The state of health in Indonesia's provinces, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Mboi, Nafsiah; Syailendrawati, Ruri; Ostroff, Samuel M; Elyazar, Iqbal; Glenn, Scott; Rachmawati, Tety; Nugraheni, Wahyu Pudji; Ali, Pungkas Bahjuri; Trisnantoro, Laksono; Adnani, Qorinah Estiningtyas Sakilah; Agustiya, Rozana Ika; Laksono, Agung Dwi; Aji, Budi; Amalia, Luna; Ansariadi, Ansariadi; Antriyandarti, Ernoiz; Ardani, I Gusti Agung Ketut Sri; Ariningrum, Ratih; Aryastami, Ni Ketut; Djunaedi, Djunaedi; Efendi, Ferry; Fauk, Nelsensius Klau; Ghozali, Ghozali; Handayani, Nariyah; Harapan, Harapan; Hargono, Arief; Harso, Agus DWI; Ikawati, Hartanti Dian; Indriasih, Endang; Karlina, Karlina; Kosen, Soewarta; Kusnali, Asep; Kusuma, Dian; Lumbantoruan, Melyana; Lusiana, Merry; Martini, Santi; meilinda, Meilinda; Mubasyiroh, Rofingatul; Musadad, D. Anwar; Ningrum, Dina Nur Anggraini; Nuraini, Syarifah; Nurlaela, Ni'matun; Pangaribuan, Helena Ullyartha; Pawitaningtyas, Indah; Purnomo, Agung; Puspasari, Herti Windya; Puspasari, Nurul; Rahmawaty, Setyaningrum; Rangkuti, Hasnani; Roosihermiatie, Betty; Rosita, Tita; Rustika, Rustika; Samodra, Yoseph Leonardo; Samosir, Jenny Veronika; Siswanto, Siswanto; Smith, Karen H.; Sudaryanto, Agus; Sugianto, Sugianto; Suparmi, Suparmi; Susilarini, Ni Ketut; Tarigan, Ingan Ukur; Ticoalu, Jansje Henny Vera; Trihandini, Indang; Wahidin, Mugi; Warouw, Tati S; Widyastuti, Retno; Wulandari, Ratna Dwi; Hay, Simon I; Murray, Christopher J L; Mokdad, Ali H.

doi:10.1016/s2214-109x(22)00371-0

Cited by 38 publications

(30 citation statements)

References 36 publications

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“…In the Indonesian setting, there are disparities between urban and rural areas regarding the quality and availability of healthcare facilities and services. Ensuring health-service equity within health systems and adequate utilization by parents and families remain the main challenges [ 16 ]. However, research on factors that influence healthcare-seeking behaviors among mothers in Indonesia, especially for children aged 0–59 months, remains scarce.…”

Section: Introductionmentioning

confidence: 99%

Healthcare-seeking behavior for children aged 0–59 months: Evidence from 2002–2017 Indonesia Demographic and Health Surveys

et al. 2023

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Background and objective Healthcare-seeking behavior for children is crucial for reducing disease severity. Such behavior can improve child health outcomes and prevent child morbidity and mortality. The present study sought to analyze the determinants of mothers’ engagement in healthcare-seeking behavior for children with common childhood diseases, focusing on mothers of children aged 0–59 months in Indonesia. Methods This cross-sectional study comprised a secondary data analysis using the 2002–2017 Indonesia Demographic and Health Survey (IDHS) databases. We included all women surveyed aged 15–49 years old who had children under five years of age. We weighted the univariate, bivariate, and multivariate logistic regression analysis of healthcare-seeking behavior for children aged 0–59 months. Results We analyzed data for 24,529 women whose children were under five years of age at the time of survey. Common diseases, such as diarrhea, fever, and acute respiratory infection (ARI) were the most frequently cited reasons for healthcare-seeking behavior. During 2002–2017, the proportion of mothers seeking healthcare for their children with diarrhea increased from 67.70% to 69.88%, that with fever increased from 61.48% to 71.64% and that ARI increased from 64.01% to 76.75%. Multivariate analysis revealed that child’s age, child’s birth order, mother’s education, ability to meet expenses, distance to nearest healthcare facility, wealth index, place of residence, and region of residence, were significantly associated with healthcare-seeking behavior. Conclusion Various individual and environmental-level factors influence healthcare-seeking behavior for childhood diseases. Available, accessible, and affordable health service facilities are recommended to assist socio-economically and geographically disadvantaged families.

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Section: Introductionmentioning

confidence: 99%

Healthcare-seeking behavior for children aged 0–59 months: Evidence from 2002–2017 Indonesia Demographic and Health Surveys

et al. 2023

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“…By comparison, through co-generation of lists of diseases and ailments which concerned people now malaria was rarely mentioned unless prompted. Across study locations, people of all ages shared their concerned about diseases with severe consequences and risk of death, those that needed surgery, and that were perceived as expensive to treat such as heart disease, hypertension, diabetes, hypercholesterolaemia—especially about the need to take medication over long periods, cancer, filariasis, and HIV/AIDs [also see 32 ]. In Sumba 1 people worried about mouth cancer and spoke about it constantly.…”

Section: Resultsmentioning

confidence: 99%

How using light touch immersion research revealed important insights into the lack of progress in malaria elimination in Eastern Indonesia

