Indonesian Journal of Health Administration

FACTORS INFLUENCING EXPECTANT MOTHERS' CONTINUED USE OF DIGITAL HEALTH INFORMATION

Philomina Pomaah Ofori — 2023-11-23

Background: Expectant women receive healthcare education at antenatal care (ANC) clinics, but it is noteworthy that expectant mothers tend to seek information from various sources beyond their primary healthcare providers.

Aims: The study aims to investigate determinants influencing expectant mothers' continuous use of digital media for pregnancy information.

Methods: The study involves participants of expectant women who attend ANC clinics in five municipal hospitals. The hypotheses were tested with 580 responses using Structural Equation Modeling (SEM) via SmartPLS version 4.

Results: The findings revealed that social media healthcare information usage, perceived severity, and emotional support on social media influence expectant mothers' decisions to continue using digital media for healthcare purposes. However, the effect of perceived vulnerability on social media healthcare information usage was insignificant.

Conclusion: This study concludes that expectant mothers will continue to adopt digital platforms to access healthcare information. The findings provide recommendations to help healthcare providers advance antenatal care.

Keywords: Emotional support, healthcare, expectant women, SMHIC, social media

THE EFFECT OF PARTICIPATION IN JKN ON UNMET NEEDS FOR HEALTHCARE SERVICES

Farikh Alfa Firori — 2023-10-25

Background: The National Health Insurance or Jaminan Kesehatan Nasional (JKN) program is one of the steps taken by the Indonesian government in developing Universal Health Coverage (UHC). However, increased participation in the National Health Insurance is not followed by an increase in met needs for healthcare services.

Aims: This study aimed to examine the effect of participation in the National Health Insurance on unmet needs for healthcare services in poor and non-poor population groups.

Methods: This study used data from the 2018 National Socio-Economic Survey/ Survei Sosial Ekonomi Nasional (SUSENAS) and Village Potential Survey/ Survei Potensi Desa (PODES). Data were processed using binary logistic model analysis to identify the effect of participation in the National Health Insurance on the unmet needs for healthcare services.

Results: Participation in the National Health Insurance, including beneficiary program for poor groups could reduce the risks of unmet needs for healthcare services by 7.7%, while non-beneficiary program could reduce the risks of unmet needs for health services for non-poor groups by 10.4%.

Conclusion: Both beneficiaries and non-beneficiaries affect the unmet needs for health services for both poor and non-poor groups. However, the non-beneficiary program is more elastic than beneficiary program to fulfill needs for both sample groups.

Keywords: Healthcare services, national health insurance, logit, unmet need

DIFFERENCES IN PARENTS’ READINESS TO ACCEPT CHILDREN’S COVID-19 VACCINATION IN PATI REGENCY

Margaretha Inadyas Verganza — 2023-11-23

Background: The coverage of COVID-19 vaccination for children in Pati Regency was still low at 37% in February 2022 compared to the 75% target. Some preliminary studies in Kudus showed that parents who received socialization about children’s COVID-19 vaccination experienced concerns affecting their responses negatively to the program.

Aims: This study aims to analyze differences in parental acceptance of the COVID-19 vaccination for children in Pati Regency.

Methods: This study was quantitative research with a cross-sectional approach. The variables consisted of 7Cs components (Confidence, Complacency, Constraints, Calculation, Collective Responsibility, Compliance, Conspiracy) and acceptance of COVID-19 vaccination. The total sample of respondents was 372 parents divided into two independent groups obtained by cluster and proportional sampling. Data were collected using a questionnaire via Google Forms and analyzed using the Mann-Whitney test.

Results: The results showed differences in parental acceptance of COVID-19 vaccination (sig = 0.006) regarding constraints (sig = 0.000), collective responsibility (sig = 0.012), compliance (sig = 0.012), confidence (sig = 0.019), complacency (sig = 0.020), calculation (sig = 0.027), and conspiracy (sig = 0.037).

Conclusion: Some differences were found between parents whose children received the vaccine and those whose children did not receive the COVID-19 vaccine. Parents whose children received the COVID-19 vaccine were likely to have a good perception of the COVID-19 vaccination. Meanwhile, parents whose children did not get vaccinated would likely have a bad perception. Educational and consulting services possibly increase vaccination coverage.

Keywords: COVID-19 vaccination for children; different acceptance; 7Cs components

CHALLENGES AND POLICY SUPPORTS IN INDONESIAN PHARMACEUTICAL RAW MATERIALS INDUSTRY

Erwan Hermawan — 2023-11-09

Background: Indonesian pharmaceutical industry is experiencing many challenges, spesficically their raw materials mostly are imported products. Several factors that cause the pharmaceutical raw materials industry to be challenging are lack of mastery of technology, lack of government support, low budget for R&D, high costs of development and time consuming, and low innovation incentives.

