scholarly journals Examining Governing Board Functions and Health Center Performances During Health System Reform: A Cross-sectional Study in 4 Regional States of Ethiopia

Author(s):  
Mesele Damte Argaw ◽  
Binyam Fekadu Desta

Background: Since 1995, the Ethiopian health system has been managed through decentralizing functions, resources, and authorities to local levels. As a result, health centers are led and managed by governing boards. In addition, the national health system strives to transform the performance of health centers through the implementation of reforms. Therefore, this study aims to examine the relationship between governing board functions and health center performances within a health reform context in 4 agrarian regions of Ethiopia. Methods: A cross-sectional survey was conducted from August 28, 2018 to September 30, 2018. Primary data were collected from governing board chairpersons or their designees using interviewer-administered structured questionnaires. The performance of each health center was rated out of 100 percentage points against the Ethiopian Health Center Reform Guideline (EHCRIG) standards. Secondary data were abstracted from a routine health information database using customized tools to capture achievements on 69 EHCRIG standards and its 174 validation criteria. Since the data violate the assumptions of the parametric test, the Spearman’s rank (rho) correlation test, (a non-parametric test) was employed to see if any correlation exists among 4 parameters; namely: structure, roles and responsibilities, training and development of governing boards, and performance of health centers against EHCRIGs standards. A statistically significant relationship was claimed at P<.050. Results: All 83 health center governing boards or designees who were approached for this study, participated. The mean health center governing board function score with standard deviation was 56.0% (SD ± 14.5%). The overall performance of health centers against EHCRIGs was 70.4% (SD ± 15.0%). There was a statistically significant and strong correlation (Spearman rho correlation coefficient) between health center performance scores measured against reform standards with governing board scores of (rho=0.866, P<.001) and overall governance scores (rho=0.828, P<.001). Conclusion: Based on the results of this study, we can conclude that well-functioning health center governing boards can improve the performance of health centers against clinical, and management reform standards. Therefore, continuous strengthening of the capacity of governing boards, focusing on improving implementation of their roles and responsibilities, and continuing training on business management is recommended.

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Choirun Nisa ◽  
Setya Haksama

Traffic accidents include non-natural disasters (Law of the Republic of Indonesia Number 24 of 2007 concering Disaster Management) that must be addressed immediately so as not to cause negative impacts and can affect the degree of public health. Surabaya city one of the metropolitan cities that is used as a pilot in East Java, although the traffic conditions in Surabaya are still classified as accidentsprone and traffic accidents often occur. The purpose of this study was to analyze the preparedness of traffic accident cases in Schools, Health Centers, and Surabaya City Police. This research is an observasional descriptive study with a cross sectional design. The time of this research was conduted in Desember 2018. The unit of analysis in this study was 91 students of State Senior High School 9 Surabaya, 6 health workers (doctors and nurses) at the Ketabang Health Center and 8 Policemen Section Dikyasa Surabaya Police Traffic Unit. Sampling in this study using non probability sampling with purposive sampling. The data collected is primary data in the form of interviews by giving questionnaires and secondary data. The results showed the level of preparedness of State Senior High School 9 Surabaya to traffic accidents was not ready (20%), whereas the level of preparedness of State Senior High School 9 Surabaya students was almost ready (60%). The level of preparedness of Ketabang Health Center health personnel and the Surabaya City Police showed a good level of preparedness (100%) while the preparedness level of Ketabang Health Center (87.5%) and Surabaya City Police (82%) was also good. To reduce the number of traffic accidents in the city of Surabaya, it requires strong coordination between schools, health centers and the police related to traffic accident preparedness to the distribution or financial assistance in the Save Our Student (SOS) program launched by the Surabaya City Police. Abstrak Kecelakaan lalu lintas termasuk bencana non alam (UU RI No. 24 Tahun 2007 tentang Penanggulangan Bencana) yang harus segera ditanggulangi agar tidak menimbulkan dampak negatif dan dapat memengaruhi derajat kesehatan masyarakat. Kota Surabaya merupakan salah satu kota metropolitan yang dijadikan percontohan di Jawa Timur meskipun kondisi lalu lintas di Kota Surabaya masih tergolong rawan kecelakaan dan sering terjadi kecelakaan lalu lintas. Tujuan penelitian ini adalah untuk menganalisis kesiapsiagaan kasus kecelakaan lalu lintas di sekolah, puskesmas dan kepolisian Kota Surabaya. Penelitian ini merupakan penelitian observasional deskriptif dengan rancangan cross sectional. Waktu penelitian ini dilakukan pada bulan Desember 2018. Unit analisis dalam penelitian ini adalah 91 siswa/siswi Sekolah Menengah Atas Negeri (SMAN) 9 Surabaya, 6 tenaga kesehatan (dokter dan perawat) Puskesmas Ketabang, dan 8 polisi bagian Dikyasa Unit Satlantas Polrestabes Surabaya. Pengambilan sampel dalam penelitian ini menggunakan non probablity sampling dengan purposive sampling. Data yang dikumpulkan merupakan data primer berupa wawancara dengan menggunakan kuesioner dan data sekunder. Hasil penelitian menunjukkan tingkat kesiapsiagaan SMAN 9 Surabaya terhadap kecelakaan lalu lintas belum siap (20%), sedangkan tingkat kesiapsiagaan sebagian besar siswa/siswi SMAN 9 Surabaya adalah hampir siap (60%). Tingkat kesiapsiagaan dari tenaga kesehatan Puskesmas Ketabang dan polisi Polrestabes Surabaya menunjukkan tingkat kesiapsiagaan yang baik (100%) sedangkan tingkat kesiapsiagaan Puskesmas Ketabang (87,5%) dan Polrestabes Surabaya (82%) juga baik. Untuk menurunkan angka kecelakaan lalu lintas di Kota Surabaya diperlukan koordinasi yang baik antara sekolah, puskesmas, dan kepolisian terkait kesiapsiagaan kecelakaan lalu lintas sampai dengan hal penyaluran atau bantuan dana pada program Save Our Student (SOS) yang dicanangkan oleh Polrestabes Surabaya