Jupp,

Ayuandini,

Tobing

et al. 2024

Malar J

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Background By 2022, the Government of Indonesia had successfully eliminated malaria in 389 out of 514 districts but continues to face a challenge in Eastern Indonesia where 95% of the total 2021 malaria cases were reported from Papua, West Papua and Nusa Tenggara Timur provinces. There is an increased recognition that malaria elimination will require a better understanding of the human behavioural factors hindering malaria prevention and treatment, informed by local context and local practice. Methods This research used a light-touch immersion research approach. Field researchers lived in communities over several days to gather data through informal conversations, group-based discussions using visual tools, participant observation and direct experience. The study was conducted in four high malaria endemic areas in Papua, West Papua, and Sumba Islands in Nusa Tenggara Timur. Results The research highlights how people’s perception of malaria has changed since the introduction of effective treatment which, in turn, has contributed to a casual attitude towards early testing and adherence to malaria treatment. It also confirms that people rarely accept there is a link between mosquitoes and malaria based on their experience but nevertheless take precautions against the annoyance of mosquitoes. There is widespread recognition that babies and small children, elderly and incomers are more likely to be seriously affected by malaria and separately, more troubled by mosquitoes than indigenous adult populations. This is primarily explained by acclimatization and strong immune systems among the latter. Conclusions Using immersion research enabled behaviour research within a naturalistic setting, which in turn enabled experiential-led analysis of findings and revealed previously unrecognized insights into attitudes towards malaria in Eastern Indonesia. The research provides explanations of people’s lack of motivation to consistently use bed nets, seek early diagnosis or complete courses of treatment. The felt concern for the wellbeing of vulnerable populations highlighted during light touch immersion provides an entry point for future social behaviour change communication interventions. Rather than trying to explain transmission to people who deny this connection, the research concludes that it may be better to focus separately on the two problems of malaria and mosquitoes (especially for vulnerable groups) thereby resonating with local people’s own experience and felt concerns.

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“…A wide variation exists between hospitals, departments, work experience and medical hierarchy. 11,15 The utilization of QIs could potentially overcome these issues by introducing them as actionable points. The 11 generic QIs in this study would provide clear guidance on appropriate antibiotic prescribing and empower clinical decision-making.…”

Section: Discussionmentioning

confidence: 99%

“…10 Indonesia is a low-middle-income country in Southeast Asia with a population of 275 million and substantial inequalities across the country. 11 In 2019, AMR accounts for the fourth largest cause of deaths just under cardiovascular diseases, malignancy and diabetes. 12 The National Action Plan for AMR exists, with antimicrobial stewardship programs in place and national health scheme aiming to achieve universal health care.…”

Section: Introductionmentioning

confidence: 99%

The Clinimetric Profile of 11 Generic Quality Indicators for Appropriate Antibiotic Use in Hospitalized Patients in Indonesia

Tunjungputri,

Lie,

Susilo

et al. 2023

Preprint

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BackgroundOne of the efforts in antibiotic stewardship for limiting antibiotic resistance is the assessment of the quality of antibiotic use. To date, the quality and appropriateness of antibiotic use in Indonesia, a low-middle-income non-European country, have not yet been assessed using proven quality indicators (QIs). One recommended tool to measure appropriate empiric antibiotic use in hospitalized patients is the generic QIs reported by van den Boschet. al., which demonstrated good validity and generalizability.ObjectiveThe aim of this study is to assess the clinimetric profile of 11 generic QIs based on van den Boschet. al. in admitted adult patients receiving empiric antibiotics in Indonesian hospitals.MethodsThis is an observational study with a cross-sectional design conducted at two government referral hospitals in Jakarta, Indonesia, from August 1, 2022, to February 2, 2023. Adult inpatients who received empiric antibiotics due to suspected infection for ≥24 hours were included in the study.ResultsIn 500 inpatients from 2 hospitals, all QIs demonstrated good measurability with less than 10% of missing data. Ten QIs showed good applicability of >10%. Four QIs show good performance, while six QIs have significant potential for improvement (two blood cultures are obtained before empiric antibiotic treatment; culture sample is obtained from location suspected of infection; antibiotic is switched from intravenous to oral when clinically possible; antibiotics are stopped when there is no evidence of infection; a guideline is available and renewed every three years; and a guideline is adjusted to the local resistance pattern) making them priority targets for interventions to enhance the quality of antibiotic use in Indonesia. All QIs display good inter-observer reliability, and no moderate or strong correlations are found between QIs.ConclusionThe clinimetric assessment of QIs is imperative before their implementation in any setting different from their country of origin. Of the 11 generic QIs, 10 demonstrated good reliability and applicability at two hospitals in Indonesia. Future intervention studies can utilize these generic QIs to measure improvement in the appropriateness of antibiotic use.

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The state of health in Indonesia's provinces, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Cited by 38 publications

References 36 publications

Healthcare-seeking behavior for children aged 0–59 months: Evidence from 2002–2017 Indonesia Demographic and Health Surveys

Healthcare-seeking behavior for children aged 0–59 months: Evidence from 2002–2017 Indonesia Demographic and Health Surveys

How using light touch immersion research revealed important insights into the lack of progress in malaria elimination in Eastern Indonesia

The Clinimetric Profile of 11 Generic Quality Indicators for Appropriate Antibiotic Use in Hospitalized Patients in Indonesia

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