COMMUNITY HEALTH CENTER

Background: Being one of the most important elements in healthcare system, Community Health Center has been promoted to improve its quality and capacity of services. Accreditation is a method that can be used to improve and measure the quality of health service. Quality service improvement is expected to enhance patient satisfaction. This study aimed to investigate the asssociations between accreditation status, patient socioeconomic factors, insurance type, patient perceived quality of service, and satisfaction at Community Health Center. Subjects and Method: This was an analytic observational study with crosssectional design. This study was conducted at Community Health Center in Surakarta, Central Java from June to July 2017. A total of 8 Community Health Centers with different accreditation status (not accredited, lowest, medium, and highest) were selected for this study. A sample of 200 patients were selected from the 8 Comunity Health Centers by proportional random sampling. The independent variables were accreditation status, patient education level, family income, and insurance type. The dependent variables were perceived quality of service and patient satisfaction. The data were collected by a set of pre-tested questionnaires. Accreditation status was identified from the record at District Health Office. Data were analyzed by path analysis. Results: Patient satisfaction was associated with Commuity Health Center acrreditation status (b= 0.39; SE= 0.22; p= 0.069), perceived quality of service (b= 0.05; SE= 0.02; p= 0.022), patient education level (b= -1.16; SE= 0.48; p= 0.017), and insurance type (b= 0.61; SE= 0.31; p= 0.044). Perceived quality of health services was associated by accreditation status (b= 2.22; SE= 0.74; p= 0.003), patient education level(b= -4.51; SE= 1.68; p= 0.007), and insurance type (b= 2.79; SE= 1.06; p= 0.008). Family income did not show statistically significant association with perceived quality of health service (b= -0.17; SE= 0.11; p= 0.123). Conclusion: Patient satisfaction is associated with Commuity Health Center acrreditation status, perceived quality of service, patient education level, and insurance type. Perceived quality of health services is associated with accreditation status, patient education level, and insurance type.

Most Americans have been shocked and dismayed and many surprised and delighted by the depth, breadth and force of the rage that has been boiling and roiling for years in the depths of the nation. Some citizens recognized that rage as something they had been familiar with, and were delighted that it had found a voice; others had seen it coming but were still shocked. Most Americans knew that American politics can be volatile, but they never expected, in the twenty-first century, that this volatility would take the form of an enraged and radical Republican Party. In their amazement, many Americans and, indeed, many around the world are asking “Where did all this rage come from? What are the deep origins of such astounding anger?” Some answers to these questions will be attempted in this essay.

Background Human milk banks (HMB) play an essential role by providing human milk to infants who would otherwise not be able to receive mother’s milk. There is currently no donor milk bank in Turkey. For any new health intervention to be successful, determining its acceptability is a vital first step. This study intends to determine the opinions, knowledge, and attitudes of native Turkish and refugee women living in Çeştepe, Aydın, a rural area in Turkey, about HMB. Methods A population-based cross-sectional, mixed-methods study was conducted. Qualitative study data were collected through in-depth interviews with 33 women, and quantitative study data were collected using a questionnaire. A total of 271 women in the region were included in the study. Qualitative data were thematically analyzed and then a conceptual framework was created. Logistic regression was performed for quantitative data. Results Fifty-seven point nine per cent of the women were willing to donate breast milk, whe...

Cervical cancer still become the first killer for women in growth countries, include Indonesia. The prevalence of cervical cancer in growth countries reached 77%. One of the risk factor  entrenched in modern women, is douching. The aim of this research was to analyze the effect of douching to cervical cancer incidence in dr. Soebandi regional hospital in Jember. This is an observational analitical research that use case-control approach. The statistical test used in this research was logistic regression with 5% significance level. There was significant effect of douching toward cervical cancer incidence, which the risk factor of a woman with douching to have cervical cancer four times greater than a woman who didn’t do douching. Key words : douching, cervical cancer

Background: Little is known about the relationship between family support (emotional, material, and informational support) with medical compliance in tuberculosis patients in the Community Health Center of Abeli KendariObjective: This study aims to examine the relationships of family support (emotional, material, and informational support) and medical compliance of patients with pulmonary tuberculosis.Methods: This was an observational study with cross-sectional design. Thirty samples were recruited by total sampling with the criteria that they had pulmonary TB with positive acid-resistant bacteria and still taking medication from the community health center of Abeli Kendari health center. Data were analyzed by chi-square processed using univariate and bivariate and presented in tabular form and narrated.Results: Findings showed that there were significant relationship between Emotional support (X2hit = 10.20 the value of X2tab = 3.841; Cc 0.50 - moderate relationship ), material su...

Introduction : Pulmonary tuberculosis (TB) is one of the most common infectious diseases and remains a major public health problem in Indonesia. Patients undergoing long-term TB treatment often experience non-adherence to medication. This non-adherence is influenced by various factors, including patients' knowledge, attitudes, and behavior toward the disease and its treatment. Objective: This study aims to determine the relationship between knowledge, attitude, and behavior of pulmonary TB patients and their adherence to anti-tuberculosis drug (OAT) treatment at Malingping Regional Hospital in 2025. Method: This research is a quantitative study with a cross-sectional approach. Sample: The sampling technique used was purposive sampling. A total of 89 respondents participated, consisting of pulmonary TB patients undergoing treatment at Malingping Regional Hospital. Data were collected using a structured questionnaire covering the variables of knowledge, attitude, behavior, and medication adherence. The data were analyzed using the Chi-square test.

UC Irvine (UCI) GWEP partnerships were designed to address a startling increase in impoverished older adults and the disproportionate medical and social determinants of health faced by Latino and Asian communities. All partner clinics primarily serve racial/ethnic minorities, including Hispanic/Latino or Asian minorities (83-88%), with >90% below the 200% poverty threshold. Our major FQHCs include the academic UCI Family Health Center, Vietnamese and Korean community Services. We established an FQHC Geriatric Clinic at UCI with the 4 M’s paradigm (i.e., matter, mobility, medication, mentation) integrated into the clinic through the Medicare Annual Wellness Exam. We are disseminating this model to our smaller community sites, along with 4 M presentations. Roughly 5-7% of patients in FQHCs are over 65, allowing leadership time to prepare a foundation for increased growth. Furthermore, we have learned that each FQHC’s cultural setting and infrastructure is unique and requires a cust...

