Contagion: Scientific Periodical Journal of Public Health and Coastal Health
Journal title CONTAGION: Scientific Periodical Journal of Public Health and Coastal Health Subject Health Sciences. Language English. ISSN 2685-0389 (online) Frequency Four times a year in January-March, April-June, July- September, and october- December. DOI Prefix 10.30829/contagion by Crossref Editor-in-chief Putra Apriadi Siregar, M.Kes (Scopus ID: 57485278200) Publisher Fakultas Kesehatan Masyarakat (FKM) UIN Sumatera Utara Citation Analysis Sinta2, Dimension, ASCI (Asian Science Citation Index), Google Scholar, Email contagion@uinsu.ac.id Contagion: Scientific Periodical Journal of Public Health and Coastal Health, a scientific periodical journal of public health published by the Public Health Study Program of the Faculty of Public Health at Universitas Islam Negeri Sumatera Utara Medan, Indonesia. These journals prioritize the collaboration of lecturers and students, with the scope of the discussion being about Public health, midwife, nursing, nutrition science, medicine, mental health, coastal public health, islamic and health sciences in islamic countries and developing countries. The journal is published four times a year in January-March, April-June, July- September, and october- December. Telp:+62895391495346||Email: contagion@uinsu.ac.id ||e-ISSN:2685-0389
Universitas Islam Negeri Sumatera Utara, Medan
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Ischemic (Low-Flow) Priapism Managed by Al-Ghorab Distal Corporoglanular Shunt - A Case Report
Priapism is a rare urological condition characterized by a persistent penile erection unrelated to sexual stimulation, most commonly affecting adults, while in children it is frequently associated with sickle cell anemia or trauma. The Al-Ghorab shunt is an open distal shunt technique that may be utilized as a first-line surgical intervention. We report the case of a 58-year-old male who presented with a one-month history of painful persistent erection, with no history of sexual stimulation, medication use, or genital and perineal trauma. Based on clinical evaluation, the patient was diagnosed with ischemic (low-flow) priapism and was scheduled for open distal shunting using the Al-Ghorab (corporoglandular) shunt technique. The operative duration was 120 minutes, and the patient was managed postoperatively in a non-intensive care ward without complications, with an Erection Hardness Score (EHS) of 1. The patient was discharged on postoperative day five and returned for follow-up on postoperative day twelve, at which time the surgical wounds on the glans and ventral penis were noted to be dry, indicating that although surgical preference may vary among surgeons, the Al-Ghorab shunt can be considered as a first- or second-line option following percutaneous distal shunting based on its success rate and side-effect profile. Keywords: Ischemic Priapism, Low-Flow Priapism, Al-Ghorab Shunt, Distal Corporoglanular Shunt.
Copyright (c) 2026 muhammad mahmud ridho, H.R. Danarto http://creativecommons.org/licenses/by-sa/4.0
Analysis of Renal Resistive Index As A Predictor of Acute Kidney Injury in Critical Care Patients
Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with increased length of hospital stay. Early detection of renal dysfunction by measuring the renal resistive index (RRI) using Doppler ultrasound is a non-invasive parameter that reflects intrarenal vascular resistance and has the potential to predict AKI occurrence in critically ill patients. This study aims to compare RRI values between patients with and without AKI based on severity levels classification from AKIN criteria, and to establish the RRI value as a predictor of AKI occurrence in critically ill patients. This study was an analytical observational study with a prospective cohort design conducted on critically ill patients treated in the ICU of dr. Zainal Abidin Banda Aceh General Hospital from June to August 2025. Data were obtained through Doppler ultrasound RRI examination performed within the first 24 hours and medical record data during treatment. Data were analyzed using ANOVA and ROC curve analysis to determine the cut-off value of RRI as an AKI predictor. Out of the 60 critically ill patients who met inclusion criteria, 30 patients (50%) developed AKI during treatment. There were significant differences (p<0.0001) between RRI and AKI occurrence as well as AKI severity, for both the right and left kidneys. ROC curve analysis identified an RRI cut-off value of 0.7 for predicting AKI, with a Receiver Operating Characteristic Area Under the Curve (AUC) of 0.9628 and CI 95% : 0.9155 – 1.000­, yielding a sensitivity and specificity of 90%. There are significant differences in RRI values between non-AKI patients and AKI patients at stages 1, 2, and 3. RRI value can be used as a predictor for AKI occurrence in critically ill patients. Keywords: Acute Kidney Injury, Critically Ill, Doppler Ultrasonography, Renal Resistive Index.
Copyright (c) 2026 Denny Andrea, Nurul Machillah, Fadhilah Rahmi, Teuku Yasir, Muhsin Muhsin, Iskandar Zakaria, Maimun Syukri http://creativecommons.org/licenses/by-sa/4.0
The Influence of Spinning Wheel Media and Module on The knowledge and Attitude of Adolescent Marriage Age Maturation at Bengkulu
Early marriage, according to the WHO, is a marriage that occurs in individuals under the age of 19. This phenomenon is often caused by a lack of knowledge and insufficient information about the importance of delaying marriage until an appropriate age. The impacts of early marriage include premature birth, delivery complications, divorce, domestic violence, school dropout, and other social problems. The aim is to determine the influence of spinning whell media on the knowledge and attitude of adolescent marriage age maturation. This study uses a Quasi-Experimental method with a Two Group Pretest and Posttest design. The research sample was taken using simple Random Sampling, involving 32 respondents who were given pretest and posttest questionnaires. The normality test used the Shapiro-Wilk test, and non-normal data were analyzed using the Mann-Whitney test. The results showed that the group receiving education through Spinning Wheel media experienced a significant increase in knowledge (average before 5.81, after 13.16) and attitudes (average before 39.00, after 52.94). Meanwhile, the group receiving education through Modul also showed an increase, though to a lesser extent, with an average knowledge score before 7.50 to 11.63 and an attitude score before 43.53 to 48.22. Statistical analysis showed a significant influence of education through Spinning Wheel media on improving adolescents' knowledge (p-value=0.000) and attitudes (p-value=0.000) about the maturity of marriage age. The findings of this study are expected to encourage academics, educational institutions, and other researchers to use Spinning Wheel media and develop other game-based learning methods to improve adolescents' knowledge and attitudes about the maturity of marriage age Keywords: Knowledge, Attitude, Early Marriage, Spinning Wheel Game, Adolescent Health.
Copyright (c) 2026 Elvi Destariyani http://creativecommons.org/licenses/by-sa/4.0
Utilization of the My ADA Application for ANC Visits for Pregnant Women in the City of Bengkulu
Antenatal care (ANC) plays an important role in the early detection and prevention of complications during pregnancy, childbirth, and the postpartum period. However, ANC utilization in Indonesia, including Bengkulu City, remains below the expected standard. Limited maternal knowledge and the less optimal use of conventional educational media, such as the Maternal and Child Health (KIA) book, contribute to low ANC attendance. Therefore, innovative digital-based educational media, such as the My ADA application, are needed to improve ANC utilization among pregnant women. This quantitative study employed a quasi-experimental design with a pretest–posttest two-group approach. The study was conducted at independent midwifery practices in Bengkulu City. A total of 50 second-trimester pregnant women who met the inclusion criteria were selected using purposive sampling and divided into two groups: the My ADA application intervention group and the KIA book comparison group. Data were collected before and after the intervention using structured questionnaires and ANC visit records. Statistical analysis was performed using appropriate parametric and non-parametric tests after normality testing with the Shapiro–Wilk test. The results demonstrated a statistically significant difference in ANC utilization and visit frequency between the intervention and comparison groups (p < 0.05). Pregnant women who used the My ADA application showed greater improvement in ANC utilization and higher ANC visit frequency compared to those who used the KIA book. The findings indicate that the My ADA application is more effective than conventional KIA book media in improving ANC utilization among second-trimester pregnant women. Digital health applications can be utilized as alternative educational and monitoring tools to support maternal health services and enhance adherence to antenatal care visits Keyword : My ADA application, antenatal care, Pregnant women, Health technology, Maternal health, ANC utilization
Copyright (c) 2026 Yuniarti Yuniarti http://creativecommons.org/licenses/by-sa/4.0
Web-Based Learning About COVID-19 Vaccination for Improved Knowledge and Perception Among Community Health Workers
CHWs play a crucial role in assisting health workers to empower communities and promote health through vaccination. However, they still have limited knowledge and perceptions in supporting the COVID-19 vaccination program. Several educational methods have been used, most of which are based on conventional approaches, and evidence regarding the effectiveness of web-based learning for CHWs is still limited. This study aimed to assess changes in CHWs’ knowledge and perceptions about COVID-19 immunization before and after an intervention and to determine the effect of group (intervention and control) and time on these changes. Linear Mixed Model (LMM) analysis was used to evaluate longitudinal changes in knowledge and perception scores. Group and time variables were included in the model as covariates to assess their influence on score changes. A total of 44 CHWs in Pontianak City were divided into an intervention group (n=22) and a control group (n=22). Results showed a significant increase in knowledge and perception scores after the intervention. Knowledge scores increased significantly from pre-test to post-test (p<0.001), with a higher average in the intervention group than in the control group. The perception score also showed a significant increase, with a p-value of less than 0.001. LMM analysis showed that the average change in knowledge scores (β = 4.04, p < 0.001) and perception (β = 6.77, p < 0.001) was higher in the intervention group than in the control group. Furthermore, time had a significant effect on changes in knowledge scores (β = −2.41, p < 0.001) and perception (β = −4.77, p < 0.001). The interaction between group and time was also significant for knowledge (β = −3.55, p < 0.001) and perception (β = −5.59, p < 0.001). Web-based learning was effective in CHWs’ knowledge and perceptions regarding COVID-19 immunization, with changes influenced by group and time factors. Keywords: Web-Based Learning, Knowledge, Perception, COVID-19 Vaccination, Community Health Workers (CHWs)
