Distribution Analysis of Doctors in Indonesia

The distribution of health workers was an important study in Indonesia which has a wide geographical range and challenges as an archipelagic country for the fulfillment of fair and equitable health services. Aim: The study was conducted to answer factors related to the distribution of doctors based on provinces in Indonesia.
Advanced analysis of secondary data from “Data and Information: Indonesian Health Profile in 2017”. The analysis unit in this study was the province, all 34 provinces in Indonesia were analyzed. The dependent variable was the Number of Doctors. Dependent variables were the number of population, density, percentage of poor people, number of hospitals, and number of Puskesmas.
Variability in the availability of doctors was very wide. The more the population, the more attractive it was for doctors to practice in the province. The denser the population, the more attractive it was for doctors to practice in the province. The more the poor population, the more attractive it was for doctors to practice in the province. The more hospitals, the more attractive it was for doctors to practice in the province. The more Puskesmas, the more attractive it was for doctors to practice in the province. Conclusions:
All variables analyzed were related to the number of doctors. Variables of population, density, percentage of poor people, number of hospitals, and number of Puskesmas were positively related to the number of doctors.

Available on INA-Rxiv Pre-Print: https://osf.io/preprints/inarxiv/df6ns/

Laksono, A. D., Ridlo, I. A., & e. (2019, June 18). Distribution Analysis of Doctors in Indonesia. https://doi.org/10.31227/osf.io/df6ns
Laksono, Agung D., et al. “Distribution Analysis of Doctors in Indonesia.” INA-Rxiv, 18 June 2019. Web.
Laksono, Agung D., Ilham A. Ridlo, and ernawaty. 2019. “Distribution Analysis of Doctors in Indonesia.” INA-Rxiv. June 18. doi:10.31227/osf.io/df6ns.

Gambaran Prevalensi Balita Stunting dan Faktor yang Berkaitan di Indonesia: Analisis Lanjut Profil Kesehatan Indonesia Tahun 2017


Hasil Riskesdas tahun 2007, 2013 dan 2018 menunjukan angka stunting pada balita masih di atas 30%. Sementara kemiskinan dibuktikan seringkali hadir bersamaan dengan terjadinya stunting pada balita. Gizi yang adekuat pada masa hamil dan pengawasan kesehatan ibu hamil melalui pelayanan antenatal care dinilai merupakan salah satu upaya sensitif dalam penanggulangan stunting. Studi ini ditujukan untuk menjawab apakah faktor kemiskinan dan ketersediaan layanan kesehatan berhubungan dengan prevalensi balita stunting di provinsi di Indonesia. Penelitian ini merupakan analisis lanjut data sekunder “Data dan Informasi: Profil Kesehatan Indonesia tahun 2017”. Data dianalisis secara deskriptif dengan tabulasi silang. Hasil penelitian menunjukkan bahwa pada kategori persentase penduduk miskin yang tinggi (> 14,43%) didominasi oleh prevalensi balita stunting yang tinggi (22,51%-30,0%). Pada kategori rasio Puskesmas per 100 ribu penduduk tinggi (≥ 4) terlihat didominasi oleh prevalensi balita stunting pada kategori tinggi (22,51%-30,0%). Pada kategori rasio tenaga gizi per 100 ribu penduduk tinggi (> 12) justru terlihat didominasi oleh prevalensi balita stunting kategori tinggi (22,51%-30,0%). Pada kategori rasio tenaga bidan per 100 ribu penduduk tinggi (> 97) didominasi oleh prevalensi balita stunting kategori tinggi (22,51%-30,0%). Disimpulkan bahwa persentase penduduk miskin berhubungan secara positif dengan prevalensi balita stunting. Sementara faktor input pelayanan kesehatan (Puskesmas, tenaga gizi, dan tenaga bidan) tidak berhubungan dengan prevalensi balita stunting. Disarankan pemerintah lebih memfokuskan sasaran kebijakan pada masyarakat miskin.

Kata Kunci: balita, stunting, profil kesehatan, kemiskinan


Laksono, Agung & Kusrini, Ina. (2019). Gambaran Prevalensi Balita Stunting dan Faktor yang Berkaitan di Indonesia: Analisis Lanjut Profil Kesehatan Indonesia Tahun 2017. 10.13140/RG.2.2.35448.70401. 

