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Ardhi Arsala Rahmani; Promotor: Dewi Susanna; Kopromotor: Tris Eryando; Penguji: Besral, Ririn Arminsih Wulandari, R. Azizah, Suwito, Ermi Ndoen
Abstrak:
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Latar belakang: Malaria merupakan penyakit yang disebabkan oleh parasit Plasmodium dan ditularkan melalui vektor nyamuk Anopheles. Kedua organisme tersebut merupakan makhluk hidup dengan daya tahan hidup dan kapasitas yang dipengaruhi oleh lingkungan sekitarnya, termasuk iklim. Oleh karena itu, berubahnya iklim akibat pemanasan global telah diasosiasikan dengan distribusi malaria global. Tujuan: Penelitian ini mengeksplorasi seberapa jauh hubungan antara faktor iklim dan kejadian malaria di kota dan kabupaten di Indonesia selama periode 2000-2020 untuk menginformasikan kebijakan pengendalian malaria yang berketahanan iklim. Metode: Dengan membangun variabel laten atau konstruk iklim yang terdiri dari indikator meteorologi yaitu suhu, curah hujan, kecepatan angin, dan kelembapan relatif yang didapatkan dari data NASA Langley Research Center (LaRC), serta menggabungkan variabel perancu sosiodemografis (pengeluaran rumah tangga, IPM, tingkat urbanisasi) dan geografis (Normalized Difference Vegetation Index, dan topografi), studi ini menawarkan analisis komprehensif tentang asosiasi mereka terhadap kejadian malaria (dari data Malaria Atlas Project dan Kementerian Kesehatan) melalui Structural Equation Modeling (SEM). Hasil: Temuan penelitian menunjukkan asosiasi antara iklim dan malaria. Kendati demikian, analisis Structural Equation Modeling (SEM) yang digunakan penelitian ini menunjukkan bahwa bobot faktor untuk iklim relatif kecil dan menunjukkan bahwa hubungannya tidak substansial dibandingkan dengan variabel lain. Analisis tambahan yang berfokus pada peristiwa cuaca ekstrem, yang diidentifikasi oleh nilai ekstrem indikator iklim, menunjukkan bahwa peristiwa tersebut secara signifikan mempengaruhi kasus malaria. Kesimpulan: Hal ini menekankan pentingnya mempertimbangkan cuaca ekstrem dalam perancangan dan pelaksanaan program pengendalian dan eliminasi malaria. Penelitian ini menyimpulkan bahwa meskipun kondisi iklim umum memiliki efek langsung yang terbatas pada kejadian malaria, peristiwa cuaca ekstrem memainkan peran penting.
Background: Malaria is a diseases caused by the parasite Plasmodium and spread by a vector, the Anopheles mosquito. The two independent organisms capacity to infect and survival are independently affected by their environmental surroundings, including climate. Therefore, the global warming induced climatic change have previously been associated with the changing global distribution of malaria. Aims: This research explores the extent of the relationship between climatic factors and malaria incidence in cities and regencies in Indonesia over the period 2000-2020 to inform malaria control policies that are climate-resilient. Methods: By constructing a climate construct as latent variable consisting of meteorological indicators such as temperature, precipitation, wind speed, and relative humidity from the NASA Langley Research Center (LaRC), and incorporating sociodemographic confounders (household expenditure, HDI, urbanization rate) and geographic confounders (Normalized Difference Vegetation Index and topography), this study offers a comprehensive analysis of their association with malaria cases (using data from the Malaria Atlas Project and Ministry of Health) through Structural Equation Modeling (SEM). Results: The study findings show an association between climate and malaria, with maximum and average climate constructs showing a negative association with malaria incidence, while minimum climate constructs show a positive association. That being said, the Structural Equation Modeling (SEM) analysis used in this research indicates that the factor loadings for climate are relatively small, indicating that the relationship is not substantial compared to other variables. Additional analysis focusing on extreme weather events, identified by extreme values of climate indicators, shows that these events significantly affect malaria cases. Conclusion: This underscores the importance of considering extreme weather in the design and implementation of malaria control and elimination programs.This research concludes that while general climatic conditions have limited direct effects on malaria incidence, extreme weather events play an important role.