Copyright (c) 2026 Fauzan Alfikrie, Uti Rusdian Hidayat, Ali Akbar, Defa Arisandi, Nurpratiwi Nurpratiwi, Debby Hatmalyakin, Mimi Amaludin http://creativecommons.org/licenses/by-sa/4.0
Effect of Virgin Coconut Oil Supplementation on Immune Function in a Rat Model of Physical Exercise
Physical exercise can induce physiological stress that triggers inflammatory responses, marked by increased levels of proinflammatory cytokines and acute-phase proteins. Virgin Coconut Oil (VCO) contains medium-chain fatty acids that are known to possess anti-inflammatory and immunomodulatory properties, which may help regulate immune responses caused by physical activity. This study aimed to evaluate the effect of VCO supplementation on immune function by examining serum levels of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), and C-Reactive Protein (CRP) in a rat model subjected to physical exercise. An experimental approach was conducted using rats divided into four groups, consisting of a control group and several VCO-treated groups undergoing physical exercise. VCO was administered orally at varying doses throughout the exercise intervention period. At the end of the treatment, blood samples were collected, and serum concentrations of IL-6, TNF-α, and CRP were analyzed using immunoassay techniques. The data were evaluated descriptively to observe trends among the treatment groups. The findings demonstrated a consistent decrease in IL-6, TNF-α, and CRP levels in rats receiving VCO supplementation compared to the control group. The most pronounced reduction in all inflammatory markers was observed in the group receiving the highest dose of VCO, indicating a dose-dependent effect. These results suggest that VCO supplementation effectively attenuated exercise-induced inflammatory responses. Overall, VCO supplementation shows potential immunomodulatory and anti-inflammatory effects in rats exposed to physical exercise, as evidenced by reduced levels of IL-6, TNF-α, and CRP. VCO may therefore be considered a functional nutritional supplement to support immune balance during physical activity. However, further studies are needed to confirm these findings and to clarify the underlying biological mechanisms involved. Keywords: Virgin Coconut Oil, Physical Exercise, Immune Function, Inflammation, Interleukin-6, Tumor Necrosis Factor-α, C-Reactive Protein, Rat Model
Copyright (c) 2026 Fajar Apollo Sinaga, Rika Nailuvar Sinaga, Alin Anggreni Ginting, Ayu Elvana http://creativecommons.org/licenses/by-sa/4.0
Analysis of Risk Factors for Perioperative Complications Following Open and Laparoscopic Nephrectomy in Patients with Non-Functioning Kidneys: A Retrospective Cohort Study
Non-functioning kidneys are a common indication for nephrectomy, especially in resource-limited settings. Minimally invasive nephrectomy is preferred over open surgery because it reduces perioperative morbidity; however, how patient-related factors such as anemia, body mass index, and immunonutritional markers affect complication risk remains poorly defined. This retrospective cohort study examined perioperative outcomes and predictors of complications in 44 patients who underwent nephrectomy for non-functioning kidneys at a tertiary center in Indonesia between January 2022 and October 2025. Laparoscopic nephrectomy was used in 68% of cases, with markedly lower intraoperative blood loss (median 150 vs. 500 cc; approximately 73% reduction), a shorter median hospital length of stay (3 vs. 4.5 days), and earlier drain removal (3 vs. 4 days) compared with open surgery. These results align with prior studies highlighting laparoscopy's benefits in reducing morbidity and expediting recovery. Overall, 32% of patients experienced intra- or postoperative complications. Open nephrectomy significantly increased the risk of complications (OR 4.0, p=0.049). Preoperative anemia (OR 8.7, p=0.006) and underweight status (OR 11.7, p=0.001) emerged as primary risk factors, emphasizing the importance of transfusion needs and the adverse nutritional impacts across major surgical interventions. In contrast, a high neutrophil-to-lymphocyte ratio, a high platelet-to-lymphocyte ratio, and a low prognostic nutritional index despite being commonly observed were not significantly associated with perioperative complications in this retrospective cohort. For benign nephrectomy addressing non-functioning kidneys, the most effective approach to curbing perioperative complications is to prioritize laparoscopic surgery coupled with systematic management of anemia and undernutrition Keywords: Nephrectomy, Perioperative Complication, Inflammatory Marker, Body Mass Index
Copyright (c) 2026 Raedi Ardlo Luzman, Ahmad Zulfan Hendri http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Health Promotion Using the Snakes and Ladders-Hopscotch Game Media on Adolescent Knowledge of Vegetable and Fruit Consumption at SMPN 6 Jambi City
Vegetable and fruit consumption among adolescents aged 10–14 years remains very low at 2.3%. Adolescents prefer fast food, often neglecting their need for vegetables and fruits, even though a balanced diet is crucial for their growth and development. This study aims to analyze the effectiveness of a Snakes and Ladders game combined with hopscotch in increasing adolescents' knowledge about vegetable and fruit consumption. The research used a quasi-experimental design with a two-group pre-test-post-test approach at SMPN 6 and SMPN 11 in Jambi City, with a sample of 52 respondents in the intervention group and 51 in the control group. Data analysis was performed using the Wilcoxon and Mann-Whitney tests. The Wilcoxon test showed a significant increase in knowledge in the intervention group (p=0.000), whereas the control group showed no significant change (p=0.257). The results of the Mann-Whitney test also showed no significant difference between the two groups at pre-test (knowledge p=0.628). Still, after the intervention, there was a significant difference in knowledge (p=0.000). The hopscotch, snakes, and ladders game is effective at increasing adolescents' knowledge about vegetable and fruit consumption. This media is recommended for use in health education in schools and healthcare facilities Keywords: Model, Snakes and Ladders Media, Hopscotch, Fruit and Vegetable Consumption, Adolescents
Copyright (c) 2026 Irma Handayani http://creativecommons.org/licenses/by-sa/4.0
Behavioral Determinants of Compliance with Iron Tablet Consumption in Pregnant Women: An Analytical Study in Primary Obstetric Services
Adherence to iron tablet consumption among pregnant women remains suboptimal despite its critical role in preventing iron deficiency anemia. Previous studies have identified various influencing factors; however, evidence regarding the relative contribution of behavioral determinants, particularly the role of the husband’s support in primary obstetric care, remains limited. This study aimed to analyze the influence of knowledge, attitudes, and husbands’ support on adherence to iron tablet consumption among pregnant women. An analytical cross-sectional study was conducted involving 47 pregnant women in primary obstetric services. Data were collected using a validated questionnaire and analyzed using Fisher’s Exact test and binary logistic regression to identify the most dominant factor. The results showed that 63.8% of respondents were non-adherent to iron tablet consumption. Bivariate analysis indicated significant associations between husband’s support (p=0.001), knowledge (p=0.024), and attitude (p=0.018) with adherence. Multivariate analysis revealed that husband’s support was the strongest predictor of adherence (OR=9.15; 95% CI: 2.45–34.1), followed by attitude (OR=5.22) and knowledge (OR=4.14). In conclusion, the husband’s support plays a pivotal role in improving adherence to iron tablet consumption among pregnant women. Therefore, interventions in primary obstetric care should incorporate partner involvement in antenatal education to strengthen reinforcing factors and improve maternal health outcomes Keywords: Husband's Support, Compliance, Knowledge, Attitude, Iron Tablets
Copyright (c) 2026 Maya Sari http://creativecommons.org/licenses/by-sa/4.0
Strengthening the Role of Case Manager in Quality and Cost Control in Hospital: A Case Study at Sembiring General Hospital, Deli Serdang, North Sumatra
Case managers in hospitals play a vital role in keeping healthcare services both high in quality and efficient in cost. With the financing system now using a packaged fee model, hospital leaders are under pressure to manage expenses effectively without compromising patient care. This study looks at how the case manager function is carried out at Sembiring General Hospital and explores the challenges faced in practice. Conducted in April 2025, the research used a qualitative case study approach with six informants: five case managers and one medical services director. Data were collected through semi-structured interviews and were analyzed thematically. Findings show that case managers encounter two main sets of challenges: organizational issues and professional care provider (PPA) issues. On the organizational side, the obstacles include limited IT/data support, unclear authority, and insufficient training. On the PPA side, challenges involve physicians’ willingness to accept input, collaboration among care providers, and adherence to clinical pathways. To strengthen the role of case managers, hospital management needs to reinforce their authority across all service units, especially among patient care professionals. Practical steps include adding a dedicated menu in the hospital information system (SIM RS) so case managers can monitor costs in real time, and issuing a director’s decree to formally confirm their duties and authority. These measures are essential to optimize case managers’ contribution to cost and quality control Keywords: The Role of Case Manager, Quality and Cost Control, Professional Care Provider
Copyright (c) 2026 Efrata Efrata, Alprindo Sembiring, Friska Ernita Sitorus http://creativecommons.org/licenses/by-sa/4.0
Effect of TIJEK Nuggets as a Local Supplementary Food on Weight Gain among Stunted Toddlers: A Pre-Experimental Study
