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Childhood obesity is a health problem that has a long-term negative impact on children. The prevalence of hypertension in young adults continues to increase year by year and it is suggested that childhood obesity affects hypertension in adulthood. This study aims to determine the effect of obesity as a child under the age of five (0-59 months) on adult hypertension (21-26 years). This retrospective cohort study data were from IFLS 1 in 1993 and IFLS 5 in 2014, with a total of 596 respondents under the age of five after meeting the inclusion and exclusion criteria. This study showed that 15,1% of the children have hypertension as adults, with the proportion of overweight children having hypertension being 17,4%. Variables significantly related to the incidence of hypertension were gender, nutritional status of obese adults, consumption of fast food, consumption of soft drinks, and smoking habits. Multivariate analysis found that childhood obesity lower the risk for hypertension by 0.83 times compared to normal nutritional status after being controlled by smoking habits and adult nutritional status variables, but this relationship was not statistically significant.
Pendahuluan Kementrian Kesehatan sedang berkomitmen untuk melakukan transformasi system Kesehatan guna meningkatkan layanan kesehatan yang lebih baik, merata, dan berkualitas bagi Masyarakat. Terdapat 6 pilar utama untuk menopang SKN. Melalui Keputusan Kemenkes RI No HK.0107/Menkes/11983/2022 ditaur mengenai penerapan sistem pemerintahan berbasis elektronik bidang kesehatan dan strategi transformasi digital kesehatan. Tetapi Kemenkes telah mempunyai banyak aplikasi pada setiap program. Pada Pada program KIA, ada 6 aplikasi yang terkait yaitu: e-Kohort, Komdat, EPPGBM, RME, ASIK dan SIP. E-Kohort dan EPPBGM merupakan aplikasi KIA yang mempunyai sasaran sama dan isian data yang sama. Sehingga perlu analisis untuk mengetahui gap pada kedua aplikasi tersebut. Tujuan Penelitian ini bertujuan untuk mengetahui Melakukan analisis secara komprehensif terhadap sistem pencatatan dan pelaporan KIA di E-Kohort dan EPPGBM di Jakarta Pusat. Metode Penelitian ini merupakan penelitian kualitatif menggunakan pendekatan Performance of Routine Information System Management (PRISM) Framework, dengan melihat pada aplikasi E-Kohort dan EPPBGM di Puskesmas didaerah Jakarta Pusat. Hasil dan Pembahasan Terjadinya perbedaan sasaran pada E-Kohort dan EPPBGM, yang mengakibatkan penjaringan permasalahan gizi di Ibu dan Anak juga tidak berjalan dengan baik. E-Kohort dan EPPBGM mempunyai isian data yang sama, meskipun E-Kohort lebih lengkap dibandingkan EPPBGM. Sehingga lebih efisien untuk dilakukan peleburan pada kedua aplikasi tersebut.
Introduction
The Ministry of Health is committed to transforming the national health system in order to provide better, more equitable, and higher-quality healthcare services for the population. There are six main pillars that support the National Health System (SKN). Through the Decree of the Minister of Health of the Republic of Indonesia No. HK.0107/Menkes/11983/2022, the implementation of an electronic-based government system in the health sector and a digital health transformation strategy has been regulated. However, the Ministry of Health currently operates numerous applications for each health program. In the Maternal and Child Health (MCH) program, there are six related applications: e-Kohort, Komdat, EPPGBM, RME, ASIK, and SIP. Among them, e-Kohort and EPPGBM are MCH applications that target the same population and collect similar data. This overlap necessitates an analysis to identify the gaps between the two systems.
Objective
This study aims to conduct a comprehensive analysis of the MCH recording and reporting systems in e-Kohort and EPPGBM in Central Jakarta.
Methods
This is a qualitative study using the Performance of Routine Information System Management (PRISM) framework, focusing on the use of e-Kohort and EPPGBM applications in community health centers (Puskesmas) located in Central Jakarta.
Results and Discussion
The study found inconsistencies in target populations between e-Kohort and EPPGBM, which have led to ineffective identification and management of maternal and child nutrition issues. Although both applications require similar data inputs, e-Kohort provides a more comprehensive dataset than EPPGBM. Therefore, integrating or merging the two systems would be a more efficient solution.
Coronary Heart Disease (CHD) is one of the leading causes of death globally with a mortality rate of nearly 17.5 million annually. Smoking accounts for 33% and hypertension accounts for 31% of all deaths from cardiovascular disease. Smoking and hypertension are major risk factors for CHD, which are a serious problem that needs to be addressed in Indonesia and the world. The purpose of this study was to determine the greater risk of smoking and hypertension with the incidence of coronary heart disease in Indonesia. The study used a retrospective cohort design. The data used are secondary data from the Indonesian Family Life Survey (IFLS-4 and IFLS-5 data for 2007-2014) with a total sample of 19,486 population respondents aged ≥18 years. Data analysis with cox regression and the amount of risk is expressed in risk ratio (RR) with a confidence interval (CI) of 95%. Data analysis using data processing software. The results of multivariate analysis after being controlled by sex and DM history showed that smoking individually was not related to CHD in Indonesia in 2007-2014 with a value (RR 1.08; 95% CI = 0.70- 1.67). Hypertension individually increases CHD risk (RR 1.19; 95% CI = 0.92-1.53). Smoking and hypertension together increase the risk of CHD compared to people who don't smoke and don't have hypertension in Indonesia in 2007-2014 (RR 1.66; 95% CI = 1.11-2.48) meaning that respondents who smoke and hypertension are at risk of experiencing CHD 1.66 times (95% CI; 1.11-2.48) compared to nonsmokers and those without hypertension.
