Village Midwives Research Articles

Ethnopedagogical Approach In Educating Elementary School Students On The Implementation Of Clean And Healthy Behaviour

Kampung Naga is a traditional village that holds firm beliefs and adheres to the customs and philosophies mandated by its elders and rejects intervention from outside parties if it interferes with and damages the preservation of the village. In the field of health, the people of Kampung Naga prefer to use natural remedies as the first step and still believe in magical medicines, namely prayers performed by shamans or paraji. If the treatment does not work, they continue to medical treatment at the health centre or village midwife. In terms of Clean and Healthy Living Behaviour (PHBS), the people of Kampung Naga Tasimalaya still use flush toilets and have not used healthy latrine facilities. The purpose of this study examines the implementation of the ethnopedagogical approach in educational activities for the application of Clean and Healthy Living Behaviour (PHBS) in Kampung Naga Tasikmalaya as education for elementary schools, this approach considers cultural values and locality in Kampung Naga Tasikmalaya to increase students' understanding and participation in carrying out or implementing PHBS in their daily lives. The research method uses a descriptive qualitative approach. The collection techniques used were observation and literature study. The results showed that the ethnopedagogical approach can effectively increase awareness and implementation of PHBS, build student engagement, and create an inclusive learning environment through the local wisdom of the Tasikmalaya Naga village community.

Collaboration and involvement of village heads, public health officer, and village midwives in improving adherence of tuberculosis patients

BackgroundTuberculosis is an infectious disease and reduces the quality of life of sufferers. Tuberculosis patiets are imprisoned by their disease and unable to provide for themselves, let alone their families. Tuberculosis requires a long and tedious treatment time, not to mention the side effects of treatment. Teamwork is required between public health officers, village midwives and village officials to jointly be able to facilitate the needs of drugs that must be taken by tuberculosis patients regularly and avoid drug withdrawal. AimsTo explore the benefits of collaboration between public health officers, village midwives and village officials in supporting tuberculosis patients to improve treatment adherence. MethodsThis research is qualitative research with a phenomenological approach. Data collection using in-depth interviews was then analyzed by content analysis. The informants in this study consisted of 8 participants. ResultThis study found three themes, namely (1) Ease of taking drugs, (2) Cooperation, (3) Motivation. ConclusionIt was concluded that compliance of tuberculosis patients in taking medication can only occur if there is good cooperation from health workers, village midwives and village officials to ensure the availability of drugs.

Syndicate Group Method for Newborn Care with the Knowledge of Posyandu Cadres in the Working Area of the Tamalanrea Health Center, Makassar City

Learning methods are the methods used by teachers in carrying out their functions as a tool to achieve learning goals. The PAI learning method is more procedural in nature. “There is a method for everything, and the method of entering heaven is knowledge. Newborn babies have a high risk of death. The reason is that knowledge and simple care practices such as preventing hypothermia, giving colostrum and exclusive breastfeeding are still very lacking. Cadres are one of the closest people who can influence changes in the behavior of BBL mothers, so that cadres can provide correct information and influence the knowledge of mothers and families if the cadre's knowledge is good. This research aims to obtain information from the analysis of the influence of newborn care education using the Syndicate Group method on the knowledge of posyandu cadres in the working area of the Tamalarea Community Health Center. The method used in this research was a pre-experiment with a one group pretest-posttest approach with a sample of 24 posyandu cadres in the Tamalarea posyandu working area registered by the village midwife. Before the intervention, 58.3% of posyandu cadres were classified as having sufficient knowledge and 66.7% of posyandu cadres were classified as good knowledge after the intervention. Hypothesis analysis using the Wilcoxon Signed Rank Test with α = 0.05 obtained p value = 0.001, which shows that there is a significant influence of newborn care education using the Syndicate Group method on the knowledge of posyandu cadres. It is hoped that the community health center and village midwives can continue efforts to increase cadre knowledge using interactive methods such as Syndicate Groups and other methods, so that the role of cadres becomes more optimal.

