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Tuberculosis preventive therapy (TPT) for people living with HIV (PLHIV) has been recommended by Indonesia’s National TB Program since 2014 but has seen limited implementation. This study describes TB screening and TPT initiation from 2019 to 2022 among eight healthcare facilities supported by the Zero TB Yogyakarta (ZTB) project. ZTB assigned a dedicated nurse to assist with active TB screening among PLHIV and recommended the immediate initiation of TPT as an innovation implemented. Data were obtained from the national HIV program reporting system, routinely reported by ART clinics from 2019 to 2022. We conducted a descriptive analysis, comparing the pre-intervention and intervention periods. During the intervention, there was a significant increase in PLHIV visits to healthcare facilities where TPT eligibility was assessed. At health centers, TB screening coverage for PLHIV decreased toward the end of the baseline period but recovered during the intervention. The number of PLHIV starting TPT also rose during the intervention. While the direct impact of ZTB is difficult to measure, the changes observed indicate progress in integrating TB/HIV services and enhancing TB prevention among PLHIV. Ongoing support, training, and supervision of healthcare facilities are crucial for improving TB screening and TPT provision.

ObjectivesColon and rectal cancer are associated with different risk factors and prognostic. However, this discrepancy has not been widely explored in the local population. This study aimed to investigate the site-specific likelihood of colorectal cancer (CRC) incidence in the Yogyakarta province, Indonesia.MethodsThis cross-sectional study analyses 1,295 CRC cases diagnosed in 2008-2019 registered in the Yogyakarta population-based cancer registry (PBCR) database. Cases were grouped into colon and rectal cancer. Log-binomial regression was used to determine the relative risk of either colon or rectal cancer across different gender, age group, and rurality of residence. The age-specific rates were calculated by age group and temporal trend for each group were analyzed using joinpoint regression.ResultsFemales displayed higher odds of colon cancer (relative risk/RR = 1.20, 95%CI = 1.02-1.41) and lower odds of rectal cancer (RR = 0.92, 95%CI = 0.85-0.99). Elevated odds of colon cancer were observed in younger age group, especially 30-39 (RR = 1.87, 95%CI = 1.10-3.19), while decreased odds of rectal cancer was apparent in age group 30-39 and 40-49 (RR = 0.75, 95%CI = 0.60-0.93 and RR = 0.82, 95%CI = 0.69-0.98, respectively). Living in urban or rural areas did not significantly influence the odds of either having colon (RR = 0.98, 95%CI = 0.82-1.17) or rectal cancer (RR = 1.01, 95%CI = 0.93-1.10). During 2008-2019, trends of colon cancer in age ConclusionsYogyakarta population shows higher odds of young-onset colon cancer, especially between age 30-39 years old. Overall observation of trend shows increasing incidence in young-onset colon cancer, and non-significant decrease in rectal cancer.

Coverage of tuberculosis preventive treatment (TPT) in Indonesia is inadequate, and persons who start TPT often do not complete treatment. In 2020, Zero TB Yogyakarta implemented person-centered contact investigation and shorter TPT regimen provision in collaboration with primary health care centers. Between 1 January 2020 and 31 August 2022, we assessed eligibility for TPT among household contacts of persons with bacteriologically confirmed TB (index cases) and offered them a 3-month TPT regimen (3RH or 3HP). A dedicated nurse monitored contacts on TPT for treatment adherence and side effects every week in the first month and every two weeks in the next months. Contacts were also able to contact a nurse by phone or ask for home visits at any point if they had any concerns. A total of 1016 contacts were eligible for TPT: 772 (78.8%) started short regimen TPT with 706 (91.5%) completing their TPT. Side effects were reported in 26 (39%) of the non-completion group. We conclude that high rates of TPT uptake and completion among contacts assessed as eligible for TPT can be achieved through person-centered care and the use of shorter regimens. Side-effect monitoring and management while on TPT is vital for improving TPT completion.