D-525
Depok : FKM-UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
☉
Mugi Wahidin; Promotor: Anhari Achadi; Kopromotro: Besral, Soewarta Kosen; Penguji: Atik Nurwahyuni, Mardiati Nadjib, Sudarto Ronoatmodjo, Ekowati Rahajeng; Masdalina Pane
Abstrak:
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Latar belakang: Diabetes Melitus (DM) menjadi salah satu masalah kesehatan masyarakat terbesar di dunia dan di Indonesia yang menjadi target pengendalian secara global dan nasional. Penelitian tentang proyeksi beban DM dengan memasukkan pengaruh faktor risiko dan program pencegahan dan pengendalian DM di Indonesia sangat terbatas. Tujuan penelitian ini adalah untuk membuat model proyeksi beban penyakit Diabetes Melitus di Indonesia berdasarkan faktor risiko dan program pencegahan dan pengendalian DM. Metode: Penelitian ini merupakan penelitian kuantitatif non-experiment menggunakan desain cross sectional study melalui pembuatan model regresi linier ganda dan system dynamics. Model proyeksi prevalens baseline dibuat berdasarkan faktor risiko, program pencegahan dan pengendalian DM. Proyeksi sampai 2045 melibatkan dinamisasi faktor risiko dan program DM, proyeksi penduduk, case fatality rate DM, unit cost DM, standar tarif pemeriksaan gula darah, dan inflasi kesehatan. Faktor risiko termasuk overweight, obesitas sentral, obesitas, konsumsi makanan manis, konsumsi minuman manis, konsumsi makanan berlemak, kurang konsumsi buah dan sayur, kurang aktivitas fisik, hipertensi, dan merokok. Program DM meliputi rasio Posbindu PTM, Desa Ber Posbindu PTM, Pemeriksaan di Posbindu PTM, Puskesmas dengan Pelayanan Terpadu PTM, pemeriksaan rutin gula darah, standar pelayanan minimal (SPM) pelayanan kesehatan DM, dan SPM skrining usia produktif. Model dibuat berdasarkan data dari 205 kabupaten/kota di 33 provinsi di Indonesia. Proyeksi dibuat secara nasional, provinsi, dan kabupaten/kota berupa prevalens, kematian, biaya langsung, dan jumlah dan biaya skrining gula darah. Penelitian ini menggunakan data sekunder dari Riset Kesehatan Dasar (Riskesdas) 2007-2018, BPJS Kesehatan 2016-2020, program P2PTM 2016-2020, dan Pusdatin Kemkes 2019-2021. Unit analisis adalah kabupaten/kota. Hasil: Model proyeksi DM menggunakan regresi linier ganda dengan formula prevalensi DM = -2,212 + 0.216 prevalens overweight +0,017 prevalens obesitas + 0,112 prevalens obesitas sentral +0,019 prevalens konsumsi makanan berlemak – 0,001 Persentase Desa Ber-Posbindu PTM + 0,003 Persentasi Pandu PTM + 1,510 prevalensi rutin diperiksa gula darah – 0.012 cakupan SPM yankes DM + 0,008 cakupan SPM skrining usia produktif. Prevalensi DM di Indonesia diperkirakan meningkat dari 9,19% pada 2020 (18,69 juta kasus) menjadi 16,09% pada 2045 (40,7 juta kasus), naik 75,1% selama 25 tahun, atau 3% per tahun. Prevalensi DM akan lebih rendah menjadi 15,68% atau 39,6 juta kasus (berkurang 5,54%) pada 2045 jika dilakukan intervensi peningkatan cakupan desa ber-posbindu dan SPM yankes DM menjadi 100%, dan menjadi 9,22% atau 23,2 juta kasus (berkurang 42,69%) jika intervensi program tersebut ditambahkan dengan pencegahan laju faktor risiko (overweight, obesitas, obesitas sentral dan konsumsi makanan berlemak). Di tingkat provinsi dan kabupaten/kota, prevalensi dan jumlah kasus meningkat dan sangat bervariasi. Proyeksi jumlah kematian akibat DM di Indonesia meningkat dari 433.752 pada 2020 menjadi 944.468 pada 2045, naik 117% selama 25 tahun atau 4,7% per tahun. Kematian akibat strok pada DM meningkat dari 52,397 pada 2020 menjadi 114,092 pada 2045. Kematian akibat IHD pada DM meningkat dari 35.351 pada 2020 menjadi 76.974 pada 2045. Sedangkan kematian akibat penyakit ginjal kronik pada DM meningkat dari 29.061 pada 2020 menjadi 63.279 pada 2045. Jumlah kematian pada 2045 lebih rendah menjadi 919.206 jika dilakukan intervensi program dan menjadi 537.190 jika dilakukan intervensi program dan menahan laju faktor risiko. Jumlah kematian akibat DM dan komplikasinya di provinsi dan kabupaten/kota meningkat dan sangat bervariasi. Biaya langsung (direct cost) DM meningkat dari Rp 37,36 triliun pada 2020 menjadi Rp 81,38 triliun pada 2045, meningkat 117,76% selama 25 tahun atau 4,71% per tahun. Jika dilakukan intervensi peningkatan program maka dapat diturunkan menjadi Rp 79,31 triliun (berkurang 2,54%) dan menjadi Rp 46,53 triliun (berkurang 42,82%) jika intervensi ditambah menahan laju faktor risiko. Di tingkat provinsi dan kabupaten/kota, biaya langsung DM mengalami kenaikan dan bervariasi antara daerah. Jumlah penduduk berusia 15-39 tahun dengan obesitas dan usia 40 tahun ke atas yang perlu diskrining gula darah di Indonesia pada 2020 diperkirakan 116.387.801 menjadi 171.913.086 orang pada 2045, meningkat 47,8% selama 25 tahun atau 1,9% per tahun. Biaya skrining Rp 2,39 trilliun pada 2020 meningkat menjadi Rp 3,53 trilliun pada 2045. Di provinsi dan kabupaten/kota, jumlah dan biaya skrining meningkat dan bervariasi. Proyeksi DM di Indonesia dan aplikasi perhitungan proyeksi dapat dilihat di www.diabetes-ina.com. Hasil proyeksi sudah dinyatakan sudah baik setelah dibahas dengan para ahli dan mempunyai Mean Absolute Percentage Error (MAPE) sebesar 13% (baik) untuk proyeksi provinsi dan nasional serta 22% (layak) untuk proyeksi kabupaten/kota. Hasil penelitian ini dapat digunakan untuk bahan perencanaan SDM, skrining, dan biaya pengobatan DM di Indonesia baik tingkat pusat, provinsi, maupun kabupaten/kota.
