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Introduction: The current situation shows that life expectancy is increasing, so the population of older people is also growing. As a vulnerable group, more senior people desperately need primary health care, and barriers to accessing services will increase vulnerability. Aim: The study aimed to investigate the impact of education on primary healthcare utilization among older people. Methods: This cross-sectional study examined 52,893 older people. It employed primary healthcare utilization as an outcome variable and education level as an exposure variable. Furthermore, the study used eight control variables: residence type, age group, gender, marital status, wealth, time travel to primary healthcare, and health insurance. We employed binary logistic regression to examine the data. Results: The study showed that older adults with primary education were 1.050 times more likely than those without to utilize primary healthcare (95% CI 1.046-1.054). Older people with secondary education were 0.643 times less likely to use primary healthcare than those without (95% CI 0.638-0.649). Older adults with secondary education were 0.378 times less likely than those without to use primary healthcare (95% CI 0.372-0.383). Furthermore, the study indicated that all control variables were significantly related to direct healthcare utilization. Conclusion: The study concluded that education level influences primary healthcare utilization among older people in Indonesia. Keywords: elderly people, education, primary healthcare, healthcare evaluation, healthcare access, public health

Background: Teenage pregnancy is a high-risk pregnancy. Teenage pregnancy often gets social sanctions in the form of stigma from the community, and the loss of school rights. Objective: The research aims to analyze the role of education in teenage pregnancy in rural Indonesia. Methods: This study analyzed the data from the Indonesian Demographic and Health Survey 2017 using a cross-sectional approach. The unit of analysis was women aged 19-24 years old. The study pooled 1,982 women as samples. Besides the education level, other independent variables analyzed were marital, employment, and wealth. In the final stage of the study, a multivariate test with binary logistic regression was carried out. Results: The results showed that women with secondary education were 0.451 times less likely to experience teenage pregnancy than women with primary education (95% CI 0.354-0.574). Higher education was 0.110 times less likely to experience teenage pregnancy than primary education (95% CI 0.070-0.171). The study found two other variables related to teenage pregnancy in rural Indonesia besides educational factors. The two variables are employment status and wealth status. Conclusion: The study concluded that education level is associated with teenage pregnancy in Indonesia's rural areas. The lower the education level, the higher the chances of experiencing teenage pregnancy.

Introduction: The delivery of health services at mother and child hospitals involves the midwife’s role. Midwives are more responsible for providing patient care when faced with high Bed Occupation Rate (BOR) situations and emergency cases. However, several factors can affect midwives’ turnover rates in hospitals. Purpose: This study aimed to analyze the relationship between individual factors (age, marital status, education level, years of service, and employment status), work factors (workload, work environment, and work stress), and financial compensation on job satisfaction and intention to leave midwives as well as recommendations for reducing turnover rates. Methods: This study was conducted at the Trisna Medika Women and Children Hospital, Tulungagung, Indonesia, in April 2022. The questionnaires were distributed to 65 respondents. The research results were analyzed using the partial least squares (PLS)Structural Equation Model (SEM) method. Results: Individual factors had no significant effect on job satisfaction or intention to leave. The variables that directly affect the intention to leave (medium) are workload, financial compensation (strong), and job satisfaction (medium). Job satisfaction is directly affected (moderately) by financial compensation and work stress. The indirect effect shows a significant relationship between job stress and job satisfaction in the work environment. Conclusion: The direct effect of financial compensation on intention to leave was stronger than the effect of financial compensation on job satisfaction.

Background: Primary health care (PHC) is the closest institution known to people in disadvantaged areas. Aims: The study determines the policy target based on the demographic characteristics to increase PHC utilization in a disadvantaged area. Methods: The cross-sectional research explored 42,644 respondents. In addition to PHC utilization, the study examined eight independent variables: residence, gender, marital, age, wealth, insurance, education, and travel time. We employed a binary logistic regression in the last stage. Results: Live in urban areas had 1.967 more likely to utilize the PHC (95%CI 1.942-1.992). Males could be 1.412 higher than females (95%CI 1.402-1.421). All marital types had more chances than never married. All education was more likely than no education. The employed had 0.972 less likely than the unemployed (95%CI 0.965-0.980). All wealth groups had less possibility than the poorest. Those with government-run insurance were likelier than other types. The ≤10 minutes travel time was more likely than the >10 minutes. Conclusion: There were seven policy target characteristics to increase PHC use in disadvantaged areas in Indonesia: live in a rural area, female, never married, have no education, employed, not the poorest, don't have government-run insurance, and have a travel time of more than ten minutes. Keywords: disadvantaged area, healthcare evaluation, primary health care, public health