#CondomEmoji: Are urban Indonesians receptive to a social media-based campaign for safer sex?

Abstract Purpose
The purpose of this paper is to explore participants’ attitudes and receptivity to a #CondomEmoji campaign insofar as investigating whether attitudes and receptivity were important predictors for brand impression and intention to buy. Design/methodology/approach – This study involved 206 research participants who live in Jakarta and Surabaya and who answered online questionnaires to measure attitudes, receptivity to #CondomEmoji advertising, brand impression and intention to buy condoms. Questionnaires were circulated on several social media platforms and instant messaging apps. The participants were asked to watch the #CondomEmoji advertising video before proceeding to fill out the questionnaires. Findings – Research findings suggested that participants mostly held negative attitudes and receptivity to the campaign. Non-sexually active participants were more likely to perceive the advertising as offensive. Attitudes and receptivity were good predictors for brand impression, yet attitude was not significantly attributed to intention to buy condoms. The result was stronger in sexually active participants. Research limitations/implications – Non-sexually active young people need to be more informed about healthy sexual behavior so that they would not feel embarrassed to discuss and ask about sexual behavior. A socially acceptable condom-use advertising campaign needs to be conducted to lessen the resistance of conservative audiences.
This paper offers an insight into how conservative audiences may respond to social-media-based campaign of safer sex.
Keywords: Social marketing, Attitudes, Health media
Paper type: Research paper

The Changing Nature of CampusHealth Insurance: Testing Portability Issues of National Health Insurance

Before National Health Insurance was implemented, the majority of leading universities in Indonesia already covered their studentswith a health insurance scheme. They managed their own campus health insurance independently. Both National Health Insurance in 2014 and single tuition policy in 2015 brought huge change to campus health insurance. This study aims to analyse students’ needsin health insurance after implementation of these policies. This is an exploratory study with cross-sectional design. The sample was taken by voluntary sample through online questionnaire. There were 83 students across different academic degree participated in this study. Most of the students (65.1%) came from various districts outside the campus district and chose to reside in boarder houses around the campus. There were only 52.9% of the students already listed as National Health Insurance participants. Out-of-pocket risk belongs to 35.5% students who were not covered by health insurance at all. Almost all of the students who already participated in National Health Insurance (93.3%) were registered in the primary healthcare in their hometown. The students are already paying for single tuition which does not accommodate health insurance. A real changing need of migrant students for health insurance coverage exists in the National Health Insurance era. 1INTRODUCTIONUniversal Health Coverage swept many countries in the last decade, including Indonesia. Even though Indonesia is the biggest archipelago country with a widely dispersed territory, National Health Insurance is chosen as the health insurance mechanism ratherthan region-based insurance. This decision has consequences in the portability challenges of the preferred health insurance scheme. Previous region-based health insurance mechanisms already implemented by local government should be merged into a national scheme. It should enable not only raising the poolinglevel in local government, but also maintaining the cross-regional participation transfer (Pan et al., 2016).Previously, the majority of universities in Indonesia had institutionally managed health services for their students before the enactment of the National Health Insurance. The provision of this health service is funded through a student health insurance scheme that is managed independently by the university and which is limited only for students in the university. Student health insurance is regulated through the policy of each rector. Generally, this fund pooling is collected through a semi-annual contribution in addition to the tuition fee. These funds are managed to finance the health of students during their education. However, in accordance with the mandate of the Ministry of Education, universities are not permitted to collect additional fees outside the national rate. However, the calculation of this national rate does not accommodatestudent healthcare insurance. The National Health Insurance that was launched one year previously also makes this situation more complicated. The availability of parental health insurance can have significant effects on the probability that a young individual enrols as a full-time student in university (Jung et al., 2013). Unfortunately, there is no individual student membership in National Health Insurance. To be able to be covered by National HealthInsurance, students should be registered with all of their family members. The huge variations of health insurance mechanisms bring many obstacles to the citizens who wish to temporarily move to another region for some years. In Indonesia, young adults from rural regions who have just graduated from senior high

Putri, N. and Ernawaty, .The Changing Nature of Campus Health Insurance: Testing Portability Issues of National Health Insurance.InProceedings of the 4th Annual Meeting of the Indonesian Health Economics Association (INAHEA 2017), pages 14-19ISBN: 978-989-758-335-3Copyright©2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved Mark as interesting Comment Delete highlight
(1) (PDF) The Changing Nature of Campus Health Insurance: Testing Portability Issues of National Health Insurance. Available from: https://www.researchgate.net/publication/329217279_The_Changing_Nature_of_Campus_Health_Insurance_Testing_Portability_Issues_of_National_Health_Insurance [accessed Mar 30 2019].