SOSIALISASI PENCEGAHAN STUNTING UNTUK MENGURANGI JUMLAH ANAK STUNTING DI DESA TAMIAJENG

Stunting is a serious problem that can affect children's growth and development and have an impact on the development of human resources (HR) in the future. This study aims to increase community understanding of stunting through socialisation and distribution of UHT milk in Tamiajeng Village. The activities were carried out by KKN-P Group 36 Year 2024 by involving Posyandu Cadres, Village Midwives, and other Health Officers. The methods used include observation, making work programs, and permission from related parties, with activities that include face-to-face socialisation of stunting, as well as assistance in Posyandu activities. The results of the activity show that parents who have toddlers understand the impact of stunting on children. So this activity is expected to provide effective education to parents, help reduce the risk of stunting, and build a healthier generation in Tamiajeng Village.

Edukasi Persiapan Diri Ibu dalam Menghadapi Persalinan untuk Menurunkan Tingkat Kecemasan dan Persiapan Mental Ibu di Poskeskel Batu Hampa

Childbirth is a process that must be prepared for because it plays a major role in how first-time mothers will develop good self-esteem, positive feelings for the baby and an easier adjustment to the role of mother. Fear and unpreparedness in facing childbirth will have a negative impact both during the birth process which will have an impact on the health of the mother and fetus as well as in the lactation process and optimizing mother and baby bonding. The aim of this community service activity is to provide education on the mother's self-preparation for childbirth including the importance of preparing for childbirth, the mother's self-preparation for childbirth, self-empowerment that pregnant women can do in preparing themselves for the birth process, the importance of positioning during pregnancy to optimize the position of the fetus. and presentation and re-demonstration of pregnancy exercises. Activities were carried out at the Poskeskel Batu Hampa involving local village midwives and health cadres. This activity was very positively welcomed by the village midwives and participants as evidenced by the enthusiasm of the participants in participating in the activity. Hopefully this activity can become a routine agenda so that it becomes a provision for pregnant women when facing childbirth.

Perspektif Masyarakat terhadap Terjadinya Diabetes Melitus dan Hipertensi di Desa Sembahe Kecamatan Sibolangit Kabupaten Deli Serdang

Diabetes Mellitus is condition when blood glucose in the body is not controlled due to impaired sensitivity of pancreatic cells to produce the hormone insulin. Hypertension is a common public health problem in developing countries. Hypertension that is not treated immediately has an impact on the emergence of degenerative diseases, such as heart disease (Hypertension Heart Disease), end-stage renal failure (End Stage Renal Disease), and peripheral vascular disease. Risk factors such as heart disease, hypertension, dyslipidemia, Diabetes Mellitus (DM) should be monitored regularly so as not to cause more serious complications. This paper describes the implementation and evaluation of the achievement of minimum service standards and to find out how the characteristics of patients with diabetes are and to find out how the relationship between blood sugar levels and blood pressure of patients with diabetes type mellitus in health sector cases of hypertension and Diabetes Mellitus (DM) in Sembahe Village, Sibolangit District, Deli Serdang Regency. The method used is a qualitative study with a phenomenological method approach, with the focus of the research on clean and healthy living behavior towards the occurrence of hypertension and diabetes mellitus. The results of this study indicate that it is important to know and prevent hypertension and diabetes mellitus from an early age. With seminars and counseling or education regarding hypertension and diabetes mellitus, this has been carried out for 1 month with the assistance of the Field Supervisor, the village midwife of worship and colleagues-his partner. Door to door counseling, healthy gymnastics and health checks have also been carried out once a month to find out how the health condition of the worshipers is.

Pengaruh Pola Pikir Ibu Terhadap Kecenderungan Stunting di Desa Sidodadi

Stunting is a slowing of growth in children whose height is shorter than children of their age and also has an impact on the psychological, intellectual, mental, psychological, and motor. As many as 43.5% of cases of stunting in Indonesia are experienced by children under five with a vulnerable mother's age between 14-15 and ages between 16-17 years as much as 22.4% are the result of early marriages. The purpose of this study was to find out how the mother's mindset influences the tendency of stunting in Sidodadi Village. This study uses a quantitative approach to the type of research to measure the value of the variables studied. Primary data is in the form of mother's mindset and upbringing, secondary data on stunting events which are influenced by mother's upbringing. The research sample consisted of 62 toddlers from 7 hamlets with an age range of 0-59 months as of August 2022. Data collection used a simple random sampling technique. Data on maternal parenting patterns were obtained through interviews with village midwives. From the data using the SPSS program, the maximum score on the mother's mindset scale is 24, the minimum score is 12 and the average is 18.22, while the maximum score on the parenting scale is 21, the minimum is 13 and the average is 15.59. From the associative test obtained an F value of 84.961 and a significance value of 0.000. Stunting in Sidodadi village is caused by several factors, one of which is parenting style and mother's mindset.