2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Febriyeni Febriyeni

<pre>Chronic Energy Deficiency is a situation where the nutritional status someone is on the Less Good Condition. Among the 22 health centers in the district of Lima Puluh Kota, CED highest coverage at the health center are Banja Laweh Namely Case 17 (16.50%) of 103 pregnant mothers. Preliminary Survey of 10 pregnant women at health centers Banja Laweh, note 4 people (40%) of them suffered CED. Based on the findings of interviews stating Not pregnant women know the importance of the size upper arm circumference on Against her pregnancy, in addition to pregnant women consume no food Diversified, because lust Eating Less and Economics not sufficient. Objectives for review determine factors related to the occurrence of Chronic energy deficiency on pregnant women. Methods descriptive analytic with cross sectional approach. Data collection is done on Date in January-February 2017. CASE is a whole population of pregnant women in the region are working Health Center Banja Laweh Year 2017, amounted to 55 people, with sampling total sampling. Operating data analysis using univariate and bivariate statistical test Chi Square. Results of univariate analysis 87,3% of respondents experienced Genesis not CED, (60,0%) High Knowledge, (56,4%) Economy High, and 61,8% of Eating Well. Bivariate analysis known Relationship of Knowledge (p = 0.013 and OR = 12,000, Economics (p = 0.035 and OR = 10,000), and Diet (p = 0.019 and OR = 13,200) with the Genesis CED pregnant women. Can be concluded that the factors related to the occurrence of CED pregnant women is Science, Economics and the Diet. Expected to conduct monitoring of the health center and Supervision of pregnant women at risk Against The Genesis CED, so the negative impact of the CED can be addressed early on.</pre>


