Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management)

IMPLEMENTASI PROGRAM INTEGRASI LAYANAN PRIMER (ILP) DALAM UPAYA PENINGKATAN KESEHATAN MASYARAKAT DI INDONESIA – SYSTEMATIC REVIEW

Putri Isriyatil Jannah — 2026-02-23

Background: Primary health care plays a key role in ensuring the achievement of Universal Health Coverage (UHC), which is a main goal in the global health system. As one effort to strengthen primary health care services, the Indonesian government launched the Integrated Primary Care (IPC) Program (Program Integrasi Layanan Primer - ILP).

Objective: This study aims to determine and analyze the implementation of the ILP program as an effort to improve public health in Indonesia.

Methods: Literature searches were conducted using the Google Scholar databases, using the keywords: "primary care integration," "effectiveness of the IPC Program," "Puskesmas," and "constraints of the IPC Program."

Results: The literature search process applied clear inclusion and exclusion criteria to obtain relevant literature. Based on the six articles obtained using the PRISMA method, the implementation of the Integrated Primary Care (IPC) Program (ILP) at the Puskesmas plays a vital role in improving public health status.

Conclusions: Collaboration among policymakers, village governments, health workers, and health cadres is a key point in the success of the IPC Program.

HUBUNGAN USIA DAN PARITAS DENGAN KEJADIAN ANEMIA PADA IBU HAMIL DI PUSKESMAS SERANG KOTA TAHUN 2024

Vega Muhida — 2026-02-25

Background: Maternal anemia remains a major public health problem and contributes to adverse pregnancy outcomes. Factors such as maternal age and parity are known to influence the risk of anemia during pregnancy.

Objective: To analyze the relationship between maternal age and parity with the incidence of anemia among pregnant women in Serang City Health Center

Methods: This quantitative analytic study used secondary data from the laboratory register of pregnant women recorded between January–December 2024. A total of 290 samples were selected using systematic sampling. Variables included hemoglobin level, maternal age, and parity. Data were analyzed using univariate and bivariate analysis (chi-square test and odds

Results: The prevalence of anemia was 22%. Pregnant women with risky age (<20 or >35 years) were more likely to be anemic (52.1%). Chi-square test showed a significant association between age and anemia (p < 0.001), with OR = 7.56. Risky parity (primipara & grande multipara) was also associated with anemia (52.8%) with significant results (p < 0.001), OR = 8.25.

Conclusions: Maternal age and parity are significantly associated with anemia among pregnant women. Strengthened screening and targeted education are needed especially for high-risk groups.

ANALISIS FAKTOR KLINIS DAN FAKTOR MATERNAL TERHADAP KEBERHASILAN PERSALINAN PERVAGINAM SETELAH SEKSIO SESAREA (VBAC) DI RSCS KOTA CILEGON

Mitsalina Durrah Judaty Mitsa — 2026-02-25

Background: Vaginal Birth After Caesarean Section (VBAC) is a viable alternative to reduce the increasing rate of repeat cesarean sections. However, its success depends on several maternal and clinical factors that need to be identified to ensure maternal and neonatal safety. This study was conducted at a RSCS in Cilegon City, so the results reflect the characteristics of obstetric services at advanced health facilities.

Objective: This study aims to analyze maternal and clinical factors determining the success of VBAC in a tertiary healthcare facility.

Methods: This was a retrospective analytic study using medical record data of mothers with a history of cesarean section who attempted VBAC from 2023 to 2024. Independent variables included maternal age, parity, body mass index (BMI), interpregnancy interval, history of vaginal delivery, cervical dilatation at admission, and neonatal birth weight. Data were analyzed using chi-square and logistic regression tests to determine predictors of VBAC success. The research sample consisted of 100 maternal respondents, and the data was obtained from one tertiary health service facility in the period 2023–2024.

Results: Out of all mothers attempting VBAC, 70% achieved successful vaginal delivery. Significant factors associated with successful VBAC were maternal age < 35 years (p < 0.05), interpregnancy interval ≥ 24 months (p < 0.01), history of previous vaginal delivery (p < 0.01), cervical dilatation ≥ 4 cm (p < 0.05), and neonatal birth weight < 3,500 g (p < 0.05).

