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Contribution of Socio Economical, Biological and Health Service Factors towards Neonatal Morbidity and Mortality Djaja, Sarimawar; Hapsari, Dwi; Sulistyowati, Ning; Lolong, Dina Bisara
Journal of the Indonesian Medical Association Vol. 59 No. 8 August 2009
Publisher : Journal of the Indonesian Medical Association

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Abstract

In the last five years period the neonatal mortality rate decreased insignificantly. The aim of this analysis is to identify the background factors of neonatal morbidity (diarrhea/acute respiratory infection(ARI)pneumonia) and neonatal mortality in Indonesia. The research designed is cross sectional and using Baseline Health Research 2007 data merged with Susenas 2007 data to get the socio-economic variabel. Sample consists of 280,000 household spreading in the 18 000 block census, chosen through probability proportional to size selection. Systematic random sampling of 16 household applied from each selected block census. Bivariate and multivariate analysis with logistic regression was done to all neonatal suffering acute respiratory infection/pneumonia/diarrhea and neonatal death. The result of multivariate analysis shows risk of neonatal morbidity for diarrhea/ARI/pneumonia increases in moderate-low level of family income, babies in the rural area, and babies not visited by midwives in the first week after born, compared to babies with high level of family income, live in urban area, and visited by midwives. The risk of low birth weight increase 9.5 times to neonatal death, and the risk of mother with no education or does not graduate the primary school increases 3.4 times to neonatal death compared with mother graduate from senior high school. To increase the survival of the neonatal babies there should be attempts with other sectors to increase the economic status of the population, education of the women, as well improving the quality of care for high risk pregnant mothers, delivery/postpartum mothers, low birth weight babies and newborn babies with respiratory disorders.Keywords: neonatal, morbidity, mortality, socio-economic, health services
STATUS IMUNISASI DAN KESAKITAN ANAK UMUR 1-2 TAHUN (BATITA) ANALISIS LANJUT SDKI 1994 Tjitra, Emiliana; Lubis, Agustina; Hapsari, Dwi; Budiarso, Ratna
Buletin Penelitian Kesehatan Vol 24, No 2&3 Sept (1996)
Publisher : Buletin Penelitian Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | http://ejournal.litbang.depkes.go.id/index.php/BPK/article/view/415

Abstract

The Indonesian Demographic and Health Survey (SDKI) was carried out in 1994. To maximize the usefulness and evaluate the relevance of the data that had been collected, extended analysis of immunizational status and morbidity of children underthree was performed. The purpose of this analysis was to assess the cases and proportion of the diseases or symptoms of children underthree who could show the KMS or Immunization card based on the status of immunization, to compare the proportion of the diseases or symptoms between the immunizational status groups, and to assess the Odds Ratio (OR) of disease in the uncompleted and non-immunized groups compared to the completed immunized group. A bivariate analysis in SPSS programme using x2 and OR tests was used.The overall diseases proportion of the 1959 children underthree who could show KMS or Immunization card was 51.3 %. The highest percentage of cases (47.7%) was cough with fast breathing (pneumonia) in the uncompleted immunization group (missed one or more of these immunization: BCG, DPT, Polio and Measle), and the highest disease proportion (26.3%) was fever with cough (non pneumonia ARI) in non-immunized group. The highest disease proportion in completed immunized children underthree was fever with cough (non pneumonia ARI); while in the uncompleted immunized group it was fever with cough with or without fast breathing (non pneumonia ARI or pneumonia); and in non-immunized group were fever with cough with or without fast breathing or with diarrhoea (non pneumonia ARI or pneumonia or with diarrhoea). The uncompleted immunized DPT group had 1.57 - 4.25 higher risk of non pneumonia ARI or pneumonia with or without diarrhoea than the completed immunized DPT group. Either in the non-immunized Measles group had 1.44 - 5.88 higher risk of non pneumonia ARI or pneumonia with or without diarrhoea than the immunized Measle group. If the immunization was not completed, they had 1.64 - 44.93 higher risk of non pneumonia AR1 or pneumonia with or without diarrhoea than the completed immunized group; and the non-immunized group had 2.24 - 3.96 higher risk of diarrhoea with or without fever compared to the completed immunized group.The most common disease of the 51.3 % sick children underthree was ARI. The status and type of immunization play a role in reducing the risk and severity of ARI and diarrhoea. 
BEHAVIOR RISK FACTORS IN INDONESIA: NATIONAL HOUSEHOLD HEALTH SURVEY 2001 Kristanti, Ch. M.; Hapsari, Dwi; Pradono, Julianty; Soemantri, Soeharsono
Buletin Penelitian Kesehatan Vol 33, No 1 Mar (2005)
Publisher : Buletin Penelitian Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | http://ejournal.litbang.depkes.go.id/index.php/BPK/article/view/204

