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Abstrak :
This study investigates the relationship between the level of socio-economic development and infant and child mortality in India. The perspective of this study is based on the "Theory of Demographic Transition" which states that improved public health programs and technological and medical advances bring down the level of mortality. The study tests the following major hypothesis: the higher level the level of socio-economic development, the lower the infant and child mortality rates among the states in India. The study applies correlation and multiple regression analysis to data collected by the National Family Health Survey 1992-1993, one of the most comprehensive surveys of its kind ever conducted in India by the Ministry of Health and Family Welfare Government of India. The finding support the theory of demographic transition in large measure revealing that the overall socio-economic development is inversely related to infant and child mortality rates among the states of India.

Abstrak :
Angka Kematian Bayi masih menjadi masalah kesehatan yang belum teratasi. Untuk menurunkan Angka Kematian Bayi, SDGs memiliki target pada tahun 2030 mengakhiri kematian bayi yang dapat dicegah, melalui Kematian Neonatal. Angka Kematian Neonatal (AKN) dan Angka Kematian Post Neonatal (AKPN) di Indonesia menurun lambat dan masih relatif tinggi.  AKN dan AKPN di Indonesia belum mencapai target prioritas SDGs yaitu 12 kematian per 1000 kelahiran hidup. Belum diketahui faktor determinan strategis kematian neonatal dan postneonatal. Tujuan penelitian ini ialah untuk menilai determinan strategis pada faktor sosial dan lingkungan, faktor program kesehatan, dan faktor maternal dan neonatal terhadap kematian neonatal dan postneonatal di Indonesia. Penelitian ini menggunakan data dari Survei Penduduk Antar Sensus 2015 (SUPAS 2015) dan Potensi Desa 2014 (Podes 2014). Populasi penelitian ialah seluruh blok sensus yang memiliki wanita usia subur (15-54 tahun) dan terdaftar dalam SUPAS 2015 dan PODES 2014.  Variabel independen yang digunakan ialah faktor ibu, sosial ekonomi, lingkungan, dan kontrol kesehatan. Variabel dependen yang digunakan AKN dan AKPN. Analisis data yang digunakan ialah Log-Linier Model Multivariat dengan desain Cross-sectional. Determinan strategis kematian neonatal ialah faktor maternal dan neonatal yaitu jarak kelahiran dan proporsi paritas 4+, masing-masing meningkatkan AKN=50% dan 22%. Faktor sosial dan lingkungan yaitu wilayah, pendidikan, status ekonomi, dan sumber air minum, masing-masing meningkatkan AKN=21%;  9%; 8%; dan 6%. Faktor program kesehatan yaitu densitas populasi dukun bayi desa meningkatkan AKN= 5%. Densitas populasi RS kabupaten, dan puskesmas kecamatan dengan masing-masing dapat menurunkan AKN 7% dan 5%. Determinan strategis kematian postneonatal ialah faktor maternal dan neonatal yaitu jarak kelahiran dan proporsi paritas 4+ masing-masing meningkatkan AKPN 32% dan 22%. Faktor sosial dan lingkungan yaitu wilayah Luar Jawa-Bali, sosial ekonomi, dan pendidikan dengan masing-masing meningkatkan AKPN 22%; 10%; dan 9%. Faktor program kesehatan yaitu densitas populasi dukun bayi desa,  dokter kecamatan, puskesmas kecamatan, rumah sakit kabupaten, dan bidan desa. Densitas populasi dukun bayi desa meningkatkan AKPN=7%. Densitas populasi dokter kecamatan, puskesmas kecamatan, rumah sakit kabupaten, dan bidan desa dapat menurunkan AKPN masing-masing 8%; 6%; 5%; 4%.Kematian neonatal lebih mempengaruhi terhadap faktor endogen yaitu jarak kelahiran. Sedangkan kematian postneonatal lebih mempengaruhi terhadap faktor eksogen yaitu status ekonomi, pendidikan