Sudibyo Supardi

PENGGUNAAN OBAT TRADISIONAL DALAM UPAYA PENGOBATAN SENDIRI DI INDONESIA (ANALISIS DATA SUSENAS TAHUN 2007)

Abstrak, Penelitian dilakukan pada tahun 2005, di empat pulau Kepulauan Seribu yaitu P.Pari, P. Karya, P. Untung Jawa dan P.Tidung. Penelitian bertujuan untuk mengetahui jenis dan fungsi tumbuhan liar dan tumbuhan budidaya di Kepulauan Seribu. Pengumpulan data dilakukan dengan metode plot atau petak cuplikan. Pengukuran keanekaragaman tumbuhan menggunakan metode sampling. Tumbuhan liar terdapat di P. Pari, P. Karya, P. Untung Jawa dan P.Tidung. Tumbuhan liar ditemukan sebanyak 52 spesies, yang berguna sebagai bahan baku obat sekitar 60%; bahan baku insektisida sekitar 20%; bahan kayu bakar dan tanaman hias 4%, tanaman peneduh 8%; sebagai perabot rumah tangga 6%, sebagai makanan ternak 6%, penangkap ikan 6% dan yang belum diketahui kegunaannya 20%. Tanaman budidaya ada 22 jenis, terdapat di P.Pari, P. Karya, P. Untung Jawa dan P. Tidung, dan 60% diantaranya tanaman buah-buahan. Kata Kunci: Tumbuhan Liar, Tumbuhan Budidaya, Keanekaragaman Tumbuhan

PENGOBATAN SENDIRI YANG SESUAI DENGAN ATURAN PADA IBU-IBU DI JAWA BARAT

KEADAAN GIZl ANAK BALITA Dl WILAYAH BOGOR, TANGERANG DAN BEKASI (BOTABEK) SELAMA KRlSIS EKONOMI

PENGARUH METODE CERAMAH DAN MEDIA LEAFLET TERHADAP PERILAKU PENGOBATAN SENDIRI YANG SESUAI DENGAN ATURAN

UJ1 COBA DEC-GARAM UNTUK PEMBERANTASAN FILARIASIS DI JAMBI, KALIMANTAN SELATAN DAN SULAWESI TENGAH

Hubungan Pengetahuan dan Sikap dengan Kepatuhan Berobat pada Pasien TB Paru yang Rawat Jalan di Jakarta Tahun 2014

800x600 Normal 0 false false false IN X-NONE X-NONE Pulmonary tuberculosis is an infectious disease caused by the Mycrobacterium tuberculosis. Pulmonary TB cure rate in certain areas in Indonesia is still low.The research objective was to determine the relationship between knowledge, attitudes and compliance outpatient pulmonary tuberculosis in 5 regional public hospitals in Jakarta. This study used a cross-sectional design with each of the 10 samples in each of regional public hospital in Jakarta. The inclusion criteria were adult patients with TB category I observed during 7-8 months. Collecting data using questionnaires and medical records of the patients, and data analysis using Chi Square test. Conclusion of the study shows that the rate of72,7% adherence to treatment. There is no significant relationship between knowledge, attitudes and compliance of out patient pulmonary tuberculosis patients (p > 0.05). Keywords: knowledge, attitudes, compliance, pulmonary tuberculosis, outpatient hospital Abstrak Tuberkulosis paru adalah suatu penyakit menular yang disebabkan oleh kuman Mycrobacterium tuberkulosis. Angka kesembuhan TB paru di daerah tertentu di Indonesia masih rendah. Tujuan penelitian adalah untuk mengetahui hubungan antara pengetahuan, sikap dan kepatuhan berobat jalan pasien TBparu di 5 RSUD Jakarta. Penelitian ini menggunakan desain cross sectional dengan masing-masing 10 sampel di setiap RSUD Kota Jakarta. Kriteria inklusi adalah pasien dewasa TB paru kategori I yang diobservasi selama 7-8 bulan. Pengumpulan data menggunakan kuesioner dan kartu rekam medik pasien, dan analisis data menggunakan uji Chi Square. Kesimpulan penelitian menunjukkan bahwa angka kepatuhan berobat sebesar 72,7%. Tidak ada hubungan yang signifikan antara pengetahuan, sikap dan kepatuhan berobat jalan pasien TB paru (p > 0,05). Kata Kunci: pengetahuan, sikap, kepatuhan, TB paru, pasien rawat jalan RS

Human Resources and Vaccine Management at Provincial Health Office, District/City Health Office and Primary Health Centre

