Oshada (O) is a peer-reviewed open access international journal established to inviting scientists and educators around the world to exchange and disseminate theory and practice oriented across the Spectrum of Health Education. All submitted manuscripts will be reviewed by the editor and then evaluated by a minimum of two Reviewers through a double-blind review process. This is to ensure the quality of manuscripts published in the journal. The journal, which has been published since 2024, is published six times each year in February, April, June, August, October and December. Journal title : Oshada Initials : O Frequency : 6 (Six) times a year DOI : 10.62872 ISSN Online : 3047-017X Editor in Chief : dr. Dito Anurogo, M.Sc., Ph.D Managing Editor : Angga A.G, Assistant Editor : Rahmat Purnomo Publisher : PT. Anagata Sembagi Education Accreditation : Index Copernicus International
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Analysis of the Relationship of Maternal Age and Parity to Gestational Diabetes Risk
This study aims to analyze the association between maternal age and parity with the risk of gestational diabetes mellitus (GDM) using a quantitative analytic observational approach. Data were collected from scientific literature, epidemiological reports, and global health policy documents published between 2018 and 2025, focusing on the Southeast Asian region. The findings reveal that maternal age above 30 years is significantly correlated with higher GDM prevalence, with the risk sharply increasing among women aged ≥35 years. High parity (≥3 births) contributes to cumulative metabolic burden, greater insulin resistance, and elevated GDM likelihood. The interaction between maternal age and parity demonstrates a synergistic effect, reinforced by biological and social factors, including limited antenatal access and low nutritional awareness. From a public health perspective, these findings highlight the need for integrated maternal risk-based screening, preconception education, and digital health interventions to identify high-risk women early. Community-based preventive strategies and the use of digital health technologies can enhance GDM prevention, strengthen maternal and child health outcomes, and contribute to sustainable health development goals across Southeast Asia.
Copyright (c) 2025 Sri Wahyuni, Isah Fitriani, Risza Presty Nurmani, Nur Wahyuni (Author) https://creativecommons.org/licenses/by-sa/4.0
Evaluation of the Free Nutritious Meal Program in the 3T Region Areas Between Nutritional Equity and Infrastructure Challenges
This study aims to evaluate the effectiveness of the Free Nutritious Meal Program implemented in Indonesia’s frontier, outermost, and disadvantaged (3T) regions using a descriptive qualitative approach. The research focuses on three key dimensions: nutritional equity, infrastructural challenges, and community participation in sustaining program outcomes. Data were collected through the analysis of official policy documents, recent empirical studies, and relevant international literature. The findings indicate that although the program has improved access to nutritious food and public awareness of balanced diets, its implementation remains constrained by logistical barriers, weak intersectoral coordination, and limited human resource capacity at the regional level. Geographic isolation further exacerbates disparities in program effectiveness across regions. Nevertheless, evidence suggests emerging local innovations, including the utilization of local food resources, digital monitoring systems, and collaborative models involving communities and private sectors. The study concludes that achieving nutritional justice requires adaptive, participatory, and sustainable policy implementation that empowers local governance and community-based ownership. Strengthening these dimensions is essential for transforming national nutrition policy into an inclusive instrument for reducing inequality and promoting human development in Indonesia’s 3T regions.
Copyright (c) 2025 Noor Diah Erlinawati (Author) https://creativecommons.org/licenses/by-sa/4.0
The Community Empowerment Approach to Diabetes Prevention in Urban Areas
The increasing prevalence of type 2 diabetes in urban areas highlights the urgency of multidimensional interventions that go beyond conventional clinical approaches. Rapid urbanization, obesogenic environments, and unequal access to healthy food reinforce the social determinants of health, which systematically trigger metabolic risks. This study used qualitative methods through a review of current literature to identify patterns, structural determinants, and the effectiveness of community empowerment as a prevention strategy. The analysis shows that individual-based programs often fail due to a lack of environmental support, the dominance of ultra-processed foods, and economic barriers. Community empowerment has been shown to improve health literacy, strengthen positive social norms, and trigger active participation in advocacy for healthier environmental policies. The findings emphasize the need for public policy reforms to regulate the food industry, expand physical activity spaces, and direct budget allocations toward prevention efforts. Cross-sectoral integration, including urban planning, education, and active transportation, fosters the sustainability of interventions. Community capacity building has the potential to create stronger collective health resilience than top-down approaches. Therefore, the synergy between community empowerment and structural policies is considered a comprehensive strategy to control the epidemiological trends of diabetes in urban areas. This study highlights the need to reposition the role of communities as key actors in the urban health ecosystem.
