Factors Affecting Public Non-compliance With Large-scale Social Restrictions to Control COVID-19 Transmission in Greater Jakarta, Indonesia

OBJECTIVES

The Indonesian government issued large-scale social restrictions (called Pembatasan Sosial Berskala Besar, or PSBB) at the beginning of the coronavirus disease 2019 (COVID-19) pandemic to control the spread of COVID-19 in Jakarta, Bogor, Depok, Tangerang, and Bekasi (Greater Jakarta). Public compliance poses a challenge when implementing large-scale social restrictions, and various factors have contributed to public non-compliance with the regulation. This study aimed to determine the degree of non-compliance and identify the factors that contributed to public non-compliance with the PSBB in Greater Jakarta, Indonesia.

METHODS

This was a quantitative study with a cross-sectional design. A total of 839 residents of Greater Jakarta participated in this study. Data were collected online using a Google Form, and convenience sampling was undertaken. Univariate and multivariate analyses were performed to explore the relationships between public non-compliance with the PSBB regulation and socio-demographic variables, respondents' opinion of the PSBB, and social capital.

RESULTS

A total of 22.6% of subjects reported participating in activities that did not comply with the PSBB. The variables that most affected non-compliance with the PSBB were age, gender, income, opinion of the PSBB, and social capital.

CONCLUSIONS

Strengthening social capital and providing information about COVID-19 prevention measures, such as washing one's hands with soap, wearing masks properly, and maintaining social distancing, is essential. Robust public understanding will foster trust and cooperation with regard to COVID-19 prevention efforts and provide a basis for mutual agreement regarding rules/penalties.

Tantangan Implementasi Konvergensi pada Program Pencegahan Stunting di Kabupaten Prioritas

Stunting is one of the nutritional problems faced in the world, including Indonesia. To overcome this problem, the government conducted a program to accelerate stunting prevention in 100 priority districts / cities through specific and sensitive nutrition interventions including health and non-health stakeholders. Interventions are carried out in a convergent manner by aligning various resources to achieve the goal of preventing stunting.The convergence is carried out from the planning, budgeting, implementation, to monitoring stages. The purpose of this study is to analyse the challenges of implementing the convergence of stunting prevention programs that have been running since 2018 by local governments in priority districts / cities based on content, context, process, and actors. The research method is operational research with a research design using a qualitative approach design with in-depth interviews in 13 priority districts/cities. The health policy triangle framework is used as an approach in analyzing the results of this study which consists of content, context, process, and actors. In-depth interview sources are policy makers and program managers to accelerate stunting reduction from province to sub-district and village. The results showed that the challenge in implementing convergence was the existence of sectoral egos in each OPD (stakeholders) because of the socialization was not yet optimal so that many stakeholders did not fully understand the stunting prevention program. Information that was late in being obtained, information cut off from socialization, and difficult demographic conditions in the area where one of the causes in certain areas of the obstruction of socialization. The implementation of convergence that has not been optimal is also due to the ansence operational and technical guidelines for implementing program when the research was conducted so that the regions do not know the steps to carry out these activities. Abstrak Masalah anak pendek (stunting) merupakan salah satu permasalahan gizi yang dihadapi di dunia, termasuk Indonesia. Untuk mengatasi permasalahan stunting, pemerintah melakukan program percepatan penanggulangan stunting di 100 kabupaten kota prioritas yang melibatkan sektor kesehatan dan non kesehatan melalui intervensi gizi spesifik dan sensitif. Penyelenggaraan intervensi dilakukan secara konvergen dengan menyelaraskan berbagai sumber daya untuk mencapai tujuan pencegahan stunting. Konvergensi dilakukan mulai dari tahap perencanaan, penganggaran, pelaksanaan, sampai monitoring. Tujuan penelitian ini adalah menganalisis tantangan implementasi konvergensi program pencegahan stunting yang telah berjalan sejak tahun 2018 oleh pemerintah daerah pada Kabupaten prioritas berdasarkan konten, konteks, proses, dan aktor. Metode penelitian merupakan operational research dengan desain penelitian menggunakan pendekatan kualitatif dengan metode wawancara mendalam di 13 kabupaten prioritas. Kerangka segitiga kebijakan kesehatan digunakan sebagai pendekatan dalam menganalisis hasil penelitian ini yang terdiri dari konten, konteks, proses, dan aktor. Informan wawancara mendalam ialah para pengambil kebijakan dan pengelola program percepatan penurunan stunting dari mulai provinsi sampai kecamatan dan desa. Hasil penelitian menunjukkan bahwa tantangan dalam implementasi konvergensi ialah masih adanya ego sektoral pada masingmasing OPD karena masih belum optimalnya sosialisasi sehingga banyak yang belum memahami secara menyeluruh mengenai program pencegahan stunting. Informasi yang terlambat diperoleh, terputusnya informasi dari sosialisasi, serta kondisi demografi wilayah yang sulit menjadi salah satu penyebab pada beberapa daerah tertentu tehadap terhambatnya sosialisasi. Implementasi konvergensi yang belum optimal juga dikarenakan belum diperolehnya juklak dan juknis dalam melaksanakan program saat penelitian dilakukan sehingga daerah belum tahu langkah untuk melakukan kegiatan tersebut.

