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Legina Anggraeni; Promotor: Evi Martha; Kopromotor: Sabarinah, Sri Murni; Penguji: Asri C. Adisasmita, Budi Iman Santoso, Soedibyo Alimoesoe, Indra Supradewi, Maryuni, Nana Mulyana
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Latar belakang Perencanaan persalinan dan pencegahan komplikasi merupakan intervensi untuk mencegah kematian ibu, namun pelaksanaanya belum optimal dan masih berpusat difasilitas kesehatan. Opat sauyunan merupakan program pendampingan ibu hamil berbasis komunitas yang perlu ditingkatkan terutama dalam pendampingan perencanaan persalinan dan pencegahan komplikasi. Penelitian ini bertujuan untuk mengembangkan dan menilai efek strategi pendampingan ibu hamil berbasis komunitas “JABAR IMAS” dalam meningkatkan perencanaan persalinan dan pencegahan komplikasi melalui opat sauyunan. Metode penelitian menggunakan pendekatan mixed methods exploratory sequential design. Pada penelitian kualitatif menggunakan desain etnografi sedangkan untuk penelitian kuantitatif menggunakan desain Quasi Eksperimen-Pre and Post Control Group Design. Penelitian ini terdiri dari tiga tahap yaitu tahap penelitian pertama adalah studi kualitatif, tahap penelitian kedua adalah tahap pengembangan model strategi pendampingan ibu hamil dan tahap ketiga adalah intervensi opat sauyunan kepada ibu hamil. Waktu penelitian pada bulan Agustus 2024-November 2025 dengan lokasi penelitian berada di Kecamatan Bogor Selatan (daerah intervensi) dan Kecamatan Bogor Utara (daerah kontrol). Sampel penelitian berjumlah 78 ibu hamil (daerah intervensi) dan 80 ibu hamil (daerah kontrol). Analisa data yang digunakan adalah difference in difference dan Generalized Estimating Equations. Hasil penelitian menunjukan setelah dilakukannya intervensi strategi “JABAR IMAS” memiliki efek yang signifikan (p=0.0001) serta mampu meningkatkan skor perencanaan persalinan dan pencegahan komplikasi menjadi 10 dari 12 komponen. Pada akhir minggu ke-8 intervensi sebesar 81.3% ibu hamil pada kelompok intervensi berhasil mencapai status well birth planning. Kesimpulan dan saran. Model penguatan JABAR IMAS dapat memperkuat program perencanaan persalinan dan pencegahan komplikasi melalui pendampingan secara holistik di komunitas. Perlu adanya keberlanjutan pendampingan ibu berbasis komunitas hingga masa nifas untuk meningkatkan kewaspadaan terhadap tanda bahaya masa nifas, pemberian ASI eksklusif, dan perencanaan pemakaian alat kontrasepsi setelah persalinan.
Background: Birth planning and complication prevention aim to reduce maternal mortality, but implementation remains suboptimal and centered in health facilities. Opat Sauyunan is a community-based program for pregnant women that needs improvement, especially in assistance with birth planning and complication prevention. This study aims to develop and assess the effectiveness of the "JABAR IMAS" community-based pregnancy support strategy in improving birth planning and complication prevention through Opat Sauyunan. The research used a mixed-methods exploratory sequential design. The qualitative study employed an ethnographic design, while the quantitative study used a quasi-experimental pre- and post-control group design. The study had three stages: a qualitative study, development of a pregnancy support strategy model, and Opat Sauyunan intervention for pregnant women. The study period was August 2024–November 2025, with locations in South Bogor District (intervention area) and North Bogor District (control area). The sample consisted of 78 pregnant women in the intervention area and 80 in the control area. The data analysis used was difference in difference and Generalized Estimating Equations. The results showed that after the intervention, the "JABAR IMAS" strategy had a significant effect (p = 0.0001) and was able to increase the score of birth planning and complication prevention in 10 out of 12 components. At the end of the 8th week of intervention, 81.3% of pregnant women in the intervention group successfully achieved a well birth planning status. Conclusions and suggestions: The “JABAR IMAS” strengthening model can strengthen birth planning and complication prevention programs through holistic assistance in the community. There is a need for continued community-based maternal assistance until the postpartum period to increase awareness of postpartum danger signs, exclusive breastfeeding, and planning for the use of contraceptives after delivery.
