Covid-19 berdampak pada berbagai aspek sehingga perlu upaya pengendalian. Selain melakukan protokol kesehatan maka perlu vaksinasi. Cakupan vaksinasi covid-19 dosis ketiga di Indonesia masih rendah sebesar 37,99%. Cakupan Provinsi Lampung masih rendah sebesar 28,58%. Provinsi Lampung juga berisiko tinggi apabila dilihat dari angka CFR covid-19 sebesar 5,59%. Berbagai strategi dilakukan untuk upaya percepatan vaksinasi dengan melibatkan berbagai aktor namun cakupan masih rendah. Dari studi pendahuluan diketahui bahwa terdapat hambatan pada unsur fungsi manajemen. Tujuan penelitian ini untuk mengidentifikasi manajemen program vaksinasi covid-19 dari penyedia layanan yang mempengaruhi cakupan vaksin covid-19 dosis ketiga. Penelitian ini menggunakan metode penelitian kualitatif dengan jenis penelitian Rapid Assesment Procedures (RAP). Hasil penelitian ini menunjukkan bahwa ada pengaruh aspek kontek meliputi pembiayaan, logistik vaksin, regulasi serta sarana dan prasarana terhadap cakupan vaksin covid-19 dosis ketiga. Terdapat pengaruh mekanisme dalam aktor meliputi pelaksanaan, pencatatan pelaporan, monitoring dan evaluasi serta koordinasi terhadap cakupan vaksin covid-19 dosis ketiga. Diketahui pada aspek hasil masih rendah yaitu rata-rata pemakaian vaksin perhari sebesar 277 dosis dan cakupan vaksin dosis ketiga sebesar 28,58%. Kesimpulan Peningkatan cakupan vaksinasi covid-19 dosis ketiga di Provinsi Lampung terkendala oleh manajemen program penyedia layanan terutama dari aspek pembiayaan, logistik vaksin, regulasi, koordinasi, pencatatan, dan pelaporan

Covid-19 has an impact on various aspects so it needs control efforts. In addition to carrying out health protocols, it is necessary to vaccinate. Coverage of the third dose of Covid-19 vaccination in Indonesia is still low at 37.99%. Lampung Province coverage is still low at 28.58%. Lampung Province is also at high risk when viewed from the CFR co-19 figure of 5.59%. Various strategies have been implemented to accelerate vaccination by involving various actors but the coverage is still low. From the preliminary study it is known that there are obstacles to the elements of the management function. The purpose of this study was to identify the management of the covid-19 vaccination program from service providers that affect coverage of the third dose of the covid-19 vaccine. This study used a qualitative research method with the type of Rapid Assessment Procedures (RAP) research. The results of this study indicate that there is an influence of context aspects including financing, vaccine logistics, regulations and facilities and infrastructure on the coverage of the third dose of the covid-19 vaccine. There is the influence of mechanisms within actors including implementation, recording of reporting, monitoring and evaluation as well as coordination of coverage of the third dose of the covid-19 vaccine. It is known that the yield aspect is still low, namely the average use of vaccine per day is 277 doses and the third dose vaccine coverage is 28.58%. Conclusion Increasing coverage of the third dose of covid-19 vaccination in Lampung Province is constrained by program management of service providers, especially from the aspects of financing, vaccine logistics, regulation, coordination, recording and reporting.

