Buletin Penelitian Sistem Kesehatan

329-335

Authors: Indirawati Tjahja Notohartojo and Lusianawaty Tana

Background: Pulmonary TB is an infectious disease of the respiratory tract caused by bacteria. Dental health professionals such as dentists and dental nurses are in charge of health personnel to prevent, treat, cure, teeth the mouth, so as not to arise or aggravate toothache. In doing their job as dental health workers is expected to use gloves or masks, and always wash their hands to avoid the transmission of pulmonary TB disease Methods: A cross sectional study was conducted involving 78 dental health professionals in 50 primary health centers that were chosen in six districts in three provinces of Banten, South Kalimantan and Gorontalo. Data were obtained by interviews and processed using SPSS Results: More than 90% dental health workers in work wore masks gloves and washed their hands after work. There was a signifi cant relationship between exercise with dental health professionals with a p value of 0.007, which means a signifi cant. Conclusion: In performing their duties, dental health workers have already used personal protective equipment such as masks, gloves, and washed their hands and did enough exercise. Recommendation: need to increase knowledge about pulmonary TB in dental health professionals.

347-354

Authors: Agung Dwi Laksono and Khoirul Faizin

Background: Muyu Tribes have an open mind toward modernization, while still holding fast to some beliefs that often collide with each other, not to mentional so the case in the original Muyu health workers. For health workers who came from the tribe Muyu, in daily life, it seems as if stuck on the pull two poles of different beliefs, and even sometimes the opposite. Medical concepts are studied and are believed to be a health worker was overlap and collide with the belief in the concept as part of the cultural tradition of his tribe. This study was conducted to explore in depth the pull of tradition surrounding the Muyu health workers. Methods: This research is a case study carried out in depth on indigenous health workers Muyu tribe. This ethnography research was conducted in Mindiptana, District Digoel. Data collection was performed by means of participant observation, in-depth interviews and document searches. Result: The research results showed the influence of western and migrants in some ways helped change the mindset or perspective of health workers to be able to receive the pattern rationalistic offered. But within certain limits if health workers are stuck in the old tradition of Muyu who tend to be irrational and mystical. Conclusion: Empirical fact that their tradition Muyu Tribe (indigenous health workers Tribe Muyu) believe, they often receive repetitive, making them not to circumvent these beliefs. Although, rationalistic culture completely different they have learned indifferent practice. Recommendation: Appropriate supervision can be a task that should be done by health personnel.

365-375

Authors: Rukmini and Ristrini

Background: In an effort to reduce maternal mortality rate required an effective referral system, especially for cases of complications. One of the fundamental aspects of primary health care is a good relationship among levels especially with above level that refl ects as an effective referral system. Method: An observational study with cross sectional design carried out in Tambakrejo and Tanah Kali Kedinding health centers Surabaya in 2013. Respondent were head of the health center and the midwives’ coordinator. Collecting data with in depth interviews, structured questionnaires and study documents of maternity referral cases period of 2010 - June 2013. Data were analyzed descriptively. Result: The implementation of maternity referral cases in Tambakrejo and Tanah Kali Kedinding health centers consisted of clinical and administrative procedures. Clinical procedures have been implemented well, on the other hand, there were some administrative procedures that had not been implemented yet, these were 1) record for patients in register books; 2) giving a referral feedback letter to health facility and worker that refer the patient; 3) There is no procedure of receiving back referred. Coordination for maternal referral among health facilities has been implemented with limitations. Implementation of maternity referral cases and childbirth cases’ handling are in accordance with medical indication primary health care authority. Conclusion: Maternity referral cases in Tambakrejo and Tanah Kali Kedinding health centers has been implementing well enough with limitations, i.e. there is no referral back from hospital to primary health care facility. Recommendation: To implement the policy of back referral, the hospital should make a written standard procedures for the return of referrals. In addition, public health centers have to make standard procedures for receiving back referred patient from hospital and returning back them to other primary health care, sub health centers or midwife.

