Endang Indriasih
Peneliti Pusat Humaniora, Kebijakan Kesehatan dan Pemberdayaan Masyarakat. Badan Penelitian dan Pengembangan Kesehatan - Kementrian Kesehatan, Jakarta

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SISTEM INFORMASI GEOGRAFIS (SIG) DALAM BIDANG KESEHATAN MASYARAKAT Indriasih, Endang
Buletin Penelitian Sistem Kesehatan Vol 11, No 1 Jan (2008)
Publisher : Buletin Penelitian Sistem Kesehatan

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Decentralization in health sector has enable to identify many health problems, population characteristics, and locally and more specific incidences. Health problems can be categorized based on geographic areas (national. regional,and local). The Geographic Information System (GIS) is one of tools for depicting the seventy of health problems and identifying health determinants specifically, as inputs for decision making process, also for epidemiological analysis and public health management. The basic framework of GIS is identification of Input, storage, data processing and output. The GIS main application consist of 1) the spatial description of a health event, 2) risk factors, high risk groups, and high risk areas identification, 3) health situation analysis, diseases pattern analysis, 4) surveillance and monitoring of public health, 5) the planning and programming of health activities; and (5) evaluation on health intervention. In Indonesia, the GIS hasbeen used in many work divisions of Ministry of Health, especially for diseases surveillance mapping. Beside the GIS is able to perform high quality products such as map, graph, and tables. The GIS map can be in the different form of various types and contents. The quality of GIS map depends on geographical precision, the representation of objects pattern and color; definition of the event which will be presented. Usually, the presentation format is developed by combining map, graph and table. Simplification on GIS data management, integration with public health data, and availability of GIS user friendly software will support policy making process according to geographical position. This article presents case in 1997-2001, on the spread of malaria cases in Ciamis District concentrated in some villages in southern coast, where mangrove forest and lagoon are usually found. It tends to spread from west to the east. Malaria cases spread mostly inareas at the height between 0-100 meters above sea level, and just a few cases were found in areas at more than 100meters above sea level. Finally, the capability of GIS to manage spatial data is enable to perform various scenarios as conducting strategic analysis. In order to minimaze bias and uncertain results, it recommends to conduct GIS analysis by multidiscipline members. It should be reminded that the final objective of GIS application in health sector is to improve the ability in plannmg, diagnosing, and intervention of health problems in many governmental administration level due tosupport the achievement of health development goals. Key words: geographic information system, public health, policy making process
HUBUNGAN PENGETAHUAN, SIKAP, DAN PERILAKU TENTANG KARIES GIGI TERHADAP INDEKS DMF-T PADA SISWA SD KELAS VI DI DAERAH KUMUH DAN TIDAK KUMUH KECAMATAN PENJARINGAN JAKARTA UTARA Ariningrum, Ratih; Indriasih, Endang
Buletin Penelitian Sistem Kesehatan Vol 9, No 4 Okt (2006)
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In Indonesia town people are being increase almost twofold. Than many people have to stay in the slum areas. The health of teeth and mouth service in health centres (puskesmas) is given toothache for low income people and specially for anxious people to toothache. The percentage of the toothache, pulpitis and periapical membrane diseases for people took the fourth rank from nine non contagious diseases at Kecamatan Penjaringan are 2.9% in 1999. The objectives of the research were to determine the relations of knowledge, attitude, and behavior aspect about dental caries with DMF-T index. The other objecllves were to determine the classification of slum and non­ slum areas regarding  the knowledge, attitude, and behavtor about caries on the elementary school students 6th class. Results by simple linear regression showed that DMF-T index were influenced by variables of knowledge (p = 0.041). Results by multiple linear regression showed that DMF-T index is influenced by variable of knowledge and attitude about dental (p knowledge = 0.010 and p attitude = 0.046). Results by t test proved there were the significant differences in the knowledge and attitude between elementary school students 6th class in the slum and non-slum area (p knowledge= 0.001 and p attitude= 0.029). Dental healthy of elementary school students 6th class were mfluenced by knowledge. If the variables of knowledge, attitude, and behavior were analyzed together, just variables of knowledge and attitude that influenced caries dentis (DMF-T index). The classification slum and non-slum areas influenced the knowledge and attitude of the students about dental caries.   Key words:  knowledge, attitude, practice, index DMF- T. slum and non-slum area