ABSTRAK Latar Belakang:Status kesehatan ibu dan anak di Indonesia sampai saat ini masih harus menjadi perhatian karena angka kematian ibu dan angka kematian bayi yang masih tinggi. Rendahnya kesadaran masyarakat akan pelayanan kesehatan oleh tenaga kesehatan yang terampil merupakan faktor yang perlu diperhatikan dalam menangani persoalan tersebut. Penelitian ini bertujuan untuk mengetahui trend pemanfaatan tenaga kesehatan penolong kelahiran di Indonesia tahun 2001–2007. Metode: Analisis menggunakan data Survey Sosial Ekonomi Nasional (Susenas) Kor tahun 2001, 2004 dan 2007. Disain penelitian menggunakan disain Cross Sectional. Ruang lingkup wilayah penelitian meliputi seluruh provinsi di Indonesia. Hasil:penelitian menunjukkan bahwa dalam kurun waktu tujuh tahun (2001–2007), pola pemanfaatan penolong kelahiran di Indonesia menunjukkan kecenderungan penggunaan tenaga kesehatan (dokter dan bidan) sebagai penolong kelahiran Hasil analisis bivariat pada faktor kepulauan, pendidikan ibu, usia ibu, kepemilikan jaminan pembiayaan/asuransi kesehatan, dan sosial ekonomi terhadap klasifikasi desa/kota ikut berperan dalam pemilihan tenaga persalinan. Saran:mengupayakan kerja sama lintas sektor untuk meningkatkan taraf hidup masyarakat serta perbaikan akses pelayanan kesehatan di perdesaan akan sangat bermanfaat bagi masyarakat. Kata kunci: penolong kelahiran, dokter, bidan, dukun bayi ABSTRACT Background:The health status of mothers and children in Indonesia is still need special attention of concern because maternal and infant mortality rates are still high. The low public awareness of health services by trained health worker is a factor to consider in addressing these issues. This study aims to determine the trends in the use of maternal health services in Indonesia in 2001–2007. Methods:This analysis used National Socio-Economic Survey (NSES) Core 2001, 2004 and 2007. The design of NSES was descriptive cross sectional cover all provinces in Indonesia as the sample. Result:The study shows that in seven years period (2001–2007), skilled health providers (doctors and midwives) are commonly reported as the source of antenatal care. The result showed bivariate analysis from type of residence (urban/rural) toward the islands, maternal education, maternal age group, ownership of health insurance, and the socioeconomic played a role in the selection of delivery attendant. Recommendation: Developing cross sectoral cooperation to improvepeople’s lives as well as improved access to health services in rural areas should be very beneficial to the community. Key words: birth attendants, doctors, midwives, traditional birth attendantsABSTRAK Latar Belakang:Klinik swasta di provinsi Bali banyak melayani wisatawan, seharusnya hal tersebut menjadi tanggung jawab pemerintah. Di sisi lain kelayakan Puskesmas Wisata Pantai berdasar ketersediaan sarana dan prasarana termasuk sumber daya manusia dengan pelayanan kesehatan yang tersedia belum diketahui dengan rinci. Analisis ini ingin membandingkan kelayakan Puskesmas Wisata Pantai (PWP) dan Puskesmas Non-Wisata Pantai (PNWP) di Provinsi Bali. Metode:Data diperoleh dari data sekunder Riset Fasilitas Kesehatan (Rifaskes 2011) semua Puskesmas di Provinsi Bali. Dibedakan antara Puskesmas Wisata Pantai dan Puskesmas Non Wisata Pantai, jumlah sampel Puskesmas yang dianalisis sebanyak 114 buah Puskesmas. Variabel penelitian terdiri dari sarana, prasarana, sumber daya manusia serta program pelayanan kesehatan. Analisis dilakukan dengan memberikan nilai (bobot) dari masing-masing variabel, selanjutnya dilakukan skoring masing-masing variabel baik pada Puskesmas Wisata Pantai maupun Puskesmas Non Wisata Pantai. Distribusi hasil perkalian antara nilai (bobot) dengan skor digunakan untuk mengetahui kelayakan dari masing-masing variabel dengan cara menghitung rerata (x) dan standar deviasi (SD). Perbandingan Puskesmas Wisata Pantai dan Puskesmas Non Wisata Pantai dilakukan dengan membedakan rerata (x) masing-masing puskesmas dengan menggunakan uji beda t-test. Hasil:Tidak ada perbedaan kelayakan antara Puskesmas Wisata Pantai dengan Puskesmas Non Wisata Pantai berdasarkan ketersediaan sarana, prasarana, sumber daya manusia dan pelayanan kesehatan (p > 0,05). Saran: Disarankan puskesmas menambah kelengkapan dan manajemen yang sesuai untuk memenuhi sebuah Puskesmas untuk wisata. Serta bekerja sama dengan klinik swasta tetapi tetap memantau pelayanan dan kasus yang terjadi mengingat wilayah tersebut menjadi tanggung jawab Puskesmas. Kata kunci: kelayakan, Puskesmas Wisata, Puskesmas Non-Wisata, Provinsi Bali ABSTRACT Background: Many private clinics in the Province of Bali service tourists. It should be the responsibility of the government. On the other hand the feasibility of health centers (HC) based on the availability of coastal tourism facilities and infrastructure, including human resources available to the health service is not clear. This study compared the feasibility of health centers shore excursions and non touristic beach health centers in Bali Province. Methods:Secondary data Healthcare Research Facility (Rifaskes 2011) all health centers in the Province of Bali. The number of samples are 114 health centers. Variabels consisted of facilities, infrastructure, human resources and health programs. The analysis is