Sudden-onset natural disasters rapidly disrupted essential maternal and neonatal health (MNH) services across the disaster cycle. This systematic review synthesized how such events affected the disruption and recovery of antenatal care (ANC), facility delivery, and emergency obstetric and neonatal care (EmONC), as well as postnatal/neonatal care, and identified the main health-system pathways involved. Searches of Scopus, ScienceDirect, and PubMed (November–December 2025) included English-language, open-access articles published between 2021 and 2026. Eligible quantitative, qualitative, and mixed-methods studies examined sudden-onset disasters and reported disruption and/or recovery of essential MNH services. Using PRISMA procedures, PEO-based criteria, and the MMAT 2018 quality appraisal, seven studies were included, primarily focusing on floods and cyclones in South Asia, Sub-Saharan Africa, and the Caribbean islands. Disasters generated acute shocks to service delivery, workforce, supplies, referral and transport, and information and coordination, leading to declines in ANC, facility delivery/EmONC, and PNC/neonatal care. Recovery ranged from return to near baseline within about three months to prolonged and uneven restoration, with poorer, marginalized, and remote groups being consistently more affected. The findings highlighted predictable but inequitable system pathways, supporting the integration of MISP-aligned preparedness, protection of ANC/PNC platforms, securing EmONC referral and transport, strengthening supply chains, and improving routine information systems to sustain continuity and accelerate recovery.
Indonesia is ranked third with the highest level of Sugar-Sweetened Beverages (SSB) consumption in Southeast Asia in 2020. SSB consumption is one of the factors in the increase in cases of Diabetes Mellitus (DM) in society, especially in children. Research purposes is to get an overview of knowledge and perceptions related to SSB consumption at various levels of education (elementary school, middle school, high school and university students). A quantitative method was used with a target population of 19,880 students across elementary, middle, high schools, and universities in Central Semarang. Proportional stratified random sampling yielded a sample size of 376 participants using the Isaac and Michael formula. The study used an SSB knowledge and perception questionnaire along with FGD guidelines. Chi-square and ANOVA tests revealed that knowledge and perceptions significantly influence SSB consumption across education levels (F: 28.053, sig 0.000), indicating that greater awareness could encourage healthier choices. The lack of knowledge about SSB consumption was most evident among elementary school children, with 72.19% reporting excessive intake. Negative perceptions were primarily found among students, followed by 56.16% in the student group, 43.48% in junior high, and 18.39% in high school. In conclusion, our study contributes to the understanding of the knowledge and perceptions in this research together have a significant influence on SSB consumption at various levels of education. This research provides insights into the importance of nutritional awareness at an earlier stage of education. Future studies should address the education intervention od SSB consumption in children.
Abstract: This study aims to identify the main determinants of hypertension in rural areas by looking at the influence of diet, age, gender, and employment status in the community of Tagolu Village, Lage Sub district, Poso District. Hypertension, known as the “silent killer”, is one of the leading causes of death globally, with more than 1.13 billion sufferers. This is a quantitative study with a cross-sectional design in 2022. 57 respondents from 134 populations were randomly drawn. The research instrument used a validated questionnaire. Data analysis was performed using the Chi-square test with a significance level of 95% using SPSS. The main results of the study indicate a significant association between dietary patterns and the incidence of hypertension (p = 0.001; OR = 50,000; 95% CI: 9,175–272,466), with poor dietary patterns having a prevalence of hyperten-sion of. Although the variables of age (OR = 1.579), gender (OR = 1.429), and employment status (OR = 0.700) did not show statistical significance (p > 0.05), the OR values indicate a trend toward increased risk of hypertension in the elderly and male groups, while employment status did not have a significant effect. Research findings indicate that poor dietary patterns are strongly associated with hypertension. .
