Background and purpose: The efforts to increase quality of service is critical in public services. Service providers should be able to identify customer needs and expectations. As one of health providers, community health centre are required to develop mechanisms for identifying needs of customers and staff. Needs assessment of clients and staff at Blahbatuh II Health Centre is never been conducted. This study aims to identify priority needs of customer and staff to improve the quality of service at Blahbatuh II Health Centre.

Methods: A quantitative study was conducted at Blahbatuh II Health Centre. Data was collected through interviews guided by a structured questionnaire. A total of 97 customers were consecutively selected and were interviewed. Eight staff of child-friendly community health centres were purposively recruited. Data was analysed using quality function deployment method and presented in the House of Quality (HoQ) matrix.

Results: There were 16 and 13 expectations from customers and staff respectively. The house of quality matrix showed that respondents ranked several expectations as the most important that include friendly staff, quick and on-time services, and effective treatment. Health staff on the other hand expected the centre to implement performance-based reward system, to provide training program and to follow the standard operating procedures.

Background and purpose: The efforts to increase quality of service is critical in public services. Service providers should be able to identify customer needs and expectations. As one of health providers, community health centre are required to develop mechanisms for identifying needs of customers and staff. Needs assessment of clients and staff at Blahbatuh II Health Centre is never been conducted. This study aims to identify priority needs of customer and staff to improve the quality of service at Blahbatuh II Health Centre.

Methods: A quantitative study was conducted at Blahbatuh II Health Centre. Data was collected through interviews guided by a structured questionnaire. A total of 97 customers were consecutively selected and were interviewed. Eight staff of child-friendly community health centres were purposively recruited. Data was analysed using quality function deployment method and presented in the House of Quality (HoQ) matrix.

Results: There were 16 and 13 expectations from customers and staff respectively. The house of quality matrix showed that respondents ranked several expectations as the most important that include friendly staff, quick and on-time services, and effective treatment. Health staff on the other hand expected the centre to implement performance-based reward system, to provide training program and to follow the standard operating procedures.

Background and Purpose: Tuberculosis (TB) is more common in developing countries, including Indonesia. Denpasar City contributes the most on the total number of TB patients in Bali Province. There is evidence on increased burden of diabetes mellitus (DM) patients with TB comorbidity. This study aims to examine risk factors of TB among DM patients.

Method: A case control study was conducted in Denpasar City. A total of 135 samples, 45 cases and 90 controls, were recruited to participate in the study. Cases were DM patients with TB comorbidity and were taken from patients register between 2013 to 2015. Controls were DM patients without TB comorbidity and were taken from Bali Province screening operational study. Data were collected using interviews, observations, measurements and document review. Data were analysed using bivariate analysis and multivariate with logistic regression model.

Results: Demographic characteristics between cases and controls were comparable in sex and family income but not comparable in age groups, education, domicile, and employment. Risk factors of TB among DM patients were house density (AOR=36.11; 95%CI: 5.0-259.9), undernutrition (AOR=24.76; 95%CI: 3.7-162.3), inadequate glycemic control (AOR=12.64; 95%CI: 2.4-66.2), and being employed (AOR=10.55; 95%CI: 1.2-92.7). TB infection among DM patients was associated with aged<60 years (AOR=7.47; 95%CI: 1.2-44.3) and being male (AOR=5.42 ;95%CI: 1.2-24.0). TB co-infection among DM patients was also associated with low education level (AOR=6.96; 95%CI: 1.0-48.6), contact with TB patients (AOR=5.84; 95%CI: 0.7-46.6) and inadequate house ventilation (AOR=2.92; 95%CI: 0.6-13.1).

Background and Purpose: Tuberculosis (TB) is more common in developing countries, including Indonesia. Denpasar City contributes the most on the total number of TB patients in Bali Province. There is evidence on increased burden of diabetes mellitus (DM) patients with TB comorbidity. This study aims to examine risk factors of TB among DM patients.

Method: A case control study was conducted in Denpasar City. A total of 135 samples, 45 cases and 90 controls, were recruited to participate in the study. Cases were DM patients with TB comorbidity and were taken from patients register between 2013 to 2015. Controls were DM patients without TB comorbidity and were taken from Bali Province screening operational study. Data were collected using interviews, observations, measurements and document review. Data were analysed using bivariate analysis and multivariate with logistic regression model.

Results: Demographic characteristics between cases and controls were comparable in sex and family income but not comparable in age groups, education, domicile, and employment. Risk factors of TB among DM patients were house density (AOR=36.11; 95%CI: 5.0-259.9), undernutrition (AOR=24.76; 95%CI: 3.7-162.3), inadequate glycemic control (AOR=12.64; 95%CI: 2.4-66.2), and being employed (AOR=10.55; 95%CI: 1.2-92.7). TB infection among DM patients was associated with aged<60 years (AOR=7.47; 95%CI: 1.2-44.3) and being male (AOR=5.42 ;95%CI: 1.2-24.0). TB co-infection among DM patients was also associated with low education level (AOR=6.96; 95%CI: 1.0-48.6), contact with TB patients (AOR=5.84; 95%CI: 0.7-46.6) and inadequate house ventilation (AOR=2.92; 95%CI: 0.6-13.1).