done by giving the value (weight) of each variabel, then performed the scoring of each variabel both in Beach Tourist and Non Tourist Health Centers. Distribution of of the multiplication of the value with a score used to determine the feasibility of each variabel by calculating the mean (x) and standart deviation (SD). Comparison of eligibility of Health Centers by differentiating the mean (x) of each health center using different test (t test). Result: There is no difference in viability between Tourist and Non Tourist Beach the shore excursions based on the availability of facilities, infrastructure, human resources and health services (p > 0.05). Recomendation: Suggested health centers increase the completeness and appropriate management to be a Health Centers for Tourist, and cooperation with private clinics, the has to monitor the services and the due to cases HC responsibility. Key words: feasibility, Tourist Health Centers, Health Centers Non Tourist, Bali ProvinceABSTRAK. Latar Belakang: Kabupaten Manggarai Barat dalam periode Januari sampai dengan Juli 2012 jumlah kematian bayi 34 kasus, Bayi lahir mati 33 kasus dan kematian ibu 9 kasus. Tujuan tulisan ini yaitu ingin menggambarkan penyebab kematian ibu, bayi, balita dan gizi buruk. Metode: Penelitian merupakan studi kualitatif di kabupaten Manggarai Barat Pada tahun 2012. Penelitian dilaksanakan di Puskesmas Wainakeng dan Labuan Bajo. Pengumpulan data secara Focus Group Discussion dengan Kepala Puskesmas, bidan desa, pengelola program gizi dan seksi KIA pada dinas kesehatan. Hasil: Penyebab kematian ibu dan bayi di wilayah kerja Puskesmas Labuan Bajo disebabkan oleh karena ibu mengalami kekurangan gizi, penyakit infeksi seperti malaria dan tipus. Perhatian ibu terhadap bayi kurang dan akses terhadap pelayanan kesehatan sulit. Permasalahan tersebut harus diatasi dengan cara ibu hamil memeriksakan kesehatan secara rutin, pemakaian kelambu, perlu penyediaan perahu motor dengan operasional lebih murah. Penyebab gizi buruk dan gizi kurang adalah pengetahuan, pola asuh dan kemiskinan serta penyakit infeksi seperti diare dan malaria, diatasi oleh bidan dengan cara proaktif memberikan konseling kepada keluarga yang mempunyai balita gizi buruk. Kematian ibu di wilayah kerja Puskesmas Winakeng disebabkan oleh beberapa factor tidak tersedianya rumah sakit di Kabupaten, masih terdapat ibu hamil yang memeriksakan kehamilannya ke dukun, pelaksanaan Perda yang mengatur tentang ibu hamil kurang tegas dan keluarga sering terlambat dalam pengambilan keputusan untuk dirujuk. Cara mengatasinya adalah petugas harus lebih aktif memberikan konseling kepada ibu hamil dan melakukan pendekatan dengan lintas sektor dalam memonitoring ibu hamil. Masalah gizi disebabkan terutama karena pola asuh, penyakit infeksi seperti malaria tipes dan diare dan asupan makan yang bergizi kurang. Kesimpulan: kematian ibu dan bayi disebabkan oleh ibu mengalami gizi buruk, akses terhadap pelayanan kesehatan yang sulit, ibu hamil yang memeriksa ke dukun dan tidak tersedianya rumah sakit di kabupaten serta penyakit infeksi malaria dan diare. Solusinya adalah bidang harus aktif dengan melibatkan kepala desa dalam memantau ibu hamil, perlu disediakan perahu motor dan pembangunan rumah sakit daerah. Kata kunci: kematian ibu dan anak, Manggarai Barat ABSTRACT Background: West Manggarai district in period January until July 2012. Infant mortality rate were 34 cases, stillbirths were 33 cases and maternal mortality rate was 9 cases. Methods:This research is qualitative study using Focus Group Discussion (FGD) desain, cooperation with head of public health center, midwife, nutrition program manager, and public health at health department. Results:Maternal and infant mortality in Labuan Bajo public health center caused by maternal nutritional deficiency, infectious diseases such as malaria and typhoid fever, mother less attention to the baby when the baby’s ill and difficult access to health services. The problem solution is pregnant women should be regularly having antenathal care, using of mosquito nets. Need to be provided cheaper sea transport. Causes of malnutrition and undernourishment is knowledge, parenting skill and infectious diseases such as diarrhea and malaria. To overcome this problem midwife should be proactive giving counseling to families with malnutrition children under five. Maternal and infant mortality in Winekang public health center caused by not availability of hospital at district, pregnant women still seeking treatment to traditional healers, the implementation of government regulations are less strict and families often late in taking decision to be referred. The solution is health officers must always giving counseling to pregnant women and cross-sector approach to monitoring. Whereas the main cause nutritional problems is parenting behavior, infectious diseases, and not enough healthy food. Conclusion:Maternal and infant mortality caused by difficult access to health services, there are pregnant womens who go to traditional healers, not availability of hospitals in the district, also infectious diseases likes malaria and diarrhea. The solution is the midwife must active involving the village and subdistrict heads in monitoring pregnant women, need to provide a boat and build district hospital