D-634
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Yudhia Fratidhina; Komisi Pembimbing; Rizanda Machmud, Artha Budhi Duarsa; Ketua Program Studi: Delmi Sulastri
D-368
Padang : Andalas, 2017
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Jumhati, Siti; Promotor: Sabarinah; Kopromotor: Kemal Nazaruddin Siregar; Penguji: Agustin Kusumayati, Artha Prabawa, Kemal Nazaruddin Siregar, Sabarinah, Sudarto Ronoatmodjo, Maryati, Arietta Pusponegoro, Ade Jubaedah, Trihono
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Hasil Long Form sensus penduduk 2020 (LF SP 2020) AKI di Indonesia sebesar 189 per 100.000 KH, sementara AKI di Provinsi Banten sebesar 127/100.000 KH. Penurunan angka kematian ibu dari hasil LF SP2020 mencapai 45 persen. Meskipun AKI pada tahun 2020 sudah ada penurunan dibanding dengan AKI pada tahun 2015, akan tetapi masih perlu usaha keras untuk mencapai target SDGs. Deteksi dini preeklampsi pada ibu hamil adalah bagian dari asuhan antenatal yang merupakan salah satu kunci intervensi utama untuk menurunkan angka kematian ibu dan mencapai target Sustainable Development Goals (SDGs) yang telah diterapkan diberbagai Negara. Tujuan penelitian ini untuk menguatkan keaktifan bidan dan kader Kesehatan di Puskesmas dalam mempengaruhi ibu hamil melakukan deteksi dini preeklampsia menggunakan mHealth. Metode penelitian ini menggunakan desain Mixs Methods Exploratory Sequential. Penelitian kualitatif dilakukan untuk pengembangan intervensi. Informan pada penelitian kualitatif terdiri dari Dinas Kesehatan, Ibu hamil, keluarga ibu hamil, bidan Puskesmas, kader kesehatan dan masyarakat. Penelitian kuantitatif menggunakan desain Quasi eksperimental. Penelitian dilakukan di Kecamatan Angsana, Kaduhejo (intervensi) dan Cikupa Pandeglang, Cadasari (kontrol) di Kabupaten Pandeglang Provinsi Banten. Populasi penelitian seluruh ibu hamil umur 15-49 tahun, di Kabupaten Pandeglang. Sampel penelitian yaitu Ibu hamil umur 15-49 tahun, usia kehamilan ≤ 34 minggu yang memenuhi kriteria inklusi dan eksklusi, besar sampel 100 orang. Teknik pengambilan sampel dengan Purposive sampling. Pada kelompok intervensi dilakukan edukasi menggunakan mHealth untuk penguatan pemeriksaan deteksi dini preeklampsi pada ibu hamil oleh bidan dan kader, pada kelompok kontrol tidak dilakukan intervensi. Analisa data dengan menggunakan analisa univariat, bivariat, multivariat: Risk Ratio (RR), Attributable Risk (AR), AR% (absolute) dan Difference in Difference (DiD). Hasil studi kualitatif Ibu hamil mempersepsikan bahwa tidak sulit untuk mengakses pelayanan kesehatan terkait deteksi dini preeklampsi, dan orang tua adalah orang yang paling banyak memberikan saran dan masukan selama kehamilan. Meskipun demikian mayoritas ibu hamil masih belum melakukan pemeriksaan deteksi dini preeklampsi dengan baik, dan masih ada beberapa ibu hamil yang tidak ingin memeriksakan kehamilannya ke bidan maupun ke dokter kandungan. Hasil studi kuantitatif variabel yang paling dominan mempengaruhi perilaku deteksi dini preeklampsi adalah Intervensi bidan dan kader kesehatan, sikap dan dukungan tenaga kesehatan terhadap deteksi dini preeklampsi dengan nilai (p-value < 0,05). Intervensi edukasi menggunakan mHealth oleh bidan dan kader secara signifikan (p value < 0,05) memberikan dampak meningkatkan perilaku well detection terhadap preeklampsi pada ibu hamil sebesar 47,1 % (AR) dan 38% (DiD).