Background and purpose: The prevalence of low birth weight (LBW) in Situbondo District increased from 2.79% in 2008 to 5.85% in 2014. The highest prevalence in 2015 was found in Bungatan Subdistrict (11%). This study aims to determine risk factors of LBW in Bungatan Subdistrict, Situbondo.

Methods: A case control study was conducted in Bungatan Subdistrict. A total of 60 infants born at the Bungatan Community Health Centre were included in the study. Cases were infants with LBW and controls were those with normal birth weight. All infants born with LBW were taken as cases (20 infants) while 40 controls were selected using a systematic random sampling. Data were collected from February to March 2016. Data were analysed using bivariate and multivariate technique with logistic regression test.

Results: The majority of respondents were unemployed (80%), aged between 20-35 years during the pregnancy (53.33%), with parity of ≤3 (66.67%), low education level (61.67%), anemia during the pregnancy (68.33%), good nutritional status (75.00%), poor nutrition intake during the pregnancy (51.67%) and without pre-eclampsia (88.33%). Parity of >3 increased the risk of LBW (AOR=6.4; 95%CI 1.66 - 24.75). Chronic energy deficiency increased the risk of LBW (AOR=5.6; 95%CI 1.41-22.57).

Background and purpose: The prevalence of low birth weight (LBW) in Situbondo District increased from 2.79% in 2008 to 5.85% in 2014. The highest prevalence in 2015 was found in Bungatan Subdistrict (11%). This study aims to determine risk factors of LBW in Bungatan Subdistrict, Situbondo.

Methods: A case control study was conducted in Bungatan Subdistrict. A total of 60 infants born at the Bungatan Community Health Centre were included in the study. Cases were infants with LBW and controls were those with normal birth weight. All infants born with LBW were taken as cases (20 infants) while 40 controls were selected using a systematic random sampling. Data were collected from February to March 2016. Data were analysed using bivariate and multivariate technique with logistic regression test.

Results: The majority of respondents were unemployed (80%), aged between 20-35 years during the pregnancy (53.33%), with parity of ≤3 (66.67%), low education level (61.67%), anemia during the pregnancy (68.33%), good nutritional status (75.00%), poor nutrition intake during the pregnancy (51.67%) and without pre-eclampsia (88.33%). Parity of >3 increased the risk of LBW (AOR=6.4; 95%CI 1.66 - 24.75). Chronic energy deficiency increased the risk of LBW (AOR=5.6; 95%CI 1.41-22.57).

Background and purpose: Low birth weight (LBW) is a major cause of neonatal and infant mortality. The Indonesian Demographic and Health Survey indicated that neonatal mortality rate in East Nusa Tenggara was 26 per 1000 live births, 15% of which were caused by low birth weight. This study aims to understand the relationship between age of mother, birth spacing, chronic energy deficiency, presence of concomitant diseases, employment status, anemia, quality of antenatal care and traditional dietary restrictions on the incidence of LBW in Ende District, East Nusa Tenggara.

Methods: A case control study was conducted at Ende District in 2015, with a total of 156 respondents. Cases were mothers giving birth to LBW infant (<2500 gram) and controls were mothers giving birth to normal weight infant (≥2500 gram). Case and control ratio was 1:1. Data were obtained from antenatal care records and interviews. Data were analysed using bivariate analysis and multivariate with logistic regression.

Results: This study found that risk factors of LBW include age of mother <20 or ≥35 years (AOR=6.8; 95%CI: 1.87-25.0), traditional dietary restrictions (AOR=6.7; 95%CI: 1.71-26.8), birth spacing <2 years (AOR=6.5; 95%CI: 1.78-24.2), chronic energy deficiency (AOR=5.3; 95%CI: 1.38-21.0), being employe (AOR=4.6; 95%CI: 1.44-14.9), anemia (AOR=4.2; 95%CI: 1.37-13.1), malaria infection (AOR=3.9; 95%CI: 1.21-12.7) and low quality of antenatal care (AOR=3.5; 95%CI: 1.11-11.3).

Background and purpose: Low birth weight (LBW) is a major cause of neonatal and infant mortality. The Indonesian Demographic and Health Survey indicated that neonatal mortality rate in East Nusa Tenggara was 26 per 1000 live births, 15% of which were caused by low birth weight. This study aims to understand the relationship between age of mother, birth spacing, chronic energy deficiency, presence of concomitant diseases, employment status, anemia, quality of antenatal care and traditional dietary restrictions on the incidence of LBW in Ende District, East Nusa Tenggara.

