Predictors of Mortality Among Children with Confirmed and Suspected Cases of COVID-19 in East Java, Indonesia.

Introduction: Coronavirus disease 2019 (COVID-19) increases rapidly and causes mortality in all groups, including children. However, the predictive risk factors of mortality among children remain inconclusive. This study aimed to analyse the predictors related to mortality among children with COVID-19. Methods: Secondary data analysis was conducted using provincial COVID-19 data from April 2020 to May 2021. We selected 6441 children under age 18 to be included in this study. Chi-square and binary logistic regression were used to evaluate the predictors of mortality in children with COVID-19. Results: This study showed that the prevalence of children who died COVID-19 was 2.7%. Age, case definition, treatment status, severity of illness, and travel history had a significant relationship with survival status in children with COVID-19. As the increasing age, the risk of death with COVID-19 will decrease [AOR=0.94; CI 95%=0.91-0.97]. Otherwise, suspected status [AOR=2.12; 95% CI=1.48-3.04], hospitalization with ventilators [AOR=22.25; 95% CI=5.73-86.42], severe illness [AOR=46.76; 95% CI=21.69-100.80], and travel history [AOR=1.78; 95% CI=1.22-2.60] were significantly related with an increased risk of death in children with COVID-19. Discussion: Severe illness in children was the strongest predictor of mortality. Disease prevention and health promotion programs are the key to preventing hospitalizations in children and decreasing the mortality rate.

Indonesian Nurses' Journey in Passing the Japan National Nursing Licensure Examination.

Background: Despite the significant number of Indonesian nurses joining the Japanese National Nursing Licensure Examination (JNNLE), only a few of those were successful. Indonesian nurses as one of active migration player to Japan's market remain a critical support in supporting human resources for health in Japan. However, the successful nurses' perspectives have yet to be understood entirely. This study aimed to explore the experiences of Indonesian nurses who successfully passed the JNNLE. Methods: This study used a descriptive qualitative approach. The participants were twenty Indonesian nurses who have passed the licensure examination. This study was carried out by semi-structured interviews conducted virtually. The data were analyzed using thematic content analysis. Results: Five themes were discovered in this study: language ability as the key to succeeding in the exam, strategies to passing the exam, supporting resources as factors to increase the passing rate, understanding the nature of nursing exam, and internal motivation to be recognized as a professional nurse in a foreign country. Conclusion: Indonesian nurses who passed the Japanese national nursing licensure examination tend to deploy planned strategies. Honing the language skills while working and living in Japan is very important, while structured support systems in the hospital, government, and social network are imperative to learning the new knowledge in the area of nursing care in Japan.

Going Global: Insights of Indonesian Policymakers on International Migration of Nurses.

BACKGROUND: The Indonesian policymakers need to respond to the current challenges, particularly the excess of nurses and the increased demand for nurses in the global market. OBJECTIVE: This study aimed to present the perception of policymakers and stakeholders on the management of overseas migration of Indonesian nurses. METHODS: This study is a descriptive qualitative design where data were collected through structured interviews with key stakeholders representing the Indonesian government, namely the Ministry of Health (MOH), the Ministry of Labour (MOL), Ministry of Education (MOE) and the Indonesian Migrant Workers Protection Agency (BP2MI). The in-depth interviews involved participants who were responsible for managing Indonesian nurses' migration. The qualitative data were analyzed thematically using a content analysis approach. RESULTS: The issues involving nurses' migration policy are quite complex and sectoral. Themes emerging from this study include the move towards global market orientation, addressing challenges on international nurse migration, strengthening coordination among stakeholders and making the most of opportunities. All the themes reflect that the country should work hard to achieve the balance between quantity and quality of nursing resources for the international market. CONCLUSION: As regulator and executor of Indonesian nurse migration, various government policies have responded to the low number of Indonesian nurses' migration overseas, emphasizing the three cycles of migration: pre-migration, migration and post-migration. The preparation of resources, regulations and placements for Indonesian nurses abroad open the opportunity to the international nursing labour market. Hence, the policies need to be strengthened from upstream to downstream to make Indonesian nurses more competitive and adaptive in global market.

Women's Empowerment and Determinants of Early Initiation of Breastfeeding: A Scoping Review.

