Public Health and Preventive Medicine Archive

Unlocking mhGAP and family medicine potential: Strategic solutions for Indonesian mental health integration

Putu Aryani — 2025-07-31

Mental health has become a critical global concern in 2025, influencing individuals, communities, and healthcare systems worldwide. Recognizing its significance is essential for fostering well-being and resilience across all aspects of life. The World Health Organization emphasizes that mental health is a basic human right and essential for both personal growth and societal progress. It empowers individuals to handle life’s difficulties, tap into their potential, learn effectively, perform well in their tasks, and make meaningful contributions to their communities¹. Global threats to mental health today include economic and social inequalities; public health emergencies (including COVID-19); humanitarian emergencies (including conflict and forced displacement); and the climate crisis². Mental health is closely linked to physical health. However, the relationship between mental health and physical disease tends to be neglected by communities as well as health care providers, specifically in Low Middle-Income Countries (LMICs)³. The vast majority of patients with mental disorder in LMICs have limited access to proper treatment ⁴. In contrast, European region countries (EUR) report the highest rate of mental health treatment compared to other regions⁵. Undetected mental disorders increased the risky behaviors related to chronic diseases, in turn, people with chronic diseases are also prone to experiencing mental health issues ^6-10.

Factors associated with the self-efficacy of private practice general practitioners in the diagnosis and management of mental disorders in Bali, Indonesia

I Komang Wirajaya — 2025-07-31

Background and purpose: General practitioners’ self-efficacy plays a crucial role in the successful diagnosis and management of mental disorders in primary care settings. In Bali, there is limited data on the factors influencing the self-efficacy of private practice general practitioners in handling mental health disorders. This study aimed to identify the factors associated with the self-efficacy of private practice general practitioners in the diagnosis and management of mental disorders in Bali.

Methods: This was an analytical cross-sectional study involving 109 private practice general practitioners in Bali, conducted from September 2024 to March 2025. The sample included general practitioners who possessed a valid practice license, practicing either independently or at primary clinics in four cities/districts, selected using convenience sampling. Self-efficacy in this study was measured with the adapted General Self-Efficacy Scale (GSE). Data were collected through a structured self-administered questionnaire, which covered demographic characteristics, direct experience, vicarious experience, social persuasion, and emotional-physiological states. Data analysis was performed using Chi-square tests and multiple logistic regression.

Results: The results showed that 67.0% of respondents had low self-efficacy in diagnosing and managing mental disorders. Factors significantly associated with self-efficacy among private practice general practitioners included direct experience (aOR=4.39; 95%CI: 1.59–12.10; p=0.004), social persuasion (aOR=3.58; 95%CI: 1.36–9.46; p=0.010), and emotional-physiological state (aOR=2.90; 95%CI: 1.14–7.42; p=0.025). Meanwhile, age, gender, years of practice, and vicarious experience were not significantly associated with self-efficacy.

Conclusion: Direct experience, social persuasion, and emotional-physiological states were found to be factors associated with the self-efficacy of private practice general practitioners in diagnosing and managing mental disorders. It is recommended that the government develop

The The relationship between history of physical activity and COVID-19 severity with post COVID-19 syndrome

Olivia Theodora — 2025-07-31

Background and purpose: The COVID-19 pandemic has resulted in severe symptoms for many patients, continuing into the formation of post-COVID syndrome which affects the quality of life of patients. This study aims to assess relationship between history of physical activity and COVID-19 severity with post-COVID-19 syndrome.

Methods: This was a cross-sectional study involving 87 randomly selected adult COVID-19 patients treated at Udayana University Hospital from January 2022 to December 2023. Data collected were characteristics of the participants, the history of physical activity measured with IPAQ questionnaire, the severity of COVID-19 based on several indicators on the medical records, and post-COVID syndrome assessed with questionnaire. Data analysis method used for the Bivariate test is Chi-Square, and Multivariate uses the Logistic Regression Test to find the relationship between all variables.

