Background: Tuberculosis (TB) is an infectious disease that is a major problem in Indonesia, placing Indonesia among the three major countries with the highest TB cases in the world. In addition, reporting of TB data from health service facilities, especially hospitals, is still weak. Since the implementation of Directly Observed Treatment Shortcourse (DOTS) in hospitals in 1995, the number of new TB case reports from hospitals is still low. In order to increase hospital participation in TB control, the government has made a breakthrough strategy, which is the integration of the DOTS strategy in hospital accreditation.Design and methods: This study conducted a literature review and document analysis related TB control standards in hospital accreditation and the implication for the involvement of hospitals in national TB program. This study analyzed regulations, policies, and procedures, including hospital accreditation instruments and annual reports of TB.Results: Accreditation standards related to TB control include: i) Hospital must implement a tuberculosis control program in the hospital, including monitoring and evaluation through activities such as health promotion, tuberculosis surveillance, controlling risk factors, detection and treatment of tuberculosis cases, providing immunity and preventive drugs; ii) Hospital prepares resources for service delivery and tuberculosis control; iii) hospital provides facilities and infrastructures for tuberculosis services in accordance with regulations; and iv) hospital conducts tuberculosis services and efforts to control tuberculosis risk factors in accordance with regulations.Conclusions: Standards and elements of the assessment of TB control components in accreditation are adjusted to the national TB control guidelines.

Background: An estimated 1.28 billion adults 30–79 years old had hypertension globally in 2021, of which two-thirds lived in low- and middle-income countries (LMICs). Previous studies on geographic and socioeconomic inequalities in hypertension among adults have limitations: (a) most studies used individual-level data, while evidence from locality-level data is also crucial for policymaking; (b) studies from LMICs are limited. Thus, our study examines geographic and socioeconomic inequalities in hypertension among adults across districts in Indonesia. Methods: We combined geospatial and quantitative analyses to assess the inequalities in hypertension across 514 districts in Indonesia. Hypertension data were obtained from the Indonesian Basic Health Survey (Riskesdas) 2018. Socioeconomic data were obtained from the World Bank. Six dependent variables included hypertension prevalence among all adults (18+ years), male adults, female adults, young adults (18–24 years), adults (25–59 years), and older adults (60+ years). Results: We also found significant geographic and socioeconomic inequalities in hypertension among adults across 514 districts. All hypertension indicators were higher in the most developed region than in the least developed region. Districts in the Java region had up to 50% higher prevalence of hypertension among all adults, males, females, young adults, adults, and older adults. Notably, districts in the Kalimantan region had the highest prevalence of hypertension, even compared to those in Java. Moreover, income level was positively associated with hypertension; the wealthiest districts had higher hypertension than the poorest districts by up to 30%, but only among males and older adults were statistically significant. Conclusions: There were significant inequalities in hypertension among adults across 514 districts in the country. Policies to reduce such inequalities may need to prioritize more affluent urban areas and rural areas with a higher burden.

