Buletin Penelitian Sistem Kesehatan

221-228

Authors: Mardiatun, Lalu Ahmad Yani, Dewi Purnamawati, Zulkifli, Ristrini

Background: The state of malnutrition occurs because the body lacks of one or several types of nutrients needed. Some things that can cause the body to nutritional defi ciencies among others: the amount of nutrients which consumed was less , low quality of nutrients or both of them. Since 1970, Departement of health of the Republic of Indonesia has implemented a prevention programme through the distribution of iron tablets free of charge to pregnant women but the impact caused due to iron defi ciency is still a problem. The aims of this study is to explain the relationship between the history of ante natal care and the level of iron consumption with incidence of malnutrition of pregnant women. Methods: The method used in this study was an observational analytic with cross sectional approach use Riskesdas data 2013 and the measurement of variable was performed at the same time. Data were analized using bivariate test with chi square test. Result: the results obtainedp value 0.000 < 0.005 which means there is a relationship between the history of the ANC with malnutrition events in NTB and DIJ. While the consumption level of Fe obtained P value 0.000 <0.005 which means there is a relationship between the level of consumption of Fe with malnutrion events in NTB and DIJ. Conclusions: mothers should be emphasized the importance of consuming Fe tablet at least 90 tablets during pregnancy and do the ANC at least 4 times during pregnancy with an emphasis on quality than on quantity. Recommendation: consumption of the should be follow up by concelling during ANC visit.

239-246

Authors: Ahmad Erlan

Background: District Parigi Moutong, Central Sulawesi Province is one of the Regional District Health Problems. Ranking Public Health Development Index Parigi Moutong to the level of Central Sulawesi was ranked 6 out of 9 districts/cities, while at the national level comes out to 320 of 440 districts/cities in Indonesia. The purpose of this study is to provide a picture of the health problems in Parigi Moutong. In more detail the objectives are observed after the implementation of such interventions and Booster Kalakarya prevention efforts in the area of health problems. Methods: The study is qualitative observational study of participatory design. Samples were taken by using purposive sampling to conduct in-depth interviews and document searches. Results: The results of in-depth interviews obtained information of some constraints in the implementation of health programs, ie no actions/movements that were signifi cant in the response to the problem. Infant mortality in 2012, registered 7 cases. Substitution head of the health center too fast. This happens because the head of the health center has held PTT doctor working period of one year, which resulted in problems in sustainability programs in health centers. Internal monthly meeting at the Department of Health and the District Health Offi ce with the entire health center no. Effort or movement to address the problems associated Regional Health Problems has not be percieved. Conclusions: Implementation of Regional Booster Kalakarya and Health Troubled make changes to the head of health policy by forming groups Conscious Movement IHC and revitalization partnership TBA and midwives who are increasing numbers toddlers weighing scope and aid delivery by health personnel.

257-266

Authors: Murlan, Ruwiah, Santi Suardi, Weny Lestari, Niniek L. Pratiwi

Backgroud: Buton District was had the highest case on children under fi ve years’ malnutritions in South East Sulawesi Province. Butonesse have culture of making Virgin Coconut Oil which made from coconut untill now. Side product of VCO was a coconut residue (blondo) which has not been used by the community. Blondo VCO contains a lot of protein clumps of coconut which is similar to the formula that can be used for food additives, especially in children because it is easily to absorb. The aim of this study was to determine increasing of knowledge, changing behavior and attitudes on mothers of children under fi ve years about the use of blondo VCO for additional nutritional improvement of local food. Methods: this study used intervention on nutritions’ knowledge based on the use of lokal ingredient. Training and practice about children’s local food processing with blondo VCO were held. Results: The results showed that there was an improvement in knowledge, attitude and practice of mothers after they had been given the intervention with counseling and training of local food with blondo VCO ingredients. There were variations of local food made by mothers more than before. Conclusions: It showed that the presence of counseling and training on the use of blondo VCO can increase knowledge, attitudes and behavior towards mothers who have children under fi ve. Recomendation: Suggestions of this study was processed of blondo VCO could be used as ingredient of local food with high nutritional value for society in general and for children in particular.

