Public Health and Preventive Medicine Archive

Integrating human rights principles to strengthen health systems for pandemic prevention, preparedness, and response among key populations in Indonesia

Ngakan Putu Anom Harjana — 2024-12-31

People living with HIV (PLHIV) and key populations, including people who use drugs, sex workers, LGBTQ+ communities, and imprisoned individuals, represent groups with heightened vulnerabilities that are significantly magnified during public health emergencies such as the COVID-19 pandemic. These populations are disproportionately exposed to both the direct health impacts of the virus and systemic barriers that limit access to essential health services.¹ One of the most critical aspects is access to antiretroviral therapy (ART), which is vital to suppress viral load and maintain immune system function in PLHIV.² Equally important are other health services such as harm reduction programs, sexual and reproductive health care, and mental health support, which together ensure the physical, emotional, and psychological well-being of these groups.

Implementation of performance-based capitation payment at public health centers in Denpasar, Bali, Indonesia

Anik rosida — 2024-12-31

Background and purpose: The National Health Insurance System has implemented a performance-based capitation (PBC) norm in primary health care facilities (PHCF). PBC has three indicators: contact rate, non-specialist referral ratio (NSRR), and controlled chronic diseases control program (Prolanis) participant ratio (CPPR). This study aims to explore the implementation of PBC payment at public health centers in Denpasar, Bali, Indonesia.

Methods: This study utilizes an explanatory sequential mixed method design. Data collection was conducted from February to March 2023. In the first phase, quantitative data were gathered through documentation studies on PBC achievements. The second phase involved qualitative data collection through in-depth interviews with 11 informants, who were selected purposively. Thematic analysis was employed to identify internal and external factors hindering and driving PBC fulfillment.

Results: Among the 11 public health centers in Denpasar, two met the PBC target in 2020, three in 2021, and seven in 2022. During 2020 to 2022, the NSRR and contact rate targets were achieved by all public health centers, except for the contact rate in 2021. The CPPR was the indicator with the lowest achievement, but shows an increasing trend. Strengths contributed to PBC's achievement including sufficient human resources and service facilities, an active Prolanis club, and a supportive Primary Care (P-Care). Weaknesses include the absence of planning documents, lack of capitation service reward, insufficient availability of medicines, and inadequate features of e-Puskesmas. Threats were suboptimal condition of Prolanis participants, the COVID-19 pandemic, non-specialist referral demands from patients, and increased number of target population.

Conclusion: The achievement of PBC at public health centers in Denpasar from 2020 to 2022 was suboptimal. The emergence of various factors namely strengths, weaknesses, opportunities and threats, can be utilized in strategic formulation to optimize PBC in Denpasar public health centers.

Comparison of lung function and self-efficacy between Balinese dancer and non-dancer students in Denpasar, Bali

Ni Luh Putu Larasati Prabawaning Tyas — 2024-12-31

Background and purpose: Balinese dance is a well-known traditional activity which has been proven to have physiological and psychological benefits. This study aims to compare the differences in lung function and self-efficacy between Balinese dancer and non-dancer students in Denpasar, Bali.

Methods: This was an analytical observational study using a cross-sectional method, which was carried out directly at the Physiology Laboratory of the Faculty of Medicine, Udayana University and Denpasar “X” Institute, from January to September 2023. Participants were students of the Dance and Visual Communication Design Study Programs of Denpasar “X” Institute who met the study criteria accounted for 48 students in each group. The data collection was conducted using a Chestgraph HI-101 spirometry for lung function measurement and a self-efficacy scale by I Made Rustika for self-efficacy measurement. The data was analyzed with SPSS 26 using T-independent and Mann-Whitney tests for mean comparison.

Results: The two groups have similar distribution of age, sex, weight, height and smoking status. The respiratory function indicators were higher in dancer group compare to non-dancer group, the mean difference of 0.34 (p=0.02) for FVC(L), 10.14 (p<0.001) for FVC%, 0.3 (p=0.04) for FEV1(L), and 0.77 (p=0.02) for FEV 25%. No significant difference in self-efficacy was observed.

Conclusion: The dancer students have higher lung function compare to non-dancer student. This signify dancing can become one form of physical activities that can be introduced to improve lung function since early age.

The increase of asthma self-medication in Indonesia during COVID-19 Pandemic: An infodemiology study using Google Trends

Hendri Setiawan — 2024-12-31

Background and purpose: The COVID-19 pandemic has significantly interrupted the care of asthma patients. In order to determine whether online search data and the number of COVID-19 cases were related, many Google Trends-based investigations were carried out throughout the pandemic. This study investigates whether asthma patients use the internet for self-management and treatment advice.

Methods: A netnographic approach with data sources from Google Trends was used in our research. The data were taken from www.https://trends.google.co.id and were collected within two timeframes: (1) the beginning of COVID-19 (March 2, 2018-March 1, 2020) and (2) during the pandemic COVID-19 (March 2, 2020-March 1, 2022). The data is displayed graphically on a scale of 0 to 100, referred to as the Relative Search Volume (RSV). The Spearman correlation test on each keyword and the confirmed cases of COVID-19 in Indonesia were done in SPSS version 25 (IBM Corp., Armonk, NY) to determine if a correlation existed.

Results: This study found an increased search volume for asthma therapy. According to the correlation test results, the keywords "inhaler" and "nebulizer" significantly correlated with the number of confirmed COVID-19 cases. However, no link between asthma symptoms and the number of COVID-19 was found. Conclusion:Indonesians sought more information on asthma self-medication during the rise of COVID-19, however not directly associated with the prevalence of the disease. Google Trends can become a potential source to explore people behaviour in relation to certain health information, however it cannot be used as the sole data collection tool for health research, especially in Indonesia.

