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The coverage of deliveries at health facilities in West Papua Province in 2019 only reached 55.39% and is one of the provinces with the lowest coverage rates in Indonesia. This coverage figure is still far from the national target of the Ministry of Health, which is 85%. The low coverage of deliveries in health facilities can be caused by several factors that vary in each district/city of West Papua Province. Spatial analysis was carried out to see the distribution of coverage along with the factors that might affect the coverage and to see the correlation between the determinant factors and the number of delivery coverage in health facilities. This research is ecology research that uses a spatial analysis approach and correlation. The data used is secondary data from the website of the Ministry of Health, the West Papua Provincial Health Office, and the Central Statistics Agency. The results of the spatial analysis show that there are 8 districts/cities with high scores, 3 districts with moderate scores, and 2 districts with low scores. Correlation analysis shows that HDI, ratio of health workers, and ratio of health facilities have no significant relationship to the coverage of deliveries in health facilities. Further research requires more specific factors or digging deeper into the factors that have been studied in West Papua Province.
Salah satu masalah dalam Program Pengendalian TB di Indonesia adalah ketidakpatuhan pasien dalam pengobatan sehingga putus obat dan mengakibatkan gagal konversi dan gagal pengobatan serta risiko menjadi kasus TB kebal obat. Salah satu provinsi dengan angka putus berobat melebihi angka nasional adalah Provinsi Riau, khususnya Kota Pekanbaru, terlebih pada angka putus berobat di Rumah sakit yang telah menerapkan strategi DOTS mencapai 15%. (Surveilens TB nasional, 2011). Angka putus berobat yang tinggi di Rumah sakit disebabkan antara lain oleh jarak yang jauh dari rumah, tidak ada petugas yang melacak pasien putus obat, jejaring yang tidak kuat antara Rumah sakit dan Puskesmas dan petugas TB Kabupaten/Provinsi. Tujuan Penelitian ini adalah melihat hubungan fasilitas pelayanan kesehatan TB DOTS dengan kesintasan kejadian putus berobat TB paru di Kota Pekanbaru. Desain Penelitian ini adalah menggunakan desain kohort retrospektif dengan melihat data surveilens pasien TB kota Pekanbaru yang terdaftar sepanjang tahun 2010 serta analisis yang digunakan adalah analisis survival menggunakan metode Kaplan Meier untuk melihat hubungan antara variabel dependen dan independen dan untuk pemodelan multivariatnya dilakukan dengan Regresi Cox. Sampel penelitian ini adalah 334 pasien yang berobat ke Puskesmas dan 120 pasien yang berobat ke Rumah sakit. Angka putus berobat pasien TB paru kasus baru di Kota Pekanbaru adalah 14,4%, dengan median waktu putus berobat 75 hari dan 73% pasien putus berobat tersebut tidak mengalami konversi atau sudah putus obat sebelum dievaluasi hasil pengobatan tahap intensifnya. Probabilitas kelangsungan pasien menyelesaikan pengobatannya adalah 62%. Angka putus berobat pasien TB paru kasus baru di Puskesmas sebesar 9% dengan probabilitas kumulatif kesintasan menyelesaikan pengobatannya sebesar 72%, sedangkan angka putus berobat pasien TB paru kasus baru di Rumah sakit sebesar 29%, dengan probabilitas kumulatif kesintasan menyelesaikan pengobatannya sebesar 50%. Pasien TB yang berobat di Fasyankes Rumah sakit memiliki kemungkinan untuk putus berobat sebesar 4.21 kali dibandingkan dengan pasien TB yang berobat di Puskesmas setelah dikontrol oleh variabel ketersediaan tenaga terlatih, dan jarak (Nilai p = 0.000). Untuk mengatasi masalah tersebut, diperlukan jejaring eksternal yang kuat antara Rumah sakit dengan dengan Dinas Kesehatan, laboratorium daerah, Puskesmas dan fasilitas pelayanan kesehatan lainnya untuk meningkatkan keberhasilan pengobatan, serta diharapkan Rumah sakit dapat memberikan pilihan tempat pengobatan kepada pasien pada sesaat setelah diagnosis, di Puskesmas wilayah tempat pasien tinggal atau tetap berobat di Rumah sakit dengan syarat harus patuh pada saat jadwal minum obat maupun harus datang ke RS pada waktu mengambil obat. Kata Kunci: Kesintasan, Putus obat, Rumah sakit, Puskesmas
