Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma Public Health and Preventive Medicine Archive (PHPMA) is an open access, peer reviewed journal published by Public Health Postgraduate Program Faculty of Medicine Udayana University in association with Indonesian Public Health Association Bali Branch. The en-US editor@phpmajournal.org (D.N. Wirawan) arul@discoversys.com (Public Health and Preventive Medicine Archive) Wed, 01 Dec 2021 00:00:00 +0000 OJS 3.3.0.10 http://blogs.law.harvard.edu/tech/rss 60 COVID-19 Pandemic: an opportunity to enhance tobacco control in Indonesia https://phpmajournal.org/index.php/phpma/article/view/394 N/A Putu Ayu Swandewi Astuti Copyright (c) 2022 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/394 Sat, 04 Dec 2021 00:00:00 +0000 Knowledge about sources and benefits of vitamin D among high school students in Bandung, Indonesia https://phpmajournal.org/index.php/phpma/article/view/384 <p><strong>Background and purpose:</strong> Indonesia is a tropical country, located through the equator line which is abundantly exposed with sun. However, vitamin D deficiency among population in Indonesia is common. To increase optimal vitamin D intake, knowledge on vitamin D and the role of sun exposure early in the adolescence period is imperative. This study aims to explore the knowledge of high school students about the sources and benefits of vitamin D.</p><p><strong>Methods: </strong>This was a quantitative analytical study with a cross-sectional design using survey method, conducted in 2019. A public <em>madrasah</em> high school in Bandung, Indonesia, was selected using convenience sampling. A validated questionnaire was distributed to students aged 16-18 years old, containing of two parts about sources of vitamin D (10 questions) and its benefits (4 questions).</p><p><strong>Results:</strong> In total, 198 high school students participated in the study, majoring in Natural Sciences (55.6%) and Social Sciences (44.4%), of whom 76.3% were females. The proportion of students who answered correctly about vitamin D was 72.8%, whereas 61.9% had correct answers about the sources of vitamin D and 83.8% about its benefits. Female students had significantly higher score compared to males (p&lt;0.001). Interestingly, the Natural Science students had no significant higher score compared to Social Science students (p=0.227).</p><p><strong>Conclusion</strong>: The knowledge about the source of vitamin D and its benefit among female high school students is significantly better than males, thus, special attention to male students is needed. There is a trend, although not significant, that the knowledge of students majoring in the Natural Sciences is higher compared to the Social Sciences. This study suggests the need of an integrative health education and outdoor activities, as well as a better nutrition program, focusing especially on male students and the Social Sciences class.</p> Reina Syafira Gisrianti, Vycke Yunivita Dewi, Edhyana Sahiratmadja Copyright (c) 2021 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/384 Wed, 01 Dec 2021 00:00:00 +0000 Overweight is associated with low fitness level among regional government employees in Denpasar City https://phpmajournal.org/index.php/phpma/article/view/317 <p><strong>Background and </strong><strong>purpose</strong><strong>:</strong> Time spent on sedentary work is a potential risk factor of nutritional problems among employees, which could lead to a low level of fitness. This study aims to determine the correlation between nutritional status with fitness level among government employees of Denpasar City.<strong> </strong></p><p><strong>Met</strong><strong>h</strong><strong>od</strong><strong>s</strong><strong>: </strong>This is an analytic observational study with a cross-sectional design. The samples of this study are 285 government employees in Denpasar City who had taken a physical fitness measurement test using the Rockport method and complete demographic data. Data on fitness level, nutritional status, age, gender, and pulse rate were included in the analysis using a multinomial logistic regression test.</p><p><strong>Results:</strong> The median age of employees are 47 years old and slightly more females (51.6%) than males. More than half of the employees had a low level of fitness (50.9%) and most were overweight (47%). The overweight group was 4.11 times more likely to have a low fitness level than the healthy weight group (RRR=4.11; 95%CI: 1.03-16.32).</p><p><strong>Conclusion</strong><strong>:</strong> There is a significant relationship between nutritional status and fitness level after gender, age, and pulse rate were controlled. Therefore, it is necessary to maintain a normal nutritional status to maintain or enhance individual fitness level by routinely following regular sports activities that have been programmed and do stretching in between working hours.