How do we improve nurse preparedness on pandemic: Learning from Theory of Planned Behavior

Luh Gede Lisnawati — 2024-12-31

Background and purpose: The drastic elevation in the number of patients during the COVID-19 pandemic demands the preparedness of nurses to provide quality services to COVID-19 patients. The purpose of this study was to determine the relationship between knowledge, attitudes, self-esteem, and nurses' intentions towards preparedness in facing the COVID-19 pandemic and an overview of the factors that influence it.

Methods: This study used a quantitative method with a cross-sectional analytic design, conducted at Sanglah General Hospital in Bali Province, Indonesia and involved 333 nurses with a total sampling technique. The research data was collected with a google form related to demographic characteristics (age, gender, education level, and length of work), knowledge, attitudes, self-esteem, intentions, and nurse preparedness. Furthermore, data were analyzed using descriptive statistics and Chi-Square tests (α<0.05).

Results: Most of the respondents were female (85.6%), had an associate degree Diploma III education history (75.7%), had the longest working time of 34 years, and the oldest age was 57 years. This study found that most nurses had poor preparedness (53.8%), good knowledge (65.5%), good attitude (51.7%), high self-esteem (68.2%), and good intentions (86.5%). The correlation test showed a significant relationship between gender (p=0.033), attitude (p<0.001), self-esteem (p<0.001), and intention (p<0.001) on preparedness for the COVID-19 outbreak. Meanwhile, knowledge (p=0.784), ages (p=0.120), education levels (p=0.094), and length of work (p=0.100) were not related significantly to nurses' preparedness for the COVID-19 pandemic.

Conclusion: Nurses’ readiness is related to attitude, self-esteem, intention, and gender. In improving nurses' preparedness in carrying out disease management during a pandemic, efforts are needed to improve attitudes, self-esteem, and intentions. These efforts can be part of the hospital disaster plan program by providing psychosocial support to improve attitudes, self-esteem, and intentions.

Compliance with COVID-19 health protocols in a restricted offline learning setting in Palembang, Indonesia: a structural equation modeling

Mohammad Eko Fitrianto — 2024-12-31

Background and purpose: The COVID-19 pandemic has brought about new-normal conditions across all sectors. At the onset of the return to offline learning, new health protocol regulations were introduced. This study aimed to predict student behaviour in the post-COVID-19 learning process using the Health Belief Model (HBM) within a restricted face-to-face learning context.

Methods: This cross-sectional survey involved 331 students from both public and private universities in South Sumatra Province, selected through convenience sampling from those participating in post-pandemic face-to-face learning. Data were collected between April and July 2022 using an online questionnaire that covered sociodemographic characteristics and perceptions based on the HBM framework. Descriptive analysis was conducted, and behavioural predictions were tested using Structural Equation Modelling (SEM).

Results: The majority of participants were female (54.4%), aged 18–21 years (64.4%), predominantly undergraduate students (84%), and residing in Palembang (63.3%). Regarding vaccination status, 54.4% had received the second dose, 39% the third dose, 5.7% only the first dose, and 0.9% were unvaccinated. Perceived benefits (β=0.129, p=0.034), cues to action (β=0.319, p<0.001), and self-efficacy (β=0.442, p<0.001) were found to be significant predictors of students’ compliance with health protocols.

Conclusion: Students’ compliance with health protocols is influenced by health-related information and their level of self-efficacy. The Health Belief Model proves effective in predicting this behaviour in a post-COVID-19 context. Policymakers are encouraged to promote compliance to health protocols through positive messaging, such as public service announcements.

Risk communication and caring behavior related to patient satisfaction: A cross-sectional study at the Mangusada Regional Hospital, Badung District, Bali Province, Indonesia

I Dewa Ayu Mas Manik Astawastini — 2024-12-31

Background and purpose: The quality of hospital services during the COVID-19 pandemic tends to decline. This can affect patients’ satisfaction in carrying out treatment and care. Risk communication and caring behavior are important aspects that can affect patient satisfaction. The purpose of our study was to determine the relationship between risk communication and caring behavior of nurses with patient satisfaction on internal medicine polyclinic in the Mangusada Regional Hospital, Badung District, Bali Province, Indonesia.

Methods: Our research design is analytic observational with cross sectional approach. We conducted research at the internal medicine polyclinic of the Mangusada Regional Hospital, Badung District from March 1 to April 21, 2022. Samples of our study were 120 patients who visited the internal medicine polyclinic. Variables of our study which include patient characteristics, risk communication and caring behavior were collected using a questionnaire and analyzed with univariate, bivariate and multivariate approach using multiple logistic regression test with 95% confidence interval.

Results: The study revealed that 52.5% of patients had low satisfaction, 54.2% of patients perceived low risk communication and 54.2% of patients perceived low caring behavior. There is a relationship between nurse risk communication with patient satisfaction (aOR=5.2; 95%CI: 1.9-14,3, p=0.001) and nurse caring behavior with patient satisfaction (aOR=9.8; 95%CI: 3.7 – 26,0, p=0.000).

Conclusion: Risk communication and nurse caring behavior are related to patient satisfaction at internal medicine polyclinic in the Mangusada Regional Hospital, Badung District. This underscores the importance of focusing on improving care practices and communication strategies to enhance patient satisfaction. It also emphasizes the need to ensure the good ratio of health care workers to the number of patients in order to provide quality health services.