ibu, densitas populasi dukun desa, densitas populasi dokter kecamatan, densitas populasi puskesmas kecamatan, dan densitas populasi bidan desa. Maka, diharapkan pemerintah dapat meningkatkan program keluarga berencana dengan meningkatkan kebutuhan kontrasepsi dan meningkatkan akses layanan kontrasepsi. Dengan demikian, Indonesia dapat meningkatkan angka prevalensi kontrasepsi yang tujuannya untuk mengatur jarak kelahiran sebelumnya. ......Infant mortality is still an unsolved health problem. To reduce the Infant Mortality Rate, the SDGs have a target by 2030 to end preventable infant mortality, through Neonatal Mortality. The Neonatal Mortality Rate (NMR) and Post Neonatal Mortality Rate (PNMR) in Indonesia had declined slowly and were still relatively high. NMR and PNMR in Indonesia have not yet reached the SDGs priority target of 12 deaths per 1000 live births. The strategic determinants of neonatal and postneonatal mortality were unknown. The purpose of this study was to assess strategic determinants of social and environmental factors, health program factors, and maternal and neonatal factors on neonatal and postneonatal mortality in Indonesia. This study used data from the 2015 Inter-Census Population Survey (SUPAS 2015) and 2014 Village Potential (Podes 2014). The study population was all census blocks that had women of childbearing age (15-54 years) and registered in the 2015 SUPAS and 2014 PODES. The independent variables used were maternal, socioeconomic, environmental, and health control factors. The dependent variable used was NMR and PNMR. Analysis of the data used was a Multivariate Log-Linear Model with a cross-sectional design. The strategic determinants of neonatal mortality was maternal and neonatal factors, namely birth distance and the proportion of parity 4+, increasing NMR=50% and 22%, respectively. Social and environmental factors, namely region, education, economic status, and unprotected water sources, each increase the NMR=21%; 9%; 8%; and 6%. The health program factor, namely high village traditional birth attendant density, increases NMR= 5%. The population density of district hospitals and sub-district health centers can reduce NMR by 7% and 5%, respectively. The strategic determinants of postneonatal mortality was maternal and neonatal factors, namely birth spacing and the proportion of parity 4+ which increase PNMR by 32% and 22%, respectively. Social and environmental factors, namely the outside Java-Bali region, socio-economic, and education with each increasing the PNMR 22%; 10%; and 9%. The health program factors are the population density of traditional birth attendants, sub-district doctors, sub-district health centers, district hospitals, and village midwives. The population density of traditional birth attendants increases the PNMR=7%. The population density of sub-district doctors, sub-district health centers, district hospitals, and village midwives can reduce PNMR by 8% each; 6%; 5%; 4%. Neonatal mortality was more influenced by endogenous factors, namely birth spacing. Meanwhile, postneonatal mortality was more influenced by exogenous factors, namely economic status, mother's education, population density of village traditional attendants, population density of sub-district doctors, population density of sub-district health centers, and population density of village midwives. So, it is hoped that the government can improve family planning programs by increasing the need for contraception and increasing access to contraceptive services. Thus, Indonesia can increase the prevalence rate of contraception with the aim of regulating the spacing of previous births.