A number of applications have been used for managing health data and information and tend to be fragmented between health programs in health offices. In consequence, the analysis and interpretation process becomes difficult since the data is scattered in separate sources. One of the solutions offered as an effort to synchronize and integrate health data in Indonesia is through implementing District Health Information Software (DHIS2). DHIS2 is an application that emphasizes data integration at the health office level. Faculty of Medicine, Public Health and Nursing UGM has been partnered with the Special Region of Yogyakarta Health Office to carry out community service activities in the context of utilizing DHIS2 for health data integration in the province. The implementation of DHIS2 was divided into 4 stages, namely workshop on data availability, socialization, and training of DHIS2; data mapping and customizing DHIS2; implementing health data integration; and dissemination, supervision, and evaluation. Six health offices were the target of community service activities in the province. DHIS2 has facilitated health office staff to analyse and visualize health information that is used for decision making and advocacy. This community service activity supports the government’s efforts to provide one-stop data and contributes to strengthening health information systems both nationally and regionally.

We aimed to explore the district-level temporal dynamics and sub-district level geographical variations of colorectal cancer (CRC) incidence in the Special Region of Yogyakarta Province. We performed a cross-sectional study using data from the Yogyakarta population-based cancer registry (PBCR) comprised of 1,593 CRC cases diagnosed in 2008-2019. The age-standardized rates (ASRs) were determined using 2014 population data. The temporal trend and geographical distribution of cases were analysed using joinpoint regression and Moran’s I statistics. During 2008-2019, CRC incidence increased by 13.44% annually. Joinpoints were identified in 2014 and 2017, which were also the periods when annual percentage change (APC) was the highest throughout the observation periods (18.84). Significant APC changes were observed in all districts, with the highest in Kota Yogyakarta (15.57). The ASR of CRC incidence per 100,000 person- years was 7.03 in Sleman, 9.20 in Kota Yogyakarta, and 7.07 in Bantul district. We found a regional variation of CRC ASR with a concentrated pattern of hotspots in the central sub-districts of the catchment areas and a significant positive spatial autocorrelation of CRC incidence rates in the province (I=0.581, p

BackgroundBreast cancer is a significant public health concern worldwide, including in Indonesia. Little is known about the spatial and temporal patterns of breast cancer incidence in Indonesia. This study aimed to analyze temporal and spatial variations of breast cancer incidence in Yogyakarta Province, Indonesia.MethodsThe study used breast cancer case data from the Yogyakarta Population-Based Cancer Registry (PBCR) from 2008 to 2019. The catchment areas of the PBCR included the 48 subdistricts of 3 districts (Sleman, Yogyakarta City, and Bantul). Age-standardized incidence rates (ASR) were calculated for each subdistrict. Joinpoint regression was used to detect any significant changes in trends over time. Global Moran's and Local Indicators of Spatial Association (LISA) analyses were performed to identify any spatial clusters or outliers.ResultsThe subdistricts had a median ASR of 41.9, with a range of 15.3-70.4. The majority of cases were diagnosed at a late stage, with Yogyakarta City having the highest proportion of diagnoses at stage 4. The study observed a significant increasing trend in breast cancer incidence over the study period the fastest of which is in Yogyakarta City with an average annual percentage change of 18.77%, with Sleman having an 18.21% and Bantul having 8.94% average changes each year (p ConclusionsWe found significant spatial clustering of BC ASR in the Yogyakarta Province, and there was a trend of increasing ASR across the region. These findings can inform resource allocation for public health efforts to high-risk areas and develop targeted prevention and early detection strategies. Further res is needed to understand the factors driving the observed temporal and spatial patterns of breast cancer incidence in Yogyakarta Province, Indonesia.

