Papers by Rukmini Rukmini
Buletin penelitian sistem kesehatan, May 31, 2022
Lansia merupakan kelompok rentan karena mengidap banyak penyakit (multimorbiditas), ketidakmampua... more Lansia merupakan kelompok rentan karena mengidap banyak penyakit (multimorbiditas), ketidakmampuan secara fungsional dan ketergantungan pada orang lain. Provinsi Jawa Timur memiliki struktur penduduk tua, sehingga perlu penanganan yang baik terutama terkait kesehatan. Penelitian ini bertujuan menganalisis implementasi program pelayanan kesehatan Lansia yang dilaksanakan oleh Dinas Kesehatan Provinsi Jawa Timur. Penelitian ini merupakan penelitian observasional dengan desain cross-sectional. Pengumpulan data dilakukan dengan wawancara mendalam, diskusi kelompok terarah, telaah data cakupan dan dokumen regulasi terkait. Analisis data secara deskriptif. Hasil penelitian menunjukkan Dinas Kesehatan Provinsi Jawa Timur telah memiliki landasan kebijakan program kesehatan Lansia, di mana kegiatan program meliputi kegiatan dalam gedung Puskesmas Santun Lansia dan kegiatan luar gedung. Hambatan program meliputi, sarana prasarana, anggaran, SDM dan kebijakan. Upaya perbaikan program Lansia dilakukan dengan perawatan jangka panjang, advokasi, pelatihan dan pendampingan Puskesmas. Cakupan pelayanan kesehatan Lansia di Provinsi Jawa Timur yaitu: 1) RS dengan pelayanan Tim Geriatri Terpadu (3,13%), 2) Posyandu Lansia yang terintegrasi dengan Posbindu (7,3%) dan 3) Puskesmas santun Lansia (42,9%). Direkomendasikan, perlunya peningkatan kapasitas SDM melalui pelatihan serta menjamin ketersediaan sarana dan prasarana untuk Yankes Lansia di Puskesmas.
BMJ Open
ObjectivesPolicymakers must ensure that the entire population has equal access to health services... more ObjectivesPolicymakers must ensure that the entire population has equal access to health services, and efforts to minimise inequalities are needed. This study aimed to analyse the regional disparities in hospital utilisation in Indonesia.DesignA cross-sectional study analysing secondary data from the 2018 Indonesian Basic Health Survey.SettingNational-level survey data from Indonesia.ParticipantsA total of 629 370 participants were included in the study.InterventionWe employed no interventionPrimary and secondary outcome measuresThe primary outcome was hospital utilisation. Aside from region, we utilise residence type, age, gender, marital status, educational level, occupation, wealth, insurance and travel time as control variables. We used binary logistic regression in the final analysisResultsThe respondents in Sumatra were 1.079 times (95% CI 1.073 to 1.085) more likely than those in Papua to use the hospital. Furthermore, compared with the respondents in Papua, those in the Java...
Medico-Legal Update, 2021
MMR data in Indonesia fluctuates according to the data source used. Based on Indonesia Demographi... more MMR data in Indonesia fluctuates according to the data source used. Based on Indonesia Demographicand Health Survey data, MMR in Indonesia in 1990 was 390 per 100,000 live births, in 2004/2007 it was228/100,000 live births, then increased sharply in 2008-2012 by 359/100,000 live births. Whereas based onthe 2015 SUPA data, MMR in Indonesia decreased by 305 per 100,000 per live birth. This study aims toanalyze the barrier to ?4 ANC visits during pregnancy. The analysis uses the 2017 Indonesian Demographicand Health Survey data. Stratification and multistage random sampling method get 15,351 respondents.Barrier determination was done using Binary Logistic Regression. The barriers consisted of the followingvariables: young age, low education, high parity, poverty, not having health insurance, not being able to read,not being exposed to the media, never using the internet, not knowing the danger signs of pregnancy, andbelief in traditional birth attendants
Introduction: The main strategy for decreasing maternal morbidity and mortality with antenatal ca... more Introduction: The main strategy for decreasing maternal morbidity and mortality with antenatal care (ANC). ANC aims to monitor and maintain the health and safety of the mother and fetus, detect all complications of pregnancy and take the necessary actions, respond to complaints, prepare for birth, and promote healthy living behavior. The study aims to analyze inter-regional disparities in ≥4 ANC visits during pregnancy in Indonesia. Methods: Data sources from 2017 Indonesian Demographic and Health Survey (IDHS). With an analysis unit of women aged 15-49 years old, a sample of 15,351 women was obtained. Besides ANC as the dependent variable, other variables analyzed were place of residence, age, husband/partner, education, parity, wealth status, and health insurance. Analysis using Binary Logistic Regression for the final test to determine disparity. Results: All regions show a gap with the Papua region as a reference, except the Maluku region which was not significant shows differen...
