Background: Quality of health service and patient satisfaction are an important element in providing a health service. Assessing and evaluating a health service based on user perceptions are important for continuous improvement of health services. This study aimed to examine the factors affecting quality of health service and patient satisfaction in community health centers in North Lampung, Sumatera, Indonesia. Subjetcs and Method: This was an analytic observational study with a cross-sectional design. This study was conducted in 25 community health centers in North Lampung, Sumatera, in January 2017. A total sample of 200 out-patients was selected for this study by simple random sampling, and stratified random sampling for community health center. The dependent variables were quality of service and patient satisfaction. The independent variables were education, income, frequency of visit, and accreditation status of community health center. Contextual effect was measured by accreditation status of community health center. The data were collected by questionnaire and analyzed by linear regression multilevel model. Results: Factors affecting quality of health service were income (b= -1.09, 95% CI= -5.71 to 3.52, p = 0.641), education (b = -11.48, 95% CI= -16.07 to -6.88, p< 0.001), and frequency of visits (b=6.88, 95% CI= 2.53 to 11.23, p=0.002). Intraclass correlation= 6%. Factors affecting patient satisfaction were income (b= -1.07, 95% CI= -1.58 to -0.56, p<0.001), education (b= -0.77, 95% CI= -1.31 to -0.23, p=0.005), frequency of visits (b= 0.88, 95% CI= 0.39 to 1.38, p<0.001), and quality of service (b=0.04, 95% CI= 0.02 to 0.06, p<0.001). Intraclass corelation= 13.79% indicating considerable contextual effect of accreditation status of community health center. Conclusion: Quality of service is affected by income, education, and frequency of visits in community health center. Patient satisfaction is affected by income, education, frequency of visits, and quality of service. Accreditation status of community health center has a considerable contextual effect on patient satisfaction.

Background: Language proficiency should be mastered by children before school admision. The process of language development was affected by cognitive and neurologic maturity. Language proficiency determine communication foundation, social, and academic interaction. Children with retardation in language proficiency may encounter problem in the social and academic relationship. This study investigated the association between parental education, occupation, income, language activity, and language proficiency in children. Subjects and Method:This was an observational analytic study with cross sectional design. This study was conducted in Gondangrejo sub-district, Karanganyar, Central Java. A total sample of 102 children aged 4 to 5 years were selected for this study. The dependent variable was language proficiency. The independent variables were parental education, occupation, income, and language activity. The data were collected by a set of questionnaire and analyzed by multiple logistic regression. Results: Parental education ≥ senior high school (OR= 2.95; 95% CI= 1.03 to 8.39; p= 0.043), employed parents (OR= 3.45; 95% CI= 1.27 to 9.39; p= 0.015), family income ≥ regional minimum wage (OR= 6.35; 95% CI= 2.02 to 19.93; p= 0.002), and intense language activity (OR= 4.32; 95% CI= 1.61 to 11.51; p= 0.003) were associated with better language proficiency. Conclusion: Parental education ≥ senior high school, employed parents, family income ≥ regional minimum wage, and intense language activity are associated with better language proficiency.

Background: Menopause is defined as the point in time when menstrual cycles permanently cease due to the natural depletion of ovarian oocytes from aging. Studies have shown, menopause causes decrease in quality of life and a positive correlation between menopausal symptoms and quality of live. This study aimed to determine the effect of menopause duration and biopsychosocial factors on quality of life of women. Subjects and Method: This study was an analytic study using cross-sectional design. The study was conducted in Bendo Community Health Center, Kediri District, East Java, from 8-31 March 2017. A sample was of 105 menopausal women was selected for this study by proportionate random sampling. The dependent variable was quality of life. Quality of life encompassed several constructs including physical, functional, emotional, social, and cognitive variables. The independent variables were duration of menopause, Body Mass Index (BMI), education, family support, and family income. The data were collected by pre-tested questionnaire, and analyzed by path analysis. Results: Quality of life was affected by menopause duration (b=2.19; SE=0.38; p<0.001), education (b=6.72; SE=1.72; p<0.001), family support (b=0.42; SE=0.17; p=0.011), BMI (b=0.71; SE=0.27; p=0.010), and family income (b= 0.13; SE= 1.60; p= 0.936). BMI was affected by education (b= 1.87; SE= 0.50; p<0.001). Conclusion: Quality of life is directly affected by menopause duration, education, family support, BMI, and family income. Quality of life is indirectly affected by education.