Introduction: Home delivery increases the chance of maternal death. Aims: The study examines suitable targets for developing policies to reduce home births. Methods: This cross-sectional study analyzed 15,357 mothers through stratification and multistage random sampling, including 13 independent variables: age, education, employment, marital, parity, insurance, knowledge of pregnancy danger signs, antenatal care (ANC), residence, the autonomy of health and family finance, household head sex, and wealth. We examined the data using binary logistic regression. Results: About 23.8% of mothers deliver at home. Older age, higher education, primiparous, insured, knowing the pregnancy danger signs, living in an urban area, and doing ANC ≥4 times were protective factors to not home delivery. Being employed, married, having a male household head, and being poor were risk factors for home delivery. Mothers without health autonomy are less likely to deliver at home than those with health autonomy. Mothers with family finance autonomy are 1.239 times more likely than those without to give home birth. Conclusion: The target to reduce home deliveries: young, low education, employed, married or divorced/widowed, having many children, uninsured, do not know pregnancy danger signs, doing ANC <4 times, living in a rural area, have no health autonomy, have no family finance autonomy, having a male household head, and poor. Keywords: big data, home delivery, maternal health, maternity care, population health, public health.

Background: Job dissatisfaction in healthcare facilities can increase medical errors. In order to reduce the medical errors, hospitals must focus on employee job satisfaction. In this case, both stress and burnout can lower job satisfaction. Aims: This research was conducted to analyze the internal factors that affect the level of job satisfaction of employees in health facilities. Methods: The method applied is the PRISMA framework, which consists of five stages, namely eligibility criteria, information sources, study selection, data collection process, and data items. Results: Systematic review was done on 34 quantitative studies about the factors that influence job satisfaction. Based on the review, the internal factors known are demographic and personal factors. In this case, demographic factors mostly do not affect employee job satisfaction, one of which is salary. Meanwhile, the most researched personal factor and the biggest influence is burnout. Conclusion: Based on the systematic review, it is known that the internal factors affecting employees' job satisfaction include demographic and personal factors. The demographic factor that has a significant effect is salary, while the most researched individual factor is burnout. Working in the health sector requires caution so as not to cause medical errors. Health workers who experience burnout are at risk of causing medical errors. For that we need a strategy to overcome burnout so as to increase job satisfaction. Keywords: burnout, healthcare, internal factor, job satisfaction, PRISMA

Background: The effort to control and prevent COVID-19 in health facilities is to optimize the use of Personal Protective Equipment (PPE) according to guidelines set by the government. The compliance of healthcare workers using the specified PPE will affect the control and prevention of the COVID-19 pandemic. Purpose: The study aims to measure the prevalence of COVID-19 in healthcare workers and to find out an overview of knowledge level and compliance with the use of PPE among healthcare workers in East Java Province during the COVID-19 pandemic. Methods: This research was an observational study with a descriptive cross-sectional design. The study population was around 183,501 healthcare workers in East Java Province, with criteria of healthcare workers who worked during the COVID-19 pandemic and were willing to be respondents. This study used a probability sampling method with a simple random sampling technique consisting of 129 healthcare workers. The variables used were knowledge level, compliance with the use of PPE, and the history of COVID-19 infection. Primary data have collected by an online questionnaire platform from September 3rd, 2020 to September 12th, 2020. Results: The prevalence of COVID-19 among healthcare workers in East Java was 6.20%, and all the healthcare workers infected with COVID-19 have a good level of knowledge and compliance with the use of PPE in health facilities. Conclusion: Most healthcare workers have good knowledge and compliance with using PPE.