Stunting remains a critical public health challenge in Indonesia, particularly in regions like Deli Serdang Regency, North Sumatra, where prevalence rates remain elevated despite ongoing interventions. This pre-experimental one-group pretest-posttest study evaluated the effect of TIJEK Nuggets a locally developed supplementary food made from tempeh (fermented soybeans), anchovies, chicken eggs, and spices as a nutrition intervention to improve the nutritional status of stunted toddlers aged 2-5 years in Pantai Labu Pekan Village. From a population of 45 eligible toddlers, 30 participants meeting the inclusion criteria (willingness to participate and measurable anthropometrics) were consecutively sampled. Baseline height and weight measurements served as pretest values, followed by daily administration of 100 grams of TIJEK Nuggets (divided into two servings) for 14 days, with posttest anthropometrics recorded thereafter. Nutritional analysis confirmed that 100 grams (4 pieces) of TIJEK Nuggets provided 150.61 kcal of energy, 26.83 g of carbohydrates, 7.92 g of protein, 11.61 g of fat, 62.56 g of water, and 1.40 g of ash, leveraging high-protein local ingredients to address macronutrient deficiencies common in stunting. Results showed no significant change in mean height (pretest-posttest: 92.72 cm ± 7.69 cm), but averages were identical due to minimal linear growth over the short term. However, mean weight increased significantly from 12.77 kg ± 2.03 kg to 13.39 kg ± 2.04 kg (p=0.001), indicating TIJEK Nuggets effectively promoted short-term weight gain. This aligns with biological expectations: height reflects chronic malnutrition, which responds to prolonged interventions, while weight responds more rapidly to energy-dense supplements. In conclusion, TIJEK Nuggets demonstrate promise as an accessible, effective supplementary food for short-term weight improvement in stunted toddlers, warranting broader, controlled applications within multifaceted anti-stunting strategies Keywords: Stunting, Toddlers, Nutritional Status, TIJEK Nuggets, Local Food
Copyright (c) 2026 Erlina Nasution, Fitriyani Pulungan, Ida Nurhayati, Syahira Addina, Elisa Julianti http://creativecommons.org/licenses/by-sa/4.0
A Conceptual Model of Family Assistance for Working Mothers in Preventing and Managing Postpartum Blues in Urban Areas
Physical recovery after childbirth. This study aimed to analyze factors influencing prevention and management efforts for postpartum blues among working mothers in an urban setting and to formulate a conceptual family-assistance model based on the significant predictors. A quantitative analytic study with a cross-sectional design was conducted among 206 working postpartum mothers in urban areas of Medan City, Indonesia. Postpartum blues symptoms were screened using the Edinburgh Postnatal Depression Scale (EPDS), with a cut-off score of ≥10. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The measurement model was evaluated through outer loading, Cronbach's alpha, rho_A, composite reliability, and average variance extracted (AVE). In contrast, the structural model was assessed using R-square, path coefficients, t-statistics, and p-values. Results: The mean EPDS score was 12.45 ± 3.18, and 142 respondents (69.0%) were categorized as having postpartum blues symptoms. All indicators demonstrated adequate outer loadings (>0.70), and all constructs met reliability and convergent validity criteria. The model explained 95.1% of the variance in prevention and management efforts for postpartum blues (R² = 0.951; adjusted R² = 0.947). The Health Belief Model had the strongest effect (β=0.312; T=7.428; p=0.000), followed by family assistance (β=0.288; T=5.236; p=0.000), psychological factors (β=0.254; T=5.644; p=0.000), social factors (β=0.210; T=3.442; p=0.001), physical factors (β=0.198; T=3.413; p=0.001), and demographic factors (β=0.185; T=3.557; p=0.000). Prevention and management of postpartum blues among working mothers should emphasize health beliefs, family assistance, psychological readiness, social support, physical recovery, and demographic vulnerability. The proposed conceptual model highlights the family as a key support system for early detection, help-seeking, and adherence to postpartum care Keywords: Postpartum Blues, Family Assistance, Working Mothers, Health Belief Model
Copyright (c) 2026 Elvalini Warnelis Sinaga, Rahmawani Fauza, Debora Lestari Simamora, Nova Linda Rambe, Wellina Br. Sebayang http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Early Warning Score (EWS) Implementation in Improving the Accuracy of Early Preeclampsia Detection in Antenatal Care
Preeclampsia remains a major contributor to the maternal morbidity and mortality rates, in which the delayed detection at the primary healthcare level often leads to late referrals and further severe complications. Objective: This study aimed to evaluate the effectiveness of an Early Warning Score (EWS) implementation for improving the accuracy of early preeclampsia detection during Antenatal Care (ANC) services at a Community Health Center. Methods: This study employed a pre-experimental one-group pretest-posttest design. A total of 20 pregnant women were selected through the total sampling. Detection accuracy was defined as the precision in systematically integrating vital signs and subjective clinical symptom assessments compared to conventional methods. Data were analyzed using a paired sample t-test with a significance level of 0.05. Results: The findings showed a significant improvement in the mean accuracy score for early detection from 62.45 (pretest) to 78.90 (posttest), with a mean difference of 16.45 (p < 0.05). Power analysis revealed a Cohen’s d value of 2.12, indicating that the EWS intervention had a large clinical effect size in enhancing the provider detection sharpness. Conclusion: The EWS implementation proved to be significantly effective for improving the accuracy of early preeclampsia detection within the scope of ANC services at the Mandala Community Health Center. Integrating EWS into the routine ANC practices is highly recommended to support a timely clinical decision-making and to prevent severe maternal complications Keywords: Early Warning Score, Preeclampsia, Antenatal Care, Early Detection, Maternal Health
Copyright (c) 2026 rapida saragih http://creativecommons.org/licenses/by-sa/4.0
The Relationship between Self-Efficacy in Choosing Nutritious Foods and the Daily Consumption Practices of Pregnant Women
Adequate consumption of nutritious food by pregnant women is a crucial factor in supporting maternal health and fetal growth and development. However, various factors such as knowledge, self-efficacy, and social support can influence the daily consumption behavior of pregnant women. This issue remains a public health challenge in Indonesia, mainly due to various behavioral, social, and environmental factors. This study aims to analyze the factors that affect the daily consumption of pregnant women in Bogor City Indonesia. An observational analytical study with a cross-sectional design was conducted on 231 pregnant women. The relationship between variables was analyzed using the Chi-Square statistical test with a p-value <0.05 as the significance threshold. Mothers' self-efficacy in choosing nutritious foods is significantly related to daily consumption adequacy (p = 0.000; OR = 0.319). Nutritional knowledge also shows a significant relationship (p = 0.016; OR = 2.043). Family social support has a significant effect on the daily consumption of pregnant women (p = 0.008; OR = 2.780). Meanwhile, food access (p = 0.978; OR = 0.976), antenatal nutrition counseling (p = 0.148; OR = 0.648), access to pregnancy nutrition information media (p = 0.116; OR = 2.872), and cultural/food taboo practices (p = 0.246; OR = 0.644) do not show a significant relationship. Self-efficacy, nutrition knowledge, and family social support are factors that significantly influence the adequacy of daily consumption among pregnant women. Efforts to improve nutrition education and strengthen family support should be the focus of interventions aimed at encouraging healthy eating behaviors among pregnant women Keywords: Food Consumption, Nutritional Knowledge, Pregnant Women, Self-Efficacy
Copyright (c) 2026 Asri Masitha Arsyati, Nhadira Mhestricia, Agustina Agustina http://creativecommons.org/licenses/by-sa/4.0
Exploring Adolescent Ideas for Designing Reproductive Health Interventions to Prevent Early Marriage and Adolescent Pregnancy
Adolescence is a transitional phase filled with challenges, characterized by social development, attraction to the opposite sex, and vulnerability to risky behaviors. Adolescent pregnancy and early marriage remain global issues, including in Indonesia. Contributing factors include poverty, low levels of education, and inherited cultural practices. These lead to serious consequences such as school dropout, limited educational opportunities, and reduced quality of life, hindering the achievement of Indonesia Emas 2045. This study aims to explore adolescents’ ideas and perspectives regarding existing policies and to design potential interventions. This research employed a qualitative, interpretative approach. The study involved 24 undergraduate students from the Public Health Study Program, Universitas Jambi. Data were collected through Focus Group Discussions (FGDs) and in-depth interviews, analyzed using data reduction, and conclusion drawing. The research findings identified a significant knowledge gap regarding the availability of adolescent-specific reproductive health services (RHS) at universities and health facilities. Although most informants had adequate knowledge about adolescent pregnancy, many were not sufficiently aware of reproductive health services or counseling specifically targeting them. Informants also reported relatively good communication with their parents, particularly with mothers, while community figures were identified as playing important roles. Young people expect the availability of adolescent-focused health services, more effective communication with parents, especially greater involvement of fathers, and forums bringing together community leaders and adolescents to strengthen preventive efforts.
Copyright (c) 2026 Adelina Fitri, Vinna Rahayu Ningsih, Marta Butar Butar, Erny Kusdiah, Ashar Nuzulul Putra, La Ode Reskiaddin http://creativecommons.org/licenses/by-sa/4.0
Insufficient Fluid Intake during Fishing as a Determinant of Hypertension among Traditional Fishermen in Coastal Soropia
Hypertension is a major public health problem and an important risk factor for cardiovascular disease, particularly among informal workers such as traditional fishers who are exposed to harsh working conditions and limited healthy lifestyle choices. Coastal fishers generally work in hot environments, spend long fishing hours, smoke, and have limited access to safe drinking water during fishing activities. This study aims to analyze the association between sociodemographic characteristics, behavioral factors, and drinking patterns during fishing activities with hypertension among traditional fishers. A cross-sectional analytical study was conducted among 168 fishers in Soropia Regency, Southeast Sulawesi, Indonesia, recruited using proportional random sampling. Univariate analysis showed a high prevalence of hypertension (50.6%), with smoking behaviors and inadequate drinking patterns during fishing being the dominant factors. Bivariate analysis showed that age ≥50 years (p=0.030; OR=2.30; 95% CI: 1.08–5.04), education level (p=0.025; OR=2.04; 95% CI: 1.09–3.83), smoking behavior (p=0.001; OR=3.62; 95% CI: 1.60–8.08), and inadequate drinking pattern (p=0.003; OR=2.60; 95% CI: 1.38–4.92) were significantly associated with hypertension. Multivariate analysis confirmed that education (p=0.040; OR=2.177; 95% CI: 1.034–4.584), smoking (p=0.005; OR=3.667; 95% CI: 1.476–9.111), age ≥50 years (p=0.019; OR=2.903; 95% CI: 1.196–7.046), and inadequate drinking pattern during fishing activities (p=0.001; OR=3.350; 95% CI: 1.628–6.892) remained the dominant factors associated with hypertension. These findings call for structured, community-based preventive interventions in coastal fishing populations that are explicitly calibrated to the magnitude of the identified risks: smoking cessation programs are prioritized given the 3.7-fold increased risk among smokers (OR=3.667), while mandatory hydration protocols during fishing trips are warranted due to the 3.4-fold increased risk associated with inadequate fluid intake (OR=3.350). Furthermore, targeted blood pressure screening for fishers aged ≥50 years (OR=2.903) and context-sensitive health education for those with lower educational levels (OR=2.177) should be integrated into coastal primary health care programs to ensure comprehensive and proportional risk reduction based on evidence Keywords: Hypertension, Public Health, Fishermen, Coastal Areas, Inadequate Fluid Intake
