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Determinan Abortus di Indonesia Kuntari, Titik; Wilopo, Siswanto Agus; Emilia, Ova
Kesmas The National Journal of Public Health Vol. 4 No. 5 April 2010
Publisher : Kesmas The National Journal of Public Health

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Abstract

Abortion has become a main problem in public health because of its impact on maternal morbidity and mortality. There is no comprehensive data on abortion in Indonesia. So far, data were based on survey with limited coverage. Unsafe abortion is responsible to 11 percent of maternal mortality in Indonesia. This research objective is to determine factors related to abortion in Indonesia. The study was an observational method with cross sectional design. These data are gathered from Indonesian Demography and Health Survey 2002–2003. Data analysis used univariate, bivariate and multivariate analysis with logistic regression. The risk of an abortion increased in line with the increasing of maternal age. Women with 0-2 parity have higher risk than multiparity (OR=5.2, IK95%=3.49-7.89). Employed women have higher risk than unemployed (OR=2.7, IK95%=2.10-3.58). The risk of abortion increased among women married at 30 years old or over (OR=1.8, IK95%=1.30-2.48). There is no significant association between history of abortion, education, socioeconomic and risk of abortion.Key words: Abortion, trend of abortion, abortion’s determinant, Indonesia
VAKSIN ROTAVIRUS: APAKAH SUDAH WAKTUNYA DIMASUKKAN DALAM PROGRAM IMUNISASI NASIONAL DI INDONESIA? Wilopo, Siswanto Agus
Jurnal Manajemen Pelayanan Kesehatan Vol 12, No 02 (2009)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Abstract

Background: Two rotavirus vaccines have been availablefor use. The objectives of the study to examine disease burdenof diare rotavirus and the cost and effectiveness of a rotavirusvaccination program in Indonesia.Material and Methods:  Data on direct and indirect costs ofchildren with rotavirus diarrhea were established in PurworejoDistrict and Yogyakarta city. It was extrapolated to nationalestimates on the basis of the projected birth cohort in 2007and diarrhea morbiditity rate at national level. The main outcomemeasures were economic burden and cost-effectiveness ratio(Rupiah per DALY averted).Results: The disease burden is equivalent to an economicburden of an estimated Rp390.4 billion in medical direct costs,Rp 67.3 bilion in nonmedical direct costs, and 70.4 billion rupiahin indirect costs. From the health care system and communityperspectives, universal vaccination of infants at a cost of lessthan US $12,7 for a vaccine dose would be a cost-effective ofpublic health intervention.Conclusions and Recommendation: In Indonesia, rotavirusvaccination would reduce the morbidity burden of rotavirusinfection, but would not be cost-effective unless the price ofvaccine decreased considerably. At the current price ofvaccine, universal vaccination program for rotavirus wouldnot be recommended.Keywords: burden of disease, rotavirus diarrhea vaccine,cost-effectiveness
Estimasi Pengaruh Vaksin DPT pada Kematian Anak: Analisis Multivariabel data Survailan Demografi dan Kesehatan di Kabupaten Purworejo Wilopo, Siswanto Agus
Berita Kedokteran Masyarakat (BKM) Vol 25, No 1 (2009)
Publisher : Berita Kedokteran Masyarakat (BKM)

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Abstract

Background: Recent  controversial  reports  suggest  that  recipients  of  one dose  of DTP  vaccines had  higher mortality  than  children who  had  received  no DTP  vaccine. We   reanalyzed data  on vaccination  and  child  survival collected  from demographic  and health  surveillance  to  challenge previous  findings.Objectives: To estimate specific and non-specific effects of DTP vaccination on child mortality age 1-24 months under  routine vaccination  program  in  Indonesia.Methods: A  longitudinal  surveillance  data  provided  information  on 5647  children  below  24 months  of age who received DTP and  other vaccinations. The main  outcome measure was all-cause mortality. Background  factors associated with mortality were  collected,  such as:  sex,  birth  order, dead  sibling, mother’s  education and  family size. We assessed DTP vaccinations  as an  independent  factor with other  variables  in Cox’s  regression models with  time  dependent  covariates.Results: There  is  no  sex  differential  of mortality  among  children  in  Purworejo  even  after  considering  other factors using Cox  regression  analysis. Mortality was  lower  in  the  group  vaccinated with DTP vaccine  compared with  those  not  vaccinated,  the  relative  risk  of mortality  (RR)  being  0.56 with  95%  confidence  interval  (CI)  is 0.453–0.690. After controlling  for  the  background  factors,  recipient of DPT vaccines  continued  to  have  a  lower mortality with RR=0.74  (95% CI:  0.586–0.925). BCG  and measles  vaccines have  stronger  non-specific  effects compared  to  effects  of DTP  vaccines.Conclusion:    Through  specific  effect  against  targeted  diseases  and  a  non-specific  benefit  against  others illnesses,  the study  showed  reduced mortality among  children who  received DTP  vaccine. There  is no  reason to  change current  vaccination policy  because DTP was not  associated with  any  harmful  effect  among  girls.Keywords: non-specific  effects, DTP  Vaccine,  child  survival, Cox’s Regression
Estimasi Pengaruh Vaksin DPT pada Kematian Anak: Analisis Diskritif Data Surveilan Demografi dan Kesehatan di Kabupaten Purworejo Wilopo, Siswanto Agus
Berita Kedokteran Masyarakat (BKM) Vol 24, No 3 (2008)
Publisher : Berita Kedokteran Masyarakat (BKM)

