Health Policy Commons^™

Experiences Of Elderly Living With Noncommunicable Diseases In Utilizing Health Services In Myanmar During The Covid-19 Pandemic, Nway Eint Chei, Kwanjai Amnatsatsue, Natkamol Chansatitporn, Ariya Bunngamchairat

Kesmas

The COVID-19 pandemic and armed conflicts in Myanmar have intensified the challenges in accessing and utilizing health services, particularly for noncommunicable diseases (NCDs) among older adults. This qualitative study explored the experiences of the elderly with NCDs regarding health service accessibility and utilization in secure areas with fully operational health facilities by conducting in-depth interviews with 20 eligible older adults in Myanmar; data were analyzed using content analysis. Four key themes emerged: NCD service utilization patterns; unmet needs; preferences and hesitancy toward NCD services; and disparities, barriers, and opportunities. The findings revealed widespread underutilization of NCD services due to several …

Government Health Spending And Life Expectancy: Evidence From Cities And Districts In Indonesia, Kurnia Sari, Budi Hidayat, Amal Chalik Sjaaf, Mardiati Nadjib

Kesmas

Life expectancy is widely recognized as a fundamental indicator of population health, and its improvement is often linked to government health spending, particularly in decentralized health systems. This study aimed to investigate the relationship between local government health expenditures and life expectancy in decentralized Indonesia. Data from 492 cities and districts, spanning from 2015 to 2019, were analyzed using a two-way fixed effects regression model to control for time-invariant district characteristics and common temporal shocks. The findings indicated that a 10% increase per capita in government health expenditure was associated with a 0.01% increase in life expectancy. This association was …

Barriers To Implementing Comprehensive Sexuality Education As A Strategy To Prevent Adolescent Pregnancy In Indramayu District, Indonesia, Een Kurnaesih, Chahya Kharin Herbawani, Nelly Febriani

Kesmas

The implementation of comprehensive sexuality education (CSE) is not optimal. This qualitative study aimed to identify and contextualize barriers to CSE implementation, specifically in Indramayu District, Indonesia. Conventional content analysis procedures were used. Seven participants, consisting of relevant authorities, were interviewed. A purposive sampling technique was employed to select participants. Data were collected through in-depth, semi-structured interviews. All interviews were recorded and transcribed verbatim. Data were analyzed using conventional qualitative content analysis. The barriers to CSE implementation in Indramayu District were identified across five themes: advocacy, technical considerations, coordination and collaboration, integration with other sexual and reproductive health projects, and …

Readiness Of Universitas Indonesia To Be An Inclusive Campus For People With Disabilities, Dumilah Ayuningtyas, Tri Auri Putri Ayuningtyas, Anita Pebrina Lubis, Anindya Naila Sabahat, Ratih Oktarina, Afaf Jauhar

Masyarakat: Jurnal Sosiologi

Ensuring equal education rights remains a challenge in Indonesia, despite constitutional mandates and the global commitment to “no one left behind.” The Disability Participation Rate remains low; in 2023, only 21.03% of individuals aged 19–23 were included. This reflects, among other factors, the limited preparedness of educational institutions. This study evaluates Universitas Indonesia’s readiness to develop inclusive education for persons with physical, sensory, mental, and intellectual disabilities. Using the capability approach, it assesses whether institutional resources can be translated into capability-enhancing conditions for students with disabilities. The study draws on literature review, targeted document searches, SWOT analysis, IFE-EFE matrices, and …

Direct Medical Costs Of Diabetes Mellitus Treatment For Patients With Cardiovascular And Renal Complications, Rizki Fadila, Ayu Tyas Purnamasari, A.A. Istri Citra Dewiyani

Kesmas

Type 2 Diabetes Mellitus (T2DM) represents a growing global health challenge with significant clinical and economic implications, notably in Indonesia. The burden is intensified by renal and cardiovascular complications, especially among National Health Insurance beneficiaries. This retrospective study evaluated the direct medical costs of hospitalized T2DM patients with such complications at a type B hospital from 2019 to 2022. Costs were analyzed from both healthcare provider and payer perspectives, covering medical services, medical support services, pharmaceuticals, and other support services. Of the 192 patients reviewed, most were male (57.8%), aged 45–64 years (72.4%), with hospital stays of 1–5 days (90,1%) …