Background: Previous research has found that husband support can increase the participation of the wife's antenatal care (ANC) to prevent an increase in maternal mortality. Meanwhile, in the eastern region, the effort to provide pregnant women's health services tends to be lower than in Indonesia's other areas. Aims: The study analyzed regional disparities of husbands' support in wives' ANC in eastern Indonesia. Methods: Secondary data from the 2017 Indonesian Demographic and Health Survey were used in the study. In eastern Indonesia, the analytic units were wives aged 15 to 49, married, and pregnant in the previous five years. The study analyzed 2,005 respondents as a sample. In addition to the husband's support, the study examined region (province), residence, age, education, occupation, wealth, and parity as the independent variable. In the final stage, the study used a binary logistic regression test. Results: A husband in East Nusa Tenggara has 1.556 times the probability of a husband in Papua for a support wife's ANC (95% CI 1.082-2.237). Maluku husbands are 0.528 times less likely to support their wife's ANC than Papua husbands (95% CI 0.363-0.768). North Maluku husbands are 0.476 times less likely than Papua husbands to support their wife's ANC (95% CI 0.320-0.709). Meanwhile, there was no significant difference in the husband's support between West Papua and Papua. Conclusion: Regional disparities of husband's support in wife's ANC existed in eastern Indonesia.

Background: The nutrition care village is one of the PELITA program's activities and has goals for reducing stunting in Lamongan District. As stunting cases in Lamongan District decreased from 15.6% in February 2018 to 7.0% in August 2020, the achievement related to toddler undernutrition has increased from 2016 to 2019, namely 4.73%, 4.10%, 5.26%, and 6.87%. That output can potentially affect the quality of human resources or other problems in the future if it not handled properly. Objectives: Analyze the components of the logic model from nutrition care village activity to assist the stunting reduction in Lamongan District. Methods: This study was quantitative research, using questionnaires and observation methods. Then the data were subjected to descriptive analysis. The research sample was nine community health centers selected by purposive sampling. Results: Logic model components in this study consist of inputs, activities, and outputs. Input factors were facilities and infrastructure, SOPs, and human resources. The facilities and infrastructure were fulfilled by coordinating with the community and stating that they do not yet have SOPs in a written document. The number of nutritionists in inpatient community health centers did not meet the minimum standards. The activities were for stunting areas, so they did not cover all villages. The outputs were 6 out of 9 community health centers reach the wasting target. Conclusions: The results of the analysis were quite good. Some community health centers that did not meet the standard need improvements.

Background: Maternal and Child Health (MCH) is still becoming a health problem in Indonesia. One of the causes of maternal mortality is the speed of decision making in the family. Decision making is influenced by knowledge, awareness, family shape and culture in the neighborhood. Aims: the study aimed to identify and analyze the relationship between the use of the internet as a health information and maternal decision-making regarding emergency help Methods: This study used a mixed-method approach. The sample of 175 respondents. Data analysis performed in this study was frequency analysis, cross tabulation and chi-square. Results: There were 40% of respondents used the internet as a source of pregnancy information. Pregnant women had the information about pregnancy from google, instagram and whatsApp group. There were 45.70% of them have made decisions independently regarding the emergency relief. Chi-square analysis showed a p-value = "0,000” with a contingency coefficient of 0,368 indicating the use of the internet as a health information related to decision making of pregnant women regarding emergency relief. Conclusion: The conclusion of this study is that there were pregnant women who were using the internet for health information and the majority of pregnant women had made decisions regarding emergency relief independently.

Background: Food for the Muyu tribe was an actualization of daily life over the belief in the religious dimension that is adopted and lived. This study aims to explore the food taboo among the Muyu tribe in Indonesia.Methods: The authors conducted the case study in Mindiptana, Boven Digoel, Papua. The study carried out data collection by participatory observation, in-depth interviews, and document searches. The authors carried out the report using an ethnographic approach an emically perspective.Results: Belief in the lord of wild animals, the lord of fruits and plants, and the lord of sago, was so thick that many spells appear to hunt and search for food in the forest, which was a form of recognition of the power of these. The Muyu tribe had restrictions on several types of food. Food can be taboo based on its physical form; meanwhile, because of Muyu people's belief that there was a bad quality inherent in these food ingredients. It was especially closely related to ritual practice for men as a process of undergoing initiation as a big man. The Muyu intended women taboo for mothers who are pregnant and breastfeeding. Abstinence for pregnant Muyu women was often related to the fetus in the womb. For children, especially for boys, it was almost the same as abstinence for adult Muyu men. This abstinence applies to boys who were prepared to be tómkót, especially when undergoing the initiation process.Conclusions: The food taboo applies to all Muyu people, both men, women, and children.