The Elderly populations in tidal flood-prone areas face heightened vulnerability to leptospirosis due to environmental hazards, recurrent inundations, and psychosocial stressors. This study analyzed an integrated socio-epidemiological model that accommodates a community-based intervention, targeting perceived stress, self-efficacy, and clean and healthy living behavior (PHBS), along with a system dynamics simulation to forecast leptospirosis incidence. This quasi-experimental study design was implemented with 70 participants (35 intervention and 35 control). The participants reside in flood-affected villages of Demak Regency, Indonesia, in 2024 (Purwosari, Sriwulan). Perceived stress (PSS-10), self-efficacy, and PHBS scores were measured at pre- and postintervention. Statistical analyses included Mann-Whitney, Wilcoxon, and paired t-tests. Delta scores were integrated into a stock-flow model (PowerSim Studio 10) incorporating behavioral and environmental risk variables to simulate leptospirosis cases for 2024–2029. The in- tervention group demonstrated significant improvements in self-efficacy (Δ=+5.69±8.17,p<0.001) and PHBS (Δ=+9.37±4.59, p<0.001), alongside a non-significant but clinically relevant reduction in perceived stress (Δ=-7.20±8.33, p=0.733 vs control). The dynamic model projected a 25–30% reduction in leptospirosis cases over five years with intervention, compared to a ≤5% decline without behavioral programs. Visual validation indicated alignment between simulated and real incidence trends (2020–2024). Integrating psychosocial behavioral interventions with dynamic modeling provides a reliable framework for leptospirosis control in flood-prone populations.
Background: This systematic review explores factors influencing the success of Vaginal Birth After Cesarean (VBAC) in response to increasing global cesarean rates. VBAC reduces the need for repeat cesareans and associated risks. Purpose: To identify key medical, psychological, and institutional factors affecting VBAC outcomes. Methods: A total of 21 studies were reviewed from PubMed, ScienceDirect, and Google Scholar using PRISMA-ScR criteria. The analysis focused on maternal age, previous vaginal birth, cervical dilatation, healthcare access, and psychosocial support. Results: Successful VBAC was linked to younger maternal age, prior vaginal birth experience, spontaneous labor onset, and adequate cervical dilatation at admission. Psychosocial support, including family encouragement and professional guidance, significantly influenced VBAC decisions. Hospital policies promoting VBAC and ensuring access to emergency services further enhanced success rates. Conclusion: Medical, social, and institutional factors significantly affect VBAC success. Establishing standardized guidelines and providing improved counseling are essential to support women’s choices during childbirth. Future research should focus on large, diverse populations to confirm predictors and assess long-term outcomes compared to repeat cesareans.
Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus (DM) and a leading cause of blindness among productive-age adults. Globally, the prevalence of DR reaches 34.6%, while in Indonesia it is 43.1%, making it the second most common diabetes complication after nephropathy. In Kapuas District, the 2022 data reported 5,390 DM patients and 56 DR cases, with a growing trend each year, particularly in areas with limited health services. This study, conducted in 2025, aimed to analyze the effect of clinical supervision by ophthalmologists on DR severity in relation to treatment duration, age, and healthcare access distance. A quasi-experimental design with a pre-test and post-test approach was applied to 52 non-proliferative DR patients divided into intervention (clinical supervision) and control groups. Results showed that clinical supervision effectively maintained mild DR conditions (p=1.000), while the non-supervised group exhibited increased severity (p=0.025). Longer treatment duration correlated with stable DR (p=0.000), age influenced severe DR (p=0.033), and healthcare distance affected moderate DR (p=0.045). Clinical supervision by ophthalmologists effectively slows DR progression, particularly among productive-age patients and those with limited access to eye care services.
Cities with high population density, high traffic volume of public and private transportation, and significant industrial operations in areas surrounding airports constitute a combination that worsens air pollution. Exposure to pollutants could impact the hematological system. The aim of this study is to determine air pollution exposures in Belendung Subdistrict, Benda District, Tangerang. This study served as a preliminary step or pilot study, conducted within a 4.6 km radius of the airport, and located near some industries in the area, using a cross-sectional and purposive method. SO₂, CO, NO₂, Ox as O₃, NMHC, TSP, Pb, PM2.5, and PM10 levels were measured as air pollution variables. These parameters were assessed on the 3rd and 5th days before blood sampling. Neutrophils, eosinophils, monocytes, basophils, lymphocytes, CRP, leukocytes, hemoglobin, erythrocytes, hematocrit, platelets, MCV, MCH, MCHC, and ESR were measured from 12 male and 12 female respondents. The results showed that the air quality ranged within the standard threshold except for PM10, and most residents have normal biomarkers in the blood. This indicated that PM10 merely activates basic immune responses in the body. The observed inflammation provides a correlation between MCH and MCV, with a value of 0.905.