The risk of HIV transmission can be prevented by early HIV detection, both transmission to prospective married couples or transmission from parents to their prospective children. Obligatory premarital HIV testing is one effective effort to protect families from HIV infection. In Surabaya, socialization of pre-marital HIV testing has been carried out to prospective brides when injecting TT immunization, but this has not been fully responded well by the community. The aim of research to identify attitudes adolescent premarital age and health centers readiness te rkait program when premarital HIV screening test. This research is a descriptive study with a mix method conducted in wi the work area of ​​the Wonokromo Community Health Center. Research variables on pre-marital adolescent age as measured by questionnaires and health center readiness obtained through in-depth interviews and questionnaires. The study sample was 72 premarital adolescents and 1 MCH coordinating midwife at the pu...

The ongoing health problems in Indonesia require the government to take action so that people can still experience justice and obtain their rights and not cause harm. In order to improve the quality of public health, the  government  provides  social  security.  This  social  security  is  provided  by  the  government  and  is  useful  for meeting the basic needs of a decent life, starting from Jamkesmas, Jamkesda, AKSES and most recently the Social Security Administering Body (BPJS) for Health. Even though there have been efforts by the government to realize efforts  to  resolve  existing  problems,  these  efforts  have  not  been  effective  due  to  several  inhibiting  factors.  A solution is needed in the form of establishing and implementing the IMP (Identity Monitoring Program) concept which  is  integrated  with  the  Capil  Population  and  Civil  Registry  Department  and  BPJS.  It  is  hoped  that  the application  of  the  IMP  concept  can  minimize  the  deficit  in  health  insurance  and  become  a  solution  to  solving claims management problems as one of the root causes of the BPJS deficit

Low  rates of exclusive  breastfeeding pose  a threat to children's growth  and  development,  affecting  the  quality  of  human  resources.  The majority  of breastfeeding  mothers  discontinue  breastfeeding  within  a  few weeks  postpartum  due  to  perceived  insufficient  breast  milk  and dissatisfaction  of  the  infant  during  breastfeeding.  The  objective  of  this community  service  activity  is  to  enhance  the  knowledge,  attitudes,  and behaviors  of  postpartum  mothers  regarding  breastfeeding  their  infants. The  methods  employed  included  lectures  and  question-and-answer sessions with mothers. This activity took place in the Postnatal Care Room of  Padjonga  Daeng  Ngalle  Hospital,Takalar  Regency,  on  March  20, 2024,  with  the  participation  of  six  postpartum  mothers.  The  results  of education  and  support  provided  to  postpartum  mothers  on  exclusive breastfeeding  using  leaflets  and  flip  charts  showed  that  prior  to  the intervention, only2 mothers (33.33%) had good knowledge, and after the education  and  support,  this  number  increased  to  5  mothers  (83.33%)  in the  post-intervention  test.  Therefore,  through  education  and  support, motivation  and  behavioral  changes  in  exclusive  breastfeeding  practices among postpartum mothers can be enhanced

Integrated service postis is a basic health activity organized from, by, and for the community to reduce infant mortality, and maternal mortality (pregnancy, childbirth, and postpartum), cultivate small happy, and prosperous families, and increase the role of participants and the community's ability to develop health and welfare activities and family planning. This study aims to describe the characteristics of mothers under five in integrated service posts in the working area of the Tarus Health Center in 2022. The type of research is a descriptive study using a cross-sectional research design. The population in this study were all mothers of children under five who were recorded at integrated service posts in the working area of the Tarus Health Center who had toddlers from 0-60 months of age as many as 3,675 people and the sampling technique used purposive sampling with a sample of 97 people. The results showed that the distribution of respondents was based on the number of visits to the integrated service post, namely active visits (52.5%), and inactive visits (47.4%). The age of the mother of children under five is at most 31-35 (36.1%), the mother's education is high school education at most (41.2%), the mother's occupation is the most in IRT work (51.5%), Mother's reassurance toddlers who have good knowledge are (59.8%), less well are as many as (40.2%), the distance from house to integrated service post is near (54.6%), far away (45.3%). Suggestions for community health service centers can provide understanding and awareness to mothers of toddlers so that they routinely bring children under five to the integrated service post every month so that the growth and development of toddlers can be monitored.

Background: Hospital management needs to be done properly, especially in terms of the efficiency ofthe health services provided. Efficiency is one of the performance parameters of an organization whichis defined as success in accommodating the maximum possible output from a number of existing inputs. Service efficiency that is important to note is the efficiency of hospital inpatient services. Monitoring and assessing the efficiency level of an inpatient hospital service can use the Barber Johnson chart approach. The Barber Johnson chart as an indicator of hospital management efficiency is useful for comparing the efficiency level of bed use, monitoring the development of bed efficiency targets and comparing the efficiency level of bed use between units. The purpose of this study was to analyze the efficiency of inpatient services based on the barber johnson chart at the Mangusada Regional Hospital.Method: This type of research is a quantitative descriptive study with a cross-sectional design. The location of this research is the Mangusada Regional Hospital. The data used in this study is secondary data derived from the annual report of the Mangusada Regional Hospital. Data analysis was carried outdescriptively, namely the BOR, BTO, TOI and AvLOs data obtained would be illustrated with a graph to see the trend of inpatient service indicators and also with a Barber Johnson Graph to describe the efficiency of inpatient services. Result: Based on the results of the analysis, it was found that the BOR indicator decreased significantly, namely BOR = 89.49% in 2019 to BOR = 62.22% in 2020 while the TOI indicator increased, namely TOI = 0.52 Days in 2019 to TOI = 2.56 Days in 2020. On the BTO and AvLOS indicators, not too muchhas changed from year to year. Judging from the barber johnson graph from 2017 to 2020, overall it shows that inpatient services at Mangusada Hospital have not shown efficiency. Conclusion: Overall, when viewed from the trend of each indicator, it is known that it is still volatilebut the BOR indicator decreased in 2020 and the TOI indicator increased in 2020. Seen from the barber johnson chart, it was obtained from 2017 to 2020, service delivery hospitalization at the Mangusada Regional Hospital has not shown efficiency.