Background: Diabetes Mellitus (DM) is one of the biggest public health problems in the world and in Indonesia which is targeted for control globally and nationally. Research on DM burden projection by including the influence of risk factors and DM prevention and control programs in Indonesia is very limited. The purpose of this study is to make a projection model of the burden of Diabetes Mellitus in Indonesia based on risk factors and DM prevention and control programs. Method: The study was a quantitative non-experiment study using cross sectional study design through the creation of multiple linear regression models and system dynamics. The baseline prevalence projection model is based on risk factors, DM prevention and control programs. Projections until 2045 involved the dynamization of risk factors and DM programs, population projections, DM case fatality rate, DM unit costs, tariffs standard of blood glucose screening, and health inflation. Risk factors included overweight, central obesity, obesity, consumption of sugary foods, consumption of sugary drinks, consumption of fatty foods, lack consumption of fruits and vegetables, lack of physical activity, hypertension, and smoking. The DM program included the ratio of NCD Post (Posbindu), percentage of Village had Posbindu, Examination at Posbindu, Puskesmas with Integrated NCD Services (Pandu), routine blood glucose checks, minimum service standards (SPM) of DM health services, and SPM of productive age screening. The model was created based on data from 205 districts/cities in 33 provinces in Indonesia. Projections was made nationally, provincially, and districts in terms of prevalence, mortality, direct costs, and the number and cost of blood glucose screening. This study used secondary data from Basic Health Research (Riskesdas) 2007-2018, BPJS Kesehatan 2016-2020, NCD programs 2016-2020, and Pusdatin Ministry of Health 2019-2021. The analysis unit is the district/city. Results: DM projection model using multiple linear regression with DM prevalence formula = -2.212 + 0.216 overweight prevalence + 0.017 obesity prevalence + 0.112 central obesity prevalence + 0.019 prevalence of fatty food consumption – 0.001 percentage of villages with Posbindu + 0.003 NCD integrated services percentage + 1.510 prevalence of routine blood glucose checks – 0.012 SPM coverage of DM services + 0.008 SPM of productive age screening coverage. The prevalence of DM in Indonesia is estimated to increase from 9.19% in 2020 (18.69 million cases) to 16.09% in 2045 (40.7 million cases), increase 75.1% over 25 years, or 3% per year. The prevalence of DM will be lower to 15.68% or 39.6 million cases (reduced by 5.54%) in 2045 if interventions are carried out to increase the coverage of Posbindu villages and SPM DM services to 100%, and to 9.22% or 23.2 million cases (reduced by 42.69%) if the program interventions are added with prevention of risk factor rates (overweight, obesity, central obesity and consumption of fatty foods). At the provincial and district/city levels, the prevalence and number of cases are increasing and vary greatly. The projected number of deaths due to DM in Indonesia increases from 433,752 in 2020 to 944,468 in 2045, increase 117% over 25 years or 4.7% per year. Deaths due to stroke among DM increases from 52,397 in 2020 to 114,092 in 2045. Deaths from IHD among DM increases from 35,351 in 2020 to 76,974 in 2045. Meanwhile, deaths from chronic kidney disease among DM increases from 29,061 in 2020 to 63,279 in 2045. The number of deaths in 2045 could be lower to 919,206 if program interventions are carried out and to 537,190 if program interventions are carried out and halt the rate of risk factors. The number of deaths due to DM and its complications in provinces and districts / cities is increasing and varies greatly. DM direct costs increased from Rp 37.36 trillion in 2020 to Rp 81.38 trillion in 2045, an increase of 117.76% over 25 years or 4.71% per year. If the program improvement intervention is carried out, it can be reduced to Rp 79.31 trillion (reduced by 2.54%) and to Rp 46.53 trillion (reduced by 42.82%) if the intervention is added to halt the rate of risk factors. At the provincial and district/city levels, DM direct costs have increased and vary between regions. The number of people aged 15-39 years with obesity and aged 40 years and above who need to be screened for blood glucose in Indonesia in 2020 is estimated at 116,387,801 to 171,913,086 people in 2045, an increase of 47.8% over 25 years or 1.9% per year. Screening costs of Rp 2.39 trillion in 2020 will increase to Rp 3.53 trillion in 2045. In provinces and districts, the number and cost of screening are increasing and varying. DM projections in Indonesia and projection calculation applications can be seen at www.diabetes-ina.com. The projection results have been declared good after discussion with experts and have an Absolute Mean Percentage Error (MAPE) of 13% (good) for provincial and national projections and 22% (feasible) for district/city projections. The results of this study can be used for human resource planning, screening, and DM treatment costs in Indonesia at the central, provincial, and district / city levels.