Contribution Of National Health Insurance Patient Revenue To Financial Performance Of Private-Profit Hospitals From 2017 To 2022, Fadlul Imansyah, Amal Chalik Sjaaf, Mardiati Nadjib, Rina Hartini

Kesmas

This study investigated the relationship between National Health Insurance (NHI) patient revenue and profit-private hospital financial performance in Indonesia. As the NHI provider, Badan Penyelenggara Jaminan Sosial (BPJS) Healthcare Security’s influence on hospital revenues has raised concerns about its impact on financial sustainability. This study used financial performance indicators to develop a financial performance index—Return on Assets (ROA), Return on Equity (ROE), Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA) Margin, Current Ratio, and Net Profit Margin (NPM)—to assess the financial impact of BPJS Healthcare Security revenue. A partial model approach of multiple linear regression was employed using secondary data …

Factors Of Anxiety Symptoms Due To Large-Scale Social Restriction Policy During The Covid-19 Pandemic In Indonesia, Indri Hapsari Susilowati, Sudibyo Alimoeso, Susiana Nugraha, Bonardo Prayogo Hasiholan, Magda Sabrina Theofany Simanjuntak, Nur Rachmat Satria

Kesmas

The Indonesian Government took some preventive measures to slow the spread of the COVID-19 virus, including social restrictions and encouraging individuals to stay at home and avoid needless gatherings. This study aimed to identify factors related to anxiety symptoms during large-scale social restrictions. This study employed a cross-sectional design using the snowball technique in an online survey. A total of 788 respondents comprised the target population to detect the smallest effect size (Cohen's dz = .2), with the level of power of 0.8 using G*Power 3.1, specifically targeting adults aged over 18 years. Out of 1,194 people who took part …

Associated Factors In Willingness To Shift Tobacco Expenditure Into National Health Insurance Premium Among Subsidized Members, Mugi Wahidin, Muhammad Agus Mikrajab, Rozana Ika Agustiya, Veza Azteria

Kesmas

In Indonesia, subsidized members are the largest group in the National Health Insurance program. Hence, it is essential to understand their ability to pay (ATP) based on tobacco expenditure. This study aimed to determine the ATP of subsidized members based on tobacco expenditure and factors associated with their willingness to pay (WTP). This cross-sectional study used secondary data from the National Institute of Health Research and Development. The population included all subsidized members; 19,918 were sampled for ATP, and 14,560 were WTP. The independent t-test, ANOVA, and logistic regression were performed. Results showed that ATP from tobacco expenditure ranged from …

The Case For Compulsory Dna Testing At Birth To Confirm Paternity: Ethical, Legal, And Social Considerations, Michael Mncedisi Willie

Journal of Indonesian Health Policy and Administration

Compulsory paternity testing at birth has sparked significant legal, ethical, and social debate due to its potential impact on family dynamics, child well-being, and parental responsibility. This review explores the ethical, legal, and societal implications of such testing, using Bioecological Systems Theory and Rawls' Theory of Justice to frame the discussion. This review evaluates the benefits and challenges of mandatory DNA testing at birth, particularly in reducing paternity fraud, ensuring fairness in child support allocation, and enhancing socio-economic outcomes, especially in low-income households. This qualitative review draws on multidisciplinary literature from family law, genetic counseling, social policy, and fathers' rights …

Factors Associated With Caregivers' Concern In Maintaining The Oral Function Of Elderly Living In Long-Term Care Facilities, Susiana Nugraha, Tri Budi Wahyuni Rahardjo, Misako Higashijima, Yuko Hirano

Kesmas

This study investigated the attentiveness of elderly caregivers in long-term care facilities in maintaining oral function. A cross-sectional approach was used to achieve the study's purpose. The sample size formula accounted for 213 caregivers randomly selected from 18 long-term care facilities in 4 provinces. A self-reported questionnaire of sociodemographic characteristics and an adapted Leopold’s oral care checklist was distributed. The average age of study participants was 35.24 (±11.2 SD; aged 18–70 years), dominated by females (62.9%), and only 39% had experienced long-term care training. Multiple linear regression analysis indicated that younger caregivers likely pay more attention in the swallowing periods …