Flexible flat feet in children are common in community and school-aged populations and may be associated with altered lower-limb biomechanics, impaired postural control, and reduced dynamic balance, potentially affecting mobility, participation, and safety in daily activities. Although custom-made foot insoles are widely prescribed, evidence regarding their functional effects on dynamic balance in community-based pediatric settings remains limited. This study aimed to evaluate the effects of custom-made foot insoles on dynamic balance among children with flexible flat feet in a community-based rehabilitation context. A pre–post intervention study was conducted involving 40 children (mean age 10.05 ± 1.04 years). Dynamic balance was assessed using the Balance Beam Test before and after the intervention. Changes in balance performance were analyzed using the Wilcoxon signed-rank test, with effect size calculated using Cohen’s d. Dynamic balance scores improved significantly after insole use (Z = −3.995, p < 0.001), with a large effect size (d = 0.81). Greater improvements were observed in children with lower baseline balance. These findings support the potential role of custom-made foot insoles within community-based rehabilitation strategies to enhance functional balance and promote safe participation among children.
This study explores how common smoking is among employees of the Greater Amman Municipality (GAM) in Jordan. It looks at patterns and reasons behind smoking within the context of both national and global efforts to create smoke-free public spaces. We used a cross-sectional design and a structured electronic questionnaire to gather data on tobacco use, demographics, job stress, quitting behavior, and knowledge of available support services. The results show that 36% of GAM employees smoke, with traditional cigarette use being the most common type. Smoking behavior is notably linked to factors like how long employees have worked there, their stress levels, and how young they started smoking. Although 53% of smokers tried to quit, only 32% of those who knew about cessation clinics actually used them. Almost 70% of respondents reported being exposed to second-hand smoke, even though 66% thought GAM was a smoke-free environment. These findings emphasize how workplace culture, psychological stress, and gaps in enforcement contribute to ongoing smoking habits. The study highlights the urgent need for health promotion strategies that include support for quitting, mental health resources, and effective policy actions focused on municipal workers. It adds to the existing literature on occupational health in urban areas of the Middle East and backs national tobacco control efforts aimed at cutting down smoking in public sector workplaces.
Education is a fundamental right for all children, both within schools and in the family environment. The psychological well-being of mothers plays a crucial role in raising children with autism. Various factors contribute to the formation of maternal psychological well-being, one of which is gratitude. This study aims to examine the correlation effect size between gratitude and mothers’ psychological well-being in raising children with autism. A meta-analysis was conducted on seven research articles and two research reports identified through Google Scholar, Portal Garuda, and Indonesia ONESEARCH within the last eight years (2018-2025). The total number of participants was 523 mothers of children with autism. Data were analyzed using correlation effect size (correlation coefficient r and sample size N). The effect size value obtained from the random effects model was r = 0.878, p < 0.001. The findings indicate that gratitude and psychological well-being have a strong effect size and are positively correlated. The higher level of gratitude, the higher psychological well-being of mothers in educating children with autism. Mothers with greater psychological well-being are better able to optimally educate and nurture their children with autism, enabling the children to grow and develop across various aspects in accordance with expectations and conditions.
The Climate change exacerbates people’s access to nutritious food and the risk ofmalnutrition, especially for vulnerable groups. West Sumatra’s stunting rate in2022 is above the national average. It is necessary to know the factors that influencemalnutrition. The study uses primary data with a questionnaire on heads of farmerand fisher families in areas vulnerable to climate change in West Sumatra, Indonesia,in 2024. We took a probability proportionate size sample of 305 and analysed it using Structural Equation Modelling with Partial Least Squares. The results showed a malnutritionincidence of 76.4%. Environmental health directly influenced infectious diseases,which in turn affected malnutrition, resulting in a large total effect of 0.113 (11.3%).Environmental health indirectly impacts malnutrition through disease, resulting in asubstantial total effect of 0.309 (30.9%). Adaptation had a direct effect on malnutritionand a large total effect of 0.197 (19.7%). Dietary patterns do not have a significant effect onmalnutrition. Adaptation to change includes reducing the incidence of infectiousdiseases and improving access to sanitation. We need adaptation strategies to enhanceenvironmental health and manage infectious diseases.