277-284

Authors: Betty Roosihermiatie, Niniek Lely Pratiwi, Rukmini, Widodo JP

Background: As a tropic country Indonesia still faces malaria problems. In Asean, indonesia is one of three countries with the highest malaria morbidity. In 2007, 396 (80%) of 495 districts/municipalities in indonesia are malaria. In 2009 the government issued a decree of the minister of health No 293 on malaria elimination. The study aimed to analyze the implementation decree of Ministry of Health No. 293/2009 on malaria elimination. Methods: It was a descriptive study. The study was conducted in 4 provinces, and 4 districts based on malaria elimination stages as in Bali province and Karangasem district, Riau islands province and Bintan district, West Nusa Tenggara province and west Lombok district, and Maluku province and South Halmahera district. The stakeholders were Heads and malaria programmers at province/district Health Offices and the related programs. Data were collected by focus group discussion and secondary data were taken. Data were collected by focus group discussion and secondary data. Analysis for Ministry of Health decree No.293 year 2009 on 1) Comphrehend, 2) Implementation, and, 3) Comittment, 4) Innovation intervension to support malaria elimination, 5) Sustainability of activity community empowerment, 6) Proportion of budget. Results: showed there was district that had not issued local policy on malaria elimination, the implementation with comittment especially that health centers in areas under study corfi rm diagnose by laboratory examination and malaria treatment by Artemisin Combined Therapy (ACT), although there were still treatment to clinical malaria, innovation activities were of bersifat local spesifi c, and reward for Juru Malaria Desa or malaria cadre to increase malaria suspect case detection, and with district budget for malaria program ranged 0,95-5,6% of the total budget. Recomendations: It suggested to advocate all malaria endemic areas to issue local policy on malaria elimination, decide intervension of the priority program with target and time schedule, enhance surveillance especially data analysis for malaria stability, and advocate local government to commit on malaria budgetting, distribution health workers, enhance health infrastructures, and also enhance health system for malaria program activities.

293-300

Authors: Turniani Laksmiarti, Asep Kusnali, Diyan Ermawan Effendi

Background: According to Article 22 of Law No. 32 of 2004 and the decision of the Court granting judicial review on Law No. 40 of 2004, local governments also have the authority and obligation to organize a social security system for its people, including health insurance. One of the problems faced by the local governments is in synchronizing the implementation of the local health insurance system (Jamkesda) with the National Health Insurance System (JKN). This study aimed at analyzing the synchronization of implementation of the health insurance system at central and regional levels. Methods: This study was using qualitative data analysis. The data were retrieved from literary data and the results of in-depth interviews with the parties that are considered to have in-depth knowledge related to the research topic. Results: Local Government of Nganjuk has developed social security system in health sector through the free of retribution policy in health services through the Regional Health Insurance System (SJKD). This health insurance system is operated by the District Health Insurance Agency (BPJKD) under the East Java Provincial Government. Since the implementation of JKN, Nganjuk Local Government has already begun to integrate this policy with JKN, but constrained by the scope of membership and dues obligations for the region. Conclusion: Nganjuk Government has conducted social service functions through a free retribution in health services policy with some restrictions and along with East Java Provincial Government held SJKD. Synchronization of health insurance in Nganjuk could be begun with the process of integration of free retribution health services policy to SJKD and continue the health policy to cost sharing with the East Java Provincial Government to facilitate the process of integration to JKN. Recommendation: Nganjuk district in efforts to achieve universal health coverage is necessary to re-collecting and validating the data of jamkesmas participants, impoverished letter and the participants who can afford to pay the dues.

311-320

Authors: Revi Rosavika Kinansi and Ika Martiningsih

Background: controlling of dengue haemorrhagic was still a complicated problems, because it has not found a cure. The best way to prevent dengue fever was to control mosquito larvae Dengue Hemorrhagic Fever (DHF). The existence of Aedes aegypti larvae in an area is an indicator of the presence of populations of Ae. aegypti in that area. In an effort to determine the interventions on the incidence of dengue in the city of Batam through mosquito larvae control, need to know how much infl uence the larvae of Ae. aegypti free house to dengue cases. The purpose of this discussion is to know what variables affect the dengue cases in the city of Batam. Methods: analysis of data using linear regression analysis. Signifi cance values provide information on the variables that signifi cantly affect the number of dengue cases in the city of Batam, so the government can seek for each house is required to be free of larvae. Results: results of the analysis provides information that the value of a statistical p-value indicates the number 0,017 on variables healthy home. Conclution: there is a signifi cant infl uence between the variables of a healthy home for the presence of dengue cases in the city of Batam. Recomendation: This suggests that a healthy home include sanitation, adequate ventilation, good lighting, good management of water access and other problems causing the lack of space used as breeding places of Ae. aegypti. Many factors affect the presence of dengue among others to note is altitude, ecology and bionomik, eggs, larvae and pupae, adult mosquitoes, the habit of perching, fl ying range, as well as the life span of transovarial transmission.