Availability And Distribution Of Stoma Bags For Colorectal Cancer Patients: A Case Study At National Referral And Private Hospitals, Ratna Aryani, Toar Jm Lalisang, Debie Dahlia, Evi Martha, Achir Yani S Hamid, Sukma Wicaturatmashudi, Helen Helen

Kesmas

Stoma bags are essential for colorectal cancer (CRC) patients with stomas. However, access and affordability in Indonesia remain challenging as the National Health Insurance (NHI) does not fully cover these devices. This study aimed to describe the availability and distribution of stoma bags for patients with CRC in national referral and private hospitals, focusing on outpatient access. A qualitative case study was conducted through observations and in-depth interviews with four enterostomal therapy nurses and six patients across three national referral hospitals and one private hospital in the Jakarta Metropolitan Area, Indonesia. Notably, the availability of stoma bags was limited in …

Job Satisfaction Among Health Workers At Primary Health Care In Palembang City, Indonesia, Asmaripa Ainy, Merri Nurmala Sarri, Poppy Fujiyanti, Hartati Inaku, Tannia Tembo

Kesmas

Health workers at primary health care are the frontline providers of community health services. This study aimed to investigate the level of job satisfaction of health workers at primary health care in Palembang City, South Sumatra Province, Indonesia, and its influencing factors. Using a questionnaire developed by the authors' team, the study involved 257 samples. A total of 66.15% of respondents indicated high satisfaction, 21.79% reported moderate satisfaction, and 12.06% expressed dissatisfaction. A statistically significant correlation was found between knowledge, skills, income, promotion opportunities, work supervision, and relationships with colleagues and job satisfaction (p-value <0.001). The correlations were strong, with Spearman's rho of 0.822, 0.869, 0.912, 0.895, and 0.821, respectively. Statistical analysis of the Wilcoxon rank-sum and Kruskal-Wallis tests showed no significant differences in median satisfaction scores between sociodemographic groups (p-value 0.072 to 0.552>0.05). These findings showed that job …

Thai Sugar-Sweetened Beverage Tax: Does It Really Help?, Sitaporn Suriya, Buraskorn Torut

Kesmas

A solution recommended by the World Health Organization to prevent and control noncommunicable diseases is the Sugar-Sweetened Beverage (SSB) tax. This study aimed to evaluate the Thai SSB tax efficiency affecting the change in post-tax individual-level consumption and find causal explanations for the people’s consumption behavior after the SSB tax was implemented. This study used a Productivity Model, and stratified random sampling was conducted by selecting 1,200 people. An in-depth interview was conducted to seek causal explanations for post-SSB tax consumption behavior with 15 key informants. The results revealed the SSB tax’s efficiency in terms of perception and understanding at …

Exploring Physician Well-Being: A Bibliometric Analysis Of Mental Health, Suriya Kumareswaran, Bala Murali Sundram, Vanitha Thurairasu

Kesmas

This bibliometric study examined the evolving research landscape on physician mental health from 2010 to 2023, analyzing key themes, publication trends, and global contributions. A total of 3,360 articles, including 3,137 original research and 223 reviews, were sourced from Web of Science and Scopus. Findings revealed a significant increase in research output, particularly during the COVID-19 pandemic, with burnout, depression, and anxiety emerging as dominant themes. The US accounted for most publications, while research from low- and middle-income countries remains limited, indicating a substantial global disparity. Thematic analysis highlighted variations in burnout assessment methodologies, underscoring the need for standardized evaluation …

Five-Year Journey Of Technical Assistance In Health Governance Reforms: A Case Report, Popy Yuniar, Indang Trihandini, Ibnu Muyassar, Latifatul Khoiriyah, Minawati Minawati, Fathiyya Aliyah Birjaman, Tyra Septi Diana, Annabel Serafina, Hertina Raisa Putri, Rana Maimunah, Riko Setiawan, Nadazaira Alifia Ramadhianisa, Aris Diyanto

Kesmas

Many districts and cities in Indonesia continue to have Public Health Development Index scores below the national average, highlighting the need for improved health governance. This study assessed the five-year impact (2019–2023) of a mentoring program for 149 District Health Offices in preparing annual work plans, focusing on stagnation or performance declines. Using a qualitative approach, the study analyzed annual work plan scores before and after technical assistance, conducted focus group discussions, and carried out in-depth interviews to identify challenges. Key barriers included data management issues, weak advocacy, knowledge transfer gaps, and poor cross-sectoral coordination, which hindered decision-making and program …