Introduction: Anemia remains a significant public health problem among adolescents in developing countries such as Indonesia. Female adolescents are more vulnerable due to menstrual blood loss and increased iron needs during growth, while dietary diversity and beverage habits may further influence anemia risk. Aim: This study aimed to analyze factors associated with anemia, including gender, diet quality, and tea or coffee consumption, and to explore their molecular relevance using a bioinformatics approach. Methods: A cross-sectional study was conducted among 199 adolescents (105 males, 94 females) aged 12–17 years in a boarding school in Malang, Indonesia. Data collection included hemoglobin measurement, anthropometric assessment, and a Food Frequency Questionnaire (FFQ). Statistical analysis was performed using Chi-square and logistic regression, while bioinformatics analysis employed STRING, Cytoscape, and ShinyGO to identify key genes and pathways. Results: Female gender (AOR = 6.595; p < 0.001), adequate diet (AOR = 0.184; p = 0.012), and tea/coffee intake (AOR = 7.532; p < 0.001) were significant predictors of anemia. Bioinformatics analysis identified SLC11A2, TFRC, and HAMP as key genes regulating ferroptosis and mineral absorption pathways. Conclusions: Gender, dietary quality, and tea or coffee consumption significantly influence anemia in adolescents.
The abundance of natural materials has attracted the attention of numerous researchers, who are now developing them into effective adsorbents for waste treatment applications. The waste stream in question includes laundry liquid waste from workshops, which is discharged directly into the environment via soil or drainage channels without any form of pretreatment. The lead content (Pb) in workshop laundry liquid waste is hazardous if discharged into the environment because it is difficult to degrade. This study investigates a filtration media composed of a combination of natural adsorbents—coconut shell charcoal, pumice stone, and hair waste as an option for treating workshop laundry liquid waste. This research was conducted in January 2021 and focuses specifically on its effectiveness in reducing Pb levels. Adsorbents are arranged in a 60 cm diameter barrel with a height of 40 cm for each adsorbent. Laboratory analysis for the lead test method according to SNI 6989.8.2009 with Atomic Absorption Spectrophotometry (SSA) shows a decrease in Pb levels starting from the control to the first repetition, second repetition, and third repetition, where the final results show that Pb levels are safe to be discharged into the environment because they are below the environmental quality standards based on the Regulation of the Minister of Environment of the Republic of Indonesia Number 5 of 2014 concerning Wastewater Quality Standards, which is a maximum of 0.03 mg/L. Filtration A showed a Pb level of 0.021 (50% decrease), and Filtration B showed a Pb level of 0.106 (80% decrease)
Early Breastfeeding Initiation (EBI) achievement globally has only reached 48%, with the target is 70% by 2030. Thus, there is still a 22% gap from the expected target. Although national coverage targets have been achieved in Indonesia, there are still some disparities in maternal characteristics, socioeconomic conditions, and access to maternal health services suggest the presence of underlying determinants that have not been fully explored at the national level. This study aimed to identify factors associated with the practice of EIBF among women of reproductive age in Indonesia. This study uses secondary data of individuals and toddlers SKI 2023 obtained from the Data Center of the Ministry of Health of the Republic of Indonesia, using 14,030 respondents’ data, who were selected based on the completeness of the data and did not have damaged data on the research variables. Chi-Square test was used with a significance level of α = 0.05 and a 95% confidence interval (CI 95%), while multivariate analysis was carried out using the Backward Likelihood Ratio (Backward LR) logistic regression test. The results of the study showed that the type of residential area (PR = 1.044; 95% CI = 1.013-1.077), maternal education level (PR = 0.920; 95% CI = 0.892-0.948), economic status (PR = 0.935; 95% CI = 0.906-0.964), parity (PR = 1.068; 95% CI = 1.024-1.114), ANC frequency (PR=0.958; 95% CI= 0.929-0.989), delivery method (PR=1.597; 95% CI= 1.597-1.745), place of delivery (OR= 1.167; 95% CI=1.021-1.335), and birth weight (PR= 1.265; 95% CI= 1.188-1.348) were associated with EBI practices in WUS in Indonesia. While maternal employment status was not associated with EBI practices in WUS in Indonesia. The variables of place of delivery and birth weight were proven to be confounded by the parity variable. The Indonesian Ministry of Health’s Data Center is advised to add data related to the mother’s age at birth. Women of childbearing age are advised to give birth in health facilities because they have a greater opportunity to practice EBI.