One of the problems in the TB Control Program in Indonesia is a non-compliance of patients in the treatment of drug withdrawal and thus lead to failed conversions and failed treatment and Multi Drugs Resistance TB. One of the provinces with treatment dropout rate exceeds the national rate is Riau Province, Pekanbaru City in particular, especially in the hospitals that have implemented the DOTS strategy reached 15%. The purpose of this study is to see the relationship of health care facilities with a survival rate of TB patients that have treatment in DOTS Health Facility, in the city of Pekanbaru. The study design was a retrospective cohort design using by looking at the data surveillance of TB patients in Pekanbaru city registered during the year 2010 as well as the analysis used is the analysis of survival using the Kaplan-Meier to see the relationship between the dependent and independent variables for multivariate modeling performed with Cox regression. The research sample was 334 patients who went to health centers and 120 patients who went to the hospital. Treatment drop-out rate of new cases of pulmonary TB patients in the city of Pekanbaru in this study was 14.4%, with median treatment time of 75 days and drop in survival probability of new cases of pulmonary TB patients in the city of Pekanbaru in a complete treatment for 6 months was 87%. Treatment drop-out rate of new cases of pulmonary TB patients at health center by 9% with a median time of default of 120 days and the cumulative probability of survival in the complete treatment period of 6 months by 92%, while the dropout rate for treatment of new cases of pulmonary TB patients in the hospital for 29 % with a median time of 60-day default and the cumulative survival probability of complete treatment within 6 months by 73%. TB patients who seek treatment at hospital have a chance to drop out 4.21 times compared with TB patients who seek treatment at health centers once controlled by the variable availability of trained personnel and the distance (p-value = 0.000). To overcome these problems, it takes a strong external network of hospitals by the district health office, local laboratories, clinics and other health care facilities to improve treatment success, as well as the hospital is expected to provide treatment options to patients in shortly after diagnosis, the health center areas where patients live or stay for treatment at the Hospital but have to comply with the requirements at the time of the schedule to take medication and have come to the hospital at the time of taking the drug. Keyword: Survival, default, hospital, health center
ABSTRAK Nama : Yolanda Handayani Program Studi : Ilmu Kesehatan Masyarakat Peminatan Biostatistik Judul : Stunting pada Anak Usia di Bawah 2 Tahun di 3 Provinsi Sulawesi Tahun 2017 dengan Pendekatan Spasial Pembimbing : Dr. Martya Rahmaniati, S.Si., M.Si Pendahuluan: Seribu hari pertama kehidupan merupakan momentum kritis yang akan menentukan kualitas generasi masa depan suatu bangsa. Hal ini karena perlunya gizi terbaik berupa asupan gizi selama kehamilan, serta ASI dan makanan yang tepat sesuai umur untuk perkembangan otak anak. Metode: Penelitian ini menggunakan pendekatan kuantitatif dengan desain studi cross sectional. Analisis penelitian ini yaitu analisis prediksi menggunakan regresi logistik dan analisis spasial menggunakan GWR. Sampel penelitian ini berjumlah 2.232 individu dan 25 kabupaten/kota di Sulawesi Tengah, Sulawesi Tenggara dan Sulawesi Barat. Hasil: Hasil penelitian ini