Public Health Entrepreneurship In Indonesia: What Is Next?, Hadi Pratomo, Roy Darmawan, Karina Samaria

Kesmas

Public health has been demanded to search for ways to improve well-being by tackling societal and ecological factors that influence health through cooperative strategies and partnerships across various fields. More interdisciplinary, interprofessional, and action-oriented approaches toward sustainable public health programs are recommended to be made. Therefore, public health entrepreneurship is an indispensable approach to creating new interventions that address future public health problems. The Indonesian Ministry of Health conceptualized five public health entrepreneurship skills as standard competence for public health personnel. In addition, the Association of Indonesian Public Health Higher Education Institutions has identified several study materials and learning outcomes …

Socio-Epidemiological Perspectives Of Sexual Trauma Experiences And Influential Factors On Sexual Orientation In Men Who Have Sex With Men, Rico Januar Sitorus, Misnaniarti Misnaniarti, Legiran Legiran, Rizma Adlia Syakurah, Diana Dewi Sartika, Asri Maharani, Retta Patresia

Kesmas

The complexity of sexuality and sexual trauma experiences, including harassment, unwanted touching, sexual urges, and forced sexual intercourse, should not be underestimated because of the tendency to initiate adverse psychosocial impacts. Sexual harassment can increase mental health risks, which may influence sexual orientation decisions. This quantitative study, using a cross-sectional design, aimed to determine a relationship between sexual trauma experiences and sexual orientation in men who have sex with men (MSM). This study population was MSM living in Palembang and Prabumulih City, with a sample size of 216 respondents. The proportion of respondents with homosexual orientation was 57.1%, and the …

Determinants Of Adolescent Resilience Levels In Surabaya City, East Java Province, Indonesia, Riris Diana Rachmayanti, Fatwa Sari Tetra Dewi, Diana Setiyawati, M Dody Izhar, Andrei Ramani

Kesmas

Assessing adolescent resilience may provide valuable insights into adult resilience. This study aimed to analyze the relationship between determinants and adolescent resilience in Surabaya City. The participants of this cross-sectional study were 277 adolescents aged 12–19 years who were in senior high school. The outcome was the resilience levels. This study's findings indicated relationships between resilience levels and stress experience (p-value = 0.01), access to mental health information (p-value = 0.00), life satisfaction (p-value = 0.00), family harmony (p-value = 0.03), presence of adults to share (p-value = 0.04), feeling safe at home, school, and community (p-value = 0.00), perception …

Analysis Of Covid-19 Prevention And Control Policy Implementation In Islamic Boarding Schools In Dki Jakarta, Dickha Adi Wibowo, Fajar Ariyanti

Journal of Indonesian Health Policy and Administration

Indonesia, as one of the countries affected by COVID-19, has implemented various efforts to prevent the transmission of COVID-19. One effort that can be implemented is the implementation of COVID-19 prevention protocols. Apart from that, according to the COVID-19 Handling Task Force, Islamic boarding schools are locations with high mobility. This research aims to determine the implementation of policies related to the prevention and control of COVID-19 in Islamic boarding schools in the DKI Jakarta Province. This research used descriptive research with a qualitative approach, with the number of respondents being three Islamic boarding school leaders and students. The results …

Contextualizing Policy Adoption: A Case Study Of Tuberculosis Control Policy In Depok City, Tri Auri Putri Ayuningtyas, Adang Bachtiar

Journal of Indonesian Health Policy and Administration

This study analyzes the formulation and implementation process of Depok Mayor Regulation No. 61 of 2023 on Tuberculosis (TB) Control using Friedman’s legal system theory (1975) and the eight General Principles of Good Governance (Asas Umum Pemerintahan yang Baik – AUPB). The regulation provides a comprehensive framework, encompassing promotive, preventive, curative, and rehabilitative aspects to support TB control. The legal structure includes the establishment of a cross-sectoral Tuberculosis Control Acceleration Team, involving government agencies and community organizations. Findings reveal that while the regulation has fulfilled several AUPB principles, such as legal certainty, utility, and public interest, there are areas …