Copyright (c) 2025 Sulistyo Andarmoyo (Author) https://creativecommons.org/licenses/by-sa/4.0
Telemidwifery: Transforming Maternal Health Care in the Digital Era
Telemidwifery represents a digital transformation in maternal health services by integrating information and communication technology into midwifery care. This study aims to analyze the effect of telemidwifery on maternal health service satisfaction in Indonesia using a quantitative approach with a survey of 150 respondents, consisting of pregnant and postpartum mothers who have used telemidwifery applications or online consultation platforms. Data were analyzed using simple linear regression to measure the relationship between the intensity of telemidwifery use and user satisfaction. The results show that telemidwifery has a positive and significant effect on maternal satisfaction (β = 0.486; t = 6.427; p = 0.000; R² = 0.302). This finding indicates that telemidwifery effectively increases accessibility, continuity of care, and user trust in midwifery services. The study also reinforces that digital health innovations play a crucial role in overcoming geographical barriers, especially in rural and remote areas. The implementation of telemidwifery aligns with global health trends toward sustainable, equitable, and technology-driven maternal care. Further development requires strengthening midwives’ digital literacy, integrating telehealth systems into national health policies, and ensuring data privacy and ethical standards.
Copyright (c) 2025 Hikmah Hikmah, Andi Nurhalizah Tenriyola A.p, Intan Rina Susilawati (Author) https://creativecommons.org/licenses/by-sa/4.0
Health as a Social Issue: a Narrative of Service Amidst Unequal Access to Medical Services
Health is understood as a universal basic right that is inseparable from human existence and requires state guarantees through fair and equitable access to services. Fulfillment of this right is not only related to the availability of medical facilities, but also to ensuring equal access without discrimination based on social, economic, or geographic status. The phenomenon of health service inequality in Indonesia shows the concentration of modern facilities in urban areas, while communities in rural and remote areas face structural barriers, including limited infrastructure, medical personnel, and funding. This condition not only increases morbidity and mortality but also reinforces social exclusion rooted in the unfair distribution of resources. On the other hand, narratives of the dedication of health workers in marginalized areas demonstrate dedication that transcends material limitations and becomes a form of social solidarity in fighting for the public's right to health. These narratives simultaneously critique the unequal distribution of health care systems and inspire the integration of empathy and compassion into medical services. This research uses a qualitative approach through a literature review, examining academic journals, policy documents, and international reports to identify key themes related to inequality in access and the social dimensions of health. The analysis was conducted using content analysis to reduce data, categorize issues, and synthesize relevant narratives to obtain a comprehensive picture of the links between health, social justice, and sustainable development. The study's findings confirm that health should be viewed as a strategic investment and a pillar of social justice, requiring data-driven policies, proportional resource distribution, and active community participation. Therefore, equitable fulfillment of the right to health is a crucial foundation for building a more equal, inclusive, and competitive nation
Copyright (c) 2025 Lyna M. N. Hutapea, Dwight Mahaputera Marulitua Hutapea (Author) https://creativecommons.org/licenses/by-sa/4.0
Digital Infrastructure Readiness in Supporting National Telehealth Services: A Comprehensive Review
The readiness of digital infrastructure is crucial for supporting effective national telehealth services, particularly in developing countries and remote areas. This comprehensive review examines the key factors influencing digital infrastructure readiness, including policy and regulation, connectivity and devices, digital competency and literacy, and equity of access. Through a systematic literature review of 21 scholarly publications from 2020 to 2025, this study identifies critical challenges in telehealth implementation, including infrastructure limitations, lack of trained human resources, regulatory barriers, and digital divides. The findings reveal that successful national telehealth implementation depends heavily on robust digital infrastructure, supportive policies, digital literacy, and equitable access. This research recommends strategic investments in infrastructure development, human resource training, adaptive policies, and inclusive technological solutions to ensure telehealth can truly expand access and improve healthcare service quality. The study contributes to both theoretical understanding and practical implementation of telehealth systems in resource-constrained settings
Copyright (c) 2025 Yumi Abimulyani, Suratno Kaluku (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effectiveness of Reproductive Health Education in Reducing Fear of Pregnancy in Women of Childbearing Age
This study aims to analyze the effectiveness of reproductive health education in reducing fear of pregnancy among women of childbearing age through a qualitative approach based on literature review. Reproductive education is seen as a strategic instrument for improving reproductive literacy, strengthening self-efficacy, and correcting irrational perceptions of pregnancy risks. The literature review shows that women with high reproductive literacy tend to have a better scientific understanding of the reproductive system, enabling them to objectively assess pregnancy risks and reduce unfounded anxiety. Effective educational programs focus not only on knowledge transfer but also on psychological strengthening and social empowerment. Sociocultural factors, educational communication, and gender relations have been shown to be important determinants in the successful internalization of educational messages. Education that is sensitive to cultural values and participatory in nature can build trust, increase acceptance of the material, and expand the program's influence on the behavioral and emotional domains. The synthesis of results shows that comprehensively designed reproductive health education contributes significantly to reducing fear of pregnancy through the integration of cognitive, affective, and social aspects. These findings emphasize the importance of a multidimensional approach in reproductive health interventions to achieve a balance between scientific understanding and psychological well-being for women of childbearing age.