Journal of Tropical Medicine
An effective strategy for combatting AMR in Indonesia is to make the use of antibiotics in hospit... more An effective strategy for combatting AMR in Indonesia is to make the use of antibiotics in hospitals more rational with the help of an Antimicrobial Resistance Control Program (AMR-CP). This study aims to analyze the implementation of the AMR-CP in hospitals by conducting in-depth interviews with health professionals from ten hospitals and health officers of ten provincial health offices in ten different provinces and observation towards its documents. The sample location was selected by purposive sampling. Informants at the hospitals were hospital directors, chairmen of the AMR-CP team, chairmen of the medical committee, persons in charge of the microbiology laboratory, clinicians, nurses, clinical pharmacists, and those program managers at the provincial health offices who are responsible for administering antibiotics. Information is first collected and then a thematic analysis is applied along with triangulation to confirm the validity of information from multiple sources, includ...
Buletin Penelitian Sistem Kesehatan, 2020
Uterine myoma is a reproductive health problem that causes serious morbidity and can affect the qu... more Uterine myoma is a reproductive health problem that causes serious morbidity and can affect the quality of life of suff erers. Many factors cause uterine myoma. This study aims to analyze the factors related to reproductive health history that can influence the occurrence of uterine myoma in women in urban Indonesia. This study is a non-intervention analysis which is a further analysis of the 2016 PTM Research results. The 2016 PTM research design is cross-sectional. The population is all women aged 25-64 years in urban Indonesia. Data collection was carried out by interview. In this paper, the data analyzed were respondent characteristics, reproductive health history and the incidence of uterine myomas. Data were analyzed univariate, bivariate, and multivariate. The results showed that the age of menarche and parity did not aff ect the incidence of uterine myoma (p= 0.861 and p= 0.424). Meanwhile, giving birth to a child for the fi rst time under the age of 30 reduced the risk by 48% (9...
Buletin Penelitian Sistem Kesehatan
One of the health efforts that have the opportunity to improve the health status of the elderly i... more One of the health efforts that have the opportunity to improve the health status of the elderly is traditional health services (Yankestrad). This paper aims to describe the use of Yankestrad among the elderly in Indonesia. The data source in this analysis is Riskesdas 2018, a research conducted by the Ministry of Health with the elderly (≥60 years) as the analysis unit. Data were analyzed descriptively. The results showed that the use of Yankestrad in the elderly was 37.0% and self-medication with traditional medicine was 17.3%. Young elderly people mostly use Yankestrad (37.9%), while self-medication with traditional medicine are dominated by elderly women (18.3%) in rural areas (19.5%). The use of Toga in the elderly in Indonesia (31.9%), mostly women (33.3%) in rural areas (36.3%). The most common types of Yankestrad used by the elderly were manual skills, potions, and homemade potions. Male elderly (55.5%) in urban areas (56.5%) used more prepared ingredients, while female elder...