The results of the Long Form Population Census 2020 (LF SP 2020) showed that the MMR in Indonesia was 189 per 100,000 KH, while the MMR in Banten Province was 127/100,000 KH. The reduction in maternal mortality from the LF SP2020 results reached 45 per cent. Although the MMR in 2020 has decreased compared to the MMR in 2015, it still needs hard efforts to achieve the SDGs target. Early detection of preeclampsia in pregnant women is part of antenatal care which is one of the key interventions to reduce maternal mortality and achieve Sustainable Development Goals (SDGs) targets that have been implemented in various countries. The purpose of this study was to strengthen the activeness of midwives at Puskesmas in influencing pregnant women to do early detection of preeclampsia using mHealth. This research method uses Mixs Methods Exploratory Sequential design. Qualitative research was conducted for intervention development. Informants in qualitative research consisted of the Health Office, pregnant women, families of pregnant women, Puskesmas midwives, health cadres and the community. Quantitative research used a Quasi-experimental design. The study was conducted in Angsana, Kadu Hejo (intervention) and Cikupa, Cadasari (control) sub-districts in Pandeglang Regency, Banten Province. The study population was all pregnant women aged 15-49 years, in Pandeglang Regency. The study sample was pregnant women aged 15-49 years, gestational age ≤ 34 weeks who met the inclusion and exclusion criteria, a sample size of 100 people. Purposive sampling technique. In the intervention group, education using mHealth was carried out to strengthen the early detection of preeclampsia in pregnant women by midwives and cadres, in the control group no intervention was carried out. Data analysis using univariate, bivariate, multivariate: Risk Ratio (RR), Attributable Risk (AR), AR% (absolute) and Difference in Difference (DiD). Qualitative study results Pregnant women perceive that it is not difficult to access health services related to early detection of preeclampsia, and parents are the people who provide the most advice and input during pregnancy. However, the majority of pregnant women still do not perform early detection of preeclampsia properly, and there are still some pregnant women who do not want to check their pregnancy with a midwife or obstetrician. The results of the quantitative study of the most dominant variable affecting the early detection of preeclampsia was the Educational interventions using mHealth by midwives and , and health worker support. Educational interventions using mHealth by midwives and CHWs significantly (p value <0.05) had an impact on improving the early detection behaviour of preeclampsia in pregnant women by 47,1% (AR) and 38% (DiD).
D-536
Depok : FKM UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Dewi Nirmala Sari; Promotor: Hadi Pratomo; Kopromotor: Kemal Nazaruddin Siregar, Hervita Diatri ; Penguji: Sudarto Ronoatmodjo, Budi Anna Keliat, Sherly Saragih Turnip, Didi Danukusumo; Indra Supradewi
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Secara global, termasuk di Indonesia, ibu hamil merupakan populasi rentan untuk mengalami gejala kecemasan dan depresi. Apabila kedua gejala tersebut tidak teridentifikasi dan ditata laksana selama kehamilan akan menimbulkan dampak terhadap kesehatan ibu seperti, depresi pascapersalinan, pre eklampsi, bahkan bunuh diri, dan kesehatan anak seperti, prematur dan berat badan lahir rendah. Oleh karena itu, skrining gejala kecemasan dan depresi pada ibu hamil sangat penting dilakukan. Indonesia telah memiliki kebijakan penilaian kesehatan jiwa dalam antenatal care (ANC) sejak Juli 2021. Indonesia juga sedang melakukan transformasi kesehatan digital untuk meningkatkan mutu pelayanan kesehatan. Namun, Indonesia belum memiliki instrumen dan protokol skrining gejala kecemasan dan depresi dalam pelayanan antenatal baik secara konvensional maupun pemanfaatan teknologi digital. Tujuan penelitian ini adalah mengembangkan sistem skrining gejala kecemasan dan depresi pada ibu hamil berbasis expert system dalam ANC. Penelitian ini terdiri dari tiga tahap. Tahap ke-1 menguji validitas dan reliabilitas instrumen Edinburgh Postnatal Depression