also determined whether regional socioeconomic status (SES) is associated with CRC survival between White and Black patients in the Clayton, West Central, East Central, Southeast, and Northeast Georgia public health districts. We performed a retrospective cohort analysis using data from the 1975 to 2016 Surveillance, Epidemiology, and End Results program. The 2015 United States Department of Agriculture Economic Research Services county typology codes were used to identify region-level SES with persistent poverty, low employment, and low education. Kaplan-Meier method and Cox proportional hazard regression were performed. Among 10,876 CRC patients (31.1% Black patients), 5-year CRC survival rates were lower among Black patients compared to White patients (65.4% vs. 69.9%; p < 0.001). In multivariable analysis, White patients living in regions with persistent poverty had a 1.1-fold increased risk of CRC death (HR, 1.12; 95% CI, 1.00-1.25) compared to those living in non-persistent poverty regions. Among Black patients, those living in regions with low education were at a 1.2-fold increased risk of CRC death (HR, 1.19; 95% CI, 1.01-1.40) compared to those living in non-low education regions. Black patients demonstrated lower CRC survival rates in Georgia compared to their White counterparts. White patients living in regions with persistent poverty, and Black patients living in regions with low education had an increased risk of CRC death. Our findings provide important evidence to all relevant stakeholders in allocating health resources aimed at CRC early detection and prevention and timely referral for CRC treatment by considering the patient's regional SES in Georgia.

Exploring workplace-based learning in distributed healthcare settings: a qualitative study

BackgroundDistributed healthcare settings such as district hospitals, primary care, and public health facilities are becoming the real-life settings for workplace-based learning required to educate the future healthcare workforce. Therefore, a major focus should be on designing and developing workplace-based learning in these learning environments. Healthcare professionals and educational policymakers play a significant role in these settings as role models in workplace-based learning, and as leaders in integrating learning into their work environments. It is relevant to explore their beliefs, attitudes, and behaviors towards workplace-based learning in their own settings, in order to provide context-relevant recommendations that can assist in shaping workplace-based learning environments.MethodsWe used individual interviews to understand professionals’ experiences with workplace-based learning in distributed healthcare settings. We - three clinicians, an educationalist, and a philosopher - thematically analyzed transcripts of 13 interviews with healthcare professionals and educational policymakers from different healthcare settings who were involved in the clinical phase of undergraduate medical education.ResultsClustering and categorizing of the data led to the construction of five overarching themes: Identification with and attitude towards medical education, Sense of ownership, Perceived time and space, Mutual preconceptions and relations, and Curriculum for a changing profession.ConclusionsThese themes accentuate aspects relevant to the development of workplace-based learning in distributed healthcare settings on the individual, team, or organizational level. We highlight the significance of individual professionals in the development of workplace-based learning and emphasize the need for recognition and support for those occupying the ‘broker’ role at the intersection of education and practice. For future research and educational practice, we recommend prioritizing initiatives that build on good-practices in workplace-based learning and involve dedicated individuals in distributed healthcare settings.

A protocol and a data-based prediction to investigate virus spillover at the wildlife interface in human-dominated and protected habitats in Thailand: The Spillover Interface project.

The Spillover Interface Project aims at assessing the encounter of wildlife, domestic animals, and humans along a landscape gradient from a protected area to a residential community, through areas of reforestation and agricultural land. Here, we present the protocols of the project that combine virus screening in humans, bats, rodents and dogs with camera trapping, land-use characterization, and network analyses. The project is taking place in the sub-district of Saen Thong (Nan Province, Thailand) in collaboration with local communities, the District Public Health Office, and Nanthaburi National Park. To formulate a predictive hypothesis for the Spillover Interface Project, we assess the wildlife diversity and their viral diversity that could be observed in Saen Thong through a data science analysis approach. Potential mammalian species are estimated using data from the International Union for Conservation of Nature (IUCN) and their associated viral diversity from a published open database. A network analysis approach is used to represent and quantify the transmission of the potential viruses hosted by the mammals present in Saen Thong, according to the IUCN. A total of 57 viruses are expected to be found and shared between 43 host species, including the domestic dog and the human species. By following the protocols presented here, the Spillover Interface Project will collect the data and samples needed to test this data-driven prediction.

Evaluation of surveillance system and response for maternal and perinatal mortalities in Meda Welabu District, Ethiopia, 2023.