Author(s):  
Wulan Citra Sari, Ana Safitri Wulan Citra Sari, Ana Safitri

ABSTRAK   Pneumonia masih merupakan masalah kesehatan yang penting karena menyebabkan kematian bayi dan balita yang cukup tinggi yaitu kira-kira satu dari empat kematian yang terjadi. Tujuan penelitian ini adalah diketahuinya hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Cross Sectional. Populasi pada penelitian ini adalah semua ibu yang membawa atau memeriksakan balitanya yang umur < 5 tahun di Puskesmas Cambai tahun 2016, pada saat penelitian. Pengambilan sampel tersebut secara Non Random dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan ada hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan bayi dan balita di Puskesmas Cambai , serta lebih sering melaksanakan penyuluhan tentang pneumonia dan penyuluhan mengenai makanan 4 sehat 5 sempurna, agar terciptanya balita sehat.     ABSTRACT Pneumonia is an important health problem because it causes the death of infants and toddlers are quite high, roughly one in four deaths. The purpose of this study is known huubungan between toddler age and maternal knowledge with pneumonia incidence in infants in health centers Cambai 2016. This study used a survey method with the Analytical cross-sectional approach. The population in this study were all mothers who carry their babies or check the age < 5 years at Health Center Cambai in 2016, at the time of the study. The sampling is non- random with accidental sampling technique. Data analysis was done using univariate and bivariate statistical test Chi - Square with significance level α = 0.05. The results of this study showed association between maternal age and knowledge toddlers with pneumonia incidence in infants in Health Center Cambai in 2016. From these results, researchers expect health care workers to improve health services in health centers babies and toddlers Cambai, and more frequently to conduct information about pneumonia and counseling about 4 healthy 5 perfect food , in order to create a healthy toddler.


2013 ◽  
Vol 16 (3) ◽  
pp. 622-632
Author(s):  
Katia Cristina Bassichetto ◽  
Denise Pimentel Bergamaschi ◽  
Deivis Elton Schlickmann Frainer ◽  
Vania Regina Salles Garcia ◽  
Edina Aparecida Tramarin Trovões

The nutritional status of people living with HIV/AIDS (PLWHA) is related to morbidity and mortality and its monitoring is important in the maintenance of the health status. This is a cross-sectional study carried out in Brazilian National Health System in the Municipality of São Paulo. It describes anthropometrical characteristics: weight and height; indices of weight for height (W/H), height for age (H/A), body mass index for age (BMI/A) and Z score for height and weight. The study includes 772 participants from all ages: children, adolescents, adults and elderly. The graphical analysis shows that in under-5s and in the 5 to 19 years old group, the W/H, the H/A and the BMI/A curves are similar to the reference population with an exception in the H/A for 5 to 19 years old group which is left-shifted (mean Z = -0.66). In the case of adults, graphics for the study population show median weight apparently lower than in the reference population for most age groups in the case of men, and when age is greater in women. The proportion of people over 20 years old with AIDS on anti-retroviral therapy is lower when coinfection is present (p < 0.001). The findings of the study showed that, for children and adolescents with HIV/AIDS, the average weight and height are lower than the values for non infected population. For adults and elderly, the weight average is lower than the reference population with a worsening among coinfected patients. This underscores the need to direct more effort in nutritional actions thus helping enhance the health status of this group.


2014 ◽  
Vol 2 (1) ◽  
pp. 24
Author(s):  
Wahyu Wijayanto ◽  
Prijono Satyabakti

  ABSTRACTHypertension being a risk factor for the entrance of various degenerative diseases such as coronary heart disease, stroke and other vascular Penyait. One factor that may increase the risk of hypertension one of them is poor lifestyle such as smoking, excessive consumption of salt in the diet and lack of exercise. This study was conducted to determine the level of knowledge about the relationship with the regularity of visits Complications of Hypertension Hypertension in Patients 45 years of age at the Tembok Dukuh  health center at Surabaya. The study was an observational cross-sectional study design. Sample size were 48 people that hypertensive patients more than 45 years old  who were treated at the Tembok Dukuh  health center. Independent variables, namely knowledge about the complications of hypertension patients and dependent variable is the regularity of visits to theTembok Dukuh health center patients with hypertension  Data analysis using the crosstab tes The results with cross-tabulation (crosstab) can be seen as many as 30 people from 48 respondents have less knowledge and affect the regularity of visits to the Tembok Dukuh health center. The conclusion can be drawn that most hypertensive patients more than 45 years old whose came to Tembok Dukuh  health centers has less knowledge about hypertension complications that result in hypertensive patients regularity of visits decreasedKeyword : hypertension, knowledge, regularity of visits 


2018 ◽  
Vol 25 (1) ◽  
pp. 9-17
Author(s):  
Nurul Khairani ◽  
Santoso Ujang Effendi ◽  
Desi Kurnia Putri

