Kesehatan

The Effect of Cost on The Completeness of Basic Infant Immunization in Winong Subdistrict, Pati District

ABSTRACT

Loekito Siswojo, 2003. The Effect of Cost on The Completeness of Basic Infant Immunization in Winong Subdistrict, Pati District. A Thesis of the Masters Program in Family Medicine, Postgraduate Program, Sebelas Maret University, Surakarta 2003.

The background for conducting this study was a high infant mortality rate (IMR) and a high mortality rate of children under fives, both of which were  associated with infectious diseases. Various infectious diseases are actually preventable by immunization. There was a gap in immunization coverage between Posyandu (free of charge, DPT1=63.7%) and Puskesmas (charge, 41.4%), in Winong subdistrict, Pati district. The question was whether this gap was associated with different costs of basic infant immunization. This study aimed to determine the effect of cost and several other variables on the completeness of basic infant immunization in Winong subdistrict, Pati district.

This study was analytic observational, using the cross sectional approach. The study was conducted in April to June 2003. The study population was mothers who had children aged between 17 and 29 months by May 2003, and lived within the jurisdiction area of Puskesmas Winong,  Winong subdistrict, Pati district. A study sample of 614 people was selected from the entire population. The data analysis used SPSS Version 9.0 to perform Logistic Regression Analysis.  

Results showed, cost was an important determinant for the completeness of infant immunization. Immunization cost that exceeds Rp. 3000 decreases the probability of complete immunization 0.48 higher than the cost less than or equal Rp. 3000,00 (OR = 0,48; 95% CI = 0,26 – 0,86). Factors that also increase the probability of complete infant immunization include mother’s education attainment, age of mother, mother’s employment status, family income – both father’s and mother’s incomes. Factors that decrease the probability of complete infant immunization include number of children, and distance to the immunization facility. Unearned income handed over to mother from father is not an important determinant for the completeness of infant immunization.

This study concludes that cost is an important determinant for the completeness of infant immunization, after controlling for several confounding factors. It is suggested that vaccination be provided free of charge through the government subsidy to increase the immunization coverage, because vaccination is an economic good that carries   positive externality.

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Key words: immunization, cost, completeness of basic infant immunization.

Kesehatan_MKK

The effect of Pregnant woman behaviour on the incidence of Low Birth Weight Baby (LBW)

ABSTRACT

Sumartono Karjo, 2004. The effect of Pregnant woman behaviour on the incidence of Low Birth Weight Baby (LBW). A Thesis. Masters Program in Family Medicine. The Post Graduate Program, Sebelas Maret University.

The background of this research is the incidence of Low Birth Weight in Surakarta still hight, as a report of Public health care in Surakarta found 86 cases (0,85%) during 2002, it can cause problem on baby growth and High of infant Mortality rate.

This research is case-control study. The population of this research are the pregnant womans who have delivered Low birth weight baby (<2500 gms) as case group and pregnant womans who have delivered normal weight baby as control group. The case sample are 71 case incidence of LBW and the control sampel are 140 incidence of normal weight baby.The dependent variable is the incidence of Low Birth Weight baby, as independent variable is pregnant woman behavior with counfounding factors are education level, work activity, family earning, age, number of child, husband support, mother weight increase and cigarrete smoke exposure. Data is taken into Microsoft Excel then its transferredto SPSS version 10.0 to be analysed by the Multiple Logistic Regression model.

The result of it show that pregnant woman behavior have effect on incidence of Low birth weight baby, after estimating the effect of confounding factors like educational level, work activity, family earning, age, number of child, husband support, mother weight increase and cigarrete smoke exposure. Bad category of pregnant woman knowledge increase the incidence of low birth weight baby 1,065 times upper than good category (OR = 1,065; CI 95% = 0,456 – 2.007); bad category of pregnant woman attitute increase the insidence of LBW 1,318  times upper than good category (OR = 1,318; CI 95% = 0,495 – 3,512); while bad category of pregnant woman action increase the incidence of LBW 1,022 times upper than good category (OR = 1,022; CI 95% = 0,496 – 2,106). The other factors increasing risk of incident LBW are low education level, work activity,  low income family, age < 20, number of child >3, without husband support, mother weight increase  < 10 kg and cigarrete smoke exposure.

Suggested to pragnent woman in order to positive behavior in taking care of and reguarding her pregnancy to avoid the incidence of LBW and always report to health provider when she has complain with her pregnancy.

Keyword: Pregnacy – positive behavior – decreasing incidence of LBW

Kesehatan_MKK

PENGARUH PROGRAM TABULIN DALAM GERAKAN SAYANG IBU TERHADAP KELENGKAPAN PELAYANAN ANTENATAL DI KABUPATEN PATI

ABSTRACT

ESTI DHARMASTUTI, 2003. The Effect of Tabulin on the Completeness of Antenatal Care in Pati District. A Thesis from Medical Magister, Post Graduate Program University of Sebelas Maret, Surakarta 2003.

The background for conducting this study was the presence of high maternal mortality rate which reached 123 maternal deaths per hundred thousand live births. An effort so-called as Tabungan Ibu Bersalin (Maternal Savings, abbreviated as Tabulin) was undertaken to help decrease the high maternal mortality. The question was whether Tabulin increases the completeness of antenatal care. This study aimed to determine the effect of Tabulin and several other factors on the completeness of antenatal care..

This study was analytic and observational, using the historical cohort design. The study population was pregnant mothers who were either members or non-members of Tabulin. The sample size was 600 people. The dependent variable of interest was completeness of the antenatal care. The primary independent variable was membership of Tabulin. The potential confounding factors accounted for in the analysis were mother’s education attainment, mother’s employment status, family income, number of children, the cost of antenatal care, types of antenatal care provider. The data was analyzed using SPSS version 9.0 to perform logistic regression analysis.

The results showed that Tabulin program significantly increases the probability of using antenatal care completely. Members of Tabulin have the probability of 6 times higher than non-members to use complete antenatal care (OR = 5.8; 95% CI = 2.9362 – 11.4768). Factors that also increase the probability of using  antenatal care include mother’s education  attainment  (OR = 4.7; 95% CI = 4.5843 – 40.6321),  family   income (OR = 6.1; 95% CI = 6.6450 – 18.3244 ), and professional antenatal attendants (OR = 3.8775; 95% CI = 0.2479 – 60.6581). Factors that decrease the probability of using antenatal care include number of children (OR = 0.1669; 95% CI = 0.7064 – 0.5337), and the cost of antenatal care (OR = 0.4; 95% CI = 0.8947 – 0.8368).

It is concluded that Tabulin program significantly increases the probability of using complete antenatal care for the members about 6 times higher than the non-members, after controlling for potential confounding factors. It is suggested that Tabulin program be developed further and its coverage be expanded to other subdistricts, at least within the Pati district, Central Java.

Key words: Gerakan Sayang Ibu, Tabulin (mothernal savings), completeness