</p> Kadek Dina Puspitasari, Putu Widarini Copyright (c) 2021 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/317 Wed, 01 Dec 2021 00:00:00 +0000 Evaluation of hypertension screening guidelines implementation at the public health centers in Tabanan District, Bali, Indonesia https://phpmajournal.org/index.php/phpma/article/view/323 <p><strong>Background and purpose</strong><strong>: </strong>World Health Organization (WHO) reported the number of people with hypertension worldwide reached one billion in 2015. Hypertension screening is an effort to manage and control hypertension through hypertension management stages. This study aims to explore in-depth the implementation of hypertension screening guidelines performed by the public health centers (PHCs)</p><p><strong>Methods</strong><strong>: </strong>This is a qualitative exploration with an exploratory case study approach by adopting the Lawrence W. Green Theory. This study was conducted in two PHCs in Tabanan District, those with the highest and the lowest target achievement. The factors examined were the implementation of guidelines and factors affecting it. The data were collected using in-depth interviews with ten informants and data were analyzed using thematic methods.</p><p><strong>Results</strong><strong>: </strong>We found the predisposing factors of the implementation including the management of Health Operational Assistance (HOA) funds, the grouping of targets at risk of hypertension, hypertension screening guidelines, and the attitudes and beliefs of the officers and the community. The driving factors consisted of the lack of community participation. The inhibiting factors were indicated by the insufficient number of health workers and community support. <strong></strong></p><p><strong>Conclusion</strong><strong>: </strong>There are several obstacles for the implementation of hypertension screening guidelines both from the health services side including budget allocation and community participation. Therefore, more thorough planning and measures to improve participation is needed.</p> Gede Agung Ratnata, Dyah Pradnyaparamita Duarsa, Luh Seri Ani Copyright (c) 2022 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/323 Mon, 13 Dec 2021 00:00:00 +0000 Community participation in the utilization of village fund for stunting prevention: Case study in two villages in Gianyar District https://phpmajournal.org/index.php/phpma/article/view/293 <p><strong>Background and purpose</strong>: The Indonesian government has set a target to reduce stunting prevalence from 27.7% in 2019 to 14% in 2024. There are 10 villages in Gianyar District have been selected as stunting loci since 2018, however, the percentages of the village fund utilized for health and nutrition were low. This research aims to identify the level of community participation in the utilization of village fund for stunting prevention in two stunting loci villages in Gianyar.</p><p><strong>Methods</strong>: This was a qualitative study using a multiple case study approach conducted in two stunting loci villages in Gianyar, Bali. Data collection was conducted from May to June 2020 through in-depth interview with 12 key informants. Thematic qualitative analysis was done using the ladder of participation concept with Arnsteinand political approach by Carpentier which involves several key concepts such as process, field, actor, decision making moment and power.</p><p><strong>Results</strong>: The level of community participation in the village fund utilization for stunting prevention was still in the of pseudo participation – Placation level. The majority of proposals or recommendation for stunting prevention program came from cadres of community health post, health care workers and the village assistants. Final decision making in the planning stage was largely depending on the village government. The community plays the role as program recipient. Several challenges for optimal utilization of village fund for stunting prevention were geographical condition, paternalistic leadership as well as the lack of understanding and capacity of key actors.</p><p><strong>Conclusion: </strong>The community participation in utilization of the village fund for stunting program in the two villages was in the vague participation level. The village government should provide more rooms to empower the community in order to increase their participation level. </p> Made Ayu Diah Prabasari, Dinar Saurmauli Lubis, Ni Ketut Sutiari Copyright (c) 2022 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/293 Thu, 30 Dec 2021 00:00:00 +0000 The impact of hospital accreditation on patient safety culture in the health services implementation at Sanglah General Hospital, Bali https://phpmajournal.org/index.php/phpma/article/view/364 <p><strong>Background and purpose: </strong>Hospital accreditation is carried out to evaluate hospitals' performance in providing patients with excellent and safe health services. One aspect of service quality is patient safety culture. This study aims to determine the impact of hospital accreditation on patient safety culture in health service implementation at the Sanglah General Hospital in Denpasar City, Bali Province.