Background: The quality of hospital care is an important element in the implementation of healthcare service. The quality which is perceived is an assessment and a form of evaluation of healthcare users. Improvement on healthcare service is continually conducted to enhance the quality of service and patients' satisfaction. The study aimed to explain the influence of patients' personal factors, doctors, payment methods and types of class toward the quality and satisfaction of inpatient care. Subjects and Methods: This was an analytic observational study with cross-sectional design. This study was conducted at Dr. Moewardi Hospital, Surakarta, from March to April 2017. A total of 144 subjects were selected by stratified random sampling. Exogenous variables in this study were family income, level of education, length of stay, doctor's salary, the surgeon, type of insurance, and type of class. Endogenous variables were patient's satisfaction and quality of service. The data were collected by a set of questionnaires and secondary data of doctor's working period and salary. Data analyzed by path analysis. Results: Patient's satisfaction were affected by family income (b=-0.08; SE=0.48; p=0.093), level of education (b=-0.44; SE= 0.27; p= 0.102), length of stay (b=0.19; SE=0.99; p=0.059), doctor's salary (b= 0.02; SE=0.01; p=0.060), doctor's working period (b=0.99; SE=0.44; p=0.024), type of insurance (b= 0.72; SE=0.32; p=0.027), type of class (b= 2.11; SE=0.38; p<0.001), and quality of health services (b=0.16; SE=0.51; p=0.002). Quality of health services were affected by family income (b=-0.15; SE=0.07; p=0.039), length of stay (b=0.37; SE=0.15; p=0.017), doctor's working period (b= 0.13; SE=0.68; p=0.056), insurance types (b= 1.04; SE=0.50; p= 0.036), and type of class (b=2.24; SE=0.59; p<0.001). Conclusion: Patient's satisfaction are affected by family income, level of education, length of stay, doctor's salary, doctor's working period, type of insurance, type of class and quality of health services. Quality of health services are affected by family income, length of stay, doctor's working period, insurance types, and type of class.

Background: Health and intelligence are the main foundation for creating quality Human Resources (HR). Exclusive breastfeeding is one of the best steps to improve the quality of human resources from an early age, in the first six months of a baby's life. The success of exclusive breastfeeding is due to several factors including age, relatively low level of education, lack of utilization of health facility services, and increased marketing of formula milk in urban areas. This study aims to analyze the effect of mother's education, geographic location of mother's residence, and place of delivery on exclusive breastfeeding. Subjects and Method: The researcher uses a systematic review and meta-analysis research, by formulating the researcher's assessment in the PICO as follows. Population: Breastfeeding mothers. Intervention: basic education, rural areas, health facility services. Comparison: Higher education, urban, without health facility services. Outcome: Exclusive breastfeeding. The articles were obtained from PubMed, Google Scholar, Science Direct, MDPI, and Scopus databases. The search keywords for the article are “maternal education” AND “residence” AND “delivery place” AND “exclusive breastfeeding” AND cross-sectional. The inclusion criterias were full-text, cross-sectional study, and reported adjusted odds ratio (aOR). Data were analyzed by Review Manager application (RevMan 5.3). Results: 20 cross-sectional studies involving 107,952 lactating mothers from Asia, Europe, and Africa were selected for systematic review and meta-analysis. This meta-analysis showed that mothers with high education were 1.27 times more likely to exclusively breastfeed than mothers with low education (aOR= 1.27; 95% CI=1.01 to 1.59; p= 0.040). Mothers who live in rural areas are 2.16 times more likely to give exclusive breastfeeding than mothers who live in urban areas (aOR= 2.16; 95% CI= 1.17 to 4.01; p=0.010). Mothers who give birth in health care facilities are 1.79 times more likely to give exclusive breastfeeding compared to mothers who give birth at home (aOR= 1.79; 95% CI= 1.54 to 2.07; p=0.005) Conclusion: Maternal education, geographic location, and place of delivery increase the likelihood of exclusive breastfeeding. Keywords: maternal education, residence, delivery place, exclusive breastfeeding Correspondence: Ade Amallia. Master’s Program in Public Healthd, Universitas Sebelas Maret . Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: amalliaadelia@gmail.com. Hp: 081228466836.