Regional perinatal mortality differences in Indonesia: Evidence from Indonesian demographic health survey.

Aim: Perinatal mortality can be used as a reference to assess health status in a country. In Indonesia, none of previous studies specifically discuss the incidence of prenatal mortality by region. The objective of this study was to analyze perinatal mortality difference by region of Indonesia. Study design: This study used a cross-sectional approach. Method: The sample in this study was 13,310 women of childbearing age obtained from the Indonesian Demographic Health Survey (IDHS) 2017. The perinatal mortality rate was calculated using data on stillbirths with a gestational duration of seven months or more and early neonatal deaths. Perinatal mortality was analyzed by region using a binary logistic regression statistical test to examine the relationship between perinatal mortality and its factors (socio-demographic factors, individual disease control factors, and maternal factors). Results: This study shows that the proportion of perinatal mortality in Indonesia is 1.5 % of total births. The highest proportion of perinatal mortality (2.5 %) was in the Papua region, while the lowest proportion (1.3 %) was in the Java region. The results of this study indicated that women in the Maluku Islands had a 1.82 times higher chance of perinatal mortality compared to the Java-Bali region. The causative variable associated with perinatal mortality in the Java-Bali and Papua regions was employment status. The causative variables associated with perinatal mortality in Kalimantan were the quality of antenatal care and delivery assistance. The causative variable associated with perinatal mortality in Nusa Tenggara and Papua was the location of delivery. The causative variable associated with perinatal mortality in Kalimantan, Maluku, and Papua was the mother's age. The causative variable associated with perinatal mortality in the Java-Bali region was parity. The causative variable associated with perinatal mortality in Sumatra was the type of delivery. Conclusion: This study show that there were disparities in the incidence of perinatal mortality between regions in Indonesia. The government needs to re-adjust the existing strategies to improve health status and focus on community empowerment for women to prevent perinatal mortality.

How Is Telehealth Currently Being Utilized to Help in Hypertension Management within Primary Healthcare Settings? A Scoping Review.

Telehealth has improved patient access to healthcare services and has been shown to have a positive impact in various healthcare settings. In any case, little is understood regarding the utilization of telehealth in hypertension management in primary healthcare (PHC) settings. This study aimed to identify and classify information about the types of interventions and types of telehealth technology in hypertension management in primary healthcare. A scoping review based on PRISMA-ScR was used in this study. We searched for articles in four databases: Pubmed, Scopus, Science Direct, and Embase in English. The selected articles were published in 2013-2023. The data were extracted, categorized, and analyzed using thematic analysis. There were 1142 articles identified and 42 articles included in this study. Regarding the proportions of studies showing varying trends in the last ten years, most studies came from the United States (US) (23.8%), were conducted in urban locations (33.3%), and had a quantitative study approach (69%). Telehealth interventions in hypertension management are dominated by telemonitoring followed by teleconsultation. Asynchronous telehealth is becoming the most widely used technology in managing hypertension in primary care settings. Telehealth in primary care hypertension management involves the use of telecommunications technology to monitor and manage blood pressure and provide medical advice and counselling remotely.

Disparity of Neonatal Care Visits by Region in Indonesia: A Secondary Data from Basic Health Research.

BACKGROUND: Neonatal care visit is one of the efforts to reduce the neonatal mortality rate. In Indonesia, few studies have analyzed neonatal care visits by region in the last decade. The purpose of this study was to analyze factors associated with neonatal care visits by region in Indonesia. METHOD: This study was a quantitative study with a cross-sectional design. It used secondary data from Riskedas (Basic Health Research). The total sample size was 64,321 female respondents of childbearing age who had babies aged 29 days to 59 months. The dependent variable was the completeness of neonatal care visits measured through at least one at the first neonatal care visit (KN 1), at least one at the second neonatal care visit (KN 2), and at least one at the third neonatal care visit (KN 3). Data were analysed using a statistical binary logistic regression test. RESULTS: The respondents who had complete neonatal care visits in Indonesia was 47.9%. The region with the highest proportion was Java-Bali at 58.5%, while the region with the lowest proportion was Papua at 23.8%. Variables influencing the completeness of neonatal care visits were delivery attendant, urban residence, secondary and higher education background, parity, delivery at a healthcare facility and compete antenatal care visits. Of these variables, delivery attendant (p < 0.05) was the most significant variable in all regions. CONCLUSION: This study showed that there were significant differences in complete neonatal care visits between regions in particularly between the ones in the west and east part of Indonesia. The government is expected to be able to provide equal distribution of and access to health facilities in rural and eastern Indonesia, especially neonatal services.

Environmental determinants and risk behaviour in the case of indigenous malaria in Muara Enim Regency, Indonesia: A case-control design.