Conclusions: Maternal and clinical factors particularly maternal age, cervical readiness, and interpregnancy interval play a critical role in determining VBAC success. These findings support the need for careful antenatal selection and intrapartum monitoring to optimize VBAC outcomes.

MODEL PREDIKSI FAKTOR-FAKTOR RISIKO OBESITAS MENGGUNAKAN MACHINE LEARNING

Husnul Khuluq — 2026-02-25

Background: Obesity is a major global health concern and a key risk factor for various non-communicable diseases, including diabetes, hypertension, and cardiovascular disorders. Despite extensive studies, accurately identifying the key contributing factors remains a challenge.

Objective: This study aims to predict the likelihood of obesity using a machine learning algorithm, based on questionnaire-derived clinical and behavioral data. Several supervised machine learning algorithms—logistic regression, naïve Bayes, support vector machine (SVM), and random forest—will be employed to build predictive models. Model performance will be evaluated using accuracy, precision, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC).

Methods: We used an open-access dataset from Kaggle comprising 2,111 samples with anthropometric, demographic, and lifestyle data. Of these, 972 individuals were categorized as obese and 1,139 as non-obese. The target variable was categorized into binary labels: "Obesity" and "Non-Obesity." Preprocessing included one-hot encoding, label encoding, and train-test splitting. All four ML models were trained and evaluated using accuracy, area under the curve (AUC), precision, sensitivity, and specificity metrics.

Results: The model achieved an accuracy of 98.58%, AUC of 99.96%, sensitivity of 98.99%, specificity of 98.21%, and precision of 98.01%. The most influential predictors were weight, frequent consumption of high-caloric food, family history of being overweight, physical activity frequency, and daily water intake.

Conclusion: The model demonstrated high performance and identified key lifestyle-related features. These findings support machine learning's potential for obesity screening and public health strategy development.

ANALISIS IMPLEMENTASI KEBIJAKAN PENCEGAHAN DAN PENGENDALIAN HIV/AIDS: MENUJU PENCAPAIAN TARGET ”THREE ZERO” DI WILAYAH KABUPATEN CIREBON

Puji Melati — 2026-02-25

Background: HIV/AIDS remains a major public health challenge in Indonesia, particularly in regions where new cases continue to increase. Cirebon Regency is one of the high-vulnerability areas, reporting 464 new HIV cases in 2024, predominantly among men who have sex with men (MSM). Local government efforts to achieve the global Three Zero targets zero new HIV infections, zero AIDS-related deaths, and zero stigma and discrimination require critical examination to assess policy effectiveness and alignment.

Objective: This study aimed to analyze the implementation of HIV/AIDS prevention and control policies in Cirebon Regency, identify supporting and inhibiting factors in policy implementation, and assess the relevance of local policies to achieving the Three Zero targets.

Methods: This study employed a qualitative descriptive policy analysis approach. Primary data were collected through in-depth interviews and limited observation involving four key informants: the Head of the Disease Prevention and Control Section of the Cirebon District Health Office, the HIV Program Coordinator at the District Health Office, the HIV Program Officer at Kalimaro Community Health Center, and a representative of a non-governmental organization supporting people living with HIV (PLHIV). Secondary data were obtained from policy documents and official program reports, including the HIV/AIDS Information System (SIHA), and were used solely to provide contextual information on program coverage and service gaps. The study did not apply a mixed-methods design. Data were analyzed using the Miles and Huberman interactive model, comprising data reduction, data display, and conclusion drawing, with validity ensured through source and method triangulation

Results: The findings indicate that HIV/AIDS policy implementation in Cirebon Regency has not yet fully aligned with the Three Zero targets. Major challenges include the absence of a specific regional regulation on HIV/AIDS, limited intersectoral coordination, and persistent social stigma toward PLHIV. Antiretroviral therapy (ARV) coverage reached 80.7%, remaining below the global target of 95%.

Conclusions: Strengthening regional regulations, expanding community-based education, and enhancing cross-sector collaboration are essential to accelerate progress toward achieving the Three Zero targets in Cirebon Regency.