menunjukkan variabel suplementasi besi folat ibu, suplementasi vitamin A baduta usia 7-23 bulan, menyusui bayi usia 0-6 bulan dan pemberian MP–ASI baduta usia 7-23 bulan membentuk model prediksi. Model lokal spasial dibentuk oleh ibu hamil yang tidak suplementasi besi folat, baduta usia 7-23 bulan yang tidak mendapatkan MP–ASI, bayi usia 0-6 bulan yang tidak ASI Eksklusif dan bayi yang tidak mendapatkan pelayanan kesehatan, serta variabel persalinan tidak dibantu tenaga kesehatan menjadi model global spasial. Kesimpulan: Ibu hamil yang tidak suplementasi besi folat, baduta usia 7-23 bulan yang tidak mendapatkan MP–ASI, bayi usia 0-6 bulan yang tidak ASI Eksklusif dan bayi yang tidak mendapatkan pelayanan kesehatan akan memicu 58% kejadian stunting di 3 Provinsi Sulawesi, di mana variabel ibu hamil yang tidak mendapatkan suplementasi besi folat berhubungan secara statistik di 8 kabupaten/kota Provinsi Sulawesi Tengah. Oleh karena itu, diperlukan intervensi tambahan berupa suplementasi besi folat ibu hamil selain intervensi persalinan dibantu tenaga kesehatan di 8 kabupaten/kota Provinsi Sulawesi Tengah. Kata kunci: stunting, spasial, GWR
ABSTRACT Name : Yolanda Handayani Study Program : Public Health Sciences Biostatistics Specialization Title : Stunting in Child Under 2 Years of Age in 3 Sulawesi Province in 2017 with A Spatial Approach Counsellor : Dr. Martya Rahmaniati, S.Si., M.Si Background: The first thousand days of life is a critical momentum that will determine the quality of future generations of a nation. This is due to the need for the best nutrition for children in the form of nutritional intake during pregnancy and breast milk foods that are age-appropriate for the child's brain development. Method: This study uses a quantitative approach using a cross sectional study design. The analysis of this study is prediction analysis using logistic regression and spatial analysis using GWR. The sample in this study are 2,232 individuals and 25 districts in Central Sulawesi, Southeast Sulawesi and West Sulawesi. Results: The results showed variable maternal folate supplementation, supplementation of vitamin A baduta aged 7-23 months, breastfeeding infants aged 0-6 months and give complementary food baduta aged 7-23 months making predictive models. The spatial local model is made by pregnant women who are not iron folate supplementation, those aged 7-23 months who do not get complementary food, infants aged 0-6 months who are not exclusive breastfeeding and babies who are not health care, and labor-dependent variables are not supported health becomes a global spatial model. Conclusion: Pregnant women who are not iron folate supplementation, those aged 7-23 months who do not get complementary food, infants aged 0-6 months who are not exclusive breastfeeding and babies who do not receive health services will trigger 58% of the incidence of stunting in 3 Sulawesi provinces, in where the variable of pregnant women who did not receive iron folate supplementation was statistically related in 8 districts of Central Sulawesi Province. Therefore, additional intervention is needed in the form of iron folate supplementation for pregnant women in addition to labor interventions assisted by health workers in 8 districts of Central Sulawesi Province. Keywords: stunting, spasial, GWR
Menurut laporan MDG's tahun 2007, 30,7% masyarakat Indonesia tanpa akses sanitasi yang layak. Provinsi Banten memiliki masalah yang cukup besar terkait dengan masalah air, higiene dan sanitasi. Beberapa cakupan sanitasi dasar di Provinsi Banten merupakan cakupan terendah di Pulau jawa, seperti cakupan jamban keluarga pada tahun 2007 yang hanya 67,69 %. Kondisi sanitasi lingkungan yang buruk ini akhirnya menyebabkan masih seringnya terjadi KLB diare dan demam berdarah di Provinsi Banten. Selain itu kejadian demam tifoid dan malaria juga mengalami peningkatan dari tahun ke tahun.
