Maternal mortality is still a problem globally and especially occur in developing countries, including Indonesia. The maternal mortality rate is one indicator of the health status of a country. Garut is one part of West Java province with the count of maternal mortality case was 45 deaths in 2015. Most of the causes of maternal death is preventable, ie factors of patients, healthcare workers, facilities, and referral. Recording and reporting of maternal deaths has not to be going well yet, so that intervention can not be set to decrease maternal mortality significantly. Research carried out by sequential explanatary mixed method. The first phase, data collection and analysis is done quantitatively, followed by collection of qualitative data in the second phase which aims to strengthen the results of quantitative research. Quantitative research using cross sectional and qualitative study using in-depth interviews and focus group discussions. The study was conducted in October-November, 2016. Based on the research showed that 96% of maternal deaths occur in Garut regency are preventable maternal deaths that caused by multifactorial, a combination of healthcare workers factors, patient factors, and referral factors. Maternal deaths are also caused by the referral process has been delayed. Besides that, recording and reporting have not been able to run well, with the availability of human resources, but the existing policy has not been adequate. Patient factors such as age, parity, and birth spacing is at risk, as well as negative perceptions of mothers and families to health facilities contributed to preventable maternal deaths. Health workers factor prefer to unqualified health workers in conducting effective communication and counseling. Access, financing, and poor communication between health professionals and patients have contributed to the occurrence of resistance in the referral process.

Kegawatdaruratan obstetri merupakan penyebab utama kematian maternal dan perinatal. Kegawatdaruratan obstetri menurut Rochjati terbagi menjadi 3 kelompok faktor risiko, yaitu APGO (Ada Potensi Gawat Obstetri), AGO (Ada Gawat Obstetri), dan AGDO (Ada Gawat Darurat Obstetri). Berbagai penelitian menyatakan salah satu upaya penatalaksanaan yang efektif pada kegawatdaruratan obstetri dengan pelaksanaan rujukan. Rujukan yang tepat dan terencana dapat menyelamatkan ibu dan bayi baru lahir. Penelitian ini bertujuan untuk mengetahui hubungan faktor risiko kegawatdaruratan obstetri (APGO, AGO, dan AGDO) dengan pelaksanaan rujukan oleh bidan di RSUD Gambiran Kediri. Desain penelitian secara kuantitatif dengan pendekatan potong silang dilaksanakan pada Januari–Februari  2014 dengan jumlah sampel sebesar 150. Pengambilan sampel dilakukan dengan cara consecutive sampling. Pengumpulan data sekunder berdasarkan laporan ruang bersalin dan rekam medik rumah sakit periode Januari–Desember 2011. Hasil penelitian menunjukkan tidak terdapat perbedaan bermakna faktor risiko kegawatdaruratan obstetri pada variabel APGO dan AGO antara rujukan terencana dan rujukan terlambat (p>0,05), namun terdapat perbedaan bermakna pada variabel AGDO antara rujukan terencana dan rujukan terlambat. Meningkatnya faktor risiko kegawatdaruratan obstetri akan meningkatkan pelaksanaan rujukan terencana lebih dari 6 kali (OR=6,12). Simpulan penelitian ini adalah  faktor risiko kegawatdaruratan obstetri pada AGDO berhubungan dengan pelaksanaan rujukan dan peningkatan faktor risiko kegawatdaruratan obstetri akan meningkatkan pelaksanaan rujukan oleh bidan

Objective Visual inspection of cervix after acetic acid application (VIA) has been considered an alternative to Pap smear in resource-limited settings, like Indonesia. However, VIA results mainly depend on examiner’s experience and with the lack of comprehensive training of healthcare workers, VIA accuracy keeps declining. We aimed to develop an artificial intelligence (AI)-based Android application that can automatically determine VIA results in real time and may be further developed as a health care support system in cervical cancer screening. Result A total of 199 women who underwent VIA test was studied. Images of cervix before and after VIA test were taken with smartphone, then evaluated and labelled by experienced oncologist as VIA positive or negative. Our AI model training pipeline consists of 3 steps: image pre-processing, feature extraction, and classifier development. Out of the 199 data, 134 were used as train-validation data and the remaining 65 data were used as test data. The trained AI model generated a sensitivity of 80%, specificity of 96.4%, accuracy of 93.8%, precision of 80%, and ROC/AUC of 0.85 (95% CI 0.66–1.0). The developed AI-based Android application may potentially aid cervical cancer screening, especially in low resource settings.