D-478
Depok : FKM-UI, 2023
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Tati Suryati; Promotor: Hasbullah Thabrany; Ko-Promotor: Nasrin Kodim, Soewarta Kosen; Penguji: Anhari Achadi, Sri Moertiningsih Adioetomo, Mardiati Nadjib, Trihono, Rustika
D-281
Depok : FKM-UI, 2013
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Margareta Maria Sintorini; Pembimbing: Haryoto Kusnoputranto, Singgih H. Sigit, Muhammadi Siswosudarmo; Penguji: Umar Fahmi Achmadi, Sudomo, I Made Djaja, Tri Edhi Budhi Soesilo
D-117
Depok : FKM-UI, 2006
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Semuel Piter Irab; Pembimbing: Ratna Djuwita; Penguji: Diah Mulyawati Utari, Besral, Kusharisupeni, Rita Damayanti, Sutanto Priyo Hastono, Abas Basuni Juhari, Trihono
Abstrak:
Disertasi ini adalah menggambarkan perubahan prevalensi balita stunting pada Kabupaten/Kota kategori membaik dan Kabupaten/Kota kategori memburuk di Indonesia dari tahun 2007 ke tahun 2013. Metode cross sectional studi, sampel yaitu 163 Kabupaten/Kota, sumber data sekunder Balitbangkes dan Kementerian Keuangan. Uji statistik t-test dan diskriminan. Hasil: perubahan prevalensi balita stunting pada 49 Kabupaten/Kota kategori membaik 30,1%, dan 114 Kabupaten/kota kategori memburuk 69,9%. Sembilan cakupan program kesehatan dan sosial pada Kabupaten/Kota kategori membaik yang memiliki perubahan lebih besar dari Kabupaten/Kota kategori memburuk yaitu prevalensi BBLR, cakupan penimbangan balita ≥ 4 kali, cakupan vitamin A, cakupan imunisasi lengkap, persentase ketersediaan air bersih, persentase pengelolaan sampah diangkut petugas kebersihan, persentase ketersediaan jamban keluarga, persentase cuci tangan pakai sabun, dan persentase KK pegawai negeri sipil. Lima cakupan program kesehatan dan sosial pada Kabupaten/Kota ketegori memburuk yang perubahannya tidak jauh berbeda dari Kabupaten/Kota kategori membaik yaitu cakupan ANC-K4, prevalensi KEK ibu hamil, prevalensi TB-Paru balita, indeks kapasitas fiskal, dan persentase KK pendidikan tinggi. Delapan cakupan program kesehatan dan sosial dengan akurasi perubahan prevalensi balita stunting pada Kabupaten/Kota kategori membaik 83,7% dan Kabupaten kategori memburuk 92,1% yaitu cakupan timbangan balita ≥ 4 kali, cakupan imunisasi lengkap, cakupan ANC-K4, persentase sampah diangkut petugas kebersihan, persentase ketersediaan jamban keluarga, persentase cuci tangan pakai sabun, indeks kapasitas fiskal, dan persentase KK PNS
This dissertation is describing changes in the prevalence of stunting toddlers the Regencies/ Cities category improves and deteriorates in Indonesia, from 2007 to 2013. Cross sectional study method, samples are 163 Regencies/Cities, secondary data source Balitbangkes and Ministry of Finance. T-test and discriminant statistical test. Results: changes in the prevalence of stunting toddlers 49 Regencies/Cities category improved 30.1%, and 114 Regencies/Cities category deteriorated 69,9%. Nine coverage of health and social programs the Regencies/Cities category improved which has a change greater than Regencies/Cities category deteriorated namely the prevalence of LBW, toddler weighing coverage ≥ 4 times, vitamin A coverage, complete immunization coverage, percentage of availability of clean water, percentage of waste management carried by janitors, percentage of availability of family latrines, percentage of hand washing with soap, and the percentage of family heads of civil servants. Five coverage of health and social programs in the Regencies/Cities category deteriorated, whose changes are not much different from the Regencies/Cities category improved namely ANC-K4 coverage, prevalence of less chronic energy in pregnant women, prevalence of toddler pulmonary TB, fiscal capacity index, and the percentage of family heads of higher education. Eight coverage of health and social programs with accuracy changes in the prevalence of stunting toddlers at the Regencies/ Cities category improved 83,7% and Regencies/Cities category deteriorated 92.1% namely toddler weighing coverage ≥ 4 times, complete immunization coverage, ANC-K4 coverage, percentage of waste management carried by janitors, percentage of availability of family latrines, percentage of hand washing with soap, fiscal capacity index, and the percentage of family heads of civil servants
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This dissertation is describing changes in the prevalence of stunting toddlers the Regencies/ Cities category improves and deteriorates in Indonesia, from 2007 to 2013. Cross sectional study method, samples are 163 Regencies/Cities, secondary data source Balitbangkes and Ministry of Finance. T-test and discriminant statistical test. Results: changes in the prevalence of stunting toddlers 49 Regencies/Cities category improved 30.1%, and 114 Regencies/Cities category deteriorated 69,9%. Nine coverage of health and social programs the Regencies/Cities category improved which has a change greater than Regencies/Cities category deteriorated namely the prevalence of LBW, toddler weighing coverage ≥ 4 times, vitamin A coverage, complete immunization coverage, percentage of availability of clean water, percentage of waste management carried by janitors, percentage of availability of family latrines, percentage of hand washing with soap, and the percentage of family heads of civil servants. Five coverage of health and social programs in the Regencies/Cities category deteriorated, whose changes are not much different from the Regencies/Cities category improved namely ANC-K4 coverage, prevalence of less chronic energy in pregnant women, prevalence of toddler pulmonary TB, fiscal capacity index, and the percentage of family heads of higher education. Eight coverage of health and social programs with accuracy changes in the prevalence of stunting toddlers at the Regencies/ Cities category improved 83,7% and Regencies/Cities category deteriorated 92.1% namely toddler weighing coverage ≥ 4 times, complete immunization coverage, ANC-K4 coverage, percentage of waste management carried by janitors, percentage of availability of family latrines, percentage of hand washing with soap, fiscal capacity index, and the percentage of family heads of civil servants