Abstrak :
The promotion of maternal health and mortality reduction is of worldwide importance, and constitutes a vital part of the UN Millennium Development Goals. The highest maternal mortality rates are in developing countries, where global and regional initiatives are needed to improve the systems and practices involved in maternal care and medical access. Taking a practical policy approach, this book covers the background and concepts underlying efforts to improve maternal and perinatal mortality, the current global situation and problems that prevent progress. It includes case studies and examples.

Abstrak :
Mortalitas anak dengan sepsis masih tinggi dengan penyebab yang belum banyak diketahui patofisiologinya. Kerusakan lapisan glikokaliks pada permukaan endotel pembuluh darah dapat menyebabkan peningkatan permeabilitas pembuluh darah yang mengakibatkan syok sepsis dan disfungsi organ pada pasien sepsis. Peningkatan kadar syndecan-1 dalam darah merupakan salah satu penanda kerusakan lapisan glikokaliks. Penelitian ini bertujuan untuk mengetahui hubungan kadar syndecan-1 dengan disfungsi organ yang dinilai dengan skor PELOD-2 dan mortalitas 28 hari pada pasien anak dengan sepsis. Hubungan kadar syndecan-1 dengan skor PELOD-2 merupakan studi potong lintang, sementara hubungan syndecan-1 dengan mortalitas merupakan studi prospektif. Penelitian dilakukan pada 55 anak berusia 1 bulan-<18 tahun dengan sepsis yang dirawat di RSCM pada bulan Maret-Agustus 2019 dengan cara consecutive sampling. Evaluasi syndecan-1 dan skor PELOD-2 dilakukan pada hari pertama dan kelima setelah diagnosis sepsis. Pasien diikuti selama 28 hari untuk evaluasi mortalitas. Didapatkan peningkatan syndecan-1 pada seluruh pasien sepsisdengan peningkatan yang lebih tinggi pada pasien dengan syok sepsis (p=0,01). Terdapat korelasi positifantara kadar syndecan-1 dengan skor PELOD-2 pada 24 jam pertama setelah diagnosis sepsis dengan koefisien korelasi 0,32 (p=0,01). Terdapat korelasi positif antara perubahan kadar syndecan-1 dengan perubahan skor PELOD-2 dengan koefisien korelasi 0,469 (p=0,002). Tidak didapatkan hubungan antara kadar syndecan-1 dengan skor PELOD-2 pada hari kelima (p=0,6). Peningkatan kadar syndecan-1 didapatkan tidak berhubungan dengan mortalitas 28 hari (p=0,49).Nilai titik potongsyndecan-1 ≥688 ng/mLpada hari pertama dapat memprediksi skor PELOD-2 ≥8 dengan AUC 73,8%, sensitivitas 67%, spesifisitas 77%, NDP 44,4%, dan NDN 89,2% (p=0,012). ......Sepsis still contributes significantly to morbidity and mortality inpediatric patients. Disruption of glycocalyx layer on vascular endothelium has been described as one of the main pathophysiological events that leads to increased vascular permeability, contributing to organ failure and septic shock. The role of glycocalyx disruption in pediatric sepsis has not been widely studied. Increased syndecan level in blood marks disruption of glycocalyx integrity. This study was aimed to analyze the correlation ofserum syndecan-1 with organ dysfunction assessed by PELOD-2 score, and to evaluate its association with mortality in pediatric sepsis. Correlation of syndecan-1 and PELOD-2 score was a cross sectional study, while association of syndecan-1 with mortality was a prospective study. The study was conducted in pediatric intensive care unit, emergency unit, and pediatric ward of Cipto Mangunkusumo Hospital, Jakarta, on March-August 2019. The subjects were 55 patients aged 1-month to 18-year-old with sepsis that fulfilled the inclusion criteria consecutively. Serum syndecan-1 level and PELOD-2 score were evaluated on day 1 and 5 after diagnosis of sepsis. Survival was assessed after 28 days. There was increased level of syndecan-1 in all subjects, with significantly higher level found in patients with septic shock (p=0,01). There was positive correlation of syndecan-1 with PELOD-2 score in the first 24 hours after diagnosis of sepsis with correlation coefficient of 0.32 (p=0.01). Changes in syndecan-1 level within 5 days positively correlated with changes of PELOD-2 score with correlation coefficient of 0.469 (p=0.002). Syndecan-1 level and PELOD-2 score on day 5 was not significantly correlated (p=0.6). There was no association of increased syndecan-1 level with mortality in 28 days (p=0.49). Cut-off point of syndecan-1 ≥688 ng/mL in the first 24 hours can predictsignificant organ dysfunction (PELOD-2 score of ≥8) with AUC of 73.8%, sensitivity 67%,specificity 77%, positive predictive value 44.4%, and negative predictive value 89.2% (p=0.012).

