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At least 343 records · Page 19Linked to original sources
PubMed1994

Maintaining technical quality of care in the introduction of Cyclofem in a national family planning program: findings from Indonesia.

This paper discusses the technical dimensions of "quality of care" in contraceptive service delivery in both the Cyclofem Introductory Trial, as well as in routine service delivery of other injectables in Indonesia. Although the quality of care in the Cyclofem trial was generally acceptable, substantial weaknesses in screening, clinical technique, the management of side-effects, and knowledge concerning re-injection time frames were identified in the provision of injectable contraceptives in routine service delivery. The findings suggest that in order for Cyclofem and other injectables to be delivered in the routine program with an adequate standard of care, considerable managerial adaptation and strengthening of providers' technical capabilities would be necessary prior to actual introduction. This would include providing training and updated technical guidelines concerning both Cyclofem and other contraceptives to providers, with an emphasis on technical issues including contraceptive indications and contraindications, re-injection time frames, maintenance of asepsis and the management of side-effects. Strengthening the existing management information system and logistics systems to facilitate differentiation between injectable contraceptives provided by the program so as to ensure sufficient supplies of both contraceptives and associated materials such as needles and syringes will also be necessary.

Contraceptive Agents, Female↗
PubMed1988

Maternal mortality in Indonesia and Egypt.

Twenty-three percent of deaths to women of reproductive age (15-49 years) in Bali, Indonesia and Menoufia, Egypt were due to maternal causes. Among the younger women, the percentage was even higher. In both areas complications of pregnancy and childbirth were a leading cause of death (the first cause in Bali, the second in Menoufia). In both sites, postpartum hemorrhage was the most common cause of maternal death. Relative to the United States, the number of maternal deaths per 100,000 live births was 20 times higher in Menoufia and 78 times higher in Bali. Families of women of reproductive age who died were interviewed about the conditions leading to death and other characteristics of the deceased. Completed histories were reviewed by a Medical Panel who were able to assign a cause of death in more than 90% of cases. Two-thirds of the maternal deaths occurred to women who were over 30 and/or who had 3 children--the usual targets of family planning programs. Other possible intervention strategies include antenatal outreach programs, training of traditional birth attendants, and better hospital management of obstetric emergencies.

Adolescent↗
PubMed1975

Japanese encephalitis virus from pigs and mosquitoes in Jakarta, Indonesia.

Japanese encephalitis virus was isolated from 11 pools of Culex tritaeniorhynchus and a single pool of C. gelidus mosquitoes at a pig-raising area near Jakarta, West Java, Indonesia, during 1972-74. Ten sentinel pigs placed in the area all developed haemagglutination-inhibition antibodies against Japanese encephalitis and the virus was isolated from the blood of 3.

Animals↗
PubMed1981

Zika virus, a cause of fever in Central Java, Indonesia.

In 1977 and 1978 selected in-patients at the Tegalyoso Hospital, Klaten, Indonesia who had recent onsets of acute fever were serologically studied for evidence for alphavirus and flavivirus infections. A brief clinical history was taken and a check list of signs and symptoms was completed on admission. Acute and convalescent phase sera from 30 patients who showed evidence that a flavivirus had caused their illnesses were tested for neutralizing antibodies to several flaviviruses which occur in South-east Asia. Paired sera from seven patients demonstrated a fourfold rise in antibody titre from acute to convalescent phase. The most common clinical manifestations observed in this series of patients included high fever, malaise, stomach ache, dizziness and anorexia. None of the seven patients had headache or rash despite the fact that headache and rash had been associated with two of the three previously studied. The onsets of illness clustered toward the end of the rainy season when populations of Aedes aegypti, a probable vector in Malaysia, were most abundant.

Adolescent↗
PubMed1983

Chloroquine resistant Plasmodium falciparum on the island of Flores, Indonesia.

The in vitro sensitivity of Plasmodium falciparum to chloroquine was studied in parasites from 45 children on the island of Flores, Indonesia. The micro in vitro culture technique and a 12-volt battery-operated field incubator were found to be well suited to the field situation encountered. Parasites from seven children (15.6%) were resistant to chloroquine in vitro: two at 8 pico-moles of chloroquine, two at 16 pico-moles, and three at 32 pico-moles. This is the first report of chloroquine resistant from Flores.

Adolescent↗
PubMed1985

Isolation of Japanese encephalitis virus from Anopheles annularis and Anopheles vagus in Lombok, Indonesia.

Three strains of Japanese encephalitis (JE) virus were recorded from mosquitoes collected in Lombok, Indonesia, during March 1979, from pools of Anopheles vagus, An. annularis and Culex tritaeniorhynchus respectively. This is believed to be the first report of isolation of JE virus from An. vagus. The frequencies of JE viral infection in zoophilic Anopheles species were higher than in Cx tritaeniorhynchus, the principle vector of JE virus in Asia. The low frequency of infection in Cx tritaeniorhynchus and the relatively infrequent raising of pigs may account for the low prevalence of JE neutralizing antibodies in the human populations of Lombok.

Animals↗
PubMed1987

Periodicity studies of Brugia malayi in Indonesia: recent findings and a modified classification of the parasite.