Copyright (c) 2026 cholik harun rosjidi, CHOLIK HARUN ROSJIDI http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of the Time Rushing Game Method in Enhancing Knowledge, Skills, and Self-Efficacy in Health-Oriented Disaster Response Simulations
This study aimed to evaluate the effectiveness of the time-rushing game method in enhancing knowledge, skills, and self-efficacy in health-oriented disaster response simulations. A quasi-experimental one-group pretest-posttest design study was conducted with 114 nursing students. The Time Rushing Game measured knowledge, skills, and self-efficacy in conducting disaster-response simulations. The Time Rushing Game intervention consisted of triage, evacuation, and initial assessment procedures, each with a 10-minute time limit. After receiving the intervention or playing the disaster simulation, knowledge, skills, and self-efficacy were measured again. Knowledge and self-efficacy were measured using a questionnaire. Skills are measured using an observation sheet. There was a significant improvement in knowledge (p=0.000), skills (p=0.000), and self-efficacy (p=0.000) after the intervention using the Time Rushing Game learning method. The number of respondents who experienced an increase was 77 for knowledge and 106 for both skills and self-efficacy. Meanwhile, 37 respondents showed no change in knowledge, and 8 respondents each showed no change in skills and self-efficacy. The Time Rushing Game effectively enhanced students' knowledge, skills, and self-efficacy in health-oriented disaster response simulations. This learning method should be implemented not only in health-oriented disaster response simulations but also in other case-study-based simulations Keywords: Time Rushing Game, Knowledge, Skills, Self-Efficacy, Disaster Preparedness
Copyright (c) 2026 Uti Rusdian Hidayat, Defa Arisandi, Debby Hatmalyakin, Ali Akbar, Fauzan Alfikrie, Nurpratiwi Nurpratiwi, Mimi Amaludin, Ihsan Angga Anjarwadi, Nurannisa Nurannisa, Andi Subandi http://creativecommons.org/licenses/by-sa/4.0
Adaptation of Coastal Adolescents to Digital Technology in Improving Health Behavior
Digital technology increasingly shapes adolescent health behavior; however, little is known about how adolescents in remote coastal communities adapt to digital health information environments. This study aims to explore how digital technology influences adolescent health behaviors and how environmental and social factors shape adolescents’ adaptation to digital technology in a coastal community. This qualitative study employed a phenomenological approach. Data were collected through in-depth interviews with 27 adolescents aged 15–19 years and two focus group discussions conducted in Mandangin Island, Madura, Indonesia. Participants were selected using purposive sampling based on their access to digital devices and internet connectivity. Data were analyzed using thematic analysis supported by NVivo 12 software. Digital technology, particularly social media platforms such as TikTok, Instagram, and YouTube, emerged as the primary source of health information for adolescents. Participants reported increased awareness of healthy behaviors, including diet, physical activity, and mental well-being. However, significant challenges were identified, including limited internet access, unequal device ownership, and difficulties in distinguishing credible information from misinformation. Peer influence played a central role in shaping how adolescents adopt and interpret online health information. Digital technology has the potential to support positive health behavior among adolescents in coastal communities. Nevertheless, digital inequality and limited digital health literacy restrict its effectiveness. Strengthening digital literacy and improving equitable access to technology are essential to optimize digital health interventions for adolescents in underserved coastal areas Keywords: Adolescent Health, Digital Health Literacy, Health Behavior, Digital Divide, Coastal Community, Qualitative Research
Copyright (c) 2026 Diah Wijayanti Sutha, Nathratul Ayeshah Binti Zulkifli, Christine Christine, Siti Novianti http://creativecommons.org/licenses/by-sa/4.0
The Impact of Magic Lift-The-Flap Books on Knowledge and Attitudes of Children Regarding Obesity Prevention at SD IT Iqra 2, Bengkulu City
The issue of imbalanced nutrition among elementary school children became a health problem that could impact children in the future, such as obesity. The effects could include health and psychosocial problems in children. One of the factors that caused this condition was the lack of knowledge and attitudes among children. As a result, the Magic Lift-The-Flap Book is an example of the kind of interactive media that might be utilized to enhance children's understanding and beliefs. This study examines the effect of the Magic Lift-The-Flap Book on children’s knowledge and attitudes regarding obesity prevention at SD IT Iqra 2, Bengkulu City. A quantitative pre-experimental study with a single-group pre-test and post-test design was conducted. The sample consisted of 40 fifth-grade students aged 10–12 years who were randomly selected from a population of 129. Data were collected via questionnaires and analyzed using the Wilcoxon Signed Rank Test. The result of this study indicated that students’ knowledge scores rose from a mean of 69.25 prior to the intervention to 88.00 following the use of the Magic Lift-The-Flap Book. Similarly, the average attitude score improved from 24.50 prior to the intervention to 36.58 after the intervention. These findings demonstrated that the Magic Lift-The-Flap Book exerted a statistically significant influence on children’s knowledge and attitudes toward obesity prevention at SD IT Iqra 2, Bengkulu City, as indicated by a p-value of <0.001. Therefore, the Magic Lift-The-Flap Book was expected to function as an engaging educational medium to enhance elementary school children’s knowledge and attitudes regarding obesity prevention Keywords: Obesity, Magic Lift-The-Flap Book, Knowledge, Attitude
Copyright (c) 2026 Lissa Ervina http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Social Media Message Framing on Caries Risk Perception among Health Science Students: A Quasi-Experimental Study Based on the Health Belief Model
Despite increasing access to oral health education, the prevalence of dental caries remains high among health science students, indicating a gap between theoretical knowledge and individual risk perception. This study aimed to evaluate the effectiveness of message framing strategies delivered via social media in enhancing caries risk perception, based on the Health Belief Model (HBM). This study employed a pretest-posttest quasi-experimental design with a control group. A total of 130 students from the Faculty of Dentistry at Prima Indonesia University were selected using purposive sampling and divided into an intervention group (n = 65) and a control group (n = 65). The intervention group was exposed to gain-framed and loss-framed health messages through social media over one month, while the control group received no intervention. Risk perception was measured using six core HBM constructs and analyzed using the Wilcoxon Signed-Rank Test and Mann–Whitney U Test. The results showed statistically significant improvements (p< 0.001) in perceived susceptibility, severity, benefits, cues to action, and self- efficacy in the intervention group, while perceived barriers showed no significant change. These findings suggest that social media–based message framing is effective in improving caries risk perception and may help bridge the gap between knowledge and behavior among the productive-age population Keywords: Dental Caries, Digital Health Promotion, Health Belief Model, Message Framing, Risk Perception, Social Media Intervention
Copyright (c) 2026 Idamawati Nababan, Member Reni Purba, Niki Yuchinda http://creativecommons.org/licenses/by-sa/4.0
The Effect of Telenursing-Based Five-Finger Hypnosis Therapy on Maternal Stress Among Mothers of Stunted Children: A Quasi-Experimental Study
Background: Stunting remains a major public health problem in developing countries, including Indonesia. In addition to nutritional factors, maternal psychological stress may indirectly affect caregiving quality and child well-being. Objective: This study aimed to examine the effect of telenursing-based five-finger hypnosis therapy on maternal stress levels among mothers of children with stunting. Methods: A quasi-experimental pretest-posttest control group design was conducted from March to May 2024 in Wanaraja Village, Garut Regency, Indonesia. A total of 34 mothers of children with stunting were recruited using purposive sampling and assigned to an intervention group (n = 17) and a control group (n = 17). The intervention group received telenursing-based five-finger hypnosis therapy for seven sessions over four weeks, while the control group received routine puskesmas services. Maternal stress was measured using 14 items derived from a modified DASS-42 questionnaire. Data were analyzed using the Friedman test and Mann-Whitney test. Results: Maternal stress in the intervention group decreased progressively from pretest to posttest 1 and posttest 2, with mean scores declining from 18.4 (SD 3.12) to 16.4 (SD 2.50) and 14.5 (SD 2.40), respectively. The control group also showed a slight reduction, from 18.9 (SD 2.29) to 17.9 (SD 2.77) and 17.6 (SD 2.50). However, the reduction in maternal stress was significantly greater in the intervention group than in the control group at week 2 (p = 0.036) and week 4 (p < 0.001), with a larger effect observed at week 4. Conclusion: Telenursing-based five-finger hypnosis therapy was associated with a greater reduction in maternal stress among mothers of children with stunting than routine care alone. This intervention may serve as a supportive psychosocial strategy in community-based stunting management programs.
