Background: Pulmonary tuberculosis (TB) is a major health problem worldwide. Detection of the most infectious cases of tuberculosis -sputum smear-positive pulmonary cases -by passive case finding is an essential component of TB control. The district of Sidoarjo in East Java reported a low case detection rate (CDR) of 14% in 2003. We evaluated the diagnostic process for TB in primary health care centers (PHC) in Sidoarjo district to assess whether problems in identification of TB suspects or in diagnosing TB patients can explain the low CDR.

The unique and enormous culture of concealed pregnancy or “Kemel” in Gayo ethnic, low coverage of antenatal care for pregnant women in health workers and high numbers of neonatal mortality, and infection in infants with low birth weight were social determinants of health issues existing in Aceh. These were urgently observed to fi gure out solution in reducing low examination of antenatal care by pregnant women in Gayo. Increasing the interest of researchers to conduct this research. This descriptive study was based on socio-cultural phenomena that aff ect a “Kemel” pregnant woman. The results showed ‘Kemel’ vulnerability perceptions were indicated by keeping the pregnancy as a secret in case of being used by those who do not like their pregnancies. ’Kemel’ perceived severity aff ects the safety of women pregnancies. Pregnant women may get some threats such as: malnutrition, lack of calorie energy, anemia, newborn with low birth weight, premature newborn, and infectious diseases. “Kemel” cues to action, pregnant women check theirpregnancies after 5 months pregnancy to a traditional birth attendant. Soon after TBA claimed their pregnancies, they refer to midwives. This the reason why examination of antenatal care were very low. Family role in the social structure, the culture of the Gayo, parents-in-law and parents of pregnant women, have a great contribution in making decisions such as pregnancy, childbirth and postpartum cares. A marriage tradition of the Gayo, was when a woman pawned into a part of male family, she must follow its habits and traditions. Thus, intervention by forming an agent of change are highly recommended by involving parent in law.  Abstrak Tingginya budaya merahasiakan kehamilan/”Kemel”pada etnis Gayo, rendahnya cakupan antenatal care ibu hamil pada petugas kesehatan dan tingginya kematian neonatal, infeksi pada bayi dengan Berat badan lahir rendah, menambah ketertarikan peneliti untuk melakukan penelitian ini. Metode penelitian adalah kualitatif, peneliti menganalisis berdasarkan fenomena sosial budaya yang dapat mempengaruhi seorang ibu hamil “Kemel”. Hasil menunjukkan Persepsi kerentanan ‘Kemel’, dengan merahasiakan kehamilannya, takut diguna-guna orang lain yang tidak suka kehamilannya. Perceived severity Kemel mempengaruhi keselamatan kehamilannya, ancaman pada ibu hamil: gizi kurang, Kurang Energi Kalori, anemia dan bayi dengan Berat Badan Lahir Rendah/BBLR, bayi lahir prematur dan serangan penyakit infeksi pada ibu hamil. Cues To Action Kemel, periksa kehamilan saat kehamilan berusia 5 bulan pada bidan kampong, setelah bidan kampong menyatakan hamil ia baru pergi ke bidan, hal inilah yang menjadi salah satu penyebab rendahnya pemeriksaanantenatal care pada ibu hamil. Peran keluarga dalam struktur sosial, budaya masyarakat Gayo, Mertua dan orang tua bumil sangat besar dalam menentukan keputusan segala sesuatu yang berkaitan dengan keputusan dalam perawatan kehamilan, persalinan dan perawatan nifas. Suatu tradisi perkawinan masyarakat Gayo, perempuan sudah tergadai menjadi bagian besar keluarga pihak laki laki, ia mengikuti kebiasaan dan tradisi keluarga laki laki, sehingga bila membentuk agen perubahan perlu mempertimbangkan peran mertua.

Background: For last decades, the mortality rate of hajj pilgrims from Indonesia was between 2.1 and 3.2 per 1000 hajj pilgrims. At the same time, morbidity affected 87% of the elderly (>65 years old), of which 83% faced high risk of health problems. This is a complex problem affecting hajj health care in Indonesia. The study was aimed to understand what extent of the hajj implementation on health care in Indonesia. Methods: This review was conducted by abstracting of three studies in Indonesian hajj health care. Two of the studies were based on cross-sectional reviews, while one was a case-control study. The majority of the studies performed laboratory tests to evaluate the disease conditions among hajj pilgrims through secondary data. Results: First study presented that hajj Posbindu (integrated post-coaching) was not functional in managing the health problems of the pilgrims. It shows that the stroke prevalence is 10.9 per 1000 people, Diabetes Mellitus (DM) 10.9% of the people, and coronary heart disease 1.5%. The second study expressed that, according to health isthitaah (policy implementation), there were 20% hajj pilgrims who delayed their trip because of health issues. Most of them had chronic kidney disease, dementia, or lung tuberculosis. The policy implementation of health isthitaah was not smooth; there was little collaboration between the Ministry of Health and Ministry of Religious Affairs, and the population was not sufficiently educated in the area, resulting in hajj pilgrims with poor knowledge, attitude, and practice in health isthitaah. This notion was enforced in the third study. Conclusion: The coaching according to health isthitaah should be encouraged alongside collaboration between the Ministry of Health and Ministry of Religious Affairs. Socialization in public health has to increase according to health isthitaah, which can be done by district health centers.