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Abstract

Background: Recent  controversial  reports  suggest  that  recipients  of  one  dose  of DTP  vaccine  have  higher mortality  than  children who  have  received  no DTP  vaccine. Those  reports were mainly  derived  from African countries where mortality and malnutrion were  higher  than  Indonesia.Objectives: To  describe  specific  and  non-specific  effects  of DTP  vaccination  on  child mortality  age  1-24 months under  routine vaccination  program  in  Indonesia.Methods: During  period of  January 1  1995  to August 31,  2001  our  longitudinal  surveillance  data at  Purworejo district provided  information on 5647 children below 24 months of age who  received DTP and other vaccinations. The main  outcome measure was  all-cause mortality. Vaccination  status  on DTP, BCG,  and measles were collected  every  90 days  and  recorded  its  time  at  vaccination. Confounding  factors  associated with mortality were  also collected. This  first  report used  descriptive analysis  and a  survival curve  (Kaplan-Meier)  to  examine the  differential of mortality according  to sex  of  the  children and  among vaccinated  and  non-vaccinated  children with DTP, BCG,  and measles vaccines. The second  report will  use  survival  analysis  to  estimate specific  and non-sprecific  effects  of DTP  by  considering  time at  vaccination and  other counfounding  factors.Results: There  is no  sex differential  of mortality among  children  in Purworejo.  A  probability of  dying was  lower in  the  children vaccinated with DTP  vaccine compared with  those  not vaccinated DTP. Simmilarly,  vaccinated children with  BCG  and measles  have  lower mortality  compared  to  unvaccinated  children.  There  is  strong indication  that BCG and measles  have  stronger protected  effects  to  risk of  dying  than DTP.Conclusion:   The study showed  lower mortality among children who  received DTP, BCG, and measles vaccines compared  those unvaccinated.  There were  not enough  evidences  to  change current  vaccination policy  because DTP was not  associated with  any harmful  effect  among  girls.Keywords: non-specific  effects, DTP  vaccine–child  survival-  Kaplan Meier’s Curve
Perilaku Seks Pranikah Remaja Rahyani, Komang Yuni; Utarini, Adi; Wilopo, Siswanto Agus; Hakimi, Mohammad
Jurnal Kesehatan Masyarakat Nasional Vol. 7 No. 4 November 2012
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (254.739 KB) | DOI: 10.21109/kesmas.v7i4.53