D-408
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
☉
Aryo Wibowo Hendra Putro; Promotor: Fatma Lestari; Kopromotor: Robiana Modjo; Penguji: Dadan Erwandi, L. Meily Widjaja, Waluyo, Audist Subekti, Alfajri Ismail; Suparni, Herlina J. EL-Matury
Abstrak:
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Stasiun Pengisian Bahan Bakar Umum (SPBU) merupakan fasilitas penjualan Bahan Bakar Minyak (BBM) ke masyarakat yang memiliki potensi bahaya dan berisiko tinggi terjadi kecelakaan. Selama tahun 2017-2018 telah terjadi 120 kecelakaan SPBU di Indonesia. Dua faktor utama yang berkontribusi terhadap kecelakaan, yaitu faktor manusia dan faktor organisasi. Tujuan dari penelitian ini menghasilkan instrumen pengukuran iklim keselamatan dan perilaku keselamatan konsumen SPBU serta model perilaku konsumen dan iklim keselamatan di SPBU yang memiliki nilai kebaruan dan orisinalitas. Tahap pertama dalam penelitian adalah penyusunan parameter ukur perilaku selamat dengan menggunakan referensi studi literatur. Pengukuran perilaku selamat dilakukan dengan mengumpulkan data dari pekerja SPBU di seluruh Indonesia dan masyarakat konsumen SPBU di wilayah Jawa Barat melalui kuesioner daring. Hasil pengumpulan data dianalisis secara kuantitatif menggunakan PLS-SEM. Hasil analisis penelitian menunjukkan bahwa variabel iklim keselamatan SPBU yang memiliki pengaruh signifikan terhadap kepatuhan dan partisipasi keselamatan pekerja, yaitu komitmen manajemen dan pemberdayaan keselamatan melalui mediasi variabel komunikasi keselamatan, aturan dan prosedur keselamatan, serta pelatihan keselamatan. Pada model perilaku selamat konsumen SPBU, Komunikasi operator, rambu keselamatan, media promosi, dan regulasi pemerintah secara signifikan mempengaruhi perilaku selamat konsumen melalui mediasi variabel norma, sikap, persepsi ancaman, serta persepsi benefit & barrier. Penelitian ini memiliki nilai manfaat yang tinggi karena menghasilkan 27 butir rekomendasi untuk pemerintah, badan usaha niaga migas, dan pengelola SPBU. Selain itu hasil penelitian ini dapat dikembangkan pada 6 topik penelitian lanjutan.
Fuel Stations are facilities for selling fuel to the public which has a potential hazard and a high risk of accidents. During 2017-2018 there were 120 gas station accidents in Indonesia. Two main factors contribute to accidents, namely human factors and organizational factors. The purpose of this research is to produce an instrument for measuring safety climate and consumer safety behavior at petrol stations as well as a model for consumer behavior and safety climate at gas stations, which are novel and original. The first stage of the research was the preparation of parameters for measuring safe behavior using references to literature studies. Measurement of safe behavior is carried out by collecting data from gas station workers throughout Indonesia and gas station consumers in West Jawa Province through online questionnaires. The results of data collection were analyzed quantitatively using PLS-SEM. The results of the research analysis show that the variables of gas station safety climate that significantly influence safety compliance and participation are namely management commitment and management empowerment, with safety communication, safety rules and procedures, and safety training as mediators. In the gas station consumer safety behavior model, operator communication, safety signs, promotion media, and government regulation significantly influence consumer safety behavior with norms, attitudes, perceived threat, and perceived benefit & barrier as mediators. This research has great value with 27 recommendations for the government, the oil and gas enterprise with downstream permit, and fuel station owners. This study results can also be expanded to more 6 new research topics.
D-499
Depok : FKM-UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
☉
Khadijah Azhar; Promotor: Bambang Wispriyono; Kopromotor: Ririn Arminsih Wulandari, Dwi Hapsari Tjandrarini; Penguji: Budi Hartono, Budi Haryanto, Tris Eryando, Miko Hananto, Dede Tarmana
Abstrak:
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Perubahan iklim berpotensi meningkatkan risiko penyakit berbasis lingkungan, termasuk diare. Di Indonesia, prevalensi diare balita masih tergolong tinggi, meskipun menurun dari 12,3% (Riskesdas 2018) menjadi 9,8% (SSGI 2020). Kondisi ini menunjukkan adanya faktor lain yang memengaruhi, termasuk parameter iklim yang belum banyak diteliti secara spesifik dalam konteks Indonesia.
Penelitian ini bertujuan untuk mengembangkan model prediksi risiko diare secara komparatif pada dua zona iklim berbeda: monsunal (Nusa Tenggara Barat) dan ekuatorial (Sumatera Barat). Desain penelitian adalah studi ekologi, dengan data sekunder tahun 2017-2021 yang diperoleh dari Kementerian Kesehatan (kasus diare), BPS (akses air minum tidak aman, sanitasi terbatas, higiene terbatas, status ekonomi dan kepadatan penduduk), dan BMKG (suhu udara, kelembapan, curah hujan). Analisis dilakukan menggunakan regresi binomial negatif.
