Prevalence and determinants of diarrhea among under-five children in five Southeast Asian countries: Evidence from the demographic health survey.

PURPOSE: To describe the prevalence and the correlation between individual, environmental and household, health behavior, and source of information factors with diarrhea among under-five children in five Southeast Asian countries based on the National Health Survey. DESIGN AND METHODS: Cross-sectional design conducted in five countries in Southeast Asia. Datasets from Demographic and Health Surveys and Multiple Indicator Cluster Surveys in five countries were analyzed. RESULTS: A total of 12,447 children under 5 years of age from five countries in Southeast Asia (Indonesia 1807, Cambodia 2650, Myanmar 1717, the Philippines 3669, and Timor-Leste 2614) were included in this study. Binary logistic regression was performed to analyze the data. A total of 12,447 under-five children were included in the study. Overall, in five Southeast Asian countries, the prevalence of diarrhea is known from 8.39% in the Philippines to 18.21% in Indonesia. Several factors related to diarrhea are individual; environmental and household; health behavior such as stool disposal, breastfeeding mothers, and children's food history; and source of information factors. CONCLUSION: The findings of this study indicate that diarrhea is a serious public health problem in the Southeast Asian region that must be addressed using preventive and curative approaches. PRACTICE IMPLICATION: The results indicate the need for cross-collaboration among nurses, medical doctor, and sanitarian is needed to tackle the childhood diarrhea and minimize the severity based on those determinants.

HIV-related knowledge, information, and their contribution to stigmatization attitudes among females aged 15-24 years: regional disparities in Indonesia.

BACKGROUND: Stigmatization attitudes among youths toward people living with HIV (PLWH) is still an issue and concern in Indonesia. The purpose of this study was to determine the regional disparities, levels of HIV-related knowledge, information, and contributions related to stigmatization attitudes among females aged 15-24 years in Indonesia. METHODS: A cross-sectional study with The 2017 Indonesian Demographic Health Survey (IDHS) was used. A total of 12,691individual records of females aged 15-24 years were recruited through two-stage stratified cluster sampling. The endpoint was stigmatization attitude. Then, bivariate and multivariate binary logistics were performed. RESULTS: The findings showed that female youths who have no HIV-related knowledge (62.15%) and some source of information (52.39%). The highest prevalence of stigmatizing attitude was 59.82%, on Java Island. Multivariate analysis showed that females living in Sulawesi and Kalimantan; those living in a rural area; and those with more HIV-related knowledge were less likely to have a stigmatizing attitude. Conversely, females with the middle- to richest-wealth index and had some HIV-related information were more likely to have a stigmatizing attitude. CONCLUSION: An understanding of stigmatizing attitudes should be considered through demographic factors, knowledge, and source of HIV-related information. The Indonesian government should pay more attention to indicators of HIV-related knowledge and information. Moreover, we suggest that the government collaborates with youths to disseminate information and restructure and reanalyze policies about HIV.

Regional disparities and their contribution to the coverage of the tetanus toxoid vaccine among women aged 15-49 years in Indonesia.

Background: The prevention of Clostridium tetani bacterial infection through the administration of the tetanus toxoid (TT) vaccine in women is important. The purpose of this study was to determine the regional disparities and factors associated with TT vaccine coverage in women aged 15-49 years in Indonesia. Methods: The Indonesian Demographic Health Survey (IDHS) 2017 data was used in this study. A total of 36,028 women, aged 15-49 years were recruited using the two-stage stratified cluster sampling technique. The questionnaire used was based on the DHS Questionnaire Phase 7. Chi-squared and binary logistic regression were used in this study as part of the analysis. Results: We found that the TT vaccine coverage was 75.32% and that the majority were spread across several provinces. The provinces of Bali and Nusa Tenggara, the richer respondents, living in a rural area, visiting the health facility, having health insurance, and those currently working were factors making it more likely that the women would receive the TT vaccine. The respondents aged 15-24 years with a primary education level and the respondents who were divorced were less likely to receive the TT vaccine. Conclusion: The coverage of the TT vaccine among women can be increased by considering the regional disparities in Indonesia and the socio-economic demographic details of the respondents. Strengthening the policies from the central government in the local governments can improve the screening process and vaccine delivery outcomes. In addition, the importance of giving the TT vaccine to women needs to be relayed through health education in collaboration between health workers and the public.

Factors Associated with National Health Insurance Coverage in Indonesia.

Background: The National Health Insurance (NHI) program is the Indonesian government's national health program. However, health insurance coverage has not been maximized. This study aims to analyze the factors associated with health insurance coverage in Indonesia.   Methods: Retrospective cross-sectional data were obtained from the Indonesian Demographic and Health Survey 2017. A total of 39,580 respondents were selected using two-stage stratified cluster sampling. The data come from the DHS Questionnaire Phase 7. In this study, we explored age, education level, wealth quintiles, residence, the number of children who are alive, marital status, current employment status, earnings, and health insurance status in relation to health insurance coverage. Then, we analyzed the data using chi-squared and binary logistic analyses.   Results: The prevalence of health insurance coverage in the Indonesian population is 62.3%. Respondent aged 15-24 years [AOR=0.88; 95% CI=0.77-1.00], secondary education level [AOR=0.44; 95% CI=0.41-0.47], poorer wealth index [AOR=0.76; 95% CI=0.71-0.82], live in rural area [AOR=0.78; 95% CI=0.75-0.82], divorced [AOR=0.72; 95% CI=0.63-0.83] were less likelihood to have health insurance. Conversely, the respondent who received earnings [AOR=1.25; 95% CI=1.18-1.32] was more likely to have health insurance.  Conclusion: This finding pointed to education level, economic status, and demographic area such as respondents who lived in rural areas should more pay attention to NHI. Intervention through the provision of appropriate information about NHI should be promoted.

Safety behaviour and healthy diving: a qualitative study in the traditional diverse fishermen.

BACKGROUND: Traditional divers from the Maluku Province of Indonesia have not received formal education and training related to standard diving tools. They only become accomplished at diving generation by generation. The use of non-standard diving tools increases the risk of injury and illness. This study aimed to get an overview of the health and safety behaviours of traditional divers. MATERIALS AND METHODS: The study was qualitative, involving 15 traditional divers who used compressors for at least 1 year and who'd had decompression sickness and barotrauma as a result of diving. The data was obtained through in-depth interviews, analysed through the Colaizzi method. RESULTS: The participants' diving health and safety behaviour is triggered by the perception of the risk of diving. This is supported by the reinforcing social and environmental factors leading to the form of health and safety behaviour when diving. These behaviours include diving without planning, using a compressor, and making "sesajen" (kind of food, leaves, and water that are believed to be a form of surrender to the creator) which is an offering or present to the gods or ancestors. This behaviour causes complaints such as trauma and an increased economic burden. Some participants consider complaints as a threat and plan to stop diving. The participants made a plan before dive and declared that they would change their behaviour to ensure safety. CONCLUSIONS: Health and safety behaviour related to diving must be socialised and facilitated. The establishment of a divers' community that cares about health and safety behaviour needs to become important as a support system.