Determinan Kemampuan Kognitif Anak Usia 4-6 Tahun: Analisis Studi Kohor Tumbuh Kembang Anak di Bogor, Indonesia

Abstract Early childhood period is a critical phase of cognitive development which could be influenced by the child's health history and family background. The purpose of this analysis was to identify the determinants of IQ scores of 115 children aged 4-6 years as part of Child Growth and Development Cohort Study conducted in Bogor in 2016 and 2018. The dependent variables were child age, child’s sex, birth weight, birth length, nutritional status, exclusive breastfeeding, number of family members, parents’ age, education and occupation. The independent variable was the cognitive ability with IQ score. Data were analyzed using multivariate logistic regression. The results showed that children’s age above 59 months were risk about 2,65 times to get IQ score below average (OR 2.6;95% CI 1,17-6,03) and child’s mother with education level below high school level had 2.81 times more likely to get IQ score below average (OR 2.81; 95% CI 1,24-6,37). The IQ score of the children was related to the level of education of the mother and the age of the children. Access to education for women as prospective mothers needs to be continuously encouraged. In addition, good stimulation by the family and the environment needs to be intensified, so that children's development would be optimal. Key words: maternal education level, child’s age, IQ score Abstrak Periode anak usia dini merupakan fase kritis perkembangan kognitif yang dapat dipengaruhi oleh riwayat kesehatan anak dan latar belakang keluarga. Tujuan analisis ini ialah mengidentifikasi determinan skor Intelligence quotient (IQ) pada anak usia 4-6 tahun. Penelitian ini merupakan analisis data sekunder dari Studi Kohor Tumbuh dan Kembang Anak (SKTKA) yang dilakukan di Bogor Tengah, Bogor tahun 2016 dan 2018. Variabel terikat dalam analisis ini ialah usia anak, jenis kelamin anak, Berat Badan (BB) lahir, Panjang Badan (PB) Lahir, status gizi, konsumsi ASI eksklusif, jumlah anggota keluarga, usia, pendidikan serta pekerjaan ibu, pendidikan dan pekerjaan ayah. Sedangkan variabel bebas ialah kemampuan kognitif dengan luaran skor (skor IQ). Data yang dianalisis sebanyak 115 anak berusia 4-6 tahun. Analisa data menggunakan deskriptif, bivariat dan multivariat dengan regresi logistik. Hasil penelitian menunjukkan faktor yang berhubungan dengan IQ anak adalah tingkat pendidikan ibu (OR 2,81: p=0,01) dan usia anak (OR 2,65:p=0,02). Skor IQ anak dalam penelitian ini terkait dengan tingkat pendidikan ibu dan usia anak. Akses pendidikan untuk perempuan sebagai calon ibu perlu terus didorong. Selain itu, stimulasi yang baik oleh keluarga dan lingkungan perlu lebih digiatkan, agar perkembangan anak lebih optimal. Kata kunci: tingkat pendidikan ibu, usia anak, skor IQ

Faktor Yang Mempengaruhi Probabilitas Waktu Penyapihan Anak Baduta Di Indonesia Pada Tahun 2013

