Proceeding of International Seminar and Workshop on Public Health Action

Microplastic Contamination in Refillable and Packaged Drinking Water: Sources, Types, and Health Impacts

Abdul Rahman — 2025-12-12

Microplastics are plastic particles smaller than 5 millimeters that have been found widely dispersed in various environments, including in bottled drinking water and refillable drinking water. The presence of microplastics in drinking water is very important because water is a basic human need and a major pathway for microplastics to enter the body, which may pose health risks. Using the literature review study method, through Google Scholar, PubMed, Scopus, and following the guidelines established by PRISMA. As a result, microplastics are found in drinking water due to packaging and processing factors influenced by packaging, distribution, and inadequate processing standards. These particles vary in shape, color, size, and types of polymers such as PET, PE, and PP. Their main sources come from plastic degradation, abrasion of gallon containers, and poor washing and storage processes. The presence of accumulated microplastics in the human body has the potential to cause health issues such as inflammation, oxidative stress, as well as metabolic and digestive disorders. Microplastics have been found in bottled and packaged drinking water, with varying shapes and sizes. This contamination comes from plastic packaging, distribution processes, and depot equipment that do not meet standards. The presence of microplastics can pose health risks.

Overview of the Information Quality of Electronic Medical Records and User Satisfaction at RS X Wonosobo

Adista Yulia Rahmasari — 2025-12-12

Digital transformation in healthcare offers both convenience and challenges, particularly regarding the quality of information generated by electronic systems. Key issues include accuracy, completeness, and timeliness, which are not always ensured due to delays in data entry after procedures, resulting in information that does not fully reflect current conditions. This study aimed to describe the quality of medical record information from healthcare digitalization and assess user satisfaction at RS X Wonosobo. A quantitative descriptive design was employed. Data were collected in April–May 2025 from 63 healthcare professionals using HIMS/EMR, selected through purposive sampling. The instrument was a closed-ended questionnaire with a 4-point Likert scale, covering six variables: accuracy, completeness, format, timeliness, relevance, and user satisfaction. Data were analyzed descriptively by frequency and percentage distribution, with scoring based on a two-category classification using the median cut-off. Results indicated that positive responses were dominant in accuracy (65,08%), format (68,25%), and relevance (60,32%), while completeness, timeliness, and user satisfaction showed balanced perceptions. Overall, these findings indicate that information quality is not yet optimal and affects user satisfaction. It is recommended that the hospital strengthen data entry supervision, conduct regular evaluations, and raise healthcare workers’ awareness of information quality to support service excellence.

K-Means Clustering for Profiling BPJS Health Traders in Semarang by Ability To Pay (ATP) and Willingness To Pay (WTP)

Agnes Oktavi Maharani — 2025-12-12

This study applies the K-Means clustering algorithm to profile market vendors in Semarang City based on their Ability To Pay (ATP) and Willingness To Pay (WTP) BPJS Health insurance contributions, addressing a notable decline in participation among Non-Salaried Workers (PBPU) in Indonesia's National Health Insurance (JKN-KIS). Utilizing quantitative data from 95 Bulu Market vendors, ATP and WTP were estimated via household income and expenditure analysis through linear regression models performed in R-Commander (p < 0.05). Clustering with k=4 yielded optimal segmentation (Davies-Bouldin Index = 0.079), identifying four distinct groups: Opportunistic (low ATP/WTP), Rational (high ATP/moderate-low WTP), Price-Sensitive (financially vulnerable with low ATP/WTP), and Prospective (high ATP and WTP). This novel integration of ATP and WTP in Indonesia's informal sector provides data-driven insights allowing BPJS policy makers to tailor intervention strategies, improving premium compliance within the JKN system. The methodology offers a replicable framework for health insurance segmentation in comparable middle-income Southeast Asian settings, supporting Universal Health Coverage goals.

Risk Factors for Tuberculosis Development in Patients with Comorbidities: A Systematic Review

Andi Rini Indriani Saedah — 2025-12-12

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Comorbid conditions worsen TB outcomes, increasing mortality risk through immune system impairment and making treatment more challenging. his review aims to examine the various risk factors associated with TB in patients suffering from comorbid diseases. A systematic review was conducted, focusing on seven national and international articles selected using the PRISMA method. The databases utilized for the literature search included ProQuest, PubMed, and Google Scholar. The articles reviewed were published between 2020 and 2025 and met specific inclusion criteria. Studies show that male gender is the most dominant risk factor. Most TB respondents may experience nutritional intake deficits and weight loss. TB patients with HIV are mostly unmarried, have low education levels, and have a history of opportunistic infections, while patients with stage 3 to 5 CKD have a higher risk of TB. TB patients require integrated care to detect and manage TB alongside comorbidities. Additionally, TB sufferers should undergo regular screenings to monitor their health status and detect the emergence of comorbidities. This also serves as an intervention to prevent the transmission of pulmonary TB in the community, especially among close contacts.

Trends Of Multidrug-Resistant Tuberculosis (MDR-TB) In Southeast Sulawesi: A Literature Review

Anjelin Rizky Fadilah — 2025-12-12

Multidrug-resistant tuberculosis (MDR-TB) poses a major challenge to the tuberculosis (TB) elimination program in Indonesia. MDR-TB imposes a greater burden because it requires longer and more expensive treatment and carries a higher risk of treatment failure compared to drug-susceptible TB. Southeast Sulawesi, as one of the provinces in eastern Indonesia, is experiencing an increase in MDR-TB cases; however, epidemiological data and local analyses remain limited. This review aims to analyze the trends of MDR-TB in Southeast Sulawesi based on recent literature, identify its risk factors, and highlight the challenges and intervention strategies for MDR-TB control. This study employed a narrative literature review approach by searching articles from PubMed, Scopus, Google Scholar, GARUDA, as well as reports from the Indonesian Ministry of Health and Provincial Health Office, covering the period of 2015–2025. Articles discussing the epidemiology, diagnosis, risk factors, treatment, or policies on MDR-TB relevant to national or local contexts were included. The review indicates an increasing trend of MDR-TB in Indonesia, including Southeast Sulawesi, with major risk factors such as incomplete TB treatment history, poor treatment adherence, delayed diagnosis, and patients’ socio-economic conditions. Limited access to rapid diagnostics (GeneXpert) and second-line drugs also remains a significant barrier. Studies from neighboring regions emphasize that family support, patient education, and community-based interventions can improve treatment success. MDR-TB control efforts in Southeast Sulawesi require a multidimensional approach through expanded access to rapid diagnostics, strengthening healthcare worker capacity, optimizing referral systems, and implementing social interventions to improve adherence. Further local research is needed to accurately map MDR-TB epidemiology as the basis for regional policy.

Influence of Workload, Motivation, and Human Resource Availability On Management Information System Quality

Annisa Aulliyah Samandy — 2025-12-12

In the digital era, the Management Information System (MIS) has become a strategic tool to support organizational performance and decision-making. However, MIS quality is not only determined by technological sophistication but also by human factors that directly influence its use and sustainability. This study aims to analyze the impact of workload, employee motivation, and human resource (HR) availability on the quality of MIS by employing a Systematic Literature Review (SLR) approach. Using PRISMA guidelines, a total of 135 articles published between 2020 and 2024 were initially identified, of which 20 met the inclusion criteria for full review. The selected studies came from various organizational contexts such as education, healthcare, corporate, and public sectors. The findings reveal that excessive workload reduces accuracy in data processing, delays information updates, and increases system-related errors.

Conversely, high employee motivation fosters accountability, proper data handling, and optimal system utilization, serving as a buffer against workload- related stress. Meanwhile, the availability of qualified HR plays a pivotal role in ensuring both the technical and managerial aspects of MIS run effectively. A lack of trained personnel often results in underutilization and mismanagement of systems. The synthesis highlights that workload, motivation, and HR availability are interconnected factors that collectively shape the quality of MIS. To enhance system performance, organizations must adopt balanced workload strategies, foster motivational work environments, and invest in HR development through training and strategic recruitment. These measures are essential for achieving sustainable, accurate, and effective MIS outcomes.

User Satisfaction Assessment of the KlikDokter Application in Indonesia: An End-User Computing Satisfaction (EUCS) Approach

Azrha Tafania Jia Agnie — 2025-12-12

KlikDokter is a digital health platform that provides online consultations with doctors, health articles, drug information, and e-commerce services for health products. Although the public’s demand for digital health services continues to grow, many users still feel dissatisfied with the KlikDokter application. This study aims to evaluate user satisfaction with the KlikDokter application using the End-User Computing Satisfaction (EUCS) approach. A descriptive quantitative method with a cross-sectional approach was used. The sample consisted of 392 respondents, and data were collected through an online questionnaire distributed via social media. Data analysis employed the Spearman Rank test with a 95% confidence level. The results showed that the majority of respondents were aged 18–25 years (55.1%), held a bachelor's degree (66.6%), and resided on the island of Java (51.8%). All EUCS dimensions—content (r=0.630), accuracy (r=0.634), format (r=0.654), ease of use (r=0.725), and timeliness (r=0.609)—had a highly significant relationship with user satisfaction (p=0.000). Overall, the KlikDokter application is recommended for conducting online consultations. However, in terms of timeliness, it is suggested that real-time support be improved through live chat features or more accessible customer service assistance.

The Role of Social Support in Reducing Occupational Stress Among Couriers: Evidence from Semarang City, 2025

Dea Garnita Puri — 2025-12-12

The courier profession involves stringent daily targets and substantial workloads, predisposing workers to occupational stress. According to the 2022 Health Safety Environment (HSE) data, approximately 870,000 workers experienced work-related stress, depression, and anxiety, with a prevalence of 2.6 per 100,000 workers. This study investigates demographic and occupational variables influencing work-related stress among couriers employed by the “X” expedition company in Semarang City, amid the rapid growth of e-commerce increasing service demands. A quantitative, observational-analytical study with a cross-sectional design was conducted. Data were collected through validated questionnaires from 86 couriers using total sampling. Due to the non-parametric dataset, Spearman’s Rank correlation was employed. Results revealed a significant negative correlation between social support and work stress (p = 0.002; contingency coefficient = -0.327), indicating that increased social support reduces occupational stress. However, age (p = 0.425), tenure (p = 0.521), working duration (p = 0.757), educational attainment (p = 0.267), and workload intensity (p = 0.475) showed no significant correlation with stress levels. These findings emphasize the key role of social support in mitigating work stress. It is recommended that the company develop health policies that include wellness programs with social-emotional and psychological support through counseling, implement safe working hour policies, and provide training for supervisors and managers on open communication and stress management.