The role of the information system in health services is increasingly needed in the implementation of the National Health Insurance (JKN) organized by BPJS Kesehatan. BPJS Kesehatan has an application called P-Care (Primary Care) BPJS. There are still problems with the use of P-Care application at primary health care. This study aims to evaluation of the BPJS primary care (P-Care) application on health services in primary health care. This study uses a systematic review through: 1) search using an indexing site (google scholar) with the specified keyword, 2) the literature obtained through indexing site then limited with certain categories, 3) the literature then selected with certain inclusion and exclusion criteria. Based on the results, it is found that the P care application is very useful and makes work easier, efficient, fast, effective in providing services and can increase the productivity of officers' performance. In addition, the P care application has provided the menus needed by the user. There are also some obstacles in implementing P Care, such as the power fails and P Care errors when a patient needs to be referred. BPJS Kesehatan need to evaluate and monitoring regularly to ensure that the P care application is running well.

The first-ever U.S. Surgeon General's report on oral health, released in May 2000, addressed the growing disparity between groups who have optimum oral health and groups who do not. 1 The report termed oral health "a mirror for general health and well-being," citing links between oral health and other health problems. A report from the National Institute of Dental and Craniofacial Research (NIDCR) followed in 2001, titled "A Plan to Eliminate Craniofacial, Oral, and Dental Health Disparities." It is an action plan, targeting disparities that result from differences in culture, language, diet, physical activity, socioeconomic and demographic status, gender, age, environmental pollutants and occupational hazards. 2 The Surgeon General, in a separate report in 2003, called for a national partnership to improve and maintain the nation's oral health. 3 According to one author, there is growing consensus among health researchers that they have a responsibility both to acquire scientific knowledge and also to apply it in a way that benefits the public health. 4 An extension of that argument is that dental scientists and educators cannot

Background: Exclusive breastfeeding is giving breast milk exclusively from newborns to 6 months of age without giving any food. Exclusive breastfeeding is essential for optimal baby growth and development, contains various essential nutrients for babies. In 2018 the coverage of exclusive breastfeeding in Indonesia still reached 65.16%, and the coverage of breastfeeding in East Java itself was still below the target of 76.98%. The low level of exclusive breastfeeding is still a problem because it can cause the baby's immune system to become lower, indigestion and illness risk in the baby is more generous to target.Objective: To determine the relationship between mothers' level of knowledge about breastfeeding and exclusive breastfeeding at Kenjeran Primary Health Center.Methods: This observational analytic study with a cross-sectional study design. The sampling technique was using the purposive sampling technique. Respondents in this study were mothers who had babies 6-24 mon...

Introduction: Tuberculosis (TB) is the leading cause of death from infectious diseases in the world and Indonesia is the second largest contributor to TB cases after India. Treatment adherence problems are a major obstacle to TB elimination. The purpose of this Literature Review is to determine the factors that affect treatment adherence among TB patients in Indonesia. Methods: Literature obtained from Science Direct, PubMed, and Google Scholar; published from 2018 -2023, research from reputable international journals and from national journals at least with SINTA 3, located in Indonesia. Indonesian and English with full text of all types of research designs. Article selection was carried out using the method "Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and analyzed using descriptive analysis techniques. Results: A total of 225 articels were deemed appropriate for the topic, but only 15 articles were included based on inclusion criteria. It was found that there are several factors that affect treatment adherence in tuberculosis patients in Indonesia, namely: predisposing factors as many as 11 articles (age, education, occupation, knowledge, self-efficacy, concordance, health behavior, motivation, marital status, income level, drug side effects, already feeling cured, and duration of treatment). Reinforcing factors as many as 2 articles (family support). Enabling factors as many as 5 articles (the role of officers, reminder SMS messages from officers, health counseling, and distance of residence to health services). The most dominant factor affecting treatment adherence among tuberculosis patients in Indonesia is the Predesposising factors, namely education, knowledge and seflefficacy.

Background: Work performance was the outcome of all cumulative actions that the nurses' performs using their skills, abilities, and knowledge in providing health services to the community. Many factors influence work performance in health personnels. The purpose of this study was to examine factors associated with work performance of health center personnel using path analysis. Subjects and Method: A cross sectional study was conducted in Ciamis, West Java, from November to December 2020. Total sample of 200 health personnel in health centers was selected by simple random sampling. The dependent variable was work performance. The independent variables were leadership style, work motivation, work satisfaction, education, patient, patient health treatment status, health worker status, tenure, perceived income, training, and type of human resources. The data were collected by questionnaire and analyzed using a multiple linear regression. Results: Work performance in health personnel increased with good leadership style (b= 6.09; 95% CI= 1.63 to 3.18; p <0.001), strong motivation (b= 3.91; 95% CI= 0.73 to 2.22; p<0.001), high work satisfaction (b= 4.09; 95% CI= 0.78 to 2.22; p<0.001), high education (b= 4.62; 95% CI= 0.99 to 2.45; p<0.001), inpatients (b= 4.67; 95% CI= 1.00 to 2.46; p<0.001), health workers (b= 4.62; 95% CI= 1.12 to 2.77; p< 0.001), tenure ≥3 years (b= 3.53; 95% CI= 0.59 to 2.07; p<0.001), good perceived income (b=4.14; 95% CI= 0.87 to 2.45; p<0.001), had trained (b= 4.96; 95% CI= 1.40 to 3.23; p< 0.001), and civil servants (b=3.97; 95% CI= 0.73 to 2.16; p<0.001). Conclusion: Work performance in health personnel increases with good leadership style, strong motivation, high work satisfaction, high education, inpatients, health workers, tenure ≥3 years, good perceived income, has trained, and civil servants.

Background: Prevention mother to child transmission counseling and testing (PMTCT) service is primarily provided at health facility level. However, their full implementation requires strong linkages with communities. The purpose of this study was to examine contextual effect of community health centers on midwife performance in the implementation of PMTCT? Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted at 24 community health centers in Madiun, East Java, from August to September 2019. A sample of 184 midwives was selected by total sampling. The dependent variable was implementation of PMTCT. The independent variables were age, tenure, knowledge, training, work performance, and accreditation. The data were collected by questionnaire and analyzed by a multiple linear regression. Results: Implementation of PMTCT counseling and testing improved with tenure ≥8 years (b= 0.51; 95% CI= 0.15 to 0.87; p= 0.006), good knowledge (b= 0.61; 95% CI= 0.33 to 0.89; p<0.001), had trained (b= 0.41; 95% CI= 0.08 to 0.74; p= 0.014), good work performance (b= 0.56; 95% CI= 0.21 to 0.92; p= 0.002), and good accreditation (b= 0.49; 95% CI= 0.04 to 0.95; p= 0.031). Implementation of PMTCT counseling and testing reduced with midwives age ≥35 years (b= -0.51; 95% CI= -0.80 to -0.21; p= 0.001). Conclusion: Implementation of PMTCT counseling and testing improves with tenure ≥8 years, good knowledge, had trained, good work performance, and good accreditation. Implementation of PMTCT counseling and testing reduces with midwives age ≥35 years.