Key words: determinants, of maternal and child health, west ManggaraiABSTRAK Latar Belakang:Buku KIA salah satu alat deteksi dini risiko tinggi ibu hamil. Cakupan deteksi dini risiko tinggi tahun 2011 dan 2012 di Kabupaten Bangkalan masih di bawah target yaitu 12%. Berdasarkan SDKI 2012 rata-rata angka kematian ibu (AKI) tercatat mencapai 359 per 100 ribu kelahiran hidup. Rata-rata kematian ini jauh melonjak dibanding hasil SDKI 2007 yang mencapai 228 per 100 ribu. Tujuan penelitian:Mengetahui motivasi bidan, beban kerja, dan bidan terlatih dalam kelengkapan pengisian buku KIA. Metode: Penelitian observasional, desain crossectional. Pengumpulan data kuantitatif dan kualitatif. Data sekunder diperoleh dari ketersediaan buku KIA, pelatihan, pembinaan bidan dan kelengkapan pengisian buku KIA pada ibu hamil dan ibu bayi yang baik pengisiannya di Puskesmas Kedundung, Kabupaten Bangkalan. Sampel bidan yang menjalankan tugas di puskesmas lebih dari 1 tahun keatas dan pendidikan minimal DIII Kebidanan. Kelengkapan pengisian buku KIA dilihat pada lembar isian identitas keluarga, menyambut persalinan, catatan kesehatan ibu hamil, catatan kesehatan ibu bersalin, catatan kesehatan ibu nifas, keterangan lahir, KMS, pemeriksaan neonatus, catatan kesehatan anak, pemberian vitamin A. Hasil: Kelengkapan pengisian buku KIA pada ibu hamil dan ibu bayi yang baik pengisiannya di Puskesmas Geger yaitu 0,66 (kategori baik adalah 0,51–1,00). Puskesmas Kedundung kurang baik yaitu 0,34 (kategori kurang baik 0,00–0,50). Motivasi bidan di Puskesmas Geger sebagian besar motivasinya kurang (50,0%), beban kerja selama ini berat (83,3%). Di Puskesmas Kedundung sebagian besar bidan motivasi baik (66,7%) danbeban kerja tidak berat atau kurang berat. Pelatihan bidan dalam 2 tahun terakhir ini tidak pernah mengikuti atau diadakan pelatihan tentang pengisian buku KIA oleh Dinas Kesehatan maupun oleh Puskesmas. Saran: Puskesmas agar membentuk tim kerja tingkat puskesmas sesuai program yang dijalankan untuk meringankan beban kerja bidan. Kepada Dinas Kesehatan Kabupaten Bangkalan agar memberikan penghargaan bagi bidan yang berprestasi. Kata kunci: Kelengkapan Pengisian Buku KIA, Deteksi Dini Risiko Tinggi, Ibu Hamil ABSTRACT Background:MCH book is a tool for early detection for vulnerable gravida. Meanwhile, the utilization of MCH book was still low. The target achieved for early detection was 12% out of 20% from 2011 to 2012. Based on SDKI 2012 duka, the average maternal mortality rate reached 359 per 100.000 live births, increased significantly from the data of SDKI 2007 which reached 228 per 100.000 live births. Methods:This study was observational with cross sectional design. Both quantitative and qualitative data were collected. Secondary data were collected by the availability of MCH book, midwives training, supervisions, and complete fulfillment of MCH book. Populations in Puskesmas Kedundung and Puskesmas Geger Bangkalan District. The samples were midwives with more than one year working and graduated from DIII (diploma). The complete fulfillment of MCH book was identified from family identity, delivery preparation, gravida medical record, antenatal medical record, postnatal medical record, KMS (Booklet to Infant Nutritional Status Detection), Neonatus medical record, infant medical record, vitamin A supplementary. Result: The complete fulfillments were in Puskesmas Geger 0.66 (category: good 0.51–1.00) and Puskesmas Kedundung 0.35 (category: low 0.00–0.50). Midwives’ Motivations were low (50.0%) and midwives workload were high (66.7%) at Puskesmas Geger. Midwives were highly motivated (66.7%) and their workloads are fair. Recomendation: make group of work and allocate the job description properly to assist midwives workload. In addition, health office of Bangkalan should give reward to those who do the work excellently. Key words: complete fulfilment of MCH book, early detection of highrisk pregnancy, pregnant womenABSTRAK Latar Belakang: Pelayanan kesehatan adalah salah satu tempat kerja di mana risiko tertular TB lebih tinggi dibandingkan dengan populasi umum. Penelitian ini bertujuan menganalisis TB paru pada pekerja Puskesmas di enam kabupaten/kota di Indonesia. Metode: Penelitian dilakukan secara potong lintang, melibatkan 509 pekerja yang bertugas di 50 Puskesmas (Puskesmas rujukan mikroskopis dan Puskesmas pelaksana mandiri) di 6 kabupaten/kota di 3 Provinsi. Data TB paru dalam 12 bulan terakhir berdasarkan diagnosis tenaga kesehatan diperoleh dari wawancara. Hasil pemeriksaan spesimen dahak SPS yang dilakukan di laboratorium Puskesmas dan dikonfirmasi oleh 2 laboratorium rujukan. Hasil: Dua dari 509 responden (0,39%) menderita TB paru dalam 12 bulan yang lalu berdasarkan diagnosis tenaga kesehatan dan satu di antaranya masih dalam pengobatan TB. Semua responden tidak ada yang menderita TB paru aktif (hasil sediaan apus negatif). Kemungkinan ada hubungan nya dengan pekerjaan belum dapat disingkirkan. Kesimpulan: Pekerja Puskesmas berpotensi tertular TB paru. Peningkatan pengetahuan tentang penularan TB dan pencegahannya perlu diberikan kepada Pekerja puskesmas. Kata kunci: TB paru, pekerja pelayanan kesehatan, Puskesmas ABSTRACT Background: Health care is one of the workplaces with a higher risk of TB than the general population. This study aims to