Methods: A case control study was conducted at Ende District in 2015, with a total of 156 respondents. Cases were mothers giving birth to LBW infant (<2500 gram) and controls were mothers giving birth to normal weight infant (≥2500 gram). Case and control ratio was 1:1. Data were obtained from antenatal care records and interviews. Data were analysed using bivariate analysis and multivariate with logistic regression.

Results: This study found that risk factors of LBW include age of mother <20 or ≥35 years (AOR=6.8; 95%CI: 1.87-25.0), traditional dietary restrictions (AOR=6.7; 95%CI: 1.71-26.8), birth spacing <2 years (AOR=6.5; 95%CI: 1.78-24.2), chronic energy deficiency (AOR=5.3; 95%CI: 1.38-21.0), being employe (AOR=4.6; 95%CI: 1.44-14.9), anemia (AOR=4.2; 95%CI: 1.37-13.1), malaria infection (AOR=3.9; 95%CI: 1.21-12.7) and low quality of antenatal care (AOR=3.5; 95%CI: 1.11-11.3).

Background and purpose: Malaria is a public health problem in Eastern Indonesia, especially in East Nusa Tenggara. Insecticide-treated bed net was massively distributed in 2014, however the incidence of malaria in Ende District remains high. This study aims to examine association between the use of insecticide-treated bed net and malaria infection.

Methods: A case control study was conducted in Wewaria Subdistrict, Ende District in 2016 involving 67 cases and 134 controls. Data on the use of insecticide-treated bed net which include methods of net use, net use practice, net maintenance and its current conditions were obtained through interviews and observations. Physical conditions of respondent’s house that include conditions of the wall, floor, window, ventilation, ceiling and lighting were also documented through observations. Data were analysed using logistic regression.

Results: Cases and control groups were comparable for gender (p=1), age (p=0.9), education level (p=0.9) and occupation (p=0.6). This study found that five variables were associated with malaria infection: irregular use of the insecticide-treated bed net (AOR=4.08; 95%CI: 1.87-8.89), torn net (AOR=2.23; 95%CI: 1.10-4.54), inadequate lighting (AOR=3.64; 95%CI: 1.77-7.47), humid floor (AOR=3.02; 95%CI: 1.24-7.34) and holes or broken ceiling (AOR=2.41; 95%CI: 1.02-5.72).

Background and purpose: Malaria is a public health problem in Eastern Indonesia, especially in East Nusa Tenggara. Insecticide-treated bed net was massively distributed in 2014, however the incidence of malaria in Ende District remains high. This study aims to examine association between the use of insecticide-treated bed net and malaria infection.

Methods: A case control study was conducted in Wewaria Subdistrict, Ende District in 2016 involving 67 cases and 134 controls. Data on the use of insecticide-treated bed net which include methods of net use, net use practice, net maintenance and its current conditions were obtained through interviews and observations. Physical conditions of respondent’s house that include conditions of the wall, floor, window, ventilation, ceiling and lighting were also documented through observations. Data were analysed using logistic regression.

Results: Cases and control groups were comparable for gender (p=1), age (p=0.9), education level (p=0.9) and occupation (p=0.6). This study found that five variables were associated with malaria infection: irregular use of the insecticide-treated bed net (AOR=4.08; 95%CI: 1.87-8.89), torn net (AOR=2.23; 95%CI: 1.10-4.54), inadequate lighting (AOR=3.64; 95%CI: 1.77-7.47), humid floor (AOR=3.02; 95%CI: 1.24-7.34) and holes or broken ceiling (AOR=2.41; 95%CI: 1.02-5.72).

Background and purpose: Period prevalence of pneumonia among children in Indonesia increased from 2.1 in 2007 to 2.7 per 1000 children in 2013. The highest incidence was found among children aged 12-23 months. This study aims to examine association between delayed access to health care facilities and severity of children pneumonia.

Methods: A case control study was conducted in Denpasar City. A total of 132 children were recruited to participate in this study, consisted of 44 cases and 88 controls. Cases were selected from 161 children with severe pneumonia who registered at Pulmonology Department of Sanglah General Hospital between January 2015 to April 2016. Controls were selected from 261 children aged 12-59 months with mild pneumonia who visited out-patient service at all community health centres in Denpasar City between January 2015 and April 2016. Cases and controls were matched by sex. Data were collected by interview with the parents in their houses. Data were analysed using multivariate analysis with logistic regression.

Results: Risk factors associated to severity of pneumonia among children aged 12-59 months were delayed access to treatment for more than three days (AOR=2.15;95%CI: 1.39-3.32), non-health care facilities at first episode of illness (AOR=4.02; 95%CI: 1.53-10.61) and frequent episodes of respiratory infections (>4 times) over the last 6 months (AOR=5.45; 95%CI: 2.13-13.96).