Abstract

A series of National Household Health Surveys (NHHS) reported the occurrence of epidemiological transition caused by demographic transition and prolonged economical diversity, Communicable diseases are still prevalent, followed by the emergence of Non Communicable Diseases (NCDs), which are due to an increasing level of behavior risk factors in the population. In the NHHS 2001, a morbidity survey collected information about behavioral risk indicators, whereas the WHOS STEPwise approach was one of the study instruments. The WHO Step 1 questionnaire was adapted with some modifications. Samples of NHHS, morbidity survey was sub-sample of module sample of National Social Economic Survey (NSES) 2001. A sample of 15,148 people aged 10 years+ were analyzed to identify their behavior regarding smoking, alcohol consumption and physical activity. These findings are a representation of the national figures, which were presented by characteristics of the population such as: sex, age, residence, region and economic status. Economic status was divided into 5 strata, which were calculated from a quintile of household expenditure. The results showed that 29.7% of the population aged 10 years+ are daily smokers. This is more prevalent in males than females (58.9% vs. 3.7%). This behavior increases by age group, except for the oldest; there are slightly more smokers in rural areas than urban areas (31% vs. 28%), and no difference among regions (30-31%). Those with better economic status are less likely to smoke than poorer ones. Alcohol consumption is reportedly very low (2.7%), more prevalent in males than females (4.9% vs. 0.8%), and higher in rural areas than urban areas (3.1% vs. 2.1%). Eastern Indonesia, was higher than Sumatra, Java and Bali (6.3%, 4.7%, and 1.2% respectively). There were no differences in alcohol consumption according to economic status. Physical inactivity is very high (68%), more prevalent in females than males (73% vs. 63%), and higher in urban areas than rural ones (78.4% vs. 60.6%). Among regions, Java Bali region (72%) was higher than Eastern Indonesia and Sumatra (62% and 59% respectively). Those with a better economic status are more likely to be inactive than their counterparts. These behaviors are a reflection of future diseases , which may cause the morbidity of NCDs. This information on risk factors is essential for future caseload predictions in regards to NCDs and for preventive program planning.
ANALISIS SITUASI PENGELOLAAN OBAT PUBLIK Dl BEBERAPA KABUPATEN/KOTA Herman, Max Joseph; Hapsari, Dwi; Budiharto, Martuti
Buletin Penelitian Sistem Kesehatan Vol 10, No 4 Okt (2007)
Publisher : Buletin Penelitian Sistem Kesehatan