Evaluating the long-term impact of large-scale trainings: an exposure based cross-sectional study on female genital mutilation-related knowledge, attitudes and practices among Sudanese midwives in Khartoum State

ObjectivesTo examine the long-term impact of large-scale training targeting midwives in a setting where they are the main female genital mutilation (FGM) practitioners. We hypothesised that trained midwives would have...

Evaluation of Local Supplementary Feeding Program in Toddler Nutrition Recovery House (Pelita) in Kedung Banteng District, Tegal Regency

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>One approach taken to reduce the prevalence of stunting is by providing additional recovery food to malnourished toddlers. The Rumah Pelita supplementary food program has been running in Kedung Banteng District since 2020. In the implementation of the Rumah Pelita Program, there are still existing cases of stunting and the nutritional status of targets and there has never been an evaluation of the Rumah Pelita program. The aim of the research is to determine the evaluation of the supplementary feeding program made from local food in Kedungbanteng District, Tegal Regency in terms of input, process and output aspects. This research method is qualitative research which is descriptive and evaluative in nature. The research period is January-March 2023. The research was conducted in 5 villages in the Kedungbanteng Community Health Center area. The main informants were 1 nutrition officer and 5 village midwives, and triangulation informants were 5 Rumah Pelita cadres and 5 mothers of toddlers. Data collection used in-depth interviews, while the source triangulation method was used to validate the data. Research data analysis is data reduction, data presentation and drawing conclusions. The results of the research show that the number of cadres is still insufficient, and there are still villages that have not budgeted for equipment rental and transportation for cadres, there are deficiencies in reporting and recording and there are still toddlers who experience stunting. There needs to be integration of central and regional government policies regarding handling stunting in toddlers, so that there is a division of the budget for handling stunting. and it is recommended that health workers provide health education about stunting prevention and routinely monitor the development of toddlers. </em></p><p> </p></td></tr></tbody></table></div><strong><em>Keyword: Stunting, Policy, Nutrition, Provision of supplementary food, Toddler</em></strong>

Pendampingan Kader Catin dalam Penjaringan Calon Pengantin di Kabupaten Jembrana

Background: Many factors cause stunting, one of which is health problems for young women (mothers-to-be) who are about to become pregnant. In several studies, smoking behavior and exposure to cigarette smoke also have an impact on pregnancy and fetal disorders which result in stunted babies being born. Before becoming pregnant, young women must really prepare their health. This preparation can start when you reach puberty until you are ready to become a prospective bride. The female bride-to-be (catin) is a woman of childbearing age who was in a healthy condition before becoming pregnant so that she can give birth to a normal and healthy baby and the male prospective bride-to-be will be introduced to the reproductive health problems of herself and the partner she will marry. Purpose: The aim of this activity is to help cadres in recruiting catin. Method: This service activity uses counseling and discussion methods for 30 cadres of prospective brides and grooms consisting of the Traditional Village Council, Village Kelian, Village Perbekel, Village PLKB, Village TPPS, and Village Midwife Element TPK. Results: There was an increase in post test scores after being given the material. The mean pre-test score was 68 and rose to 70. There was agreement in selecting potential brides, especially Hindu brides. This flow will be disseminated to each village, and will be socialized at every meeting with teenagers. So that teenagers who will later get married go through this flow. Conclusion: The importance of health screening for prospective brides and grooms to prevent stunting in children in the future. The catin flow is a tool to make it easier to disseminate information about how prospective brides and grooms, especially Hindus, report to Kelian Desa about their wedding plans.