Digital health is transforming healthcare globally, with ASEAN nations like Singapore, Thailand, and Indonesia showing diverse progress. This study analyzes and compares their digital health services to pinpoint best practices and improvement areas. Employing a mixed-methods approach involving literature reviews, policy analysis, and data gathering on infrastructure and service adoption from government and academic sources, the research focuses on governance, investment, infrastructure, and service uptake. Findings reveal Singapore as a digital health frontrunner due to its strong governance, substantial investment, advanced infrastructure, and high adoption. Thailand shows progress but grapples with decentralized governance and urban-rural divides. Indonesia's developing sector faces fragmented governance, limited investment, and infrastructure deficits. The study underscores the importance of centralized governance and robust investment for successful digital health implementation, highlighting Singapore's cohesive strategy as a beneficial model. Thailand and Indonesia need to enhance policy consistency and infrastructure development to improve the effectiveness of digital health services in ASEAN. Ultimately, advancing digital health in ASEAN necessitates a comprehensive strategy encompassing strengthened governance, increased investment, better infrastructure, and greater public awareness, drawing lessons from successful models to improve regional healthcare access and quality.
The production of paint involves the use of volatile organic compounds (VOCs) and heavy metals, which can impact health. Gender differences play a significant role in toxicokinetics and toxicodynamics. Variations in sex hormones, xenobiotic-metabolizing enzymes, and distribution volumes influence the body's response to toxins. This study aims to investigate biochemical parameters—including ALP, AST, ALT, Gamma-GT, total cholesterol, creatinine, cholinesterase, total bilirubin, fasting glucose, N Urea, eLFG, and uric acid—in paint industry workers, stratified by gender. An analytical observational study with a cross-sectional design was conducted on 89 workers engaged in production, research and development, and logistics within a paint manufacturing facility. Demographic data were obtained via questionnaires, and laboratory test results were analyzed. Statistical evaluation was performed using the chi-square test to determine the association between gender and biochemical abnormalities, with an odds ratio (OR), 95% confidence interval (CI), and significance level set at p<0.05. The assessment of paint exposure among workers, based on biochemical test results stratified by gender, demonstrated that gender significantly influences these parameters (p<0.05). The findings of alkaline phosphatase (ALP) (OR: 7.500, 95% CI: 1.146–49.100), total cholesterol (OR: 3.841, 95% CI: 1.142–12.916), and creatinine (OR: 30.179, 95% CI: 7.706–118.193) suggest that exposure to paint substances impacts liver function (as indicated by ALP), total cholesterol, and renal function (creatinine). These outcomes may be attributed to physiological, hormonal, enzymatic, and genetic differences between male and female individuals in their toxicological responses, as supported by biochemical examination results.
In Indonesia, central obesity among people aged 15-54 years has become a health problem that continues to increase from 2018 (30.8%) to 2023 (36.8%) and significantly contributes to degenerative diseases. This study aims to analyze dietary patterns and consumption of risky foods related to central obesity in Indonesia using a spatial analysis approach. Data are sourced from the 2023 Indonesian Health Survey (SKI) Report with 38 provinces as the analysis unit. The variables studied include consumption of risky foods (sweet foods and drinks, salty foods, markers, seasonings, and instant noodles) and consumption patterns of foods such as nuts, milk, sugar, oil, vegetables, and fruit. Data analysis was carried out using Moran’s I and Local Indicator of Spatial Autocorrelation (LISA) to identify spatial autocorrelation and Ordinary Least Squares (OLS) as the regression analysis. The results show that the incidence of central obesity in Indonesia forms a clustered pattern across provinces. OLS regression analyzed the main variables that were significantly related, namely consumption of salty foods, fried/fatty foods, nuts, and vegetables and fruit. The negative association between salty foods and nuts is explained by local cultural factors and relatively low-calorie consumption, while the positive association between fruit and vegetable consumption indicates low consumption frequency, thus suboptimal preventive factors for central obesity. These findings demonstrate the need for community nutrition interventions that consider spatial variation across provinces to improve the effectiveness of central obesity prevention efforts in Indonesia.