Kanker pada anak merupakan masalah kesehatan yang serius karena berdampak tidak hanya pada kelangsungan hidup, tetapi juga kualitas hidup anak dan keluarganya. Instrumen penilaian Health-Related Quality of Life (HRQoL) yang tersedia, seperti EQ5D-Y dan PedsQL, belum sepenuhnya mampu menangkap pengalaman spesifik anak dengan kanker di Indonesia. Di sisi lain, ketersediaan data yang menghubungkan luaran kualitas hidup dengan biaya pengobatan masih terbatas. Penelitian ini bertujuan mengembangkan dan memvalidasi instrumen HRQoL baru, yakni PEDIAQoL (Pediatric Experience and Disease-related Impact Assessment–Quality of Life), serta mengaplikasikan nilai utilitas yang diperoleh dari PEDIAQoL pada studi Evaluasi Ekonomi dalam bentuk Analisis-Biaya Utilitas (Cost-Utility Analysis). Penelitian menggunakan desain potong lintang (cross-sectional) dengan pengambilan data primer di RS Kanker Dharmais selama periode Juli 2025–Februari 2026 pada 219 pasien kanker anak berusia 6–18 tahun beserta orang tua atau caregiver. Instrumen PEDIAQoL dikembangkan berdasarkan tinjauan sistematis dan dievaluasi melalui serangkaian pengujian psikometri. Instrumen versi final terdiri atas enam item dengan struktur unidimensional yang terkonfirmasi, ditunjukkan oleh satu faktor dengan eigenvalue 2,502 yang menjelaskan 41,70% variansi, factor loading berkisar antara 0,536–0,641, konsistensi internal yang baik, serta tidak menunjukkan bias pengukuran berdasarkan jenis kelamin (p = 0,152). Berdasarkan performa psikometrinya, nilai utilitas PEDIAQoL diturunkan melalui pemetaan statistik terhadap EQ5D-Y dengan membandingkan tiga model regresi. Model Ordinary Least Squares (OLS) dipilih sebagai dasar algoritma skoring karena kesesuaian dengan central limit theorema dan sifat linearitas dalam perhitungannya. Pada perbandingan kinerja, PEDIAQoL dan EQ5D-Y terbukti mengukur konstruk HRQoL yang saling berkaitan, tetapi tidak sepenuhnya tumpang tindih. PEDIAQoL lebih sensitif terhadap beban gejala kanker, seperti kelelahan dan nyeri, sedangkan EQ5D-Y lebih menekankan keterbatasan fungsional. Analisis determinan menunjukkan bahwa jenis kanker dan derajat toksisitas (CTCAE Grade) pengobatan merupakan faktor klinis yang paling konsisten memengaruhi biaya medis langsung, kerugian produktivitas, dan skor utilitas. Rerata biaya medis langsung mencapai Rp165.339.238 per responden, sedangkan rerata kerugian produktivitas keluarga sebesar Rp8.796.118 per tahun. Nilai utilitas PEDIAQoL selanjutnya diaplikasikan dalam Cost-Utility Analysis (CUA) yang membandingkan omeprazol dan ranitidin sebagai gastroprotektor pada pengobatan Acute Lymphoblastic Leukemia. Hasil analisis menunjukkan bahwa omeprazol merupakan strategi yang dominan dibandingkan ranitidin, dengan ICER yang konsisten menguntungkan berdasarkan nilai utilitas EQ5D-Y maupun PEDIAQoL. Temuan tersebut tetap stabil pada analisis sensitivitas satu arah, multi-arah, dan probabilistik. Hasil penelitian ini menunjukkan bahwa nilai utilitas yang dihasilkan oleh instrumen PEDIAQoL dapat digunakan sebagai alternatif yang valid dalam evaluasi ekonomi intervensi kesehatan pada kanker anak.

Childhood cancer is a major public health concern because it affects not only survival but also the quality of life of children and their families. Existing health-related quality of life (HRQoL) instruments, such as the EQ-5D-Y and PedsQL, do not fully capture the disease-specific experiences of children with cancer in Indonesia. In addition, evidence linking HRQoL outcomes with treatment costs remains limited. This study aimed to develop and psychometrically validate a novel HRQoL instrument, the Pediatric Experience and Disease-related Impact Assessment–Quality of Life (PEDIAQoL), and to apply the utility values derived from PEDIAQoL in an economic evaluation using Cost-Utility Analysis (CUA). A cross-sectional study was conducted using primary data collected at Dharmais Cancer Hospital between July 2025 and February 2026 from 219 pediatric cancer patients aged 6–18 years and their parents or caregivers. The PEDIAQoL instrument was developed based on a systematic review and evaluated through a comprehensive psychometric assessment. The final instrument comprised six items with a confirmed unidimensional structure, characterized by a single factor with an eigenvalue of 2.502 explaining 41.70% of the variance, factor loadings ranging from 0.536 to 0.641, good internal consistency, and no evidence of measurement bias across sex (p = 0.152). Utility values were subsequently derived by statistically mapping PEDIAQoL onto the EQ-5D-Y using three regression models. The Ordinary Least Squares (OLS) model was selected as the scoring algorithm because of its consistency with the central limit theorem and its linear additive properties. Comparative analyses demonstrated that PEDIAQoL and EQ-5D-Y measure related but non-identical HRQoL constructs. PEDIAQoL was more sensitive to cancer-specific symptom burden, particularly fatigue and pain, whereas EQ-5D-Y placed greater emphasis on functional limitations. Determinant analyses identified cancer type and treatment toxicity (CTCAE grade) as the clinical factors most consistently associated with direct medical costs, productivity loss, and utility scores. The mean direct medical cost was IDR 165,339,238 per patient, while the mean annual family productivity loss was IDR 8,796,118. The utility values generated from PEDIAQoL were subsequently applied in a CUA comparing omeprazole and ranitidine as gastroprotective agents in the treatment of acute lymphoblastic leukemia. Omeprazole was found to be the dominant strategy over ranitidine, with consistently favorable incremental cost-effectiveness ratios (ICERs) based on utility values derived from both EQ-5D-Y and PEDIAQoL. These findings remained robust in one-way, multi-way, and probabilistic sensitivity analyses. Overall, the findings demonstrate that utility values generated by PEDIAQoL provide a valid alternative for conducting economic evaluations of healthcare interventions in pediatric oncology.