Strategi Pemerintah Desa dari Berbagai Tingkat Cakupan Peserta Menuju UHC di Kabupaten Karimun

The government issued Presidential Instruction No. 1 of 2022 concerning Optimizing the Implementation of the JKN Program. Coverage of JKN participants in Karimun Regency is 83.28%. This study aims to explore village government strategies with various levels of participant coverage in achieving UHC in Karimun Regency. The method used in this research is a qualitative approach based on thematic analysis. Data was collected through Focus Group Discussions, in-depth interviews, and literature reviews. The research subjects were village governments with the highest, medium, and lowest UHC achievements on Karimun Island in Karimun Regency. The village government's strategy in achieving UHC included data collection and identification of individuals whom JKN does not cover; actively involving the participation of cadres of Posyandu, Posbindu and village midwives; providing education and advice; proposing JKN for poor society to the local government, and collaborating with sub-district offices and the Health Office in submitting PBIs. Implementation of this strategy is constrained by the absence of regulations regarding using village funds for JKN registration, limited funds, and JKN budgeting requires significant funds. There is a gap between the highest and lowest UHC village government strategies, including the active involvement of community cadres in the highest UHC village government. It is recommended that the most subordinate UHC village government involve the active participation of cadres from the community. The BPJS Kesehatan are advised to socialize Presidential Instruction No. 1 of 2022 to the village government

Pendekatan Saving Mothers Giving Life (SMGL) untuk Mencegah Komplikasi Ibu Post Partum

The most common complication that occurs in developing countries is bleeding, namely 27% (UNICEF, 2015). One of the post partum psychological disorders in Indonesia is baby blues, which is 0.9% (Banlitbangkes, 2018). One of the factors causing low utilization of maternal health services is cultural practices (WHO, 2018). The proportion of people who use traditional health services in Indonesia is 31.4% and those who use traditional health workers is 98.5%. The proportion of utilization of traditional health services in South Sumatra is 29.5%. Then the number of people who ask for help from traditional health workers is very high, namely 98.4% (Banlitbangkes, 2018). Community service results show that the health cadre team experienced increased knowledge and post partum maternal health problems were controlled by all mothers in Pegayut Village who gave birth and made postpartum visits to the village midwife. It can be concluded that the Saving Mothers Giving Life (SMGL) approach is a multi-system approach to reduce maternal mortality and to prevent post-partum maternal complications in Pegayut village.
 The most common complication that occurs in developing countries is bleeding, namely 27% (UNICEF, 2015). One of the post partum psychological disorders in Indonesia is baby blues, which is 0.9% (Banlitbangkes, 2018). One of the factors causing low utilization of maternal health services is cultural practices (WHO, 2018). The proportion of people who use traditional health services in Indonesia is 31.4% and those who use traditional health workers is 98.5%. The proportion of utilization of traditional health services in South Sumatra is 29.5%. Then the number of people who ask for help from traditional health workers is very high, namely 98.4% (Banlitbangkes, 2018). Community service results show that the health cadre team experienced increased knowledge and post partum maternal health problems were controlled by all mothers in Pegayut Village who gave birth and made postpartum visits to the village midwife. It can be concluded that the Saving Mothers Giving Life (SMGL) approach is a multi-system approach to reduce maternal mortality and to prevent post-partum maternal complications in Pegayut village.

Kontruksi Sosial Mengenai Stunting di Indonesia

Stunting in toddlers is caused by insufficient nutritional intake for quite a long time due to parents/family not knowing or not being aware of providing food according to their child's nutritional needs. The purpose of this paper is to provide an overview of the social construction of society that shapes an understanding of the nutritional status of toddlers and the parenting style of toddlers that causes stunting. This study uses the theory of social construction by Peter L. Berger and Thomas Luckmann. This research uses a descriptive qualitative method. The results of this study can be concluded that it is not because of a lack of budget, lack of health workers, and related programs, but rather the difference in communication and meaning from the health service providers (village midwives, health center staff and the health office), with those in the community

Implementasi Intervensi Gizi Spesifik Pada Ibu Hamil dan Bayi di Desa Kalipang Kecamatan Grogol Kabupaten Kediri