Analysis of Burnout and Occupational Safety in Nurses: A Literature Review

DELISTIANI DELISTIANI — 2025-12-12

Burnout and occupational safety are increasingly recognized as critical issues affecting the quality of nursing care in healthcare settings. This study aims to explore the contributing factors to nurse burnout and associated occupational safety risks through a structured literature review. A narrative review was conducted on 50 national and international journal articles published between 2019 and 2025. The review focused on study location, research design, examined variables, and key findings. The results show that high workload, extended working hours, lack of managerial support, and psychosocial stressors such as role conflict are major contributors to burnout. In parallel, occupational safety is often compromised due to fatigue, mental pressure, negligence, and poorly designed work environments. The findings highlight a strong interrelation between burnout and occupational safety, with both shaped by individual, organizational, and environmental factors. Preventive measures, including workload management and psychological support systems, are essential to improve nurses' well-being and reduce safety incidents. This study underscores the need for integrated interventions targeting both burnout and safety to ensure high-quality nursing services and better occupational health outcomes.

Associations Between Psychosocial Stress, Saturated Fat, Physical Activity, and Blood Glucose in Type 2 Diabetes

Nabilah Intan Junita — 2025-12-12

Background: Type 2 diabetes mellitus involves dysregulated glucose homeostasis due to impaired insulin production, secretion, or action. Psychosocial stress activates the HPA axis, elevates cortisol, and reduces insulin sensitivity; saturated fat intake may aggravate insulin resistance; physical activity enhances insulin-mediated glucose uptake and endothelial function. Objective: To examine associations between psychosocial stress, saturated fat intake, and physical activity with blood glucose among adults with T2DM attending Sawah Lebar Public Health Center, Bengkulu City, 2025.Method: Case–control study with purposive sampling (n=138). Data collected via validated stress scales, physical-activity questionnaires, and dietary assessments; univariate and bivariate analyses used chi-square tests. Results: No significant associations between psychosocial stress (p=0.518) or saturated fat intake (p=0.213) and blood glucose status. Physical activity was significantly associated with glycemic status (p=0.016), suggesting a protective effect. Conclusion: Despite plausible pathways linking saturated fat and stress to insulin resistance, only physical activity showed a significant association with glycemic control in this sample. Findings highlight physical activity as a modifiable behavioral target in T2DM management at the primary care level; larger, longitudinal studies with objective measures of diet, stress, and activity are warranted.

Formulation, Evaluation, Antibacterial Activity Of Roll-On Deodorant With Butterfly Pea Flower Extract Against Staphylococcus Aureus

Dian Novia Ningtias — 2025-12-12

Body odor is a common physiological problem caused by the metabolic activity of Staphylococcus aureus, which converts odorless sweat compounds into malodorous substances. Conventional deodorants often rely on synthetic agents that may cause skin irritation and long-term health risks. Therefore, herbal-based deodorants have gained growing attention. Butterfly pea (Clitoria ternatea) contains flavonoids, tannins, and alkaloids with known antibacterial activity. This study aimed to formulate a roll-on deodorant containing butterfly pea extract, evaluate its physical characteristics, and determine its antibacterial activity against S. aureus. The extract was obtained by maceration in 70% ethanol and incorporated into three concentrations: 5% (F1), 10% (F2), and 15% (F3). Physical evaluation included organoleptic properties, homogeneity, pH, viscosity, spreadability, and adhesion. Antibacterial activity was tested using the disc diffusion method. Results showed that all formulas met physical requirements, with increasing extract concentration leading to higher viscosity and adhesion but reduced spreadability. Antibacterial activity increased significantly with concentration, with F3 showing the highest inhibition zone (19.89 mm), classified as strong activity. One-way ANOVA confirmed significant differences among formulas (p<0.05). These findings suggest that butterfly pea extract is a promising candidate for developing safe, effective, and eco-friendly herbal roll-on deodorants.

Evaluation of Elsimil Application Data Management System for Stunting Prevention By BKKBN¬ Of Central Java

Fany Kusuma Dewi — 2025-12-12

The stunting data management system supports the stunting reduction program through data collection and management, with the Elsimil application developed by BKKBN in 2022 as a tool for recording intervention data. This study aims to evaluate its implementation in Central Java using a descriptive qualitative method with in-depth interviews based on the input–process–output approach. Informants consisted of BKKBN Central Java staff and TPK cadres. The findings show that Central Java has 27,948 TPK cadres, with qualifications limited to owning Android phones and no age restrictions. Cadres receive training, although none was held this year, and are given an honorarium of IDR 100,000 per month. Guidelines are available in e-book format but are not fully followed, while facilities such as cellphones, data packages, and forms exist though form printing is self-funded. Data input for prospective brides and pregnant women faces errors and workload barriers, while supervision through monitoring and evaluation is hindered by slow central follow-up. Coverage targets have not been achieved, with only 45,607 of 56,671 prospective brides and 39,533 of 137,542 pregnant women assisted. The study concludes that strengthening cadre training, improving guideline compliance, enhancing application performance, and developing quantitative indicators are essential for optimizing Elsimil implementation.

Health Promotion Strategies in Preventing and Handling Sexual Violence against Children : a Literature Review

Hasmawati Hasmawati — 2025-12-12

Sexual violence against children (CSA) is a major public health issue with long-term physical, psychological, and social consequences. This study reviewed health promotion strategies effective in preventing and addressing CSA. A systematic literature review was conducted across four databases (PubMed, Scopus, Google Scholar, and SINTA) for articles published between 2020–2025. From 50 records identified, 17 met inclusion criteria after PRISMA-guided screening. Results showed that school-based sexual education reduced CSA risk by 23%, underscoring the importance of integrating comprehensive sexual literacy into formal curricula. Parenting education improved parents’ ability to detect early warning signs and report cases promptly. Community-based interventions, safe houses, and social media campaigns helped reduce stigma and strengthen recovery support systems. Psychosocial approaches such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and mindfulness were effective in alleviating PTSD, depression, and anxiety in victims. However, challenges remain, including underreporting, social stigma, and limited capacity among health workers. In conclusion, CSA prevention requires multisectoral collaboration involving families, schools, healthcare services, and communities. Policy implications emphasize strengthening sex education programs, institutionalizing parenting education, expanding digital literacy campaigns, and improving healthcare worker training on CSA. These integrated strategies are essential to building sustainable child protection systems and ensuring safer environments for children.

Strategies for Increasing Access to Adequate Sanitation and Their Impacts On Public Health: A Literature Review

HIKMA SRI NURWIDIARNI — 2025-12-12

Sanitation is one of the most fundamental human needs. Lack of access to adequate sanitation facilities not only reduces the quality of life but is also the root of various health and environmental problems. Access to adequate sanitation is a key pillar of public health and a key indicator of the Sustainable Development Goals (SDGs). However, many communities in developing countries, including Indonesia, still face challenges in achieving universal sanitation access. This literature review aims to synthesize and analyze studies published in the last five years on intervention strategies to improve sanitation access and their impact on public health. The method used is a systematic literature review. The analysis shows that community-based approaches such as Community-Based Total Sanitation (STBM) remain an effective core strategy, but their success depends heavily on integration with other factors. A strong correlation was found between increased sanitation access and reduced prevalence of diarrheal diseases, stunting, and worm infections. Sociocultural factors, the role of women, post-intervention program sustainability, and innovations in technology and financing models are key determinants of success. Successful sanitation interventions are holistic, participatory, gender-sensitive, and tailored to specific contexts (urban, rural, post-disaster) to deliver significant health, social, and economic impacts.

Factors Influencing Pulmonary TB Transmission Among Household Contacts of TB Cases : Systematic Review

Histina Histina — 2025-12-12

Tuberculosis (TB) remains a major global health problem, with Indonesia ranked second worldwide in TB incidence, estimated at 1,090,000 cases and 125,000 deaths annually. Household contacts are at particularly high risk due to prolonged exposure, making this setting crucial for transmission control. This study applied a systematic literature review based on PRISMA 2020 guidelines. Eligible studies (2020–2025) included case–control, cohort, and cross-sectional designs conducted in Indonesia and comparable settings. Populations consisted of household contacts of pulmonary TB cases. Eight articles have been analyzed. Data collection methods varied, including interviews, diagnostic tests and structured questionnaires. Statistical analyses commonly used logistic regression, yielding odds ratios (OR), confidence intervals (CI), and p-values. Key risk factors included poor ventilation, room crowding, and prolonged daily contact (≥5 hours), Biological risks were age <5 years (OR 8.38, CI 95%), malnutrition (OR 8.88), diabetes mellitus, and HIV infection, Social determinants included low education, inadequate hygiene, and weak family support, Protective factors were good nutrition, BCG vaccination, health education, and strong social support. Pulmonary TB transmission among household contacts is multifactorial, influenced by environmental, biological, and social-behavioral determinants. Actionable implications include improving home ventilation, reducing overcrowding, strengthening contact tracing, and enhancing family-based health education.