Background: Epidemiological transition is causing a shift from Communicable to Non-Communicable Diseases (NCD). NCD is a serious threat because it impacts decreasing productivity and increasing economic and social burdens for the community. The control of NCD risk factors in Indonesia is carried out by empowering the community through the Integrated Non-Communicable Diseases Health Post (Posbindu NCD). One of the important factors determining the success of implementing Posbindu is the role of cadres. This study aims to analyze the factors that affect the performance of Posbindu cadres. Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in 25 posbindus in Karanganyar, Central Java, from February to April 2020. A sample of 200 cadres from 25 cadres was selected by stratified random sampling. The dependent variable was the performance of the Posbindu cadres. The independent variables were training, ability, length of employment, motivation, the leadership of the Posbindu chairman, social network support and appreciation. Data were analyzed using multilevel logistic regression with Stata 13. Results: Job performance increased with training (b= 1.75; 95% CI= 0.28 to 3.22; p= 0.019), good ability (b= 2.50; 95% CI= 0.95 to 4.04; p= 0.002), tenure ≥1 year (b= 1.99; 95% CI= 0.05 to 3.92; p= 0.044), strong motivation (b= 2.57; 95% CI= 1.25 to 3.89; p <0.001), good leadership of Posbindu chairman (b= 1.73; 95% CI= 0.44 to 3.03; p= 0.009), and strong social network support (b= 1.24; 95% CI= 0.14 to 2.34; p= 0.028). Incentive increased job performance, but it was statistically non-significant (b= 1.19; 95% CI= -0.35 to 2.73; p= 0.132). Posbindu had a strong contextual effect on job performance with an ICC of 62.73%. Conclusion: Job performance increases with training, good abilities, tenure ≥1 year, strong motivation, good leadership of Posbindu chairman, strong social network support, and appropriate incentives. Posbindu has a strong contextual effect on job performance.

In Indonesia, the component prevalence of metabolic syndrome continuously increases. The main risk factors for metabolic syndrome are obesity and inactive lifestyle. This research aimed at finding out influential factors of preventive behaviours of risk factors for adults' metabolic syndrome in Ponorogo using a Health Belief Model (HBM) theory. This cross-sectional research was done in Ponorogo Regency, East Java, Indonesia on October 2019. The dependent variable of this research was the preventive behaviours of risk factors for metabolic syndrome. Then, the independent variables were perceived susceptibility, perceived severity, perceived barriers, perceived benefits, and cues to action. The data was obtained using questionnaires and analysed using chisquare. The findings shows that the HBMconstruct had an effect on preventive behaviours of risk factors for metabolic syndrome including perceived susceptibility (OR= 2.00; CI 95%=1.06 -3.77; p= 0.032); perceived severity (OR= 2.05; CI 95%=1.38 -4.61; p= 0.003); perceived benefits (OR=1.86; CI 95%= 1.01 -3.34; p= 0.045); perceived barriers (OR= 0.48; CI 95%= 0.25 -0.90; p= 0.024); cues to action (OR= 3.92; CI 95%= 1.94 -7.92; p= <0.001).

Our conceptual model demonstrates our goal to investigate the impact of clinical decision support (CDS) utilization on cancer screening improvement strategies in the community health care (CHC) setting. We employed a dual modeling technique using both statistical and computational modeling to evaluate impact. Our statistical model used the Spearman's Rho test to evaluate the strength of relationship between our proximal outcome measures (CDS utilization) against our distal outcome measure (provider self-reported cancer screening improvement). Our

Stimulation is one of the factors that affect a child’s development. The age of 3-6 months is included in the first 1000 days of life which is a critical period in which the child&#39;s brain begins to develop. Mothers can stimulate children according to their developmental stages. During infancy, a close relationship exists between the mother and child, so the influence of mother in educating the childis very big. The purpose of this study is to find out the correlation between the mothers ability to stimulate 3-6 months infant with their development in Puhjarak Community Health Center in Kediri Regency. The research desain used correlational study. The data collection was done by conducting cross sectional methods, with population of 38 mothers and their babies. The sampling used simple random sampling technique with total sample of 35 respondents who met the inclusion criteria. The analysis data used spearman rank showed p value 0,001. The conclution of this research was  there w...

Every pregnancy and childbirth is a risky event, therefore every pregnant and childbirth woman must be as close as possible to basic emergency obstetric services. Health service units that are close and affordable to the community Community Health Centreare expected to be able to provide basic emergency neonatal obstetric services. Deli Serdang Regency has a high number of maternal mortality rates (AKI) and there are still cases of maternal deaths due to delays in handling due to geographical factors which is one of the causes of the low utilization of PONED (Pelayanan Obstetri Neonatal Emergency Dasar) Community Health Centre. The study aims to analyze the relationship between geographic access and the use of PONED in Hamparan Perak Health Center, Deli Serdang Regency.This type of research is an explanatory survey with cross sectional approach. The study was conducted in the working area of the Hamparan Perak Health Center with a sample of 100 pregnant, childbirth and postpartum wo...

Background Recruitment and retention in clinical trials of minorities is low, particularly in rural underserved populations. This has slowed progress in addressing racial/ethnic disparities in oral health. Purpose To describe factors associated with successful recruitment, and identify predictors of continued retention of pregnant women attending a community health center into a randomized controlled clinical trial to prevent early childhood caries. Methods The Mothers and Youth Access (MAYA) Trial recruited women in the second trimester of pregnancy. At baseline, consenting women completed an oral health questionnaire and received a dental exam and oral health counseling. Four months postpartum, women returned with their babies for randomization with follow up at 9-, 12-, 18-, 24-, 30-, and 36-month postpartum visits. To assess predictors of retention, data about respondents&#39; demographics, and oral health-related knowledge, attitudes, and behaviors were obtained by questionnair...