analyze pulmonary TB on PHC workers in six districts/cities in Indonesia.Methods: A cross sectional study was conducted, involving 509 workers, in 50 health centers (PHC referral microscopic and PHC self- executing) of 6 districts/cities of 3 provinces. Data pulmonary tuberculosis in the last 12 months based on diagnose by health professionals was collected. Sputum specimen examination conducted in the laboratory Primary Health Center and confirmed with two referent laboratories. Results: Two of the 509 respondents (0.39%) had been diagnosed pulmonary tuberculosis by health workers since 12 months ago and one of them is still in the treatment of tuberculosis. All respondents have no active pulmonary tuberculosis (smear negative results). The relationship of the disease and work can not be ruled out. Conclusion: Workers PHC potentially infected by pulmonary tuberculosis. Increased knowledge about TB transmission and prevention needs to be given to the health center workers. Key words: pulmonary tuberculosis, health care workers, primary health centerABSTRAK Latar Belakang: Angka kematian ibu di Indonesia saat ini masih cukup tinggi dan sangat bervariasi di tingkat provinsi. Provinsi Jawa Barat (Jabar) merupakan penyumbang kematian ibu terbesar yaitu 19,8%, sedangkan yang relatif kecil adalah Provinsi Daerah Istimewa Yogyakarta (DIY) yaitu 1,1%. Mencegah anemia pada ibu hamil dengan minum tablet besi ≥ 90 selama hamil diharapkan mampu menekan kematian ibu akibat perdarahan. Tujuan: Membandingkan pemberian tablet zat besi oleh tenaga kesehatan dan kepatuhan ibu hamil mengonsumsinya, di daerah kumuh perkotaan di Provinsi Jabar dan DIY. Metode: Penelitian ini merupakan analisis lanjut objek dengan sampel dari data hasil Riskesdas 2010. Hasil: Berdasarkan karakteristik, sebagian besar ibu di Provinsi DIY berpendidikan tingkat menengah, bekerja sebagai wiraswasta/tani/nelayan/buruh. Sedangkan di Provinsi Jabar, sebagian besar hanya berpendidikan rendah dan tidak memiliki pekerjaan. Jumlah kepemilikan asuransi kesehatan di Provinsi DIY relatif lebih banyak dibanding di Provinsi jabar. Berdasarkan cakupan pemberian tablet zat besi, tampak bahwa sebagian besar ibu di Provinsi Jabar maupun DIY mendapatkan tablet zat besi selama kehamilannya (84,7% vs 96,0%). Kondisi ini jauh berbeda ketika dilihat dari persentase ibu hamil yang mengonsumsi tablet zat besi minimal 90 tablet. Terlihat bahwa ibu hamil yang mengonsumsi tablet zat besi ≥ 90 di Provinsi Jabar hanya 12,6% saja. Sebaliknya di Provinsi DIY, konsumsi tablet zat besi ≥ 90 persentasenya cukup tinggi yaitu mencapai 60,0%. Kesimpulan: Cakupan pemberian tablet zat besi di kedua provinsi relatif cukup baik, namun konsumsi tablet zat besi ≥ 90 tablet di Provinsi DIY relatif lebih baik dibanding di Provinsi di Jabar. Saran: disarankan pemerintah Provinsi Jabar melakukan promosi dan penyuluhan yang lebih gencar melalui berbagai media serta melakukan terobosan, misalnya dengan menunjuk orang terdekat dari si ibu hamil untuk menjadi pengawas dan motivator bagi ibu hamil supaya bersedia mengonsumsi tablet zat besi ≥ 90 tablet selama kehamilannya. Kata kunci: Tablet zat besi, kumuh perkotaan, Jabar, DIY ABSTRACT Background:The maternal mortality rate in Indonesia is still quite high. At the provincial level, the maternal mortality vary widely. West Java Province is the largest contributor to maternal mortality with the estimated number 19.8% of all maternal deaths in Indonesia. While the province of Yogyakarta contribution is relatively small (1.1%). Objective:To compare the provision of iron tablets by health workers and pregnant women compliance consume, in urban slums in West Java Province and Yogyakarta. Methods:This study describes and analyzes object that is obtained from the Riskesdas 2010. Results:Based on the characteristics, the majority of mothers in the province of Yogyakarta are in middle education level, working as a self employed/farmer/fisherman/laborer. Meanwhile, in West Java province, mostly just poorly educated and do not have a job. Total ownership of health insurance in the province of Yogyakarta relatively more than in the province of West Java. Based on the scope of the giving of iron tablets, it appears that most of the mothers in the province of West Java and Yogyakarta get iron tablets during pregnancy (84.7% vs 96.0%). However, this condition is much different when viewed from the percentage of pregnant women who consumed at least 90 tablets of iron tablets. Seen that pregnant women who consumed iron tablets ≥ 90 in West Java province only 12.6 percent. By contrast, in the province of Yogyakarta, the consumption of iron tablets ≥ 90 percentage is quite high, reaching 60.0%. Conclusion:Coverage giving iron tablets in both provinces relatively good. However, the consumption of iron tablets ≥ 90 tablets in Yogyakarta Province is relatively better than in West Java Province. Recomendations:It is suggested for the provincial government of West Java and other areas for the promotion and extension through various media as well as to the to make a breakthrough, such as pointing person the closest of the pregnant mother for to be a supervisor and motivator for willing consume iron tablets during pregnancy ≥ 90 tablets . Key words: Iron tablets, urban slums, West Java, Yogyakarta

