Factors for Minimum Acceptable Diet Practice among 6-23-Month-Old Children in Rural and Urban Areas of Indonesia.

Background: Malnutrition is common among children under 5 years of age in Indonesia, with the rates varying between urban and rural areas. The minimum acceptable diet (MAD) assesses nutrient quality and quantity. This study aimed to identify the potential variables for MAD in 6-23-month-old children in both urban and rural Indonesia. Methods: We used the data from the 2017 Indonesia Demographic and Health Survey to conduct this nationally representative study. A total of 4,688 children aged 6-23 months were included in the study. MAD was classified using the 2017 World Health Organization global nutrition monitoring framework. The determinants of MAD were analyzed using multiple logistic regression. Results: Overall, 45% of children aged 6-23 months received the required MAD, with 47.4% receiving the MAD in urban areas and 35.7% in rural areas. Children's age, fathers' age, parents' education level, mothers' employment, and wealth index were strongly linked to MAD in both rural and urban homes. The factor specifically related to MAD in urban areas was mother living with her husband. For rural households, mothers' involvement in decisionmaking and a minimum of four antenatal care (ANC) visits significantly increased the likelihood of their children's MAD status. Conclusion: MAD status was determined by increased child age, higher parent education, younger father, working mother, and higher wealth index in children aged 6-23 months in both urban and rural settings. Mothers living with a spouse determined the MAD status only in urban areas. More frequent ANC visits and mother participation in household decisions were other factors related to MAD status in rural areas.

Pandemic Pressure: Changes in Hypertensive Management Adherence in Indonesia.

PURPOSE: This study aimed to determine factors associated with changes in adherence to hypertension management (medication adherence and blood pressure control) in respondents with hypertension before and during the COVID-19 pandemic in Bogor city, Indonesia. METHODS: An observational study was conducted using two sources of data (before and during COVID-19 pandemic). Data before the pandemic were derived from the 2019 Cohort Study of non-communicable disease risk factors. Data during the pandemic were derived from an online survey conducted in September and October 2020. Information from 880 participants were analyzed. The dependent variable was the change in adherence to hypertension management before and during the COVID-19 pandemic. Multivariate analysis was performed using logistic polynomial regression. RESULTS: Respondents who adhered to hypertension management decreased from 82.0% in 2019 to 47.8% in 2020. The likelihood of non-adherence (respondents who did not adhere to hypertension management both before and during the pandemic) increased in respondents below 55 years old, who did not own any healthcare insurance, who were not obese, and who had no other comorbidities. In the partial adherence group (respondents who did not adhere to hypertension management either before or during the pandemic), we found that most respondents adhered before the pandemic but no longer adhered during the COVID-19 pandemic. We found an increased partial adherence in young and highly educated respondents. CONCLUSIONS: Efforts to improve adherence to hypertension management after the COVID-19 pandemic should target those who were young, highly educated, who did not have any healthcare insurance, and who did not perceive themselves as not having comorbidities.

Number of comorbidities and the risk of delay in seeking treatment for coronary heart disease: a longitudinal study in Bogor City, Indonesia.

BACKGROUND: The aim of this study was to investigate the relationship between the number of patient comorbidities and the delays in seeking treatment for coronary heart disease (CHD). METHODS: This longitudinal study utilized secondary data from the Non-Communicable Disease Risk Factor (NCDRF) cohort study conducted in Bogor City. Individuals who participated in the NCDRF cohort study and were diagnosed with CHD within the 6-year study period met the inclusion criteria. Respondents who were not continuously monitored up to the 6th year were excluded. The final sample included data from respondents with CHD who participated in the NCDRF cohort study and were monitored for the full 6-year duration. The final logistic regression analysis was conducted on data collected from 812 participants. RESULTS: Among the participants with CHD, 702 out of 812 exhibited a delay in seeking treatment. The risk of a delay in seeking treatment was significantly higher among individuals without comorbidities, with an odds ratio (OR) of 3.5 (95% confidence interval [CI], 1.735-7.036; p<0.001). Among those with a single comorbidity, the risk of delay in seeking treatment was still notable (OR, 2.6; 95% CI, 1.259-5.418; p=0.010) when compared to those with 2 or more comorbidities. These odds were adjusted for age, sex, education level, and health insurance status. CONCLUSION: The proportion of patients with CHD who delayed seeking treatment was high, particularly among individuals with no comorbidities. Low levels of comorbidity also appeared to correlate with a greater tendency to delay in seeking treatment.

Postpartum Depression in Young Mothers in Urban and Rural Indonesia.

OBJECTIVES: Young mothers are vulnerable to postpartum depression due to role transition-related stress. Understanding the causes underlying these stressors is essential for developing effective interventions. METHODS: This study analyzed the 2018 Indonesian Basic Health Research data. The Mini International Neuropsychiatric Interview was used to assess postpartum depression symptoms in mothers aged 15-24 years with infants aged 0-6 months. In 1285 subjects, the risk factors for postpartum depression were evaluated using multivariate logistic regression. RESULTS: The overall prevalence of depression in the 6 months postpartum was 4.0%, with a higher prevalence in urban areas (5.7%) than in rural areas (2.9%). Urban and rural young mothers showed distinct postpartum depression risk factors. In urban areas, living without a husband (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.24 to 11.76), experiencing preterm birth (OR, 4.67; 95% CI, 1.50 to 14.50), having pregnancy complications (OR, 3.03; 95% CI, 1.20 to 7.66), and having postpartum complications (OR, 5.23; 95% CI, 1.98 to 13.80) were associated with a higher risk of postpartum depression. In rural areas, postpartum depression was significantly associated with a smaller household size (OR, 3.22; 95% CI, 1.00 to 10.38), unwanted pregnancy (OR, 4.40; 95% CI, 1.15 to 16.86), and pregnancy complications (OR, 3.41; 95% CI, 1.31 to 8.88). CONCLUSIONS: In both urban and rural contexts, postpartum depression relates to the availability of others to accompany young mothers throughout the postpartum period and offer support with reproductive issues. Support from the family and the healthcare system is essential to young mothers' mental health. The healthcare system needs to involve families to support young mothers' mental health from pregnancy until the postpartum period.