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Berat badan lahir rendah berkontribusi terhadap morbiditas dan mortalitas neonatal, menjadikannya indikator penting kesehatan ibu dan anak. Data Riskesdas 2018 dan SKI 2023 menunjukkan prevalensi BBLR di Indonesia belum mengalami penurunan signifikan, dengan variasi antarwilayah, sehingga perlu penelitian tentang determinan BBLR berdasarkan regional. Penelitian ini menggunakan desain cross-sectional dengan data sekunder SKI 2023, dianalisis berdasarkan lima regional Indonesia menggunakan uji chi-square dan regresi logistik. Hasil menunjukkan variasi proporsi BBLR antarregional, dengan Sulawesi tertinggi dan Sumatera terendah. Di Sumatera, faktor terkait BBLR adalah anemia, plasenta previa, kehamilan kembar, kelahiran prematur, dan interaksi kehamilan kembar dengan komplikasi. Di Jawa-Bali, faktor yang berhubungan adalah paritas, komplikasi kehamilan, kehamilan kembar, jenis kelamin, kelahiran prematur, dan kelahiran prematur yang berinteraksi dengan kehamilan kembar. Di Kalimantan, faktor terkait adalah usia ibu, paritas, komplikasi, serta interaksi kehamilan kembar dengan jenis kelamin dan kelahiran prematur. Di Sulawesi, faktor yang berhubungan adalah status ekonomi, pendidikan ibu, paritas, konsumsi tablet tambah darah, komplikasi, plasenta previa, kehamilan kembar, jenis kelamin, dan kelahiran prematur. Di Papua, Maluku, Nusa Tenggara, faktor terkait adalah status ekonomi, paritas, komplikasi, dan interaksi kehamilan kembar dengan kelahiran prematur. Diperlukan intervensi berbasis wilayah untuk meningkatkan pelayanan kesehatan ibu hamil, terutama di Sulawesi, dengan fokus pada faktor risiko utama seperti kehamilan kembar, kelahiran prematur, dan anemia.
Low Birth Weight (LBW) contributes to neonatal morbidity and mortality, making it an important indicator of maternal and child health. The 2018 Riskesdas data and the 2023 SKI reveal that the LBW prevalence in Indonesia has not significantly decreased, with regional variations, indicating the need for research on the regional determinants of LBW. This cross-sectional study uses secondary data from SKI 2023, analyzed across five regions in Indonesia using chi-square tests and logistic regression. The results show regional variations in LBW proportions, with Sulawesi having the highest and Sumatra the lowest prevalence. In Sumatra, factors associated with LBW include anemia, placenta previa, multiple pregnancies, prematurity, and interactions between multiple pregnancies and complications. In Java-Bali, factors associated with LBW include parity, pregnancy complications, multiple pregnancies, gender, prematurity, and the interaction between prematurity and multiple pregnancies. Kalimantan's related factors are maternal age, parity, complications, and interactions between multiple pregnancies, gender, and prematurity. In Sulawesi, factors related to LBW include maternal socioeconomic status, education, parity, iron supplement consumption, complications, placenta previa, multiple pregnancies, gender, and prematurity. Papua, Maluku, and Nusa Tenggara show associations with socioeconomic status, parity, complications, and interactions between multiple pregnancies and prematurity. Regional-based interventions are needed to improve maternal health services, especially in Sulawesi, with a focus on key risk factors such as multiple pregnancies, prematurity, and anemia.
Preterm birth is the third leading cause of neonatal mortality in Indonesia. It significantly contributes to neonatal morbidity and mortality, thereby affecting the overall health indicators of the country. This study aims to identify the determinants of preterm birth in urban and rural areas of Indonesia. The data were obtained from the 2023 Indonesian Health Survey using a cross-sectional study design. The study sample consisted of 32,288 ever-married women aged 10–54 years who had given birth in the last five years. Data were analyzed using chi-square tests and multivariable logistic regression. The results showed that antenatal care (ANC) visits, multiple pregnancies, hypertension, and antepartum hemorrhage were significant determinants of preterm birth in both urban and rural areas. Maternal age, premature rupture of membranes, and mode of delivery were only associated with preterm birth in urban areas, while placenta previa was only significant in rural areas. Multiple pregnancies were the most dominant factor associated with preterm birth in both settings.
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.
Background: Breast cancer is the leading cause of cancer-related deaths among women in Indonesia, with data from the Global Cancer Observatory 2022 recording 68,271 new cases, 209,748 cases in the last five years, and 22,598 deaths. The 5-year survival rate of breast cancer patients in Indonesia remains relatively low compared to other countries. Various factors, including individual factors and healthcare services, may affect patient survival. Therefore, this study was conducted to determine the 5-year survival rate of breast cancer patients under the National Health Insurance (JKN) program and the factors influencing it. Methods: This study uses data from the BPJS Kesehatan sample from 2018 to 2023 with a retrospective cohort study design. The analysis was conducted using the Kaplan-Meier method and Cox Proportional Hazard test. Results: The study found a 5-year survival rate of 52.2% (95% CI: 46.4-58.7%), indicating a still-low survival rate. Individual factors that influenced survival were marital status (aHR = 1.632; 95% CI: 1.102 – 2.416), residence in Regional 4 (aHR = 2.230; 95% CI: 1.497 – 3.321), and the presence of one or more comorbidities (aHR = 1.498; 95% CI: 1.182 – 1.899). Meanwhile, healthcare provider-related factors influencing survival were severity level II (aHR = 5.566; 95% CI: 3.396 – 9.12) and severity level III (aHR = 11.118; 95% CI: 6.706 – 18.432). Conclusion: The 5-year survival rate of breast cancer patients in Indonesia remains low. Therefore, comprehensive efforts are needed to address breast cancer, involving the community, BPJS Kesehatan, and policymakers.