Scale (EPDS) versi bahasa Indonesia pada 125 ibu hamil secara daring melalui penyebaran formulir Google. Tahap ke-2 menilai kemampuan skrining instrumen EPDS dibandingkan dengan instrumen MINI-International Neuropsychiatric Interview (MINI) sebagai gold standard pada 298 ibu hamil. Tahap ke-2 ini dilakukan di Kota Depok (Puskesmas Beji, Cipayung, Jati Jajar, dan Pancoran Mas). Penilaian MINI dilakukan secara daring oleh dua orang enumerator terlatih. Tahap ke-3 dilakukan pengembangan prototipe sistem skrining gejala kecemasan dan depresi berbasis expert system. Analisis statistik pada tahap 1 dengan berbagai jenis uji validitas dan reliabilitas. Tahap ke-2 dilakukan penilaian sensitivitas dan spesifisitas. Tahap ke-3 dilakukan evaluasi terhadap akurasi expert system dan fisibilitas prototipe. Penelitian ini menghasilkan instrumen EPDS versi bahasa Indonesia yang terbukti valid dan reliabel untuk digunakan pada populasi ibu hamil. Instrumen ini memiliki sensitivitas dan spesifisitas > 90% untuk skrining gejala kecemasan dan depresi kehamilan. Proporsi akurasi pada expert system > 90%. Ibu hamil menyatakan prototipe ini mudah, waktu penilaian singkat, dan bermanfaat untuk digunakan. Prototipe berbasis expert system yang disebut BMoms, layak dan mampu laksana untuk skrining gejala kecemasan dan depresi pada ibu hamil dalam ANC. Oleh karena itu, prototipe BMoms dapat dikembangkan lebih lanjut menjadi aplikasi siap dan tepat guna sehingga menjadi solusi inovatif untuk skrining kesehatan jiwa pada ibu hamil.
Globally, including Indonesia, pregnant women are vulnerable population to experience symptoms of anxiety and depression. If these two symptoms are not identified and treated during pregnancy, it will have an impact on maternal and child health, such as suicide, pre-eclampsia, postpartum depression, premature, and low birth weight. Therefore, screening for symptoms of anxiety and depression in pregnant women is very important. However, Indonesia does not yet have instruments and protocols for screening symptoms of anxiety and depression in pregnant women in antenatal care (ANC) both conventionally and the use of digital technology. In fact, Indonesia already has a mental health assessment policy in ANC since July, 2021 and is currently carrying out a digital health transformation to improve the quality of health services. This study aimed to develop a screening system for symptoms of anxiety and depression in pregnant women based on an expert system in ANC.
The study consists of three stages. Phase 1 tested the validity and reliability of the Indonesian version of the Edinburgh Postnatal Depression Scale (EPDS) instrument on 125 pregnant women online through the dissemination of Google forms. Phase 2 assessed the screening ability of EPDS instrument compared to MINI-International Neuropsychiatric Interview (MINI) instrument as gold standard in 298 pregnant women. This 2nd phase was carried out in Depok City (Beji, Cipayung, Jati Jajar, and Pancoran Mas public health centre). The MINI assessment was carried out online by two trained enumerators. The 3rd stage was carried out by developing a prototype of an anxiety and depression symptom screening system based on expert system. Statistical analysis at stage 1 employed various types of validity and reliability tests. The 2nd stage was carried out to test sensitivity and specificity. The 3rd stage was evaluated on the accuracy of the expert system and the feasibility of the prototype.
This study produced an Indonesian version of the EPDS instrument that was proven to be valid and reliable for use in the population of pregnant women. This instrument had a sensitivity and specificity of > 90% for screening for symptoms of pregnancy anxiety and depression. The proportion of accuracy in expert systems was > 90%. Pregnant women state that this prototype was easy, short assessment time, and useful to use.
The prototype based on expert system called BMoms, was feasible and able to be carried out for screening symptoms of anxiety and depression in pregnant women in ANC. The BMoms prototype can be further developed into a ready and appropriate application so that it becomes an innovative solution for mental health screening in pregnant women.