Results: Of the 87 patients, 56.3% were men with age range from 19 to 56 years. The majority, 83.9% of patients had severe COVID symptoms and 43.7% experienced post-COVID syndrome, with the highest distribution being fatigue, at 81.6%. Low physical activity was associated with post-COVID syndrome (p=0.004), 60.5% patients with low physical activity experience post-COVID syndrome compared to 27.3% with moderate physical activity. A significant relationship was also found between the severity of COVID-19 symptoms and the incidence of post-COVID syndrome (p=0.002). As many as 35.6% of patients who experienced mild COVID-19 experienced post-COVID syndrome, while 85.7% of COVID-19 patients who experienced moderate-severe COVID-19 experienced post-COVID syndrome. The multivariate test also provided significant results between history of physical activity and post-COVID syndrome (p=0.014) and the relationship between COVID-19 severity and post-COVID syndrome (p=0.011).

Conclusion: A relationship was found between the history of pre-COVID physical activity and the severity of COVID symptoms with the incidence of post-COVID syndrome. On the other hand, there is no relationship between gender, age and comorbidity with post-COVID syndrome.

Relationship between diarrhea history, exclusive breastfeeding, and feeding patterns with stunting incidence in toddlers aged 24-59 months

Jamilatul Wahida — 2025-07-31

Background and purpose: Stunting remains a major public health issue globally, including in Jember District. Despite the significant stunting reduction in the region—from 21.4% in 2020 to 6.6% in 2024—Rambipuji Public Health Center (PHC) reports a comparatively high prevalence of 19.94%, indicating a persistent public health concern. This study aimed to analyze the association between diarrheal history, exclusive breastfeeding, and feeding patterns with the incidence of stunting among children aged 24–59 months.

Methods: An analytical observational study with a case–control design was conducted among 114 children aged 24–59 months (57 cases and 57 controls) selected by simple random sampling in the Rambipuji PHC area based on growth monitoring data from May 2025. Data which include stunting status, children characteristics and maternal characteristics were collected through structured interviews and observations, and analyzed using chi-square tests (α=0.05) with SPSS.

Results: The results indicated significant associations between maternal education (OR=11.25; 95%CI: 1.354-93.504; p=0.026), exclusive breastfeeding (OR=3.352; 95%CI: 1.377-8.159; p=0.006), and feeding patterns (OR=10.5; 95%CI: 2.336-47.201; p=0.005) with stunting incidence. However, a history of diarrhea was not significantly associated with stunting.

Conclusion: Maternal education, exclusive breastfeeding, and feeding patterns are associated with stunting among children. Strengthening maternal nutrition and feeding education, as well as optimizing services at integrated health posts (Posyandu) and public health centers (Puskesmas), are essential to reduce stunting prevalence.

Association between body shape index and body mass index with knee osteoarthritis: a case control study

Anik Nurmalikah — 2025-12-31

Background and purpose: Being overweight or obese, which can be determined using the
body mass index (BMI), is one of the risk factors for knee osteoarthritis (KOA).
Whilst, body shape index (BSI) is considered as more accurate indicator, hence,
this study aims to assess correlation of BSI and BMI with KOA.
Methods: This study employed a case control design conducted in Jenggawah
Village, East Java. Samples were randomly taken from the social service program
of the Faculty of Medicine, University of Jember which conducted on June 18,
2023, included 30 KOA patients and 30 non-KOA patients who met the inclusion
and exclusion criteria. The instruments used were Omni Calculator and KOA
clinical criteria sheet. The statistical analysis used the Spearman Rank
correlation test with a significance level of p<0.05.
Results: The statistical analysis revealed a significant, moderate, and direct
correlation between BSI and KOA (p=0.002; r=0.391). On the other hand, BMI
showed an insignificant, very weak, and inverse correlation with KOA (p=0.432;
r=-0.103). BSI values indicate low amount of skeletal muscle mass with increased
visceral or abdominal adiposity. BMI only assesses overweight, while BSI can
represent central adiposity, which also affects KOA.
Conclusion: The study concludes that BSI is related to the incidence of KOA, while
BMI is not related to the incidence of KOA in Jenggawah Village, Jember Regency.
Future research could use a cohort plan to validate whether BMI and BSI can
predict the incidence of KOA.