Introduction: Adolescent pregnancy remains a difficult problem in developing countries, including Indonesia. Pregnancy at an early age is a risk factor for maternal and infant mortality. A recent report indicates that adolescent pregnancy is even higher in rural areas. Therefore, this study aims to identify factors associated with adolescent pregnancy in rural Indonesia and formulate intervention actions to reduce the teenage pregnancy rate. Methods: Participatory action research (PAR) was conducted in the rural area of Mesuji District, Lampung Province, Indonesia. Six meetings, including four focus group discussions (FGDs), were Rural and Remote Health rrh.org.au

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The high rate of maternal (MMR) and infant mortalities (IMR) is a detrimental health development challenge in Indonesia. The use of the Maternal and Child Health (MCH) handbook and MCH service guidelines are the government’s eff orts in reducing the MMR and IMR. However, the reduction of MMR and IMR is still slow. The fi nding of the previous study asserts the need for MCH handbook and MCH service guidelines modifi cations to be suited to the needs of users, both health workers, and expectant mothers. Therefore, this study mainly aims to analyze the needs and use of MCH handbook and service guidelines by doctors and midwives in the primary health centers. The method was qualitative needs analysis with 137 informants from 12 health centers in three regions of Indonesia. The results revealed that the needs of health workers were clustered in three signifi cant aspects; instrumental (language and book-making materials), managerial (procurement, distribution, and dissemination) and operational (ease of access to MCH handbook and service guidelines as well as the availability of SOP). The fulfi llment of these three aspects is expected to improve the MCH program’s achievement, especially in cities where the research took place and other areas with similar characteristics. Abstrak Tingginya Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) masih menjadi masalah dalam pembangunan kesehatan di Indonesia. Penggunaan buku Kesehatan Ibu dan Anak (KIA) serta pedoman pelayanan KIA merupakan upaya pemerintah dalam penurunan AKI dan AKB. Meskipun demikian, penurunan AKI dan AKB dinilai masih lambat. Hasil penelitian sebelumnya menunjukkan perlunya modifi kasi buku dan pedoman pelayanan KIA disesuaikan dengan kebutuhan pengguna, baik tenaga kesehatan maupun ibu hamil. Oleh sebab itu, penelitian ini bermaksud menganalisis kebutuhan dan pemanfaatan buku dan pedoman pelayanan KIA oleh dokter dan bidan di puskesmas. Metode yang digunakan adalah analisis kebutuhan kualitatif dengan 137 informan dari 12 puskesmas di tiga Kabupaten/kota di Indonesia. Hasil analisis menunjukkan kebutuhan nakes terkelompok pada tiga aspek utama, yaitu instrumental (bahasa dan bahan pembuat buku), manajerial (pengadaan, pemerataan distribusi dan sosialisasi) dan operasional (kemudahan akses pada buku dan pedoman layanan KIA dan ketersediaan SOP). Pemenuhan terhadap tiga aspek tersebut diharapkan mampu memperbaiki capaian program pelayanan KIA khususnya di wilayah tempat penelitian.

Objective: To investigate the prevalence of belief in COVID-19 vaccine efficacy and its associated factors. Methods: Due to mobility restriction, this study was conducted cross-sectionally via online platforms. The included factors were age, gender, religious identity, marital status, education level, occupation, and living with health workers. Logistic regression was used to assess the association between belief in COVID-19 vaccine with the predictors. Results: A total of 5 397 responses were taken into analysis. The prevalence of belief in COVID-19 vaccine efficacy was 62.3%. Whereas factors associated with belief in COVID-19 vaccines were being in the age of 45-54 (aOR 1.767; 95% CI 1.219-2.562), 55-64 (aOR 1.703; 95% CI 1.219-2.562), and >64 (aOR 2.136; 95% CI 1.128-4.047), completing education until the secondary level (aOR 1.354; 95% CI 1.111-1.650), working as health practitioners (aOR 2,353; 95% CI 1.655-3.344), and living with health workers (aOR 1.278, 95% CI 1.079-1.514). All religious identities including Muslim (aOR 2.447; 95% CI 1.183-5.062), Protestant (aOR 3.615; 95% CI 1.703-7.677), Catholic (aOR 4.486; 95% CI 2.015-9.987), and Hindu (aOR 3.286; 95% CI 1.410-7.655) showed significant association with belief in COVID-19 vaccine efficacy. Conclusions: A high prevalence of belief in COVID-19 vaccine efficacy was evident. Since vaccine compliance is determined by an individual’s risk-benefit perception, this study emphasizes the need of raising awareness of the benefits of COVID-19 immunization.

Health citizenship is understood over how the government provides access to healthcare. This paper aims to describe the development of health citizenship from the post-colonial until the democratization era in Indonesia by analyzing health accessibility. The social-history approach was applied to analyze contemporary study in Indonesian healthcare access from 1945 to 2020. This article analyses the dynamic over political regime changes context and its approach to deal with health accessibility based on acceptability, availability, and affordability issues. This study found that each political regime provides a different social-political context in prioritizing and administrating the accessibility of healthcare. Besides each regime appears issues of accessibility, all of which provoke inequity in healthcare. This paper argues that health citizenship development in Indonesia shows the underlying cause of inequity. Consequently, the minimal presence of public participation raises inequity. Inequity leads to healthcare access that provides pointless improvement. Narratives in health citizenship fulfillment call for public participation space in administering access to healthcare.