D-620
Depok : FKM-UI, 2022
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Dewa Ayu Putu Mariana Kencanawati; Promotor: Evi Martha; Kopromotor: Sabarinah, Ermi Ndoen; Penguji: Dewi Susanna, Purwadi Soeriadiredja, Lukman Hakim, Indra Supradewi, Bringiwatty Batbual
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Pencegahan malaria dalam kehamilan dilakukan melalui penggunaan kelambu berinsektisda sepanjang kehamilan yaang diperoleh melalui layanan ANC terpadu dengan pelayanan malaria. Faktor sosial budaya menjadi penentu ibu hamil untuk mengakses layanan ANC dan mendapatkan kelambu berinsektisida. Kecamatan Kodi Utara merupakan salah satu daerah endemis malaria di Pulau Sumba. Ibu hamil yang tinggal di wilayah ini beresiko tinggi terinfeksi malaria namun akses ibu hamil terhadap kelambu dan pemanfaatannya masih rendah. Penelitian ini bertujuan untuk menyusun sebuh model pemberdayaan masyarakat berbasis sosial budaya untuk dapat meningkatkan penggunaan kelambu berinsektisida di Kecamatan Kodi Utara. Desain pada penelitian ini menggunakan mix method dengan desain exploratory sequensial dengan subjek penelitian adalah ibu hamil. Jumlah sampel pada penelitian sebesar 144 ibu hamil yaitu 71 ibu hamil pada kelompok kontrol dan 73 ibu hamil pada kelompok intervensi. Efek intervensi diketahui dengan menggunakan analisis diference in difference. Setelah dilakukan identifikasi sosial budaya dan bentuk partisipasi masyarakat terkait penggunaan kelambu berinsektisida, kemudian disusun model pemberdayaan masyarakat berdasarkan hasil identifikasi tersebut dan kemudian intervensi dilakukan selama 2 bulan pada kelompok intervensi terdapat peningkatan pengetahuan ibu sebesar 21,13% dan praktik penggunaan kelambu yang benar sebesar 20,83% lebih baik daripada kelompok kontrol. Peneliti menyarankan agar dalam menyusun sebuah strategi pencegahan malaria dalam kehamilan dengan mempertimbangkan faktor sosial budaya dan melibatkan secara aktif setiap komponen masyarakat. selain itu secara regulasi perlu untuk membuat aturan turunan mengenai edukasi penggunaan kelambu berinsektisida kepada ibu hamil yang dilakukan saat pembagian kelambu ru tin pada layanan malaria terinterasi KIA di Kabupaten Sumba Barat Daya
Malaria prevention during pregnancy is achieved through the use of insecticide-treated mosquito nets, which can be obtained through integrated ANC services that include malaria services. Socio-cultural factors are determinants of pregnant women's access to ANC services and obtaining insecticide-treated mosquito nets. Kodi Utara District is one of the malaria-endemic areas on Sumba Island. Pregnant women who live in this area are at high risk of being infected with malaria, but pregnant women's access to mosquito nets and their utilization are still low. This study aims to develop a model of community empowerment based on socio-culture to increase the use of insecticide-treated mosquito nets in the Kodi Utara District. The design in this study used a mixed-methods method with an exploratory sequential design with pregnant women as the research subjects. The number of samples in the study was 144 pregnant women, namely 71 pregnant women in the control group and 73 pregnant women in the intervention group. The effect of the intervention was known using difference-in-difference analysis. After the identification of socio-cultural and forms of community participation related to the use of insecticide-treated mosquito nets, a community empowerment model was then prepared based on the results of the identification and then the intervention was carried out for 2 months in the intervention group there was an increase in maternal knowledge by 21.13% and the practice of using mosquito nets correctly by 20.83% better than the control group. The researcher suggests that in developing a malaria prevention strategy in pregnancy, consideration should be given to socio-cultural factors and actively involving every component of society. In addition, in terms of regulation, it is necessary to make derivative rules regarding education on the use of insecticide-treated mosquito nets for pregnant women, which is carried out during routine mosquito net distribution at integrated malaria services for KIA in West Sumba Regency
D-583
Depok : FKM-UI, 2025
