Background Accessing immediate health care during pregnancy is key to preventing and treating pregnancy-related complications, which are the leading cause of maternal morbidity and mortality. As the largest archipelago country in the world, Indonesia faces the challenges of disparity in access to healthcare services across geographical regions and socioeconomic groups. Objective This study aims to assess the relationship between perceived barriers to accessing health care and the risk of pregnancy-related complications among women of reproductive age in Indonesia. Methods Data from a nationally representative sample of 15,021 last births within 5 years preceding the 2017 Indonesia Demographic and Health Survey were analyzed to examine barriers in accessing health care and the risk of having complications during pregnancy. The statistical model of logistic regression was used to investigate the effect of barriers on the risk of pregnancy complications, and results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results The majority of women in Sumatra and Maluku–Papua regions encountered physical, cultural, and financial barriers to accessing health care. The results indicate significantly higher odds of having complications in mothers who had distance barriers (OR: 1.46, 95% CI: 1.20–1.77), relative to mothers who reported no barriers, after adjusting for women’s characteristics. Conclusion The findings suggest that it is necessary to tackle specific physical barriers by providing more developed health-care systems in rural and geographically isolated areas, to bring health services closer to home.
ABSTRACT The implementation of government policies in stunting prevention has been carried out from the central level to the village level. The Ministry of Home Affairs annually establishes stunting locus villages in 34 provinces. At the stunting locus village, sensitive and specific interventions were carried out. Many factors influence the prevalence of stunting. This study aims to determine the determinants of stunting in locus and non-locus villages in 13 stunting locus districts in Indonesia. This study was a quantitative study with a cross-sectional design. The study was conducted in 13 districts of stunting locus. Each district was chosen one sub-district which was then selected one locus of stunting village and one village of non locus. In each village 90 children were selected. Data analysis was carried out univariate, bivariate, and multivariate with logistic regression test to see the relationship between independent and dependent variables after being controlled by several variables. The results showed that 20 percent lower chance of stunting in locus villages than non locus villages. Toddlers who are breastfed for more than 24 months have a 1.7 times risk of becoming stunted. Toddlers who do not do early initiation of breastfeeding have a 1.5 times risk of becoming stunted compared to toddlers who do early initiation of breastfeeding. High maternal education can prevent stunting 2 times compared to mothers with low education. The selection of stunting locus villages affects the prevalence of stunting. In addition, several determinant factors influence the incidence of stunting, namely the sex of the child, the duration of breastfeeding more than 24 months, the child's age, early initiation of breastfeeding, growth monitoring, the mother's age and the mother's education. ABSTRAK Implementasi kebijakan pemerintah dalam pencegahan stunting telah dilaksanakan mulai dari tingkat pusat sampai tingkat desa. Kementerian Dalam Negeri setiap tahun menetapkan desa lokus stunting di 34 provinsi. Pada desa lokus stunting dilakukan intervensi sensitif dan spesifik. Banyak faktor yang mempengaruhi prevalensi stunting. Studi ini bertujuan untuk mengetahui faktor determinan kejadian stunting pada desa lokus dan non lokus di 13 kabupaten lokus stunting di Indonesia. Studi ini merupakan studi kuantitatif dengan desain potong lintang. Penelitian dilakukan di 13 Kabupaten lokus stunting, setiap kabupaten dipilih satu kecamatan yang kemudian dipilih satu desa lokus stunting dan satu desa non lokus. Pada setiap desa dipilih 90 balita. Analisis data dilakukan secara univariat, bivariat, dan multivariat dengan uji regresi logistik untuk melihat hubungan variabel bebas dan terikat setelah dikontrol oleh beberapa variabel. Hasil penelitian memperlihatkan