Background: Food for the Muyu tribe was an actualization of daily life over the belief in the religious dimension that is adopted and lived. This study aims to explore the food taboo among the Muyu tribe in Indonesia.Methods: The authors conducted the case study in Mindiptana, Boven Digoel, Papua. The study carried out data collection by participatory observation, in-depth interviews, and document searches. The authors carried out the report using an ethnographic approach an emically perspective.Results: Belief in the lord of wild animals, the lord of fruits and plants, and the lord of sago, was so thick that many spells appear to hunt and search for food in the forest, which was a form of recognition of the power of these. The Muyu tribe had restrictions on several types of food. Food can be taboo based on its physical form; meanwhile, because of Muyu people's belief that there was a bad quality inherent in these food ingredients. It was especially closely related to ritual practice for men as a process of undergoing initiation as a big man. The Muyu intended women taboo for mothers who are pregnant and breastfeeding. Abstinence for pregnant Muyu women was often related to the fetus in the womb. For children, especially for boys, it was almost the same as abstinence for adult Muyu men. This abstinence applies to boys who were prepared to be tómkót, especially when undergoing the initiation process.Conclusions: The food taboo applies to all Muyu people, both men, women, and children.

Introduction: Hospital as one of the health services in Indonesia is required to implement the development of human resources or health workers in health services. Conducting hospital coach should be specific to build on certain aspects. The coaching can be done by looking at aspects that are lacking in the assessment of human resources. Wiyung Sejahtera Surabaya Hospital has a decision of discipline that decreased from year to year. Researcher needed see any factor that can lead to low employees’ discipline. One factor that can contribute was the job barrier felt by the employees. This study aimed to determine the relationship of work barriers as one of the employees’ benchmark in the hospital on the employees’ performance level at Wiyung Sejahtera Surabaya Hospital. Method: The type of this research was quantitative research with an analytic observational method. Based on the time, this research used a cross-sectional design. The population in this study was the employees of Wiyung Sejahtera Surabaya hospital with 80 samples taken through proportional sampling technique. The independent and dependent variables of this research were work barriers and work discipline. Data were analyzed using Kendall's tau-b test to determine the correlation between the two variables. Results: The results obtained that the work barrier had a negative significant correlation to the discipline of employees in the Wiyung Sejahtera Surabaya hospital. The higher the obstacle of work owned by employees in the hospital, the lower the discipline of the employees. Conclusion: The barriers can lower the discipline of employees at the hospital.Keywords: discipline, occupational health and safety, work barriee

Introduction: Hospital as one of the health services in Indonesia is required to implement the development of human resources or health workers in health services. Conducting hospital coach should be specific to build on certain aspects. The coaching can be done by looking at aspects that are lacking in the assessment of human resources. Wiyung Sejahtera Surabaya Hospital has a decision of discipline that decreased from year to year. Researcher needed see any factor that can lead to low employees’ discipline. One factor that can contribute was the job barrier felt by the employees. This study aimed to determine the relationship of work barriers as one of the employees’ benchmark in the hospital on the employees’ performance level at Wiyung Sejahtera Surabaya Hospital. Method: The type of this research was quantitative research with an analytic observational method. Based on the time, this research used a cross-sectional design. The population in this study was the employees of Wiyung Sejahtera Surabaya hospital with 80 samples taken through proportional sampling technique. The independent and dependent variables of this research were work barriers and work discipline. Data were analyzed using Kendall's tau-b test to determine the correlation between the two variables. Results: The results obtained that the work barrier had a negative significant correlation to the discipline of employees in the Wiyung Sejahtera Surabaya hospital. The higher the obstacle of work owned by employees in the hospital, the lower the discipline of the employees. Conclusion: The barriers can lower the discipline of employees at the hospital.Keywords: discipline, occupational health and safety, work barriee