Pregnancy is a happy thing for every husband and wife but sometimes complaints arise during pregnancy, one of them that is very annoying is back pain problems when pregnant. Back pain when pregnant is usually experienced by women in certain time of the pregnancy, usually happens often in trimester 3 pregnancy. The purpose of this research is to know the difference of pregnancy exercise effectiveness with endhorpin message to decrease in lower back pain in trimester III pregnancy at Sipatana Public Health Center. This research type was quasi experiment by using the method of pre and post test with two group design. The total samples were 30 people. The result of bivariate analysis was pregnancy exercise (p = 0.000) and endhorpin message (p = 0.000) which (p<0.05), so that there was an effect of doing pregnancy exercise and endhorpin message to decrease in lower back pain in Trimester III pregnancy. The difference of effectiveness between pregnancy exercise and endhorpin massage is (p = 0.042), so that there is a significant difference between doing pregnancy exercise and back massage to decrease in lower back pain in trimester III pregnancy at working area of Sipatana Public Health Center. It is expected that Trimester III pregnant women can apply pregnancy exersice and back massage in order to be healthy especially decrease lower back pain in pregnancy.

Background: The whole of humanity has suffered dire consequences related to the novel coronavirus disease 2019 (COVID-19). Vaccination of the world base population is considered the most promising and challenging approach to achieving herd immunity. As healthcare organizations took on the extensive task of vaccinating the entire U.S. population, digital health companies expanded their automated health platforms in order to help ease the administrative burdens of mass inoculation. Although some software companies offer free applications to large organizations, there are prohibitive costs for small clinics such as the Good Health Associates Clinic (GHAC) for integrating and implementing new self-scheduling software into our e-Clinical Works (ECW) Electronic Health Record (EHR). These cost burdens resulted in a search that extended beyond existing technology, and in investing in new solutions to make it easier, more efficient, more cost-effective, and more scalable. Objective: In compa...

Background: Puskesmas plays an important role in reducing maternal and neonatal morbidity and mortality. Contextual factors of health center and dimensions of service quality may influence patients statisfaction. This study aimed to analyze the factors that influence patient satisfaction Subject and Method: This was an observational study using cross sectional design conducted in Klaten Regency, Central Java. A sample of 200 antenatal patients was selected at random from 25 puskesmas (community health centers) comprising 8 antenatal patients from each selected puskesmas. The dependent variable was antenatal care (ANC) patient satisfaction. The independent variables were five dimensions of quality healthcare, including (1) reliability, (2) tangible, (3) empathy, (4) responsiveness, (5) assurance. The data were analyzed by multilevel linear regression using the Stata 14 application. Results: Patient satisfaction was positively affected by reliability (b= 0.30; 95% CI= -0.48 to -0.13; p= 0.001), tangible (b= 0.28; 95% CI= 0.14 to 0.42; p<0.001), responsiveness (b=0.17; 95% CI = 0.07 to 0.27; p= 0.001), and assurance (b= 0.16; 95% CI= 0.04 to 0.28; p= 0.007). The relationship between patient statisfaction and empathy was statistically non significant (b=-0.02; 95% CI= -0.28 to 0.23; p=0.837). The contextual effect at the puskesmas level was substantial with intraclass correlation (ICC= 36.4%). Patient satisfaction is positively affected by reliability, tangible, responsiveness, and assurance. The relationship between patient statisfaction and empathy is statistically non significant.

Background: Community health center (puskesmas)management information system or often referred to as SIMPUS is a local health system aimed at providing health information at primary health care level. P Care (Primary Care) application is an information system that is designed to serve BPJS patients. The bridging system links SIMPUS with P care application. These three systems have been used in all puskesmas in Sukoharjo district since 2017. This study aimed to evaluate the implementation of community health center management information system (Simpus), Primary Care (P Care), and bridging data system, in Sukoharjo District, Central Java. Subjectsand Method: This was a qualitative study. The study was conducted in Sukoharjo, Kartasura, Bendosari, Mojolaban community health centers, in Sukoharjo District, Central Java, from October to December, 2017. Four community health centers were selected randomly from 13 community health centers in Sukoharjo. The dependent variables were information service, performance, efficiency, and security. The independent variable was health information system (SIMPUS, P care, and bridging system). The data were collected by in-depth interview, direct observation, and document review. Data credibility was checked by a triangulation method. Results: Three health information systems (SIMPUS, P care, and bridging system) have been implemented in Sukoharjo District. However, their performance is yet to be improved. Loading time was lengthy and error often occurred. Patients often complained of the lengthy service. Some items in the information system form were left blank. Data entry occasionally was inconsistent with examination outcome. The security system of the health information existed, but sometimes unauthorized individuals can access and use that information. There was a lack of human resources and hardware. The health information system had not met the information need. Conclusion: Three health information systems (SIMPUS, P care, and bridging system) have been implemented in Sukoharjo District. However, their performance is yet to be improved. Some obstacles have yet to be resolved.

Background: Quality health care needs are increasing. The service quality of one public health center andanother does not have the same standard yet. One of the factors that influence the assessment of service quality is the patient satisfaction. Several factors can influence patient satisfaction, especially from the doctor's side. This study aims to determine the effect of physician motivation, the age of the doctor, and the head of the health center on physician job satisfaction and patient satisfaction. Method: This was an analytic observational study with a cross-sectional design. The study was conducted at community health centers in Karanganyar and Surakarta, Central Java, in August 2018. A total of 25 doctors and 225 patients were selected using proportional random sampling. The dependent variable in this study is patient satisfaction. The independent variables in this study were doctor's motivation, doctor's work satisfaction, doctor's age, and the head of the health center. Data were obtained using questionnaires and analyzed using path analysis. Results: Patient satisfaction was directly increased by by the doctor's work satisfaction (b = 0.10; SE= 0.02; p<0.001) but decreased by doctor's age (b= -0.82; SE= 0.02; p<0.001). Patient satisfaction was indirectly affected by doctors' motivation and head of community health center. Conclusions: Patient satisfaction is directly increased by by the doctor's work satisfaction but decreases by doctor's age. Patient satisfaction is indirectly affected by doctors' motivation and head of community health center.