The weekly disease surveillance system (WDSS) serves as a precursor to possible public health emergencies. The Meda Welabu Woreda Bale Zone in Ethiopia has reporting rates of 87% overall timeliness and 88% completeness in 2023, falling short of the 100% objective. Low reporting rates could mean that epidemics in the province are only discovered later. In the Meda Welabu Woreda Bale Zone of Ethiopia, the study was carried out to assess the WDSS maternal and perinatal death surveillance response (MPDSR). Using the most recent Centers for Disease Control (CDC) criteria for assessing public health monitoring systems, we carried out a descriptive cross-sectional analysis. Data from the health workers were gathered through key informant interviews and questionnaires given by the interviewer. Using checklists, the availability of resources was evaluated. Twenty-two health personnel and twelve Health Extension Workers were questioned; of them, 15 (44%) were females. Nurses made up 18 (53%) of the health personnel. Only sixteen (47%) of the respondents were aware of the WDSS goals, compared to thirty-four (53%) who were aware of the deadlines for submitting data to the next level. A total of eight (24%) responders received training in using the WDSS. 26(76%) respondents said they would be willing to continue participating in the WDSS, whereas 6 (18%) respondents said they had analyzed the data from the WDSS. Of the health facilities, seven (50%) reported having issues with the district public health emergency officer. However, low attention to immediately report on maternal and perinatal death (42.9%). It was concluded that the WDSS was adaptable, reasonable, and easy to use. That was erratic and premature, though. We suggest that healthcare professionals in the province receive training on maternal and perinatal death surveillance response. In Meda Welabu Woreda Bale Zone conducted an evaluation in 2023 of the weekly disease surveillance system, maternal and perinatal death surveillance response. Launched in 1998, the system tracks weekly trends of diseases under surveillance to provide an early warning of any dangers to public health, but maternal and perinatal death surveillance were included on 2013. On the other hand, in 2023, the overall completion and timeliness of reports was 88%, falling short of the 100% aim. Low rates of reporting could mean that outbreaks and quality of service in the province were discovered later than expected. Using current centers for disease control criteria and interviewer-administered data, a descriptive cross-sectional study was undertaken.

Regional Public Services Agency Income, Retribution Revenue, and Non-Capitation Funds BPJS Health at Kemayoran District Public Health Center, Central Jakarta Administration City

Regional Work Unit of Regional Public Services Agency has been granted the authority to manage the income generated by the services provided to the public in order to improve service quality. Retaliation is deducted from the costs of medical care that the uninsured patient pays. Whereas, Non-capitation funds paid by the Health Social Security Administrator (BPJS Kesehatan). This study aims to know the effect of Health Service Retribution Revenue and Non-Capitation funds of the revenue of BPJS Health toward income, how great the impact is. This study is done in Public Health Center in Kemayoran District. Quantitative method is used as the method of the study. And secondary data is used as the data of the study. Classical Assumption Test and Hypotheses Testing, such as multiple regression equations, are used as the statistic method. T test and f test with significant level 5%. The data is processed using SPSS 25 program. The results are based on Retribution Revenue data, Non-Capitation funds, and Regional Public Services Agency of Public Health Center Revenue in Kemayoran District in 2014 to 2018. All of the data showed that Retribution Revenue data, Non-Capitation funds and Regional Public Services Agency of Public Health Center Revenue results, significantly and positively toward BPJS services.

Suspected human anthrax outbreak investigation in a tribal village of Koraput, India, 2021

AbstractBackgroundOdisha is a state in India endemic to anthrax disease with frequent reports of suspected animal cases. A suspected outbreak of anthrax in humans was reported on 24 October 2021 at Tukum village in Koraput district of Odisha, India after a bullock was found dead and consumed by the locals on 17 October 2021.MethodsThis extended outbreak investigation was carried out through house‐to‐house active surveillance from 24 October to 2 November 2021 in the Koraput district. Eschar skin swabs from wounds were collected and processed at District Public Health Laboratory, Koraput, and analyzed in Indian Council of Medical Research‐Regional Medical Research Centre, Bhubaneswar for molecular confirmation. Samples from bone, soil, and dried meat were collected from the contaminated sites and were transported to Animal Diseases Research Institute, Cuttack for confirmation.ResultsFour suspected cases of human anthrax were identified who had handled and consumed dead bullock meat, among which one human had died later. The attack rate of the persons at risk in the village was calculated to be 1.23%. However, no Bacillus anthracis were identified in human swab samples when tested in real‐time polymerase chain reaction. Samples collected from contaminated sites were confirmed to have anthrax bacilli.ConclusionInvestigation revealed that a suspected anthrax cluster outbreak was due to butchering/de‐skinning and consumption of the anthrax‐infected dead animal. The presence of bacilli in human samples could not be confirmed due to the intake of antibiotics before the collection of sample. This finding highlighted the importance of sample collection at a suitable time and a possible need for one health approach for better coordination among the different responsible departments.