<strong></strong></p><p><strong>Methods:</strong> This study used a qualitative research design. In-depth interviews were conducted to 11 informants consisting of hospital management, clinicians and nurses which were chosen purposively since they were directly related to the assessment and supervision of health service providers at Sanglah Hospital. The interview guide was based on the Modified Manchester Patient Safety Framework (MaPSaF). Data were analyzed with a thematic approach.<strong></strong></p><p><strong>Results: </strong>The interview results show that the ten dimensions of patient safety culture had been implemented well but still need to be improved in the dimensions of giving priority to safety, system errors and responsibilities, recording incidents and best practices, learning and influencing change, also education and training of staff and teamwork. The maturity level of patient safety culture at Sanglah Hospital is at generative culture in four dimensions and at proactive culture on the six dimensions of patient safety culture.<strong></strong></p><p><strong>Conclusion: </strong>Accreditation had a positive impact on the maturity level of patient safety culture at a proactive level, mainly changes in knowledge, attitudes, and behavior in health service providers. However, in its implementation, there were still constrained on infrastructure, time, and energy.</p> Putu May Indrayani, Pande Putu Januraga, Surya Negara Copyright (c) 2022 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/364 Thu, 30 Dec 2021 00:00:00 +0000 Maternal social determinants of stunting events in Kulon Progo, Yogyakarta https://phpmajournal.org/index.php/phpma/article/view/407 <p><strong>Background and purpose</strong>: Kulon Progo District is one of the 100 priority districts in Indonesia for stunting program with a prevalence of 22.65%. The purpose of this research is to identify association between mother's education, family income and exclusive breastfeeding history with stunting events in Kulon Progo District, Yogyakarta.</p><p><strong>Methods</strong>: This research used a cross sectional design which conducted in Kulon Progo District, Yogyakarta. There were 729 children aged 0-59 months recorded in the integrated service post <em>(posyandu)</em> who met the inclusion criteria. Data collection was conducted using a questionnaire for children and mothers’ characteristics, while stunting status was retrieved from the growth monitoring card. Data analysis was conducted using Chi-Square test.</p><p><strong>Results</strong>: Children in the survey were 53.77% boys and around a quarter (24.69%) were at 25-36 months old. The majority of the mothers (72.98%) were between the ages of 26 and 35 years with high school education (67.35%) and most of them did not work (82.17%). Children with lower maternal education are less likely to experience stunting (PR=0.751; 95%CI: 0.593-0.952; p=0.013), and those from lower income family have almost five fold increased chance of stunting (PR=4.562; 95%CI: 2.643–7.874; p&lt;0.001). Whilst for history of exclusive breastfeeding, the association was not statistically significant with stunting (PR=0.795; 95%CI: 0.529–1.196; p=0.239)</p><p><strong>Conclusion:</strong> There is a relationship between maternal and family education with the probability of stunting, while there is 20% reduced chance of stunting if children were breast fed although it was not statistically significant. Improving maternal awareness on stunting is essential for stunting management programs.</p> Suci Musvita Ayu, Liena Sofiana, Yuniar Wardani, Yus Haryanto Copyright (c) 2022 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/407 Thu, 30 Dec 2021 00:00:00 +0000 Willingness to pay for dengue vaccine among parents of elementary school students in Denpasar https://phpmajournal.org/index.php/phpma/article/view/312 <p><strong>Background and purpose</strong>: The incidence of Dengue Hemorrhagic Fever (DHF) in Bali, especially in Denpasar, remains high. Efforts to eradicate mosquito nests have been carried out but did not give a significant reduction in the incidence number. The dengue vaccine is now available and can be a way of prevention. The dengue vaccine has not been included in the mandatory immunization program by the government so people who want to get vaccinated have to pay for it by themselves. This study aims to determine the relationship between socio-demographic factors and perceptions with the willingness to pay for the dengue vaccine among parents of elementary school students in Denpasar.</p><p><strong>Methods</strong>: This study used a cross sectional design involving 100 mothers of students from grade 3 to grade 6 at Dauh Puri 5 Elementary School and Dauh Puri 6 Elementary School who were selected with systematic random sampling. Data collected included education level, income, respondents' perceptions and willingness to pay for dengue vaccine. Data were collected by interview using a questionnaire, the results were analyzed using a multivariate logistic regression.</p><p><strong>Results</strong>: The average willingness of parents to pay for the dengue vaccine per dose was IDR 131,170. Percentage of respondents who were willing to pay for the dengue vaccine was 31%. The results of analysis showed that variables associated with parents’ willingness to pay for the dengue vaccine were education level (OR=4.06; 95%CI: 1.19-13.76), perceived susceptibility (OR=1.59; 95%CI: 0.58-4.37) and perceived benefits (OR=2.60; 95%CI: 1.00-6.81).