Mental Health of Adolescents in Indonesia : Barriers, Risk Factors, and Intervention Strategies : A Literature Review

I Dewa Putu Oka Diatmika — 2025-12-12

WHO (2022) reported a 25% increase in global depression prevalence, with adolescents among the most affected groups. In Indonesia, one in seven adolescents experiences a mental disorder, and suicide ranks as the third leading cause of death among individuals aged 15–29 years. National surveys in 2018 and 2023 confirmed rising depression rates, compounded by stigma and limited access to mental health services. I-NAMHS 2022 reported around 15.5 million adolescents (34.9%) experiencing at least one mental health problem. This study synthesizes risk factors, barriers, and intervention strategies for adolescent mental health in Indonesia. Fifteen peer-reviewed articles (2020–2025) were retrieved from Google Scholar, and Science Direct, following PRISMA 2020 guidelines. Inclusion criteria included quantitative and qualitative studies, open-access full-text availability, publications in English or Indonesian, and focus on adolescent populations. Results identified three main themes: risk factors, including adverse family environments, problematic parenting, bullying, digital overuse, academic stress, and socioeconomic inequality; barriers, such as stigma, rural service gaps, low literacy, and dual effects of digitalization; and effective interventions, including school-based psychoeducation, digital platforms, and integrated community approaches. Evidence underscores the urgent need for multisectoral collaboration to address barriers, expand infrastructure, and reduce stigma through culturally appropriate adolescent mental health strategies.

Factors Influencing Interest In Using Contraception Implants Among Women At Seremuk Public Health Center, Sorong Selatan Regency

Fibrianti Fibrianti — 2025-12-12

Family Planning improves the welfare of mothers and children and creates happy and prosperous small families through birth control and controlling population growth in Indonesia. The global prevalence of contraception in 2022 using any type of contraceptive method is estimated at 65% and modern methods at 58.7%. Users of contraceptive implants in Southwest Papua Province in 2021 were 1,440, in 2022 there were 1,431, in 2023 there were 1,242 implant users.

The aim of this study is to analyze the factors that influence the interest in using contraceptive implants in women of childbearing age in the Community Health Center of Seremuk work area.

The method used in this study is a quantitative method. The research design used in this study is observational using a cross-sectional study design. The location of this research will be carried out at Seremuk Community Health Center. The population in this study was the number of women of childbearing age in the last 6 months, amounting to 187 people. With sample 67 people.

The results of this study are that there is a relationship between attitudes and interest in using implant contraception, meaning that Ho is accepted and Ha is rejected. The results of the statistical analysis obtained a value of ρ = 0.004 <p standard 0.05. There is a relationship between subjective norms and interest in using implant contraception, meaning that Ho is accepted and Ha is rejected. The results of the statistical analysis obtained a value of ρ = 0.019 <p standard 0.05. There is a relationship between intentions and interest in using implant contraception, meaning that Ho is accepted and Ha is rejected. The results of the statistical analysis obtained a value of ρ = 0.026 <p standard 0.05

The conclusion of this study is that a person's interest is sometimes influenced by attitudes, thus giving rise to subjective norms that are good to do and have an impact on the intention to do it. It is recommended that future researchers examine other variables related to women's interest in using contraceptive implants.

Comparison of Face-to-Face and Mobile Health Messaging Interventions to Enhance Hypertension Knowledge among Cadres in Ngabean dan Trisobo Village, Kendal Regency

Izzatul Alifah Sifai — 2025-12-12

Hypertension remains the leading risk factor for cardiovascular morbidity and mortality. However, knowledge gaps among the community hinder prevention, early detection, and treatment adherence. Community health cadres play a crucial role as frontline actors in health promotion, screening, and referral. This study aimed to compare the effectiveness of online and face-to-face health education interventions in improving knowledge and attitudes toward hypertension among community health cadres. A pre-experimental one-group pretest–posttest design was conducted from November 2024 to January 2025 in the working area of Boja II Primary Health Care Center, Kendal Regency, Central Java. Thirty-one cadres participated (20 in the online group and 11 in the face-to-face group). The online intervention was delivered via a WhatsApp group over 3 days using 12 educational flyers, while the face-to-face intervention involved a 90-minute session with presentations and discussions. Knowledge and attitudes regarding hypertension were measured using a validated questionnaire (Hypertension Knowledge-Level Scale). Data were analyzed using Wilcoxon signed-rank and Mann–Whitney U tests. In the online group, knowledge scores increased from 11.2 ± 2.1 to 16.5 ± 1.4 and attitude scores from 12.3 ± 1.8 to 16.8 ± 1.5 (p < 0.001). In the face-to-face group, knowledge increased from 11.5 ± 2.3 to 17.2 ± 1.1 (p = 0.003) and attitudes from 12.6 ± 1.7 to 17.5 ± 1.2 (p = 0.004). Posttest comparisons showed significantly higher knowledge (U = 64.5, p = 0.041) and attitude (U = 66.0, p = 0.048) scores in the face-to-face group than in the online group. Both online and face-to-face educational interventions significantly improved knowledge and attitudes toward hypertension among health cadres. However, face-to-face education demonstrated superior effectiveness. Strengthening capacity-building programs for cadres through interactive learning may enhance community-based hypertension prevention and control.

Epidemiology of Non-Communicable Diseases and Predictive Factors in the Elderly in Southeast Asia

Jelin Natalia Fahira Delo — 2025-12-12

The elderly are defined as individuals aged 60 and above, often associated with physical decline and helplessness. The increasing number of elderly people in the Southeast Asian region is followed by a high prevalence of Non-communicable Diseases (NCDs) and overall, the leading cause of death in 2021 was non-communicable diseases (NCDs), which contributed more than 74% of total deaths, with about 18 million of them being premature deaths before reaching the age of 70. This study aims to analyze the epidemiology of non-communicable diseases and to identify predictive factors affecting the incidence of non-communicable diseases in the elderly population in the Southeast Asian region. This research uses a qualitative method with a literature review approach. Diseases such as hypertension, diabetes mellitus, heart disease, and obesity are increasingly prevalent among the elderly population. Risk factors include unhealthy eating patterns, lack of physical activity, smoking, obesity, socio-economic limitations, poor living environments, and uneven access to healthcare services. In conclusion, managing Non-Communicable Diseases (NCDs) in the elderly population in Southeast Asia requires an approach that involves multiple sectors. This approach must include attitude changes, health system improvements, preventive policies, and efforts to reduce socio-economic disparities.

Socioeconomic and Environmental Determinants of Community Stunting Prevention Behaviors: A Systematic Literature Review

Jumriyanti Nasaru — 2025-12-12

Stunting represents a critical public health challenge in developing countries, affecting over a quarter of children globally and resulting from complex interactions between socioeconomic, environmental, and behavioral factors that require comprehensive understanding for effective intervention strategies. This study aimed to identify, analyze, and synthesize the determinants of stunting prevention behaviors in developing countries through systematic literature review to provide evidence-based recommendations for targeted intervention strategies. A systematic literature review following PRISMA 2020 guidelines was conducted using PubMed, Scopus, Science Direct, and Google Scholar databases. Search terms included "stunting," "malnutrition," "determinant factors," "prevention," "community behavior," and "developing countries." Inclusion criteria encompassed articles published 2019-2024 focusing on children aged 0-59 months in developing countries. Quality assessment utilized Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool, resulting in 20 high-quality studies from 309 initially identified articles. Maternal education emerged as the most consistent determinant, with low educational levels significantly correlated with suboptimal parenting practices. Economic status demonstrated complex relationships where poverty limited nutritious food access and affected family resource allocation priorities. Health promotion models proved effective for behavioral change, with self-efficacy and social support as significant factors. Environmental and sanitation factors played crucial roles through infection prevention and optimal nutrient absorption mechanisms. Multisectoral collaborative approaches emerged as most effective strategies requiring stakeholder trust and integrated coordination mechanisms. Comprehensive stunting prevention requires holistic intervention programs integrating maternal education, economic empowerment, and improved healthcare access. Strategic recommendations include participatory health education approaches, community-involved sanitation infrastructure development, and multisectoral collaboration models with neutral coordination platforms and shared performance indicators for sustainable program implementation.

Effect of OSH Supervision on Safe Work Behavior of Construction Workers, Ponorogo Indonesia, 2025

Kartika Hermawati — 2025-12-12

Unsafe behavior is a major contributor to occupational accidents in construction projects. In Ponorogo, local reports documented 18 construction accidents in early 2024, with most caused by unsafe acts. Effective Occupational Safety and Health (OSH) supervision is essential to ensure compliance with safety standards and reduce unsafe practices.

This study aimed to determine the effect of OSH supervision on safe work behavior among construction workers in Ponorogo, Indonesia, 2025. A quantitative cross-sectional design was applied involving 42 construction workers recruited through simple random sampling, with inclusion criteria of at least one month of active employment. Data were collected using structured questionnaires and direct observations. Variables studied were OSH supervision (low, high) and safe work behavior (unsafe, safe). Associations were analyzed using the Chi-square test and prevalence ratio (PR) with 95% confidence intervals.

Results showed that 71.4% reported high supervision, and 69.0% demonstrated safe behavior. Workers with high supervision were significantly more likely to behave safely (p = 0.000; PR = 19.50; 95% CI: 3.642–104.411).

In conclusion, OSH supervision strongly influences safe work behavior. Strengthening consistent monitoring, corrective actions, and enforcement mechanisms is recommended to improve compliance and guide policy in construction safety management.

Determinants of Chronic Energy Deficiency (CED) in Pregnant Women at Banjarejo Health Center

Khusnul Khotimah Al Isthikhomah — 2025-12-12

Chronic Energy Deficiency (CED) in pregnant women remains a major contributor to low birth weight (LBW) cases in Indonesia. The Indonesian Ministry of Health, in line with the 2015–2030 Sustainable Development Goals (SDGs), has targeted a reduction in CED prevalence among pregnant women to 5%. However, the 2024 report from the Madiun City Health Office recorded the highest prevalence of CED among pregnant women at the Banjarejo Community Health Center, reaching 8.5%. This study aimed to analyze factors associated with the incidence of CED among pregnant women at the Banjarejo Health Center in Madiun City. An observational analytic method with a case-control design was employed. The study involved 78 respondents, consisting of 39 cases and 39 controls, with inclusion criteria of pregnant women in their first and second trimesters. Data were collected using a structured questionnaire and analyzed through univariate and bivariate approaches. The findings showed that maternal knowledge level (p = 0.040) and compliance with iron (Fe) tablet consumption (p = 0.008) were significantly associated with CED. It is recommended that pregnant women at risk of CED improve their knowledge of pregnancy nutrition and adhere to proper Fe tablet intake, including correct timing, dosage, and management of side effects.