IMPLEMENTASI DAN TATA KELOLA SINERGI PROGRAM HIV–TBC DI KABUPATEN CIREBON: ANALISIS CAPAIAN, HAMBATAN, DAN ARAH PENGUATAN LAYANAN TERPADU

Awaludin — 2026-02-26

Background: The integration of HIV and tuberculosis (TB) services is a key strategy to achieve communicable disease elimination targets. At the subnational level, the effectiveness of integration is strongly influenced by governance capacity, continuity of care, and interoperability of health information systems. Cirebon District has established a local regulatory framework for HIV–TB collaboration; however, its implementation and performance remain suboptimal.

Objective: This study aimed to analyze the performance, barriers, and governance of HIV–TB program synergy in Cirebon District during 2024–August 2025 and to identify directions for strengthening integrated services.

Methods: This study employed a convergent parallel mixed-methods design, integrating descriptive quantitative analysis of routine program data with qualitative thematic content analysis. Program performance data were obtained from the HIV/AIDS Information System (SIHA), the Tuberculosis Information System (SITB), and the Public–Private Mix for TB Control (PHTC) dashboard. Policy implementation was examined through a review of Regent Regulation No. 33/2016 and semi-structured interviews with key program managers and service providers. Quantitative and qualitative findings were analyzed concurrently and integrated at the interpretation stage.

Results: HIV testing coverage exceeded 100% of the target among groups integrated into routine health services, such as pregnant women (103.2%), but was lower among tuberculosis (TB) patients (84.7%) and markedly low among stigmatized populations, including transgender individuals (52.0%) and people who inject drugs (33.3%). The cumulative number of people living with HIV/AIDS continued to rise, reaching 3,960 cases by 2025, with 492 new cases reported in 2024. The HIV–TB cascade analysis revealed that only 46.8% of TB patients were recorded as having undergone HIV testing. A total of 28 HIV–TB patients (approximately 0.6% of all TB patients) were identified, and all initiated antiretroviral therapy; however, no patients received tuberculosis preventive therapy (TPT). Fragmentation between the SIHA and SITB information systems, along with weak cross-program coordination, undermined continuity of care.

Conclusions: HIV–TB program synergy in Cirebon District is constrained primarily by weaknesses in governance and health system integration rather than by a lack of clinical services. Strengthening operational integration, data interoperability, and performance-based supervision is essential to ensure that expanded HIV testing and treatment translate into measurable reductions in HIV–TB transmission and mortality.

PENGARUH MEDIA GALERI IMERSIF DAN KUIS INTERAKTIF TERHADAP PENINGKATAN PENGETAHUAN GIZI ANAK SEKOLAH DASAR

Desy Eliana — 2026-02-27

Background: Good nutritional knowledge among elementary school children plays an essential role in supporting healthy physical growth and cognitive development. However, many children still have limited understanding of nutrition due to monotonous learning approaches that do not stimulate engagement. Innovative tools such as immersive gallery media and interactive quizzes have the potential to enhance learning experiences by providing visual, enjoyable, and participatory activities..

Objective: This study aimed to examine the effect of immersive gallery media and interactive quizzes on improving nutritional knowledge among elementary school students

Methods: This research used a quasi-experimental one-group pretest–posttest design involving 26 second-grade students from SDICT Al Abidin Surakarta. Nutritional knowledge was measured using a 15-item questionnaire. Data analysis included the Shapiro–Wilk test to assess normality and the paired sample t-test to compare pretest and posttest scores

Results: The findings showed an increase in the mean knowledge score from 57.12 before the intervention to 76.92 after the intervention. The statistical test yielded p = 0.000 (p < 0.05), indicating a significant improvement in nutritional knowledge following the use of immersive gallery media and interactive quizzes.

Conclusions: In conclusion, immersive gallery media and interactive quizzes are effective learning tools that significantly enhance students’ nutritional knowledge. These methods are recommended as engaging and developmentally appropriate innovations for nutrition education, although further research with larger samples and control groups is needed to strengthen generalization.