Background: Prolonged wasting and not receiving proper treatment will progress to stunting. One indicator of Medium Term Development is a reduction in stunting and wasting. Specific nutrition and nutrition sensitive intervention efforts were launched to overcome these nutritional problems. Assistance efforts are also needed to increase access for toddlers who are prone to nutritional problems. Objective: The purpose of this research is to analyze the implementation of specific nutritional interventions for pregnant women and babies in Kalipang Village, Grogol District, Kediri Regency. Method: This research is a qualitative analytical survey research with purposive sampling. The main informants were 20 people consisting of malnourished mothers of toddlers and stunted mothers of toddlers. Other informants involved were Puskesmas practitioners, Village Midwives, Village Officials and Posyandu cadres. The research was conducted in Kalipang Village, Grogol District, Kediri Regency. in January – March 2023. Data collection through in-depth interviews and document review, data analysis using direct interviews. Data analysis carried out data reduction, data display and drawing conclusions. Results: Implementation of specific interventions in Kalipang Village including pregnancy care (85%), administering blood supplement tablets (90%), implementing Early Breastfeeding Initiation (50%) and providing exclusive breastfeeding (20%). Conclusions and Suggestions: Most of the stunted and malnourished toddlers in Kalipang Village come from mothers of healthy reproductive age and KEK. Toddlers who have a history of LBW were born to mothers who were CED, had regular ANC, regularly took Fe tablets but did not provide exclusive breast milk. Research needs to be carried out regarding parental behavior in providing complementary foods to toddlers Keywords: Toddlers, Specific Nutritional Interventions

Peran Kader Posyandu dalam Penurunan Angka Stunting

Posyandu cadres have a role as the main movers of all activities carried out at the posyandu. The existence of important and strategic cadres, when the services provided receive sympathy from the community, will have positive implications for community awareness and participation. Stunting is one of the national development problems in Indonesia which can hamper economic growth, increase poverty and inequality. This research aims to determine the role of posyandu cadres in dealing with stunting in Pesanggrahan Village, Kwanyar District, Bangkalan Regency. The type of research used is descriptive qualitative. Using the case study method (case studies). The data collection technique for this research is using in-depth interviews, observation, documentation. To determine the informants, what was done was to determine the target population elements that were thought to be most suitable for collecting data, including posyandu cadres, family planning cadres and village midwives. Based on e-PPGBM data, the prevalence of stunting in 2022 will reach 85 toddlers spread across 16 villages. The Pesanggrahan village of Kacatan Kwanyar is one of the villages with a relatively high stunting rate compared to other villages, namely reaching 10 children under five in 2022. From the research results, posyandu cadres have carried out their duties and roles optimally. This is proven by the very drastic reduction in stunting rates in a relatively fast period, namely from 10 in 2022 down to 2 in 2023.

Keberlangsungan Inovasi Gerakan Masyarakat Peduli Ibu dan Balita (GEMPITA) pada Ibu Hamil Resiko Tinggi

Background: The need for innovation in the public sector, one of which is health, is important. The Covid-19 pandemic has caused an increase in the number of illnesses experienced by pregnant women.Objective: The research aims to find out the health program innovations that have been carried out in detail and in-depth at Puskesmas Karangtengah as the initiator of GEMPITA.Methods: The research uses a qualitative descriptive approach. Primary data includes input, process, and overall output components for GEMPITA. There were 4 informants, namely the Community Health Center Midwife Coordinator, Community Health Center Midwife, Community Health Center Nutrition Coordinator, and Head of Village Midwife. Data was analyzed using content analysis.Results: GEMPITA accommodates the implementation of integrated ANC. Sources of funding come from BOK, APBD, and village funds. Programs are periodically proposed through RAB on the BOK scheme in the form of PoA. Health program planning activities at community health centers based on PWS.Conclusion: Involvement in implementing GEMPITA includes community health center midwives, nutrition officers, laboratory officers, pharmacists, health promotion officers, general practitioners, dentists, village midwives, cadres, and village officials. Increasing the participation of all stakeholders and the community includes promotive efforts, preventive efforts, and community empowerment efforts.

Pengaruh Situation Awareness terhadap Peningkatan Task Performance Bidan Desa

The strategy to reduce the high infant mortality rate (IMR) is by placing midwives in the village. One of the tasks of village midwives is the prevention of complications through early detection, which is indicated by the performance of midwives based on neonatal coverage. Situation awareness is an important component of decision making that has a significant impact on the performance of the village midwife's duties, so the purpose of this study was to analyze the effect of the role of situation awareness on the performance of the village midwife's duties in detecting problems in young infants. Quantitative research was designed using a cross sectional study. All village midwives became the population and were determined based on the results of a sample calculation of 151 village midwives who would be taken proportionally. The research variables were situation awareness and task performance. The instrument used a questionnaire and analyzed using Simple Linear Regression. The results explained that the consistent value of task performance was 43.041. B situation awareness value (regression coefficient) 0.917. The regression coefficient is positive that the direction of the influence of situation awareness on task performance is positive. Decision making in simple linear regression is 0.000 <0.05 with the t value showing 8.256> from the t table of 1.97, which means that situation awareness has an influence on the performance of the village midwife's duties. Situation awareness is a predictor that is able to influence task performance for village midwives in providing care to neonates in early detection of problems in young infants.