Copyright (c) 2025 Yumi Abimulyani (Author) https://creativecommons.org/licenses/by-sa/4.0
A Mediation Analysis of Digital Engagement on the Influence of Exposure to HIV/AIDS Educational Content on TikTok on Adolescents' Knowledge
Advances in digital technology have driven significant transformations in adolescents' information consumption patterns, particularly through short video-based platforms like TikTok. This medium serves not only as a space for entertainment but also as an effective educational platform for conveying health messages, including on the issue of HIV/AIDS, which still faces social stigma. This study aims to analyze the relationship between exposure to HIV/AIDS educational content on TikTok and increased adolescent knowledge, and to examine the role of digital engagement as a mediating variable in this process. Using a qualitative approach with a literature review method, this study combines narrative and thematic synthesis to comprehensively interpret empirical and conceptual results. The results indicate that digital engagement, such as commenting, sharing, or recreating content, plays a crucial role in strengthening the internalization of health messages through a reflective and participatory process. Repeated exposure to creatively and emotionally packaged educational content can enhance adolescents' understanding and critical awareness of HIV/AIDS. However, the challenge of misinformation demands increased digital literacy to ensure the credibility of messages received. The implications of this study emphasize that effective digital health education strategies require collaboration between health workers, educators, and content creators to create an interactive, inclusive, and evidence-based learning environment in the digital era.
Copyright (c) 2025 Gusti Ayu Tirtawati, Suryo Ediyono (Author) https://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Health Education Program on Self-Management of Elderly with COPD (Chronic Obstructive Pulmonary Disease)
Chronic Obstructive Pulmonary Disease (COPD) is a major cause of decreased quality of life in the elderly, requiring optimal self-management skills. Poor understanding of symptom management and treatment by the elderly is a major barrier to long-term care. This study aims to analyze the effectiveness of a health education program on improving self-management in the elderly with COPD. The study design used a quasi-experimental pretest–posttest control group with 150 respondents (75 experimental and 75 control) selected through purposive sampling. The education program was administered for four weeks with a focus on improving knowledge, attitudes, and symptom management skills. Data analysis used the Shapiro–Wilk test, paired t-test, independent t-test (Welch), and ANCOVA at a significance level of 0.05. The results showed a significant increase in self-management skills in the experimental group compared to the control (t = 10.64; p < 0.001; Cohen's d = 1.74). The average score increased by 14.66 points in the experimental group and 2.61 points in the control group. It was concluded that the health education program was effective in improving self-management in elderly with COPD, so it is recommended as a routine intervention in elderly health services.
Copyright (c) 2025 Erika Erika (Author) https://creativecommons.org/licenses/by-sa/4.0
Benefits of Telemedicine for Maternal Health: Access, Education, and Monitoring
This study aims to analyze the benefits of telemedicine on maternal health through three main dimensions: service access, health education, and technology-based pregnancy monitoring systems. Using a qualitative approach with a literature review method, this study examined 25 scientific articles published between 2020 and 2025 that were relevant to maternal health and telemedicine issues. A thematic analysis was conducted to identify patterns of findings indicating that telemedicine contributes significantly to increasing equitable access to antenatal care, strengthening maternal health literacy, and optimizing real-time pregnancy monitoring. The study results indicate that the use of digital platforms not only expands the reach of services but also increases pregnant women's participation in self-care and accelerates early detection of complications. However, the effectiveness of telemedicine is still influenced by infrastructure, digital literacy, and ethical and data security aspects. This study confirms that the integration of these three dimensions creates an adaptive, inclusive, and prevention-oriented maternal service ecosystem. These findings are expected to serve as a conceptual foundation for the development of equitable and sustainable technology-based maternal health policies in Indonesia.
Copyright (c) 2025 Enggar Enggar, Parti Parti, Eki Nawang Wulandari (Author) https://creativecommons.org/licenses/by-sa/4.0
Implementation of an ISO 45001-Based Occupational Health and Safety Management System in Healthcare Companies
The implementation of an ISO 45001-based Occupational Safety and Health (OHS) Management System in healthcare companies is a strategic effort to improve workforce safety and the quality of healthcare services sustainably. This study uses a qualitative method with a literature review approach to examine the effectiveness, obstacles, and strategies for strengthening the implementation of ISO 45001. The analysis results indicate that the implementation of this standard can reduce the rate of workplace accidents, increase compliance with safety procedures, and strengthen an organizational culture oriented towards risk prevention. However, obstacles such as limited human resource competency, work culture resistance, and financial constraints remain significant challenges. Effective strengthening strategies include transformative leadership, continuous training, quality management system integration, and the use of digital technology to strengthen audits and reporting. The implementation of ISO 45001 has been proven not only to improve operational efficiency but also to build public trust in the professionalism of healthcare organizations. In conclusion, the successful implementation of an ISO 45001-based OHS management system is determined by the synergy between managerial commitment, structural readiness, and a sustainable safety culture, which together serve as an important foundation for improving the quality and sustainability of healthcare services.
Copyright (c) 2025 Siti Nurmanis Sari, Andi Yepita Deviyanti, Hardianty Hardianty (Author) https://creativecommons.org/licenses/by-sa/4.0
The Influence of Occupational Safety Training on Compliance With The Use of PPE in Health Facilities
This study aims to analyze the effect of occupational safety training on compliance with the use of Personal Protective Equipment (PPE) in healthcare facilities. The background of the study is based on the high risk of exposure to occupational hazards faced by healthcare workers and the low consistency in the correct use of PPE. This study used a quantitative method with a survey approach and simple linear regression analysis of 100 healthcare worker respondents consisting of nurses, midwives, and laboratory personnel. The results showed that occupational safety training had a positive and significant effect on compliance with PPE use with a regression coefficient value of 0.684, a t-test of 9.247, and a significance level of 0.000. The coefficient of determination (R²) value of 0.468 indicates that the training was able to explain 46.8% of the variation in healthcare worker compliance. These findings indicate that structured, interactive, and simulation-based training is more effective in increasing awareness and compliance with safety procedures. Organizational support and ongoing supervision also strengthen the training outcomes so that safe behavior can be maintained in the long term. This study confirms that occupational safety training is a strategic instrument for strengthening OSH culture and creating a safe and productive work environment in the healthcare sector.