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Dhian Probhoyekti Dipo; : Budi Utomo; Kopromotor: Endang L Achadi, Elvina Karyadi; Penguji: Ratna Djuwita, Tris Eryando, Minarto, Anies Irawati, Toto Sudargo
D-339
Depok : FKM-UI, 2016
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Ariasih, Rr. Arum; Promotor: Besral; Kopromotor: Sudarto Ronoatmodjo; Penguji: Dumilah Ayuningtyas, Evi Martha, Fidiansjah, Eunike Sri Tyas Suci, Erwinsyah Harahap
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Depresi selama kehamilan dapat terjadi pada sekitar 10-15% ibu. Risiko depresi pascamelahirkan lebih tinggi pada ibu yang mengalami depresi selama kehamilan. Tujuan penelitian ini adalah mendapatkan strategi edukasi pencegahan depresi pascamelahirkan pada kelas ibu hamil dengan pendekatan Impelementation Science (IS).Penelitian ini adalah operational research yang menggunakan mixed methods exploratory sequential design dengan 4 tahapan yaitu eksplorasi, instalasi, implementasi dan keberlanjutan. Penelitian dilakukan di Kota Tangerang Selatan dengan kelompok intervensi (kecamatan Pamulang, Pondok Aren, dan Ciputat Timur); dan kontrol (kecamatan Ciputat, Seru, Serpong dan Serpong Utara). Waktu penelitian November 2022 hingga April 2024. Sampel penelitian adalah ibu hamil dengan kehamilan trimester akhir sebanyak 280 orang (intervensi=137 dan kontrol=143). Pada kelompok intervensi dilakukan pelatihan edukasi depresi pascamelahirkan terhadap fasilitator kemudian mereka melakukannya di kelas ibu hamil. Kelompok kontrol tidak dilakukan intervensi. Skrining dilakukan pada kedua kelompok sebanyak empat kali. Analisis data menggunakan univariat, bivariat, dan multivariat Generalized Estimating Equations (GEE). Hasil tahap eksplorasi didapatkan dukungan dari Dinas Kesehatan dan tim pelaksana untuk strategi edukasi. Tahap instalasi terlaksananya pelatihan dan tersusun pedoman, modul, booklet dan lembar balik pencegahan depresi pascamelahirkan. Strategi edukasi secara signifikan efektif menurunkan skor SRQ 56,14%, skor EPDS 16,88% dan meningkatkan skor pengetahuan 11,27% dan sikap 5,51% dari pengukuran awal hingga akhir. Variabel karakteristik respoden, suami/keluarga, dan fasilitator terbukti sebagai variabel perancu. Riwayat depresi merupakan variabel perancu yang memiliki efek paling besar dalam meningkatkan skor SRQ dan EPDS.
Depression during pregnancy can occur in approximately 10-15% of mothers. The risk of postpartum depression is higher in mothers who experience depression during pregnancy. This study aims to develop a strategy for postpartum depression prevention education in antenatal classes using the Implementation Science (IS) approach. This operational research employs a mixed methods exploratory sequential design through four stages: exploration, installation, implementation, and sustainability. The study was conducted in South Tangerang City with control groups (Pamulang, Pondok Aren, and East Ciputat sub-districts) and intervention groups (Ciputat, Serpong, Serpong, and North Serpong sub-districts). The research period was from November 2022 to April 2024. The sample consisted of 280 pregnant women in their late trimester (intervention = 137 and control = 143). In the intervention group, postpartum depression education training was conducted for facilitators and then they did it in the pregnant women's class. The control group did not receive any intervention. Screening was conducted in both groups four times. Data analysis was performed using univariate, bivariate, and multivariate GeneralizeEstimating Equations (GEE). The results from the exploration stage indicated support from the Health Office and the implementation team for the education strategy. The installation stage included the execution of training and the development of guidelines, modules, booklets, and flipcharts for postpartum depression prevention. The education strategy was significantly effective in reducing SRQ scores by 56.14%, EPDS scores by 16.88%, and increasing knowledge scores by 11.27% and attitudes by 5.51% from the initial to the final measurement. Variables related to respondent characteristics, spouse/family and facilitators were identified as confounding variables. A history of depression was the most significant confounding variable in increasing SRQ and EPDS scores.
