Buletin Penelitian Sistem Kesehatan

109–116

Authors: Suharmiati, Agung Dwi Laksono and Wahyu Dwi Astuti

Background: To improve coverage and equity of health services, plans and development plans is formulated. The Ministry of Health 2010, one of strategy almost is to increase to qualited health care. Methods: policy research on health centers in remote border areas, also conducted document review/policy, literature review, and the review of primary and secondary data. The purpose of the policy review of health centers in remote areas of the border is to acquire strategies and policy options related to health services in remote areas of the border. Results: Policy issues: Remote, Border and Islands (DTPK) has an extreme topography; The role of infrastructure is one of the important physical components of the border region. Therefore, there is a significant correlation between the condition of the infrastructure with the pulse of social and economic activities of society, and also the welfare of the people at the border;Availability of health services and support facilities in the Rural Sector, Border and Islands (DTPK) are still low. Policy options: Fulfillment of the availability of facilities and basic health services in accordance with Border topography; Compliance with the availability of transport for referral in accordance Border topography; Development of infrastructure in a systematic, consistent and targeted, will lead to improved well-being of border communities. Conclusion:The availability of infrastructure and the health services and health center network in the border areas is not optimal, clinic staf especially doctors and paramedics have not received an appropriate reward. Recommendation:Meeting the health care facilities and health centers and their networks in border areas and patterns of prime services at least equal to the neighboring state of health services, the nearest health center personnel exchanges between countries on a regular basis to follow up the International Health Regulations (IHR), and Availability transport for referral in DTPK

128–133

Authors: Lusianawaty Tana and Lannywati Ghani

Background:Backpain can cause temporary or permanent limitation of mobility to workers until they need sick leave and treatment. Back pain is also known as the second leading cause of sick leave. The objective of this study was to analyze back pain impact to work attendance among paramedics working at 3 hospitals in Jakarta. Methods: A cross sectional study was conducted in three hospitals in Jakarta. The subject inclusion criteria were paramedics working in care unit, had back pain in the last 1 year, aged 20–45 years old, and had worked more than 1 year. There were 109 subjects eligible. Results: Back pain occurred first in workplace was 2 times higher than outside workplace. A total of 16.5% paramedics took sick leave and the highest length of sick leave was 1–3 days and 7–14 days consecutively. Most of the subjects experienced back pain recurrence more than once in a year. The sick leave was significantly associated with the back pain scale: higher in subjects with back pain scale of 6–10 than 1–5 (p = 0.006 OR 4.5 95% CI 1.5–3.2). Conclusions:Back pain can be recurrent and has an impact on work attendance of paramedics in the hospital.

143–153

Authors: Alfridsyah, Ichsan and Ampera Miko

Background:In 2003, WHO formulates multicenter growth references study (MGRS) concept, conducted in 6 countries, with 8440 samples of children living in a healthy environment that allows, then grow in accordance with their genetic potency. Primary health research (Riskesdas) in 2007 were conducted simultaneously in 33 provinces and the assessment of children under-five nutritional status has referred to WHO 2006. Overall NAD Province was inducted within the top 10 provinces with nutritional problem. This research aims to determine the effectiveness of the use of the new standard anthropometric 2006 to increase knowledge and assessment of nutritional status on Nutrition Implementation Force in Banda Aceh in 2009. Methods:The design of this study is exploratory analytical method with Quasi-Experimental Design approach, carried out at 70 TPG and divided into two groups. Data collected included primary and secondary. Analysis of the data was applied the Independent T-Test and Dependent T-Test at 95%. Results:The results of the Independent T-Test analysis shows that there is a significant difference between knowledge (p = 0.000), attitude (p = 0.004), behavior (p = 0.005) and an increase in PSG (p = 0.031) between the post-test on the lecture with discussion and lectures with practice. While the results of analysis Dependent T-Test showed a significant increase from the pre-test to post-test for both groups at TGP in the working area of Banda Aceh. The results of the Independent T-Test analysis shows that there is a significant difference between knowledge (p=0.000), attitude (p = 0.004), behavior (p = 0.005) and an increase of PSG (p=0.031) between the post-test on the lecture with discussion and lectures with practice. While the results of analysis Dependent T-Test Showed a significant increase of from the pre-test to post-test for both groups at TGP in the working area of Banda Aceh. Recommendation:It’s suggested that by improving equity Nutritional Status Assessment Program (PSG) means to improve the health and nutritional status of children to be more optimal, while involving profession nutritionist in the implementation of nutrition program PSG, and use the lecture method with practice in providing education/counseling to TPG and then to cadres-cadres who are working each region, as this can increase the knowledge, attitude and behavior of executive power of nutrition in improving the nutritional status assessment.