387-397

Authors: Noor Edi Widya Sukoco, Joko Pambudi, Maria Holly Herawati

Background: Indonesia is one of 117 countries which has three crucial nutritional problems in children under fives,such as stunting, wasting and overweight. This study is important because nutritional status of children under five years old was closely related with economic factors. While economic conditions of families depend on the work of both parents. Methods: The study design was cross sectional based on health research “Riskesdas 2007 and 2013”. Type of research was quantitative and qualitative methods. Samples consisted of children under fives years old of whom their parents were still alive and have completed the information for the questionnaires. The informants of the qualitative research came from caregivers, district nutrition officer, sub-district nutrition officer, district labor office, and parliament at district. Quantitative data was processed and analyzed by SPSS version 15 under the licensed of NIHRD MOH RI. While primary data was explored by indepth interview and analyzed using content analyses. Result: There was no relationship between parents who were both working with the nutritional status of children under fi ves based on indicators: weight/age p= 0,77 2007), p = 0,92 (2013); height/age p = 0,58 (2007), p = 0,71 (2013); weight/height p = 0,77 (2007), p =,33(2013). These qualitative results were confi rmed by informants’ opinions that the nutritional status of children under fives years were not differ between those whose parents are working and not working. Conclusion: The analysis whether quantitative or qualitative found there was no significant relationship between the nutritional status of children under fives to those both of the parents working. Recommendation: Nutritional problems should be solved inter - sectoraly, it does not guarantee that only the economic capacity to bring about positive impacts the nutritional status of children under five.

407-419

Authors: Marwansyah and Hidayad Heny Sholikhah

Background: Pulmonary tuberculosis healing takes a long time. These were any problems that often occurs in the care and treatment of pulmonary tuberculosis in Indonesia. Family members should be empowered to be able to carry out the duties of health, to avoid mistakes in patient care at home. Methods: This study aims to analyze the influence of family empowerment Pulmonary TB sufferers of the ability of the family in carrying out the tasks of family health. The study design was Quasy-experiment research Nonequivalent control group design. Each group of interventing and control consist of 16 people. The family empowerment activities were conducted 3 times a week for visits at interval of one day. Data were analyzed by Wilcoxon Singed Ranks Test and Mann-Whitney Test. Results: Intervention results showed that the ability to carry out family health tasks which includes most of the known health problems (87.5%) category of good, take the right decisions most of the action (62.5%) categories of good, giving care to sick family (100%) categories of good, maintaining physical environments that support health home (100%) categories of good, using the majority of health facilities (93.8%) categories of good. Statistical test results obtained family empowerment pulmonary TB patients can improve the ability of family task of family health (p=0.001). Conclusion: Family empowerment affect the family ability to carry out family health tasks to prevent, to care and to cure pulmonary tuberculosis, which includes the known health problems, take the right decisions, giving care to sick family, maintaining physical environments that support health home, using the majority of health facilities. Recommendation: Health workers are expected to increase health education, especially for newly diagnosed patients with positive pulmonary TB.

431-435

Authors: Erna Luciasari and Liestiana Indriyati

Background: Gayo Lues is a regency in Aceh Province having the second place of the lowest PHDI (Public Health Development Index) grade in Indonesia. Gayo Lues get low scores in almost all of PHDI absolute indicator, such as imunization coverage and child weighing. Gayo Lues have high percentage of poverty more than national average and the low percentage of village midwife number, made Gayo Lues categorized as MUD (Mentoring of Underdeveloped District). The research goal to identify the change of inovation or new breakthrough to increase the IPKM grade. Method: Observation, foccus group discussion and structured interviews using questionnaire to midwife and housewife using posyandu (Maternal and Child center) also indepth interview for directur and staf of health institutions. Result: The sweeping of child weighing is one of programme handling by midwife to increase the child weighing coverage, so in the end of 2012, the coverage have been going almost 100% until 100%. Conclusion: The result it can be concluded that The Goverment of Gayo Lues have been made some breakthrough for the increasing of IPHDI grade. Recommendation: Breakthrough and movements that teach people about the importance of monitoring the health of children by weighing needs to be improved, among others, could empower community leaders.