ABSTRACT Nowadays, phubbing phenomena occur in various social groups, including college students. This has an impact on social relationships and physical health. This is a qualitative study which aims to describe the causes, behavior, and impact of phubbing. The informants were fifth semester Faculty of Public Heath, University of Indonesia undergraduate students’ year 2018. Data collected through focus group discussions on female students and in-depth interviews with male students. The results of this study indicate that students understand phubbing as a phenomenon where a person is more engaging with mobile phones than interacting with the surrounding environment. Duration of internet usage starts from 5 hours to almost 24 hours a day. Phubbing among students was due to the desire to get updated information and events, entertainment, and shows the activities or achievements of themselves. The influence of the social environment and the demands of the academic environment encourage the use of smartphones frequently. Some students experience physical health problems (tiredness, sore eyes, dizziness, nausea) and sign of mental problem (sad, depressed, lost confidence) due to improper use of smartphones. Therefore, education students regarding the use of the internet wisely to prevent phubbing behavior and its effects are needed. In addition, academic and student activities through direct interaction rather than internet need to be maintained. Keywords: Phubbing, student, internet, smartphone   ABSTRAK Saat ini fenomena phubbing  terjadi di berbagai kelompok sosial, tidak terkecuali mahasiswa.  Hal ini berdampak pada hubungan sosial maupun kesehatan fisik seseorang. Penelitian  ini  merupakan  studi kualitatif yang bertujuan untuk mengetahui penyebab, perilaku, dan dampak phubbing. Informan adalah mahasiswa FKM UI Strata 1, semester 5 tahun 2018. Pengumpulan data dilakukan dengan cara Focus group discussion (FGD) kelompok mahasiswa perempuan dan wawancara mendalam terhadap mahasiswa laki-laki. Hasil penelitian menunjukkan bahwa mahasiswa mengetahui phubbing sebagai fenomena dimana seseorang lebih banyak berkutat dengan handphone dibandingkan berinteraksi dengan lingkungan sekitarnya. Durasi penggunaan internet sehari mulai dari 5 jam sampai hampir 24 jam. Phubbing yang terjadi di kalangan mahasiswa dikarenakan keinginan agar tetap update informasi dan kejadian yang berlangsung, hiburan,  dan juga menunjukkan kegiatan atau capaian diri sendiri. Pengaruh lingkungan sosial dan tuntutan lingkungan akademik mendorong penggunaan smartphone setiap saat. Sebagian mahasiswa mengalami gangguan kesehatan fisik (lelah, mata pedih, pusing, mual) dan tanda gangguan kesehatan mental (sedih, depresi, hilang percaya diri) akibat penggunaan smartphone yang tidak tepat. Perlu adanya upaya edukasi kepada mahasiswa mengenai penggunaan internet secara bijak sehingga mencegah perilaku phubbing dan dampaknya. Selain itu juga, perlu dipelihara kegiatan akademis maupun kegiatan mahasiswa yang dilakukan melalui interaksi secara langsung dibandingkan melalui internet. Kata kunci: Phubbing, mahasiswa, internet, smartphone

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Background: Healthcare systems in many low- and middle-income countries (LMICs) are not yet designed to tackle the high and increasing burden of non-communicable diseases (NCDs), including hypertension. As a result, a large proportion of people with disease or risk factors are undiagnosed. Policymakers need to understand the disparity better to act. However, previous analyses on the disparity in undiagnosed hypertension, especially from LMICs, are lacking. Our study assessed the geographic and socioeconomic disparity in undiagnosed hypertension and compared it with diagnosed hypertension. Methods: We used the Basic Health Survey (Riskesdas) 2018 and performed geospatial and quantitative analyses across 514 districts in Indonesia. Dependent variables included diagnosed and undiagnosed hypertension among adults (18+ years) and by gender. Results: A high prevalence of undiagnosed hypertension at 76.3% was found, with different patterns of disparity observed between diagnosed and undiagnosed hypertension. Diagnosed hypertension was 1.87 times higher in females compared with males, while undiagnosed hypertension rates were similar between genders. Urban areas had up to 22.6% higher rates of diagnosed hypertension, while undiagnosed hypertension was 11.4% more prevalent among females in rural areas. Districts with higher education rates had up to 25% higher diagnosed hypertension rates, while districts with lower education rates had 6% higher rates of undiagnosed hypertension among females. The most developed regions had up to 76% and 40% higher prevalence of both diagnosed and undiagnosed hypertension compared with the least developed regions. Conclusion: The disparity patterning differs between diagnosed and undiagnosed hypertension among adults in Indonesia. This highlights the need for effective measures, including healthcare system reforms to tackle NCDs in LMICs.