Health and Environmental Risk Assessment due to Pesticide Exposure in Agricultural Communities: A Review of the Literature

Magvirah Tuljannah — 2025-12-12

The use of pesticides in agriculture increases productivity but also poses significant health and environmental risks, particularly in farming communities with high exposure levels. Most previous studies have examined health or environmental effects separately, creating a gap in understanding the combined risks faced by vulnerable populations. This study seeks to assess both health and environmental risks of pesticide exposure and identify contributing factors through a literature review. A total of 50 scientific journals were reviewed, with 10 articles selected based on inclusion criteria and analyzed using a descriptive-thematic approach. The findings indicate that pesticide exposure is linked to acute poisoning, neurological symptoms, respiratory problems, and potential reproductive or developmental disorders in children. Chronic risks are most evident among farmers, children, and pregnant women, largely due to limited use of personal protective equipment, long spraying duration, and weak regulatory control. Environmentally, pesticide residues accumulate in soil, water, and aquatic ecosystems, contributing to degradation and biodiversity loss. Overall, the study highlights that pesticide exposure presents dual risks to human health and the environment, underscoring the need for integrated risk assessment, longitudinal studies, and stronger, sustainable management policies.

Literature Review: Factors Influencing Medication Adherence In Pulmonary TB Patients

Malika Puspahadi — 2025-12-12

The health problem that is a global challenge today is tuberculosis. This is due to the high incidence of infection, low coverage of treatment adherence and widespread drug resistance rates. Tuberculosis (TB) is the leading cause of death due to infectious diseases in the world, and Indonesia is the second largest contributor of TB cases after India. Medication adherence issues are the main obstacle in TB elimination.
This study aimed to examine the factors that affect treatment adherence in TB patients and assess the effectiveness of interventions designed to improve adherence. The method used in this study is a literature review. The sources for making literature reviews were taken from Google Scholar, ProQuest and PubMed since the last 5 years (2019-2024), a total of 15 articles were found and filtered into 8 articles that met the inclusion requirements, namely medication compliance. The results of the study are intended to make an important contribution to designing more targeted intervention strategies to improve treatment adherence, especially in areas with high prevalence of tuberculosis. This study confirms that the success of tuberculosis control and therapy is greatly influenced by continuous monitoring, patient education, and adequate support.

Controlling Occupational Hazards and Safety Using Job Safety Analysis (JSA) and Hazard Identification, Risk Assessment and Risk Control (HIRARC) Methods

Mila Faila Sufa — 2025-12-12

Workplace health and safety is an effort to create a healthy and safe working environment, thus reducing the likelihood of accidents that can cause demotivation and decreased productivity. Issues identified include workers still frequently making mistakes in their work, lack of awareness among workers in adhering to company regulations and Standard Operation Procedures, failure to use personal protective equipment while performing tasks, aging machinery with some parts experiencing unrepaired damage, insufficient insulation installation in pipe lines, hot working environment due to machine heat and sunlight, noise pollution from operating machinery, and oil spills on the production floor. The aim of this research is to reduce workplace accidents in the company by conducting hazard identification, risk assessment, and proposing improvement recommendations. The research utilizes the Job Safety Analysis method to break down activities in each machine operation into work stages, thus obtaining a more detailed identification. The next method used is Hazard Identification, Risk Assessment, and Risk Control, which evaluates job hazards related to machine operation. The results of risk assessment greatly aid in reducing risks and identifying necessary improvements to support production activities. From the research results, 17 activities were identified, resulting in 26 accident hazards stemming from work activities. Based on the results, there are 7 low-risk work hazards, 12 medium-risk work hazards, 5 high-risk work hazards, and 2 extreme- risk work hazards. Risk control measures include administrative controls and the use of personal protective equipment.

Patient Safety in Community-Based Independent Midwifery: A Global Systematic Review of Conceptual Models and Frameworks

Mozha Desri Puji Astuti — 2025-12-12

Independent, community-based midwifery, defined as midwife-led care delivered outside obstetrician-led hospital wards, including home births, freestanding or alongside birth centers, and continuity-of-care teams for predominantly low-risk pregnancies, requires clear conceptual guidance to ensure patient safety. Guided by PRISMA 2020, we conducted a global search of Scopus, PubMed, Web of Science, and CINAHL (January 2013–December 2025). Of 1,215 records screened, 34 studies (2015–2025) met inclusion and were synthesized thematically. Six clusters of frameworks emerged: continuity-of-care and community-integrated models; reflective and ethical practice models; education and professional training frameworks; policy and governance reform; interprofessional communication and collaboration; and spatial, cultural, and structural influences on care. Illustrative examples include the Midwifery Continuity of Carer model (operationalizing relationship-based safety via smaller caseloads and coherent pathways), the US MERA consensus framework (standardizing regulation and scope to support safer system integration), the MIDWIZE midwife-led care framework, and the WHO Safe Childbirth Checklist. Cross-cutting implementation enablers included relational trust, professional ethics, system integration, experiential learning, and equity-oriented design. Practically, these frameworks inform training (simulation and reflective pedagogy), strengthen handover protocols and interprofessional norms, guide person-centered facility and service design, and support regulatory alignment to broaden safe access to midwife-led care. Policy relevance lies in adopting standardized regulatory models and capacity-building approaches to embed continuity, cultural safety, and accountability, with potential downstream gains in maternal–newborn outcomes.

Consumption of Ultra-Processed Foods and Its Association with Increased Obesity Risk: A Recent Literature Review

Muhammad Amin — 2025-12-12

Background: The global increase in ultra-processed food (UPF) consumption has been strongly linked to rising obesity rates. UPFs are typically high in calories, sugar, unhealthy fats, and additives, while lacking fiber and essential nutrients. Methods: This narrative literature review examined studies published between 2015 and 2025 in PubMed, Scopus, and Google Scholar. Eligible articles included observational and interventional research assessing UPF consumption and outcomes related to obesity, including body mass index (BMI) and waist circumference. Results: Twenty studies met the inclusion criteria. Findings from randomized trials, prospective cohorts, and meta-analyses consistently showed that high UPF intake is associated with increased calorie consumption, weight gain, higher BMI, central adiposity, and obesity prevalence across age groups. A dose–response relationship was evident, with greater UPF consumption linked to more adverse outcomes. Proposed mechanisms include excessive energy intake, poor satiety regulation, and metabolic dysfunction. Despite some heterogeneity, the evidence strongly supports UPFs as a major dietary contributor to obesity. Conclusion: UPF consumption is a significant driver of obesity and related metabolic disorders. Recommendations: Public health strategies should prioritize reducing UPF intake through taxation, front-of-pack labeling, marketing restrictions, nutrition education, and clinical counseling. Further research should assess long-term impacts of such interventions on population health.

Assessment of User Satisfaction on a HalloBumil Application Through the End User Computing Satisfaction (EUCS) Framework in Semarang

Mutiara Indah Sari — 2025-12-12

Mobile health (M-health) applications can enhance maternal health by providing accessible and accurate information. HalloBumil is one of the most widely used maternal health applications in Indonesia, yet few studies have assessed user satisfaction. This study aimed to evaluate user satisfaction with HalloBumil using the End User Computing Satisfaction (EUCS) model. A cross-sectional survey was conducted among pregnant women in Semarang City, with Puskesmas selected through stratified random sampling. Respondents were active HalloBumil users and completed the EUCS questionnaire, which measures five dimensions: Content, Accuracy, Format, Ease of Use, and Timeliness. Data were analyzed descriptively and with correlation tests. Findings indicated that most respondents were satisfied with HalloBumil across all dimensions. Ease of Use achieved the highest score, highlighting that the application is considered intuitive and simple to operate. Timeliness had the lowest score, suggesting a need to improve the delivery of up-to-date and relevant information. Correlation analysis demonstrated significant positive relationships between all EUCS dimensions and overall satisfaction (p < 0.001). In conclusion, HalloBumil is generally well-received by pregnant women in Semarang City. These results provide important input for app developers to enhance features, particularly in information timeliness, and for policymakers to optimize digital maternal health services

Literature Systematic Literature Review: Environmental Sanitation Conditions and Health Risks in Kendari Coastal Areas, Indonesia

Nadia Dwihajra Musrin — 2025-12-12

Globally, coastal populations face increasing sanitation challenges, with over 40% of the world’s population living within 100 kilometers of coastlines experiencing limited sanitation infrastructure. In Indonesia, where 60% of citizens reside in coastal areas, these problems are particularly evident in rapidly growing cities such as Kendari. Although several studies on coastal sanitation exist, there is still a lack of systematic reviews that comprehensively analyze sanitation conditions and health outcomes in Indonesian coastal settings. This study aims to describe environmental sanitation conditions in Kendari’s coastal areas. A Systematic Literature Review (SLR) was conducted following PRISMA guidelines by analyzing 10 eligible studies (2017–2025) from international and national databases. Articles were assessed for methodological rigor, sample representativeness, and data validity. Findings showed low household latrine ownership, unsafe water, poor waste management, and inadequate sanitation practices. Health impacts identified include diarrhea, dengue hemorrhagic fever, and childhood stunting. Contributing factors were economic limitations, low environmental literacy, and persistent socio-cultural practices. Policy implications highlight the need for integrated infrastructure development, culturally sensitive community education, and monitoring systems to achieve sustainable coastal health outcomes and support SDG targets.