Copyright (c) 2026 Iwan Wahyudi, Tanti Suryawantie, Ishmah Hamidah http://creativecommons.org/licenses/by-sa/4.0
Effects of Digital Maternal Referral Systems on Referral Performance and Maternal Survival-Related Outcomes: A Systematic Review
Timely maternal referral is essential for emergency obstetric care, but the effectiveness of digital maternal referral systems in improving referral performance and maternal survival-related outcomes remains uncertain. This systematic review synthesized evidence on digital, mobile, or information-based referral interventions that have core functions comparable to those of integrated referral systems such as SISRUTE. Scopus and PubMed were searched for English-language records published from 1 January 2000 to 31 December 2025. The review followed PRISMA 2020 guidance. Eligible studies involved pregnant, intrapartum, or postpartum women, obstetric emergency referrals, or health workers managing maternal referrals, and evaluated implemented digital or mobile referral interventions. Studies limited to non-digital referral barriers, prototype development without evidence of implementation, or non-maternal referral populations were excluded. Owing to heterogeneity in design, interventions, and outcomes, narrative synthesis was conducted. Six studies from Uganda, Ghana, Liberia, and Iraq were included in the primary synthesis. Evidence for a reduction in direct maternal mortality was insufficient. However, digital referral interventions were associated with improved process and survival-related proxy outcomes, including lower adverse maternal-fetal outcomes, faster referral response, better identification of receiving hospitals, improved preparedness, and shorter decision-to-incision intervals for emergency cesarean delivery. The most consistent benefits were observed in communication, triage, coordination, and treatment timeliness. Digital maternal referral systems appear to be more strongly supported as tools for improving referral performance than as interventions with proven direct effects on mortality. Their potential contribution to maternal survival is most plausibly indirect and depends on transport, receiving-facility readiness, clinical triage, and implementation support Keywords: Digital health, e-referral, maternal referral, maternal survival, mHealth, obstetric emergency, triage
Copyright (c) 2026 Erni Suryani Wongso, Zulvayanti Zulvayanti, Hardi Sursiano http://creativecommons.org/licenses/by-sa/4.0
The Impact of Nutritional Counseling Using Flyers on Knowledge of Chronic Energy Deficiency (CED) Among Pregnant Women
Chronic energy deficiency (CED) is one of the nutritional problems of pregnant women that can be prevented through counseling. The prevalence of CED at Waara Community Health Center increased from 2022 (20.9%), in 2023 (29.8%), and in 2024 (32.2%). The purpose of this study was to determine the effect of nutritional counseling using flyers on pregnant women’s knowledge of CED. This research is a pre-experimental study with a one-group pre-test and post-test design. This study was conducted in the working area of the Waara Community Health Center in Muna Regency from Juny 6 to November 10, 2025. The sample comprised 27 pregnant women in the working area of the Waara Community Health Center in 2025, during the October to November period, selected through total sampling. Data were collected using a questionnaire to measure knowledge about CED and tested using a paired t-test. The results of the study on 27 samples, the average score of knowledge of pregnant women increased from 7.00 to 10.00. The results of the paired t-test obtained a p < 0.001. The conclusion is that nutritional counseling using flyers resulted in a significant increase in knowledge about CED among pregnant women in the Waara Community Health Center, Muna Regency Keywords: Counseling, Flyer, Knowledge, Nutrition, Pregnant women
Copyright (c) 2026 Desidarius Bela Dhesa, Asran Asran, Desidarius Bela Dhesa http://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Exclusive Breastfeeding and Speech Delay in Toddlers in Coastal Areas
Speech delay in early childhood is a serious problem that affects communication and cognitive development. Exclusive breastfeeding may be related to children’s speech development. The purpose of this study was to determine the relationship between exclusive breastfeeding and speech delay in toddlers in the coastal area of the Lansilowo Community Health Center. This was a quantitative, cross-sectional study. The sample consisted of 62 toddlers aged 24-59 months in the working area of the Lansilowo Health Center in Konawe Kepulauan Regency in June 23-September 9, 2025. The sampling technique used was proportionate stratified random sampling. Data on speech delay were assessed using the Denver II instrument, which is a validated and reliable questionnaire, and analyzed using Fisher’s exact test. The results showed that of the 2 toddlers who were exclusively breastfed, 100% did not have speech delays. Furthermore, of the 60 toddlers who were not exclusively breastfed, the majority had speech delays (93.3%). The Fisher’s exact test yielded a p-value of 0.008. The study concludes that an exclusive breastfeeding history was associated with speech delay among toddlers, and there is a relationship between exclusive breastfeeding and speech delay in toddlers Keywords: Child Development, Coastal Areas, Exclusive Breastfeeding, Speech Delay, Toddlers
Copyright (c) 2026 Ellyani Abadi, Haswindah Arifin, Siti Hadrayanti Ananda http://creativecommons.org/licenses/by-sa/4.0
Health Workers’ Experiences and Challenges in Providing Comprehensive Antenatal Care in Rural Primary Health Centers in West Nias District
Antenatal care (ANC) plays a critical role in reducing maternal and neonatal risks, yet its delivery in rural and remote areas remains constrained by geographic isolation, limited health resources, workforce shortages, and sociocultural barriers. This study explored the experiences and challenges of health workers in providing comprehensive ANC services in rural primary health centers in West Nias District, North Sumatra, Indonesia. A qualitative study with a grounded theory approach was conducted among 16 health workers, consisting of 11 midwives and five physicians, who were selected through purposive sampling. Data were collected through in-depth semi-structured interviews, supported by field notes, limited participant observation, and review of relevant service documents. Data were analyzed using open, axial, and selective coding. The findings identified professional resilience as the core category explaining how health workers sustain ANC services in resource-limited and culturally complex settings. This resilience was shaped by four interrelated themes: limited resources and infrastructure, human resource constraints, sociocultural influences, and adaptation strategies. Health workers maintained service continuity through manual examination methods, mobile services, home visits, informal counseling, community-based education, and collaboration with village leaders, religious leaders, and traditional birth attendants. These strategies helped strengthen community trust and improve access to ANC services. The study highlights the need to strengthen rural maternal health systems through improved infrastructure, adequate staffing, supportive supervision, and culturally responsive service planning Keywords: Antenatal Care, Health Workers, Maternal Health, Professional Resilience, Rural Health Services, Community Collaboration
Copyright (c) 2026 Putri Ayu Yessy Ariescha, Peny Ariani, Nur Mala Sari, friska ernita Sitorus http://creativecommons.org/licenses/by-sa/4.0
Ketupat Processing Traditions in Minangkabau: An Eco-Theological, Health, and Cultural Resilience Study
This study examines the Ketupat tradition, a Minangkabau food wrapped in young coconut leaves, through the lenses of eco-theology, public health, and cultural resilience. Employing a qualitative methodology that integrates in-depth interviews with 25 informants (15 entrepreneurs, 5 cultural leaders, and 5 academics), participatory observation, and textual analysis with data analyzed thematically using NVivo software the research was conducted across key centers of Minangkabau diaspora life in Padang (West Sumatra, Indonesia), Yogyakarta (Indonesia), and Negeri Sembilan (Malaysia). The findings reveal three interrelated dimensions. First, the use of natural leaf wrappers embodies the Islamic eco-theological principle of khalifah fil-ardh (humans as stewards of the earth), expressed through faith-driven ecological awareness among tradition bearers. Second, coconut leaves provide tangible health benefits by eliminating risks of chemical migration from plastic and styrofoam packaging, reinforcing community-based food safety rooted in natural materials. Third, Ketupat-making sustains cultural identity and social cohesion within diaspora communities through intergenerational transmission and collective rituals. Overall, the study argues that traditional food practices grounded in natural materials represent a convergence of ecological wisdom, health protection, and spiritual values, underscoring the importance of integrating local wisdom into sustainable food policies and national food security strategies Keyword: Ketupat ; Ketupat; Minangkabau; eco-theology; traditional food systems; public health; cultural resilience; food packaging
Copyright (c) 2026 Azhari Akmal Tarigan, Jufri Naldo, Syahrial Arif Hutagalung, Uswatun Hasanah, Ismail Ismail http://creativecommons.org/licenses/by-sa/4.0
Determinants of Post-Odontectomy Complications: A PLS-SEM Analysis of Clinical Pathway Effectiveness and Patient Risk Profiles
This study analyses the effect of clinical pathway implementation on post-odontectomy complications. It examines the influence of patient-related factors on postoperative outcomes at the Dental and Oral Hospital of Universitas Airlangga. Globally, oral diseases remain a major public health burden, emphasizing the need to improve the quality and safety of dental surgical care. However, evidence on the effectiveness of clinical pathways in minor oral surgery, particularly in developing countries, remains limited. A quantitative cross-sectional approach was applied using a survey method. A total of 107 participants were included in this study, consisting of 97 odontectomy patients and 10 healthcare professionals selected through purposive sampling. Data were collected from clinical pathway documents, medical records, and structured questionnaires and analyzed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). The results show that patient-related factors have a significant positive effect on post-odontectomy complications (β = 0.855; p < 0.001), indicating that age, comorbidities, and adherence to postoperative instructions are key determinants. In contrast, Clinical Pathway implementation has no significant direct effect (β = −0.012; p = 0.406) and does not moderate the relationship between patient factors and complications (β = −0.028; p = 0.296). The model demonstrates strong explanatory power (R² = 0.731). These findings suggest that improving postoperative outcomes requires strengthening patient-centered risk assessment and more effective, consistent implementation of clinical pathways in practice Keywords: Clinical Pathway, Odontectomy, Postoperative Complications, Patient Factors, Healthcare Quality
Copyright (c) 2026 Rachman Indharmawan, kusbaryanto kusbaryanto http://creativecommons.org/licenses/by-sa/4.0
Development and Functional Testing of BETAPA ANTIK 2.0: An Android-Based Mobile Application for Community Dengue Surveillance and Reporting in North Sumatra, Indonesia
Dengue fever remains a major public health concern in Indonesia, particularly in tropical regions such as North Sumatra, where Deli Serdang Regency reports persistently high case numbers. Conventional larva surveillance and the 1 House 1 Larva-Monitor movement (G1R1J) still rely on manual, paper-based reporting that is slow, poorly documented, and difficult to coordinate in real time. The initial BETAPA ANTIK 1.0 application supported larva-survey reporting but lacked educational video content and adult mosquito identification tools, limiting its utility for community education and vector surveillance. This study aims to develop and functionally test BETAPA ANTIK 2.0 (Based on Larvae Surveillance and Analysis Technology), an Android-based mobile application, incorporating GPS-based location tracking, digital case reporting, multimedia public education, and an adult-mosquito identification camera. A design-and-development (Research and Development) approach was employed, following the Waterfall software-development life cycle: requirements analysis, system design, implementation, testing, and maintenance. The application was built on the Android platform using Kotlin/Java, and functional verification was conducted through black-box testing of each feature. BETAPA ANTIK 2.0 provides five core modules: GPS enabled geotagging, a digital reporting workflow integrated with WhatsApp and Gmail, video and poster-based educational media, and an adult-mosquito identification camera covering 23 species. All functional (black-box) test cases performed according to specifications, with the only limitation being dependence on a stable internet connection. Usability, user acceptance, and the accuracy of mosquito-identification were not formally evaluated and are identified as priorities for future studies. BETAPA ANTIK 2.0 was successfully developed and passed functional (black-box) testing, representing a promising digital tool to support participatory dengue surveillance and reporting. However, its effectiveness in dengue control requires further filed implementation and usability evaluation. Recommended next steps include developing an offline mode, risk-zone notifications, and integration with existing health information systems. Keywords: Dengue Prevention and control, Mosquito Vectors, Mobile Applications, Epidemiological Surveillance, Community Participation, Indonesia
Copyright (c) 2026 Risnawati Tanjung, Helfi Nolia, Jernita Sinaga, Adristi Wina Damanik, Deli Syaputri, Samuel Marganda H Manalu, Nelson Tanjung http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Family Planning Counseling in Improving Knowledge among Women Not Using Contraception in the Working Area of Siatas Barita Community Health Center, North Tapanuli Regency 2025
Insufficient understanding and misconceptions about contraceptive techniques may impede women's capacity to make educated reproductive health choices. This study investigated short-term alterations in family planning knowledge subsequent to counseling among women not utilizing contraception in the jurisdiction of Siatas Barita Community Health Center, North Tapanuli Regency, Indonesia. A pre-experimental one-group pretest-posttest study was executed in Pancurnapitu Village from July to December 2025. A total of 53 women aged 20 to 49 years, who were not utilizing contraception, were recruited via convenience sampling. The assessment of family planning knowledge was conducted prior to counseling and 12 days post-intervention utilizing a structured 10-item true-or-false questionnaire. Total scores were categorized as good knowledge, assigned a code of 1, or poor knowledge, assigned a code of 2; hence, a lower mean coded score signified superior knowledge. Differences between pre-intervention and post-intervention scores were examined utilizing a paired-samples t-test. The average coded knowledge score diminished from 1.74 ± 0.445 prior to counseling to 1.40 ± 0.494 subsequent to therapy, resulting in a mean difference of 0.34 points. The decrease in scores, which signified enhanced knowledge, demonstrated an improvement in family planning knowledge subsequent to counseling (p < 0.001). Furthermore, 35 women (66.04%) indicated a willingness to utilize contraception but had not obtained consent or support from their husbands or family members. Family planning counseling correlated with enhanced short-term knowledge in women not utilizing contraceptives. These findings endorse the use of structured, client-centered, and rights-based counseling within basic healthcare services. The lack of a control group, the application of non-probability sampling, and the brief follow-up duration constrain causal inference and generalizability. Additional controlled trials employing validated instruments, representative populations, and extended follow-up durations are necessary to ascertain if enhanced knowledge results in informed and maintained contraceptive utilization Keywords: Contraceptive Counseling, Family Planning, Health Education, Reproductive Health, Women Of Reproductive Age.