D-537
Depok : FKM UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Novita Rina Antarsih; Promotor: Besral; Kopromotor: Rima Irwinda, Eka Budiarto; Penguji: Kemal Nazaruddin Siregar, Sutanto Priyo Hastono, Prihatin Oktivasari, Soewarta Koesen, Indra Supradewi, Omo Abdul Majid
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Latar Belakang: Intrauterine Growth Restriction (IUGR) merupakan salah satu penyebab utama morbiditas dan mortalitas perinatal. Deteksi dini di Puskesmas masih menghadapi keterbatasan akses ultrasonografi, variasi kemampuan skrining, dan keterlambatan rujukan. Pemanfaatan Artificial Intelligence Clinical Decision Support System (AI-CDSS) berpotensi mendukung skrining dan pengambilan keputusan rujukan secara lebih konsisten. Tujuan: Mengembangkan model Artificial Intelligence (AI) berbasis data antenatal untuk skrining risiko IUGR di Puskesmas, menilai efikasi diagnostiknya dibandingkan metode konvensional, serta mengevaluasi dampak potensial implementasi sistem AI terintegrasi telehealth terhadap deteksi dini dan ketepatan rujukan IUGR di Puskesmas. Metode: Penelitian pengembangan dengan pendekatan multiphase mixed-methods ini dilakukan dalam lima tahap, yaitu analisis kebutuhan sistem, pengembangan model AI, evaluasi usability dan feasibility, uji efikasi diagnostik, serta evaluasi dampak potensial implementasi (simulated effectiveness). Pengembangan model menggunakan 1.761 data longitudinal dari 571 ibu hamil. Uji efikasi dan evaluasi dampak potensial melibatkan 604 ibu hamil di empat Puskesmas. Hasil: Model hybrid yang menggabungkan data maternal, tinggi fundus uteri, dan biometrik janin dari USG non-citra menunjukkan performa terbaik. AI-CDSS mencapai sensitivitas 100% (95%CI: 0,95–1,00), spesifisitas 87% (95%CI: 0,84–0,90), akurasi 89%, dan AUC 0,935 (95%CI: 0,916–0,954; p<0,001). Pada evaluasi dampak potensial implementasi, penggunaan sistem meningkatkan deteksi risiko IUGR dari 14,7% menjadi 25,8% (p=0,001) dan mengidentifikasi tambahan 67 kasus yang sebelumnya tidak terdeteksi. Kesimpulan: AI-CDSS VITA-Scan menunjukkan performa yang baik sebagai alat bantu skrining risiko IUGR di Puskesmas. Integrasi AI, aturan klinis, dan telehealth berpotensi meningkatkan deteksi dini serta mendukung ketepatan rujukan maternal.
Background: Intrauterine Growth Restriction (IUGR) remains a major contributor to perinatal morbidity and mortality. Early detection in Indonesian primary healthcare centers (Puskesmas) is often challenged by limited access to ultrasonography, variations in screening practices, and delayed referral decisions. Artificial Intelligence Clinical Decision Support Systems (AI-CDSS) may help improve screening consistency and support timely referral decisions. Objective: To develop an artificial intelligence (AI)-based antenatal screening model for identifying the risk of IUGR in primary healthcare centers, assess its diagnostic efficacy compared with conventional approaches, and evaluate the potential impact of an AI-CDSS integrated with telehealth on early detection and referral accuracy. Methods: This multiphase mixed-methods study was conducted in five stages: needs assessment, AI model development, usability and feasibility evaluation, diagnostic efficacy testing, and simulated effectiveness evaluation. Model development used 1,761 longitudinal records from 571 pregnant women. The model integrated maternal characteristics, symphysis-fundal height measurements, and non-image ultrasound fetal biometric parameters using a hybrid approach that combined machine learning and clinical rules. Diagnostic efficacy and simulated effectiveness were evaluated among 604 pregnant women from four Puskesmas. Results: The hybrid model demonstrated the best performance. The AI-CDSS achieved a sensitivity of 100% (95% CI: 0.95–1.00), specificity of 87% (95% CI: 0.84–0.90), accuracy of 89%, and an AUC of 0.935 (95% CI: 0.916–0.954; p<0.001). During simulated effectiveness evaluation, the system increased IUGR risk detection from 14.7% to 25.8% (p=0.001) and identified 67 additional cases that were not detected through routine practice. Conclusions: VITA-Scan AI-CDSS demonstrated good performance as a decision-support tool for IUGR risk screening in primary healthcare centers. The integration of AI, clinical rules, and telehealth has the potential to improve early detection and support more appropriate maternal referral decisions.