This study is aimed to determine the role of Social Service Office in the implementation of Natio... more This study is aimed to determine the role of Social Service Office in the implementation of National Health Insurance System (JKN) for recipients of contribution subsidy (PBI) including the aspects of membership determination, poverty criteria, verification, validation, and implementation obstacles. It was an observational study with cross sectional design, which was conducted in Blitar and Malang City in 2015. The data were collected by conducting in-depth interviews and focus group discussion with the authorities of Social Service Office, City Health Office and BPJS and also with secondary data on membership and policy documents investigation. Social Service Offices in Blitar city and Malang city have conducted the updating of the membership of central PBI based on the Integrated Data Base of Social Protection Program (PPLS) in 2011. Blitar Social Service Office had not completed the verification and validation processes for local PBI participants yet. In 2014 Malang Social Servic...
Exclusive breastfeeding is the initial stage in nutritional intake for children. Problems that oc... more Exclusive breastfeeding is the initial stage in nutritional intake for children. Problems that occur because the pattern of breastfeeding is not in accordance with the concept of exclusive breastfeeding, such as providing complementary foods with breast milk (MP-ASI) earlier. This paper is a policy article, based on the results of qualitative research with a health ethnographic approach, to determine the factors that influence the low coverage of exclusive breastfeeding. The research was conducted in Mauya Village (ethnic Banjar) and Marajai Village (ethnic Dayak Meratus), Balangan District, South Kalimantan. The main informants are mothers who have babies 0-6 months (16 people), while the informants who support village midwives (2 people), traditional / community leaders (2 people) and health workers (2 people). Data collection by participant observation, in-depth interviews and unstructured interviews, audio-visual documentation and secondary data search in facilities and health w...
Medico-Legal Update, 2021
Systematic Reviews in Pharmacy, 2020
The illness was what the patient feels when he goes to the doctor, the disease was what he has on... more The illness was what the patient feels when he goes to the doctor, the disease was what he has on the way home. The illness was a patient context. The study was conducted to synthesize the concept of illness in ethnic communities in Indonesia. This research was carried out with a meta-ethnographic approach. A literature search was carried out for ethnographic studies in Indonesia which have been published with the help of Scopus, Google Scholar and Indonesia Publication Index, specifically for the last five years (2013-2018), with keywords: illness, disease, self-efficacy, traditional medicine, indigenous medicine, and health-seeking, we used in various combinations to identify relevant literature. The sample in this meta-ethnography study obtained 15 relevant research literature. The synthesis results reveal a metaphor that describes the concept of illness, that was "not being able to move as usual", and two metaphors for causing illness, are "due to supernatural or ...
A BSTRAK Terdapat 396 (80%) dari 495 kabupaten/kota di Indonesia merupakan endemis malaria pada t... more A BSTRAK Terdapat 396 (80%) dari 495 kabupaten/kota di Indonesia merupakan endemis malaria pada tahun 2007, yang melatarbelakangi diterbitkannya Peratuan Menteri Keseharan No. 293 Tahun 2009 tentang Eliminasi Malaria. Dukungan antar sektor terkait dibutuhkan untuk menciptakan pembangunan lingkungan yang berawawasan sehat untuk mendukung program eliminisi malaria. Penelitian ini dilakukan untuk mengetahui peran lintas sektor di Provinsi Kepulauan Riau melalui studi obervasi dengan desain potong lintang. Pengumpulan data dilakukan dengan cara diskusi kelompok terarah (FGD) melibatkan antar program dan institusi seperti Badan Perencanaan dan Pembanguan Daerah, Dinas Pekerjaan Umum, Dinas Lingkungan Hidup, Dinas Perikanan dan Kelautan, dan swasta. Data diolah dengan konten analisis. Hasil penelitian menunjukkan peran masing-masing institusi. Konstruksi drainase yang dilakukan Dinas Pekerjaan umum menciptakan dukungan lingkungan atas eliminasi malaria karena mengurangi genangan air. D...