Tujuan penelitian ini adalah untuk mengetahui risiko dan dampak sanitasi lingkungan terhadap status kesehatan balita di Provinsi Banten dengan menggunakan data sekunder hasil RISKESDAS 2007. Penelitian ini merupakan penelitian kuantitatif dengan desain cross sectional. Populasi dan sampel dari penelitian ini adalah balita (12 - 59 bulan).
Hasil penelitian menunjukkan bahwa balita yang pernah menderita sakit sebanyak 17,2%. Sedangkan faktor sanitasi lingkungan yang memiliki risiko terhadap status kesehatan balita adalah ketersediaan air bersih (OR = 1,6; 95%CI 1,2 - 2,3), sarana pembuangan air limbah (OR = 1,7; 95% CI 1,0 - 3,1) dan tempat penampungan air (OR = 1,9; 95%CI 1,2 - 2,9). Sarana pembuangan air limbah memberikan dampak yang paling besar diantara ketiga variabel yang berisiko, dimana jika di populasi, sarana pembuangan air limbah yang tidak memenuhi syarat diperbaiki, maka akan menurunkan kejadian sakit pada balita sebanyak 36,9%. Hasil penelitian ini menyarankan bahwa untuk mengurangi risiko dan dampak sanitasi lingkungan diperlukan upaya pengelolaan terhadap air, mulai dari air bersih sampai dengan air buangan.
According to the MDG's in 2007, 30.7% of Indonesian people without access to improved sanitation. Banten province has a considerable problem associated with the problem of water, hygiene and sanitation. Some basic sanitation coverage in Banten Province is the lowest coverage in Java, such as family latrine coverage in 2007 is only 67.69%. Conditions of poor environmental sanitation is still ultimately lead to frequent outbreaks of diarrhea and dengue fever in the province of Banten. In addition to the incidence of typhoid fever and malaria also increased from year to year.
The purpose of this study was to determine the risk and impact of environmental sanitation on the health status of children under five in Banten province by using secondary data from RISKESDAS 2007. This research is quantitative cross-sectional design. Population and sample of the study was a toddler (12-59 months).
The results showed that infants who have suffered from as much as 17.2%. While environmental sanitation factors that have exposure to the health status of children under five are the availability of clean water (OR = 1.6, 95% CI 1.2 to 2.3), wastewater disposal (OR = 1.7, 95% CI 1, 0 to 3.1) and a reservoir of water (OR = 1.9, 95% CI 1.2 to 2.9). Wastewater disposal provide the greatest impact among the three variables is at risk, which if in the population, wastewater disposal are not eligible eliminated, it will reduce the incidence of illness in infants as much as 36.9%. Results of this study suggest that to reduce the risk and impact of environmental sanitation to water management efforts are needed, ranging from clean water to waste water.
Breastfeeding is an easy way to reduce morbidity and mortality in infants and childrens. The delay in giving the first breast milk can be caused by the chosen method of birth such as vaginal or cesarean delivery. This study was conducted in a cross sectional and quantitative approach using the 2017 IDHS data to determine the relationship between cesarean delivery and Early Breastfeeding Initiation (EBFI) in DKI Jakarta Province. The sample used was women of childbearing age 15-49 years during the survey in DKI Jakarta Province who had their last child born in the last 2 years as many as 236 respondents. Univariate, bivariate statistical analysis was performed using chi-square (95% CI) and multivariate analysis with multiple logistic regression tests. The results of the analysis showed that mothers who gave birth by cesarean had 0.52 times [95% CI 0.27-1.01] times lower risk of having an EBFI than mothers who gave birth vaginally. Multivariate analysis in this study showed that mothers who delivered by cesarean had 0.54 times lower risk [95% CI 0.18-1.61] of having an EBFI compared to mothers who gave birth vaginally after controlled by variables such as education level, age, and economic status. It is concluded that policy making and providing interventions on how to implement and the importance of early breastfeeding initiation need to be carried out on mothers who have low levels of education, age under 35 years, low economic status, and who plan to give birth by cesarean delivery method.