The COVID-19 pandemic has limited routine community health services, including screening for non-communicable diseases (NCDs). An adaptive and innovative digital approach is needed in the health technology ecosystem. A portable health clinic (PHC) is a community-based mobile health service equipped with telemonitoring and teleconsultation using portable medical devices and an Android application. The aim of this study was to assess the challenges and potential improvement in PHC implementation in Indonesia. This study was conducted in February–April 2021 in three primary health centers, Mlati II in Sleman District, Samigaluh II in Kulon Progo, and Kalikotes in Klaten. In-depth interviews were conducted with 11 health workers and community health workers. At the baseline, 268 patients were examined, and 214 patients were successfully followed-up until the third month. A proportion of 32% of the patients required teleconsultations based on automatic triage. Implementation challenges included technical constraints such as complexity of applications; unstable networks; and non-technical constraints, such as the effectivity of training, the availability of doctors, and the workload at the primary health center. PHCs were perceived as an added value in addition to existing community-based health services. The successful implementation of PHCs should not only be considered with respect to technology but also in terms of human impact, organization, and legality.

Abstract Background Dengue is an emerging vector disease with frequent outbreaks in Nepal that pose a major threat to public health. Dengue control activities are mostly outbreak driven, and still lack systematic interventions while most people have poor health-related knowledge and practices. Mobile Short Message Service (SMS) represents a low-cost health promotion intervention that can enhance the dengue prevention knowledge and practices of the affected communities. This study aimed to explore the acceptability, appropriateness, and effectiveness of mobile SMS intervention in improving dengue control practices. Methods This study was an implementation research that used mixed-methods design with intervention. A total of 300 households were divided into three groups, i.e. one control group, one dengue prevention leaflet (DPL) only intervention group and one DPL with mobile SMS intervention group (DPL + SMS). We used a structured questionnaire to collect information regarding participants’ knowledge and practice of dengue prevention. We conducted in-depth interviews with key informants to measure acceptability and appropriateness of intervention. Mean difference with standard deviation (SD), one-way ANOVA, paired t-test and regression analyses were used to assess the effectiveness of the interventions. Thematic analysis was used to assess the acceptability, and appropriateness as well as barriers and enablers of the intervention. Results The DPL + SMS intervention produced significantly higher mean knowledge difference (32.7 ± 13.7 SD vs. 13.3 ± 8.8 SD) and mean practice difference (27.9 ± 11.4 SD vs 4.9 ± 5.4 SD) compared to the DPL only group (p = 0.000). Multivariate analysis showed that the DPL + SMS intervention was effective to increase knowledge by 28.6 points and practice by 28.1 points compared to the control group. The intervention was perceived as acceptable and appropriate by the study participants and key stakeholders. Perceived barriers included reaching private network users and poor network in geographically remote areas, while enabling factors included mobile phone penetration, low cost, and shared responsibility. Conclusions Mobile SMS is an effective, acceptable and appropriate health intervention to improve dengue prevention practices in communities. This intervention can be adopted as a promising tool for health education against dengue and other diseases.

Di fasilitas publik, peran manajemen obat dan perbekalan kesehatan melibatkan berbagai level organisasi, mulai dari pusat, provinsi, kabupaten dan fasilitas kesehatan. Kebutuhan obat dan perbekalan kesehatan di layanan kesehatan primer dilakuan oleh instalasi farmasi level Kabupaten/Kota yang memiliki peran untuk melakukan perencanaan, pembeliaan, penyimpanan, distribusi dan pelaporan. Sistem informasi elektronik juga telah digunakan. Sayangnya, mekanisme pelaporan dari level yang paling bawah tidak dapat berjalan secara optimal akibat kompleksitas pelaporan, keterbatasan sumber daya dan banyaknya obat dan perbekalan kesehatan yang harus dikelola. Penelitian ini bertujuan untuk menggambarkan alur pelaporan data obat dan perbekalan kesehatan sebagai upaya melakukan pemantauan ketersediaan obat dan perbekalan kesehatan nasional di Indonesia. Penelitian kualitatif dilakukan pada bulan Oktober-Desember 2013 untuk mengidentifikasi alur pelaporan, tantangan dan peluang memperkuat sistem informasi obat dan perbekalan kesehatan. Data dikumpulkan melalui diskusi kelompok terarah, wawancara mendalam dan kunjungan lapangan di 3 instalasi farmasi Kabupaten/Kota dan 1 Instalasi farmasi provinsi. Diskusi kelompok terarah dilakukan di tingkat pusat yang melibatkan penanggung jawab pengelola pelaporan dan pemantauan obat dan perbekalan kesehatan. Sistem informasi obat dan perbekalan kesehatan dibuat untuk mengakomodasi kebutuhan manajemen logistik obat dan perbekalan kesehatan instalasi farmasi (internal) dan pihak eksternal (laporan), baik pemerintah daerah maupun Kementrian Kesehatan. Pengelolaan informasi tersebut sangat tergantung pada sumber daya, alat bantu dan kemampuan masing-masing instalasi farmasi. Penggunaan teknologi informasi dan komunikasi berpotensi untuk mengakomodasi kebutuhan pencatatan dan pelaporan secara lebih baik. Namun demikian, perlu dipertimbangkan untuk penguatan infrastruktur, penggunaan standar data dan dukungan kebijakan dari pemangku kepentingan. Kata kunci: manajemen logistik, pemantauan obat dan perbekalan kesehatan, pencatatan dan pelaporan, sistem informasi