HUBUNGAN KETERSEDIAAN TENAGA KEFARMASIAN DENGAN KARAKTERISTIK PUSKESMAS DAN PRAKTIK KEFARMASIAN DI PUSKESMAS

Latar Belakang: Hipertensi merupakan masalah utama dalam kesehatan masyarakat baik di negara maju maupun di negara sedang berkembang. Mengingat komplikasi yang ditimbulkan hipertensi ini sangat besar, maka penyakit iniperlu dikontrol atau dikendalikan. Tujuan: penelitian ini adalah untuk mengetahui insiden hipertensi dan faktor risiko yang berkaitan dengan hipertensi. Metode: Desain penelitian adalah kohor prospektif yang dilakukan pada responden umur 25-65 tahun sebanyak 1311 orang di Kelurahan Kebon Kalapa, Kota Bogor tahun 2012. Semua responden telahbebas dari penyakit hipertensi dan toleransi glukosa terganggu (TGT), kemudian dilakukan follow-up pengukuran tekanan darah setiap kwartalan (3 kali) dalam satu tahun. Variabel dependen (kasus baru) adalah responden yang didiagnosis hipertensi 2 kali dari 3 kali pemeriksaan dalam periode waktu follow up. Variabel independen meliputi faktor demografi (jenis kelamin, umur, pendidikan), status gizi dan obesitas abdominal, perilaku (merokok, aktifi tas fi sik dan stres) danstatus TGT (Toleransi Glukosa Terganggu). Data dianalisis dengan uji regresi logistik. Hasil: Hasil penelitian menunjukkan bahwa insiden hipertensi yang muncul dalam periode satu tahun (2012) di Kota Bogor sebesar 16,8%. Faktor risiko yang berhubungan dengan kejadian hipertensi meliputi umur, pendidikan (rendah dan menengah), status gizi (berat badan berlebih dan obese) dan stres. Kesimpulan dan saran: Perlu dilakukan pengendalian hipertensi melalui penurunan berat badan (pencegahan obesitas), meningkatkan pengetahuan (pencegahan maupun akibat yang ditimbulkan penyakit hipertensi) dan mengendalikan stres.Latar belakang: Melalui iklan, Sarana Pengobatan Tradisional (SPT) seringkali memberikan berbagai janji menggiurkan kepada pasien, antara lain kepastian kesembuhan, tanpa efek samping, tenaga berpengalaman, resep eksklusif, dan kesaksian pasien yang sembuh. Iklan dengan janji yang masih diragukan kebenarannya ini mungkin turut berperan dalam kecenderungan masyarakat beralih ke SPT, bahkan ada dugaan terjadinya pelanggaran periklanan SPT. Kajian ini bertujuan mencermati karakteristik iklan di surat kabar dan kebijakan terkait iklan pengobatan tradisional. Karakteristik iklan diambil melalui iklan yang dimuat di surat kabar lokal kota Surabaya dan Jakarta. Metode: Kajian dilaksanakan tahun 2012, merupakan penelitian deskriptif analitik, rancangan cross-sectional, dan pendekatan metode kualitatif. Hasil: Hasil penelitian menunjukkan bahwa ditemukan pelanggaran di hampir semua iklan dengan karakteristik yang hampir serupa walaupun kebijakan terkait iklan sudah cukup banyak keberadaannya. Disarankan agar ada kerja sama secara multisektoral untuk terlibat dalam lembaga sensor iklan, perlu payung hukum di tingkat Provinsi dan kabupaten/kota dalam menindak pelanggaran iklan, perlu ada upaya pemberdayaan masyarakat agar sadar media.Background: Coronary heart disease (CHD) is the leading cause of death in Indonesia. Central obesity is one of the risk factors that is often found in patients with CHD. Body mass index (BMI) of waist and hip circumference is commonly used to measure the central obesity in individuals. And now, this method is considered as the anthropometric measurement which is more sensitive, cheaper and easier to assess central obesity.This study aims to determine the relationship between hip and waist circumference ratio with the incidence of coronary heart disease in Sukoharjo district hospital. Methods: This study is an analytic study using cross-sectional study design. Blood pressure and blood sugar levels in this study serve as a controlling variable. 109 study subjects were taken through simple random sampling. The subjects were those who came to the emergency room for ECG assesment conducted between May and September 2009. Result: Based on chi-square test, the results show the relationship between hip and waist circumference ratio with the occurence of CHD with a value of RP = 1.760; CI 95% = 1.115 < RP < 2.778 and p-value = 0.007. Relationship between blood pressure and the CHD incident is at the value of RP = 1.533; 95% CI = 1.041 to 2.256 and the p-value = 0.022, while the relationship of blood sugar levels with CHD is at a value of PR = 1.148; 95% CI = 0.779 to 1.691 and the p-value = 0.317. Based on logistic regretion result show the relation between hip and circumference ratio with the occurence of CHD with value of p-value 0.028. There are no relation blood pressure and blood sugar levels with CHD, with value of p-value 0.083 and 0.782. Conclusion: The relationship between the ratio of waist and hips with the incidence of CHD is confi rmed in the patients of Sukoharjo District Hospital.

