Diphteria’s Outbreak Control in Blitar District

Introduction: Diphtheria is an acute bacterial disease that attacks the pharynx, tonsils, larynx, nose, and sometimes attacks the mucous membranes or skin, conjunctiva, and vagina. Implementing diphtheria control in the Blitar district is constrained by program implementation management, with the number of diphtheria cases still high. This study aimed to analyze the implementation of the prevention of diphtheria outbreaks during the preparation, surveillance, investigation, and response stages. Methods: This study was qualitative on health workers in charge of managing diphtheria outbreaks at both the health office and community health centers. Data were collected through in-depth interviews and observations and analyzed using content analysis methods. Results: The results showed that the availability of human resources to deal with diphtheria was inadequate both in terms of numbers and educational background, surveillance training has not been conducted, supplies of Anti-Diphtheria Serum and erythromycin were depleted, limited room isolation, active surveillance has not been carried out, some communities refuse immunization, disinfection has not been carried out, and lack of public knowledge about diphtheria. Conclusion: This study recommends several suggestions. The Health Office should provide specific surveillance training to health workers, sufficient supply of Anti Diphtheria Serum and erythromycin, establish regulations for supervising close contact and create an isolation room in a private hospital. Community health centers should supervise close contact, disinfection of patients' houses, increase education, and conduct community empowerment in carrying out surveillance.

Analysis of Inpatient BPJS Claim Returns Using the PDCA Method at Jember Clinic Hospital

Health financing is one of the important things in the implementation of the National Health Insurance, which is held in hospitals by the Health Social Security Administering Body through the submission of claims. The file submitted was not fully confirmed, resulting in the return of the claim file. This happened at the Jember Clinic Hospital, inpatient claimed files pending for 3 months an average of 8%. The purpose of this study analyzes the return of inpatient claim files by social security administrator health verifiers with the (Plan, Do, Check, Action) approached at Clinic Hospital Jember. The type of research was qualitative. Data collection through interviews, observations, questionnaires, documentation and brainstorming conducted to four informants. The results of the identification of the factors causing the return of inpatient claim files were caused by several things, one was the patient administrative discrepancy. The planning carried out in this research was making checklist sheet for completeness of claim files, makimg Standard Operating Procedures for completeness of claim files and making a request form for the completeness of the claim files. Based on the results of the planning implementation that had been carried out, the return of the claim file was still quite high because it was not in accordance with the target set by the researcher. Recommendations from this study was to minimize the return of claim files, namely to include training for related officers, making Standard Operating Procedures related to claim process systematically and carried out computer maintenance regularly.

Integrated Information System for Early Detection of Maternal Risk Factors Based on Continuum of Care Approach of Mother and Toddler Cohorts

Objectives

The aim of this study is to demonstrate how an integrated information system of mother and toddler cohorts can be developed as a basis of the continuum of care approach that subsequently can be used as the basis of early detection of risk factors of maternal mortality.

Methods

This research was carried out qualitatively. The data was collected through three techniques: in-depth interviews, focus group discussion, and document studies at six public health centers located in four sub-districts of Surabaya, Indonesia. This research was conducted from 2016 to 2018.

Results

The data collected from this research has become a basis input data requirement analysis for an integrated mother and toddler cohort information system. The system accommodates all the variables in each period of pre-marriage, pregnancy, labor, infancy and toddlerhood. The system facilitates healthcare workers to retrieve data and information related to mother and toddler health status.

Conclusions

The availability of various pieces of information enables the health status of mothers and toddlers to be monitored thoroughly throughout their long-life cycle. This continuum of care approach is beneficial in the early detection and management of risk factors of maternal mortality, such as pregnancy complications as well as childbirth and postpartum complications.

Analisis Faktor yang Berpengaruh Terhadap Angka Kematian Ibu (AKI) di Kabupaten Jember Tahun 2018

Kabupaten Jember merupakan salah satu kabupaten yang terdapat di Propinsi Jawa Timur yang pada tahun 2016 menempati peringkat dua untuk Angka Kematian Ibu tertinggi. Jumlah kematian ibu di Kabupaten Jember dari tahun 2014 sampai dengan tahun 2017 mengalami peningkatan dimana pada tahun 2017 sebanyak 43 kematian. Puskesmas memiliki peranan utama dan sangat vital dalam upaya penurunan AKI di Indonesia. Program-program kesehatan di Puskesmas yang difokuskan pada kegiatan preventif dan promotif dalam program Kesehatan Ibu dan Anak masih belum berjalan dengan maksimal. Menyusun upaya untuk menurunkan AKI melalui pelaksanaan manajemen program kesehatan ibu di Puskesmas yang meliputi planning, organizing, actuating dan controlling. Penelitian ini menggunakan metode observasional analitik dengan sampel berjumlah 34 Puskesmas. Hasil penelitian menunjukkan planning dan organizing telah dilakukan namun dalam kategori cukup, actuating dan controlling dalam kategori baik. Terdapat pengaruh yang signifikan pada faktor organizing, actuating dan controlling terhadap AKI. Rekomendasi yang diberikan adalah mempertahankan kegiatan peningkatan cakupan ibu hamil dan ibu bersalin, melengkapai job description masing masing pekerjaan, meningkatkan keterlibatan lintas sektor pada kegiatan promosi, mempertahankan kegiatan controlling. Perlu keterlibatan seluruh pihak dalam menurunkan AKI.