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Abstract

ABSTRACT Drugs as an essential element in health care must be available at the time they are needed. Accessibility to essential drugs is a public right, therefore it is the government responsibility to make them available. Before the era of regional autonomy, public drug management in all districts/cities was performed by the so-called District Pharmaceutical Warehouses (Gudang Farmasi  Kesehatan). However. at present the situation has changed  because of differences in vision and perception  of each regional government on the past warehouses. Some public drug management  units in certain districts/cities are not functioning optimally. Inefficient drug procurement on numbers and kinds of drugs as well as timeliness result in gap between drug needs and procurement. Furthermore, loosening in drug supply procedure makes essential drugs more inavailable to public. On the other hand, decentralization  policy in drug management  also undeniably  provides advantages to districts, for example capacity  building  in drug procurement, increasing capability in budget management and negotiation with district decision makers as well as enhancing regional economic activity. In revitalizing district pharmaceutical warehouses as to attain minimal health care standards in districts/cities (Keputusan MenKes No.1457 tahun 2003), baseline data in drug management  and financing in several districts/cities should therefore give a valuable contribution. A cross sectional descriptive  study had been carried out during July to December  2006 in 26 districts/cities out of 11 provinces. Samples were 26 district health offices (Dinas Kesehatan Kabupaten/Kota), 26 district pharmaceutical warehouses (GFK) and 52 primary health cares (Puskesmas), i.e. two PHCs from each district, where as respondents were heads of drug section, heads of warehouse and drug provider, respectively. Data were collected by structured questionnaires and analysis of effectiveness and efficiency of district drug management were using the evaluation guidelines issued by Directorate General of Pharmaceutical Care And Medical Devices. Results showed 1) Almost all districts drug procurement was conducted by open tender (90.5%); 2) Timely reporting from primary health cares was 68.7%; 3) The average  percentage of drug budget  allocation from 21 district health offices was only 12.06%; 4) The average drug budget per capita was Rp2,670,- whereas average drug expenditure per capita was slightly higher, Rp2,817,-;5) All district warehouses use price guidelines of PHC and Programme drugs; 6) The average percentage of drugs included in essential and/or generic drug list and in appropriateness with morbidity pattern were 87.47%, 85.22%, and 147%, respectively; 7) The average drug availability in 24 district warehouses was slightly higher than 18 months and the average percentage of safely stock drug was 79.0%; 8) The average time out of stock drug in a year was 24 days, while the average percentage of expired drugs was 9.51% (average value Rp5,328,615,-) and the average of damaged drugs was 4.18% (average  value Rp7,154,779,-). A part from the achievement of predetermined indicators stated in minimal health care standards in districts/cities, drug management in general has been performed well.Key words: District Pharmaceutical Warehouse (GFK), public drugs, drug management    
POLA PERSEDIAAN DAN PENGGUNAAN OBAT BERDASAR RESEP DAN NON RESEP OLEH ANGGOTA RUMAH TANGGA DI INDONESIA Raharni, Raharni; Hapsari, Dwi; P, Julianty; Herman, Max. J.
Buletin Penelitian Sistem Kesehatan Vol 11, No 1 Jan (2008)
Publisher : Buletin Penelitian Sistem Kesehatan

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Abstract

Drug resources and health enforcement are essential to each effort to ensure the availability of high quality drugs in the market, as well as easy and equity acces to them. Along with health awareness, they foster community health Drug and health awareness problems are so complex, because related to some aspects, such as quality, policy, on price performance, safety, availability and value for money. From this point of view, it is interesting to conduct a research on the pattern of drug availability in households representing the community. The analysis aims to identify the pattern of drug availability in housholds, either prescribed or non prescribed. Results shows that the highest percentage (23%) of prescribed drugs belong to analgesic, antipyretic, and antinflammatory therapy class, followed by anti infection and (respiratory medicine) for 13% and 10%, respectively. For non prescribed drugs, the highest percentage is analgesic, antipyretic, and antiinflammatory (5%), followed by traditional herbs/medicines and respiratory medicines and digestive medicines, for 10%, 10%, and 8%,respectively. For joint diseases, accidents, and asthma, a majority of non prescribed drugs are used. While for cardiovascular diseases and diabetes, most of drugs used are prescribed drugs. It concluded that drugs belong to analgesic, antipiretic,and antinflammatory therapy class are widely used for chronic diseases, cardiovascular diseases, asthma, and other diseases, either prescribed or non prescribed. Key words: drugs, therapy class, prescribed - non prescribed drugs
FORMULATION OF INDONESIAN PUBLIC HEALTH DEVELOPMENT INDEX Hidayangsih, Puti Sari; Hapsari, Dwi
Buletin Penelitian Sistem Kesehatan Vol 14, No 2 Apr (2011)
Publisher : Buletin Penelitian Sistem Kesehatan