ABSTRACT Background: Breastmilk is an important food needed by the children, containts nutrients that provide protection from infection and inflammation of various diseases. Economically breastfeeding also saves household expenses in consumption, but the fact shows that breastfeeding is decreasing with increasing age. The purpose of the study were to analyse the weaning time of children in Indonesia and factors contribute to early weaning. Methodology : The study used secondary data of Basic Health Research (RISKESDAS) conducted in 2013. Data analysis uses survival analysis. Results: By using survival analysis, the probability of weaning time for children in Indonesia is 7.4 months. Factors related to early weaning were maternal education level, the gestational agewhen the baby is born, complications during pregnancy, laborandpostpartum period, the intention to have children, economic status, place of living, baby's birthweight, number of babies born, antenatal care, childbirth helper, place of birth and duration of baby being treated in hospital. Fourteen factors related to the age of weaning in a multivariate manner, the the mothereducation level,  place of living, birth weight and childbirth helper. Conclusion: Factors contribute to early weaning were mothers education level, the place of living, the baby's birthweight and childbirth assistance. Recommendations: strengthening counseling, baby handling procedure Keywords: Weaning, Breatsfeeding, Under Two Years   ABSTRAK LatarBelakang: Air Susu Ibu (ASI) merupakan makanan yang sangat dibutuhkan oleh anak, mengandung zat gizi yang memberikan perlindungan dari infeksi dan inflamasi yang melindungi anak dari serangan berbagai penyakit. Secara ekonomi pemberian ASI juga menghemat pengeluaran rumah tangga dalam konsumsi.  Namun fakta menunjukan pemberian ASI semakin menurun dengan bertambahnya usia anak, untuk itu analisis ini menggali waktu penyapihan dari anak baduta di Indonesia dan faktor apa yang mempengaruhi. Metodologi : sumber data Riskesdas 2013. analisis data menggunakan analisis survival. Hasil: Dengan menggunakan analisis survival diperolah probabilitas waktu penyapihan anak baduta di Indonesia adalah 7,4 bulan, dan faktor-faktor yang terkait adalah, tingkat pendidikan ibu, usia kandungan ketika bayi dilahirkan, komplikasi pada saat kehamilan, persalinan, nifas, keinginan memiliki anak, status ekonomi, wilayah tinggal, berat badan bayi waktu dilahirkan, jumlah bayi yang dilahirkan, ANC, penolong persalinan, tempat persalinan dan lamanya dirawat.  Dari 14 faktor terkait usia penyapihan secara multivariate yang berpengaruh adalah tingkat pendidikan ibu, wilayah tempat tinggal, berat badan lahir dan penolong persalinan. Kesimpulan: Faktor yang menyebabkan usia penyapihan dini adalah tingkat pendidikan ibu, wilayah tinggal, berat badan bayi waktu dilahirkan dan penolong persalinan. Saran: penguatan penyuluhan, protap penanganan bayi Kata Kunci: penyapihan, ASI, anak baduta  

Pelayanan Manajemen Terpadu Balita Sakit (MTBS) pada Puskesmas di Regional Timur Indonesia