KEBIJAKAN PENEMPATAN APOTEKER DI PUSKESMAS

ABSTRACT Backgrounds: Since decentralization year 2001, various innovations have been made by the districts or municipalities, especially on delegating broader decision space for management of community health centers to meet demands for qualified medical care. Objective: This study aimed to determine the relationship on autonomy level at health centers (decision space) of employee motivation. The motivation of employees was related to the concept of Motivating Potential Score, that composed of Skill Variety, Task Identity, Task Significance, Autonomy, and Job Feedback. Methods: tt was an observational study with a cross sectional design, carried out at Puskesmas Depok /I (150 type), Sleman District, Yogyakarta Province and at Puskesmas Bangil (self-management type), Pasuruan District, and Puskesmas Karangsari (free type), Blitar Municipality both in East Java Province. The study was done from May to December 2009. Respondents were employees at public health centers taken by random sampling to proportional size. Analysis were to assess the status of autonomy relationship with employee motivation at public health centers, tested by anova and combined with qualitative analysis from in-depth interviews to heads of the centers. Results: Results showed that most employeer motivation at each type of health centers was cathegorized as fairly autonomy status for public health center with 150 (62.5%), self-management (72%) and free type (75.7%). The Anova test were F = 1.450 at p-value = 0.240 (p > 0.05). Hence, it could be said there was no difference on employee motivation at health center type, 150, self-managed and free type. Recommendations: This study recommends that heads of community health centers should be able to encourage development of intrinsic motivation to create leadership to give inspiration for employees and supportive work environment, empowering employees, delegating meaningful work and enhancing employee competency Key words: motivation of employee, motivating potential score, autonomy status, public health center ABSTRAK Sejak diberlakukannya otonomi daerah tahun 2001, berbagai inovasi telah dilakukan oleh pemerintah kabupaten/kota, khususnya menyangkut pemberian decision space yang lebih luas kepada manajemen puskesmas dalam memenuhi tuntutan masyarakat akan pelayanan kesehatan yang berkualitas. Penelitian ini bertujuan untuk mengkaji hubungan tingkatan otonomi pada puskesmas (decision space) terhadap motivasi karyawan. Motivasi karyawan adalah terkait dengan konsep Motivating Potential Score, yang terdiri dari Skill Variety, Task Identity, Task Significance, Autonomy, dan Job Feedback. Penelitian ini adalah penelitian observasional dengan disain cross sectional, lokasi di Provinsi 0.1 Yogyakarta Kabupaten Sleman untuk Puskesmas Depok /I (tipe 150) dan Jawa Timur di Kabupaten Pasuruan yaitu Puskesmas Bangil (tipe swakelola) dan Kota Blitar di Puskesmas Karangsari (tipe gratis) pada bulan Mei-Desember 2009. Jumlah sampel karyawan puskesmas diambil secara proportional random to size di puskesmas yang diteliti. Analisis untuk menilai hubungan status otonomi puskesmas dengan motovasi karyawan, dilakukan uji ANOVA dan didukung dengan analisis data kualitatif dari hasil wawancara mendalam dengan kepala puskesmas. Hasil penelitian menunjukkan bahwa sebagian besar motivasi karyawan puskesmas disetiap tipe status otonomi adalah kategori cukup, yaitu puskesmas 150 (62,5%), swakelola (72%) dan gratis (75,7%), sedangkan hasil uji Anova menunjukkan bahwa F adalah 1,450 dan P value 0,240 (P> 0,05), sehingga dapat dikatakan bahwa tidak ada perbedaan motivasi karyawan di puskesmas, 150, swakelola dan gratis. Penelitian ini merekomendasikan kepala puskesmas harus mampu mendorong terbentuknya motivasi intrinsik yaitu menciptakan kepemimpinan (leadership) yang memberi inspirarasi kepada karyawan dan lingkungan kerja yang mendukung, memberi kuasa pada karyawan dan menoeteqeslken pekerjaan yang berarti dan meningkatkan kompetensi karyawan. Kata kunci; motivasi karyawan, motivasi potensial skor, status otonomi, puskesmasABSTRACT Background: The general objective of this study is to describe dental health condition of Indonesian aged 12 years or over using Basic Health Research 2007 data. The specific objective is (1) to determine the prevalence of dental caries among the study population based on their socio-demographic characteristics (2) to determine determinants of their dental health, (3) to determine magnitude of each determinant in term of Odds ratio and (4) to determine their DMFT - index. Methods: This is a combination of descriptive (estimatian and prevalence) study and analytic (using Odds ratio to describe relation between independent and dependent variable). In the year 2007, the provinces of highest prevalence of dental caries in lndonesia are Jambi, Bangka Belitung, Kalimantan Barat, Kalimantan Selatan, dan Sulawesi Utara. Results: Dental caries prevalence in urban (38%) is not far different from that in rural (35%). The same is true between men (37.4%) and women (35%). Rural community have caries risk 1,329 times more than urban community Woman have dental caries risk 2,186 times more than man. Non regular tooth brusher have caries risk 1,66 times more than the regular tooth brush er. Non filtered cigarette use increasing dental caries risk. Non filtered cigarette use increasing dental caries risk have caries risk 1,461 times more than non smoker. The last determinant that causing the level of caries after multivariate analysis test are the type of area, all the level of age, 26-44 years old, <::: 45 years old, education in senior high school and university, the habit use tobacco without filter, and man community Key words: people dental of health, DMFT-index, dental caries ABSTRAK Tujuan Umum analisis lanjut ini menentukan gambaran kesehatan gigi pada penduduk usia 12 tahun ke atas di lndonesia. Tujuan Khususnya adalah menentukan prevalensi karies gigi di tingkat provinsi pada penduduk usia 12 tahun ke atas di lndonesia, menentukan prevalensi karies gigi berdasarkan karakteristik sosiodemografi pada penduduk usia 12 tahun ke atas di lndonesia, menentukan determinan yang berhubungan dengan kesehatan gigi pada penduduk usia 12 tahun ke atas di lndonesia, menentukan besarnya determinan yang berhubungan dengan kesehatan gigi pada penduduk usia 12 tahun ke atas di lndonesia, menentukan besaran risiko (Odd Ratio) dari determinan yang berhubungan dengan kesehatan gigi pada penduduk usia 12 tahun ke atas di lndonesia, dan menentukan angka DMF- T pada penduduk lndonesia yang berumur 12 tahun ke atas di lndonesia. Desain analisisnya adalah deskriptif (estimasi prevalensi) dan analitik (hubungan variabel independen terhadap variabel dependen serta besaran risiko/OR). Beberapa provinsi yang menunjukkan prevalensi terbanyak pada tingkat keparahan karies sangat tinggi adalah provinsi: Jambi, Bangka Belitung, Kalimantan Barat, Kalimantan Selatan, dan Sulawesi Utara. Hasil analisis univariat mengenai tingkat keparahan karies gigi masyarakat di daerah perkotaan dan perdesaan, menunjukkan bahwa di kedua daerah tersebut prevalensi tertinggi adalah karies sangat rendah (perkotaan 38% dan pedesaan 35%). Tingkat keparahan karies gigi masyarakat di daerah perkotaan dan perdesaan, menunjukkan bahwa di kedua daerah tersebut prevalensi tertinggi adalah karies sangat rendah (perkotaan 38% dan pedesaan 35%). Hasil analisis bivariat berdasarkan karakteristik sosiodemografi menunjukkan bahwa penduduk yang tinggal di wilayah perdesaan berisiko untuk mengalami karies berat sebesar 1,329 kali dibandingkan penduduk yang yang tinggal di wilayah perkotaan. Perempuan lebih berisiko 2,186 kali dari pria untuk terjadinya karies berat. Orang-orang yang tidak teratur menggosok gigi mempunyai risiko menderita karies berat sebesar 1, 166 kali dibandingkan mereka yang teratur menggosok gigi. Penggunaan rokok/tembakau tanpa filter ternyata sangat memengaruhi kejadian karies berat. Mereka yang mempunyai kebiasaan tersebut berisiko untuk menderita karies berat sebesar 1,461 kali dibandingkan masyarakat yang menggunakan rokok/tembakau dengan filter. Determinan akhir yang berpengaruh terhadap tingkat keparahan karies gigi, setelah beberapa kali dilakukan uji analisis multivariat, adalah: tipe wilayah, umur secara keseluruhan umur 26-44 tahun umur -: 45 tahun, pendidikan penduduk yang tamat SLTA dan pendidikan perguruan tinggi, penggun~an rokok/tembaka~ tanpa filter (5), dan penduduk laki-laki. Kata kunci; profil kesehatan gigi, indeks DMFT, karies gigi