Angka persalinan sesar (C-Section) senantiasa meningkat sebagaimana dilaporkan SDKI, Riskesdas, dan SKI. Persalinan C-Section merupakan layanan kesehatan yang dijamin oleh Jaminan Kesehatan Nasional (JKN), dengan klaim terbanyak yaitu 1.117.463 operasi pada tahun 2023 dan total biaya Rp 6.266,59 Miliar. Pada tahun yang sama, Badan Pelaksana Jaminan Sosial (BPJS) Kesehatan mengalami defisit. Di antara penyebabnya adalah kinerja penerimaan iuran dari Segmentasi Kepesertaan PBPU dan Bukan Pekerja yang hanya mencapai 69,29%. Hal ini diperparah sebagian oknum PBPU yang menunjukkan kecenderungan adverse selection, hanya membayar iuran agar dapat layanan persalinan. Penelitian ini bertujuan menganalisis asosiasi segmentasi kepesertaan JKN dan metode persalinan dalam Data Sampel BPJS Kesehatan 2018-2023 Kontekstual KIA. Desain penelitian ini adalah cross-sectional dengan sampel Ibu yang mengakses layanan persalinan dengan pembiayaan JKN di Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) pada data sekunder di atas. Hasil regresi logistik pada penelitian ini menunjukkan hubungan signifikan antara Segmentasi Kepesertaan JKN PBPU dan CSection setelah dikendalikan kovariat (ref. PBI, OR=1,22 [1,14 - 1,30] dan ref. PPU, OR=1,12 [1,05 - 1,20]). Karena OR secara substansial tidak besar, peneliti menyarankan upaya umum tanpa segmen spesifik untuk mengatasi defisit BPJS Kesehatan, yaitu penggunaan kelengkapan kunjungan antenatal care sebagai mekanisme gatekeeping untuk mendapatkan pembiayaan persalinan dalam program JKN.
Cesarean section (C-Section) rate is continually increasing as reported in IDHS, Riskesdas, and SKI. Childbirth with C-Section is a healthcare covered by Jaminan Kesehatan Nasional (JKN) with the highest number of claims reaching 1.117.463 surgeries in 2023 and total funding of Rp 6.266,59 billion. At the same year, deficit struck Indonesia’s Social Security Agent (BPJS) for Health. One of the causes is Non-Wage Earner and Non-Worker membership segment’s contribution collection only reaching 69,29% of target. The situation is exacerbated by certain Non-Wage Earner member showing signs of adverse selection, paying contributions only for childbirth. This study aims to analyze the association of JKN membership segment and childbirth method in BPJS Kesehatan Sample Data 2018-2023 on Maternal-Child Health Context. This is a cross-sectional study involving as samples mothers accessing childbirth services with JKN funding at advanced referral health facilities in said secondary data. Logistic regression results demonstrate significant association between Non-Wage Earner segment and C-Section after covariates are controlled (ref. Beneficiaries, OR=1,22 [1,14 - 1,30] and ref. Wage Earner, OR=1,12 [1,05 - 1,20]). As the OR not substantially high, general measures not catering to particular segment is suggested to address the deficit. Said suggestion being the establishment of antenatal care visit completeness as a gatekeeping mechanism to access childbirth funding with JKN program.
Hypertension can lead to serious complications such as heart disease, stroke, and kidney failure, making it a leading cause of premature death. The global prevalence of hypertension among adults aged 30–79 years reached 33% in 2019. Hypertension can affect various population groups, including workers, impacting their productivity and long-term health. Identifying hypertension risk factors is important to support targeted prevention efforts. This study used a cross-sectional design by analyzing secondary data from medical check-up, body composition measurement, and worker characteristic in 2024. The prevalence of hypertension among PT X workers in 2024 was 10.3%. The analysis showed significant associations between age, work tenure, dyslipidemia, body composition, and fat dimension with hypertension. The risk of hypertension increased among workers aged 40–49 years (AOR: 3,22) and ≥ 50 years (AOR: 4,15), with work tenure > 20 years (AOR: 3,83), dyslipidemia (AOR: 1,55), high body fat and low muscle composition (AOR: 2,15), and high fat dimension (AOR: 2,46). Therefore, preventive efforts through health education, regular blood pressure and body composition monitoring, and fat reduction programs are needed to control the risk of hypertension.
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.