168–175

Authors: Indirawati Tjahja Notohartojo and Lelly Andayasari

Background:The common cause of periodontal disease is poor oral hygiene, so it lead to make plaque accumulation containing various bacteria. Methods: The study used Cross Sectional study design and conducted in selected sub district primary health centers in DKI Jakarta. The amount of people were 950 persons conducted both gender with 20–55 years age and ever lived in Jakarta. Research goal is to get how much value oral hygiene industry employees Pulogadung in Jakarta. Data analyses were using Chi Square and Logistic Regression by SPSS version 15.Results: The result of this study showed related significant between variable education and variable age with the OHIS (Oral Hygiene Indeks Simplified).By analyse Logistic Regression only variable age was significant (p < 0.001). Conclusion:Worker oral hygiene indeks in the industrial area in Pulo Gadung Jakarta most still low. Recommendation: Recommended brushing teeth 2 times a day after breakfast and before bedtime to maintain oral hygiene.

185–193

Authors: Merryana Adriani and Vita Kartika

Background:According to UNICEF, is direct cause of children under five are malnutrition toddler food consumption is not balanced and the presence of infectious diseases, while indirect factors such as parenting toddlers. Methods:The research was conducted over ten months in 2011, in three provinces of East Java, Central Java and Central Kalimantan. The design of the research done crossectional. Quantitative data collection through interviews using a structured questionare on maternal nutriton status of children under five with malnutrition. Sampling was conducted under five are malnourished purposively in each study site. Results:Most of which 33.3% have children under five maternal education level of primary school and 26.7% graduated from high school. In this district there is a 45.8% Sumenep toddler educated mothers completed primary school, while the toddler’s mother graduated from high school in the city of Semarang and counties Gn. Mas respectively 38% and 35.1%. Malnourished children under five who have fathers with education level did not complete as much as 16.7% of schools in the district Sumenep. Malnourished children under five who have fathers with education level did not complete as much as 16.7% of schools in the district Sumenep, while in Semarang and counties Gn Mas most educated toddler’s father graduated from high school is as many as 44.8% and 35.1%. Type of disease that often affects children under five are malnourished in the three study sites was 68.9% as fever, cough and colds was 15.6%, and diarrhea 8.9%. A diet that is given in addition to breast milk in children aged 0–6 months include honey, water, starch, milk formula, baby biscuits, bananas are softened, milk porridge, soft food, rice, vegetables, fish, eggs, beef, snacks with reason that children want to eat and not cry. Conclusion:Inappropriate diet for toddlers makes early breastfeeding initiation and exclusive breast feeding can not be implemented properly.

203–216

Authors: Muhammad Agus Mikrajab and Syahrianti

Background: Implementing the Childbirth Planning and Complications Prevention Program that has released by Ministry of Health in 2007 for Pregnant women Services at Posyandu still tackles concern maternal health services particularly pregnant women that will be affected in achieving Fourth and Five MDGs Goals targets.Objectives: This study aimed to describe characteristics of pregnant women and to assess utiliziation of pregnant women services through integrating Childbirth Planning and Complications Prevention Program and Antenatal Care at Integrated Health Sevices Post.Methods: A cross sectional design with explorative approach through interview using structured questionn arias of pregnant women. Sample Size in this study was 69 pregnants women. Data were analyzed descriptively with STATA 11SE licensed©. This study was conducted in two health centers in Mojokerto City, Provincial East Java. Results: According to the observation shows that Posyandu services was conducted routinely by midwives, physician, nurses and health cadres involves counseling on imunization (92.8%) and family planning (85.5%), basic imunization services for maternal and neonatal (84.1%), allocating supplementary foods (82.6%), and maternal and neonatal services (81.2%) whereas Posyandu services was not conducted involves development and training for cadres (56.5%), receive referrals from traditional birth attendants (TBAs) and cadres (44.9%), referral for pregnant women to health center/hospital (34.8%), examining fundus utery (33.3%), examining fetal heart rate (31.9%), examining fetus position (27.5%), examining breastfeeding and postpartum mothers (26.1%), Screening(early detection of pregnant women at high risk (23.2%), examining tension and family planning (20.3%). Conclusions: P4K and ANC Services focused on high risk groups for pregnancies and delivery problems were 18–25 years and 34–41years. Most of households head were work in private sector. Most of pregnant women were not referred to health facilities by family when they suffer complications. According to the medical views that pregnant women parity for Grande Para category has a serious health problems particularly maternal and neonatal death. Furthermore, availability of maternal and neonatal cohorts was still low as it cannot be obtained adequate information concerns progress/mother health problems. Integrating P4K and ANC services have founded that services routine coverage of pregnant women at Integrated Health Services Post that conducted by midwives was still low. Recommendations: Increasing role of pregnant women through pregnant women class and more broadly socialization concern important of referral system and health services facilities availability for pregnant women and health examination only to health professions. Building partnership with traditional birth attendants in referring as pregnant women examination coverage to traditional birth attendants can be decreased. Conducting pregnant women counseling is concerned with pregnant women risk and number children that fulfill health requirements. It also, policy of local government to implement recording system for maternal and neonatal cohorts, information system based local area monitoring and its application particularly midwives and other health professions.