We have recently reinvestigated the position of Brugia malayi in Indonesia. Periodicity patterns of microfilariae from several endemic areas were mathematically determined. We have also designed a simple method to quantify microfilaria periodicities in these studies. To determine whether periodicity patterns of microfilariae were stable, repeated studies were performed in the same individual or community. Other biological features of the parasite were also investigated. The parasite from each isolate was taxonomically identified as B. malayi. It could be classified into two distinct biological types, one nocturnally periodic and the other aperiodic, nocturnally subperiodic, or nocturnally periodic. We therefore propose to modify Wilson's classification, using the biological behaviour of the parasite in animals as the discriminating feature, and classify the two types as zoophilic and anthropophilic B. malayi.

Animals↗
PubMedDate not supplied

Hand-washing reduces diarrhoea episodes: a study in Lombok, Indonesia.

Sixty-five mothers from Balai Lua, Central Lombok, Indonesia were given soap and an explanation of the faecal-oral route of diarrhoea transmission. This very simple health message was repeated and reinforced fortnightly when mothers were also asked whether any members of their family had suffered from diarrhoea over the previous 2 weeks. Children of these mothers experienced an 89% reduction in diarrhoea episodes compared to a control period before the intervention.

Diarrhea↗
PubMedDate not supplied

Sustained improvements in hygiene behaviour amongst village women in Lombok, Indonesia.

Fifty-seven mothers in Indonesia were involved in a face-to-face health education programme which encouraged hand-washing with soap. The intervention spanned 4 months and comprised fortnightly visits by 2 community organizers, who supplied free soap. Two years after the intervention, 79% of mothers were still using hand soap, despite the fact that they now had to buy it themselves. The community seemed to be benefiting from a sustained reduction in diarrhoea episodes due to improved hygiene practices.

Child↗
PubMed1991

Prevalence of tuberculosis in Indonesia, Singapore, Brunei Darussalam and the Philippines.

Tuberculosis remains a major health problem in South-East Asia and ranks high in the list of causes of morbidity and mortality. There are still many smear-positive cases, about half a million in Indonesia and almost 400,000 in the Philippines, and these are a reservoir of infection. Cooperation between countries in this region is required for the control of tuberculosis.

Adult↗
PubMed1991

Oral immunisation against typhoid fever in Indonesia with Ty21a vaccine.

When tested under conditions of moderate transmission of typhoid fever, a liquid formulation of the oral typhoid fever vaccine Ty21a had a protective efficacy of 96% in Egypt, and an enteric coated capsule formulation had an efficacy of 67% in Chile. We compared the two formulations under conditions of intense transmission of typhoid fever in Indonesia in a randomised, double-blind trial. 20,543 subjects (age range 3-44 years) received either three doses of enteric coated capsules containing placebo or live Ty21a, or three doses of lyophilised placebo or live Ty21a reconstituted with phosphate buffer. During 30 months of follow-up, the rate of blood-culture-positive typhoid fever among controls was 810/100,000 per year. Rates of typhoid fever were 379/100,000 per year for subjects who received the liquid formulation of vaccine and 468/100,000 per year for subjects who received enteric coated capsules. The protective efficacies of the liquid and enteric coated formulations were 53% and 42%, respectively. Neither formulation protected against infection with Salmonella paratyphi A. No major side-effects were noted, but the overall incidence of side-effects was greater in the vaccine groups. Under conditions of intense transmission, Ty21a protected against typhoid fever; however, because Ty21a will not protect all individuals, there is a need for additional approaches to prevent the disease.

Administration, Oral↗
PubMed1993

Care-seeking for fatal illnesses in young children in Indramayu, west Java, Indonesia.

To examine patterns of seeking care for gravely ill infants and children, we studied all deaths in children under 5 in 10,000 households in Indramayu, West Java, Indonesia, between July 1, 1991, and Dec 31, 1992. 141 deaths were identified (mortality rate 80.7 per 1000), of which 139 were due to causes other than trauma. No treatment of any kind was sought outside the home for 30 (22%) of the children who died from natural causes, and for 59 (42%) others only a traditional healer or other source of non-western medical advice was consulted. Whether or not a mother sought western medical care was strongly associated with the age of the child, the duration of the terminal illness, the previous attendance of the mother at a community-based maternal-and-child-health facility, and the mother's response to a prospectively asked question about what care should be sought for a hypothetical 1-month-old baby with signs of severe pneumonia. Household income, maternal age, and education, and distance between home and government health post were not associated with whether or not western medical care was sought.

Child Health Services↗
PubMed1984

Village health workers in Java, Indonesia: coverage and equity.