Background: The percentage infants with complete basic immunization is still below the minimum target of immunization coverage. The immunization coverage survey showed that complete basic immunization and valid dose immunization status in Surabaya City is still below the international averages. Purpose: The purpose of the study was to describe the knowledge and attitudes of cadres and mothers with under two years child (Baduta) towards My Village My Home (MVMH) in the City of Surabaya, Indonesia Methods: Sampling was done by simple random sampling method. Samples were grouped into exposed groups and unexposed groups. The sample comparison was 1: 2. The respondents of the exposed group were 20 cadres and 20 mothers who had received MVMH training. The respondents of the unexposed group were 40 cadres and 40 mothers who did not receive training. Data collection was done using interviews. The study was conducted in 30 Health Centers. Results: Most cadres in the group who had received training or had not received training had good knowledge, but in the group that had not received training there were 5% of cadres who had poor knowledge. Both mothers in the group of cadres who had received training or had not, had good knowledge, but in the group of cadre that had not received training as much as 10% of mothers had poor knowledge. Both cadres and mothers had a good attitude. Conclusion: Both cadres and mothers in two groups had good knowledge and attitude. Cadres who have good knowledge and attitude towards MVMH have the potential to apply MVMH to the community.

Background: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output.Aim: This study analyzed the urban-rural disparity in the utilization of primary healthcare center by the elderly.Method: This study used in the 2013 Basic Health Research raw data. The 2013 Basic Health Research was designed as a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province participated. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in primary healthcare centers than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424).Conclusion: There was a disparity between urban and rural areas in the utilization of outpatient primary healthcare centers in East Java by the elderly. Policymakers in East Java are recommended to improve facilities and infrastructure of the primary healthcare centers in rural areas by paying attention to the results of this study.Keywords: elderly, urban-rural disparities, primary healthcare center, healthcare utilization, inpatient-outpatient.

Measles is one of endemic diseases in East Java especially in north Surabaya, the home of specific ethnic which resist of immunization. Surabaya District Health Office targeted their Measles immunization is above 90%,but unfortunately this target are never been reached. The purpose of this study was to analyze the management process of immunization program, especially the supervision. The guidance of supervision is regulated in HealthMinister Regulation number 42, on 2013. Supervision is involved performance standard setting, monitoring and corrective action. This is a quantitative study with descriptive and cross sectional design. The sampling wascalculated by using simple random sampling. The interviews through open and close question were conducted to 38 Managers of Immunization program in Public Health Centre. The result showed that the implementation ofsupervision has implemented by guidance the supervision of immunization programme. The study showed that only 2.63% or just one of Public Health Centre has already supervised by District Health Office and 5.26% or twoPublic Health Centres has supervised three times and suit with guidance implementation of general supervision. From this study, it is important for District Health Office to add new person as Supervisor and Public HealthCentres and ensure that its supervision follow the supervision guidance.Keywords: Measles immunization, North Surabaya, supervision

Hospital is a health institution that provide comprehensive health service which is including aspects of promote, preventive, curative, and also rehabilitative. To achieve the goal, the government has been releasedRegulation of the Minister of Health Number 4 Year 2012 about Technical Instructions of Health Promotion in Hospital. In means by all hospitals must implement health promotion in their institution. Based on the earliersurvey, the implementation of the regulation of Health Promotion Hospital (PKRS) in the Universitas Airlangga Hospital was considered less than optimal. The purpose of this research was to analyze the planning factor ofHPH policy implementation. The number of respondents are seven which chosen by purposive sampling. This research was conducted by deep interview and observation method. The results showed that the planning ofPKRS unit has not been prepared as it should be as set out in the regulations. There is neither strategic planning nor operational planning. Unit PKRS not yet have a systematic and structured organization. Qualification ofhuman resources in general are already qualified, but need additional quantity. PKRS unit does not have special health worker health promotion.Keywords: health promotion hospital, implementation, planning, policy