Copyright (c) 2025 Hardianty Hardianty, Siti Nurmanis Sari, Andi Yepita Deviyanti (Author) https://creativecommons.org/licenses/by-sa/4.0
Implementation of the Occupational Health and Safety Program in Reducing the Number of Work Accidents in the Manufacturing Industry: A Literature Study
This study aims to analyze the implementation of the Occupational Safety and Health (OHS) program in reducing the number of workplace accidents in the manufacturing industry through a qualitative approach using a literature study method. The study was conducted on various scientific sources, including international journals, official agency reports, and the results of the latest research for the period 2015–2025. The synthesis results indicate that the effectiveness of the OHS program is greatly influenced by the integration of policies, management commitment, and the safety culture established in the workplace. Systematically implemented OHS programs have been proven to be able to reduce the workplace accident rate by up to 40–50 percent through the implementation of continuous training, safety audits, and the use of digital-based hazard detection technology. However, obstacles still arise due to limited resources, low worker compliance, and weak internal supervision. Strategies for strengthening safety culture through participatory leadership, worker involvement, and a reward system for safe behavior are identified as key to the sustainability of OHS implementation. The study's conclusion confirms that the development of a strong safety culture and consistent regulatory support are the main foundations in creating a safe, productive, and highly competitive manufacturing work environment in the era of modern industrialization.
Copyright (c) 2025 Andi Yepita Deviyanti, Hardianty Hardianty, Siti Nurmanis Sari (Author) https://creativecommons.org/licenses/by-sa/4.0
The Experiences Of Menopausal Women In Managing Hypertension In The Cempaka Putih Community Health Center Work Area In 2025
Hypertension in postmenopausal women is related to estrogen deficiency which causes a seven-fold increase in the risk of arteriosclerosis, thus resulting in an increase in the prevalence of hypertension cases among women who have experienced menopause. If this change is managed properly, then the perspective and behavior in dealing with hypertension is the right way in self-care based on Orem's self-care theory. Purpose: this study is to understand in depth how menopausal women who experience hypertension interpret and interpret their experiences in overcoming hypertension problems. Method: This study uses a qualitative method with a descriptive phenomenological approach, with in-depth interviews with sampling using purposive sampling of 8 participants with the results of the interviews analyzed using the Colaizzi technique. Results: This study identified 8 research themes related to the experience of menopausal women in overcoming hypertension, namely: changes due to menopause, efforts to overcome changes due to menopause, perceptions of hypertension, responses when diagnosed with hypertension, strategies to control hypertension, efforts to improve physical health, support from those closest to them, forms of support from those closest to them. Conclusion: The study shows that the management of hypertension in menopausal women requires a comprehensive understanding of physical, psychological, and social aspects, as well as collaboration between menopausal women with hypertension, families, and health workers. Health workers are expected to provide intensive education to menopausal women about managing hypertension by managing diet, emotions, spirituality, energy and regular medication.
Copyright (c) 2025 Irna Nursanti, Elsmin Tri Yulyana Kiayi, Wati Jumaiyah, Dhea Natashia, Mira Rosmiatin, Diana Irawati (Author) https://creativecommons.org/licenses/by-sa/4.0
Correlation of Body Weight with Plasma Atherogenic Index in Obese Rats Given Black Garlic
Obesity triggers changes in blood lipid profiles and increases the risk of atherosclerosis, one of which is measured by the plasma atherogenic index (IAP). Black garlic contains active compounds such as allicin and S-allylcysteine, which are known to have hypolipidemic effects. This study aims to determine the relationship between changes in body weight and IAP values ​​in obese rat models given black garlic extract. This study was a pre-post test experiment with a control, using 28 male Sprague Dawley rats divided into 4 groups: negative control (normal diet), positive control (high-fat and fructose diet), treatment dose 1 (black garlic 1.6 ml/day), and treatment dose 2 (black garlic 0.8 ml/day). Measurements of body weight and triglyceride and HDL levels were carried out before and after the intervention. The results showed that administration of black garlic caused significant changes in body weight and IAP values ​​(p<0.05), but the correlation between changes in body weight and IAP values ​​was not significant (p>0.05). In conclusion, there was no significant relationship between changes in body weight and IAP values ​​in obese mice given black garlic.