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Abstract

The objective of formulation the Indonesian Public Health Development Index (IPHDI) was to describe the successful development of public health based on composite several community-based health indicators. Cross sectional study design.The data analyzed was a combination of a nationwide survey covering Baseline Health Research (Riskesdas) 2007, National Social Economic Survey (Susenas) 2007 and the Village Potential (Podes) in 2008. Selection of appropriate indicators included in IPHDI associated with LE at birth, selected on the basis of consensus expert team. When the indicator has the RSE (relative standard error) value of less than 30% and the value was held for more than 75% of districts. then the indicator is a candidate in the calculation IPHDI. The team doing the analysis on 22 models of the combination of indicators. The number of indicators chat involved between 18 to 24. These models have been made and tested for correlation weighting of life expectancy each district. Results of correlation ranged from 0.314 to 0.512 and all models have a significance value p< 0.001. The model was chosen considering the variables that are considered priorities and values of correlation. IPHDI Highest value is 0.708959 (Magelang City, Central Java) and the lowest is 0.247059 (Pegunungan Bintang district, Papua). Conclusion. IPHDI utilization is to know district who has severe health problems, resulting in enhancement programs that have intervened, resulting in focusing the target location, and became one of the parameters for the calculation of aid allocations fairly from center to the region. Key words: health indicators, Indonesian public health development index, life expectancy
Ten-Year Trend of Acute Respiratory Infection (ARI) and Diarrheal Diseases Based on Healthy Houses in Indonesia Hapsari, Dwi; Dharmayanti, Ika; ., Supraptini
Buletin Penelitian Sistem Kesehatan Vol 16, No 4 Okt (2013)
Publisher : Buletin Penelitian Sistem Kesehatan

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Background: Housing is a basic human need that can affect health. To achieve a decent standard of living, peopleshould live in an adequate housing, so that its occupants have a safe and healthy environment. Condition of the houseis part of the quality of the environment. One of the environment-related diseases is ARI and diarrhea. Objectives: Thisstudy determines trends of ARI and diarrheal diseases and their relation to healthy houses in Indonesia in the last tenyears. Methods: This analysis combines two data sources that are Riskesdas 2007–2010 and Susenas 2001–2010. Thedesign of Riskesdas and Susenas is descriptive cross sectional. Research area for this analysis covers the entire provincein Indonesia. The limitation of this analysis is only eight variables that can be used from data sources every year, beside 14 indicators of healthy houses. Results: This study indicates that: 1. Trends of ARI and diarrheal disease against healthy houses are similar. If percentage of healthy houses are high then the percentage of ARI and diarrheal disease are low, andvice versa. Therefore, there is a correlation among healthy houses with ARI and diarrhea; 2. In low-income groups with similar healthy houses conditions, the percentage of ARI and diarrheal disease is higher than high-income groups. The role of economic status is an important point to reduce the percentage of ARI and diarrheal diseases; 3. During 2007, it shows a rise in ARI and diarrhea rate along with a decrease percentage of healthy houses. Conclusion: This study concludes that if the percentage of healthy houses is low then the percentage of ARI and diarrhea will increase, and vice versa. Socioeconomic factors have a role in the rise of healthy houses and a reduction in the percentage of ARI and diarrhealdiseases. Recommendation: the population needs to increase awareness of the environmental and healthy behaviors toform a Healthy Household.
FAKTOR-FAKTOR YANG BERPENGARUH TERHADAP RISIKO KEHAMILAN “4 TERLALU (4-T)” PADA WANITA USIA 10-59 TAHUN (ANALISIS RISKESDAS 2010) H, Puti Sari; Hapsari, Dwi; Dharmayanti, Ika; Kusumawardani, Nunik
Media Penelitian dan Pengembangan Kesehatan Vol 24, No 3 Sep (2014)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