Aims: This study aims to conduct a study on the strategies for developing the pharmaceutical raw material industry in Indonesia

Methods: This study employed a qualitative method, the data triangulation gathered from interviews and discussions with several industries and institutions. The study was conducted for six months in 2022.

Results: The policies that are required to be implemented to make the pharmaceutical raw materials industry thrive are (i) the presence of a clear grand strategy, (ii) determining the priority of pharmaceutical raw materials based on industrial needs, (iii) protecting domestic products, (iv) increasing health spending, (v) strengthening basic chemical product, and (vi) increasing the budget for R&D.

Conclusion: Some policies that can be enhanced include providing incentives and policies that favor the local pharmaceutical raw material industry, ranging from regulated prices, putting an end to dependence on imported products, tax incentives, domestic products protection through import tariff policies, energy subsidies, technology transfers, et cetera.

Keywords: pharmaceutical raw materials, policy, pharmaceutical

A LONG AND WINDING ROAD OF THE TOBACCO-FREE AREAS IMPLEMENTATION IN SEMARANG

Novia Handayani — 2023-11-27

Background: The Tobacco-Free Areas (TFA) policy is an effective way to control the negative effects of smoking on the community, especially passive smokers. Semarang has had a TFA policy since 2013. However, some people still smoke freely in some areas, such as workplaces, kindergartens, and other public places.

Aims: Identifying the implementation of Semarang City Local Government Regulation Number 3 of 2013 concerning Tobacco-Free Areas.

Methods: This was qualitative research using the case study method. Data were collected using in-depth interviews with some key informants according to the inclusion criteria. Triangulation was conducted through observation and in-depth interviews with some informants. Data were analyzed using content analysis.

Results: Some violations still occurred, mostly at the workplace and educational places, including government offices and schools. Violations happened due to inadequate support of the office’s heads, insufficient workers and the society’s awareness, policy rejection, inadequate financial support, lack of media exposure, and obscurity of the regulation articles, which led to misinterpretation. For example, Article 7, verse 3 states that the TFA regulation will be regulated by the mayor's decree. This statement weakens the regulation itself since the mayor's decree is not as strong as the local regulation.

Conclusion: The implementation of Semarang City Local Government Regulation Number 3 of 2013 concerning Tobacco-Free Areas has not been carried out properly in all of the TFA areas. Violations were still found in many areas.

Keywords: regulation, secondhand smokers, smoking, tobacco-free areas

FACTORS ASSOCIATED WITH THE UTILIZATION OF PUBLIC HEALTH CENTER IN CENTRAL JAVA

Marizka Khairunnisa — 2023-11-15

Background: The Public Health Center (PHC) is a gatekeeper to formal healthcare in Indonesia. PHCs in Central Java have met the basic health facility readiness standard, but there are still numerous challenges to increasing the utilization of PHCs.

Aims: This study aimed to analyze the factors related to the utilization of PHC in Central Java.

Methods: This cross-sectional study used secondary data from the 2018 Indonesia Basic Health Research, with 63,118 total samples. The independent variables were residence, age, gender, marital status, education, insurance, and socioeconomic, while the dependent variable was the utilization of PHC. The data were analyzed using a binary logistic regression.

Results: The average rate of utilization of PHC in Central Java in 2018 was 5.7%. Those aged 46-65 and >65 years old, women, married and widowers, and those with health insurance had a higher possibility of utilizing PHC. Meanwhile, those who graduated from secondary and tertiary school, the employed, and the wealthiest group had a lower possibility of utilizing PHC.

Conclusion: The factors related to the utilization of PHC in Central Java are age group, gender, marital status, education level, working status, health insurance ownership, and socioeconomic status.

Keywords: basic health service, health service access, public health, public health center

NURSE BURNOUT PREDICTORS IN HEALTHCARE UNITS DURING COVID-19 IN EAST JAVA, INDONESIA

Windu Santoso — 2023-11-28

Background: As frontline health service providers, nurses are important in directly caring for patients during the COVID-19 pandemic. Nurses are very vulnerable to infection, and this causes ongoing anxiety and ultimately causes burnout.

Aims: This study aims to identify factors that may lead to nurse burnout in various East Java healthcare facilities.