Abstrak :
ABSTRAK
Status kesehatan bayi merupakan salah satu indikator yang sensitif untuk menilai kesehatan masyarakat di suatu negara. Penilaian derajat kesehatan masyarakat dapat dilakukan dengan melihat beberapa indikator yang tercermin dalam kondisi morbiditas, mortalitas dan status gizi. Derajat kesehatan masyarakat di Indonesia digambarkan melalui Angka Kematian Bayi (AKB), Angka Kematian Balita (AKABA) dan Angka Kematian Ibu (AKI). Beberapa penelitian telah menunjukkan bahwa lebih dari 50% kematian bayi terjadi dalam periode neonatal, yaitu 0-28 hari pertama kehidupan. Data SDKI menunjukkan angka kematian neonatal dari tahun 1993-1997 sebesar 25 menjadi 20 per 1.000 kelahiran pada tahun 1998-2002, dan kemudian pada tahun 2003-2007 Angka Kematian Neonatal (AKN) menjadi 19 per 1.000 kelahiran (BKKBN dkk, 1997, 2003, 2007).

Penelitian ini bertujuan untuk mengetahui hubungan jumlah anak yang dilahirkan dengan kejadian kematian neonatal berdasarkan data SDKI Tahun 2007. Penelitian dilakukan dengan desain cross sectional menggunakan data SDKI Tahun 2007 dengan sampel sebanyak 15.273. analisis multivariat menggunakan Logistic Regression.

Hasil penelitian menunjukkan bahwa hubungan jumlah anak yang dilahirkan terhadap kejadian kematian neonatal dipengaruhi oleh tingkat pendidikan, jarak lahir, kunjungan ANC, tempat persalinan, riwayat operasi saesar dan jenis kelamin. Diketahui nilai POR sebesar 2,314 (95% CI : 1,122-4,7722) artinya ibu dengan jumlah anak yang dilahirkan 1 dan ≥ 4 memiliki risiko 2,314 kali untuk terjadinya kematian neonatal dibandingkan ibu yang memiliki jumlah anak yang dilahirkan 2-3 setelah dikontrol oleh tingkat pendidikan, jarak lahir, kunjungan ANC, tempat persalinan, operasi saesar dan jenis kelamin.

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ABSTRACT
Health status of infant is one sensitive indicator to assess the public health in a country. Public health status assessment can be done by looking at some indicators that reflected in the condition of morbidity, mortality and nutritional status. Public health in Indonesia is illustrated by infant mortality Rate (IMR), Child Mortality Rate (CMR) and Maternal Mortality Rate (MMR). Several studies have shown that more than 50% of infant deaths occur in the neonatal period, that is the first 0-28 days of life. IDHS data shows that neonatal mortality rate from year 1993-1997 is 25 to 20 per 1.000 live births in 1998-2002 and Neonatal Mortality Rate (NMR) is 19 per 1.000 births in 2003-2007 (BKKBN et al, 1997, 2003, 2007).

This study aims to know the relationship of parity with neonatal mortality events based on IDHS data 2007. This study is done by using cross-sectional design using and taking the IDHS data 2007 with the samples of 15.273. in analysis of multivariate, it uses Logistic Regression.

The results show that the relationship of parity with neonatal mortality events are influenced by education level, birth spacing, ANC visiting, childbirth place, caesar operating history and gender. The value of POR known that is 2,314 (95% CI: 1,122 to 4,7722), it means that mother and parity 1 and ≥ 4 who have 2,314 times the risks for the occurrence of neonatal death than mother who has parity 2- 3 after controlled by education level, birth spacing, ANC visiting, childbirth place, Caesar operating and gender.