Number of hypertension cases in Cicurug, West Java, Health Center of Sukabumi District is 40% reported risk factors which are smoking habit, and clean healthy living behavior (PHBS) amounted 70%. Non communicable diseases control effort which is done by agent of change (AoC) through community empowerment. These activities could be held in collaboration with Corporate Social Responsibility (CSR). Operational research to analyze the implementation of CSR in community empowerment. Community empowerment is conducted in Nyangkowek Village (As Intervention Village) and Purwasari Village (As Control Village), Cicurug District, Sukabumi Regency. It has been selected 20 AoC from each village. Data were collected by in-depth interviews and observations. The AoC triggered has improved the knowledge, attitude and behavior of AoC in the control of NCD, they became promoters in controlling NCD risk factors for themselves, families, and community. Community empowerment through the selection of candidates and triggering AoC is the key to the successful implementation of P2TMBM. AoC as the spearhead in changing the risky behavior of NCD in the community that is coronary heart, hypertension, and obesity. CSR program in Cicurug District is able to develop community empowerment in controlling NCD risk factors.  Health Office and Puskesmas are expected to be facilitators in forming AoC. Assistance by CSR is needed in the effort to control smoking behavior, diet and physical activity.   Abstrak Jumlah kasus hipertensi di Puskesmas Cicurug Kabupaten Sukabumi sebesar 40%, dengan faktor risiko yang terlaporkan kebiasaan merokok, perilaku hidup bersih dan sehat (PHBS) sebesar 70%. Pengendalian penyakit tidak menular dilakukan melalui pemberdayaan masyarakat dengan pemicuan agen perubahan (agent of change). Tujuan penelitian untuk menerapkan program pemberdayaan masyarakat dalam pengendalian penyakit tidak menular berbasis masyarakat (P2PTM) melalui agen perubahan.Kegiatan tersebut terselenggara atas dukungan  Corporate Social Responsibility (CSR) yang ada di Kabupaten Sukabumi. Metode penelitian adalah Riset operasional yang dilaksanakan dengan program CSR dalam pemberdayaan masyarakat. Tempat kegiatan di Desa Nyangkowek (intervensi pemicuan P2TMBM,) dan Desa Purwasari (kontrol).Penelitian ini dilakukan di bulan Februari- Oktober2015. Terpilih 20 agen perubahan dari masing-masing desa. Cara pengumpulan data dengan wawancara mendalam dan observasi. Hasil penelitian menunjukkan bahwa Pemicuan pada AOC telah berhasil meningkatkan pengetahuan, sikap dan perilaku Agent of Change dalam pengendalian penyakit tidak menular  serta mereka menjadi promotor dalam pengendalian faktor risiko PTM baik untuk dirinya sendiri, keluarga maupun masyarakat sekitarnya. Pemberdayaaan masyarakat melalui pemicuan, pemilihan calon ‘Agen Perubahan’ serta dukungan CSR merupakan kunci keberhasilan program. Program CSR di Kecamatan Cicurug mampu mengembangkan pemberdayaan masyarakat dalam pengendalian faktor risiko PTM. Untuk keberlanjutan program pemberdaayan masyarakat dengan model pemicuan P2TMBM, diharapkan dinas kesehatan dan puskesmas dapat menjadi fasilitator dalam pembentukan ‘Agen Perubahan’ berikutnya, dalam upaya pengendalian perilaku merokok, pola makan dan aktifitas fisik dengan  pendampingan oleh CSR.

Previous studies have suggested that a toddler stunting is closely related to maternal characteristics. Working mothers, as a group, are vulnerable to having a stunted toddler. The present research aimed to analyze factors related to stunting incidence in toddlers with working mothers in Indonesia. The study sampled 44,071 toddlers with working mothers. The final stage used a multinomial logistic regression test. The study found that working mothers living in rural areas have a higher probability of having stunted or severely stunted toddlers. Maternal age partially affects the incidence of stunted toddlers in Indonesia. Mothers in the ≤19 age group are 1.461 (95% CI 1.140–1.872) times more likely than those in the ≥45 group to have a severely stunted toddler. Those who were never married were 1.433 (95% CI 1.006–2.043) times more likely than those who were divorced/widowed to have a severely stunted toddler. A married mother was 0.734 (95% CI 0.617–0.872) times less likely to have a severely stunted toddler than a divorced/widowed mother. Better education is protective against working mothers having stunted toddlers. Moreover, the present study found that the toddler’s age determined the incidence of stunted toddlers. This study concluded that there are five variables related to stunting incidence in toddlers with working mothers in Indonesia: residence, age, marital status, education, and toddler age.