Background: Adherence to treatment is important to reduce viral replication, improve clinical and immunological conditions, reduce the risk of developing ARV resistance, and reduce the risk of HIV transmission. Peer support is suspected to be one of the factors driving drug intake adherence in patients with chronic disease. This study aimed to examine the influences of peer support and psychosocio-economic determinants on treatment compliance in HIV/AIDS patients. Subjects and Method: This was a case control design study conducted in Sragen, Central Java, Indonesia. A sample of 200 people with HIV/AIDS (PLWH) was selected by fixed disease sampling. The dependent variable was treatment compliance. The independent variables were knowledge toward HIV/AIDS, perceived benefit, perceived belief, perceived threat, perceived susceptibility, perceived seriousness, perceived barrier, attitude, indirect experience, family support, and peer support. The data were obtained from medical record an...

The completeness of antenatal care is an effort to reduce prenatal mortality. This study aimed to analyze the contextual effect of the community health center on the use of antenatal care. Subjects and Method: This study was an analytical observational study with a cross-sectional approach. This study was conducted from June to August 2020. The sample consisted of 250 study subjects that were selected by simple random sampling. The dependent variable was antenatal care. The independent variables were husband support, knowledge, attitude, antenatal information, self-efficacy, cues to action, perceived seriousness, perceived susceptibility, perceived benefits, perceived barriers, and complete facilities. This study used questionnaires to collect the data with multilevel analysis through a logistic regression approach in STATA 13. Results: Complete antenatal care visits increased with strong support (b= 4.36; 95% CI= 0.92 to 7.81; p= 0.013), high knowledge (b= 3.59; 95% CI= 0.67 to 6.51; p= 0.016), positive attitude (b= 4.07; 95% CI= 0.65 to 7.50; p= 0.020), much antenatal information (b= 4.20; 95% CI= 0.94 to 7.46; p= 0.012), high self-efficacy (b= 3.05; 95% CI= 0.20 to 5.90; p= 0.036), high cues to action (b= 3.41; 95%CI= 0.62 to 6.20; p= 0.017), high perceived seriousness (b= 4.48; 95% CI= 1.20 to 7.76; p=0 .007), high perceived susceptibility (b= 3.35; 95% CI= 0.31 to 6.38; p= 0.031), high perceived benefit (b= 3.82; 95% CI =0.49 to 7.16; p= 0.025), high perceived barrier (b= -3.13; 95% CI= -6.10 to -0.16; p= 0.039), and complete facilities (b= 4.97; 95% CI= 0.59 to 9.34; p= 0.026). The variation at the community health center level showed a contextual effect on antenatal care with an intraclass correlation (ICC) = 51.09%. Conclusion: Complete antenatal care is affected by husband support, knowledge, attitude, antenatal information, self-efficacy, cues to action, perceived seriousness, perceived susceptibility, perceived benefits, perceived barriers, complete facilities, and community health center.

Community health centers exist to help their constituents become proactive in addressing their own health care needs and to improve the overall well-being of the community. However, they pose a different set of challenges when implementing an electronic health record system. This article applies 2 project management principles, initiation and early planning, to the electronic health record implementation in a community health center. Issues such as planning, financial considerations, and quality improvement are discussed.

Background: Federally qualified health centers (FQHCs) are implementing innovative interventions to address heightened anxieties of immigrant patients amid changing immigration policies. Purpose: To describe the integration of ''Know Your Rights'' legal rights education in clinic waiting rooms of an FQHC in Los Angeles, California. Methods: This is a qualitative study using key informant interviews, direct field observations, and document review. Results: Collaboration with community health workers and local immigrant-serving community-based and legal organizations was key to intervention design and implementation. Conclusion: Integrating legal education into medical care is one action health centers can take to support immigrant patients, address their complex realities, and optimize patients.

Penelitian ini bertujuan untuk menganalisis pemanfaatan Sistem Informasi Manajemen (SIM) dalam pelayanan kesehatan yang terafiliasi dengan BPJS Kesehatan di Indonesia. Transformasi digital menjadi landasan utama dalam peningkatan efisiensi dan kualitas pelayanan publik, termasuk sektor kesehatan. Dengan menggunakan pendekatan kualitatif deskriptif berbasis studi literatur, penelitian ini mengevaluasi implementasi sistem seperti P-Care, VClaim, Mobile JKN, dan i-Care JKN dalam mendukung pelayanan kesehatan. Hasil penelitian menunjukkan bahwa SIM telah memberikan kontribusi positif terhadap percepatan proses administrasi, peningkatan akurasi pencatatan data, dan transparansi layanan bagi peserta. Namun demikian, tantangan masih dihadapi dalam hal keterbatasan infrastruktur, minimnya pelatihan SDM, dan rendahnya integrasi sistem antar unit layanan. Temuan juga menunjukkan bahwa penerimaan pengguna terhadap Sistem Informasi Manajemen sangat bergantung pada kesiapan organisasi dan literasi digital. Penelitian ini menyarankan perlunya pemerataan infrastruktur digital, pelatihan berkelanjutan, serta pengembangan sistem yang lebih ramah pengguna dan terintegrasi. Dengan dukungan kebijakan yang kuat dan kolaborasi lintas sektor, Sistem Informasi Manajemen memiliki potensi besar dalam memperkuat sistem pelayanan kesehatan nasional.

Community health centers (Puskesmas) is one of the important public health service facilities in Indonesia. Puskesmas serves many patients on performing the examination or treatment in every day. Accumulated medical record data is not utilized to generate new information or knowledge. One existed datamining techniques is the process of grouping an object with unknown label into a class. The C.45 algorithm is used to mine the patients diagnosis data available on 2015 2016. As a result, C4.5 algorithms can be applied for grouping disease. The first test using 85 training data has 78% accuracy level, while the second test of 115 training data reaches 88% accuracy rate.