Copyright (c) 2026 Naomi Isabella Hutabarat http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Leaflet-Based Health Education on Pregnant Women’s Knowledge of Anemia Prevention: A Quasi-Experimental Study at Paniaran Community Health Center, North Tapanuli, Indonesia
Anemia in pregnancy remains a major public health problem in Indonesia and is associated with serious maternal and neonatal complications, including hemorrhage, low birth weight, prematurity, and stunting. Adequate maternal knowledge is essential for prevention, and simple educational media such as leaflets may help improve awareness. This study aims to analyze the effect of leaflet-based health education on pregnant women’s knowledge of anemia prevention. A quasi-experimental one-group pretest–posttest design was conducted from July to December 2025 at Paniaran Community Health Center, North Tapanuli Regency. Twenty-five pregnant women attending antenatal classes were recruited. Knowledge was assessed using a structured questionnaire before and 14 days after the intervention. Data were analyzed using the Wilcoxon signed-rank test with a significance level of 0.05. Prior to the intervention, 72% (n=18) of respondents demonstrated good knowledge; this proportion increased to 92% (n=23) after the intervention. The Wilcoxon test indicated a statistically significant improvementin knowledge (p = 0.011 < 0.05). Leaflet-based health education significantly improved pregnant women’s knowledge of anemia prevention. This approach can serve as a simple, low-cost educational tool to strengthen anemia prevention within antenatal care services. Keywords: Anemia In Pregnancy, Maternal Health Education, Health Promotion, Iron Deficiency Anemia Prevention, Leaflet.
Copyright (c) 2026 riance mardiana ujung http://creativecommons.org/licenses/by-sa/4.0
Analysis Of The Use Of The Tuberculosis Information System On The Effectiveness Of Tb Treatment Services Using The Hot-Fit Model Approach At Dr. Rehatta Regional General Hospital, Central Java Province
The Tuberculosis Information System (SITB) has been implemented at Dr Rehatta Regional General Hospital in Central Java to support the recording, reporting and monitoring of the TB programme; however, its effectiveness still needs to be evaluated. This study aims to evaluate the effectiveness of the SITB in supporting TB treatment services based on the HOT-Fit model. This is a quantitative analytical survey with a cross-sectional design involving 21 healthcare workers who use the SITB as the sample, selected via total sampling, as well as 4 respondents selected via purposive sampling for open-ended questions. Data were collected using a Likert-scale questionnaire and analysed using validity tests, internal consistency tests, descriptive statistics, and Spearman’s rank correlation test. The results indicate that respondents’ perceptions of human and technological factors fell within the ‘good’ to ‘very good’ categories, with the quality of technical support services identified as a weak point. There was a positive and significant relationship between user skills, adoption, system quality, service quality and technical support on the effectiveness of TB services; however, user satisfaction did not show a significant relationship. This study concluded that the SITB makes a positive contribution to the effectiveness of TB services; however, improvements in technical support, regular training and the involvement of doctors are still required to optimise its benefits Keywords: Tuberculosis Information System, HOT-Fit Model, Effectiveness of TB Services
Copyright (c) 2026 Figi Bayu Joko Saputro, Farid Agushybana, Cahya Tri Purnami http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Health Education on Self-care and Self-efficacy of Patients with Coronary Heart Disease: A Systematic Review
Coronary heart disease is a leading cause of morbidity and mortality worldwide. Health education is needed to improve patient self-care and self-efficacy. This research aims to synthesize the literature on health education, focusing on self-care outcomes and self-efficacy among patients with coronary heart disease. A systematic review was conducted through a literature search on ScienceDirect, PubMed, Wiley Online Library, and Scopus. The search strategy used a combination of keywords with the Boolean operators "AND" and "OR." Study selection was performed by screening titles, abstracts, and full texts in Rayyan. The methodological quality of articles meeting the inclusion criteria was assessed using the Joanna Briggs Institute (JBI) instrument. Of the 3,520 identified articles, five studies with a total of 958 coronary heart disease patients met the inclusion criteria. The interventions evaluated included diversified and staged health education, eHealth cardiac rehabilitation, a workbook in health education, web-based education, and problem-based learning. Overall, Diversified and Staged Health Education, eHealth Cardiac Rehabilitation, and Workbook in Health Education were effective in improving self-care and self-efficacy. Furthermore, a problem-based educational approach had a positive impact on self-efficacy. Findings indicate that multifaceted and phased health education effectively improves self-care, and eHealth cardiac rehabilitation and workbooks in health education have been shown to increase self-efficacy in patients with coronary heart disease. These improvements in self-care and self-efficacy have the potential to support cardiovascular risk factor management and improve patient health outcomes. Health education based on diversified and staged health education, eHealth cardiac rehabilitation, and workbook in health education is effective in improving self-care and self-efficacy in coronary heart disease patients. Integrating these interventions into coronary heart disease service standards has the potential to improve the quality of care, prevent complications, and reduce the risk of rehospitalization. Keywords: Coronary Heart Disease, Health Education, Self-Care, Self-Efficacy.
Copyright (c) 2026 rita rita, Azizah Khoiriyati http://creativecommons.org/licenses/by-sa/4.0
Risk Factors Associated with Hyperbilirubinemia in Newborns at Muhammadiyah Hospital Palembang
Neonatal jaundice remains a significant global health challenge, contributing to substantial neonatal morbidity and potential long-term neurological complications if not managed effectively. This study investigated the risk factors associated with hyperbilirubinemia at Muhammadiyah Hospital Palembang. Utilizing an analytical survey with a case-control approach, we compared 30 neonates diagnosed with hyperbilirubinemia (cases) against 30 neonates without the condition (controls). Participants were selected through purposive sampling between October and December 2024. Data were analyzed using chi-square tests and multivariate logistic regression to determine the strength of associations. The analysis revealed that gestational age (OR = 4.2; 95% CI: 1.8–9.5; p < 0.001), type of delivery (OR = 3.8; 95% CI: 1.5–8.2; p < 0.001), male gender (OR = 2.5; 95% CI: 1.1–5.4; p = 0.001), and low birth weight (OR = 5.1; 95% CI: 2.1–11.3; p < 0.001) were significant independent risk factors for hyperbilirubinemia. These findings underscore the necessity for midwives to implement comprehensive early screening and specialized management for high-risk neonates to mitigate the incidence of severe jaundice. Preterm birth and low birth weight are the most critical predictors of neonatal hyperbilirubinemia in this clinical setting, necessitating targeted postnatal surveillance. Keywords: Neonatal Jaundice, Risk Factors, Case-Control Study, Midwifery Care, Low Birth Weight.
Copyright (c) 2026 Wita Solama http://creativecommons.org/licenses/by-sa/4.0
Low Birth Weight as A Predictor of Stunting in Bojonegoro, East Java, Indonesia
Birth weight is the primary indicator of a baby's health. Babies with low body weight often face challenges in physical growth, metabolic function, and cognitive and intellectual development. The purpose of this study is to determine the relationship between a history of low birth weight and stunting. This study used a correlational analytical design with a cross-sectional approach. The population included 120 pairs of mothers and children aged 2–3 years. A simple random sampling technique selected 108 pairs as the sample. Data were collected by measuring the child's height and by obtaining secondary data on birth weight. Data analysis was carried out using Chi-Square and Contingency Coefficient tests. The results showed that of 69 respondents (63.9%) who had a history of low birth weight, as many as 45 children (41.7%) were stunted. The majority of respondents were children aged 2-3 years (92.3%), female, and firstborn. A chi-square statistical test yields a P-value = 0.008 < a (0.05). This indicates a relationship between a history of low birth weight and the incidence of stunting in children aged 2–3 years, with a Contingency Coefficient rate of 0.462. The conclusion shows that there is a link between low birth weight and the incidence of stunting in children aged 2–3 years. Parents are encouraged to attend Posyandu regularly for growth monitoring and optimal nutrition. Healthcare workers should prioritize nutritional counseling during pregnancy and the first two years of life. Policymakers are recommended to strengthen prenatal screening programs targeting low birth weight as an early predictor of stunting, particularly in agricultural communities with limited healthcare access. Keywords: Low Birth Weight, Stunting, Child Nutrition, Indonesia, Growth Disorders.