Protecting those who care: The characteristics of occupational Tuberculosis risk in health care workers

Nosocomial TB infection remains an urgent public health problem that requires relentless efforts to overcome. In general, health care workers (HCWs) have a significantly higher risk of suffering from active and latent TB owing to their daily occupational TB risk exposure. The risk is indeed more severe in high TB burden countries, such as Indonesia. In this research, we aimed to: (1) investigate the underlying factor structure of risk characteristics, specifically the risk of nosocomial TB transmission in health care facilities; (2) estimate the effects of work-related determinants and risk characteristics on risk perception; and (3) compare occupational risk perception of contracting TB with expert risk assessment. A paper-based questionnaire was administered to 179 HCWs working for ten public health centres and two hospitals in Surabaya, Indonesia. An exploratory factor analysis of nine risk characteristics revealed a two-factor solution (knowledge-evoked dread and controllability of damage). Structural equation modelling indicated a piece of suggestive evidence that controllability of damage positively affected risk perception, while knowledge-evoked dread did not. Perceived safety conditions yielded a positive and moderate association to controllability of damage, implying that safety infrastructure could be perceived as ‘a cue’ to the presence of a dangerous hazard. The intensity of exposure to TB patients was negatively correlated with the controllability of damage. This indicates that more experience in handling TB patients could lead to underestimation of risk. Our research showed that HCWs tended to accurately estimate the risk of contracting TB based on their specific profession/duties, yet overestimated the risk of contracting TB when it was aggregated to the health care facility level. Although further research is necessary, to include the prevalence of latent/active TB as a part of risk assessments, our research highlights the importance of addressing risk perception, especially encouraging HCWs to become more active in advocating for the required allocation resources for their workplaces or even aiding in raising communities’ awareness of TB transmission.

Urban and rural disparities in hospital utilization among Indonesian adults

Equal access to healthcare facilities, patient’s satisfaction, and respect for the desire of the patient were recognized as the basic principles of each of the health care system. Each person must be given the opportunity to access health services in accordance with the requirements of their health. We aimed to prove the existence of disparities hospital utilization based on the category of urban-rural areas. Methods: The research used the 2013 Indonesian Basic Health Survey (RKD) as analysis material, that was de-signed a cross-sectional survey. With the multi-stage cluster random sampling method, 722,329 respondents were obtained. Data were analyzed using Multinomial Logistic Regression tests. Results: The results showed adults living in urban were likely to use hospital outpatient facilities 1.246 times higher than adults living in rural areas (OR 1.246; 95% CI 1.026 – 1.030). The likelihood of utilizing at the same time outpatient and inpatient facilities at 1.134 times higher in adults living in urban than those in rural areas (OR 1.134; 95% CI 1.025 – 1.255). While for the category of hospital inpatient utilization, there was no significant difference. Conclusion: There was a disparity in hospital utilization between urban-rural areas. Urban show better utilization than rural areas in outpatient and at the same time the use of inpatient care.

Do Justice and Trust Affect Acceptability of Indonesian Social Health Insurance Policy? A cross-sectional survey of laypeople and health care workers

After two bills passed in 2004 and 2011, a nation-wide social insurance in Indonesia has formally established. Aiming at a universal health coverage in 2019, the Jaminan Kesehatan Nasional (JKN) will cover almost 260 million Indonesians and be one of the biggest single payer national health insurance scheme in the world. Our research attempted to investigate whether justice, trust to health care services, confidence level of health system, political party support and evaluation of health care services post-JKN affected policy acceptability in our health workers (N=95) and laypeople (N=308) sample. A-two level multilevel modelling in our health worker sample revealed that justice negatively correlated to policy acceptability, while confidence to health system and institutions as well as evaluation of health care service post-JKN yielded positive correlation. In our laypeople sample, trust to health care service and evaluation of health care service post-JKN were positively affected policy acceptability. In this paper, we discussed why justice matters to a positive policy acceptability for health workers, but not for laypeople. We also discussed the possibility of laypeople’s pragmatic motives of joining JKN scheme.