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Tingginya Angka Kematian Ibu (AKI) menjadi salah satu isu prioritas kesehatan di Indonesia. Penggunaan kontrasepsi modern pascasalin merupakan strategi efektif untuk menekan AKI dengan mengatur jarak kehamilan. Namun, cakupannya belum merata, dengan disparitas signifikan antarprovinsi. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan penggunaan kontrasepsi modern pascasalin di Provinsi Jawa Timur dan Sumatera Utara.
Penelitian ini menggunakan desain potong lintang (cross-sectional) dengan analisis data sekunder dari Survei Kesehatan Indonesia (SKI) 2023. Sampel terdiri dari wanita usia subur (15-49 tahun) yang telah melahirkan. Analisis data dilakukan menggunakan regresi logistik multivariabel. Hasil penelitian menunjukkan proporsi penggunaan kontrasepsi modern pascasalin di Jawa Timur (79,2%) lebih tinggi secara signifikan dibandingkan Sumatera Utara (50,5%). Faktor determinan di Sumatera Utara adalah umur, status pekerjaan, dan konseling KB. Di Jawa Timur, faktor yang berhubungan adalah daerah tempat tinggal, status ekonomi, paritas, dan konseling KB. Konseling KB pascasalin menjadi satu-satunya faktor yang berhubungan signifikan di kedua provinsi. Kesimpulannya, terdapat perbedaan determinan dalam penggunaan kontrasepsi modern pascasalin antara kedua provinsi, yang menyoroti pentingnya intervensi spesifik sesuai konteks wilayah. Penguatan layanan konseling menjadi kunci strategis untuk meningkatkan cakupan secara nasional.
The high Maternal Mortality Rate (MMR) is a priority health issue in Indonesia. The use of modern postpartum contraception is an effective strategy to reduce MMR by managing pregnancy spacing. However, its coverage is uneven, with significant disparities between provinces. This study aims to analyze the factors associated with the use of modern postpartum contraception in East Java and North Sumatra provinces. This study employed a cross-sectional design using secondary data analysis from the 2023 Indonesian Health Survey (SKI). The sample consisted of women of childbearing age (15-49 years) who had previously given birth. Data were analyzed using multivariate logistic regression. The results showed that the proportion of modern postpartum contraceptive use in East Java (79.2%) was significantly higher than in North Sumatra (50.5%). The determining factors in North Sumatra were age, employment status, and family planning counseling. In East Java, the associated factors were area of residence, economic status, parity, and family planning counseling. Counseling was the only factor significantly associated in both provinces. In conclusion, there are different determinants for the use of modern postpartum contraception between the two provinces, highlighting the importance of region-specific interventions. Strengthening counseling services is a strategic key to increasing coverage nationally.
Pneumonia is the leading causes of death among children under five in Indonesia. Exclusive breastfeeding and vitamin A supplementation are recommended strategies for preventing pneumonia. Although the coverage of both has reached national targets, the prevalence of pneumonia increased from 4.8% in 2018 to 15% in 2023. This study aimed to examine the association between exclusive breastfeeding and vitamin A supplementation with the incidence of pneumonia among children aged 12–23 months in Indonesia. This study used a cross-sectional design based on data from 2023 SKI. Data analysis was conducted using univariate, bivariate, and multivariate methods. The results showed no statistically significant association between exclusive breastfeeding and vitamin A supplementation with pneumonia incidence. However, after considering interaction variables and controlling for confounding variables (child’s sex, history of diarrhea, and drinking water source), an increased risk of pneumonia was found among children who were not exclusively breastfed (AOR: 1.466; 95% CI: 0.928–2.315), although the association was not statistically significant. Meanwhile, the association between vitamin A supplementation and pneumonia became statistically significant (AOR: 3.029; 95% CI: 1.339–6.852). Therefore, strengthening educational programs through community empowerment is needed as a promotive-preventive strategy to improve exclusive breastfeeding and vitamin A practices in efforts to prevent pneumonia in children.
Treatment adherence for tuberculosis (TB) remains one of the major health challenges in TB control efforts in Indonesia. The proportion of TB patients adhering to treatment decreased from 69.2% in 2018 to 62.5% in 2023. In the DOTS strategy, one of the key efforts to improve treatment adherence is the presence of a Treatment Supervisor (Pengawas Menelan Obat or PMO). However, the proportion of TB patients with a PMO also declined from 66.2% to 62.1%. This study aims to examine whether the decline in PMO presence contributed to the decrease in treatment adherence among TB patients aged ≥15 years in Indonesia, using secondary data from the 2023 Indonesia Health Survey (Survei Kesehatan Indonesia or SKI). The study design is cross-sectional, and analyses were conducted using univariate, bivariate, and multivariate methods. The results showed a significant association between the presence of a PMO and treatment adherence (OR: 4.62; 95% CI: 2.39–8.93). After controlling for age, sex, education level, economic status, comorbid diabetes mellitus, and health insurance ownership, the presence of a PMO remained positively associated with adherence (AOR: 4.41; 95% CI: 2.18–8.90). These findings indicate that the presence of a PMO is relevant and essential for improving TB treatment adherence and success in Indonesia. The efforts to enhance patient adherence should also focus on optimizing the role and quality of PMO, whether from family members or healthcare providers.
Background: Diarrhea remains a significant health problem globally and nationally. In Indonesia, West Java has a diarrhea prevalence of 11% among under-five children. This figure is the 5th highest nationally and the highest on Java Island. Various interventions have been implemented to reduce diarrhea rates in under-five children. However, the persistently high incidence of diarrhea in under-five children in West Java necessitates this research to identify the determinants of diarrhea incidence in under-five children in West Java. Methods: This study utilized SKI 2023 data with a total sample of 913 under-five children. A cross-sectional study design was employed. Data were analyzed using complex sample analysis, including univariate, bivariate with chi-square test, and multivariate with multiple logistic regression. Results: Factors significantly associated with diarrhea incidence in under-five children in West Java were wastewater drainage (p-value 0.004; OR 2.188; CI 1.283-3.733) and handwashing facilities (p-value 0.044; OR 1.808; CI 1.017-3.213), while drinking water source and drinking water treatment were identified as confounding variables. Conclusion: Efforts to optimize community sanitation still need to be improved. Furthermore, prevention efforts need to be intensified to enhance the successful reduction of diarrhea prevalence in under-five children in West Java.