Local Food Based Supplementary Feeding To Prevent Stunting In Coastal Areas: A Review

Nur Afifah — 2025-12-12

Stunting remains a persistent public health challenge in Indonesia, particularly in coastal communities where food insecurity and limited dietary diversity are common. Locally sourced foods, especially fish and moringa based products, have been proposed as culturally relevant and sustainable interventions. This systematic literature review analyzed 18 peer reviewed articles published between 2022 and 2025 that evaluated supplementary feeding interventions using local food ingredients for stunting prevention and treatment in children. Evidence consistently indicates that local food based products such as fish nuggets fortified with moringa leaves, rebon shrimp based meals, and other seafood innovations significantly improve child growth indicators, including height for age and weight for age z scores. Community acceptance was generally high, highlighting the importance of cultural relevance. Key challenges included seasonal variability of raw materials, production costs, and caregiver knowledge gaps. Community empowerment and integration with health policies were essential for sustainability. Overall, locally sourced supplementary feeding is both effective and socially acceptable for reducing stunting in coastal settings. Indonesia’s experience demonstrates how nutrition, culture, and policy can converge to create scalable models for child health, underscoring the urgent need to strengthen and replicate these approaches to prevent intergenerational cycles of malnutrition

Digital Health Innovations in Supporting Healthy Aging: An Epidemiological Perspective: A Literature Review

Nurul Amalliah — 2025-12-12

The development of digital health technology has presented great opportunities in supporting healthy aging amid the increasing number of elderly people. Healthy aging has become an important agenda in the public health system, especially in the era of digital disruption. This study aims to explore the impact of digital innovations, such as telemedicine, wearable health devices, health apps, and artificial intelligence, on the health of the elderly. The method used is a literature review of national and international journals published between 2020 and 2025 that are relevant to the topics of digital health and aging. Each piece of literature was evaluated based on its methodology, results, and contribution to the epidemiological understanding of digital interventions for the elderly. The results indicate that digital technology has great potential in improving the early detection of chronic diseases, expanding access to healthcare services, and promoting the independence of the elderly. However, digital and technological literacy remain major challenges that need to be addressed through interdisciplinary approaches and inclusive policies. Conclusion This study underscores the need to strengthen epidemiological research to comprehensively assess the effectiveness of digital interventions in support of sustainable healthy aging.

Determinants of maternals’ handwashing practices in rural Dayak community: Evidence from Tasik Payawan, Katingan Regency Central Kalimantan

Oktaviani Mahar — 2025-12-12

Water, sanitation, and hygiene (WASH) interventions, particularly handwashing practices, significantly impact children's growth and development by 20%. Primarily, handwashing pratice prevent chronic exposure to enteric pathogens. Therefore, this study aims to assess the determinants of handwashing practice in rural community with limited access to clean water. This was a cross-sectional study, conducted in the rural Tasik Payawan District, located by the Katingan River, from October-November 2024. Approximately 30 women with children aged 6 to 24 months were included. We gathered sociodemographic and behavioral data related to handwashing with a questionnaire. Two-way association tables, c² p-value were calculated using EasyR v 1.68 for Windows. The analysis revealed that maternal knowledge (p-value: 0.010), attitudes (p-value: 0.006), and water sources (p-value: 0.017) significantly influence handwashing behavior. The study indicated that mothers with strong decision-making skills regarding handwashing positively impact these behaviors. Our findings suggest that maternal knowledge and attitudes are crucial for effective handwashing practices in the Tasik Payawan sub-district of Katingan. Enhancing maternal knowledge is essential for improving handwashing behaviors, suggesting that mothers require targeted educational interventions.

Risk Factors for Pulmonary Tuberculosis in Patients with HIV : A Systematic Literature Review

Putu Ayu Sawitri — 2025-12-12

Coinfection of tuberculosis (TB) and human immunodeficiency virus (HIV) is a significant global health problem, especially in developing countries. In 2023, an estimated 10.8 million people fell ill with TB worldwide, about 161 000 people died of HIV-associated TB. The percentage of notified TB patients who had a documented HIV test result in 2023 was 80%. HIV weakens the immune system, increasing susceptibility to TB, which is the leading cause of death in patients with HIV. This study aimed to identify and analyze various risk factors that contribute to the occurrence of pulmonary tuberculosis in HIV patients. This study is a literature review with a systematic approach to fifty journals published between 2020 until 2025, search on various scientific databases such as Google Scholar, PubMed, and Garuda Ristekbrin portals. The main risk factors for pulmonary TB in HIV patients include CD4 levels <200 cells/mm³, advanced clinical stage of HIV, low socioeconomic status, low education levels. In addition, environmental factors such as household air pollution and a history of contact with TB people also increase the risk. Behavioral variables such as substance use and delays in antiretroviral therapy also aggravate the patients condition. In conclusion, patients with HIV have a high risk factor for developing TB, so it is necessary to increase active screening, strengthening patient education, and strengthen social support. Appropriate risk-based interventions will improve treatment success and lower coinfection mortality.

Health Promotion Strategies in Reducing Loneliness in The Elderly in Indonesia: Literature Review

Rahma Fanti — 2025-12-12

Background: Loneliness is a common problem experienced by the elderly and negatively impacts quality of life. Based on data from the Central Statistics Agency in 2023, more than 2.3 million elderly people or approximately 7.10% of the total elderly population in Indonesia live alone, this condition is an additional risk factor for increasing loneliness among the elderly. Objective: To determine what health promotion methods are provided to the elderly to reduce levels of loneliness. Method: Qualitative research using a literature review method. Journals were taken from the period 2017-2025. The search followed the PICO model (patient, population, problem; intervention, prognostic, factor; comparison; outcome study). Inclusion criteria included studies with elderly subjects and health promotion interventions involving community approaches, education, social support, physical activity, arts and culture, and technology. Results: Various interventions such as cross-sector coordinated elderly posyandu, storytelling, art therapy, health education through print media and lectures, and physical activities such as Tai Chi have been proven effective in reducing loneliness. A community-based approach with social empowerment and family support has a positive impact on reducing loneliness and improving the quality of life of the elderly. Key barriers include limited access in remote areas, social stigma, and readiness to use technology. Conclusion: Health promotion that integrates sustainable community approaches, education, and technological innovation is crucial in addressing loneliness in older adults. Strengthening policies and resource capacity is needed to ensure program effectiveness and sustainability.

Maternal Micronutrient and Protein Intake and Birth Outcomes: A Systematic Review in LMICs

Rista Ekaputri — 2025-12-12

Maternal nutrition is a critical determinant of fetal growth and neonatal health. This systematic review aimed to synthesize current evidence on the impact of maternal nutritional intake and interventions—including micronutrient supplementation, protein–energy support, and dietary counseling—on key outcomes such as birth weight, gestational age, preterm birth, intrauterine growth restriction (IUGR), and neonatal morbidity. A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published between 2018 and 2024, following the PRISMA framework. Eligible studies included original research assessing maternal diet, nutritional status, or interventions during pregnancy. Fifteen studies met the inclusion criteria, comprising 6 cohort studies, 6 randomized controlled trials, 3 case-control studies, and 1 community-based trial conducted across Asia, Africa, and Latin America. Findings showed that adequate intake of iron, folic acid, calcium, vitamin D, and protein was associated with improved birth outcomes, including higher birth weight, reduced preterm delivery, and better Apgar scores. Conversely, undernutrition, protein–energy deficiency, and low dietary diversity were strongly linked to IUGR and neonatal morbidity. This review concludes that maternal nutrition interventions can effectively improve perinatal health, particularly in resource-limited settings. Future research should employ multicenter, longitudinal designs with standardized measures to generate stronger causal evidence for maternal nutrition policies.

Healing Progression of Diabetic Ulcers Post Debridement with Comprehensive Wound Care: A Case Study

Salfitriana Rebecha Lakawa — 2025-12-12

Background: Diabetes mellitus (DM) is characterized by hyperglycemia or elevated blood sugar levels above normal limits. Patients with diabetes mellitus are at high risk of skin integrity disorders, and treatment for this condition involves debridement and comprehensive ongoing wound care. This case study analyzes the outcomes of debridement surgery on a diabetic ulcer in the left antebrachial region at a secondary healthcare facility, as well as ongoing wound care at a primary healthcare facility. Method: Descriptive case study approach. A 59-year-old patient with a history of DM since 2018 and a diabetic ulcer in the left antebrachial region underwent debridement surgery at the secondary healthcare facility and received continuous care using a comprehensive wound care method until complete healing was achieved at the primary healthcare facility over approximately four to five months. Results: Wound healing was achieved in the patient's hands through comprehensive wound care, which is crucial for achieving the desired tissue repair goals. Conclusion: The involvement of a multidisciplinary healthcare team also facilitated the development of an integrated strategy. Emotional support from the family also played a significant role in the patient's wound healing.

A Review : Relationship Between Mental Health and Safety Compliance Among Night Shift Manufacturing Workers

SALSABILA ROSYA — 2025-12-12

Night shift workers in the manufacturing industry are at high risk of experiencing mental health disorders due to work rhythms that are misaligned with the body's natural biological clock. These disorders can lead to decreased compliance with Occupational Safety and Health (OSH) procedures, which are essential for preventing workplace accidents. This study aims to examine the relationship between mental health and compliance with OSH procedures among night shift workers in the manufacturing sector through a literature review. A narrative review was conducted using 10 national and international journal articles related to shift workers' mental health and OSH compliance. Articles were retrieved from PubMed, Google Scholar, and GARUDA databases using keywords such as "mental health", "shift work", "occupational safety", and "K3 compliance". The review found a significant relationship between mental health issues—such as stress, anxiety, and fatigue—and low compliance with safety procedures. Mediating factors such as social support, safety culture, and stress management training were also found to influence this relationship. The findings suggest that mental health among night shift workers has important implications for their compliance with OSH procedures. Psychosocial-based promotive and preventive interventions are recommended to improve overall workplace safety.