Hasil menunjukkan bahwa curah hujan berhubungan signifikan terhadap kejadian diare di Sumbar (IRR=0,998) dan NTB (IRR=1,002). Suhu udara hanya signifikan di Sumbar (IRR= 0,955), sedangkan kelembapan hanya signifikan di NTB (IRR=0,954). Akses air minum tidak aman dan sanitasi terbatas berhubungan signifikan di kedua provinsi, sedangkan higiene terbatas tidak menunjukkan hubungan signifikan. Tingkat kemiskinan berpengaruh signifikan hanya di NTB (IRR=1,025). Model prediksi menunjukkan performa yang baik, meskipun akurasinya berada pada kategori rendah hingga sedang.
Kesimpulannya, variabilitas iklim berkontribusi terhadap risiko diare dengan pola yang berbeda antarwilayah. Faktor lokal seperti letak geografis, infrastruktur, dan ketersediaan layanan dasar—khususnya akses terhadap air minum aman dan sanitasi layak—memegang peran penting. Diperlukan penguatan kolaborasi lintas sektor dan keterlibatan masyarakat untuk pengendalian diare yang adaptif terhadap perubahan iklim.
Climate change can exacerbate environment-related disease, including diarrhea. In Indonesia, diarrhea prevalence among children under five remains high, although it declined from 12,3% (Basic Health Research, 2018) to 9,8% (National Health Survey, 2020). This indicates the influence of additional factors, including climatic parameters that have not been thoroughly examined in the Indonesian context.
This study developed a comparative diarrhea risk prediction model across two climate zones: monsunal (West Nusa Tenggara) and equatorial (West Sumatera). An ecological design was employed using 2017-2021 secondary data from the Ministry of Health (diarrhea cases), the Central Bureau of Statistics (BPS) (unsafe drinking water access, sanitation, hygiene, economic status, population density), and the Meteorology, Climatology, and Geophysics Agency (BMKG) (temperature, humidity, rainfall). Data were analyzed using negative binomial regression.
Rainfall was significantly associated with diarrhea incidence in both provinces (West Sumatera IRR = 0,998; West Nusa Tenggara IRR = 1,002). Air temperature was significant only in West Sumatera (IRR = 0,955), while humidity was significant only in West Nusa Tenggara (IRR = 0,954). Unsafe water access and poor sanitation were significant in both provinces, whereas hygiene showed no association. Poverty was significant only in West Nusa Tenggara (IRR = 1,025). The model performed well, with accuracy in the low-to-moderate range.
In conclusion, climate variability contributes to diarrhea risk, with distinct patterns across regions. Local factors such as geography, infrastructure, and the availability of basic services— particularly access to safe drinking water and adequate sanitation—play a crucial role. Strengthening cross-sectoral collaboration and community engangement is essential for developing climate-adaptive diarrhea control strategies.
D-599
Depok : FKM-UI, 2025
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Milla Herdayati; Pembimbing: Budi Utomo; Penguji: Tris Eryando, Ratna Djuwita, Meiwita P. Budiharsana, Kemal Nazaruddin Siregar, Wendy Hartanto, Sri Sunarti Purwaningsih, Yayat Supriyatna
Abstrak:
ABSTRAK Nama : Milla Herdayati Program : Kesehatan Masyarakat Judul : Pola commuting, Peran Gender dan Kualitas Hidup Komuter: Studi Kasus di Tiga Kota Metropolitan di Indonesia. Mobilitas ulang alik (commuting) telah menjadi fenomena global di seluruh kota-kota metropolitan di dunia termasuk Indonesia. Kegiatan perekonomian/bisnis cenderung berada di pusat kota, mengharuskan mereka bermobilitas (commuting) untuk bekerja. Mereka berhadapan kemacetan/kepadatan, polusi, durasi commuting yang panjang, hal ini diperberat buruknya sistem transportasi publik. Pada perempuan kondisi tersebut menjadi permasalahan tersendiri, dikarenakan perempuan bekerja tidak serta merta dapat melepaskan peran domestiknya. Tujuan studi ini menganalisis apakah commuting berkaitan dengan kualitas hidup komuter, dan apakah peran gender memodifikasi pengaruh commuting terhadap kualitas hidup komuter. Studi ini menggunakan data Badan Pusat Statistik (BPS) pada tiga Kawasan Metropolitan di Indonesia, yaitu Jabodetabek tahun 2014, Mebidang dan Sarbagita tahun 2015. Sampel studi: Pekerja komuter berusia 15-65 tahun di wilayah tersebut dengan kriteria eksklusi adalah commuting dengan berjalan kaki/bersepeda (active commuting). Untuk memperkaya studi ini dilakukan studi kualitatif. Temuan studi ini membuktikan adanya commuting paradox pada komuter, perempuan memiliki pola commuting yang khas multi-trips dan multi-destinatios. Temuan lain studi pola commuting berhubungan negative dengan kualitas hidup lebih baik belum dapat dibuktikan. Peran gender berpengaruh terhadap negative terhadap kualitas hidup komuter. Selain itu efek commuting terhadap kualitas hidup berbeda menurut kewilayahan. Beberapa rekomendasi studi ini bahwa beban commuting harus diminimalisir dengan mengembangkan sistem transportasi public yang handal dan humanis dan ramah perempuan, serta dan juga mendorong penggunaan transportasi massal lewat dengan kampanye dari perspektif kesehatan masyarakat. Keywords Commuting, peran gender, kualitas hidup, transportasi publik ABSTRACT Name : Milla Herdayati Study Program : Public Health Title : Commuting Patterns, Gender Roles and Quality of Life of Commuters: Case Study in Three Metropolitan Cities in Indonesia. Commuting has become a global phenomenon in various metropolitan cities in the world including Indonesia. Economic and business activities tend to be located in the city center has requires people live suburb