Abstract

Hubungan seksual sebelum nikah pada remaja merupakan masalah yang serius, berhubungan dengan peningkatan penularan penyakit menular seksual, mempunyai pasangan lebih dari satu, dan kehamilan dini. Suatu kerangka kerja model perilaku terintegrasi (Integrated Behavioral Model, IBM) digunakan untuk menilai berbagai faktor prediktor hubungan seksual prematur pada remaja. Tujuan penelitian ini adalah mengeksplorasi inisiasi hubungan seksual sebelum nikah pada remaja level 10 dan 11 berdasarkan kerangka kerja IBM, meliputi komunikasi tentang seks kelompok peers, orang tua, paparan perilaku pornografi, kepercayaan normatif, agen personal, dan keinginan hubungan seksual. Metode yang digunakan adalah menyertakan 626 responden dalam survei awal. Responden adalah siswa sekolah menengah atas level 10 – 11 di kota Denpasar. Data dikumpulkan dengan kuesioner laporan sendiri khususnya prediktor inisiasi hubungan seksual sebelum menikah. Penelitian ini menemukan bahwa pajanan pornografi, perilaku langsung dan tidak langsung berhubungan secara signifikan dengan inisiasi hubungan seksual sebelum nikah (nilai p < 0,05). Remaja laki-laki tampaknya melakukan lebih banyak aktivitas seksual daripada remaja perempuan. Penelitian ini berimplikasi terhadap pemahaman perilaku langsung dan pajanan pornografi mungkin digunakan dalam meningkatkan program kesehatan dan kesehatan remaja.Kata kunci: Hubungan seksual sebelum nikah, penyakit menular seksual, remajaAbstract Premarital sexual inisiation on adolescence is a serious problem, associated with increased transmition sexually transmitted disease/STD, had having more partners, and early pregnancy. An Integrated Behavioral Model (IBM) framework used to assess predictors of premarital sexual on adolescents. The purpose of this research is to explore predictors of premarital sexual inisiation in adolescents grade 10 and 11 based on IBM framework, includes: communication about sex with peers, parents, pornography exposure, attitude, normative belief, personal agency, and intention to have sex. Method that used is 626 respondent included in earlier survey, and respondent were students of senior high school grade 10 – 11 in Denpasar City. Data collected with self reported questionaire particularly predictor of premarital sexual initiation. The result found that pornography exposure, indirectly attitude, and directly attitude were significantly associated with premarital sexual initiation (p < 0,05). Male adolescents engage in more sexual activity like premarital sexual inisiation than female adolescents. This study has implications for understanding how directly attitude and pornography exposure may be used in intervention to promoting adolescents health program and adolescents ressiliency.Keywords: Premarital sexual, sexually transmitted disease, adolescence
Determinan Abortus di Indonesia Kuntari, Titik; Wilopo, Siswanto Agus; Emilia, Ova
Jurnal Kesehatan Masyarakat Nasional Vol. 4 No. 5 April 2010
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (205.87 KB) | DOI: 10.21109/kesmas.v4i5.173

Abstract

Abortus menjadi masalah yang penting dalam kesehatan masyarakat karena berpengaruh terhadap morbiditas dan mortalitas maternal. Di Indonesia, belum ada data yang komprehensif tentang kejadian abortus, berbagai data yang ada sebelumnya berdasarkan survei dengan cakupan yang relatif terbatas. Abortus yang tidak aman bertanggung jawab terhadap 11% kematian ibu di Indonesia. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian abortus di Indonesia. Penelitian ini dilaksanakan dengan metode observasional menggunakan disain studi cross sectional. Data penelitian diperoleh dari data Survei Demografi dan Kesehatan Indonesia 2002-2003. Analisis data dilakukan secara bertahap yaitu: analisis univariat, analisis bivariat dan analisis multivariat dengan regresi logistik. Hasil menunjukkan bahwa risiko abortus meningkat seiring dengan peningkatan usia ibu. Wanita dengan paritas 0-2 berisiko lebih tinggi untuk mengalami abortus dibandingkan wanita dengan paritas 3 atau lebih (OR=5,2, IK 95%=3,49-7,89). Wanita yang bekerja berisiko 2,7 kali lebih tinggi untuk mengalami aborsi daripada wanita yang tidak bekerja (OR= 2,7 , IK 95%= 2,10-3,58). Selain itu, risiko abortus meningkat pada wanita yang menikah pada usia 30 tahun atau lebih (OR=1,8, IK95%= 1,30-2,48). Risiko abortus tidak berhubungan bermakna dengan riwayat abortus sebelumnya, tingkat pendidikan dan tingkat sosial ekonomi.Kata kunci : Abortus, tren abortus, determinan abortus, IndonesiaAbstractAbortion has become a main problem in public health because of its impact on maternal morbidity and mortality. There is no comprehensive data on abortion in Indonesia. So far, data were based on survey with limited coverage. Unsafe abortion is responsible to 11 percent of maternal mortality in Indonesia. This research objective is to determine factors related to abortion in Indonesia. The study was an observational method with cross sectional design. Thesedata are gathered from Indonesian Demography and Health Survey 2002–2003. Data analysis used univariate, bivariate and multivariate analysis with logistic regression. The risk of an abortion increased in line with the increasing of maternal age. Women with 0-2 parity have higher risk than multiparity (OR=5.2, IK95%=3.49-7.89). Employed women have higher risk than unemployed (OR=2.7, IK95%=2.10-3.58). The risk of abortion increased among women married at 30 years old or over (OR=1.8, IK95%=1.30-2.48). There is no significant association between history of abortion, education, socioeconomic and risk of abortion.Key words : Abortion, trend of abortion, abortion’s determinant, Indonesia
Pendidikan Kesehatan Reproduksi Formal dan Hubungan Seksual Pranikah Remaja Indonesia Pinandari, Aggriyani Wahyu; Wilopo, Siswanto Agus; Ismail, Djauhar
Jurnal Kesehatan Masyarakat Nasional Vol. 10 No. 1 Agustus 2015
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (990.162 KB) | DOI: 10.21109/kesmas.v10i1.817