PKM Pendampingan Kelas Ibu Anti Razia (Kurang Gizi Dan Anemia) di Wilayah Kerja Puskesmas Durian Luncuk

Stunting is still a national health problem, including in Jambi Province. The highest prevalence of stunted toddlers was found in Batanghari Regency, precisely in the Durian Luncuk Health Centre Working Area. Malnutrition and anemia in pregnant women will cause low birth weight and malnutrition in toddlers, including the stunting. The trend of the percentage of mothers giving birth to low birth weight babies (BBLR) in the last three years tends to increase, while babies with BBLR are more at risk of stunting. Efforts to prevent malnutrition and anemia in pregnant women include increasing the consumption of foods high in iron and protein around the mother's residence, which is the local wisdom of the region. The purpose of this activity is to carry out the assistance of anti-Razia (Malnutrition and Anemia) pregnant women's classes as a forum for health education for pregnant women and posyandu cadres to empower communities to prevent stunting, as well as midwives who can facilitate and become resource persons in anti-Razia women's classes with the method of theoretical exposure and demonstration of food processing practices which are divided into three classes where each class consists of three meetings. After a series of activities, the knowledge of pregnant women increased by 61%, the knowledge of posyandu cadres increased by 63%, and the knowledge of village midwives increased by 19%, the formation and implementation of the anti-Razia mother class, the implementation of cadre and village midwife training, increased knowledge and behavioral changes about the use of local food to prevent malnutrition and anemia in pregnant women and intellectual property rights for the Anti-Razia Mother Class module.

Poskeswa in Sidorejo Sukorejo Ponorogo case study: ODGJ income growth through innovation in doormat production

People with Mental Disorders (ODGJ) are a group of people who often face stigmatization and limitations in participating in economic activities. Empowering ODGJ in increasing income through creativity in making doormats is an effort that can provide social and economic benefits. Sidorejo is a village that has 41 ODGJ. People with mental disorders (ODGJ) are often considered less productive and cannot do work or skills that can produce results. This literature review aims to provide positive benefits and contribute to increasing the productivity of ODGJ. The Poskeswa self-help group (SHG) community development program aims to improve the social and economic capabilities of ODGJ in Sidorejo Village. This research aims to analyze efforts to empower ODGJ in increasing income through their creativity in making doormats and identify the empowerment program's positive impacts. Secondary data was obtained through the Sidorejo Health Post SHG report and information from the village midwife. This research shows that community development programs assist ODGJ through counselling individually and in groups using language signs. Through effective assistance, ODGJ in Sidorejo Village has life skills. Therefore, they can be independent, have a job, be creative and have an income that meets their daily needs.

SOSIALISASI MANFAAT TANAMAN TOGA DAN PENDAMPINGAN PRAKTEK BUDIDAYA BAGI IBU-IBU PKK DI DESA PANCAKARYA KECAMATAN AJUNG, JEMBER

Lemongrass is a plant which is classified as a medicinal plant or often shortened as tanaman toga in Indonesian language. Lemongrass has numerous benefits. After conducting a survey for several days in Pancakarya, the students of KKN Kolaboratif 82 found that the growth with abundance of lemongrass in the village was not utilized optimally. A lot of lemongrasses was left to dry on the roadside throughout the village. Alongside with this identified problem, the students of KKN Kolaboratif 82 strive to define the solution by doing socialization and accompaniment on planting the lemongrass. This event was held by cooperating with the Village Midwife, the members of PKK, and the cadres of Posyandu. This socialization aims to increase the understanding and awareness in terms of utilizing the potential of lemongrass in Pancakarya. The method which was used in carrying out the activities were problem identification, needs analysis, procurement of socialization as well as practices and assistance in growing lemongrass using polybag. The result evaluation was carried out by implementing a post-test. The results of the activity showed that the understanding of the participants in the socialization of the material provided increased significantly.