Village health workers are often the main vehicle for promoting the primary health care approach in developing countries. Services provided by these workers are expected to be more appropriate to the health needs of populations than those of clinic-based services, to be less expensive and to foster self-reliance and local participation. Because village workers are more accessible and acceptable to clients in their communities, they are expected to improve the overall coverage of services as well as equity--increased service use by poorer individuals and households. This paper presents research on coverage and equity from village health worker programs in Java, Indonesia. Rural health and nutrition projects in Java using village-level volunteers with limited training have grown since the early 1970s to include large national programs managed by the government's rural health system. Volunteer village workers are now the most extensive link between the rural population and the formal health service structure. Previous research on coverage and equity of these village worker activities is reviewed and results from the author's own study are presented. Services provided by village health workers achieve significantly higher levels of population coverage than similar clinic-based services. In most cases, village workers show no bias towards better-off clients and they may favor poorer beneficiaries. These findings show that village workers are meeting the coverage and equity objectives of the primary health care approach. However, some of the research reviewed raises questions about the ability of village worker activities to maintain these results over a longer period. The rapid expansion of these programs requires continued research, not only on coverage and equity, but also on health outcomes, costs, and participation.

Adult↗
PubMed1986

An integrated sociocultural curriculum for community medicine in Bali, Indonesia.

Since 1983, social scientists have collaborated with teaching staff at the Faculty of Medicine, Udayana University, Bali, Indonesia, to develop an integrated sociocultural curriculum for undergraduate students in community health. The Udayana curriculum is discussed in the context of an international commitment over the last two decades to appropriate education for primary health care and community health in developing countries. The authors describe their work as consultants with Udayana staff. Participants formulated a five-stage project of curriculum development and community health research that could be continued as part of an ongoing community medicine teaching program. Recommendations for integrating social science perspectives within medical domains are outlined, based on the project experience. The paper also discusses the undertaking as a 'development project' suggesting that many of the issues and problems that arose are common to bureaucratic institutions in Third World countries when development projects are initiated.

Community Medicine↗
PubMed1986

Utilization of health services in Indonesia.

This paper examines the utilization patterns of traditional and modern health services in Indonesia, using household sample survey socio-economic data in conjunction with community-level data on availability of services. The results strongly suggest that low household income is a barrier to the utilization of modern health services, even where they are publicly provided. The relatively well-to-do use the services of trained practitioners and physicians more and spend more on these services than do the poor. That is, income has a qualitative effect shown as a shift to more expensive and sophisticated practitioners and services rather than increased expenditures on the same type of services. Nevertheless, public facilities do make a difference; where they are available people prefer them to indigenous practitioners. Despite limitations of data and method of estimation, it is clear that both income and availability of services matter and hence that public services are more important to the poor than to the rich. The results further suggest that exposure to modern services that may involve health education brings about the right kinds of substitutions from an efficiency viewpoint: paramedics for traditional practitioners as well as physicians.

Adolescent↗
PubMed1988

Social factors affecting use of immunization in Indonesia.

This paper examines the importance of certain social and demographic factors in the acceptance of child immunization in rural Yogyakarta, Indonesia. The major findings concern the importance of the role of the community (hamlet) leader in motivating or instructing parents to seek immunization for their children. While these leaders can be effective in conveying information about availability of immunization services, they are not in a position to provide education on immunization function or procedure. The survey results also show that knowledge of the disease-prevention function of the specific vaccines is important, and it is recommended that vaccines be given names which incorporate the name of the disease which they prevent.

Attitude to Health↗
PubMed1990

Breast-feeding in the modern health sector in Indonesia: the mother's perspective.

This paper presents findings of a study of postpartum women in major hospitals throughout Indonesia. The objective was to assess the mothers' practices and attitudes regarding several key aspects of breast-feeding and 'rooming-in'. The study found that most of the women breast-fed their babies, with many believing infants should be breast-fed for 18 months or longer. However, many mothers lacked information about ideal infant feeding patterns and were unaware of how to solve problems that may arise. Only 38% recognized the value of feeding colostrum, and many feared the effect of breast-feeding on breast shape. They often gave supplementary formula. Almost none understood the importance of frequent suckling in promoting milk production. Only 50% of infants were kept in the same hospital room with their mothers for 24 hr a day, or full rooming-in. Women who kept their infants in the nursery (39%) were generally younger, better educated, primiparous, or had non-normal deliveries. They knew little about rooming-in, and if given more information to allay their doubts, they might consider rooming-in as a viable and safe arrangement. The results of this study reinforce the importance of identifying the perceptions and the knowledge of women concerning breast-feeding and rooming-in, so that hospital administrator, and health professionals can design programs and provide environments that encourage women to breast-feed their infants in optimal ways.

Adult↗
PubMed1996

Helminth infections of sheep in North Sumatra, Indonesia.

Gastrointestinal tracts of 73 indigenous sheep were obtained from the Medan abattoir in North Sumatra, Indonesia, and examined for the presence of helminths. A total of 13 species of helminths, eight nematodes, one cestode and four trematodes were encountered. All sheep were infected by more than one species of nematodes. Trichostrongylus colubriformis, T. axei and Haemonchus contortus were the most common species. The intensity of the nematode infections was very high: the average burden was over 7500 worms. Trichostrongylus spp. accounted, on average, for 81.5% of the total nematode burden. No influence of age on total nematode burden could be shown. Eurytrema pancreaticum and Schistosoma spindale were found in 23.3% and 4.1% of the examined sheep, respectively. The results are discussed in relation to common management and helminth control systems.

Abattoirs↗