area to commute to work. The people facing several problems such as traffic, pollution, long duration of commuting also poor transportation system. For women, this condition becomes a real problem, because women have dual role within the households. The purpose of this study is to analyze whether commuting have an impact for the quality of life of commuters, and whether gender roles also influence of commuting on the quality of life. This study uses 2015 and 2014 Central Bureau of Statistics (BPS) data on three municipality in Indonesia, namely Jabodetabek (Jakarta, Bogor, Depok Tangerang and Bekasi) and Mebidang (Medan, Binjai, dan Deli Serdang) and Sarbagita (Denpasar, Badung, Gianyar dan Tabanan). Sample study: Commuter workers aged 15-65 years within three municipality with exclusion criteria are walker and people whose work by cycling (active commuting). To enrich this study a qualitative study was conducted. The findings of this study prove the existence of commuting paradoxes in commuters, women have a commuting pattern that is typical of multi-trips and multi-destinations and commuters with minor gender roles have a better quality of life. In addition, the effects of commuting on quality of life differ according to region/area. Some recommendations from this study that the burden of commuting must be minimized by developing a reliable public transportation system that is friendly to women, and providing subsidies for low-income commuters, and also encouraging the use of mass transportation through campaigns from a public health perspective. Keywords Commuting, gender roles, quality of life, public transportation
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D-406
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Fauzan Budi Prasetya; Pembimbing: Putri Bungsu; Penguji: Ratna Djuwita Hatma, Uswatun Hasanah
Abstrak:
Diabetes adalah salah satu penyebab kematian tertinggi di dunia. Indonesia merupakansalah satu negara dengan angka diabetes tertinggi. Aktivitas fisik merupakan salah satufaktor risiko penyakit diabetes yang dapat dimodifikasi. Penelitian ini bertujuan untukmengetahui kuatnya hubungan aktivitas fisik pada berbagai tingkat dengan penyakitdiabetes setelah dikontrol oleh variabel confounding. Penelitian ini merupakan analisislanjut Indonesian Family Life Survey Tahun 2014 (IFLS 2014). Metodologi penelitianyang digunakan dalam penelitian ini adalah cross-sectional dengan uji multivariat.Setelah dikontrol oleh variabel tempat tinggal, aktivitas fisik sedang (OR = 1,62 CI 95%:1,21 - 2,18) dan aktivitas fisik rendah (OR = 1,94 CI 95% = 1,47 - 2,56) lebih berisikodibandingkan aktivitas fisik tinggi untuk penyakit diabetes. Intervensi yang dapatdilakukan antara lain sinergitas antar lembaga seperti kementerian dan lembagapemerintah, lembaga swasta, non-profit, dan BPJS Kesehatan untuk program optimalisasiprogram aktivitas fisik yang sesuai dengan gaya hidup masyarakat urban sertameningkatkan fasilitas pendukung yang memadai untuk beraktivitas fisik tingkat sedanghingga berat di area perkotaan.Kata kunci:Diabetes, aktivitas fisik, IFLS 2014, cross-sectional
Diabetes is one of the leading death causes in the world. Indonesia is one of the highestrates of death caused by diabetes. Physical activity is one of the modifiable diabetes riskfactors. This study focuses on understanding association of physical activity in differencelevels and diabetes after being controlled by confounding variables. This study is ananalysis of Indonesian Family Life Survey Tahun 2014 (IFLS 2014). Researchmethodology in this study is cross-sectional with multivariate analysis. After beingcontrolled by residential area variable, moderate physical activity (OR = 1,62 CI 95%1,21 - 2,18) and low physical activity (OR = 1,94 CI 95% = 1,47 - 2,56) have higher riskcompared to high physical activity for diabetes. Health interventions that are feasible tobe executed are synergy between all departments and government bodies, the privatesector, non-profit, and BPJS Kesehatan (National Health Insurance) for optimization ofphysical activity program that is suitable for urban lifestyle and encouraging adequateinfrastructures and facilities for people in urban areas to be able to do moderate until highphysical activity.Key words:Diabetes, physical acitivity, IFLS 2014, cross-sectiona.
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Diabetes is one of the leading death causes in the world. Indonesia is one of the highestrates of death caused by diabetes. Physical activity is one of the modifiable diabetes riskfactors. This study focuses on understanding association of physical activity in differencelevels and diabetes after being controlled by confounding variables. This study is ananalysis of Indonesian Family Life Survey Tahun 2014 (IFLS 2014). Researchmethodology in this study is cross-sectional with multivariate analysis. After beingcontrolled by residential area variable, moderate physical activity (OR = 1,62 CI 95%1,21 - 2,18) and low physical activity (OR = 1,94 CI 95% = 1,47 - 2,56) have higher riskcompared to high physical activity for diabetes. Health interventions that are feasible tobe executed are synergy between all departments and government bodies, the privatesector, non-profit, and BPJS Kesehatan (National Health Insurance) for optimization ofphysical activity program that is suitable for urban lifestyle and encouraging adequateinfrastructures and facilities for people in urban areas to be able to do moderate until highphysical activity.Key words:Diabetes, physical acitivity, IFLS 2014, cross-sectiona.