The Relationship Between Self-Efficacy And Self-Management Behavior In Gestational Diabetes Mellitus Control, Fatimah Dwi Cahyani, Shrimarti Rukmini Devy

Journal of Indonesian Health Policy and Administration

Diabetes mellitus gestasional (DGM) merupakan kondisi kesehatan yang meningkat dalam kehamilan dan dapat menyebabkan komplikasi serius bagi ibu dan janin. Self-management yang mencakup pemahaman, penerapan, dan pemeliharaan perilaku kesehatan memiliki peran kunci dalam mengelola DGM. Health Belief Model (HBM) digunakan sebagai kerangka kerja teoretis yang membentuk dasar intervensi untuk meningkatkan self-efficacy pada ibu hamil dengan GDM. Studi ini menganalisis hubungan antara efikasi diri dan manajemen diri dalam pengendalian diabetes gestasional pada ibu hamil. Artikel ini adalah tinjauan pustaka dengan menerapkan metode pencarian literatur. Pencarian literatur dilaksanakan melalui tiga basis data yaitu PubMed, Scopus, dan Google Scholar, yang mencakup artikel-artikel yang …

Implementation Of Emr System In Indonesian Health Facilities: Benefits And Constraints – A Case Study Of Two Clinics In Central Java, Rasyid Juliansyah, Bukhori Aqid, Andien Putri Salsabila, Kurnia Nurfiyanti

Journal of Indonesian Health Policy and Administration

This paper delves into the widespread implementation of Electronic Medical Records (EMR) within healthcare facilities across Indonesia. It addresses the challenges encountered by clinic owners and healthcare providers in transitioning to these digital systems. The study is supported by empirical data collected through a mixed-method approach, combining internal data from Klinik Pintar with qualitative validation from key stakeholders responsible for clinic operations. The research focuses on two case studies: Lembaga Pemasyarakatan (LAPAS) II Purwokerto Clinic and Palang Merah Indonesia (PMI) Purbalingga Clinic, where the adoption of EMR is analyzed in terms of efficiency, compliance with regulatory standards set by the …

The Readiness For Integrated Primary Health Care (Ilp) At Puskesmas Pamulang In Tangerang Selatan City, Firda Safitri Rachmaningsih, Kurnia Sari

Journal of Indonesian Health Policy and Administration

. Integrated primary healthcare (ILP) is part of the transformation of primary healthcare aimed at improving access to quality healthcare. This study aims to analyze the readiness of Pusat Kesehatan Masyarakat (Puskesmas) and their networks to implement ILP. This research used a qualitative approach, focusing on a case study of a Puskesmas in an urban setting, specifically in the operational area of Puskesmas Pamulang in South Tangerang. Data collection methods include in-depth interviews, observations, and document reviews. This research adopts the conceptual framework of PHC monitoring based on WHO and Weiner's theory of organizational change readiness. The research findings indicate …

Health Literacy Of Unhealthy Diet Consumption In Thailand, Sitaporn Suriya, Buraskorn Torut

Makara Journal of Health Research

Background: The burden of noncommunicable diseases (NCDs) is increasing worldwide, including in Thailand. One risk factor for NCDs is an unhealthy diet. Thus, this study aimed to investigate the factors affecting the consumption of an unhealthy diet and determine the proactive policies that support factors inhibiting an unhealthy diet.

Methods: We investigated the factors affecting unhealthy diet consumption behavior by multiple linear regression analysis by surveying 970 Thai patients with early-stage NCD. In addition, we investigated appropriate policy proposals by conducting in-depth interviews with 20 key informants.