Health Promotion Strategies in the Prevention and Management of Delirium, Dementia, and Dysphagia in Older Adults: A Literature Review

Sitti Marzuqoh Aidah Basri — 2025-12-12

Elderly individuals, defined as those aged 60 years or older, experience various physical, psychological, social, and spiritual changes as part of the aging process. Common health problems among the elderly include delirium, dementia, and dysphagia, which can reduce quality of life and increase the risk of complications. According to UN data, the elderly population in Indonesia is estimated at approximately 30.9 million in 2023 and projected to reach 48–50 million by 2035. These trends highlight the urgent need for effective health promotion strategies to prevent and manage these conditions. This literature review utilized secondary data from scientific articles retrieved from Google Scholar and PubMed, published between 2019 and 2025. Selected studies focused on health promotion strategies, prevention, and management of delirium, dementia, and dysphagia in elderly populations. Descriptive analysis was performed to identify the most effective interventions and approaches. Findings indicate that comprehensive health promotion interventions can enhance awareness among the elderly and their families regarding early signs of delirium, dementia, and dysphagia. Effective strategies include health education, nutritional management, cognitive stimulation, caregiver training, and active involvement of healthcare professionals and community support. Early interventions were shown to reduce complication risks, slow dementia progression, and improve overall quality of life for elderly individuals. However, implementation challenges persist, including limited resources, low health literacy, and unequal access to healthcare services. Health promotion strategies play a critical role in preventing and managing delirium, dementia, and dysphagia in the elderly. Evidence-based programs, support from healthcare providers, family involvement, and community-based interventions are key factors in successfully addressing these health issues.

The Role of Social Determinants and Risky Behaviors in HIV/AIDS Transmission: A Review

Sitti Umu Nasibah — 2025-12-12

HIV/AIDS remains a pressing global health challenge, particularly in developing nations such as Indonesia. Transmission is strongly shaped by social determinants and high-risk behaviors. This review examines the role of these factors in HIV/AIDS spread, drawing on ten recent national and international studies, including systematic reviews, observational research, and cross-national surveys. Key populations identified are men who have sex with men (MSM), sex workers, injecting drug users (IDUs), and prisoners. The main social determinants associated with heightened vulnerability include low education, unemployment, unmarried status, and minority sexual orientation. Risky behaviors consistently linked to HIV infection involve unprotected sex, multiple partners, anal intercourse, and injecting drug use with shared needles. The intersection of these social and behavioral factors creates compounded risks, reinforcing patterns of vulnerability in key populations. Effective prevention requires strategies that address both domains simultaneously. Community-based programs should promote safer sexual practices, expand condom access, and strengthen harm reduction services for IDUs. Equally critical are educational initiatives, stigma reduction, and ensuring inclusive, non-discriminatory healthcare access. By integrating social and behavioral approaches, HIV/AIDS interventions can more effectively curb transmission and reach populations most at risk.

Twenty Years of Research Trends Regarding the Application of Ovitraps in Controlling Aedes sp. ; Bibliometric Analysis

Suharyo Suharyo — 2025-12-12

Background: One of Aedes sp. vector control that is environmentally friendly and relatively cheap in terms of costs is an ovitrap application. Information about research on this matter is still limited.

Objective: The aim of this research focuses on the type of ovitrap, the research methods, the surrounding attractants, and the country chosen for the research described.

Methods: This paper was written as a result of bibliometric analysis of 681 documents from the Scopus, PubMed, and Wiley Online Library databases of 2003-2023. Mapping terms using VOSviewer.

Results: The largest ovitrap type theme was the lethal ovitrap (15.65%), and the smallest was the CDC light trap (2.27%). There are the terms "attractant" and "ovopo attractant" (7.94%) apart from grass and hay infusion at 19.84%. The research method most widely used is intervention research (33.26%), apart from experiments and trials. The research locations that appeared the most were from Southeast Asia (39.06%), Europe (6.86%), the US, Latin America (18.61%), and Australia (6.07%). Research on resistance, first detection, recyclable material, control area, and combination related to the application of ovitrap on Aedes sp. has become a trend from 2018 until now.

Conclusion: There are still many themes and challenges in the development of Aedes sp. vector control with the ovitrap application.

Patient Empowerment Strategies to Improve Tuberculosis Treatment Adherence in Surakarta: A Qualitative Perspective

Sulistiyani Prabu — 2025-12-12

Tuberculosis (TB) is a global health problem that requires intensive efforts to control, especially in improving patient adherence to treatment. One strategy that has been found to be effective is patient empowerment. This study aims to explore patient empowerment strategies in improving medication adherence among TB patients in Surakarta. The approach used in this study was qualitative, involving in-depth interviews with TB patients, healthcare workers, and patients' families. The results of the study indicate that patient empowerment through an individualised education-based approach, social support, and motivation from family members and healthcare workers plays a crucial role in improving treatment adherence. Additionally, patient involvement in decision-making processes related to treatment and providing an understanding of the importance of completing treatment have been proven to reduce treatment discontinuation rates. This study recommends the importance of training for healthcare workers in effective communication and enhancing the role of families in supporting the continuity of patient treatment. The patient empowerment model based on a holistic approach is expected to serve as a reference in developing health promotion strategies at both local and national levels.

Nutritional Status and Sleep Quality as Predictors of Work Fatigue among Shift Workers in Indonesian Convenience Stores: A Cross-Sectional Study

Supriyono Asfawi — 2025-12-12

Work fatigue is a common challenge faced by retail employees, especially those working long shifts in 24-hour convenience stores. This study explored how individual factors—such as age, sex, nutritional status, sleep quality, and length of employment—relate to work fatigue among 50 Indomaret and Alfamart employees in Gajahmungkur District, Semarang, Indonesia. Using questionnaires and the Spearman rank correlation test, the study found that poor sleep quality and abnormal nutritional status (underweight or overweight) were significantly associated with higher fatigue levels (p < 0.001). Sleep quality showed the strongest correlation (r = -0.539), highlighting its critical role. Meanwhile, age, sex, and length of employment were not significantly related to fatigue. These findings suggest that personal health factors—especially sleep and nutrition—may play a more pivotal role in fatigue than demographic or work-related variables. Interventions to improve sleep hygiene and promote balanced nutrition could be effective strategies to reduce fatigue in this often-overlooked workforce

Risk Factors for Type 2 Diabetes Mellitus (DM) in Southeast Sulawesi: A Literature Review

Thiufatin Terezky Brilyanti — 2025-12-12

Type 2 Diabetes Mellitus (DM) is a non-communicable disease that poses a significant public health problem not only at the global and national levels but also in the province of Southeast Sulawesi. The high incidence of DM in this region is caused by various major contributing risk factors such as lifestyle, physiological status, and genetic and socio-economic factors. This study aims to identify and analyze various risk factors for the incidence of type 2 DM based on a review of 16 local research journals conducted within the Southeast Sulawesi region. This research uses a literature review method, selecting 16 journals out of 50 that were searched through national and international scientific databases. The inclusion criteria included journals published between 2020–2024 that examined DM risk factors in the Southeast Sulawesi region. The analysis was conducted thematically based on the type of risk factor and the research location. The results of this study found that the dominant risk factors for DM include low physical activity, unhealthy dietary patterns, obesity (high BMI), family history, stress, smoking habits, poor sleep quality, and alcohol consumption.

The Utilization of Telehealth for Adolescents Mental Health 2019-2025: A Review

Tiara Muslimah Jamal — 2025-12-12

Globally, one in seven adolescents experiences mental disorders, accounting for 15% of the disease burden in this age group. Depression, anxiety and behavioral disorders are the most common mental health problems experienced by adolescents. Services that can be used to prevent and address mental health problems include telehealth-based digital consultation services. Telehealth refers to remote healthcare services. This study aims to determine the effectiveness of telehealth in managing mental health issues, particularly among adolescents. The method is a Systematic Literature Review (SLR) with PRISMA guidelines. Articles were searched through Google Scholar and PubMed. Inclusion criteria are the use of telehealth among adolescents with mental health issues, articles in English with full access and published between 2019 and 2025. 21 articles were reviewed. Most telehealth applications for addressing mental health issues in adolescents have been conducted in developed countries, while studies in developing countries, including Indonesia, remain limited. Telehealth is an effective, efficient, and widely accepted solution for improving adolescent mental health access, but it is not a perfect substitute for face-to-face services. Its success depends on technological adaptation, equitable access, and an approach based on adolescent preferences. Telehealth offers an innovative solution but still faces several challenges in its implementation.

Evaluating Electronic Medical Record Implementation: Human Resource Readiness, System Efficiency, and Service Quality

Wa Ode Wulan Nur Rewangi — 2025-12-12

The implementation of Electronic Medical Records (RME) is a strategic initiative in advancing digital health transformation in Indonesia. The primary healthcare level, especially in Puskesmas, the readiness and success of RME still face challenges. Limitations in infrastructure, insufficient human resource capacity, and the lack of consistent training are key issues impacting the effectiveness of RME implementation. This study aims to assess the actual implementation of RME in selected by reviewing insights from various scientific sources. It also highlights both the supporting and hindering factors influencing the digitalization process within primary health services. Systematic Literature Review (SLR) approach was analyzing peer-reviewed articles published from 2020-2024, focusing on RME readiness and implementation in Indonesian Puskesmas. The literature was examined based on study locations, research variables, methodologies. Findings indicate that RME is strongly shaped by staff training, technical capacity, leadership involvement, and policy support. Puskesmas with proactive management and adequately trained staff are more prepared. However, numerous health centers unprepared in terms of technical and operational capabilities. The success of RME implementation requires internal organizational competent human resources and robust technological infrastructure. Support from local and national governments is crucial to close the gap in readiness across regions.

The Existence, Characteristics, Sources, and Impact of Microplastics in Salt Products in Indonesia

Widarni Widarni — 2025-12-12

Salt is one of the nine essential commodities in Indonesia and is consumed daily as a crucial household food ingredient. However, the use of contaminated seawater as raw material in salt production has resulted in microplastic pollution, which is categorized as a hazardous contaminant and does not meet food safety standards. This study aims to describe the presence, characteristics, sources, and impacts of microplastics in coastal ecosystems and salt products in Indonesia through a Systematic Literature Review (SLR). Evidence shows that microplastics are consistently found in salt across different regions, with diverse shapes such as fragments, fibers, and films, in various colors and polymer types including Polypropylene (PP), Polyethylene (PE), Polyamide (PA), and Low-Density Polyethylene (LDPE). The main sources of contamination are polluted seawater, conventional evaporation-based salt production, and unmanaged plastic waste. This condition raises serious concerns regarding salt quality and potential risks to human health, while also threatening marine ecosystems and the food chain. In conclusion, microplastics are recognized as significant pollutants in Indonesian salt products. Addressing this issue requires integrated strategies such as improving waste management, adopting sustainable production technologies, monitoring salt quality according to food standards, and enhancing public awareness, and support from government collaboration.