COVID-19 is highly contagious and the transmission dynamics are associated with intercontinental spread. The pandemic’s short-term and long-term impact on healthcare worker’s mental health and well-being remains largely unknown. This systematic review used preferred reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The articles were searched from PubMed, the reviewers had screened 729 abstracts, 372 full-text publications, and ultimately included 11 systematic reviews. The review found ten factors associated with the work performance and mental health of healthcare workers in Asia, including experiencing feelings of anxiety, having inadequate support, depression, experiencing occupational stress, loneliness, lack of workplace preparedness, financial concerns associated with changes in income and daily living, fear of transmission, burnout/fatigue and sleep disturbance. This systematic review can be used as input for governments and employers as a reference to develop strategies to support healthcare workers’ mental health, well-being and work productivity.

Abstract. In managed care, primary healthcarecare facilities acts as the gatekeepers, and its success is judged from the number of visits. In the year 2016, the Healthcare Centers in Tangerang was unable to meet the targets set by BPJS healthcare, ideally the visit rate should reach >150‰ and the referral ratio <10%. However, the visit rate only reachd 41‰ and the referral ratio was 29%. In addition, most healthcare centers the nonspecialised referral ratio was above 5%. The purpose of this research is to analyze the healthcare service system as the gatekeepers in managed care. This research is a descriptive analytical study with a qualitative approach. The data was collected through in-depth interviews, examination of documents and observations. Research conducted at healthcare centers and clinics Pedurenan Pabuaran Tumpeng from May-June 2018. From this research we discovered that the low contact lrate was caused be the low first contact levels, continuity, and comprehensiveness. The registering process was also complicated. We also discovered that the lack of human resources also influences the low contact rate. Abstrak. Dalam managed care, pelayanan primer bertugas sebagai gatekeeper, dan keberhasilannya dinilai dari tingginya angka kunjungan dan angka rujukan. Di tahun 2016, Puskesmas Kota Tangerang memiliki pencapaian yang tidak sesuai dengan target yang ditetapkan oleh BPJS Kesehatan, karena tingkat kunjungan hanya mencapai 41‰, idealnya >150‰; dan rasio rujukannya sebesar 29%, sedangkan idealnya adalah 10%. Selain itu, sebagian besar Puskesmas memiliki rasio rujukan nonspesialistik diatas 5% yang berarti berada di zona tidak aman. Tujuan penelitian ini adalah menganalisis sistem pelayanan puskesmas sebagai gatekeeper di Kota Tangerang pada tahun 2018. Penelitian ini merupakan penelitian deskriptif analitik dengan menggunakan pendekatan kualitatif.  Data dikumpulkan dengan melakukan wawancara mendalam, telaah dokumen dan observasi. Penelitian dilakukan di Puskesmas Pedurenan dan Puskesmas Pabuaran Tumpeng dari bulan Mei-Juni 2018. Dari penelitian ini ditemukan bahwa output angka kontak masih rendah. Pada variabel proses, yang menyebabkan angka kontak rendah adalah angka first contact, continuity, dan comprehensiveness yang rendah, serta proses pendaftaran pasien yang masih rumit. Sedangkan pada variabel input yang menjadi masalah adalah kurangnya sumber daya manusia.

Abstract. JKN (National Health Insurance) is a government program that aims to provide health assurance for all Indonesian citizens for a healthy, productive, and prosperous life. In the two years after JKN was implemented, various problems occurred. This research used the qualitative approach with the Edward II implementation theory. Results of the research indicated that there were problems in communication, stemming from the lack of socialization and inharmonic regulations, there was also the problem of the lack of healthcare resources. From the disposition side, the policy makers often obstructs the implementation preparation, this is evident from the information on determining the premium size. From the organization structure, all the stakeholders have been well coordinated. We conclude that we are not ready to implement the JKN. We recommend that mass and effective socialization program to be performed using various methods of communication and involve the community. To reduce the disparity of healthcare services, we recommend that the regional government to establish various healthcare facilities to accelerate health development. There should also be regulations that allocates healthcare staff in every corner of the country to achieve Universal Health Coverage in 2019, as stated in the National Health Insurance Road Map. Keywords: policy analysis, national health insurance, universal health coverage