Conclusion: Delayed access to treatment, did not access healthcare facilities at first episode of illness, and high frequency of acute respiratory infections are risk factors of severe pneumonia among children.

Background and purpose: Period prevalence of pneumonia among children in Indonesia increased from 2.1 in 2007 to 2.7 per 1000 children in 2013. The highest incidence was found among children aged 12-23 months. This study aims to examine association between delayed access to health care facilities and severity of children pneumonia.

Methods: A case control study was conducted in Denpasar City. A total of 132 children were recruited to participate in this study, consisted of 44 cases and 88 controls. Cases were selected from 161 children with severe pneumonia who registered at Pulmonology Department of Sanglah General Hospital between January 2015 to April 2016. Controls were selected from 261 children aged 12-59 months with mild pneumonia who visited out-patient service at all community health centres in Denpasar City between January 2015 and April 2016. Cases and controls were matched by sex. Data were collected by interview with the parents in their houses. Data were analysed using multivariate analysis with logistic regression.

Results: Risk factors associated to severity of pneumonia among children aged 12-59 months were delayed access to treatment for more than three days (AOR=2.15;95%CI: 1.39-3.32), non-health care facilities at first episode of illness (AOR=4.02; 95%CI: 1.53-10.61) and frequent episodes of respiratory infections (>4 times) over the last 6 months (AOR=5.45; 95%CI: 2.13-13.96).

Conclusion: Delayed access to treatment, did not access healthcare facilities at first episode of illness, and high frequency of acute respiratory infections are risk factors of severe pneumonia among children.

Background and purpose: Transmission of HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) in Bali Province is increasing. This increased transmission is due to their sexual networks and behaviours. This study aims to examine sexual behaviours and sexual networks among MSM population in Bali Province.

Methods: A descriptive cross-sectional study was conducted in Denpasar City and Badung District. A total of 130 MSM were recruited from Denpasar II Public Health Centre and Bali Medica Clinic – Badung District. Data were collected through interviews among MSM who visited both providers for STIs services from August to October 2015. Variables of this study included sociodemographic, sexual network (pattern and density), sexual activities in the last month, sexual role, condom/lubricant use, and history of previous STIs. Data were descriptively analysed.

Results: As many as 53.1% respondents were aged <25 years, 90.8% were senior high school or higher degree graduates, 6.2% were married, 91.5% were employed, and 59.2% were having a regular partner. In the last month, as many as 70.8% respondents reported to have sex with first sexual partner, 52.3% with second sexual partners, and 45.6% with third sexual partners. Younger respondents tended to seek for younger sexual partners. The majority of respondents had had insertive sex, as many as 40.0% with their first partner, 44.6% with their second partner, and 43.2% with their third partner. About 20% of respondents were having high density sexual network and 71.5% of respondents were having concurrent sexual partnership. The consistent condom use within six months was 67.6% with the first partner, 72.8% with the second and the third partners. As many as 23% of respondents were diagnosed to have STIs.

Conclusion: MSM population in Bali Province seem to have high risk sexual behaviours with great sexual network density, high concurrent sexual partnership, and selective mixing between older and younger MSM population.

Background and purpose: Transmission of HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) in Bali Province is increasing. This increased transmission is due to their sexual networks and behaviours. This study aims to examine sexual behaviours and sexual networks among MSM population in Bali Province.

Methods: A descriptive cross-sectional study was conducted in Denpasar City and Badung District. A total of 130 MSM were recruited from Denpasar II Public Health Centre and Bali Medica Clinic – Badung District. Data were collected through interviews among MSM who visited both providers for STIs services from August to October 2015. Variables of this study included sociodemographic, sexual network (pattern and density), sexual activities in the last month, sexual role, condom/lubricant use, and history of previous STIs. Data were descriptively analysed.

Results: As many as 53.1% respondents were aged <25 years, 90.8% were senior high school or higher degree graduates, 6.2% were married, 91.5% were employed, and 59.2% were having a regular partner. In the last month, as many as 70.8% respondents reported to have sex with first sexual partner, 52.3% with second sexual partners, and 45.6% with third sexual partners. Younger respondents tended to seek for younger sexual partners. The majority of respondents had had insertive sex, as many as 40.0% with their first partner, 44.6% with their second partner, and 43.2% with their third partner. About 20% of respondents were having high density sexual network and 71.5% of respondents were having concurrent sexual partnership. The consistent condom use within six months was 67.6% with the first partner, 72.8% with the second and the third partners. As many as 23% of respondents were diagnosed to have STIs.

Conclusion: MSM population in Bali Province seem to have high risk sexual behaviours with great sexual network density, high concurrent sexual partnership, and selective mixing between older and younger MSM population.