Abstract

AbstrakTransisi demografi kedua akan terjadi di Indonesia dan ditandai denganrevolusi seksual dan reproduksi. Masalah potensial di masa ini adalah peningkatan perilaku seksual pranikah, kehamilan yang tidak diinginkan,infeksi menular seksual dan penyalahgunaan obat. Penelitian ini bertujuan untuk menguji pengaruh pendidikan kesehatan reproduksi formal terhadap penundaan hubungan seksual pranikah pada remaja dan dewasa muda Indonesia. Penelitian potong lintang yang dianalisis sebagai kohort retrospektif menggunakan data Survei Kesehatan Reproduksi Remaja Indonesia tahun 2012 (10.980 laki-laki dan 8.902 perempuan). Efek pendidikan kesehatan reproduksi formal terhadap penundaan perilaku hubungan seksual dianalisis menggunakan kurva kaplan meier, uji log-rank, dan uji chi square, sedangkan analisis multivariabel menggunakan regresi logistik. Semua tes menggunakan tingkat kepercayaan 95% dan nilai p = 0,05. Hasil analisis keberlangsungan berpantang melakukan hubungan seksual pranikah menunjukkan bahwa remaja yang tidak menerima atau hanya menerima salah satu dari materi pendidikan kesehatan reproduksi memiliki hazard ratio yang lebih besar (berturut-turut 1,55 ( CI= 1,32 – 1,82); 0,99 (CI=0,86 – 1,15) dan 2,26 (CI=1,43 – 3,56). Menerima informasi secara lengkap memberikan waktu berpantang yang lebih lama. Penyalahgunaan obat, merokok, minum alkohol, laki-laki, berusia 20 - 24 tahun dan miskin berpeluang lebih besar untuk melakukan hubungan seksual pranikah. Penerimaan informasi kesehatan reproduksi pada jenjang pendidikan formal dapat menunda terjadinya hubungan seksual pranikah.Formal Reproductive Health Education and Premarital Sexual Intercourseamong Indonesian TeenagersAbstractThe second demographic transition will occur in Indonesia and be markedby sexual and reproductive revolution. Potential problems in this era are the increase of premarital sexual behavior, unwanted pregnancy, sexual transmitted infection and drug abuse. This study aimed to examine the influence of formal reproductive health education to delay premarital sexual intercourse among Indonesian teenagers and young adults. Cross sectional study analyzed as retrospective cohort used data of Indonesian Teenage Reproductive Health Survey in 2012 (10,980 men and 8,902 women). Effects of formal reproductive health education to delay sexual intercourse behavior was analyzed using kaplan meier curve, log-rank test, and chi square test, meanwhile multivariat analysis used logistic regression. All tests used confidence interval 95% and p value = 0.05. Results of survival analysis of abstinence committing sexual intercourse showed that teenagers who didn’t receive or only receive one of reproductive health education materials had bigger hazard ratio (respectively 1.55 (CI=1.32 – 1.82); 0.99 (CI=0.86 – 1.15) and 2.26 (CI=1.43 – 3.56)). Receiving complete information gave longer abstinence time. Drug abuse, smoking, alcohol, men, aged between 20 – 24 years old and poor were more likely to commit premarital sexual intercourse. Receipt of reproductive health information at formal education level may delay the occurrence of premarital sexual intercourse.
Injury In Preschool-Age Children: A Population-Based Study Surjono, Achmad; Sastrowijoto, Soenarto; Wilopo, Siswanto Agus; Rusito, Harun
Paediatrica Indonesiana Vol 35 No 9-10 (1995): September 1995
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (480.539 KB) | DOI: 10.14238/pi35.9-10.1995.231-5

Abstract

A study on the type and frequency of injuries in preschool-age children was conducted in a sample of households representing population of Purworejo district. A two stages cluster (wilcah) method was used to select 4.354 preschool-age children living in 12,721 households in the district. The mother or other child caretakers provided responses about injuries occurring during the 3 months period to interview. Injuries among these preschool-age children included trauma by cutting or sharp object (6.5%), falls (5.7%), bums (0.6%), bites (0.4%), traffic accident (0.4%), unconsciousness (0.2%) and poisoning (0 .1 %). The typical injury in under the 12 months olds was falls. Children aged 12 to 23 month accounted for 18% of the injury episodes which were typical fall and trauma. Children aged 24 to 59 months accounted for 76.6% of injury episodes which were typically trauma, falls, bums, bites and traffic accident. No statistical differences in the frequency and type on injuries were observed between urban and rural areas. The relative frequency in age-grouped and type of injuries from this population-based study can be used in planning injury prevention especially for family health education program.
ARAH DAN IMPLEMENTASI KEBIJAKSANAAN PROGRAM KELUARGA BERENCANA DI INDONESIA* Wilopo, Siswanto Agus
Populasi Vol 8, No 1 (1997): Juni
Publisher : Pusat Studi Kependudukan dan Kebijakan, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jp11574