</p><strong>Conclusion</strong>: Parents' willingness to pay for the dengue vaccine remains very low compared to the current price of vaccine per dose. The government needs to provide subsidies so that the dengue vaccine can be included in the national immunization program and be accessed by all people. Further research is needed with a broader scope and more varied population’s characteristics to obtain a willingness to pay value that can represent society in general.<p> </p> Ni Luh Astri Indraswari, Dewa Nyoman Wirawan, Made Pasek Kardiwinata, Pande Putu Januraga Copyright (c) 2022 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/312 Thu, 30 Dec 2021 00:00:00 +0000 Factors affecting quality of life of fracture patients with productive age at dr. Haryoto Regional General Hospital, Lumajang District, East Java https://phpmajournal.org/index.php/phpma/article/view/343 <p><strong>Background and purpose: </strong>Fractures can affect activity and productivity due to delayed time of returning to work. It may have impacts on the patient’s physical, psychological, social, and environmental conditions that can influence the quality of life. The purpose of this study was to explore factors associated with the quality of life of fracture patients with productive age.</p><p><strong>Methods: </strong>This research used a cross sectional approach conducted at the Orthopedic Clinic of dr. Haryoto Regional General Hospital, in Lumajang District, East Java from October 2020 to February 2021. The study involved 84 patients whom were selected using simple random sampling. Data was collected with interview using the WHOQOL-BREF questionnaire which can assess a person’s quality of life. The data were analysed using univariable, bivariable and multivariable analysis with Chi-square and Logistic Regression.</p><p><strong>Results: </strong>Most respondents were aged 20 to 60 years, male, have worked, completed secondary education, and married. Most of them had health insurance, experienced fractures in lower extremity with open fracture type, had severe condition since more than 12 months and had an accident on the highway. Factors associated with quality of life were family support with OR=0.631 [95%CI: 0.524-0.760; p=0.004], duration of fracture with OR=0.333 [95%CI: 0.123–0.900; p=0.049] and fracture severity with OR=11.00 [95%CI: 3.261–37.106; p=0.00]</p><p><strong>Conclusion: </strong>Family support, duration of fracture, and fracture severity were associated with quality of life of productive aged fracture patients. Special attention and family support are needed for fracture patients during the healing period to improve their health status.</p> Anastasya Marli Yugiana, Santi Martini Copyright (c) 2021 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/343 Fri, 03 Dec 2021 00:00:00 +0000 Factors associated with minimum dietary diversity among 6-11-month-old children in Indonesia: Analysis of the 2017 Indonesian Demographic and Health Survey https://phpmajournal.org/index.php/phpma/article/view/340 <p><strong>Background and purpose:</strong> The indicators to assess food diversity in complementary feeding is minimum dietary diversity (MDD). In 2017, the proportion of MDD among 6-11-month-old children in Indonesia was 33.8%, which was the lowest among other age group and below the national rate. This study aims to explore factors associated with MDD among 6-11-month-old children in Indonesia</p><p><strong>Methods:</strong> This study was a secondary data analysis of the 2017 Indonesia Demographic and Health Survey (IDHS), a cross-sectional study involving 17,848 children across all provinces in Indonesia. The final samples included in this analysis were 1,593 children aged 6-11-month-old. Variables analyzed were parent’s education level, access to information, parent’s occupation, wealth index, and access to health facilities. Logistic regression model was applied to identify factors associated with MDD.</p><p><strong>Results</strong>: The proportion of MDD in this study was 35.1%. The highest food groups that were consumed were staple food, vitamin-A rich fruits and vegetables, and breastmilk. The final model showed factors which correlated significantly with complementary feeding practices that met MDD requirement were wealth index categorized as richer (OR=1.72; 95%CI: 1.16-2.55; p=0.007), wealth index categorized as richest (OR=2.42; 95%CI: 1.58-3.68; p&lt;0.001) and using internet almost every day (OR=1.42; 95%CI: 1.05-1.91; p=0.023).</p><p><strong>Conclusion</strong>: Wealth index and internet use were independently associated with MDD. Online media should be considered as channel to spread information of complementary feeding diversity to children, while socio-economic factor which associated to food accessibility should be addressed by involving beyond health sector.</p> Eurika Zebadia, Dominikus Raditya Atmaka Copyright (c) 2021 Public Health and Preventive Medicine Archive https://phpmajournal.org/index.php/phpma/article/view/340 Fri, 03 Dec 2021 00:00:00 +0000