Copyright (c) 2025 Prima Adelin, Relly Angelica Putriza, Haves Ashan, Dian Puspita, Rifkind Rifkind , Letvimona Letvimona (Author) https://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Structured Lactation Education on Increasing Breast Milk Production in Postpartum Mothers
Breast milk (ASI) is the best nutrition for newborns because it contains complete nutrients and immunological factors that cannot be replaced by formula. Although the WHO recommends exclusive breastfeeding for the first six months of life, the coverage of this practice in Indonesia remains low due to various barriers, particularly the perception of breast milk insufficiency, inappropriate breastfeeding techniques, and minimal support from families and health workers. Structured lactation education presents a comprehensive strategy to improve breastfeeding success through a systematic approach, encompassing physiological, psychological, and social aspects. This approach not only provides technical knowledge such as breast care and baby attachment techniques, but also strengthens maternal confidence through repeated counseling and emotional support. Research shows that structured education can increase the oxytocin reflex, improve practical skills, and reduce postpartum maternal anxiety. A qualitative method based on a literature review was used to examine empirical evidence regarding the effectiveness of this intervention from various international and national publications. The study results indicate that structured lactation education has a positive impact on increasing breast milk production, exclusive breastfeeding success, and the quality of life of mothers and babies. Its implementation also has policy implications, including strengthening the health care system, regulations supporting lactation, and the provision of supporting facilities. Thus, structured lactation education can be considered a long-term health investment that contributes to public health development and the achievement of global goals.
Copyright (c) 2025 Nelly Mariati, Siti Maria Ulfa (Author) https://creativecommons.org/licenses/by-sa/4.0
Ecological Immunological Adaptation in Traditional Communities: Biological Strategies to Environmental Risks
This study investigates ecological immunological adaptation in traditional communities, focusing on how biological strategies are shaped by cultural practices and environmental interactions. Traditional populations living in close contact with natural environments face persistent ecological risks, yet demonstrate resilience through practices rooted in Traditional Ecological Knowledge (TEK). A qualitative ethnographic case study design was employed, with purposive sampling targeting key informants such as elders, traditional healers, and household representatives. Data were collected through in-depth interviews, focus group discussions, participant observation, and documentation of field notes and local archives. Data were analyzed using thematic analysis, involving coding and triangulation to identify recurrent cultural and ecological patterns influencing immunological resilience. Findings reveal that adaptive strategies emerge in three major dimensions: ecological cognition and ritualized health practices, dietary diversity including traditional fermentation and medicinal plants, and communal solidarity in managing ecological risks. These strategies represent a biocultural system where immunity is reinforced not only by biological exposures but also by cultural interpretation and collective action. In conclusion, ecological immunological adaptation in traditional communities highlights the interdependence of environment, culture, and health. Preserving TEK is essential for sustaining biocultural resilience and can inform One Health approaches in the face of climate change and global health challenges.
Copyright (c) 2025 Ayu Rischi Utami (Author) https://creativecommons.org/licenses/by-sa/4.0
Innovations in Maternal and Child Health Services in Remote Areas: An Effective Strategy to Reduce Infant Mortality
Infant mortality rates remain a serious public health issue, particularly in remote areas of Indonesia that face limitations in terms of facilities, infrastructure, and resources. This situation is exacerbated by difficult access to transportation, a shortage of health workers, and low levels of health literacy among the population. This article aims to examine various innovations in maternal and child health services that can contribute to reducing the IMR in remote areas. The method used is a literature review of recent studies discussing the implementation of innovative strategies, including the use of digital technology, strengthening the role of local healthcare workers, and community involvement in health programs. The findings indicate that the implementation of telemedicine, enhancing the capacity of village midwives, providing emergency transportation, and community-based health education have proven effective in improving access to and the quality of healthcare services. These findings underscore that innovative strategies tailored to local social and cultural conditions hold significant potential for sustainably reducing infant mortality rates in remote areas.
Copyright (c) 2025 Riska Maulidanita, Rizca Annur Hanya, Endrixs Endrianto, Sulfianti (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effect Of Back Massage With Lavender Essential Oil Aromatherapy On Reducing Back Pain Intensity In Pregnant Women In The Thirty-Thirty Trimester
Back pain is one of the discomforts often felt by pregnant women entering the third trimester. Treatment to reduce pain can use complementary care, one of which is by providing Back Massage. The aim is to determine the effect of Back Massage with lavender essential oil aromatherapy on the scale of back pain in pregnant women. The research method used a quasi-experimental one group pretest-posttest design. The population of this study was all 30 pregnant women, with a total sample of 15 pregnant women in the third trimester who experienced back pain. The results of the study obtained an average pretest of 0.00 and posttest 6.50, this indicates a difference in the pain scale with the results of p-Value = 0.001 <0.05, which means there is an effect of Back Massage with lavender essential oil aromatherapy on reducing back pain in pregnant women in the third trimester. It is hoped that pregnant women who experience back pain can know the treatment using Back Massage therapy with lavender essential oil aromatherapy.
