This cluster randomized clinical trial examines the effect of implementing the Safe Childbirth Checklist with medium-intensity coaching on the performance of essential birth practices in health care facilities in Aceh, Indonesia.

BackgroundIn an effort to mitigate missed opportunities to provide high-quality care, the World Health Organization (WHO) has developed the Safe Childbirth Checklist (SCC) to support health providers perform essential tasks. Our qualitative study is a baseline assessment of quality of care (QoC) perceived by mothers who gave birth at health facilities aiming to highlight areas where implementing the SCC can potentially improve the QoC as well as areas that are not part of the SCC yet require improvement.MethodsAssessing the overall experience of care, our qualitative study focuses on 8 out of 29 items in the checklist that are related to the personal interactions between healthcare provider and mothers. Using a set of semi-structured questions, we interviewed 26 new mothers who gave institutional births in Aceh province in Indonesia.ResultsOur findings revealed some gaps where implementing the SCC can potentially improve safety and QoC. They include communicating danger signs at critical points during birth and after discharge, encouraging breastfeeding, and providing mothers with information on family planning. Moreover, taking a qualitative approach allowed us to identify additional aspects such as need for clarity at the point of admission, maintaining dignity, and protecting mothers’ rights in the decision-making process to be also essential for better QoC.ConclusionsOur study highlights the need to actively listen to and engage with the experiences of women in the adaptation and implementation of the checklist. While our findings indicate that implementing the SCC has the potential to improve the quality of maternal care and overall birth experience, a more holistic understanding of the lived experiences of women and the dynamics of their interactions with health facilities, care providers, and their birth companions can complement the implementation of the checklist.

Background The role of sociodemographic and economic characteristics in mental distress has been rarely investigated in Indonesia. Aims To investigate the prevalence of common mental disorders (CMD) and identify any associations between mental distress and sociodemographic and economic characteristics among communities living in urban and rural (peri-urban) areas. Method A community-based household survey was conducted in the province of Aceh, Indonesia, in 2018. The 20-item Self Reporting Questionnaire (SRQ-20) screening tool was used to measure symptoms of CMD. Information on sociodemographic characteristics, family functioning, labour market outcomes and healthcare costs was collected. Multivariate regressions were conducted to analyse the relationships between the measures of mental distress and sociodemographic and economic characteristics. Results We found that 14% of the respondents had CMD symptoms. SRQ-20 scores were higher for female, older and lower-educated individuals. CMD prevalence was higher among non-married participants and clustered within families. Participants with CMD perceive their families as performing significantly better in the dimensions of affective involvement and behaviour control compared with their counterparts. Their work was more often affected by negative feelings; they were also twice as likely to report a recent physical or mental health complaint and faced twice the treatment costs compared with their non-affected counterparts. Conclusions The prevalence of mental disorders is especially high in disadvantaged population groups. Moreover, mental distress is associated with a lower perceived productivity and a higher physical health burden.

This study aims to examine the relationship between family support and the quality of life of DM patients. This type of research is a quantitative research using a cross-sectional design. The results showed that most DM patients (64.3%) had a good quality of life. There is a statistically significant relationship between the quality of life of patients with emotional support (p-Value = 0.0002), instrumental (p-Value = 0.0005), and informational (p-Value = 0.000), but the relationship is not significant with support award (p-Value = 0.52). In conclusion, factors related to the quality of life of DM patients are emotional, instrumental, and informational support.   Keywords: Diabetes Mellitus, Family Support, Quality of Life

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Based on the Indonesian Disaster Risk Index, 75% schools in Indonesia are located in the medium to high-risk disaster-prone area. However, many educational institutions in Indonesia especially in Aceh Province, still consider disaster preparedness as inessential issues and tend to be ignored. This study aims to evaluate the preparedness of the high risk school communities after 13 years of post - tsunami 2014; related to policy parameters, knowledge, emergency planning, disaster warning systems and resource mobilization capacity. This is a descriptive explorative study using questionnaires to collect data from 80 elementary school teachers and 265 elementary students. A semi structured interviews with eight elementary school principals was also conducted to enrich the research findings. The study findings show that the school preparedness is in the low category (total index value 20.50); school teacher preparedness is in the medium category (total index value 61.79) and student preparedness is in the low category (total index value 52.12). The preparedness of the school community (a composite index of school institutions, teachers and students) is also in low category (total index value 43.09). The result of the study indicated that disaster preparedness programs in most elementary schools have not been well implemented. The lack of sustainability of the disaster preparedness school program and its monitoring and evaluation might contribute to this condition.

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