PELAKSANAAN STANDAR PELAYANAN KEFARMASIAN DI APOTEK DAN KEBUTUHAN PELATIHAN BAGI APOTEKERNYA

Tuberculosis (TB) Pulmonary is still one of the major health problems in Indonesia, and included in the province of West Sumatra. Many efforts has been conducted to outcome the problem, one of them is the DOTS strategy. From the results of countermeasures that have been implemented was the scope of the discovery of the TB patients are expected to 70% in Year 2009 in West Sumatra Province can only be achieved 48.8%. The study of socio-cultural factors underlying the low coverage of the discovery of pulmonary TB patients have been conducted in the region of Padang Kandis health centers, Guguk Subdistrict, District 50 City. This study uses a qualitative approach, and data collection techniques used were Focus Group Discussions (FGD) and in-depth interviews. The results showed that some socio-cultural aspects that are considered related to the low coverage of the discovery of patients with pulmonary TB are the economic aspects, education/knowledge, perceptions, habits and beliefs as well as access to health services. Knowledge and awareness in the prevention of pulmonary TB disease is still lacking. Some people still have the perception that the diseases associated with pulmonary TB supernatural power, and includes diseases that are considered shameful.

KETERSEDIAAN DAN PERESEPAN OBAT GENERIK DAN OBAT ESENSIAL DI FASILITAS PELAYANAN KEFARMASIAN DI 10 KABUPATEN/KOTA DI INDONESIA

Background: The Ministry of Health has a special guidance for increasing the utilization of generic drugs in governmental health facilities. Beside, The Ministry of Health also has regulation for writing a generic drugs prescription at governmental hospital (permenkes RI No. 085/Menkes/Per/I/1989). This regulation push the doctors in governmental hospital to write prescription on generic and essential drugs, for the patient treatment. The objective of this research was getting information about the availability of generic and essential drugs in governmental health facilities as well as private health facilities upon same district and cities in Indonesia. Methods: This research has been conducted in July to December 2006, using the cross sectional research design. Location selected consist of three areas, there were archipelagoes, wide continent and development area. A purposive sample has been selected, there were 10 distributor unit, 10 govermental hospitals, 20 primary health centers (puskesmas), and 20 dispensaries, as well as 10 drugstores. The method of data collection were interviewed using structure question instrument, prescription observation in hospital, primary health centers, and dispensaries, private dispensaries in hospital, drugstore as well. Results: A descriptive analyzed has been done to get some tables presenting as result. The results show that the range of availability of generic drugs in primary health centers 84.89–100% (x¯ = 95.4%), in governmental hospital 11.29–95.65%) (x¯ = 51.44%) and in dispensaries 1.97–66.6% (x¯ = 18.73%). Generic medicine prescription in primary health centers 91.60–100% (x¯ = 98.82%) while the essential medicine prescription in primary health centers 92.83–100% (x¯ = 97.22%). The range of generic medicine prescription in governmental hospital is 14.58–100% (x¯ = 55.38%), and essential medicine prescription in governmental hospital 52.30–91.75% (x¯ = 69.93%). In dispensaries generic medicine prescription have range 2.63% - 80.20% (x¯ = 26.24%), while the essential medicine prescription in dispensary 46.85–78.88% (x¯ = 52.74%). Due to those results, the suggestion are to develop Rational Drug Use Training in hospital and private clinic continuely. Besides advocation to distric health office (Dinkes Kab/kota) to implement utilization generic and essential medicine and also activation of Pharmacy and Therapy Commission to monitoring and evaluating rational drug use. Key words: generic medicine, essential medicine, primary health care, governmental hospital, dispensary, drugstore

KAJIAN PROGRAM POS OBAT DESA DI KABUPATEN KARANGANYAR DAN SUBANG

Background: The Ministry of Health has a special guidance for increasing the utilization of generic drugs in governmental health facilities. Beside, The Ministry of Health also has regulation for writing a generic drugs prescription at governmental hospital (permenkes RI No. 085/Menkes/Per/I/1989). This regulation push the doctors in governmental hospital to write prescription on generic and essential drugs, for the patient treatment. The objective of this research was getting information about the availability of generic and essential drugs in governmental health facilities as well as private health facilities upon same district and cities in Indonesia. Methods: This research has been conducted in July to December 2006, using the cross sectional research design. Location selected consist of three areas, there were archipelagoes, wide continent and development area. A purposive sample has been selected, there were 10 distributor unit, 10 govermental hospitals, 20 primary health centers (puskesmas), and 20 dispensaries, as well as 10 drugstores. The method of data collection were interviewed using structure question instrument, prescription observation in hospital, primary health centers, and dispensaries, private dispensaries in hospital, drugstore as well. Results: A descriptive analyzed has been done to get some tables presenting as result. The results show that the range of availability of generic drugs in primary health centers 84.89–100% (x¯ = 95.4%), in governmental hospital 11.29–95.65%) (x¯ = 51.44%) and in dispensaries 1.97–66.6% (x¯ = 18.73%). Generic medicine prescription in primary health centers 91.60–100% (x¯ = 98.82%) while the essential medicine prescription in primary health centers 92.83–100% (x¯ = 97.22%). The range of generic medicine prescription in governmental hospital is 14.58–100% (x¯ = 55.38%), and essential medicine prescription in governmental hospital 52.30–91.75% (x¯ = 69.93%). In dispensaries generic medicine prescription have range 2.63% - 80.20% (x¯ = 26.24%), while the essential medicine prescription in dispensary 46.85–78.88% (x¯ = 52.74%). Due to those results, the suggestion are to develop Rational Drug Use Training in hospital and private clinic continuely. Besides advocation to distric health office (Dinkes Kab/kota) to implement utilization generic and essential medicine and also activation of Pharmacy and Therapy Commission to monitoring and evaluating rational drug use. Key words: generic medicine, essential medicine, primary health care, governmental hospital, dispensary, drugstore