Buletin Penelitian Kesehatan
Traditional health services (Yankestrad) run by the Health Office in puskesmas have increased, ma... more Traditional health services (Yankestrad) run by the Health Office in puskesmas have increased, marked by an increase in the coverage of Yankestrad visits from year to year. Puskesmas is a health technical implementation unit under the supervision of the District Health Office / city. The purpose of knowing the policy of Yankestrad Surabaya Yankestard Program in Puskesmas includes the type of service, financing, efforts made, obstacles faced and potential Yankestrad can be developed as learning for yankestrad improvement. This research method is a case study with qualitative assessment, data collection with indepth interviews and targeted group discussions, equipped with a review of related regulatory documents. Descriptive data analysis. The results of research by the Surabaya Health Office have been Yankestrad in puskesmas since 2010. Types of Yankestrad Puskesmas Surabaya are acupuncture, acupressure, aroma therapy and herbal medicine. The Department of Health has provided adequat...
Journal of Public Health Research
Background: Young people is a vulnerable period of the emergence of various problems that may occ... more Background: Young people is a vulnerable period of the emergence of various problems that may occur especially to those who are pregnant. The study was aimed to analyze the determinants of healthcare childbirth among young people in Indonesia in 2017.Design and Methods: The samples of this study were young people (15-24 yo.) who labored in the last 5 years, and there were 3,235 female young people involved. The study analyzed some variables, such as childbirth healthcare, a type of residence, age, education, employment, marital, parity, wealth, insurance, the autonomy of family finances, the autonomy of health, knowledge of pregnancy danger signs, and ANC. The data were analyzed by binary logistic regression.Results: Young people in urban were 2.23 times more likely to attend healthcare childbirth than those in rural (95%CI 1.84-2.70). Young people who completed secondary education were 4.12 times more likely to undergo delivery care than no education (95% CI 1.51-11.23). The riches...
Buletin Penelitian Sistem Kesehatan
Traditional health services (Yankestrad) are part of the health care subsystem in the National He... more Traditional health services (Yankestrad) are part of the health care subsystem in the National Health System, aiming to change the curative treatment paradigm to be promotive and preventive. The study was conducted in 2019, collecting data through in-depth interviews with the Head of Puskesmas and FGD with related cross sectors. The implementation of traditional health services at the Surabaya Made Health Center had been in line with central and regional policies and regulations. The types of complementary traditional health services provided are acupuncture, acupressure, baby massage, and herbal medicine. Most cases of traditional health services for the elderly are relaxation, for non-communicable diseases, stroke, diabetes mellitus, hypertension, and obesity. Yankestrad’s innovation in building with the integration of internal referrals from other polyclinics such as general poly, wound care poly, dental poly, and nutrition poly to yankestrad poly. Innovation outside the building...
Buletin Penelitian Sistem Kesehatan
Antimicrobial resistance has become a problem in Indonesia. The Ministry of Health has establishe... more Antimicrobial resistance has become a problem in Indonesia. The Ministry of Health has established a policy ofAntimicrobial Resistance (AMR) Control Program in hospitals to resolve the issue. A qualitative case study was conducted at Dr. RSUP Wahidin Sudirohusodo hospital, Makassar in 2018 to analyze the implementation of AMR control program. The data were collected through in-depth interviews and analyzed descriptively. The study showed that policy AMR control program has not be carefully implemented. The function of AMR control program team is to make policies and guidelines for antibiotic use, to make surveillance of germ patterns and antibiotic sensitivity, clinical audits of antibiotic use, to conduct studies/research and to make evaluation that is reported to the Hospital Director. However, this AMR control program has not been optimally implemented due to many challenges such as lack of budget, lack of commitment and internal coordination between the AMR control program team ...