Methods: This research used correlational analysis with a cross-sectional approach. The approach of purposive sampling was applied to select nurses from various health units in East Java with 200 respondents. The Maslach Burnout Syndrome Inventory-Human Services Survey (MBI-HSS) questionnaire was used for burnout variables and questionnaires for efficacy, job stress, and fear variables. Data analysis used multiple logistic regression with the ENTER method.

Results: The findings indicated that the variable that had a significant relationship with burnout was work stress. The Odds Ratio (OR) analysis results for the job stress variable are 2.860, meaning that respondents who experience high job stress have a 3-fold risk of experiencing burnout compared to those who do not experience high stress.

Conclusion: Job stress is predicted to be the most dominant variable causing burnout during the COVID-19 pandemic. Respondents with high job stress are more at risk of experiencing burnout.

Keywords: burnout, COVID-19 pandemic, nurse

DO ANTI-SMOKING ADVERTISEMENTS INFLUENCE STUDENTS TO QUIT SMOKING?

Debri Rizki Faisal — 2023-11-30

Background: The prevalence of adolescent smoking in Indonesia increased from 2013 to 2018.

Aims: This study examines the influence of pro and anti-cigarette advertising on students' smoking cessation.

Methods: The study uses the Global Youth Tobacco Survey Indonesia 2019 data. The sample was students aged 13-15 years who had smoked. The dependent variable is quitting smoking, and the independent variables are pro-cigarette and anti-smoking ads: chi-square and logistic regression tests with a 95% confidence interval and a p-value of 0.05.

Results: The total sample was 1023 students, and 79.32% wanted to quit smoking. In the anti-smoking ads variables: anti-smoking messages in various media (OR=1.63, 95% CI=1.14-2.34); pictorial health warnings (PHW) on cigarette packs (OR=3.46, 95% CI=2.40-4.97); feeling afraid when seeing health warnings on packaged cigarettes (OR=3.03, 95% CI=2.16-4.26); education about harmful of cigarette consumption (OR=1.40, 95% CI=1.00 – 1.96) had a significant association to quit smoking. The most dominant factor in multivariate analysis was pictorial health warnings on cigarette packs (OR=2.53, 95% CI=1.67-3.81).

Conclusion: Most student smokers express a desire to quit smoking. Pictorial health warnings are significantly associated with quitting smoking among students.

Keywords: cigarette ads, GYTS, pictorial health warning, students

PHYSICIANS AND DISRUPTION ON TELEMEDICINE: A SYSTEMATIC LITERATURE REVIEW

Arief Priyo Nugroho — 2023-11-12

Background: Telemedicine has developed rapidly since the COVID-19 pandemic. Telemedicine applications have marked significant transformations in healthcare. Rapid changes in healthcare services inevitably affect health service providers, specifically physicians.

Aims: This study examines physicians' responses to a disruptive era in the healthcare industry.

Methods: This paper applies a systematic literature review approach to characterize physicians’ experiences, challenges, and obstacles in managing disruption in the health service delivery context. A comprehensive literature review was conducted using the Scopus database and borrowing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method. There were 78 articles included in the analysis.

Results: This study found that doctors who use telemedicine experience several types of disruption. The studies that examine physicians’ experience in health service disruption tend to be dominant in 4 (four) out of 5 (five) disruption types. First, disruption to the current delivery mode. Second, disruption to clinical practice role and responsibility. Third, disruption to clinical practice role and responsibility. Fourth, disruption to the work environment. Meanwhile, the disruption in personal life becomes less elaborated in the telemedicine studies debate.

Conclusion: It is essential to pay close attention to the disruptions that have an effect on physicians' personal lives. Personal life is essential because it benefits physicians and directly supports the quality and sustainability of telemedicine services.

Keywords: Disruption, Physician, and Telemedicine.

HUMAN RIGHTS-BASED LEGAL PROTECTION FOR HEALTH WORKERS IN CONFLICT ZONES

Maria Lusyana Br Ginting — 2023-11-20

Background: One of the human rights issues in the health sector is legal protection in conflict areas. The obstacles faced were the limited number of security personnel on guard and the long distance between the security post's location and the conflict's location.

Aims: This study aims to determine how legal protection for health workers in conflict areas is.

Methods: The method of this study is a literature review. The nature of this study is descriptive. The data collection method used is the literature study method, namely by collecting secondary data related to the issues raised.

Results: The results of this study show that the central and regional governments have not been maximal in protecting health workers in conflict areas.

Conclusion: Based on the results and discussion of this study, the recommendations are to make a grand design for health, security, and occupational safety for health workers, specifically in conflict areas, and to make standard operating procedures for handling cases of attacks on health workers in conflict areas.

Keywords: Human Rights, Legal Protection. Health Workers.