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Abstract

Abstrak Tujuan penulisan ini adalah mengidentifikasi faktor-faktor tidak langsung yang dapat mempengaruhi risiko kehamilan. Desain penelitian cross sectional. Data yang dianalisis merupakan data hasil Riset Kesehatan Dasar (Riskesdas) tahun 2010 yang telah dilaksanakan oleh Badan Litbangkes. Unit analisis adalah ibu atau wanita usia subur (WUS) yang pernah melahirkan minimal 1 anak dalam kurun waktu 5 tahun terakhir sampai dengan saat wawancara. Analisis dilakukan dengan menggunakan metode logistik regresi untuk mengetahui faktor yang paling dominan. Berdasarkan hasil analisis ditemukan bahwa variabel yang paling dominan dalam hubungan antara faktor tidak langsung dengan kejadian fisiko kehamilan 4-T (terlalu tua, terlalu muda, terlalu banyak dan terlalu dekat) adalah variabel tempat tinggal  (desa/kota),  tingkat  pendidikan,  status  ekonomi,  dan  keinginan  hamil.  Ibu  yang  tinggal  di perdesaan berpeluang 1,1 kali berisiko kehamilan 4T, sementara ibu yang berpendidikan rendah (SD ke bawah) berpeluang 1,4 kali untuk mengalami risiko kehamilan. Ibu dari keluarga miskin berpeluang 1,3 kali mengalami risiko kehamilan, sedangkan ibu yang sulit akses ke pelayanan kesehatan berpeluang 1,9 kali berisiko hamil dengan kondisi 4-T, dan ibu yang tidak/belum ingin hamil berpeluang 4,9 kali mengalami risiko kehamilan. Masalah risiko kehamilan lebih mungkin terjadi pada kelompok ibu yang tinggal di perdesaan, dengan tingkat pendidikan dan ekonomi rendah, dan kesulitan akses ke fasilitas kesehatan serta belum atau tidak menginginkan kehamilannya. Oleh sebab itu diperlukan pemerataan program jamkesmas agar keluarga tidak mampu dan yang tinggal di perdesaan semakin mudah untuk mendapat  pelayanan  kesehatan.  Selain  itu  memprioritaskan  pembangunan  fasilitas  kesehatan  dan penyediaan tenaga kesehatan di perdesaan, dan juga penyuluhan tentang cara mengatur kehamilan yang sehat.Kata kunci : risiko kehamilan, WUS, 4-TAbstract The purpose of this paper is to identify factors that may indirectly affect the risk of pregnancy. Crosssectional study design. The data is from the Basic Health Research (Riskesdas) in 2010 which has been implemented by the National Health Research, Ministry of Health. The unit of analysis is the mothers or women of childbearing age (WUS) who had delivered at least one child within a period of 5 years up to the time of the interview. The analysis was performed by using logistic regression to determine the most dominant factor. Based on the analysis found the most dominant variable in the relationship between the indirect factors associated with the incidence of pregnancy risk 4-T (too old, too young, too many and too often) is variable residency (rural/urban), level of education, economic status, access to health facility and desire of pregnancy. Mothers who live in rural areas are likely 1.1 times have the chance of pregnancy risk, while mothers with low education (elementary school and below) 1.4 times as likely to experience a pregnancy risk. Then, mothers of poor families having a chance to experience 1.3 times the risk of pregnancy, whereas mothers who have difficult access to health services were likely 1.9 times at risk of pregnancy with 4-T conditions, and women who did not want to get pregnant were likely to experience 4.9 times the risk of pregnancy. Risk of pregnancy problems is more likely to occur in the group of women who live in rural areas, with low levels of education and the economy, and the difficulty of access to health facilities and does not want her pregnancy. Therefore, it requires health insurance or “jamkesmas”in order to provide an equal health services for poor people and those who living in rural areas. In addition to prioritize the provision of health facilities and health workers in rural areas, as well as counseling on how to manage a healthy pregnancy.Keywords : risk of pregnancy, fertility.
Needs for Counselling in Communication of Family Planning Program in Decentralizatim Era in Purbalingga Puspita, Dyah Retna; Wahyuningsih, Eri; Hapsari, Dwi
Jurnal KMP (Jurnal Komunikasi Pembangunan) Vol 12, No 1 (2014): Februari 2014
Publisher : Institut Pertanian Bogor