Results: Knowledge (−0.247, 95% confidence interval (CI) −0.285 to −0.210), …

Telemedicine Adoption In Developing Economies: A Systematic Review On The Enablers And Barriers, Zaidbren Macabato, Lemuel Clark Velasco, Art Brian Escabarte, Mae-Lanie Ong Poblete, Armando Isla Jr., Rentor Cafino, Sarah Lizette Aquino-Cafino, Frevy Teofilo-Orencia

Kesmas

Telemedicine’s adoption has been effective in certain contexts despite being controversial in certain settings because of its tendency to cause misdiagnosis and concerns about data privacy. This study aimed to synthesize the research findings on the factors leading to the adoption of telemedicine among developing economies. The study utilized Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology to analyze 27 related literature and the Unified Theory of Acceptance and Use of Technology to map out the factors considered enablers and barriers in adopting telemedicine. Results showed that performance expectancy, effort expectancy, social influence, and facilitating conditions were significant predictors. …

Economic Growth, Poverty Gap, And Health Inequality: Implications Based On Panel Analysis Of Organization For Economic Cooperation And Development Data, Sangik Han

Kesmas

This study investigated the impact of economic growth and income distribution on health inequality using data from the Organization for Economic Cooperation and Development (OECD). Employing a panel analysis, this study amalgamated 21 years of data (spanning from 2000 to 2020) from 37 OECD countries. The dependent variables (life expectancy and avoidable mortality) were scrutinized against independent variables (gross domestic product and poverty gap). Control variables encompassed body mass index, consumption patterns, smoking rates, health workers availability, number of beds in health facilities, national medical expenses, and unemployment rates. This study revealed significant associations between economic growth, poverty gap, and …

Social Determinants Of Neonatal Health Outcomes In Indonesia: A Multilevel Regression Analysis, Rooswanti Soeharno, Amal Chalik Sjaaf

Kesmas

Indonesia’s neonatal mortality rate remains alarmingly high. This study addressed the determinants of neonatal outcomes in Indonesia, including the effects of a decentralized health system, socioeconomic disparities, and geographic variations. The analysis used 2018 national survey data across 34 provinces, 513 cities/districts, and 300,000 households, with a sample of 73,864 women aged 10-54 years who have given birth in the preceding five years. The multilevel regression was used to assess the impact of social determinants and systemic inequalities on neonatal health. Key findings revealed a neonatal mortality rate that, despite being preventable in many cases, remained high with significant disparities. …

Implementation Of Sugar-Sweetened Beverages Excise Policy And Its Implications In Various Countries: Literature Review, Roissiana Khotami, Vetty Yulianty, Ratih Oktarina

Journal of Indonesian Health Policy and Administration

The prevalence of diabetes in the world is projected to continue to increase to 643 million in 2030. Indonesia is ranked 7th with the highest number of diabetes mellitus sufferers and the only one in Southeast Asia with a total of 10.7 million sufferers. Consumption of sweetened drinks is the most dominant factor in the incidence of diabetes mellitus in Indonesia. Indonesia ranks third highest in Southeast Asia in sweetened drink consumption. Excise on sweetened drinks is an effective intervention to reduce consumption of sweetened drinks, but Indonesia has not yet implemented it. This research aims to determine the implementation …

Addressing Patient Loyalty Through Their Commitment Influenced By Electronic Word-Of-Mouth And Hospital’S Image, Al Quadhri Upe, Alida Palilati, Sudirman Zaid, Nasrul Nasrul

Kesmas

This article explores the influence of Electronic Word of Mouth (e-WoM) and hospital image on hospital patient loyalty, emphasizing the mediating role of patient commitment. Amidst the development of the healthcare industry sector in Indonesia, this study highlighted that e-WoM and hospital image significantly enhanced patient loyalty, with patient commitment playing an important mediating role. This article suggested practical strategies for hospitals, such as improving the quality of healthcare services, leveraging positive e-WoM, and implementing loyalty programs to elevate patient commitment and loyalty. These findings underscore the importance of hospital image and e-WoM in patient retention, providing valuable insights for …

Exploration Of Positive Deviance In Prevention Of Underweight In The Under-Five: A Qualitative Study On Low-Income Urban Families, Irwan Budiono, Lukman Fauzi, Dewi Sari Rochmayani

Kesmas

Children under the age of five (the under-five) from low-income families are more vulnerable to experience underweight. This nutritional vulnerability is evident in the preliminary study, where 35.1% of the under-five experience underweight, and 28.48% are low-income families. This study aimed to explore Positive Deviance (PD) behaviors in preventing underweight among the under-five. The study applied a qualitative approach with a case study design. Data collection took place in July-August 2022, focusing on low-income families in the Gunung Brintik area. Data were collected through two focus group discussions, seven in-depth interviews, and five key informant interviews. Coding, subtheme, and theme …