INTRODUCTION: Early initiation of breastfeeding (EIBF), the immediate provision of mothers' breast milk to infants within the first hour of life, has been recommended by the WHO. However, EIBF is not widely practiced, thereby increasing infant mortality risk. This review explored the available and published studies that identified interventions that empower mothers to practice EIBF. METHOD: We conducted a scoping review to answer the aforementioned aims. Empowerment, Women, Breastfeed, and Initiation were used as initial keywords, which were further developed using Medical Subject Headings by the National Center for Biotechnology Information. Five databases, namely: Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature via EBSCO, ProQuest, and MedLine via PubMed, were searched for potential articles. We also searched the references in addition to the main search. FINDINGS: We included 28 articles in this review. Education was mostly used as women's empowerment indicator in EIBF intervention. Additionally, we identified barriers (C-section and postoperative pain, lactation problems and pregnancy complications, mothers' social and demographic factors, mothers' lack of professional support, babies' condition preventing EIBF) and facilitators (mothers' positive behavior in relation to educational level, completion of antenatal care, poor economic situations of mothers, babies' size at birth) of EIBF. DISCUSSION: Education is the widely used intervention to promote mothers' participation in improving EIBF rate. Furthermore, mothers' and babies' deferring conditions and traditional practices are barriers for EIBF. This review recommends future research and empowerment efforts that sensitively address the identified barriers.

Determinants of safe delivery utilization among Indonesian women in eastern part of Indonesia.

Background: Improving maternal health and reducing maternal mortality are part of the United Nations global Sustainable Development Goals for 2030. Ensuring every woman's right to safe delivery is critical for reducing the maternal mortality rate. Our study aimed to identify determinants of safe delivery utilization among women in the eastern Indonesia. Methods: This study was cross-sectional and used a secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). A total of 2,162 women who had their last child in the five years preceding the survey and lived in the eastern part of Indonesia were selected as the respondents. Chi-squared test and binary logistic regression were used to understand the determinants of safe delivery. Results: Higher child rank and interval ≤2 years (OR: 0.30, 95% CI: 0.19-0.47), unwanted pregnancy at time of becoming pregnant (OR: 1.48, 95% CI: 1.05-2.08), richest wealth quintile (OR: 5.59, 95% CI: 3.37-9.30), more than four antenatal care visits (OR: 3.62, 95% CI: 2.73-4.79), rural residence, good composite labor force participation, and a good attitude towards domestic violence were found to be significantly associated with delivery at health facility. Higher child rank and interval ≤2 years (OR: 0.49, 95% CI: 0.29-0.83), husband/partner having completed secondary or higher education (OR: 2.18, 95% CI: 1.48-3.22), being in the richest wealth quintile, and four other factors were found to be significantly associated with the assistance of skilled birth attendants. Conclusions: This research extends our knowledge on the determinants of safe delivery among women in the eastern part of Indonesia. This study revealed that the economic status of household remains an important issue in improving safe delivery among women in eastern part of Indonesia. An open innovation and partnership process to improve safe delivery program that engages the full range of stakeholders should be developed based on economic situation.

Determinants of contraceptive use among married women in Indonesia.

Background: Contraceptives in family planning are used to control the timings between pregnancies. Although the number of those using family planning has increased, determinants of contraceptive use among married women in Indonesia remain insufficient. This research aimed to identify the factors associated with contraceptive use among married women in Indonesia. Methods: This study employed data from the Indonesian Demographic and Health Survey 2017. We selected 35,621 married women aged 15-49 years. Then, the determinants of contraceptive use among married women in Indonesia were examined by binary logistic regression. Results: Women's age (Adjusted Odds Ratio (AOR)=0.529; 95% CI=0.470-0.597), the number of living children (AOR=44.024; 95% CI=33.193-58.390), education level (adjusted odds ratio=2.800; 95% CI=2.181-3.594), wealth index (AOR=1.104; 95% CI=0.978-1.246), frequency of watching television (AOR=1.555; 95% CI=1.321-1.829), and frequency of using the Internet (AOR=0.856; 95% CI=0.794-0.924) were significantly associated with contraceptive use among married women. Conclusions: This study highlights the determinants of contraceptive use among married women in Indonesia. Women's age, the number of living children, education level, wealth index, and access to information may influence contraceptive use among these women. This study emphasizes that health education and promotion on the importance of using contraception should be initiated in innovative ways.