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (316.304 KB) | DOI: 10.29244/jurnalkmp.12.1.%p

Abstract

AbstractThis study examined the husbands? perspective about family  planning counseling in Purbalingga District. Target of this study were 30 husbands who experienced gender role shifting. Data obtained through interview and focus group discussions. Results of this  research were: first, they initially had experience of gender role conflict; second, they never involved in family planning counseling whereas they need information about family harmony, reproductive health, child development and other related issues.Keywords: family planning counseling, gender role shift, gender role conflict
Asma pada Anak di Indonesia : Penyebab dan Pencetusnya Dharmayanti, Ika; Hapsari, Dwi; Azhar, Khadijah
Jurnal Kesehatan Masyarakat Nasional Vol. 9 No. 3 Februari 2015
Publisher : Faculty of Public Health Universitas Indonesia

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AbstrakAsma merupakan penyakit kronis yang dapat mengganggu kualitas hidup. Hingga saat ini, jumlah penderita asma semakin meningkat termasuk di Indonesia. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan dengan kejadian asma dan pencetus asma pada anak usia 6 - 14 tahun di Indonesia. Metode yang digunakan adalah potong lintang dengan menggunakan data Riset Kesehatan Dasar (Riskesdas) 2013 di 33 provinsi di Indonesia. Variabel bebas adalah karakteristik responden, faktor lingkungan dan perilaku merokok anak dan orangtua. Hasil analisis menunjukkan bahwa jenis kelamin laki-laki, kondisi sosial ekonomi rendah, riwayat asma pada orangtua, anak yang merokok atau pernah merokok, dan orangtua yang merokok atau pernah merokok adalah faktor risiko yang berhubungan secara signifikan dengan tinggi kejadian asma pada anak (p < 0,05). Sedangkan variabel yang tidak berhubungan secara bermakna (p > 0,05) adalah usia, kepadatan hunian, bahan bakar memasak, penerangan dalam rumah, dan penanganan sampah. Lima pencetus utama asma pada anak adalah udara dingin, flu dan infeksi, kelelahan, debu, dan asap rokok. Oleh karena itu, orangtua harus mendorong anak untuk bergaya hidup sehat agar anak terhindar dari serangan asma. AbstractAsthma is a chronic disease that can interfere the quality of life. Up to now, the prevalence of asthma is increasing including in Indonesia. This study aimed to identify factors related to the incidence and triggers of asthma in children aged 6 - 14 years in Indonesia. The method used was cross section using 2013 Basic Health Research (Riskesdas) data in 33 provinces over Indonesia. The independent variables are the characteristics of respondents, environmental factors and smoking behavior of children and parents. The analysis result shows that male sex, low socio-economic status, parental asthma record, children and parental smoking are the risk factors significantly related to the increasing prevalence of asthma incidence in children (p < 0,05); meanwhile, age, housing density, cooking fuel, home lighting and waste handling are the other variables significantly not related (p > 0,05). Five potential triggers of asthma in children are cold weather, flu and infections, fatigue, dust and tobacco smoke. Therefore, parents have to encourage their children to get a healthy lifestyle in order to prevent them from asthma attack.