Copyright (c) 2026 Wiwik Utami http://creativecommons.org/licenses/by-sa/4.0
Characteristics of Mothers Undergoing Caesarean Section at Swadana Tarutung Regional General Hospital
Caesarean section (CS) delivery remains high in referral hospitals and requires continuous monitoring to support maternal health service planning. This study aimed to describe the characteristics of mothers undergoing CS at Swadana Tarutung Regional General Hospital in 2024. This study employed a retrospective descriptive design with a cross-sectional approach. The population consisted of 1,250 mothers who delivered by CS from January to December 2024. A total of 303 medical records were selected using systematic random sampling. Secondary data were obtained from medical records and delivery registers, including maternal age, gravidity, parity, education, and occupation. Data were analyzed using SPSS version 23.0. Univariate analysis was used to describe frequency distributions, while the Chi-square goodness-of-fit test was used to assess differences in the distribution of each characteristic, with a significance level of p < 0.05. The results showed that most mothers undergoing CS were aged 20–35 years (75.2%), multigravida (41.4%), multipara (50.8%), had completed senior high school education (66.7%), and worked as farmers (39.3%). The distribution of maternal age, education, occupation, gravidity, and parity among CS cases showed statistically significant differences. These findings indicate that CS cases were concentrated in certain maternal characteristic groups. However, because this study did not include non-CS deliveries as a comparison group, the findings should not be interpreted as determinants of CS incidence. Future studies are recommended to include both CS and non-CS deliveries and analyze clinical indications to identify factors associated with CS delivery Keywords: Caesarean section, maternal characteristics, gravidity, parity, medical records
Copyright (c) 2026 Urhuhe Dena Siburian, Paruhum Tiruon Ritonga http://creativecommons.org/licenses/by-sa/4.0
A Case Study Approach to Families Risk of Hyperemesis Gravidarum: Community Midwifery Care
Hyperemesis gravidarum (HG) is a pregnancy complication characterized by excessive nausea and vomiting, which may lead to dehydration, electrolyte imbalance, weight loss, and adverse health problems for both mother and fetus. Effective management of HG requires not only clinical intervention but also comprehensive family support and community-based midwifery care. This case study describes the application of community midwifery care for families at risk of HG and identifies family-related factors influencing the success of case management. A qualitative exploratory case study approach was employed to examine family perspectives on health services in depth, focusing comprehensively on a single case. Informants were selected purposively, with inclusion criteria targeting pregnant women at risk of HG. Data were collected through observation, interviews, physical examinations, and home visits. The findings revealed that the pregnant woman, Mrs. R, experienced severe nausea and vomiting, which reduced her appetite and daily functioning. Risk factors included her fourth pregnancy and limited family support, especially from her husband. Community midwifery interventions comprised education about HG, nutritional counseling, maternal condition monitoring, and family involvement in her care. Following these interventions, the mother's condition improved, as evidenced by reduced nausea and vomiting and enhanced family capacity to support her pregnancy. In conclusion, family-centered community midwifery care plays a crucial role in managing hyperemesis gravidarum. Ongoing education and family involvement can mitigate complications and promote maternal and fetal health during pregnancy Keyword: Case Study, Midwifery Care, Community, Hyperemesis Gravidarum
Copyright (c) 2026 Sumaifa Sumaifa, Isnaeny Isnaeny, Rahmi Suci Ramadhani http://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Anthelmintic Therapy Compliance and The Health Status and Quality of Life of Young Adults
Helminth infection remains a significant public health concern that may affect the health status and quality of life of young adults living in high-risk areas. However, this productive age group is often under-represented in soil-transmitted helminth (STH) research. This study aims to examine the relationship between adherence to anthelmintic therapy and both health status and quality of life among young adults in the working area of UPT Puskesmas Stabat. An analytic cross-sectional design was employed. A total of 47 young adults (aged 18–25 years) with a history of anthelmintic therapy in the previous 6–12 months were recruited through purposive sampling. Adherence was assessed using the modified 8-item Morisky Medication Adherence Scale (MMAS-8), health status with a validated complaints questionnaire combined with objective Body Mass Index (BMI) measurement, and quality of life with the WHO Quality of Life-BREF (WHOQOL-BREF) instrument covering the physical, psychological, social, and environmental domains. Data were analyzed using the chi-square test (with Yates correction or Fisher’s exact test where appropriate) on collapsed 2×2 tables, complemented by odds ratios (ORs) with 95% confidence intervals (CIs) and the phi coefficients. Most respondents were female (57.4%), aged 22–25 years (51.1%), students (55.3%), and had a normal BMI (68.1%). Adherence was high in 68.1% and moderate in 31.9% of respondents; 61.7% had good health status and 72.3% reported high quality of life. Adherence was not significantly associated with health status (χ² = 2.11; p = 0.147; OR = 2.51, 95% CI 0.71–8.86; φ = 0.21). In contrast, adherence was strongly and significantly associated with quality of life (Fisher’s exact p < 0.001; φ = 0.90). Within the limitations of a cross-sectional design, higher adherence to anthelmintic therapy was associated with better quality of life but not with measurable health status. Strengthening adherence through education and health-promotion efforts may therefore enhance the quality of life of young adults Keywords: Anthelmintic Therapy Adherence; Health Status; Quality of Life; Young Adults; Soil-Transmitted Helminth
Copyright (c) 2026 Muhamad Sulthan Tanjung, Ali Napiah Nasution, Qori Fadillah http://creativecommons.org/licenses/by-sa/4.0
The Impact of Health Education Using Audio-Visual Media on the Family's Role in LBW Care at Mutia Sari Hospital, Duri, Riau
Low birth weight (LBW) is a major neonatal health concern that places considerable demands on families, who often lack adequate knowledge and skills to care for their infants. Health education through audiovisual media offers a concrete and engaging means of strengthening the family's caregiving role. This study aimed to determine the effect of health education using audiovisual media on the family's role in caring for LBW infants at Mutia Sari Hospital, Duri, Riau. A quantitative quasi-experimental design with a one-group pretest–posttest approach was employed. The population comprised all families of LBW patients at the hospital, and 30 respondents were selected through total sampling. Data on the family's role were collected using a validated questionnaire and analyzed using the Wilcoxon signed-rank test. Before the intervention, the family's role was predominantly in the poor category (50.0%), whereas after the intervention, the majority shifted to the adequate category (46.7%), with the good category rising to 36.7% and the poor category declining to 16.7%. The Wilcoxon signed-rank test yielded Z = −3.272 with a p-value of 0.001 (p < 0.05), indicating a statistically significant difference in the family's role before and after the intervention. It is therefore concluded that health education using audiovisual media significantly improved the family's role in LBW care, and it is recommended that nurses integrate this approach into routine maternal and neonatal care Keywords: Health education, Audiovisual media, Family role, Low birth weight, Neonatal care
Copyright (c) 2026 Helfrida Situmorang, Sri Dewi Br Siregar, Nopita Yanti Sitorus http://creativecommons.org/licenses/by-sa/4.0
The Effectiveness of the SIAPP Digital Learning Platform in Improving Community Self-Efficacy in Providing Basic Life Support in Pontianak City, Indonesia
Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge globally, with low survival rates largely attributed to delayed or inadequate Basic Life Support (BLS) provided by lay responders. Limited access to educational resources and low self-efficacy among community members further hinder effective early intervention. This study aimed to evaluate the effectiveness of the First Aid Learning Administration Information System (SIAPP) in improving community self-efficacy in providing BLS in Pontianak City, Indonesia. A quasi-experimental study using a one-group pretest–posttest design was conducted among 33 community participants recruited through convenience sampling. The study, including the intervention and outcome assessments, was conducted over 2 weeks. The intervention consisted of SIAPP-based first-aid training. Self-efficacy was measured using a structured questionnaire before and after the intervention. Data were analyzed using the Wilcoxon signed-rank test to determine differences in self-efficacy scores. Participants’ self-efficacy improved significantly after the intervention (p = 0.001). The findings indicate that SIAPP effectively increases community members' confidence in performing BLS procedures. SIAPP is an effective and scalable digital learning platform for improving community self-efficacy in BLS provision. Its implementation may strengthen early response capacity in OHCA cases and improve community-based emergency preparedness Keywords: SIAPP, Self-efficacy, Basic Life Support, Out-of-Hospital Cardiac Arrest, Health Education
Copyright (c) 2026 Uti Rusdian Hidayat, Fauzan Alfikrie, Debby Hatmalyakin, Ali Akbar, Defa Arisandi, Nurpratiwi Nurpratiwi, Mimi Amaludin, Ruhil Iswara, Nurannisa Nurannisa, Ihsan Angga Anjarwadi, Delvi Yanto http://creativecommons.org/licenses/by-sa/4.0
The Effectiveness of Video and Booklet Media in HIV/AIDS Health Education for Adolescents: A Quasi-Experimental Study
Health education is an important strategy to improve HIV/AIDS prevention in adolescents, but the effectiveness of educational media can vary. This study aims to compare the effectiveness of video media and booklet media in HIV/AIDS health education in adolescents. The study used a quasi-experimental pretest–posttest design with a control group, involving 60 students (30 in each of the video media and booklet media groups). Knowledge, attitudes, and practices related to HIV/AIDS were measured before and after the intervention using a standardized questionnaire, and the data were analyzed to determine baseline equivalence and differences in outcomes between groups at pretest and posttest, with a significance level of 5%. The results showed that both groups had equivalent baseline means, indicated by no significant differences in the pretest knowledge (p=0.770), attitudes (p=0.802), and practices (p=0.715). After the intervention, the posttest mean knowledge of the video media group (86.03±4.916) was higher than that of the booklet media group (82.97±4.902) and was significantly different (p=0.019). In the attitude and action variables, the posttest mean of the video media group was also higher, but the difference was not significant (attitude: 84.73±5.595 vs 83.33±6.019; p=0.355; action: 84.67±5.713 vs 82.67±6.397; p=0.207). These findings indicate that both media are effective in improving post-intervention outcomes, with video media superior, especially in increasing knowledge. Conclusion: Video media is more effective than booklets in increasing HIV/AIDS knowledge in adolescents, while there is no significant difference in effectiveness between the two media in attitudes and actions Keyword: HIV/AIDS, adolescents, health education, video media, booklet, quasi-experimental
Copyright (c) 2026 Arihta Br. Sembiring, Novita Andriani Br. Manjorang http://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Lifestyle and the Severity of Diabetic Peripheral Neuropathy at Sapta Medika Indrapura Hospital
Diabetes mellitus (DM) is a chronic metabolic disorder whose prevalence continues to increase globally. One of its most detrimental microvascular complications is diabetic peripheral neuropathy (DPN), which is strongly influenced by the patient’s lifestyle. This study aimed to analyze the relationship between lifestyle and the severity of DPN in patients with DM at Sapta Medika Indrapura Hospital. This was a quantitative, descriptive-analytical study with a cross-sectional design. A total of 51 patients with DM were selected through purposive sampling. Lifestyle was measured using the FANTASTIC Lifestyle Checklist (covering family/friends, physical activity, nutrition, smoking, alcohol, sleep/stress, and behavioral patterns), and the severity of DPN was assessed using the Diabetic Neuropathy Score (DNS). Data were analyzed using Spearman’s rho correlation test. Most respondents had an unhealthy lifestyle (68.6%) and experienced severe DPN (64.7%). The Spearman’s rho test showed a significant but weak positive correlation between lifestyle and DPN severity (r = 0.116; p = 0.042; p < 0.05). Lifestyle is significantly associated with the severity of DPN in patients with diabetes, although the association is weak. Healthy behavioral change remains an important strategy to reduce the risk of further complications such as ulceration and amputation. The small, single-center sample limits generalizability, and the cross-sectional design precludes causal inference. Keywords: Diabetes Mellitus, Lifestyle, Diabetic Peripheral Neuropathy, Disease Severity, Indonesia.