Stunting is a physical growth failure condition signed by height based on age under −2SD. The research goal is knowing the dominant factor associated with stunting on toddler age of 12–24 months in the working area of Singaparna Public Health Center Tasikmalaya regency. The research applies to the cross-sectional design of gender, weight, exclusive breastfeeding history, completeness immunization, and clinically healthy variables, while case-control is for nutrition intake variable. The sample was a total sampling of 376 toddlers, then 30 for case and control group with the simple random method from December 2017 to February 2018. The instrument is a questionnaire, food frequency questionnaire (FFQ), and infantometer. Data analyzed in several ways; univariable, bivariable with chi-square, and multivariable with logistic regression. Research result shows stunting prevalence was 22.5%, next pertain factor of stunting are gender (POR=0.564, 95% CI=0.339–0.937, p value=0.011), exclusive breastfeeding giving history (POR=1.46, 95% CI=1.00–2.14, p value=0.046), and clinically health (POR=1.47, 95% CI=1.00–2.16, p value=0.044). Moreover, dominant factor were gender (OR=0.56, 95% CI=0.339–0.937, p value=0.027) and clinically health (OR=1.68, 95% CI=1.022–2.771, p value=0.041). Thus, gender and clinical health are stunting determinant factors. Children’s health should increase to create maximum growth. DETERMINAN STUNTING PADA ANAK USIA 12–24 BULAN DI PUSKESMAS SINGAPARNA KABUPATEN TASIKMALAYAStunting merupakan kondisi kegagalan pertumbuhan fisik yang ditandai dengan tinggi badan menurut usia berada di bawah −2SD. Penelitian ini bertujuan mengetahui faktor determinan stunting pada anak usia 12–24 bulan di wilayah kerja Puskesmas Singaparna Kabupaten Tasikmalaya. Penelitian menggunakan desain cross-sectional untuk variabel jenis kelamin, berat badan lahir, riwayat ASI eksklusif, kelengkapan imunisasi, dan  sehat secara klinis, sedangkan desain case-control untuk variabel asupan nutrisi. Pengambilan sampel secara total sampling sejumlah 376 anak, selanjutnya diambil 30 anak untuk kelompok kasus dan kontrol dengan metode random sederhana periode Desember 2017 hingga Februari 2018. Instrumen menggunakan kuesioner, food frequency questionaire (FFQ), dan infantometer. Analisis data dilakukan secara univariabel, bivariabel dengan chi-square, dan multivariabel dengan regresi logistik. Hasil penelitian menunjukkan prevalensi stunting sebesar 22,6%, faktor yang berhubungan dengan stunting di antaranya jenis kelamin (POR=0,564; IK95%=0,339–0,937; p=0,011), riwayat pemberian ASI eksklusif (POR=1,46; IK95%=1,00–2,14, p=0,046), dan sehat secara klinis (POR=1,47; IK95%=1,00–2,16; p=0,044). Faktor dominan yang berhubungan dengan stunting adalah jenis kelamin (OR=0,56; IK95%=0,339–0,937; p=0,027) dan sehat secara klinis (OR=1,68; IK95%=1,022–2,771; p=0,041). Jenis kelamin dan sehat secara klinis merupakan faktor determinan stunting. Kesehatan anak perlu ditingkatkan untuk menciptakan pertumbuhan anak yang maksimal.

Energy imbalance in delivery can inhibit the action of glycolytic enzymes and interfere with chemical reactions in muscle cells. These nuisances may interfere with uterine contractions that obstruct cervical dilatation. Therefore, mothers require a nutritional alternative which is practical, generates energy quickly and supplies glucose needed for uterine contractions. These can be fulfilled with a mixed-fruit juice beverage. Mixed-fruit juice consists of fruits, Tunisian dates, honey, and red beans. This study aims to analyze the effect of the mixed-fruit extract on uterine contraction and cervical dilatation during the first stage of delivery. This study used a randomized controlled trial design. The target population was all the mothers who would give birth in Bandung city in March−April 2017. The samples of this study were the gravida <4 who would give birth at the Pelayanan Obstetri Neonatal Emergensi Dasar/PONED (Basic Emergency Obstetric and Neonatal Care/BEONC) Puskesmas (Public Health Center) Ibrahim Ajie, Puter, Garuda, Pagarsih, and Padasuka, consisting of 30 subjects as the treatment group and other 30 subjects as the control group. Uterine contractions and cervical dilatation were measured clinically and recorded on partograph. The analysis of data was done using the chi-square test, independent t test, and Mann-Whitney test. The results showed that there was the effect of mix-juice on the frequency, the duration and the intensity of uterine contractions and cervical dilatation with p value<0.05 and relative risk (RR) values respectively of 1.3, 3.3, 2.6, 1.7. In conclusion, consuming mixed-fruit juice during the first stage of delivery give an impact on the progress of uterine contractions and cervical dilatation.

Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/UdG0GRk0ZWM Background and purpose: The prevalence of tuberculosis (TB) in Indonesia is still high, whereas the prevalence of extra pulmonary tuberculosis such as female genital tuberculosis (FGTB) affecting infertility is unknown. FGTB caused irreversible severe damaged of tubes and endometrium, resulting in tubal occlusion and partial or total obliteration of the uterine cavity. Diagnosis of FGTB is difficult. Therefore, a prompt diagnosis and treatment of pulmonary TB in women can prevent fertility complications. This study aims to analyze the correlation of clinical features taken from the history, physical examination, investigation of blood laboratory and gynecological ultrasound of pulmonary tuberculosis women with infertility. Patients and methods: This was an observational analytic study with cross-sectional method. Subjects were women with pulmonary TB treated in TB-DOTS (tuberculosisdirectly observed treatment, short-course) services at Dr Hasan Sadikin Hospital Bandung during December 2016 until March 2017. Subjects were divided into two groups consist of 32 TB patients with infertility, and 35 TB patients without infertility. Results: The results showed that clinical features such as intermenstrual bleeding, endometrial synechiae, hydrosalpinx and endometritis appearance were the difference between two groups (p <0.001), those clinical features had a moderate correlation with the incidence of pulmonary tuberculosis women. Conclusion: Clinical features like endometrial synechia and ultrasound imaging such as hydrosalpinx and endometritis encountered in pulmonary and extra pulmonary tuberculosis patients with infertility can be used as a basis for the diagnosis of alleged genital TB.

Background: Bacterial vaginosis (BV) is polymicrobial that causes superficial vaginitis due to a shift in vaginal flora. In pregnant women, BV can result in a significant risk of some serious consequences. The objective of this study was to identify the BV prevalence and to explore the characteristics and personal hygiene practices among pregnant women. Methods: This study was conducted in Desa Cipacing, Jatinangor, using the cross-sectional descriptive method, including pregnant women. The BV was detected by Gram-stained vaginal smears using Nugent Score. Furthermore, other microorganisms such as trichomoniasis and candidiasis were detected by direct microscopic observation. The questionnaire was distributed, consisting of details of personal hygiene practices. Results: In total, 17.9% of 52 pregnant women included were diagnosed with BV and 14.3% with mixed infection. Pregnant women with BV were predominantly aged younger than 25 years (61.1%), nullipara (50%) and in a second-trimester pregnancy (50%). Conclusions: Bacterial vaginosis (BV) is common among young pregnant women, predominantly in their first pregnancy. It is related to personal hygiene practices, indicating the need for targeted interventions of healthcare education among these young pregnant women to reduce the BV prevalence.

Penelitian ini bertujuan untuk mengeksplorasi faktor yang memengaruhi kelulusan pada uji kompetensi bidan dan memperoleh instrumen baku berdasarkan hasil studi eksploratif yang telah diuji validitas dan reliabilitas. Desain penelitian yang dipergunakan adalah mixed methods dengan strategi sequential exploratory. Eksplorasi faktor dilakukan melalui analisis tematik dan untuk memperoleh instrumen yang valid dan reliable dilakukan melalui analisis dengan menggunakan rasch model. Subyek penelitian adalah 6 alumni yang tidak lulus uji kompetensi, 3 alumni yang lulus uji kompetensi, dan 3 dosen D III di Jurusan kebidanan Poltekkes Kemenkes Palu. Hasil eksplorasi yang diperoleh menunjukkan bahwa faktor-faktor yang memengaruhi kelulusan mahasiswa pada uji kompetensi bidan dari diri mahasiswa yaitu minat dan motivasi belajar yang sangat rendah, kurang percaya diri, ketelitian dalam mengisi lembar jawaban komputer dan ketidakjujuran selama proses pendidikan. Kesimpulan, tingkat kelulusan mahasiswa pada uji kompetensi masih rendah dikarenakan rendahnya motivasi dan minat belajar mahasiswa, ketidakjujuran dalam membuat laporan dan belum ada bimbingan belajar khusus menghadapi uji kompetensi. Disarankan Dosen agar memotivasi mahasiswa untuk belajar dan menfasilitasi mahasiswa dalam menghadapi uji kompetensi