The Evaluation Of Rembug Stunting In The Convergence Action At The Bappeda Of Central Java Province

Widya Putri Ardana — 2025-12-12

This study aims to evaluate the implementation of Rembug Stunting (stunting forum) in Regional Development and Planning Agency (BAPPEDA) of Central Java Province, especially in terms of input, process, and output. This study uses a descriptive qualitative approach with in-depth interview methods and focus group discussions (FGD) with key informants and triangulation. Data were collected from BAPPEDA of Central Java Province, Central Java Health Office (DINKES), and Central Java Communication and Informatics Office (DISKOMINFO) as related policy makers. The results of the study indicate that the implementation of Rembug Stunting is supported by five main components (5M): Man (cross-sectoral human resources), Money (Provincial Budget), Material (adequate facilities and infrastructure), Method (Ministry of Home Affair Technical Instructions), and Machine (supporting technology). The process includes integrated planning, organizing competent resource persons, implementation based on field needs, and supervision through Directorat General of Regional Development (BANGDA) Web Monitoring. The main output is a joint commitment across sectors to accelerate stunting reduction.

Nutrition Programs and Health Policies for Stunting Prevention in Indonesia: Systematic Review

Yulya Lasmita — 2025-12-12

Stunting remains a major public health concern in Indonesia, with a national prevalence of 21.5% in 2023, exceeding the global target of 14%. Significant disparities exist, with prevalence reaching 39.4% in Central Papua, 37.9% in East Nusa Tenggara, and 37.3% in Highland Papua, compared to only 7.2% in Bali. This narrative literature review, conducted under PRISMA principles, searched PubMed, ProQuest, and Google Scholar for studies published between 2020 and 2025 using the keywords “stunting,” “nutrition policy,” and “Indonesia.” From 6,410 records, 10 studies met the inclusion criteria. Three dominant themes emerged: (1) regional policies and cross-sectoral coordination, where East Lombok reduced stunting from 43.5% (2018) to 18.1% (2021), while Asmat experienced an increase from 38.1% (2021) to 54.5% (2022) due to weak implementation; (2) health sector–driven interventions remain central, yet multisectoral strategies that integrate sanitation, education, and community empowerment are more effective; and (3) data-driven policies using SSGI and strong community participation ensure targeted and sustainable outcomes. Despite progress, challenges persist in equity, monitoring, and scalability, particularly in eastern provinces with weaker health systems. Strengthening multisectoral collaboration, expanding evidence-based policies, and enhancing community engagement are essential to accelerate stunting reduction in Indonesia.

Analysis Of Factors Related To Dermatitis Among Laundry Workers In Pedurungan District, Semarang

Reihan Nuraisya — 2025-12-12

The skin acts as a protective barrier for the body, but excessive exposure can cause occupational dermatitis, especially in women. WHO data states that 10% of cases of irritant contact dermatitis were occupational. Laundry businesses in Semarang also increase this risk. The aim of this study was to analyze factors associated with dermatitis among laundry workers in Pedurungan District, Semarang. This study used a quantitative method with a cross-sectional design, with a sample of 117 respondents selected through accidental sampling. Data were collected using a structured questionnaire. Data analysis used the Spearman Rank test. The results showed that the average age of respondents was 37.77 years. Most respondents were female (77.8%) and had a high school education (70.9%). The average work duration was 9.92 hours per day. There were relationship between the use of personal protective equipment (p<0.014; r=-0.226), the use of chemicals (p<0.001; r=0.569), and chemical exposure (<0.001; r=0.661) with contact dermatitis. There was no relationship between length of service and personal hygiene. The use and exposure to high levels of chemicals increase the risk of contact dermatitis, so the use of personal protective equipment and good personal hygiene can reduce the risk of contact dermatitis.

Impact Of Polyethylene Terephthalate Microplastic Contamination On Andosol Soil Quality

Dilean Zeva Balistyadhana — 2025-12-12

The increasing volume of single-use plastic bottle waste, particularly that made from Polyethylene Terephthalate (PET), has become a serious environmental issue due to its non-biodegradable nature and potential degradation into microplastics, which pollute and affect the soil's physical and chemical properties as well as plant growth. This study aims to determine the effect of Polyethylene Terephthalate (PET) microplastic contamination on andosol soil quality and spinach (Amaranthus sp.) plant growth. The research was conducted using an experimental method under the framework of a control group and a treatment group. Using 4 reactors, namely one control reactor and 3 treatment reactors with microplastic variations of 10 grams, 15 grams, and 20 grams, where each reactor is given daily watering of 200ml. The results showed that exposure to PET microplastics decreased soil pH and moisture, but increased c-organic and bulk density.

Correlation Between Medical Terminology Accuracy and ICD-10 Coding

Gama Bagus Kuntoadi — 2025-12-12

Background: Accurate medical terminology is essential for diagnostic documentation and forms the basis of reliable ICD-10 coding. Inconsistencies in terminology may lead to coding errors, reduced data quality, and inaccurate reimbursement for health insurance claims.

Methods: This retrospective quantitative study employed a cross-sectional design at Setia Mitra Hospital. Data were analyzed to evaluate the accuracy of medical terminology in diagnosis writing, the accuracy of ICD-10 coding, and the correlation between the two variables.

Results: Out of 137 outpatient diagnoses, 97 (71%) were consistent with standard medical terminology, while 40 (29%) were not. Regarding ICD-10 coding, 65 codes (47.44%) were accurate, whereas 35 (25.54%) were inaccurate. Chi-Square correlation analysis yielded a p-value of 0.276 (p > 0.05), indicating no significant association between the accuracy of medical terminology and ICD-10 coding accuracy.

Conclusion: The study found no correlation between medical terminology accuracy and ICD-10 coding accuracy. These findings highlight the need for standardized documentation, continuous training, stronger coder–clinician collaboration, and routine audits to improve diagnostic and coding reliability. Future research may involve multiple facilities, inpatient data, or qualitative approaches to explore contextual factors affecting coding accuracy.

Risk Factor of Hypertension among Urban Community Living in Kartini Sub district, Central Jakarta

Nurusysyarifah Aliyyah — 2025-12-12

Hypertension is a chronic condition of high blood pressure, which, over a long period, can cause organ damage and lead to increased morbidity and mortality. Central Jakarta, as an urban city in Indonesia, has a high rate of hypertension, about 39,05%, and Kartini subdistrict is one of the areas in Central Jakarta with relatively high cases of hypertension. This study aims to identify the risk factors for hypertension in the urban community with hypertension. This research was conducted in May 2023 in the Kartini sub-district, using a qualitative method. Data was collected through in-depth interviews with six respondents of productive age (18-60 years old). Supporting participants are also involved in this research for the triangulation process. Collected data will be analyzed using content analysis techniques. The results showed that the risk factors of hypertension among communities with hypertension consist of family history of hypertension, smoking behavior, sleep quality, less physical activity, and less fruit and vegetable consumption. From the study, we can conclude that modifiable and non-modifiable factors influence the incidence of hypertension in urban communities in Kartini Subdistrict. Support from local health workers is crucial to ensuring communities maintain and adopt healthier lifestyles, thereby eliminating risk factors for hypertension.

Sentiment Analysis of Satu Sehat App Usage Reviews on Google Play Store

Ayulia Putri — 2025-12-12

The Satu Sehat application is a digital platform that supports access to health information and services in Indonesia. This research analyzes the sentiment of user reviews on the Google Play Store to evaluate perceptions and obstacles faced. A total of 10,000 reviews were collected using Google-Play-Scraper and analyzed with a lexicon-based approach using TextBlob in Python. The results showed 56.9% of positive reviews were related to ease of use and access to health data, while 43.1% of negative reviews were due to technical constraints, such as login difficulties and app bugs. These findings highlight the need for technical improvements to enhance system stability and user satisfaction.

Research Trends in Nutrition and Dysmenorrhea (2010-2025): A Bibliometric Analysis

Ridha Restila — 2025-12-12

Dysmenorrhea remains a concern among women of productive age. The role of nutritional status in modulating pain severity is still need to be explored. This study aimed to visualize profiles and hotspots in dysmenorrhea related to nutritional status through a bibliometric analysis. Relevant publications were retrieved from Scopus (2010 to 2025). We used combinations of keywords such as “anemia”, "dysmenorrhea," "nutrition," "diet," “nutriotional status”, and "micronutrients." The publications were limit to: article, review, final publication stage, and english language. Bibliometric indicators were analyzed using Scopus Analyze and VOSviewer. A total 1192 papers were selected. The volume of dysmenorrhea-related publications has increased significantly in the past four years. Iran leads in research output, followed by China and the United States. Shahid Beheshti University of Medical Sciences contributed the highest number of articles (n = 35), while Nutrients published the most papers (n = 39). Keyword co-occurrence analysis revealed four thematic clusters: (1) risk factors, menstrual patterns, and impact; (2) symptoms, pathogenesis, and pharmacological treatment; (3) in vivo studies; and (4) alternative therapies, including diet, supplements, and acupuncture. Dysmenorrhea remains a relevant research topic, with studies expanding from risk factors to biomarkers and therapies.

A Case Control Studies of Factors that Associated with Tuberculosis of Child

Prita Handayani — 2025-12-12

Childhood tuberculosis (TB) remains a major health issue in Magetan District, East Java. Key risk factors include contact history, exposure duration, nutritional status, and parental income. To analyze the association between these factors and TB incidence in children aged 0–5 years. This case-control study was conducted from January to March 2025 at Panekan Health Center, involving 38 respondents (19 cases and 19 controls). Data were collected through structured interviews and medical records. Bivariate analysis used the Chi-square test, and variables with p < 0.25 were entered into logistic regression. TB incidence was significantly associated with contact history (OR = 11.56; 95% CI: 2.41–55.39; p = 0.003), exposure duration (OR = 11.56; 95% CI: 2.41–55.39; p = 0.003), and nutritional status (OR = 10.50; 95% CI: 2.34–47.20; p = 0.003). Parental income was not significant (p = 0.097). Multivariate analysis identified contact history (aOR = 8.67; p = 0.013) and poor nutrition (aOR = 7.87; p = 0.018) as dominant predictors. Contact history and poor nutrition strongly predict childhood TB. Strengthening contact tracing and nutritional programs are essential. This study is limited by small sample size, purposive sampling, and potential reporting bias, which may affect generalizability.