Early childhood development determines the quality of future generations. A mother is crucial in encouraging a child’s growth and development. This research aims to determine the influence of social psychological factors that influence maternal behavior on healthy child growth and development using the Social Cognitive Theory (SCT) model. This cross-sectional study was conducted from July to October 2023 in Yogyakarta, Indonesia. A sample of 400 mothers with children under five (12-59 months). The dependent variable is the maternal behavior in child development, and the independent variables are observational learning, outcome expectations, self-efficacy, and family support. All variables were measured by questionnaire, and the data were analyzed by path analysis using Stata 13 statistical software. A maternal’s behavior is directly and positively related to observational learning (b= 0.28, p<0.001), outcome expectations (b= 0.24, p<0.001), self-efficacy (b= 0.37, p<0.001), and family support (b= 0.09, p=0.005). The goodness of fit path analysis indicates p > 0.05, RSME< 0.001, TFI= 1.00, TLI= 1.00, and SRMR< 0.001. A maternal’s behavior is directly and positively related to observational learning, outcome expectations, self-efficacy, and family support. Interventions to improve mothers’ healthy behavior in accelerated child development should prioritize efforts to increase self-efficacy.
Batik home industry waste not managed with standardized WWTP can lead to environmental pollution. This is caused by the remaining synthetic batik dyes containing heavy metal lead. The remaining dyeing waste is disposed of into the river, a water source in the surrounding environment. Waste containing heavy metals causes a neurotoxic effect on the human body. Furthermore, exposure to heavy metals due to synthetic batik dyes is more at risk for workers who do coloring since they do not use personal protective equipment while working and do not live a clean and healthy lifestyle. One of the behavioral disorders associated with the effects of accumulated lead exposure is an antisocial personality disorder. In this study, blood lead levels were checked for batik dye workers by taking blood samples using a 3 ml purple vacuum tube and placing them in an ice box to be sent to the Yogyakarta Health Laboratory Center (BLK). The blood sample was then wet destroyed, and the Pb levels were read using an AAS tool. Antisocial tendency scale data was measured using STAB (Subtypes of Antisocial Behavior), where the validity test had previously been carried out with the Pearson product-moment of 0.327-0.786 and the reliability test with the Cronbach alpha technique of 0.936. The results of the data analysis showed a correlation between blood lead levels and antisocial disorder tendencies of 0.690, but no correlation was found between blood lead levels and body mass index (BMI)
The exploration of potential blood-based biomarkers that could be useful in the early detection of cognitive impairment associated with ischemic stroke is still being studied. The objective of this study was to examine the correlation between serum clusterin levels and the prevalence of cognitive impairment in individuals with ischemic stroke. A total of 86 outpatients with mild ischemic stroke within the first three months of its onset were recruited from three primary hospitals in Mataram, Indonesia. ELISA was used to measure the serum clusterin level. Patients’ sociodemographic and clinical data were also collected as covariates. The Montreal Cognitive Assessment-Indonesian version (MoCA-INA) instrument was used to evaluate cognitive status. The study used multivariate logistic regression analysis to investigate the effect of clusterin on the occurrence of cognitive impairment associated with ischemic stroke while controlling for other variables. Results: The multivariate logistic regression analysis revealed a significant correlation between elevated serum clusterin levels and a higher prevalence of cognitive impairment in ischemic stroke patients (odds ratio [OR] 3.56, 95% confidence interval [CI] 1.04-12.16, p = 0.043). Conclusion: Elevated serum clusterin levels have been associated with a higher occurrence of cognitive impairment in ischemic stroke patients.