Copyright (c) 2025 Cindy Putri Febrianti, Dwi Reza Wahyuni, Wafiq Syakila (Author) https://creativecommons.org/licenses/by-sa/4.0
Analysis of Factors Associated with Patient Acceptance in the Cancer Navigation Program at Dr. M. Djamil Padang General Hospital in 2024
Cancer remains one of the leading causes of morbidity and mortality in Indonesia, posing challenges in access, timely diagnosis, and continuity of care. To address these gaps, RSUP Dr. M. Djamil Padang implemented a cancer navigation program to guide patients through the treatment process. This study aimed to analyze the factors associated with patient acceptance of the program in 2024. A quantitative cross-sectional design was applied with 100 cancer patients recruited through purposive sampling. Data were collected using a validated structured questionnaire covering socio-demographics, knowledge, family support, healthcare communication, and perceived benefits. Analysis included Chi-square tests and logistic regression with a 95% confidence level. The results showed that 65% of patients accepted the program, while 35% did not. Family support (p=0.001), knowledge level (p=0.021), and healthcare provider communication quality (p=0.004) were significantly associated with acceptance, whereas age, gender, education, and perceived benefits were not. Logistic regression identified family support as the most dominant predictor (OR=3.25), followed by communication quality (OR=2.89) and knowledge (OR=2.10). These findings highlight the importance of social and interpersonal factors in shaping patient engagement. In conclusion, strengthening family involvement, patient education, and communication competencies among healthcare providers is essential to optimize navigation program acceptance, improve continuity of care, and support the national cancer control strategy.
Copyright (c) 2025 Wawan Wahyudi (Author) https://creativecommons.org/licenses/by-sa/4.0
Analysis of Environmental Factors and Parenting of Pregnant Women on the Development of Stunted Children
Stunting is a chronic nutritional problem influenced by environmental factors and parenting patterns starting during pregnancy. This study aims to analyze the relationship between environmental factors and maternal parenting patterns and the incidence of stunting in children in Gunungkidul Regency. This quantitative study used a case-control design with a sample of 210 mothers with children aged 24–59 months. Data were collected through structured interviews, home observations, and medical records of pregnancy examinations. The variables studied included antenatal care (ANC) compliance, home sanitation, nutritional intake during pregnancy, housing density, and access to clean water. Data analysis was performed using the Chi-Square test and logistic regression with a significance level of p<0.05. The results of the analysis showed that low ANC compliance (OR=3.11; 95% CI: 1.21–8.01; p=0.013), poor home sanitation (OR=2.75; 95% CI: 1.18–6.38; p=0.019), and poor nutritional intake of pregnant women (OR=2.42; 95% CI: 1.03–5.66; p=0.043) were the dominant factors significantly associated with stunting. Meanwhile, access to clean water and housing density showed a weaker relationship. The conclusion of this study is that increasing ANC compliance, improving household sanitation, and fulfilling nutritional needs of pregnant women are key strategies for preventing stunting in Gunungkidul. Integrated interventions from pregnancy are needed to break the cycle of stunting between generations.
Copyright (c) 2025 Tunggul Sri Agus Setyaningsih, Hesti Wahyuni, Fithri Ratnasari, Irwanto . (Author) https://creativecommons.org/licenses/by-sa/4.0
The Surge in Type 2 Diabetes Cases Among Young People: Risk Factors and Community-Based Prevention
The prevalence of Type 2 Diabetes Mellitus (T2DM) among adolescents and young adults has risen sharply worldwide, posing a major public health concern. This study aimed to identify key risk factors and evaluate community-based prevention strategies targeting youth-onset T2DM. A systematic literature review was conducted using PubMed and Scopus, covering studies from January 2010 to June 2025. Eligible studies included randomized controlled trials, cohort studies, cross-sectional analyses, and quasi-experimental designs focusing on individuals aged 10–25 years. Twenty-eight high- and moderate-quality studies were synthesized. Risk factors clustered into lifestyle-related behaviors (poor diet quality, excessive sugar-sweetened beverage intake, physical inactivity, prolonged screen time), biological determinants (family history, early-onset obesity, pubertal insulin resistance), and psychosocial/environmental influences (sleep deprivation, stress, socioeconomic disadvantage). School-based and family-centered interventions showed moderate improvements in BMI, fasting glucose, and HbA1c, particularly when culturally tailored and sustained for over one year. Community-wide programs yielded mixed results but were more effective when integrated across multiple settings. Findings highlight that effective prevention requires multi-level, long-term strategies addressing both individual behaviors and structural determinants. This review provides actionable insights for designing sustainable, community-anchored approaches to curb the rising burden of T2DM in young populations.
Copyright (c) 2025 Rita Septiana (Author) https://creativecommons.org/licenses/by-sa/4.0
Mobile Health Campaigns and Changes in Clean and Healthy Living Behavior (PHBS) in the Community
Changes in clean and healthy living behavior (PHBS) are an important component in improving public health. However, conventional outreach often faces limitations in reaching the community broadly and sustainably. This study aims to analyze the effect of mobile-based health campaigns (mobile health or mHealth) on changes in PHBS behavior in urban and semi-urban communities. This study used a quantitative approach with a descriptive-correlational design. Data were collected through an online survey of 385 respondents aged 18–50 years in Depok City and Sleman Regency, using a Likert-scale questionnaire. Data analysis was performed using the Pearson correlation test and simple linear regression. The results showed a positive and significant relationship between exposure to mHealth campaigns and PHBS behavior, with the highest correlation values for content quality (r = 0.47) and total exposure score (r = 0.521; p < 0.001). Linear regression showed that mHealth explained 27.1% of the variation in PHBS behavior (R² = 0.271) with a coefficient of b = 0.513. In conclusion, high-quality, relevant, and consistent mHealth campaigns play a crucial role in driving change in healthy, clean, and healthy lifestyle behaviors. Health promotion strategies in the digital era need to integrate these approaches in an adaptive and evidence-based manner.