The decline in under-five mortality remains target of health development in Indonesia. One effort that can be done, among others, is to improve the skills of health workers in dealing with sick children through the Integrated management of Chilhood Illness (IMCI). This study aims to evaluate the implementation of IMCI in 10 selected districts/cities in Eastern Region of Indonesia with a sample of 20 puskesmas selected randomly. In total 40 under-five children were observed when receiving IMCI services at the puskesmas. In addition, an assessment of the completeness of filling out of 200 forms of IMCI under-five children who had come to the puskesmas a week before the survey was conducted. Information related to the availability of equipment to support IMCI services is collected through direct observation in 20 selected puskesmas assisted by a check list form. The results showed that 80% of puskesmas in the eastern region have implemented IMCI, but only 25% of puskesmas reaching all the under-five children. As many as 90% of puskesmas have been trained for IMCI, however only 15% have been monitored post training. Only 25% of puskesmas received supervision from the District Health Office in implementing IMCI. The observation results at the IMCI service for children under five showed that, the lowest score for compliance with IMCI was counseling (25.8%) and the highest was diarrhea assessment (73.8%). The results of observing the IMCI forms showed that the lowest score was feeding practice (30.4%) and repeat visits (30.8%). Meanwhile, oral rehydration facilities for diarrhea are reported to be inadequate, because they are only available at 50% of puskesmas. There needs to be monitoring and supervision of officer compliance and increasing the availability of supporting equipment and facilities/insfrastructure in the implementation of IMCI.  Abstrak Penurunan angka kematian balita masih menjadi target pembangunan kesehatan di Indonesia. Salah satu upaya yang dapat dilakukan antara lain meningkatkan keterampilan tenaga kesehatan dalam menangani balita sakit, melalui pendekatan Manajemen Terpadu Balita Sakit (MTBS). Penelitian ini bertujuan untuk mengevaluasi pelaksanaan MTBS di 10 Kabupaten/Kota terpilih di regional timur, dengan jumlah sampel 20 puskesmas yang dipilih secara acak. Secara total, 40 pasien balita diobservasi pada saat mendapatkan pelayanan MTBS di puskesmas. Selain itu, dilakukan asesmen kelengkapan pengisian dari 200 formulir MTBS balita yang pernah datang ke puskesmas dalam kurun waktu seminggu sebelum survei. Infomasi terkait dengan ketersediaan peralatan untuk mendukung pelayanan MTBS dikumpulkan melalui observasi secara langsung di 20 puskesmas terpilih dibantu dengan formulir check list. Hasil analisis menunjukkan bahwa 80% puskesmas di regional timur telah melaksanakan MTBS, namun hanya 25% puskesmas yang menjangkau seluruh balita. Sebesar 90% puskesmas telah terlatih MTBS, namun hanya 15% yang dilakukan monitoring pasca pelatihan. Hanya 25% puskesmas yang mendapatkan supervisi dari Dinas Kesehatan Kabupaten/Kota dalam pelaksanaan MTBS. Hasil observasi pada saat pelayanan MTBS pada balita menunjukkan, skor kepatuhan pelaksanaan MTBS yang terendah adalah konseling (25,8%) dan tertinggi adalah asesmen diare (73,8%). Hasil observasi pengisian formulir MTBS menunjukkan, skor terendah pada pengisian pemberian makan (30,4%) dan kunjungan ulang (30,8%). Sementara itu, fasilitas rehidrasi oral untuk diare dilaporkan belum memadai, karena hanya tersedia di 50% puskesmas. Perlu adanya monitoring dan supervisi terhadap kepatuhan petugas serta peningkatan ketersediaan peralatan dan sarana/prasarana pendukung dalam pelaksanaan MTBS. 

Pemberian Makanan dengan Frekuensi Sesuai dan Beragam Merupakan Salah Satu Kunci Status Gizi Normal pada Baduta yang Memiliki Riwayat BBLR di Kota Bogor (Studi Kualitatif di Kecamatan Bogor Tengah)

AbstractThe level of infant mortality and morbidity in Indonesia still high. The factor that is one of the causes of neonatal death is Low Birth Weight (LBW). Therefore, knowing the practices of early initiation breast feeding, exclusive breast feeding, and child feeding of children with normal nutritional status who had low birth weight history is very important. This research is a qualitative study part of growth and development cohort study held in Kota Bogor in 2017. In-depth interviews were conducted to 12 informants of mothers who have children with normal nutritional status (WAZ/WHZ) who at birth had a history of low birth weight. The results showed that most of the informants did not practice early breast-feeding initiation. However, the practice of feeding shows that the frequency of feeding to children tends to be in accordance with recommendation from the WHO. Promotion and education are very necessary to be done for mothers and families to support the success of initial breast feeding practices, exclusive breast-feeding appropriate and varied frequency for low birth weight children. AbstrakTingkat morbiditas dan mortalitas bayi di Indonesia masih tinggi. Faktor yang menjadi salah satu penyebab kematian neonatus ialah Bayi Berat Lahir Rendah (BBLR). Oleh karena itu, mengetahui praktik Inisasi Menyusui Dini (IMD) dan pemberian Air Susu Ibu (ASI) esklusif serta pola pemberian makan pada bayi di bawah dua tahun (baduta) dengan status gizi normal yang mempunyai riwayat BBLR sangatlah penting. Penelitian ini merupakan penelitian kualitatif bagian dari penelitian kohor tumbuh kembang anak (TKA) tahun 2017 di Kota Bogor. Penelitian dilakukan dengan cara wawancara mendalam terhadap 12 informan ibu yang memiliki anak baduta dengan status gizi normal (BB/U dan BB/TB) yang pada saat lahir mempunyai riwayat berat badan lahir rendah. Hasil penelitian menunjukkan bahwa sebagian besar informan tidak melakukan IMD. Namun pada praktik pemberian makanan memperlihatkan bahwa frekuensi pemberian makan kepada anak cenderung sesuai dengan anjuran dari WHO. Promosi dan edukasi amat perlu dilakukan pada ibu dan keluarga untuk mendukung keberhasilan praktik IMD, pemberian ASI eksklusif, pemberian makanan dengan frekuensi sesuai dan beragam pada anak BBLR.