INTRODUCTION: Malaria is a significant public health concern in Indonesia. Muara Enim Regency is one of the districts in South Sumatra with the most important number of indigenous malaria cases in the last three years (2018-2020). Therefore, this study aimed to identify determinants of indigenous malaria in the Muara Enim Regency. METHODS: This study was designed as a case-control study. A stratified random sample in 2018, 2019, and 2020 was used at the Primary Health Centres (PHCs) areas of Tanjung Enim and Tanjung Agung. The sample included 49 cases and 49 controls. Indigenous malaria determinants were discovered using both bivariable and multivariable logistic regression models. RESULT: The multivariable logistic regression model results show that mosquito repellent reduces malaria risk by 71% (AOR = 0.29, 95% CI: 0.11-0.64). Besides, the presence of wire mesh on ventilation reduces the risk of malaria by 76% (AOR = 0.24, 95% CI: 0.10-0.57), and the distance from mosquito breeding sites near hundred meters and fewer increases the risk of malaria by 3.88 fold (AOR = 3.88; 95% CI: 1.67-8.97). CONCLUSIONS: Multivariable analysis revealed distance from mosquito breeding sites as a risk factor for malaria. Besides, the study shows that using insect repellent, wire netting in ventilation, eliminating mosquito breeding sites, mosquito repellent or protective clothing, and improving house conditions were protective factors for indigenous malaria. Therefore, preventive and promotional efforts are essential as the first step toward malaria elimination at the study site, including avoiding direct contact between residents and vectors near mosquito breeding sites.

Factors associated with the completion of antenatal care in Indonesia: A cross-sectional data analysis based on the 2018 Indonesian Basic Health Survey.

Background: The global incidence of maternal mortality remains high, including in Indonesia, and the utilization of antenatal care services can help reduce these rates. Despite numerous studies examining factors affecting antenatal care utilization, there has been limited focus on identifying factors related to the completion of these services. Objective: This study aimed to analyze factors associated with the completion of antenatal care in Indonesia. Methods: The study used a cross-sectional analysis of secondary data from the Basic Health Research conducted by the Indonesian Ministry of Health in March 2018. The sample consisted of 65,929 pregnant women aged 15 to 49. Descriptive statistics, chi-square tests, and multiple logistic regression were used for data analysis. Results: The majority of respondents (75.2%) completed antenatal care. Factors significantly correlated with antenatal care completion were education level, occupation status, health insurance ownership, place of antenatal care services, travel time to health facilities, area of residence, history of pregnancy, parity, desired pregnancy, and pregnancy complications (p <0.05). The multiple logistic regression test showed that education level was the most dominant factor associated with antenatal care completion (p <0.001, OR = 2.023, 95% CI = 1.839-2.225). Conclusion: Completion of antenatal care is influenced by various factors, including education, job status, health insurance ownership, antenatal care services' location, travel time to health facilities, residence area, previous pregnancy history, number of children, desired pregnancy, and pregnancy complications. However, education is crucial in determining a mother's understanding and approach toward using these services. The Indonesian government should enhance public education and awareness initiatives to increase utilization. Healthcare professionals, particularly nurses and midwives, play a vital role in educating pregnant women about the significance of utilizing prenatal care services consistently and facilitating their access to these services efficiently.

Factors associated with depressive symptoms among adolescents in Indonesia: A cross-sectional study of results from the Indonesia Family Life Survey.

Introduction: Depression is one of the mental illnesses that affect adolescents worldwide. This study analysed the factors associated with depressive symptoms among adolescents in Indonesia. Method: A quantitative cross-sectional study was conducted using secondary data from the Indonesian Family Life Survey 2014. The sample included 3,603 adolescents aged 10-19 years. Data were analysed using logistic regression statistical tests. Results: Of the adolescents, 29.1% had depressive symptoms. The bivariate analysis showed that sex, region, economic status, chronic illness history, sleep quality, smoking habit, and personality type were associated with a higher probability of depressive symptoms among the adolescents. Conclusion: A history of chronic diseases contributes the most to the occurrence of depressive symptoms among adolescents. To reduce the prevalence of chronic diseases associated with depression, the Indonesian government must make preventive efforts through early detection among young people.

The practice of exclusive breastfeeding by region in Indonesia.

OBJECTIVE: Exclusive breastfeeding has important benefits for both children and mothers. However, the proportion of exclusive breastfeeding is still not evenly distributed among regions, including in Indonesia. The purpose of this study was to analyze the practice of exclusive breastfeeding by region in Indonesia and its influencing factors. STUDY DESIGN: This study was cross-sectional study. METHODS: This study used secondary data from the Indonesia Demographic and Health Survey 2017. The total sample was 1621 respondents, which consisted of mothers whose last child was under six months old and was still alive; the mothers did not have twins and lived with their child. Data were analyzed by using Quantum GIS and binary logistic regression statistical tests. RESULTS: This study shows that 51.6% of respondents gave exclusive breastfeeding in Indonesia. The highest proportion was in the Nusa Tenggara region (72.3%), whereas the lowest was in Kalimantan province (37.5%). Mothers who lived in the regions of Nusa Tenggara, Sulawesi, Java-Bali, and Sumatra had a higher chance of exclusive breastfeeding compared to those in the Kalimantan region. The factors associated with the exclusive breastfeeding vary widely across all regions, and the child's age is the only common factor associated with the exclusive breastfeeding in all regions, except Kalimantan. CONCLUSION: This study shows wide variation in regional proportions and determinants of exclusive breastfeeding in Indonesia. Therefore, appropriate policies and strategies are needed to increase equitable exclusive breastfeeding practices across all regions in Indonesia.