Copyright (c) 2026 Heni Triana, Suherni Suherni, Lilis Pujiati, Chairul Munir http://creativecommons.org/licenses/by-sa/4.0
The Interplay of Transcultural Competence, Therapeutic Communication, and Self-Efficacy Among Community Health Nurses
Nurses working in culturally diverse environment possess valuable knowledge and experience in fostering interpersonal communication and can strengthen their self-efficacy. Nursing competence is defined as a continuous, dynamic process of providing care to patients from diverse cultural backgrounds, aimed at reducing risk and understanding patient needs. This study aimed to investigate the relationship between transcultural nursing competence, therapeutic communication skills, and self-efficacy among community health nurses in Samarinda. A quantitative descriptive cross-sectional study was employed, involving 224 nurses from 26 public health centers in Samarinda. Data were collected from April to June 2025 using validated questionnaires assessing transcultural nursing competence, therapeutic communication skills, and self-efficacy. Statistical analyses included chi-square tests and logistic regression to explore correlations and predictive relationships. Results showed that 52.7% of nurses demonstrated good transcultural nursing competence, 55.8% exhibited good therapeutic communication skills, and 58.5% reported high self-efficacy. Transcultural nursing competence significantly influenced therapeutic communication skills (OR=2.044, p=0.011) and self-efficacy (OR=2.256, p=0.004). Length of work also positively correlated with self-efficacy (OR=2.574, p=0.016), while demographic factors such as gender, age, and education showed no significant associations. Transcultural nursing competence emerged as a critical factor in enhancing therapeutic communication and self-efficacy among nurses. The findings highlights the importance of cultural competency training to improve nursing care in multicultural settings. Keywords: Transcultural Nursing, Therapeutic Communication, Self-Efficacy, Community Health Nurses.
Copyright (c) 2026 Dwi Nopriyanto, Ruminem Ruminem, Bahtiar Bahtiar, Rita Puspasari, Iwan Samsugito, Mayusef Sukmana, Ratna Wati http://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Postpartum Mothers' Knowledge of Personal Hygiene and The Healing of Perineal Tears at Romana Clinic, Tanjung Anom Village
Postpartum perineal wounds are common complications during vaginal delivery that significantly affect maternal health and recovery. The healing process of these wounds is influenced by multiple factors, including the mother's knowledge and practice of personal hygiene. This study aimed to examine the relationship between postpartum mothers' knowledge of personal hygiene and the healing duration of perineal tears at Romana Clinic, Tanjung Anom Village, Pancur Batu Subdistrict, Deli Serdang Regency. A quantitative descriptive-analytic study with a cross-sectional design was employed. A total of 32 postpartum mothers who experienced perineal tears were included using total sampling. Data were collected via a validated structured questionnaire on knowledge and hygiene practices, supplemented by clinical wound healing assessment conducted by qualified midwives on postpartum day 6. Data were analyzed using Fisher's Exact Test, with a significance threshold of p < 0.05. The results indicated that 40.6% of respondents had fair knowledge, 37.5% had poor knowledge, and 21.9% had good knowledge of personal hygiene. Regarding wound healing outcomes, 65.6% of respondents experienced delayed healing (>6 days), while 34.4% achieved wound healing within six days (≤6 days). Statistical analysis revealed a significant association between knowledge of personal hygiene and the healing of perineal tears (p = 0.003), with a large effect size (Cramer's V = 0.60). Respondents with good knowledge demonstrated substantially higher rates of timely wound healing (85.7%) compared to those with fair (30.8%) or poor knowledge (8.3%). Higher levels of knowledge regarding personal hygiene are significantly associated with faster perineal wound healing. These findings underscore the importance of integrating structured hygiene education into routine antenatal and postnatal midwifery services to minimize postpartum complications and promote maternal recovery. Keywords: Maternal Knowledge, Postpartum Mothers, Personal Hygiene, Perineal Wound Healing, Wound Healing Duration. Key
Copyright (c) 2026 Helmi Wardah Nasution http://creativecommons.org/licenses/by-sa/4.0
Evaluation of Socioeconomic and Occupational Barriers to Breastfeeding: A Comparative Study Among Weaving Mothers
In Indonesia, stunting continues to affect many children, making breastfeeding practices a critical focus of early prevention. Mothers working in the informal sector, such as traditional weavers, often encounter occupational and socioeconomic barriers that may hinder optimal breastfeeding. This study aims to describe the sociodemographic characteristics of weaving mothers and compare the mean scores of Early Initiation of Breastfeeding (EIBF) implementation and knowledge of exclusive breastfeeding between North Tapanuli and Samosir, North Sumatra. A cross-sectional study was conducted among 72 weaving mothers, with 36 respondents from Siatas Barita Health Center, (North Tapanuli) and 36 from Buhit Health Center (Samosir) selected through purposive sampling. Data were collected using a structured questionnaire and analyzed descriptively through frequency distributions, percentages, and mean scores. Most respondents were aged 26–35 years and had completed senior high school. The mean EIBF score was 3.19 in North Tapanuli and 2.89 in Samosir, both classified as high. The mean score for exclusive breastfeeding knowledge was 3.25 in North Tapanuli (very high) and 2.79 in Samosir (high). These findings suggest that weaving mothers in North Tapanuli had higher EIBF implementation and higher knowledge of exclusive breastfeeding knowledge compared to those in Samosir. Region-specific breastfeeding education and community-based support are recommended, particularly in Samosir, to strengthen maternal knowledge and promote optimal breastfeeding practices. Keywords: Breastfeeding, Occupational Barriers, Weaving Mothers, Comparative Study.
Copyright (c) 2026 Marni Siregar, Hetty Panggabean http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Red Dragon Fruit Juice in Reducing Blood Glucose Levels among Elderly Patients with Type II Diabetes Mellitus
Type II Diabetes Mellitus (T2DM) is a major chronic health problem among the elderly, characterized by persistent hyperglycemia and increased risk of complications. Alongside pharmacological therapy, safe and affordable non-pharmacological interventions are needed to support glycemic control. Red dragon fruit (Hylocereus polyrhizus) contains dietary fiber and bioactive compounds with potential hypoglycemic effects. This study aims evaluate the effect of red dragon fruit juice on fasting blood glucose levels in elderly patients with Type II Diabetes Mellitus (T2DM). A quasi-experimental pretest–posttest control group design was employed. Fifty elderly patients aged 60-75 years with Type II Diabetes Mellitus were recruited through purposive sampling and assigned to an intervention group (n = 25) or a control group (n = 25). The intervention group received red dragon fruit juice (200–250 mL/day) for 14 days, while the control group received standard care. Fasting blood glucose levels were measured before and after the intervention and analyzed using paired sample t-tests. The intervention group demonstrated a significant reduction in mean fasting blood glucose from 139.20 mg/dL to 121.40 mg/dL, with a mean difference of 17.80 mg/dL (p = 0.001). In contrast, the control group exhibited only a slight decrease from 138.60 mg/dL to 136.80 mg/dL, with a mean difference of 1.80 mg/dL, which was not statistically significant (p = 0.075). These findings indicate that red dragon fruit juice significantly reduces fasting blood glucose levels in elderly patients with Type II Diabetes Mellitus (T2DM). This intervention may be considered a safe and practical complementary nutritional therapy to support diabetes management in the elderly. Keywords: Type II Diabetes Mellitus, Red Dragon Fruit Juice, Fasting Blood Glucose, Elderly, Complementary Nutrition.
Copyright (c) 2026 FEBRIYANTI FEBRIYANTI http://creativecommons.org/licenses/by-sa/4.0
Diabetes Risk Factor Screening in the Adult Population Using the Findrisc Score and Oral Glucose Tolerance Test
The global rise in the prevalence of type 2 diabetes is heavily concentrated in urban centers, yet more than half of those affected remain completely undiagnosed. Non-invasive clinical risk assessment tools can indeed stratify population risk, but there remains a gap in operational validation regarding the Finnish Diabetes Risk Score (FINDRISC) when combined with biochemical verification in urban populations in Indonesia. This study evaluated the diagnostic accuracy of the FINDRISC questionnaire in identifying undiagnosed type 2 diabetes and dysglycemia, using the oral glucose tolerance test (OGTT) as the gold standard. The study was conducted in the community using a cross-sectional design with non-random, purposive sampling in six subdistricts to recruit 300 adults aged 30–75 years. The 8-item FINDRISC questionnaire and anthropometric measurements were administered, followed by biochemical verification via OGTT and chi-square analysis. FINDRISC categorized 33.7% of participants as low-risk and 5.3% as high-risk, while the OGTT confirmed 18.0% had prediabetes and 30.0% had diabetes. Increased risk was significantly correlated with advanced age, high body mass index (BMI), central obesity, lack of physical activity, inadequate fruit and vegetable intake, treatment for hypertension, a history of hyperglycemia, and family predisposition (p<0.005). Among low-risk respondents, 68.3% had normal glucose levels, whereas 61.8% of high-risk individuals had glucose levels indicative of diabetes (p<0.005). The integration of the non-invasive FINDRISC triage tool prior to laboratory testing offers a resource-efficient sequential screening framework for urban primary health care. This strategy optimizes the allocation of institutional resources, detects subclinical dysglycemia early, and enables targeted preventive lifestyle interventions. Keywords: Type 2 Diabetes, FINDRISC, Oral Glucose Tolerance Test, Mass Screening, Public Health Surveillance.
Copyright (c) 2026 Fazidah Aguslina Siregar, Tri Makmur, Asfriyati Asfriyati http://creativecommons.org/licenses/by-sa/4.0