Indonesia 15.000 kasus baru kanker serviks terjadi setiap tahunnya, sedangkan angka kematiannya 7.500 kasus per-tahun. Pada tahun 2009, kasus baru kanker serviks berjumlah 2.429 (25.91%) dari seluruh kanker yang ditemukan di Indonesia. IVA (Inspeksi Visual dengan Asam asetat) merupakan metode deteksi dini yang dianjurkan oleh pemerintah karena mudah, murah, praktis (dapat dilakukan oleh tenaga kesehatan terlatih) dan sederhana. Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan kejadian lesi prakanker serviks melalui deteksi dini dengan metode IVA di Puskesmas Kecamatan Jatinegara Tahun 2013. Penelitian ini merupakan penelitian kuantitatif dengan desain Case-Control. Data yang diambil adalah data sekunder Puskesmas Kecamatan Jatinegara. Analisis data menggunakan Uji Chi-Square dan Regresi Logistik. Hasil penelitian didapatkan dari 100 responden, 48% diantaranya positif lesi prakanker serviks, 74% berumur ≥ 35 tahun, 68% memiliki paritas <3 kali, 67% berhubungan seksual pertama kali pada umur >20 tahun, 94% memiliki partner sex 1 orang, 96% tidak merokok dan 78% menggunakan pil kontrasepsi <4 tahun. Hasil uji didapat bahwa ada hubungan yang signifikan antara umur responden, paritas, umur seks, jumlah partner sex dan lama penggunaan pil kontrasepsi dengan kejadian lesi prakanker serviks (p<0.05). Variabel utama yang dominan berhubungan dengan kejadian lesi prakanker serviks adalah lama penggunaan pil kontrasepsi, diperoleh nilai p<0.05,OR=42.00(95%CI:5,350-329,723) artinya responden yang menggunakan pil kontrasepsi ≥ 4 tahun mempunyai peluang 42 kali untuk mengalami kejadian lesi prakanker serviks dibandingkan responden yang menggunakan pil kontrasepsi <4 tahun. Perlu digalakkannya penyuluhan dan promosi kesehatan mengenai kanker serviks agar para wanita memeriksakan kesehatan organ reproduksinya secara berkala.

Exclusive Mother&#39;s Milk (ASI) is breast milk that is given to babies from birth to 6 months without providing additional food or replacing it with other foods or drinks, except drugs, vitamins and minerals. Breast milk also contains colostrum which is rich in antibodies, because it contains protein to maintain the baby&#39;s immune system and kills germs in high quantities which can also reduce the risk of death in infants. Umban Sari Public Health Center, Rumbai District, is the area with the lowest coverage percentage, which is 48.5%. The problems found at the Umban Sari Health Center related to this exclusive breastfeeding program are HR/Health Personnel, Facilities and Infrastructure, Funding, Coordination, Counseling and Counseling. The purpose of this study was to determine the implementation of the exclusive breastfeeding program at the Umban Sari Health Center, Rumbai District in 2022. This type of research was a qualitative research with descriptive research methods to ...

Introduction: COVID-19 booster Vaccination is a COVID-19 vaccination after a person has received a full dose of primary vaccination which aims to maintain the level of immunity and extend the period of protection. The COVID-19 booster vaccination is organized by the Government. Objective: Knowing the determinants of community willingness to vaccinate the COVID-19 booster at Pengasinan Health Center in Bekasi City. Method: This type of research was a quantitative study with a cross-sectional study design. Result and Discussion: The results showed that there was a relationship between education (p-value = 0.000), knowledge (pvalue = 0.001), attitude (p-value = 0.000), the role of health workers (p-value = 0.000) and the public's willingness to vaccinate booster COVID-19 and there is no relationship between gender (p-value = 0.174) and the community's willingness to vaccinate the COVID-19 booster at the Pengasinan Health Center in Bekasi City. Conclusions: Education, knowledge, attitudes and the role of health workers are related to the community's willingness to vaccinate the COVID-19 booster at Pengasinan Public Health Center in Bekasi City.

Transgender and Gender Diverse (TGD) individuals face unique healthcare challenges, including increased cancer burden, systemic barriers to care and limited reported data in scientific literature. In dermatology and particularly in dermato-oncology, TGD populations remain notably underrepresented. This case series aims to contribute to the limited body of literature by describing melanoma incidence and treatment patterns among TGD individuals within a large, integrated health system. We conducted a retrospective review of the Kaiser Permanente Northern California Regional Cancer Registry to identify TGD patients diagnosed with cutaneous melanoma between January 1, 2018 and December 31, 2022. Medical records were reviewed for demographic data, gender identity, Gender-Affirming Hormone Therapy (GAHT) use, melanoma features and treatment timelines. Among 6,456 identified TGD individuals, only six (four transfeminine, two transmasculine) were diagnosed with a total of eight melanomas (four in situ, four pT1a). All were Stage Ia or lower, with no evidence of regional or distant spread. Five patients had a history of GAHT, with an average estradiol duration of 13.75 years. Notably, a transfeminine patient on long-term estradiol and progesterone developed three melanomas over four years. Time to surgical excision ranged from 11 to 49 days (mean 24), aligning with institutional averages for cisgender patients. This study offers an early contribution to understanding melanoma in TGD populations and highlights the importance of documenting care patterns in a group with historically limited representation. Our findings suggest that, within an insured and integrated care system, TGD patients may receive timely, guideline-concordant melanoma treatment. Still, further work is urgently needed to evaluate risk factors, explore the role of GAHT and amplify TGD voices to inform inclusive dermatologic oncology care.

Degree of thinking process affect student achievement. Measurement of the degree of thinking process with Polya is expected to obtain knowledge in the form of students thinking level abilities. Data collection of respondent used purposive sampling and snowball. The data then analyzed based on Polya. This study concluded that 10th-grade science students completely reach all four Polya.

Melihat rendahnya cakupan ASI Ekslusif di wilayah Kota Magelang peneliti ingin melihat seberapa besar dukungan suami terhadap istri yang sedang menyusui. Penelitian ini bertujuan untuk mengetahui dukungan suami terhadap pemberian ASI Eksklusif pada ibu menyusui di wilayah Kramat utara Magelang Utara. Dengan menggunakan rancangan penelitian studi fenomenologi yang merupakan suatu pendekatan untuk menggali pengalaman hidup dari individu. Jumlah responden dalam penelitian ini enam responden. Dalam penelitian ini, dilakukan menjadi 3 proses; intuiting, analyzing dan describing. Penggalian data pada penelitian ini adalah dengan melakukan wawancara dengan suami secara mendalam. Selama proses wawancara peneliti akan menggunakan alat perekam berupa Mp4, dan peneliti meminta ijin bahwa selama wawancara akan direkam. Tahap awal penelitian ini dimulai dengan membina hubungan saling percaya dengan keluarga, peneliti menggali data dengan cara wawancara, hasil wawancara akan dibentuk transkrip da...