Factors associated with the choice of delivery place: A cross-sectional study in rural areas of Indonesia.

Background: Developing countries, including Indonesia, commonly face maternal mortality as a public health concern, which needs special attention. Using maternal delivery services in health facilities may reduce maternal mortality. However, little is known about the general use of delivery services in health facilities in rural areas, Indonesia. Objective: This study aimed to analyze determinants in choosing delivery places in rural areas of Indonesia. Methods: A cross-sectional quantitative design with secondary data from the 2014 Indonesian Family Life Survey (IFLS) was used in this study. There were 2,389 mothers aged 15-49 years in rural areas were included. Data were analyzed using a logistic regression test. Results: It was found that 67% of mothers gave birth in health facilities. Tertiary and secondary education levels, residence in Java and Bali regions, economic status, insurance ownership, and job status were significantly related to the choice of delivery place in health facilities. Tertiary education was the most dominant factor correlated with the use of delivery services in health facilities (p < 0.001; PR = 4.55; 95% CI = 3.751-5.542). Conclusion: Education is the key factor associated with the choice of delivery place. Therefore, it is suggested that the government and healthcare workers, especially nurses and midwives, improve mothers' education and provide strategies to increase knowledge in choosing delivery services to enhance their health outcomes.

Utilization of Teleconsultation: Mitigation in Handling Mental Disorders in the COVID-19 Era.

The COVID-19 pandemic has caused many undesirable effects, including death. The COVID-19 outbreak occurred suddenly, and many countries were ill prepared to face it. Community behaviour has been altered due to the pandemic. Uncertainty surrounding the disease triggered panic buying; public panic caused additional worry about limited food supplies, and thus demand increased. World economies have also felt the impacts of the COVID-19 outbreak. Owing to the measures put in place to address the spread of COVID-19, many service providers and industries were closed, resulting in financial losses, and the risk of unemployment was elevated, which inevitably increased negative emotions in individuals. A psychosocial consequence of the COVID-19 pandemic is worldwide fear. Because psychological defence is a supporting factor for the recovery of COVID-19 patients, it is important to encourage prevention of mental stress. Psychotherapy is able to provide counselling services to the community through teleconsultation. Strengthening psychological defences can help countries fight against this disease.

Analysis of Diabetes Mellitus Determinants in Indonesia: A Study from the Indonesian Basic Health Research 2013.

BACKGROUND: diabetes mellitus is a silent-killer. Its prevalence and impact on health expenses increase from year to year. This study aims to investigate the characteristics and the risk factors that affect  diabetes mellitus in Indonesia. METHODS: this is a cross sectional study. Data were obtained from the Basic Health Research (RISKESDAS) in 2013. The samples were individuals aged ≥15 years, whose fasting blood glucose and 2 hours blood glucose after the imposition have been measured. 38.052 individuals were selected for this study. The variables of age, sex, marital status, level of education, employment status, living area, regional status, hypertension, obesity, smoking habit, and dyslipidemia are analyzed as risk factors for diabetes mellitus. Bivariate analysis was using chi-square test with significance level of p<0.05 and confidence interval (CI) of 95%, and multivariate analysis using multiple logistic regression test. RESULTS: our study showed that 13% have diabetes mellitus in 2013. Factors affecting diabetes mellitus were age>55 years (OR=5.10; 95%CI 4.42 to 5.89; p<0.001), female (OR=1.37; 95%CI 1.26 to 1.49; p<0.001), rural (OR=1.16; 95%CI 1.08 to 1.26; p<0.001), married (OR=1.31; 95%CI 1.07 to 1.58; p<0.05), unemployed (OR=1.14; 96%CI 1.05 to 1.23; p<0.05), obesity (OR=1.46; 95%CI 1.35 to 1.58; p<0.001), hypertension (OR=1.68; 95%CI 1.55 to 1.81; p<0.001) and dyslipidemia (OR=1.53; 95%CI 1.39- 1.68; P<0.001). CONCLUSION: as many as 13% of individuals have diabetes mellitus in 2013. Age, gender, living area, employment status, obesity, hypertension, and dyslipidemia are the contributing factors to diabetes mellitus.