Copyright (c) 2025 hasnidar hasnidar, mustar mustar (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effect of Oxytocin Massage on Breast Milk Production and Uterine Recovery in Postpartum Mothers
Breast milk (ASI) is the ideal nutrition for newborns because it contains complete nutrition, antibodies, and irreplaceable protective factors. However, many postpartum mothers experience delayed milk production due to physiological and psychological barriers, which can reduce the success of exclusive breastfeeding. One effective non-pharmacological intervention is oxytocin massage, a light massage technique along the spine and ribs to stimulate the release of the hormone oxytocin. This mechanism supports the milk ejection reflex (let-down reflex) through contraction of breast myoepithelial cells and accelerates the release of colostrum. In addition to its benefits for lactation, oxytocin also plays a role in accelerating uterine involution, thereby reducing the risk of postpartum hemorrhage. The psychological effects of relaxation and reduced anxiety contribute to successful breastfeeding and increase maternal self-confidence. Despite physiological and clinical evidence, the implementation of oxytocin massage in the field remains limited due to lack of training, limited socialization, and suboptimal integration into postpartum care standards. This study used a literature review method to analyze the mechanisms, benefits, and challenges of implementing oxytocin massage. The study results confirm that oxytocin massage is a simple, safe, and effective intervention that has the potential to increase the success of exclusive breastfeeding while accelerating maternal recovery.
Copyright (c) 2025 Yumi Abimulyani, Ismawanti Sawedi (Author) https://creativecommons.org/licenses/by-sa/4.0
Meconium Aspiration Syndrome (MAS) merupakan salah satu penyebab utama gangguan pernapasan dan morbiditas pada neonatus, terutama di negara berkembang. Sindrom ini terjadi ketika janin menghirup cairan amnion yang terkontaminasi mekonium, yang dapat menyebabkan obstruksi jalan napas, inflamasi paru, dan infeksi. Artikel ini bertujuan untuk mengulas secara komprehensif aspek etiologi, diagnosis, dan penatalaksanaan MAS berdasarkan temuan terkini. Kajian ini dilakukan melalui tinjauan literatur naratif terhadap 42 artikel ilmiah yang dipublikasikan antara tahun 2015 hingga 2024, diperoleh dari database PubMed, Google Scholar, dan ScienceDirect. Artikel yang diseleksi merupakan publikasi yang relevan dengan fokus pada aspek klinis MAS, termasuk penelitian asli, ulasan sistematis, dan panduan praktik klinis. Hasil kajian menunjukkan bahwa pendekatan diagnosis MAS didasarkan pada temuan klinis dan radiologis, sedangkan penatalaksanaannya melibatkan oksigenasi, ventilasi mekanik, hingga pemberian surfaktan. Artikel ini memberikan kontribusi terhadap literatur yang ada dengan menyintesis perkembangan terkini dalam praktik klinis, serta menekankan pentingnya intervensi dini dan protokol penanganan terstandardisasi guna menurunkan angka morbiditas dan mortalitas pada neonatus dengan MAS.
Copyright (c) 2025 Fetria Faisal , Irwandi Irwandi (Author) https://creativecommons.org/licenses/by-sa/4.0
Anesthetic Considerations in Pediatric and Adult Tonsillectomy Procedures
Tonsillectomy remains one of the most frequently performed procedures in otolaryngology, especially in pediatric patients, where anesthetic management is critical for ensuring intraoperative safety and optimizing postoperative outcomes. The complexity of airway access, high risk of airway-related complications, and diversity of international anesthetic guidelines highlight the need for context-specific, evidence based anesthetic strategies. This narrative literature review synthesizes findings from 45 peer-reviewed articles and clinical practice guidelines published between 2015 and 2024. The review focuses on preoperative assessment, intraoperative airway management, and postoperative complication control in both pediatric and adult tonsillectomy. Sources were selected based on relevance, clinical applicability, and methodological rigor. The findings indicate that the use of oral Ring–Adair–Elwyn (RAE) endotracheal tubes (ETT) and reinforced laryngeal mask airways (LMA) offers optimal airway stability, reduces the risk of kinking, and improves surgical field access. ETTs remain the gold standard for securing the airway, especially in cases involving high bleeding risk. Additionally, adequate premedication protocols and antiemetic prophylaxis significantly reduce postoperative nausea and vomiting (PONV). Management of hemorrhage and laryngospasm remains crucial to reduce morbidity. This study concludes that selecting the appropriate airway device particularly ETTs or LMAs based on patient age, anatomy, and surgical technique is vital. Integrating standardized anesthetic protocols with individualized adjustments contributes to safer, more effective tonsillectomy outcomes across varied clinical settings.