PLOS ONE
Introduction The main strategy for decreasing maternal morbidity and mortality has been antenatal... more Introduction The main strategy for decreasing maternal morbidity and mortality has been antenatal care (ANC). ANC aims to monitor and maintain the health and safety of the mother and the fetus, detect all complications of pregnancy and take the necessary actions, respond to complaints, prepare for birth, and promote a healthy lifestyle. This study aims to analyze interregional disparities in �4 ANC visits during pregnancy in Indonesia. Methods Data was acquired from the 2017 Indonesian Demographic and Health Survey (IDHS). The unit of analysis was women aged 15-49 years old, and a sample of 15,351 women was obtained. In addition to ANC as the dependent variable, the other variables analyzed in this study were a place of residence, age, husband/partner, education, parity, wealth status, and health insurance. For the final analysis, binary logistic regression was used to determine disparity. Results With the Papua region as a reference, all regions showed a gap except for the Maluku region, which was not significantly different in the use of ANC compared to the Papua region. Women in the Nusa Tenggara have 4.365 times the chance of making �4 ANC visits compared to those in the Papua region (95% CI 3.229-5.899). Women in Java-Bali have 3.607 times the chance of making �4 ANC visits compared to women in the Papua region (95% CI 2.741-4.746). Women in Sumatra have 1.370 times the chance of making �4 ANC visits compared to women in the Papua region (95% CI 1.066-1.761). Women in Kalimantan have 2.232 times the chance of making �4 ANC visits compared to women in the Papua region (1.664-2.994). Women in Sulawesi have 1.980 times more chance of making �4 ANC visits compared to women in the Papua region (1.523-2.574). In addition to the region category, other variables that contributed to the predictor were age, husband/partner, education, parity, wealth and insurance.
Buletin Penelitian Sistem Kesehatan
BPJS is legal body of National Health Insurance providers to achieve Indonesia universal coverage... more BPJS is legal body of National Health Insurance providers to achieve Indonesia universal coverage. This study aims at identifying BPJS role to increase the number Recipient of Contribution Subsidy membership. This was observational study with cross sectional design. This study conducted in Blitar and Malang city. The data were collected by in-depth interview to some stakeholders such as: the chief of BPJS, the head of membership division, district health ofice. Meanwhile, focused group discussion were conducted to gathered the opinions of some stakeholders such as: district health ofice, BPJS, local government, district inancial management and asset agency, district planning and development agency, and social ofice. Result was BPJS had issued regulation to support the increased number of National Health Insurance as beneiciaries. Moreover, they implemented advocacy to deal with local government. District health ofice and other sectors in both Blitar and Malang had played role to int...
Buletin Penelitian Sistem Kesehatan
The National Health insurance (JKN) appropriate road map is expected in 2016, all Jamkesda for th... more The National Health insurance (JKN) appropriate road map is expected in 2016, all Jamkesda for the poor has been integrated in the JKN system. This study aims to investigate the implementation of Jamkesda (District Health Insurance) integration into the National Health Insurance implemented in the city. It was an observational study with a cross-sectional design, carried out in the city of Blitar and Malang in 2015. The respondents were related areas Jamkesda participation in City Health office, Social Services, BPJS and Local Government (Bappeda, BPKAD, Welfare). Data were collected by in-depth interviews, focus group discussions, and secondary data on participation and policy documents. Integration process of membership Jamkesda into the system of JKN for PBI(Recipient of Contribution Subsidy ) has been supported by the local regulations in the decree of the Mayors for determination of PBI participants and Cooperation Agreement BPJS withMunicipal Government. Membership ofcentral PBI