Spatial Autocorrelation Analysis of Stunting Prevalence in Central Java Province

Sylvia Anjani — 2025-12-12

Stunting remains high in Central Java, with a prevalence of 20.8% in 2022, posing a serious threat to the realization of Indonesia’s Golden Generation 2045 due to its direct impact on future human resource quality. This study aims to examine the spatial autocorrelation of stunting prevalence in Central Java Province in 2023. An quantitative descriptive study was conducted using aggregated data from 35 districts/cities. Secondary data were sourced from the 2023 Central Java Health Profile and the Central Bureau of Statistics. Data analysis employed Moran’s Index and Local Indicators of Spatial Association (LISA) using GeoDa software. This study shows that each stunting determinant has a distinct spatial pattern in Central Java Province. The variables of adequate sanitation, chronic energy deficiency (CED), and exclusive breastfeeding exhibit significant spatial patterns, whereas iron supplementation (TTD 90), low birth weight (LBW), and access to clean drinking water display random distributions. Adequate sanitation forms a significant cluster in Wonogiri, CED is concentrated in Tegal, Pemalang, Purbalingga, and Banyumas, while high exclusive breastfeeding coverage is found in Purworejo and low coverage in Salatiga. Integrated interventions that incorporate spatial factors and local determinants are essential to effectively and equitably reduce stunting prevalence across Central Java.

Correlation between Knowledge and Self-Efficacy in Prevention Sexual Harassment among University Student in Semarang City

Imtiyaz Yumna Huwaida — 2025-12-12

In 2024, The National Commission on Violance Again Women recorded 17,305 cases. Additionally, the Semarang Legal Aid Institute (LBH) reported 25 cases of gender-based violence and child abuse in 2024. If this trend continues, it will negatifly impact. Based on Health Belief Model (HBM) theory, self-efficacy and knowledge are essential factors in preventing sexual harassement. This study aims to see the relationship between knowledge and self-efficacy in preventing sexual harassment among collage students in Semarang. Cross-sectional quantitative methods was used. The population consisted of 287,186 Students Collage in Semarang with 419 sample choosen by purposive sampling with the slovin formula. The Rank-Spearman correlation was used because the data was not normally distributed. The results showed that there was a significant corelation between self-efficacy and sexual harassment prevention (p-value=0.000) with low correlation amount (R=0.291). Furthermore, there was no significant corelation between knowledge of sexual harassement prevention (p-value=0.116). Although variable knowledge did not show significant corellation. However, according to HBM theory, increasing knowledge is the first step in changing behavior. Universities should collaborate with the Gender-Based Violence Prevention Task Force (PPKS) to create campaigns against sexual harassment prevention to increase students' knowledge and self-efficacy prevention.

Correlations of Perceived Susceptibility and Severity of Sexual Harassment Prevention among University Students in Semarang City

Mufidaturrizqiyah Mufidaturrizqiyah — 2025-12-12

Sexual harassment within Indonesian universities continues to rise, leading to the issuance of Ministry of Education, Culture, Research, and Technology Regulation No. 30/2021 as a preventive response. Data from the national SIMFONI PPA system reported 1,216 cases of sexual harassment in schools and higher education institutions as of July 2025, while Semarang City’s DP3A also documented an increase in violence among individuals aged 18–25 from 2022 to 2024. This study aims to analyze the correlation between perceived susceptibility and perceived severity with sexual harassment prevention behaviors among university students in Semarang City. A cross-sectional quantitative design was employed with 419 respondents selected through purposive sampling. Data analysis examined the relationships between health belief model constructs and preventive measures. The findings showed that perceived susceptibility was not significantly associated with prevention behavior (p = 0.331), whereas perceived severity demonstrated a significant relationship (p = 0.000). These results indicate that students’ awareness of the serious consequences of sexual harassment plays a more influential role in motivating preventive actions. The study concludes that universities should enhance prevention efforts through quarterly counseling activities, campaigns, education, and seminars highlighting the impacts of sexual harassment, supported by regular evaluations and strengthened victim-friendly reporting mechanisms.

Utilization of Digital Technology to Improve Access and Quality of Primary Health Care in Indonesia

Inda Rabbihim — 2025-12-12

Primary health care is the foundation of the national health system, especially for reaching underserved and remote populations. In Indonesia, challenges persist in ensuring equitable access and improving the quality of primary care services. Digital technology offers a promising solution through platforms such as telemedicine, electronic medical records, and mobile health applications. However, its adoption is uneven due to infrastructure limitations, digital literacy gaps, and unclear regulatory frameworks. This study explores how digital technology can improve access and quality in Indonesia’s primary health care system through a Systematic Literature Review (SLR). Peer-reviewed articles from 2015 to 2024 were analyzed using the PRISMA protocol, sourced from Google Scholar, PubMed, and ResearchGate. The keywords used included digital health, telemedicine, primary health care, and health access. The findings show that digital technologies enhance service efficiency, expand outreach, and support remote consultations. Tools like mobile-based education and telemedicine have proven beneficial in strengthening primary care delivery. However, persistent challenges include inadequate digital infrastructure, limited training for health workers, and the absence of integrated policy frameworks. To fully harness digital health's potential, Indonesia must invest in infrastructure, improve digital literacy, and strengthen regulations. These steps are essential for ensuring sustainable and equitable improvements in primary health care delivery.

Community Exercise Interventions for Elderly: Health Outcomes and Quality of Life Meta-Analysis

Indriani Indriani — 2025-12-12

Physical and mental degeneration in elderly persons reduces their Quality of Life (QoL). Aerobic (AE) and Multi-Component Exercises (MCE) are two examples of community-based exercise programs that are effective in improving the mental and physical health of senior persons. However, the evidence comparing the effectiveness of MCE versus AE in older adults living in the community remains limited. Subjects and Methods: This meta-analysis used a PICO approach with a population of community-dwelling older adults aged ≥60 years, comparing multi-component exercise (MCE) and aerobic exercise (AE) on quality of life (QoL). Relevant RCT studies from 2015–2025 were retrieved from PubMed, ScienceDirect, ResearchGate, Google Scholar, and Scielo using relevant keywords. Data were analyzed using RevMan 5.4 with pooled standardized mean differences (SMD) to assess the effects of the interventions.

Results: Six RCTs involving 478 participants were included. Multicomponent exercise showed a higher effect size (SMD = 0.27) than aerobic exercise (SMD = 0.18), although neither reached statistical significance. The overall pooled effect favored exercise interventions (SMD = 0.23; 95% CI: -0.05 to 0.50). Conclusion: MCE having slightly better effects than AE. Multicomponent exercise is an excellent way to promote physical activity and improving QoL in the elderly population.

Descriptive Study of Characteristics, Length of Stay, Clinical Examination, Supporting Examinations, and Diagnosis of Dengue Fever Patients in 7 Hospitals

Zaenal Sugiyanto — 2025-12-12

Dengue fever is an endemic disease affecting infants, children, adolescents, adults, and the elderly. Patients often require hospitalization and can even cause death. The purpose of this study was to describe the characteristics, clinical data, supporting examinations, and diagnosis of dengue fever patients in 7 hospitals in Central Java. This study was descriptive in nature. The subjects were all medical records of dengue fever patients in the 7 hospitals. This study used a total population of 507 medical record documents. The results of the study showed that the majority of patients were aged 1-10 years, as many as 244 (48.1%), most of them were female, as many as 257 (50.7%), and the longest length of treatment was 1-4 days, as many as 267 (52.7%). The results of physical examination of DHF patients are as follows: blood pressure is mostly normal, namely 127 (25.5%), body temperature between 38 0C- 39 0C, 263 (51.9%), pulse rate is mostly 91 - 130 times / minute, 253 (49.9%), respiratory rate is mostly 11-20 times / minute, 175 (34.5) mostly 20 times / minute, 115 (22.7%), the results of supporting examinations of DHF patients show hematocrit 20-59, mostly 30 - 39, 284 (56.1%)), platelet examination results 2000-408,000, mostly 430 (84.8%) <150,000, the most common diagnosis is DHF (Dengue Hemorrhagic Fever) with code A91, 430 (84.8%), as many as 177 (34.9%) had comorbidities.

Challenges and Trends in Optimized CNN for Leaf Feature Extraction Optimization in Multi-Disease Plant Detection

Panji Novantara — 2025-12-12

Early detection of plant diseases is crucial for ensuring crop health and preventing yield losses. Convolutional Neural Networks (CNN) have experienced rapid development in plant disease image recognition due to their ability to extract significant visual features from plant leaves. However, optimal results require CNN architecture customization according to unique disease and crop characteristics. While this approach offers high accuracy and efficiency, various challenges hinder widespread application, including limited representative datasets, high computational requirements, and difficulties in designing generalizable models for different field scenarios. Additionally, model interpretability issues often arise, hindering large-scale adoption among agricultural practitioners. This systematic literature review addresses these challenges and explores recent trends in optimized CNN development for plant leaf feature extraction. Through PRISMA methodology, 26 peer-reviewed studies from 2018-2024 were analyzed from Scopus Q1-Q4 journals. Key findings include the effectiveness of data augmentation techniques (improving dataset diversity by 40-60%), transfer learning approaches (reducing training time by 50-70%), and hybrid model integration (achieving 85-95% accuracy rates). Architecture improvements and optimization algorithms help overcome computational constraints, with lightweight models reducing processing time by 30-50% while maintaining 90%+ accuracy. This study provides comprehensive guidance for researchers and practitioners in developing more adaptive, accurate, and efficient plant disease detection solutions, ultimately improving agricultural yields and global food security.