Background: E-learning as a new paradigm in modern education, is an alternative learning model than just face to- face. As simply, e-learning is defined as learning to use the electronic media, which aims to increase knowledge and performance. Studying by using e-learning is important to build the education sector in Indonesia, particularly as an effort to improve equity and access in education, particularly in health domain. Implementing of e-learning in health education are very relevant to the concept of continuing medical /health education that leads to continuous professional education. However, the higher education in Indonesia is still slightly to implement learning-based electronic systems. Several studies have shown the enthusiasm of higher education in using e-learning. The benefits and differences of using e-learning need to be carefully evaluated, especially for health education. This study analyzed the use of e-learning for teaching and learning in health education. In addition, identifying the barriers of e-learning for students. Method: The study was conducted in Poltekkes Kemenkes Palembang involving second-year Nursing students. A quasi-experimental approach was used for two groups of students, 1) e-learning users (treatment) and 2) non e- learning users (control), who were taking the Health Promotion subject. The data were collected using a pre-post tests and questionnaires. Data was analysed quantitatively and qualitatively. Results: Pre-post test results showed a significant difference to the increasing of students’s knowledge who is participating in e-learning compared with conventional learning (p

Penggunaan open source software (OSS) merupakan sebuah pilihan yang diambil oleh rumah sakit untuk menghemat anggaran dan kemudahan dalam pengembangan sistem informasi rumah sakit (SIRS). Penggunaan OSS juga mendukung program pemerintah “Indonesia Goes Open Source”. Sayangnya masih sedikit bukti seberapa jauh OSS digunakan di fasilitas kesehatan. Penelitian ini bertujuan untuk mendeskripsikan bagaimana OSS di rumah sakit dan bagaimana OSS digunakan untuk pengembangan SIRS pada rumah sakit yang ada di Indonesia. Metode yang digunakan adalah kualitatif dengan rancangan studi kasus, mengunakan tipe multikasus holistik. Proses pengumpulan data menggunakan instrumen observasi dan wawancara. Subyek dalam penelitian ini adalah manajer, staff dan programmer pada unit teknologi informasi di 3(tiga sampel) rumah sakit dengan karakteristik yang berbeda. Hasil dalam penelitian ini menunjukan bahwa OSS telah digunakan rumah sakit baik untuk kegiatan umum maupun khusus, yaitu pengembangan SIRS. Faktor biaya secara umum bukan merupakan faktor utama ketika memutuskan untuk mengunakan OSS padapengembangan SIRS. Peran vendor yang memiliki komitmen dalam pengembangan SIRS berbasis OSS berpengaruh terhadap keberlangsungan SIRS di rumah saki. Selain itu transfer pengetahuan dan dukungan dari universitas juga merupakan faktor yang berpengaruh terhadap keputusan rumah sakit dalam penggunaan OSS untuk pengembangan SIRS.Kata Kunci: Open Source Software, Sistem Informasi Rumah Sakit.