Developing hospital resilience domains in facing disruption era in Indonesia: a qualitative study.

BACKGROUND: The studies of hospital resilience have been of increasing importance during the last decade due to disasters and pandemics. However, studies in developing the domain and indicators of hospital resilience were limited mainly on disaster response. A few studies of hospital resilience focused on how to deal with disruptions such as environmental turbulence, rapid technological changes, and changes in patient preferences. This study aims to develop domains and indicators of hospital resilience in facing the disruption era. METHODS: This qualitative study focused on exploring the domains and indicators to face disruptions that have been identified in the first exploratory phase of the studies. Key informants included hospital experts from the government, medical practitioners, and academics. A total of 20 key informants were involved in semi-structured interviews which were conducted face-to-face, via telephone and Zoom. Data was analyzed using a grounded theory approach to discover domains for a resilient hospital. RESULTS: The study identified a number of domains that are fundamental for a hospital to become a resilient in the face of disruption. These include readiness to face digital transformation, effective leadership, and flexibility in managing resources among others. Situation awareness and resilience ethos, implementation of marketing management, networking, and disaster anticipation are found to be equally important. These domains focused on the hospital's ability to deal with specific shocks from different perspectives as the result of changes from disruptions which are inevitable within the organizational business environment. CONCLUSIONS: The domains identified in the study are able to respond to the limitations of the concept of hospital resilience, which is currently more focused on hospital disaster resilience. They can be used to measure hospital resilience in the context of the volatility, uncertainty, complexity, and ambiguity (VUCA), which are relevant to the context of the Indonesia hospital industry.

Effect of Moringa oleifera supplementation during pregnancy on the prevention of stunted growth in children between the ages of 36 to 42 months.

BACKGROUND: The government has made provisions to improve the nutrition of stunted children under the age of five nationally by providing iron folic acid (IFA) tablet since conception. However, these drugs were not able to reduce the incidence of stunted growth. The aim of this study is to assess the effect of moringa intervention during pregnancy on the incidence of stunted growth in children between the ages of 36 to 42 months. DESIGN AND METHODS: This study is a follow-up to an experimental RCT-DB study during pregnancy. The interventions given were PG (Moringa Flour), EG (Moringa Extract) and IG (IFA) which was used as control. RESULTS: The highest number of children that had stunted growth after taking the PG by IG and EG extracts were 66 (41.5%), 53 (33.3%) and 40 (25.2%), respectively. The stunted risk factor analysis did not show a significant relationship to the stunted incidence. Furthermore, the consumption and dietary patterns of children were based on only fat consumption which was associated with stunted incidence (p<0.05). The results of multivariate analysis showed that the EG extract was effective in reducing the incidence of stunted growth (p<0.005) and as a protective factor of 0.431 times the incidence of stunted growth (LL-UL=0.246-0.754). CONCLUSIONS: The administration of Moringa oleifera extract during pregnancy prevents the incidence of stunted growth in children.

Dietary diversity, dietary patterns and dietary intake are associated with stunted children in Jeneponto District, Indonesia.

OBJECTIVE: The most influence of occurrence children stunted are those related to food, both in terms of quantity and quality. The aim of this study is seeing of the relationship between dietary diversity, dietary pattern and dietary intake for children stunted. METHODS: This study is a follow up of the previous study of nutrition interventions in children, where the total sample size children was 340 measured the dietary intake with 24-hour recall. The dietary diversity and dietary patterns was measured by the FFQ (Food Frequency Questioner) form for children. RESULTS: The results showed that a lack of energy intake associated with children stunted was 132 (44.9%) (p=0.050), and lacked fat intake was 125 (45.6%) (p<0.050). For the dietary diversity there is a relationship with stunted at a mean value of 7.51±0.87 (p<0.050). As for the dietary pattern, there is a relationship between insufficient of consumption nuts and stunted (p=0.019) and foods containing sugar (p=0.050) also, namely 135 (45.3%) and 103 (43.8%). CONCLUSION: Stunting in children is related to the quality and quantity of food.