Background and purpose: 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.

Methods: This was a quantitative analytical study with a cross-sectional design using survey method, conducted in 2019. A public madrasah 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).

Results: 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<0.001). Interestingly, the Natural Science students had no significant higher score compared to Social Science students (p=0.227).

Conclusion: 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.

Background and purpose: 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)

Methods: 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.

Results: 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.

Conclusion: 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.

Background and purpose: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Background and purpose: 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.

Methods: 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.

Results: 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).

Background and purpose: 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

Methods: 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.

Results: 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<0.001) and using internet almost every day (OR=1.42; 95%CI: 1.05-1.91; p=0.023).

Conclusion: 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.