BENEFIT MONITORING AND EVALUATION (BME): A CASE STUDY Malik, A. Ridwan; Suryati, Tati; Indriasih, Endang
Buletin Penelitian Sistem Kesehatan Vol 9, No 3 Jul (2006)
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Theoretically, the ultimate benefits of health development projects are reflected as increased incomes or tangible improvements in quality of life. They will only be forth coming if services provided by project have more direct effect for those who use the services. However the effects of health programs might be direct or indirect so that they are difficult to be measured comparing with other sectors. The study team conducted a study on Benefit Monitoring and Evaluation (BME) by using The Rural Health and Population Project (ADB Ill-Loan No.1299-lno) as objective of the study. The study was conducted in the year 2000, however, the results of this study is relevant to be published due to it is difficult to find the references, which showed the experiences of the BME study in the health sector. The prime objective of the Rural Health and Population Project was to assist the Government in raising the health status of the population and reducing total fertility rates through the improvement of quality, relevance, efficiency and effectiveness of community-based rural health and family planning (FP) delivery system. The Project adopted the following three strategic initiatives: (1) to change the role and orientation of the district hospital; (2) to improve community-based rural health, nutrition and FP service delivery and capabilities; and (3) to strengthen the organization and management at district level. To examine the extent, to which these reforms through the project implementation have intended benefits and effects, both individually and collectively, the evaluation team conducted a study to evaluate the progress on the field implementation of these reforms in the area of the project. The evaluation  of benefits of projects will be conducted, whether or not the benchmarks of benefit monitoring was adequately documented when the project is prepared. The study team using a conceptual  model called a Logical Framework (LF) a set of cause-and-effect relationship through which resources provided through the project are transformed so they contribute to achieving the objective of the intervention, and assumptions about external factors which affect these relationships. ALF enables one to describe a project in terms of three sequential relationships: inputs to outputs, outputs to effects and effects to impact. Assessment was used benchmark that information available in the project documents. Addition primary and secondary data needed was collected in the locations of the project. The study identified three group or stakeholders which have benefits of the projects; (1) the local authority; (2) The health provider; (3) the community or recipients. By using the benchmark which available in the regularly reporting and recording system the benefits of the project was assessed as; (1) no benefit; (2} minimal benefit; (3) and optimal benefit. Results of the study showed that (1) the local authority in general have optimal benefit, however several activities have minimal benefits; (2) the health providers have minimal benefit, some showed have no benefit, it is only improvement of medical services have an optimal benefit; (3) the community or recipients almost have optimal benefit.
ANALISIS KESESUAIAN KLAIM DENGAN REALITAS PEMBAYARAN PPK RUJUKAN DALAM JAMINAN KESEHATAN MASYARAKAT MISKIN Tarigan, Ingan Ukur; Indriasih, Endang
Buletin Penelitian Sistem Kesehatan Vol 11, No 4 Okt (2008)
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The main goal of health development in lndonesia is providing quality health care and assuring community access to equal health services for all citizen (universal coverage). In assuring the access to health services for the poor. Ministry of Health has launched special health insurance program for the poor (Askeskin). PT Askes was assigned by MOH to manage this program. Therefore, it is very important to improve facilities and management capabilities of health insurance administering bodies and health care providers. These include, improvement in case management, hospital accounting system, medical record, etc. This will be very useful for verification process and reducing the fraud and abuse. This study was conducted in order to provide valuable input for the Improvement of financing mechanism and payment system of referral providers in health insurance program for the poor (Askeskin). The objectives of this study are to calculate hospital claim on case management of Askeskin members and its real payment by PT Askes and to calculate the differences between claim and reimbursement (real payment) based on hospital components. The study design is cross-sectional. A Stratified Random Sampling method was conducted to select the study sites based on Human Development Index (HOI) and Fiscal Capacity (refers to Ministry of Finance Data) of district and city. Districts and cities were then classified into high, middle, or low level. The 3 selected study sites were: Kampar