S-10232
Depok : FKM UI, 2019
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Musafah; Promotor: Tris Eryando; Kopromotor: Martya Rahmaniati Makful, Meiwita Paulina Budiharsana; Penguji: Besral, Kemal Nazaruddin Siregar, Wendy Hartanto, Sudibyo Alimoeso
Abstrak:
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Unmet need KB di Indonesia belum mencapai target khususnya di Pulau Kalimantan. Penurunan unmet need KB dapat mencegah kematian ibu. Adanya desentralisasi menuntut pemerintah daerah membuat kebijakan kesehatan seperti program KB. Analisis spatio-temporal dibutuhkan untuk menyelidiki unmet need KB yang berguna untuk memantau program KB. Tujuan penelitian ini adalah mengetahui pola spasial dan faktor-faktor yang mempengaruhi unmet need KB tahun 2018-2021 di tingkat Kabupaten/Kota di Pulau Kalimantan, Indonesia. Studi ekologi dilakukan pada 56 Kabupaten/kota di Pulau Kalimantan pada tahun 2018-2021. Data berbentuk agregat dan bersumber dari Laporan Pengendalian dan Pelayanan Kontrasepsi BKKBN, Buku Publikasi Badan Pusat Statistik (BPS) dan Website Dewan Jaminan Sosial Sistem Informasi Terpadu. Analisis data dengan menggunakan Geographically Temporal Weighted Regression. Hasil penelitian menunjukkan Bulungan, Malinau, Nunukan, Tana Tidung, Kota Tarakan, Bontang, Kutai Kartanegara, dan Kutai Timur konsisten berada pada klaster I (High-high) pada tahun 2018-2021. Pemodelan unmet need KB yang didapatkan pada tingkat Kabupaten/kota di Pulau Kalimantan selama 2018-2021 adalah kemiskinan, pendapatan, non cakupan JKN, rasio praktik bidan mandiri, rasio faskes KB pemerintah, rasio faskes KB swasta, rasio penyuluh KB dengan nilai adjusted R square sebesar 46,06%. Kemiskinan berpengaruh dalam meningkatkan unmet need KB di 43 Kabupaten/Kota (76,8%) di Pulau Kalimantan, Indonesia selama 2018-2021. Non cakupan JKN berpengaruh dalam meningkatkan unmet need KB di 35 Kabupaten/kota (62,5%) di Pulau Kalimantan, Indonesia selama 2018-2021. Rasio praktik bidan mandiri, rasio faskes KB pemerintah dan rasio faskes KB swasta berpengaruh terhadap unmet need KB tetapi belum dapat menurunkan unmet need KB di Pulau Kalimantan, Indonesia selama 2018-2021. Rasio penyuluh KB berpengaruh dalam menurunkan unmet need KB di 22 Kabupaten/kota (39,3%) di Pulau Kalimantan, Indonesia selama 2018-2021. Berdasarkan hasil penelitian tersebut direkomendasikan kepada SKPD-KB di Kabupaten/kota untuk memprioritaskan program KB pada penduduk miskin dalam menurunkan unmet need KB dengan mendekatkan program KB seperti pelayanan KB dan penyuluhan KB khususnya pada Kabupaten/kota yang konsisten tergolong kemiskinan tertinggi selama 2018-2021, yaitu Kapuas Hulu, Melawi, Kayong Utara, Paser, Kutai Barat, Kutai Timur, Mahakam Ulu dan Bulungan.
Unmet need for family planning in Indonesia has not yet reached the target, especially on the island of Kalimantan. Reducing the unmet need for family planning can prevent maternal deaths. Decentralization requires local governments to create health policies such as family planning programs. Spatio-temporal analysis is needed to investigate unmet need for family planning which is useful for monitoring family planning programs. The aim of this research is to determine the spatial patterns and factors that influence the unmet need for family planning in 2018-2021 at the district/city level on the island of Kalimantan, Indonesia. Ecological studies were carried out in 56 districts/cities on Kalimantan Island in 2018-2021. Aggregate data is used and comes from the BKKBN Contraception Control and Services Report, the Central Statistics Agency (BPS) Publication Book and the Social Security Council's Integrated Information System Website. Data analysis using Geographically Temporal Weighted Regression. Poverty has an influence in increasing the unmet need for family planning in 43 districts/cities (76.8%) on Kalimantan Island, Indonesia during 2018-2021. Non-coverage of JKN has an influence in increasing the unmet need for family planning in 35 regencies/cities (62.5%) on Kalimantan Island, Indonesia during 2018-2021. The ratio of independent midwife practices, the ratio of government family planning health facilities and the ratio of private family planning health facilities have an influence on the unmet need for family planning but have not been able to reduce the unmet need for family planning on the island of Kalimantan, Indonesia during 2018-2021. The ratio of family planning instructors has an influence in reducing the unmet need for family planning in 22 districts/cities (39.3%) on Kalimantan Island, Indonesia during 2018-2021. Based on the results, it is recommended for SKPD-KB in districts/cities to prioritize family planning programs for the poor in reducing the unmet need for family planning by bringing family planning programs closer together such as family planning services and family planning counseling, especially in districts/cities which consistently have the highest poverty level during 2018-2021 namely Kapuas Hulu, Melawi, North Kayong, Paser, West Kutai, East Kutai, Mahakam Ulu and Bulungan.
D-510
Depok : FKM-UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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