In 2014 patient visits to pharmacy services increased 75% from the previous year. Man power in the pharmacy unit was not comparable with the number of pharmacy service.The availability of human resources isinadequate when being compared to the number of outpatient pharmacy visits, therefore it influenced the respon time up to 43,91% for non paten drugs which as not in accordance with the standart services minimum pharmacy services. This data indicate that there was overload capacity on man power in outpatient pharmacy unit. The purpose of this study was to show wordload category on man power in outpatient pharmacy unit, particularly to pharmacists and assistants pharmacists. This was quantitative descriptive study. There were 26 samples consisting of 1 pharmacist, 16 asisstants pharmacists in depo 1 and 9 asisstants pharmacists in depo 5 outpatient pharmacy unit. Data collected by observation for 2 week in working hours. Result of the study was pharmacicts and assitants pharmacists in depo 1 had subjective and objective workload in overload category while depo 5 inmoderate category.Keywords: subjective and objective workload, pharmacicts and assitants pharmacists, work sampling

More than 80.0% maternal deaths occured in hospital in Surabaya between 2012-2014. Most of them who died in hospital were referral patients from midwife, private clinics, and public health centers. This study assessed the effectiveness of maternal referral system based on perspective of public health centers and hospitals in Surabaya. This was a descriptive cross sectional study. Samples were 43 public health centers in Surabaya and two main referral destination hospitals. Data was collected by interviewing one representative midwife in each public health center and hospital. This study showed that a total of 81.4% health centers assess that maternal referral system in Surabaya District was quite effective. While, one of the hospital assessed quite effective, and the other assessed less effective. The reason was because public health centers difficulty to contacting hospitals about referral, hospitals often rejected referral case, pregnant women often do self-referral to hospital, and incompatibility referral reason by most of public health centers. So it was necessary to repair maternal referral system at Surabaya based on identification of each variables in effectiveness of maternal referral system.Keywords: effectiveness, hospitals, maternal refferal system, public health center

The coverage of under-five children weighed is an indicator of community participation in Posyandu. During 2012 until 2014, Puskesmas Kenjeran had not reached the target of this indicator. The objective of this study is to arrange recommendations for Posyandu utilization improvement based on total customer sacrifice analysis. This was a quantitative analytical study with observational approach and cross sectional design. The sampling was calculated by using multistage random sampling method. The interviews through instrument were conducted to 112 respondents to obtain information on Posyandu utilization and respondents sacrifice required to utilize Posyandu. The results showed that respondents thought time was the greatest sacrifice among monetary, energy, and psychological sacrifices. Spearman correlation test on any sacrifice required showed significant correlation (p<0.05), except for monetary sacrifice.This study concluded that even total customer sacrifices was very small, but the huge expense of time spent still made respondents to be less likely to utilize Posyandu. Therefore, efforts are needed to reduce the magnitude of the sacrifice required by community utilizing Posyandu in Puskesmas Kenjeran area. Keywords: Posyandu utilization, total customer sacrifices, under-five children weighed

The survey about coordination in hospital showed that the coordinaton between units have low score including the lack of communication and problem solving between units. The objectives of this study is to describe coordination in hospital considered by high performance practices that consist of 5 items : selection for cross-functional teamwork, rewards for cross-functional teamwork, cross-functional teamwork conflict resolution, cross-functional meetings, and cross-functional boundary spanner. This research is descriptive study using cross sectional design. Samples or respondents are 16, selected using purposive sampling according to the units which their function and job still related with the medical service in the hospital. The result showed that there are a specific criteria to select their employee. The most responden said that education level is the most important criteria for the selection. There is a reward for the best employee those are trophy and some money given to the best employee and the best group of the months. There is conflict resolution through the meeting with the supervisor and director to discuss their problems. There is functional meeting that is weekly report, and there is boundary spanner to coordinated with the other unit if they have problems. This study conclude that coordination in hospital can complete four items of performance work practice, but aspect cross-functional meetings still not working properly. Therefore, it needs to be repaired because this meeting is important to discuss about development of the medical service in this hospital.Keywords :Coordination, high performance work practices, medical service