Copyright (c) 2025 Aji Mustiadji, Ade Ariadi (Author) https://creativecommons.org/licenses/by-sa/4.0
Severe Anemia Normocytic Normochromic EC CKD
This study aims to clinically describe a case of severe normocytic normochromic anemia due to chronic kidney disease (CKD) and contribute to strengthening medical understanding of the relationship between anemia and kidney dysfunction. The method used is a descriptive case study with a clinical observation approach and literature review. Data were obtained from a 58-year-old male patient who came to the Emergency Department of M. Natsir Solok Regional Hospital complaining of weakness, pallor, joint pain, and decreased appetite. Laboratory examination results showed a hemoglobin level of 5.8 g/dL and creatinine of 8.13 mg/dL, indicating severe anemia due to stage V CKD. The patient underwent PRC transfusion therapy, intravenous fluids, and folate and antihypertensive administration. During four days of treatment, the patient's condition showed gradual clinical improvement. The discussion emphasized the importance of early detection of normocytic normochromic anemia in CKD patients because decreased erythropoietin production is a major factor. This study concluded that appropriate diagnosis and treatment of anemia due to CKD not only improve the clinical prognosis but also play a crucial role in preventing systemic complications and improving the patient's overall quality of life.
Copyright (c) 2025 Elvi Fitraneti, Alimurdianis Alimurdianis (Author) https://creativecommons.org/licenses/by-sa/4.0
Benign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo (BPPV) is a common peripheral vestibular disorder, particularly in elderly women, characterized by brief vertigo attacks caused by changes in head position. This study aims to present a comprehensive clinical review of the etiology, pathophysiology, diagnosis, and non-pharmacological and pharmacological management of BPPV. Using a descriptive qualitative approach based on a literature review, this study analyzed selected literature sources from 2019 to 2024. The results indicate that the primary mechanism of BPPV is the displacement of otoconia from the utricle into the semicircular canals, causing vertigo through abnormal stimulation of the vestibular system. Diagnosis is confirmed through provocative maneuvers such as the Dix-Hallpike and Supine Roll Tests. Primary management includes the Epley maneuver, Semont, and Brandt-Daroff exercises, which have proven effective and safe, even for self-administration at home. Pharmacological therapy is only given to relieve acute symptoms, while surgery is considered in refractory cases. This study emphasizes the importance of accurate diagnosis, appropriate mechanical therapy approaches, and patient education as key strategies for improving treatment success and preventing long-term recurrence. Integrating anatomical-physiological understanding with clinical application is key to everyday medical practice.
Copyright (c) 2025 Jenny Tri Yuspita Sari, Elfahmi Elfahmi (Author) https://creativecommons.org/licenses/by-sa/4.0
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that interfere with children's academic, social, and emotional functioning. This study aims to comprehensively review the definition, epidemiology, risk factors, diagnosis, and management of ADHD based on literature studies and clinical observations at M. Natsir Solok Regional General Hospital. A qualitative descriptive approach was used with literature review and guided observation methods. The results showed that ADHD has multifactorial risk factors, including prenatal (alcohol exposure, smoking), perinatal (birth complications), and postnatal (brain injury) exposure. Diagnosis was confirmed using DSM-5 and PPDGJ-III criteria with the help of instruments such as SNAP-IV and ASRS. An effective ADHD management strategy is a multimodal approach, namely a combination of pharmacological (methylphenidate, dextroamphetamine) and non-pharmacological (behavior modification at home and school) therapies. Family and school-based interventions, including parent education and teacher training, have been shown to positively improve children's adaptive functioning and behavior. Barriers to pharmacological therapy were also identified, particularly parental resistance to medication side effects. In conclusion, ADHD management requires ongoing cross-sector collaboration and a contextual approach that is culturally appropriate to improve children's overall quality of life.
Copyright (c) 2025 Sulistiana Dewi, Hiddayaturrahmi Hiddayaturrahmi (Author) https://creativecommons.org/licenses/by-sa/4.0
Utilization of Mobile Health (M-Health) Technology to Increase Coverage and Monitoring of Basic Immunization
Rural areas in Indonesia still face significant challenges in improving maternal and child health, as reflected in high maternal and infant mortality rates (MMR) and infant mortality rates (IMR). Posyandu, as a community-based health service, is a key instrument in reaching vulnerable populations through promotive and preventive approaches. However, Posyandu's effectiveness in various rural areas is strongly influenced by structural factors such as the availability of infrastructure, cadre competence, and village government support, as well as cultural factors such as local values and health literacy. This study aims to evaluate Posyandu's effectiveness in improving maternal and child health in rural areas using a descriptive qualitative approach based on literature studies. Data were obtained from various scientific sources and analyzed using a thematic approach and the PRISMA framework. The study results indicate that Posyandu's success is highly dependent on cross-sector synergy, policy support, and digital transformation through the implementation of e-Posyandu. Geographical constraints, poor cadre training, and minimal community participation are key inhibiting factors. Therefore, a participatory approach, ongoing training, and information technology integration are strategic keys. These findings provide an important basis for evidence-based policy-making in order to strengthen the role of Posyandu as a pillar of basic health services in rural areas.
Copyright (c) 2025 Andriyana Abdullah, Wahyuningsih Triana Nugraheni, Novian Aldo (Author) https://creativecommons.org/licenses/by-sa/4.0