Birth Place Preference and Birth Attendant Selection during Covid-19 Pandemic in Tarakan City, North Kalimantan

Background: Childbirth assistance during the Covid 19 pandemic needs attention to reduce maternal mortality rate and infant mortality rate. This study aimed to analyze the factors influencing the choice of place and birth attendant during the Covid 19 pandemic in Tarakan City. Subjects and Method: This was an observational analytic study with a case control design. The study was carried out in Tarakan, North Kalimantan, Indonesia, in 2020. A sample 100 pregnant women was selected by quota sampling. The dependent variable was the place and birth attendant. The independent variables were place of working, family income, distance to the place of delivery and knowledge. The data were collected by questionnaire using google form. The data were analyzed by a multiple logistic regression. Results: The choice of place of delivery during the COVID-19 pandemic was influenced by place of working (OR= 1.61; 95% CI= 1.49 to 17.02; p= 0.009), family income (OR= 2.57; 95% CI= 3.74 to 45.37; p <0.001), distance travel (OR= 1.53; 95% CI= 0.07 to 0.73; p= 0.014) and knowledge (OR= 1.66; 95% CI= 1.58 to 17.31; p= 0.007). The choice of birth attendant was also influenced by place of working (OR= 1.32; 95% CI= 1.17 to 12.40; p= 0.027), family income (OR= 2.28; 95% CI= 2.94 to 32.23; p <0.001), distance traveled (OR= -1.42; 95% CI= 0.08 to 0.78; p= 0.016) and knowledge (OR= 1.88; 95% CI= 2.05 to 20.85; p= 0.002). Conclusion: The choice of place and birth attendant is influenced by place of working, family income, distance traveled and knowledge. Keywords: place of delivery, birth attendant, pandemic covid 19 Correspondence: Ririn Ariyanti. Department of Midwifery, Universitas Borneo Tarakan. Jl. Amal Lama 1 Tarakan, Kalimantan Utara. Email: ririnariyanti.- [email protected]. Mobile: +6285345553- 400

Meta-Analysis the Effect of Section Caesarea on Early Breastfeeding Initiation

Background: Early Initiation of Breastfeeding is the baby's first activity to find the mother's nipple within the first hour of birth. UNICEF and WHO recommend Early Breastfeeding Initiation as a strategy to achieve the 4th MDG, namely reducing child mortality. Early Breastfeeding Initiation has many benefits but its prevalence is still low, one of the contributing factors is cesarean section delivery. This study aims to estimate the effect of cesarean section delivery on early breastfeeding initiation based on the results of a number of previous studies. Subjects and Method: This study was a meta-analysis and systematic study. The articles used were obtained from PubMed, Science Direct and Google Scholar published from 2009-2020. The inclusion criteria used were full text articles with observational designs, articles published in English and Indonesian. The PICO study problems are as follows. Population= post partum mothers. Intervention= cesarean section delivery. Comparison= normal delivery. Outcome= early initiation of breastfeeding. Articles were collected using a prism flow diagram. Meta analysis was performed using RevMan 5.3 with a Random Effect Model. Results: A total of 11 articles conducted a meta-analysis review of this study. The metaanalysis of 11 articles showed that women who gave birth through cesarean section technique were 0.33 times more likely to have early breastfeeding initiation compared to normal delivery. (aOR= 0.33; 95% CI= 0.18 to 0.59; p<0.001). Conclusion: Mothers who gave birth through cesarean section technique were more likely to initiate early breastfeeding by 0.33 times compared to normal delivery. Keywords: caesarean section, delivery method, early initiation of breastfeeding Correspondence: Ferda Fibi Tyas Nurkholifa. Masters Program in Public Health, Universitas Sebelas Maret, Surakarta, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ferdafibi13@- gmail.com. Mobile: +62856557788

Multilevel Analysis on the Ecological Effect of School on the Risk of Anemia among Female High School Students in Klaten Central Java

Background: Anemia is a major nutritional problem worldwide. In 2018, at least 1.62 billion people were affected by anemia, and 33% were school children. Anemia in female adolescents contributes to high rates of maternal and infant mortality. This study aims to analyze the determinants of anemia among female adolescent at the individual level and at the school level. Subjects and Method: This study used a cross sectional research design. The study was conducted in Klaten Regency in February 2020. Sampling used was probability sampling with a total of 200 female adolescents aged 15 to 19 years old. The independent variables include knowledge, family economy, menstrual pattern, consumption of blood supplement tablets, and nutritional status. The dependent variable is anemia. Data were collected by using the Easy Touch brand hemoglobinometer, weighing scale, microtoice and questionnaire. Data were analyzed using multilevel multiple logistic regression with a stata of 13. Results: The results of this study indicated that good knowledge (b=-2.29; 95% CI= -4.23 to -0.32; p= 0.022), family economy ≥Rp 1,947,821 (b= -2.73; 95% CI= -4.58 to -0.75; p= 0.006), regular menstrual patterns (b= -2.29; 95% CI= -4.58 to -0.75; p= 0.001), blood supplement consumption (b= -3.22; 95% CI= - 8.96 to -2.17; p= 0.001), normal nutritional status (b= -3.36; 95% CI= -6.65 to -1.74; p= 0.001) reduce the incidence of anemia in adolescents. Variations at the school level indicate a contextual influence on the incidence of anemia in adolescents (ICC= 59.36%). Conclusion: There was a statistically significant influence of knowledge, family economy, menstrual patterns, blood supplement consumption and nutritional status on the incidence of anemia in adolescents. Variations at the level of school indicated that there was a contextual influence on the incidence of anemia in adolescents. Keywords: Multilevel, Anemia, Adolescents, School Correspondence: Nurmala Dewayanti. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6287734875004.