D-639
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Wijayantono; Promotor: Umar Fahmi Achmadi; Ko Promotor: Dewi Susana, Tris Eryando; Penguji: Soekidjo Notoatmodjo, Holani Achmad, Toni Wandra, Soewarta Kosen
D-255
Depok : FKM-UI, 2011
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Fitrah Reynaldi; Promotor: Dumilah Ayuningtyas; Kopromotor: Prastuti Soewondo, Purnawan Junadi; Penguji: Adang Bachtiar, Wachyu Sulistiadi, Veni Hadju, Harimat Hendarwan, Aripin Ahmad
Abstrak:
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Prevalensi stunting di Provinsi Aceh mengalami proses penurunan yang gradual (dengan rata-rata 3,42% per tahun) meskipun telah diperkenalkan berbagai program dan alokasi anggaran yang besar. Penelitian ini bertujuan mengembangkan model kebijakan Kolaboratif Governansi Plus melalui integrasi kearifan lokal guna memperkuat kolaborasi polisentris antara pemerintah daerah, Majelis Adat Aceh (MAA), dan Majelis Permusyawaratan Ulama (MPU). Studi kualitatif dengan pendekatan multi-kasus dilakukan di Kota Sabang, Kabupaten Nagan Raya, dan Kabupaten Gayo Lues yang memiliki karakteristik wilayah dan capaian penurunan stunting berbeda. Data dikumpulkan melalui wawancara mendalam dengan 18 informan kunci, telaah dokumen kebijakan, dan observasi, lalu dianalisis secara tematik. Hasil menunjukkan integrasi kearifan lokal masih bersifat parsial dan belum terlembaga sistematis. Peran MAA dan MPU dalam siklus kebijakan sangat terbatas dan lebih bersifat simbolik daripada substantif. Penelitian menghasilkan model Kolaboratif Governansi Plus yang menempatkan pemerintah, MAA, dan MPU sebagai pusat otoritas setara dalam tata kelola stunting. Model ini menawarkan mekanisme pelembagaan kolaborasi, penganggaran inklusif, dan indikator berbasis budaya untuk menghasilkan kebijakan yang tidak hanya efektif secara teknis tetapi juga memiliki legitimasi kultural dan keberlanjutan sosial.
The prevalence of stunting in Aceh Province has experienced a gradual decline (averaging 3.42% per year) despite the introduction of various programs and substantial budget allocations. This study aims to develop a Collaborative Governance Plus policy model through the integration of local wisdom to strengthen polycentric collaboration between the regional government, the Aceh Customary Council (MAA), and the Ulema Consultative Council (MPU). A qualitative study employing a multi-case approach was conducted in Sabang City, Nagan Raya Regency, and Gayo Lues Regency three regions with distinct characteristics and varying rates of stunting reduction. Data were collected through in-depth interviews with 18 key informants, policy document review, and observation, then analyzed thematically. The findings reveal that the integration of local wisdom remains partial and has not been systematically institutionalized. The roles of MAA and MPU within the policy cycle are highly limited and tend to be more symbolic than substantive. The study produces a Collaborative Governance Plus model that positions the government, MAA, and MPU as equal centers of authority in stunting governance. This model offers mechanisms for institutionalizing collaboration, inclusive budgeting, and culturally-based indicators to generate policies that are not only technically effective but also possess cultural legitimacy and social sustainability.
D-623
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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