BackgroundElderly people tend to have greater healthcare utilization because of their health status. However, with the 4th largest population in the world, little is known concerning the use of services among the Indonesian elderly. Hence, this study aimed to identify factors related to the use of outpatient services among the Indonesian elderly.MethodsThis is cross sectional study using data from the Indonesian Family Life Survey 5 (IFLS 5), conducted in 2014 and 2015. Only those who were 60 years or older were included in the analyses. We used a logistic regression analysis to determine factors associated with use of outpatient services.ResultsAmong 2912 participants, only 22.7% of respondents had visited health workers or doctors within the previous 4 weeks before the survey. After controlling for other variables, factors associated with the use of outpatient services were socioeconomic status, insurance status, regions of residence, self-rated health, and the number of chronic conditions.ConclusionInequality in outpatient services was observed among the elderly in Indonesia. More effort is need to expand insurance coverage for the elderly, particularly for those in the lower economic status, and to improve access to outpatient services in rural regions by allocating the needed resources.

Purpose -Bantul in Central Java was the most severely damaged area by a devastating earthquake in May 2006. Even after being victims themselves, nurses and midwives at public health centers worked devotedly. The purpose of this paper is to identify the nurses' and midwives' perceptions and understanding of their roles, as well as the needs of training in disaster preparedness and management. Design/methodology/approach -Focus group discussions and questionnaire survey were conducted with 11 nurses and 11 midwives of public health centers in Bantul. Content analysis was applied to analyze transcripts of the focus group discussions and the responses to questionnaire. Findings -Health care for survivors and community were provided by highly committed health professionals supported in strong community resilience. Donors driven relief programs tended to be unorganized and insensitive for local health providers. Besides, organized disaster management trainings are strongly needed to develop disaster nursing and preparedness. Research limitations/implications -Embedded problems of local health system and current nursing practice were highlighted. Originality/value -Focus group discussions provided vital information that can and must be used to improve disaster response capabilities. Moreover, it was equally it is crucial to examine carefully what unfolded during post-disaster intervention.

Gout is one of the non-communicable diseases that can affect the quality of life. The high prevalence of gout is apparent in Indonesian research and records in primary health services. However, adult people's needs regarding gout management programs were barely explored. The study aimed to identify the association between the character of demographics, food consumption, and prevalence of gout in the rural areas in The Sleman Regency. This study is a quantitative study using a cross-sectional approach. Samples consisting of 109 adult people were chosen by purposive sampling with inclusion criteria: 1) residents of The Jaranan sub-village, Cangkringan, Sleman, D.I. Yogyakarta Province and 2) age over 25 years old. Data was collected through a survey using questionnaires adapted from the Indonesian Basic Health Survey Questionnaire, Gout Knowledge Questionnaire (GKQ) and Gout Assessment Questionnaire (GAQ), and food frequency form. Association between gout, food consumption, and knowledge were analyzed using the chi-square test.As a result, the prevalence of gout in adult people in rural areas was 18.35%. They have limited knowledge regarding gout diagnosis, treatment, and prevention (66,97%). Half of the respondents reported consuming food with medium content of purine such as tempeh (56%) and tofu (52%), and were not well-hydrated (63.3%). There was a significant relationship between gout and hypertension and meat consumption. Respondents reported they worried about the progress of gout (>70%) they will experience. In conclusion, the prevalence of gout is high in adult people in rural areas. The adult people who did not have formal education, hypertension, and meat consumption have a significant association with gout diseases. There is a need for a gout prevention program to maintain a healthy lifestyle and healthy diet, improve gout-related knowledge and control the progress of gout disease.

Background: Stunting is a common malnutrition problem among children in the world. The Care for Children Development (CCD) intervention is a strategy to reduce stunting. Objective: This study aimed to identify the effect of culturally modified CCD training on the knowledge, attitude, and efficacy (KAE) of cadres about stunting in the community.Methods: We conducted a community-based study with a quasi-experimental research design using a comparison group. The study was conducted from March 2018 to February 2019 at three Public Health Centers in Yogyakarta, Indonesia. The total participants were 69 in the intervention group and 53 in the comparison group. Cadres in the intervention group received two days of training on a culturally modified CCD guideline. In contrast, cadres in the comparison group received a brief explanation (a one-day training) on that program. The nurses from three public health centers were facilitators in this training. Knowledge and self-efficacy were assessed using a modified Caregiver Knowledge of Child Development Inventory and General Self-efficacy Scale, respectively. Data were analyzed using Mann-Whitney U tests and Wilcoxon tests.Results: All 122 cadres completed the training. In the intervention group, CCD training significantly increased cadres’ knowledge (median score 14 vs. 11), attitude (58 vs. 55), and efficacy (30 vs. 28), all with p <0.001. In the comparison group, the short explanation of CCD significantly improved cadres’ knowledge (median score 12 vs. 10) and efficacy (29 vs. 27) but not their attitude. The delta or change in score before and after CCD training for cadres’ attitude in the intervention group was significantly higher than that of the comparison group (3.78 vs. 0.72; p = 0.050). Conclusion: A culturally modified CCD training significantly improves cadres’ KAE in the intervention group and cadres’ knowledge in the comparison group. The learning delivery methods with demonstrations and role-plays significantly improved the cadres’ attitudes as health educators for stunted mothers in the community. For sustainability, community health nurses should regularly collaborate with cadres to improve the nutritional status of children in their area.