Abstract

There are some interesting differences between the Family Planning Program in Indonesia and the family planning in Cairo Action Program. The FP Program has larger actions, such as the societys attention to the increasing age limit of marriage, family resistance building, increasing the family welfare, and birth control. While, the family planningin Cairo Action Program is only limited to the birthcontrol. This writing tries to describe those differences as well as to clarify the direction and the implementation of the FP Program which increasingly become an FP movement.
Pendidikan Kesehatan Reproduksi Formal dan Hubungan Seksual Pranikah Remaja Indonesia Pinandari, Anggriyani Wahyu; Wilopo, Siswanto Agus; Ismail, Djauhar
Jurnal Kesehatan Masyarakat Nasional Vol. 10 No. 1 Agustus 2015
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (990.162 KB) | DOI: 10.21109/kesmas.v10i1.817

Abstract

AbstrakTransisi demografi kedua akan terjadi di Indonesia dan ditandai dengan revolusi seksual dan reproduksi. Masalah potensial di masa ini adalah peningkatan perilaku seksual pranikah, kehamilan yang tidak diinginkan, infeksi menular seksual dan penyalahgunaan obat. Penelitian ini bertujuan untuk menguji pengaruh pendidikan kesehatan reproduksi formal terhadap penundaan hubungan seksual pranikah pada remaja dan dewasa muda Indonesia. Penelitian potong lintang yang dianalisis sebagai kohort retrospektif menggunakan data Survei Kesehatan Reproduksi Remaja Indonesia tahun 2012 (10.980 laki-laki dan 8.902 perempuan). Efek pendidikan kesehatan reproduksi formal terhadap penundaan perilaku hubungan seksual dianalisis menggunakan kurva kaplan meier, uji log-rank, dan uji chi square, sedangkan analisis multivariabel menggunakan regresi logistik. Semua tes menggunakan tingkat kepercayaan 95% dan nilai p = 0,05. Hasil analisis keberlangsungan berpantang melakukan hubungan seksual pranikah menunjukkan bahwa remaja yang tidak menerima atau hanya menerima salah satu dari materi pendidikan kesehatan reproduksi memiliki hazard ratio yang lebih besar (berturut-turut 1,55 ( CI= 1,32 – 1,82); 0,99 (CI=0,86 – 1,15) dan 2,26 (CI=1,43 – 3,56). Menerima informasi secara lengkap memberikan waktu berpantang yang lebih lama. Penyalahgunaan obat, merokok, minum alkohol, laki-laki, berusia 20 - 24 tahun dan miskin berpeluang lebih besar untuk melakukan hubungan seksual pranikah. Penerimaan informasi kesehatan reproduksi pada jenjang pendidikan formal dapat menunda terjadinya hubungan seksual pranikah.AbstractThe second demographic transition will occur in Indonesia and be marked by sexual and reproductive revolution. Potential problems in this era are the increase of premarital sexual behavior, unwanted pregnancy, sexual transmitted infection and drug abuse. This study aimed to examine the influence of formal reproductive health education to delay premarital sexual intercourse among Indonesian teenagers and young adults. Cross sectional study analyzed as retrospective cohort used data of Indonesian Teenage Reproductive Health Survey in 2012 (10,980 men and 8,902 women). Effects of formal reproductive health education to delay sexual intercourse behavior was analyzed using kaplan meier curve, log-rank test, and chi square test, meanwhile multivariat analysis used logistic regression. All tests used confidence interval 95% and p value = 0.05. Results of survival analysis of abstinence committing sexual intercourse showed that teenagers who didn’t receive or only receive one of reproductive health education materials had bigger hazard ratio (respectively 1.55 (CI=1.32 – 1.82); 0.99 (CI=0.86 – 1.15) and 2.26 (CI=1.43 – 3.56)). Receiving complete information gave longer abstinence time. Drug abuse, smoking, alcohol, men, aged between 20 – 24 years old and poor were more likely to commit premarital sexual intercourse. Receipt of reproductive health information at formal education level may delay the occurrence of premarital sexual intercourse.