ABSTRAK Nama : Debri Rizki Faisal Program Studi : Epidemiologi (Field Epidemiology Training Program) Judul : Pengaruh Status Gizi Stunting Saat Balita dan Obesitas Ketika Dewasa Terhadap Risiko Hipertensi (Studi Longitudinal IFLS 1993 – 2014) Pembimbing : dr.Syahrizal Syarif, MPH, PhD. Stunting merupakan salah satu bentuk kekurangan gizi kronis yang ditandai dengan tinggi badan menurut usia kurang dari -2 SD (standar deviasi). Kondisi stunting pada usia balita berdampak jangka panjang terhadap dewasa yang pendek dan rentan terhadap penyakit tidak menular ketika dewasa. Penelitian ini bertujuan untuk mengetahui pengaruh efek gabungan kondisi stunting saat balita dan obesitas ketika dewasa terhadap risiko hipertensi. Desain penelitian cohort retrospective menggunakan data sekunder Indonesia Family Life Survey (IFLS) periode 1-5. Populasi target adalah balita usia 2-5 tahun pada tahun 1993 sebanyak 2.642 orang, kemudian di follow up hingga dewasa pada tahun 2014. Jumlah sampel yang memenuhi kriteria inklusi dan eksklusi adalah 588 orang. Analisis data menggunakan uji cox regression dengan 95%CI. Standar pengukuran sebagai berikut stunting (TB/U < -2 SD), obesitas (IMT ≥ 27 kg/m 2 ) dan hipertensi (≥ 140/90 mmHg). Hasil penelitian didapatkan bahwa dari 588 orang dimana 13.27% mengalami hipertensi dengan proporsi orang yang stunting saat balita dan obesitas ketika dewasa 27.27%. Analisis multivariate ditemukan bahwa responden dengan status gizi stunting dan obesitas berisiko 2.46 (95% CI; 1.23 - 4.90) kali; obesitas dan tidak stunting 2.25 (95% CI; 1.12 – 4.50) kali; stunting dan tidak obesitas berisiko 0.95 (95% CI; 0.55 – 1.62) kali, mengalami hipertensi dibandingkan dengan responden yang tidak mengalami stunting saat balita dan tidak obesitas ketika dewasa. Risiko kejadian hipertensi meningkat 10.56% akibat interaksi antara kondisi stunting saat balita dan obesitas ketika dewasa. Pentingnya pencegahan stunting pada 1000 Hari Pertama Kehidupan dan mengoptimalkan Posbindu PTM dalam melakukan skrining obesitas dan hipertensi serta pengendalian faktor risiko PTM untuk menurunkan prevalensi penyakit tidak menular terutama obesitas dan hipertensi. Kata kunci: Stunting, Obesitas, Hipertensi, Kohort, Efek Gabungan.
ABSTRACT Name : Debri Rizki Faisal Study Program : Epidemiology (Field Epidemiology Training Program) Title : The Effect Of Early Stunting And Adult Obesity To Increase Risk Of Hypertension (Longitudinal Study IFLS 1993 – 2014) Counsellor : dr.Syahrizal Syarif, MPH, PhD. Stunting due to chronic malnutrition condition that is characterized by Height for Age Z score less than -2 SD (standard deviation). The early stunting in children under five years has a long-term impact on adults are short stature and vulnerable to risk non-communicable diseases in later life. This study aims to determine the joint effect of early stunting conditions and adult obesity to risk for hypertension. This study design was a cohort retrospective using secondary data from the Indonesia Family Life Survey (IFLS) period 1-5. The target population was children aged 2-5 years in 1993 with numbers of 2,642 people and then follow up until adulthood in 2014. The number of samples that met the inclusion and exclusion criteria were 588 people. Data analysis used Cox regression test with 95% CI. Standard of measurements was stunting (HAZ <-2 SD), obesity (IMT ≥ 27 kg / m 2 ) and hypertension (≥ 140/90 mmHg). The results showed that of 588 people where 13.27% had hypertension where the proportion of respondent with early stunting and adult obese was 27.27%. Multivariate analysis found that respondents with nutritional status both early stunting and adult obesity have a risk of 2.46 (95% CI; 1.23 - 4.90) times; obese and not stunting 2.25 (95% CI; 1.12 - 4.50) times; stunting and not obese 0.95 (95% CI; 0.55 - 1.62) times, for having risk of hypertension compared to respondents neither experience stunting and obese. The risk of hypertension increases 10.56% due to the interaction between early stunting and obesity adults. The importance prevention of stunting in The First 1000 Days of Life and optimize Posbindu PTM in screening obesity, hypertension and controlling risk factors NCD to reduce the prevalence of non-communicable diseases, especially obesity and hypertension. Key words: Stunting, Obesity, Hypertension, Cohort, Joint Effects.