The quality of service does not only involve physical recovery but also concerns satisfaction with the attitude, knowledge and skills of staff in providing services as well as the availability of adequate facilities and infrastructure at the Community Health Center (Hartawan et al., 2018). Standards of pharmaceutical services at community health centers, counseling and providing drug information (PIO) is one of the jobs of pharmacists at community health centers. Providing pharmaceutical services, pharmacists can identify and overcome drug-related problems, empower patients to implement positive behavioral management, increase patient satisfaction, and can optimize the quality of patient care. The level of patient satisfaction is the patient's feeling that arises from the performance of health services obtained after comparing it with what is felt. The level of patient satisfaction is viewed from five Servqual dimensions, namely the reliability dimension, which is the ability to provide services that satisfy patients. The responsiveness dimension is the ability to help patients and fulfill their requests. The assurance dimension is the ability to create trust and a sense of security. The empathy dimension is personal attention to consumers. The tangible dimension is physical facilities and equipment. (Kevin, 2016). The general objective of this research is to analyze the level of community service satisfaction at the pharmacy unit health service facility at the Pengadang Community Health Center, Central Lombok Regency. The method used in this research is a descriptive survey method which collects data using a questionnaire that has been tested on pharmacy visitors/patients incidentally or momentarily on patients who visit the pharmacy unit, and/or have visited and received health services from the pharmacy unit at the Community Health Center. Central Lombok Regency Roadblocks in 2023, through direct interviews by filling out a questionnaire. The population in this study is based on the number of outpatient and inpatient visitors to the Pengadang Community Health Center, Central Lombok Regency in 2023, based on initial observations at the Pengadang Community Health Center of 770 patients. The total sample (Slovin) was 88 respondents. The conclusion of this research is that the level of service satisfaction in the reliability dimension is 79.05% in the satisfied category, the level of service satisfaction in the responsiveness dimension is 75.65% in the satisfied category, the level of service satisfaction in the guarantee dimension is 84.1% in the very satisfied category, the level of service satisfaction Empathetically it was 85.77% in the very satisfied category, the level of service satisfaction in appearance was 64.42% in the satisfied category. Analysis of the Level of Community Service Satisfaction in the Pharmacy Unit Health Service Facilities at the Pengadang Community Health Center, Central Lombok Regency in 2023, with an average value of 77.79% in the satisfied category. Recommendations for good service are maintained and improved.

The implementation of this Kuliah Kerja Mahasiswa (KKM) is part of the students' concern to participate in efforts to improve the health of residents through free examinations and treatment as well as education on the use of medicines, especially cholesterol, uric acid, and blood sugar drugs, KKM partners are local adults and elderly residents in Sasagaran Village. The KKM implementation method applies an observation approach, socialization, stages of activity implementation and evaluation. Implementation of KKM activities The activity begins with the provision of socialization and education which begins with an announcement by local cadres, interactive lectures, followed by free examinations and treatment. The output of the activity, health checks can provide information about normal blood glucose levels of elderly residents and the potential risk of diabetes, as well as increase awareness of signs of diabetes.

Background-Enhancing the capability of community health centers to implement best practices may mitigate health disparities. We investigated the association of Practice Adaptive Reserve (PAR) to implementation of Patient Centered Medical Home (PCMH) colorectal cancer (CRC) screening best practices (BPs) at community health center clinics in seven states. Methods-A convenience sample of clinic staff participated in a self-administered online survey. We scored eight PCMH CRC screening BPs as a composite ranging from 0-32. The PAR composite score was scaled from 0 to 1 then categorized into three levels. Multilevel analyses examined the relationship between PAR and self-reported implementation of the PCMH BPs.

Human papillomavirus (HPV) vaccination continues to lag behind other adolescent vaccines, especially in areas with pervasive disparities in HPV-related cancers. The purpose of this study was to examine HPV vaccine completion and dosing intervals among low-income adolescents in urban areas. The study included electronic health record data on HPV vaccination for 872 adolescents who received at least one dose of the HPV vaccine. Only 28.4 % completed the 3-dose series. For the whole sample, HPV vaccine completion was higher for non-English speakers and among adolescents seen at Newark-South and East Orange sites. Completion was higher among non-English speaking female and Hispanic adolescents, females seen in Newark-South and East Orange sites, and insured Black adolescents. Completion was also dramatically lower among non-English speaking Black adolescents seen at Newark-North, Irvington, and Orange sites (12.5 %) compared to other Black adolescents (22.0-44.4 %). The mean dosing inte...

The implementation of health protocols in the community has decreased after the decline in Covid-19 cases globally, especially in Indonesia. People assume that they will be immune to the virus after being vaccinated, and the President's discourse that people can already take off their masks outside the room, resulting in decreased public compliance in implementing health protocols. This study aimed to analyze factors related to community compliance in implementing the Covid-19 post-vaccination health protocol at the Matiti Health Center, Humbang Hasundutan Regency in 2022. The cross-sectional method was used in the study design. Data collection was in the form of primary data by giving questionnaires to the public who visited the Maititi Health Center with a total sample of 237 people using accidental sampling. The results of the bivariate analysis show that the variables age, education, knowledge, attitudes and availability of Covid-19 prevention facilities and infrastructure are related to community compliance in implementing health protocols after Covid-19 vaccination. It can be concluded that the dominant variables related to community compliance in implementing the post-vaccination Covid-19 health protocol are education and the availability of Covid-19 prevention facilities and infrastructure.

Background: Malnutrition early in life can result in growth failure. Several efforts to improve malnutrition include giving only breast milk to babies from birth to 6 months of age. Most babies who receive exclusive breast milk have good nutritional status compared to babies who do not receive exclusive breast milk. Research Objective: To determine the relationship between the duration of breastfeeding and the nutritional status of 6 month old babies in the Karanganom Klaten Community Health Center working area. Methods: Quantitative research type with an analytical observational design with a cross sectional design. Samples were taken using purposive sampling as many as 52 babies aged 6 months. Data analysis using the Spearman rank correlation test at a significance level of 0.05. Results: The duration of breastfeeding alone for babies up to 6 months of age is presented in table 4.1. while the nutritional status of babies up to 6 months of age is in table 4.2. The relationship between the duration of breastfeeding and the nutritional status of babies aged 6 months with a correlation of 0.797, p value 0.000. There is a significant relationship between the duration of breastfeeding with the nutritional status of 6 month old babies in the Karanganom Klaten Community Health Center working area.