This study was based on the still high nutrient deficiency of  elderly in                  the working area of  Bentiring  Community  Health  Center   Bengkulu. This study aimed to study the relationship between education and knowledge with                        nutritional  status of  elderly in  Elderly  Integrated  Service  Post  working  area  of   Bentiring  Community  Health  Center Bengkulu. The  research type was Analytical Survey and the desain of research was Cross Sectional. The population of  this  study  was  all  elderly who visited  Elderly Integrated  Service Post                in  the  working  area  of Bentiring Community  Health  Center  Bengkulu                   in January to April 2017 which amounted to 52 elderly. Sampling technique in this research used   Total  Sampling. The data collected in this study used primary data and secondary data with data analysis technique done by univariate and bivariate analysis with Chi-Square test (c²) through SPSS 16 program. The result of  this research were : from 52 elderly,  there were  35 elderly (67,3%)  with basic education, 27 elderly  (51,9%)  who had  less knowledge, 20 elderly  (38,5%)  had  less  nutritional  status, there was significant relationship  between  education  with  nutritional  status of  elderly  with  medium category, and there was a significant relationship between knowledge with nutritional status  of  elderly with close category. It was expected to Bentiring Community Health Center Bengkulu to improve health services to the elderly by providing nutrition education and medical  examination  for  elderly.  Keywords : education, elderly, knowledge, nutritional status, elderly


2018 ◽  
Vol 10 (1) ◽  
pp. 59-67
Author(s):  
Hani Siti Hanifatun Fajria ◽  
Annisa Annisa Dwi Yuniastari

During pregnancy, pregnant women would usually have complaints. Moderated exercise such as pregnancy exercise would make your feet and heels more comfortable. Percentage of antenatal care in health centers of West Navan especially for K1 and K4 already met the target of 95% . The purpose of this studied is analysis of factors associated with the implementation of the health center pregnancy exercise in Navan western region in 2013. This researched used analytic studied with cross -sectional correlation. The population in this study were all pregnant women in the region checkups Navan West Health Center in 2012 as many as 871 pregnant women then took sample of 59 samples using accidental sampling methode. Analyzed used univariate and bivariate analysis with the chi square test. These results it could be concluded that most of the samples have a relatively good knowledge (67.8 %), good attitude (69.5 %) , not working (55.9 %) , support pregnant women during pregnancy (67.8 %) and doing pregnancy exercise (71.2 %). Thechi-square statistical test found no relationship between knowledge , attitude and family support with the implementation of the pregnancy exercise with each value p = 0.005 , p = 0.001 and p = 0.005 then found that there was no relationship between job execution pregnancy exercise with p = 0.362.


Author(s):  
Mohammad Khammarnia ◽  
Fatemeh Setoodehzadeh ◽  
Mostafa Peyvand ◽  
Amir Hossein Setayesh ◽  
Kosar Rezaei ◽  
...  

Background: The integrated health system (IHS) entitled “SIB” was launched in 2016 aimed to electronic health record (EHR) in the field of health. Given that, in addition to deploying the system, its acceptance criteria by users has a significant effect on its effectiveness and benefits: therefore, the present study was carried out aimed to determine the acceptance rate of IHS technology in health centers. Methods: This study as a cross-sectional survey and applied research was conducted in Zahedan University of Medical Sciences (ZAUMS) in 2017. The population in the present study consisted of all users of SIB system affiliated ZAUMS. Of these, 285 users were selected (physician, health care provider, Behvarz) in five counties affiliated with ZAUMS using multistage cluster sampling. In this study, standard technology acceptance questionnaire was used for data collection. The data were analyzed by SPSS-v22 software and analyzed using descriptive statistics, one-way Anova, T test and other related tests. Results: About 77.9 % of users used the system for several times a day. The SIB system acceptance rate by 49.5 % of users was moderate and 38.9% of the users had excellent acceptance of this system. There was a significant relationship between the acceptance rate of SIB system among the users with age, gender, city, level of education, type of employment, place of work and organizational position (P < 0.05). Conclusion: The results of this study show that, most users have accepted and confirmed the SIB system. Modification of the system with regional approach with the opinion and participation of specialists in comprehensive health service centers is suggested.