in Blitar City (25,266 people) and Malang city (106,902), while district PBI in Blitar results integration of Jamkesda (8,508 people) and Malang (20,190 inhabitants). Integration of membership Jamkesda to JKN system for PBI has been implemented by the region in a different ways, both in terms of setting criteria, verification and validation of implementing institutions of the participants, the addition and reduction participant data, distributing the card and premium payment. Some of the constraints experienced by stakeholders in the integration Jamkesda include constraints in the membership management, limited human resources and budget, technical verification and system validation poor people and information system BPJS still new. The integration membership Jamkesda to JKN system has been implemented fairly well in accordance with the conditions in their respective areas. It needs a legal basis and Guidelines of Integration Implementation Jamkesda to JKN system, which may be a valid inference thus reducing inaccuracies in the implementation. Abstrak Sesuai peta jalan JKNdiharapkan pada tahun 2016, semua Jamkesda untuk masyarakat miskin telah terintegrasi dalam sistem JKN. Penelitian ini bertujuan untuk mengetahui proses integrasi Jamkesda ke dalam Jaminan Kesehatan Nasional yang dilaksanakan di daerah. Jenis penelitian observasional disain potong lintang, dilaksanakan di Kota Blitar dan Kota Malang tahun 2015. Responden adalah Bidang terkait kepesertaan Jamkesda di Dinas Kesehatan, Dinas Sosial, BPJS dan Pemerintah Daerah (Bappeda, BPKAD, Kesra). Pengumpulan data dengan wawancara mendalam, diskusi kelompok terarah dan data sekunder tentang kepesertaan serta dokumen kebijakan. Integrasi kepesertaan Jamkesda ke sistem JKN bagi PBI didukung oleh regulasi daerah berupa SK Walikota untuk penetapan peserta PBI dan Perjanjian Kerjasama Pemerintah Kota dan BPJS. Kepesertaaan PBI, di Kota Blitar PBI Pusat (25.266 jiwa) dan Kota Malang (106.902), sedangkan PBI Daerah di Kota Blitar hasil integrasi Jamkesda (8.508 jiwa) dan Kota Malang (20.190 jiwa). Integrasi Jamkesda ke sistem JKN bagi PBI telah dilaksanakan oleh daerah dengan cara yang berbeda, baik dalam aspek penetapan kriteria, institusi pelaksana verifikasi dan validasi peserta, penambahan dan pengurangan data peserta, pendistribusi kartu dan waktu pembayaran premi.Beberapa kendala yang dialami oleh stakeholder terkait dalam integrasi Jamkesda meliputi kendala dalam manajemen kepesertaan, keterbatasan SDM, anggaran, teknis verifikasi validasi masyarakat miskin dan sistem BPJS yang masih baru. Proses integrasi kepersertaan Jamkesda ke sistem JKN telah dilaksanakan cukup baik sesuai dengan kondisi di daerah masing-masing. adanya landasan hukum dan Pedoman Pelaksanaan Integrasi Jamkesda ke sistem JKN, yang dapat menjadi acuan yang benar sehingga mengurangi ketidaktepatan dalam pelaksanaan.
Buletin Penelitian Sistem Kesehatan, 2016
Kedinding terdiri dari prosedur klinis dan administrasi. Prosedur klinis telah dilaksanakan, namu... more Kedinding terdiri dari prosedur klinis dan administrasi. Prosedur klinis telah dilaksanakan, namun ada beberapa prosedur administrasi yang belum terlaksana yaitu: 1) Pencatatan di buku register penerimaan rujukan pasien; 2) Pemberian surat balasan rujukan kepada fasilitas atau petugas kesehatan yang merujuk; 3) Prosedur standar menerima rujukan balik belum terlaksana. Koordinasi rujukan maternal antar fasilitas kesehatan telah terlaksana, dengan beberapa keterbatasan. Pelaksanaan rujukan maternal sudah sesuai dengan indikasi medis dan penanganan kasus persalinan sesuai dengan kewenangan Puskesmas. Kesimpulan: Pelaksanaan rujukan maternal di Puskesmas Tambakrejo dan Tanah Kali Kedinding telah berjalan dengan cukup baik dengan beberapa keterbatasan yaitu belum terlaksananya rujukan balik dari rumah sakit ke Puskesmas, khususnya prosedur administrasi. Saran: Untuk mengimplementasikan kebijakan rujukan balik, maka rumah sakit perlu membuat prosedur standar secara tertulis untuk pengembalian rujukan. Demikian pula Puskesmas perlu membuat prosedur standar penerimaan rujukan balik dari RS dan prosedur standar pengembalian rujukan ke Puskesmas lain, Pustu atau bidan.
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Papers by Rukmini Rukmini