District (HPI 34,1) in Riau Province which represent high HOI; North Bengkulu District (HPI: 30.4) in Bengkulu province which represent middle HOI, and Pontianak City (HPI: 27.7) in West Kalimantan Province which represent low HOI. The results show that tariff agreement of case management for Askeskin members was not in accordance with local real condition. Therefore, clear operational and technical Askeskin guidelines are needed to gain similar perception between PT Askes and health care providers· beside Improvement of socialization activities to the community. The amount of differences between claim and reimbursement varied among study sites. The difference was influenced by following factors: (1) existed guidelines that were not suitable with local specific real demand and (2) disparity among hospital facilities. Hospital with limited facility has difficulty to refer patient to another closed hospital which doesnt have contract with PT Askes. Furthermore, in some cases hospital with good facility cannot optimalize using their advanced equipment for treatment, because not stated in the contract with PT Askes. Contract review, tariff adjustment, and re-negotiation between hospitals and PT Askes should be encouraged to provide better services for Askeskin members. Key words: health insurance, the part of community, financing mechanism, referral providers
RISIKO PENYAKIT JANTUNG PADA PEROKOK PESERTA PROGRAM JAMKESMAS Indriasih, Endang; Tarigan, Ingan
Buletin Penelitian Sistem Kesehatan Vol 12, No 2 Apr (2009)
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Background: For years heart disease prevalence have increased. Results of Basic Health Research (known as riset Kesehatan Oasar-Riskesdas) 2007 showed that heart disease is the second major cause of death after stroke inmortality cases in Indonesia. As a matter of fact, other researches results indicate that smoking as a risk factor for heart disease and most of smoker are poor people. Indonesian government guarantees the poor to get free medical treatment through Jamkesmas program (social assistance program in health sector for the poor). In 2007 Cipto Mangunkusumo National Hospital (RSCM) noted that 60% of heart disease patients treated in this hospital is poor. The trends of cases and government budget to control heart disease are always increasing. Objective of this study was to know smoker prevalence, food consumption and activity for participants JAMKESMAS and also to know risk factor of heart disease for them Methods: Cross sectional was utilized as the study design The Riskesdas and Susenas 2007 data was used in this research. All research variables had been analyzed in univariat, bivariat (X2 test) and multivariat (logistic regression) by using a complex sample in SPSS v16. Results: The results shows that smokers Jamkesmas are most in aged 3-4 years do enough physical activities, and less eating fruits and vegetables, 1.8% of Jamkesmas smokers had diagnosed heart disease by health personnel. Based on statistical analysis, physical activity, fruit and vegetable consumption, smoking, gender and age is risk factor of heart disease. Key words: Heart, Tobacco, Jamkesmas
IDENTIFIKASI WILAYAH DENGAN PERMASALAHAN KESEHATAN ANAK BALITA DI PROVINSI JAWA TIMUR Indriasih, Endang; Ariningrum, Ratih
Buletin Penelitian Sistem Kesehatan Vol 14, No 1 Jan (2011)
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Background: Government Regulation no. 38 year 2007 about the distribution of governmental power between central, provincial and district/town was one reference for government. Despite of decentralization was expected to remain the relevance from the administration. Meanwhile, to view the performance or measured the success of development held by local districts, especially in the field of health has issued the Ministerial Regulation Rl No. 741/Menkes/Per/VII/2008 on Minimum Service Standards (SPM) in the Health Sector which is an effort to accelerate the achievement of the MDGs in 2015. Child health problems focused on the decline in mortality because even the trend was declining but the achievement is still rae from target, particularly the MDGs in 2015, either RPJPM or Minimum Service Standards (SPM). When in handling found of resource limitation, it is necessary to scale the priority to handle with the regional approach or program. The objective of the study is to know distribution areas and offers an alternative method of diagnosing the area of Children under 5 health problems so that it shows children under 5 priority areas. Methods: The data for this analysis from a survey called RISKESDAS 2007 with sample unit is children under 5. Variables used are; state of poor and malnutrition, the completed Immunization coverage, posyandu utilization, morbidity (diarrhea, pneumonia and TB), clean and healthy lifestyle. lack of clean water, lack of sanitation in the districts of East in Java. Results: This result is several thematic maps when it is overlay; find the two districts in the eastern part is relatively problematic area among the districts and other towns in East Java. Key words: Spatial analysis, children under 5 health, East Java