2018 ◽  
Vol 4 (1) ◽  
pp. 13
Author(s):  
Tirta Adikusuma Suparto ◽  
Asih Purwandari Wahyoe Puspita ◽  
Yanti Hermayanti ◽  
Slamet Rohaedi ◽  
Lisna Annisa Fitriani

ABSTRAK Sistem jaminan kesehatan nasional di Indonesia baru beroperasi sejak 2014 melalui Badan Penyelenggara Jaminan Sosial (BPJS) kesehatan. Dalam pelaksanaannya, pemberian pelayanan kesehatan pada pasien BPJS menggunakan sistem rujukan berjenjang, dimulai dari Fasilitas Kesehatan (FasKes) tingkat pertama, salah satunya yaitu Puskesmas. Hasil studi pendahuluan menunjukkan bahwa program BPJS kesehatan ini, teridentifikasi dapat memengaruhi pemberi pelayanan kesehatan, termasuk salah satunya dapat memengaruhi Kualitas Kehidupan Kerja Perawat/Quality of Nursing Work Life (QNWL) perawat di Puskesmas Kota Bandung. Padahal QNWL tersebut, pada akhirnya sangat memengaruhi komitmen dan kinerja perawat (Gray & Smelzer, 1990). Penelitian ini bertujuan untuk mengetahui gambaran QNWL dan mengetahui gambaran faktor demografi beserta pengaruhnya terhadap QNWL. Metode penelitian yang digunakan dalam penelitian ini adalah deskriptif kuantitatif dengan pendekatan  cross-sectional survey. Penelitian ini dilakukan pada tahun 2017 di 15 Puskesmas Kota Bandung. Data dikumpulkan dengan kuesioner, dan dianalisis menggunakan  uji beda 2 mean independen (uji t) dan uji Anova (α=5%). Hasil penelitian ini menunjukkan bahwa:  1) perawat di Puskesmas Kota Bandung memiliki nilai QNWL secara keseluruhan dan dimensi-dimensi QNWL yang berada dalam kategori baik. Namun demikian terdapat 3 komponen yang masih bermasalah, yaitu: masih banyaknya tugas non keperawatan, alat dan bahan untuk perawatan pasien yang kurang memadai, tempat perawat/tempat istirahat/loker yang kurang memadai; 2) tidak terdapat pengaruh yang signifikan faktor-faktor demografi (umur (p=0.096), jenis kelamin (p=0.776), status pernikahan (p=0.953), tingkat pendidikan (p=0.183), status kepegawaian (p=0.217), lama bekerja sebagai perawat (p=0.162))  terhadap Quality of Nursing Work Life (QNWL) perawat di Puskesmas Kota Bandung. Implikasi penelitian ini adalah perlu adanya upaya perbaikan komponen-komponen dan faktor-faktor QNWL yang masih bermasalah. Selain itu, perlu adanya upaya peningkatan status kepegawaian perawat kontrak BLUD menjadi PNS atau minimal setara dengan PNS ABSTRACT National health insurance system in Indonesia has been operated since 2014 by the Social Insurance Administration Organization (BPJS). Practically, the provision of health services used tiered referral system, from the first-level health facilities (FasKes), such as Health Center. The result of preliminary studies showed that BPJS program may affect health care providers, including one that can affect the Quality of Nursing Work Life (QNWL) nurses at the health center of Bandung. In the end, QNWL affects the commitment and performance of nurses (Gray &Smelzer, 1990). This research aimed to describe QNWL and to find out demographic factors and its influence on QNWL.  The method used in this research is quantitative descriptive cross-sectional survey. This research was conducted in 2017 in 15 health centers in Bandung. The data were collected through questionnaire and analyzed using independent sample t Test and Anova. The results of this study showed (1) Nurses at the health center of Bandung were in a good category on both overall scores of QNWL and dimensions. However, there are three components which are still problematic, namely: a huge number of non-nursing tasks, inadequate tools and materials for patients’ care, inadequate nurses’ restrooms/locker rooms; (2) There is no significant effect of demographic factors, age (p=0.096), sex (p=0.776), marital status (p=0162), level of education (p=0.183), employment status (p=0.217), length of nursing experience (p=0.162)  to the Quality of Nursing Work Life (QNWL) nurses in 15 health centers in Bandung. The implications of this research are the need to improve problematic components and factors of QNWL. Moreover, improving the employment status of contract nurses BLUD to civil servants or at least equal to PNS is also needed


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