bahwa peluang terjadinya stunting 20 persen lebih rendah di desa lokus dibanding desa non lokus. Balita yang mendapatkan ASI lebih dari 24 bulan berisiko 1,7 kali menjadi stunting. Balita yang tidak melakukan inisiasi menyusui dini (IMD) berisiko 1,5 kali menjadi stunting dibandingkan dengan balita yang melakukan IMD. Pendidikan ibu yang tinggi dapat mencegah kejadian stunting 2 kali dibandingkan ibu berpendidikan rendah. Pemilihan desa lokus stunting memengaruhi kejadian stunting. Selain itu, terdapat beberapa faktor determinan yang memengaruhi kejadian stunting yaitu jenis kelamin anak, durasi menyusui ASi lebih dari 24 bulan, usia anak, IMD, pemantauan pertumbuhuan, umur ibu dan pendidikan ibu. [Penel Gizi Makan 2021, 44(2):79-92]
Background: COVID-19, which started in Wuhan, has become a global pandemic leading to a new global risk to human health. Lack of information or misinformation about COVID-19 can lead to stigmatization, including for health workers. This study aims to determine the stigmatization among health workers during the COVID-19 pandemic within the Greater Jakarta Metropolitan Area. Methods: This study was a cross-sectional study conducted online using Google Forms in the Jabodetabek area. The questionnaire’s link was distributed through social media, including Whatsapp, Facebook, Twitter, and Instagram. The study sample is health workers who live in Jabodetabek and carry out health practices. Stigma is measured using four dimensions: personalized stigma, disclosure concerns, public attitudes, and negative self-image. Result: The negative self-image dimension is the dimension most felt by health workers. More than half of health workers agreed that during the COVID-19 pandemic, they put their families at risk because of their status as health workers. The stigma of health workers who work in hospitals is higher than that of non-hospital health workers, such as health centers, clinics, and laboratories. Conclusion: There was any stigmatization among healthcare workers in Greater Jakarta Metropolitan Area. Stigmatization was higher among healthcare workers who work in hospitals compared to those who work in non-hospitals. Some efforts should be made to reduce stigmatization among health workers, such as provide correct information to the public, equip health personnel with adequate personal protective equipment, and give incentives periodically to the health workers. Keywords: Stigma, COVID-19, healthcare workers, Greater Jakarta Metropolitan Area Abstrak Latar belakang: COVID-19 yang bermula dari Wuhan telah menjadi pandemi global yang mengancam kesehatan umat manusia. Kurangnya informasi atau informasi yang salah mengenai COVID-19 dapat menyebabkan adanya stigmatisasi termasuk terhadap tenaga kesehatan. Penelitian ini menilai adanya stigmatisasi terhadap tenaga kesehatan selama pandemi COVID-19 di wilayah Jabodetabek. Metode: Penelitian ini merupakan penelitian potong lintang dan dilakukan secara daring menggunakan Google Form di wilayah Jabodetabek. Tautan pengisian kuesioner disebarkan melalui media sosial seperti Whatsapp, Facebook, Twitter dan Instagram. Sampel studi adalah tenaga kesehatan yang tinggal di Jabodetabek dan melakukan praktik kesehatan. Stigma diukur menggunakan empat dimensi yaitu personized stigma, disclosure concerns, concerns about public attitudes dan negative self-image. Hasil: Dimensi negative self-image merupakan dimensi yang paling dirasakan oleh tenaga kesehatan. Lebih dari separuh tenaga kesehatan setuju bahwa selama pandemi COVID-19 mereka membahayakan keluarga mereka karena status mereka sebagai tenaga kesehatan. Stigma pada tenaga kesehatan yang bekerja di rumah sakit lebih tinggi disbanding tenaga kesehatan yang bekerja bukan di rumah sakit seperti puskesmas, klinik dan laboratorium. Kesimpulan: Terdapat stigmatisasi pada petugas kesehatan di jabodetabek. Stigmatisasi lebih tinggi di antara petugas kesehatan yang bekerja di rumah sakit dibandingkan dengan mereka yang bekerja tidak di rumah sakit. Beberapa upaya yang perlu dilakukan untuk mengurangi stigmatisasi di kalangan petugas kesehatan, seperti memberikan informasi yang benar kepada masyarakat, melengkapi tenaga kesehatan dengan alat pelindung diri yang memadai, dan memberikan insentif kepada mereka secara berkala. Kata Kunci: Stigma, COVID-19, tenaga kesehatan, jabodetabek
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