1.  Peer Reviewed Title: Do women increase their use of reproductive health care when it becomes more available? Evidence from Indonesia. Author: Frankenberg E; Buttenheim A; Sikoki B; Suriastini W Source: Studies in Family Planning. 2009 Mar;40(1):27-38. Abstract: Data from the Indonesia Family Life Survey are used to investigate the impact of a major expansion in access to midwifery services on women's use of antenatal care and delivery assistance. Between 1991 and 1998, Indonesia trained some 50,000 midwives, placing them in poor communities that were distant from health-care centers. We analyze information from pregnancy histories to relate changes in the choices that individual women make across pregnancies to the arrival of a trained midwife in the village. We show that regardless of a woman's educational level, the placement of village midwives in communities is associated with significant increases in women's receipt of iron tablets and in their choices about care during delivery-changes that reflect their moving away from reliance on traditional birth attendants. For women with relatively low levels of education, the presence of village midwives has the additional benefit of increasing use of antenatal care during the first trimester of pregnancy. The results of the study suggest that bringing services closer to women can change their patterns of use. Language: English Keywords: INDONESIA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | MIDWIVES AND MIDWIFERY | COMMUNITY WORKERS | UTILIZATION OF HEALTH CARE | CHILDBIRTH | WOMEN'S HEALTH | PROGRAM ACCESSIBILITY | DECISION MAKING | COMMUNITY HEALTH SERVICES | ANTENATAL CARE | TRADITIONAL BIRTH ATTENDANTS | Developing Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Health Services | Pregnancy Outcomes | Pregnancy | Reproduction | Program Evaluation | Programs | Organization and Administration | Behavior | Primary Health Care | Maternal Health Services | Maternal-Child Health Services Document Number: 341081 |
| 2. Peer Reviewed Title: Do women increase their use of reproductive health care when it becomes more available? Evidence from Indonesia. Author: Frankenberg E; Buttenheim A; Sikoki B; Suriastini W Source: Studies In Family Planning. 2009 Mar;40(1):27-38. Abstract: Data from the Indonesia Family Life Survey are used to investigate the impact of a major expansion in access to midwifery services on women's use of antenatal care and delivery assistance. Between 1991 and 1998, Indonesia trained some 50,000 midwives, placing them in poor communities that were distant from health-care centers. We analyze information from pregnancy histories to relate changes in the choices that individual women make across pregnancies to the arrival of a trained midwife in the village. We show that regardless of a woman's educational level, the placement of village midwives in communities is associated with significant increases in women's receipt of iron tablets and in their choices about care during delivery--changes that reflect their moving away from reliance on traditional birth attendants. For women with relatively low levels of education, the presence of village midwives has the additional benefit of increasing use of antenatal care during the first trimester of pregnancy. The results of the study suggest that bringing services closer to women can change their patterns of use. Language: English Keywords: INDONESIA | RESEARCH REPORT | FAMILY LIFE SURVEYS | WOMEN | MIDWIVES AND MIDWIFERY | ANTENATAL CARE | REPRODUCTIVE HEALTH | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | PROGRAM ACCESSIBILITY | Developing Countries | Asia, Southeastern | Asia | Family Research | Family and Household | Sociocultural Factors | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Program Evaluation | Programs | Organization and Administration Document Number: 341338 |
| 3. Peer Reviewed Title: Change in contraceptive methods following the Yogyakarta earthquake and its association with the prevalence of unplanned pregnancy. Author: Hapsari ED; Widyawati; Nisman WA; Lusmilasari L; Siswishanto R; Matsuo H Source: Contraception. 2009 Apr;79(4):316-22. Abstract: BACKGROUND: This study was conducted to examine access to contraception and change in contraceptive methods before and after the disaster in Bantul area, and to evaluate the prevalence of unplanned pregnancy. STUDY DESIGN: In total, 450 married women participated. Questionnaires, which included participants' background, contraceptive methods, difficulties in accessing contraceptive method, and unplanned pregnancy, were completed. RESULTS: Within 1 year of the disaster, the percentage of participants who used injections and implants tended to decrease, while the percentage of participants who used pills tended to increase. Use of coitus interruptus significantly increased after the disaster. The prevalence of unplanned pregnancy was significantly higher in a group of participants who had difficulty accessing contraceptive methods compared to a group that did not. CONCLUSIONS: Health personnel should not only actively deliver contraceptive methods in a disaster situation but also educate couples to prevent unplanned pregnancy. Language: English Keywords: INDONESIA | RESEARCH REPORT | PREVALENCE | PREGNANCY, UNPLANNED | CONTRACEPTION FAILURE | NATURAL DISASTERS | CHANGES | Developing Countries | Asia, Southeastern | Asia | Measurement | Research Methodology | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Usage | Contraception | Family Planning | Environment | Social Change | Sociocultural Factors Document Number: 330555 |
| 4. Title: Confidential inquiries into maternal deaths: Modifications and adaptations in Ghana and Indonesia. Author: Hussein J; D'Ambruoso L; Armar-Klemesu M; Achadi E; Arhinful D; Izati Y; Ansong-Tornui J Source: International Journal of Gynaecology and Obstetrics. 2009 May 8; Abstract: OBJECTIVE: Factors contributing to the limited use of confidential inquiries into maternal deaths include the negative focus and demotivating effect of such inquiries, perceptions of unavailability of sufficient documentation of events, and lack of time and resources. To ascertain whether these problems can be overcome, variations to confidential inquiries into maternal deaths were introduced in Ghana and Indonesia. METHODS: Clinical review panels were set up as part of the usual process of confidential inquiries, and modifications to the confidential inquiries were introduced. In Ghana, the traditional confidential inquiry process focusing on health facility care was modified to introduce the assessment of positive factors. In addition to the assessment of positive factors, adaptations in Indonesia consisted of including cases of obstetric complications, as well as deaths, and the use of interview testimonials as data sources. Information about resource and time needs for conducting confidential inquiries was collected. RESULTS: The introduction of positive aspects to the process provided a balanced and more motivating setting for the inquiry. The data obtained from case notes in district hospitals and interview testimonials provided sufficient information to assess why maternal deaths and severe complications occurred. The costs of conducting the inquiries ranged from US $4000 to US $11000 (per study), and the estimated time required for a panel member to review each case was more than 3 hours. CONCLUSION: This study introduced practical ways to encourage the implementation of maternal death reviews, inquiries, and audits that are context specific and, therefore, acceptable to local practitioners. Language: English Keywords: GHANA | INDONESIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | CONFIDENTIAL INFORMATION | MATERNAL MORTALITY | PERCEPTION | MOTIVATION | TIME FACTORS | PREGNANCY COMPLICATIONS | ECONOMIC FACTORS | AUTOPSY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Asia, Southeastern | Asia | Research Methodology | Economic Development | Population Characteristics | Demographic Factors | Population | Ethics | Sociocultural Factors | Mortality | Population Dynamics | Psychological Factors | Behavior | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341454 |
| 5. Peer Reviewed Title: Contraceptive method switch and discontinuation among women migrants in Indonesia. Author: Liew HP Source: Population, Space and Place. 2009;15:267-276. Abstract: Using the 2000 wave of the Indonesian Family Life Survey (IFLS3), this study attempts to examine the relationship between migration and contraceptive method switch and discontinuation in Indonesia. The major conclusion from the multinomial logistic regression is that repeated migrants are more likely than one-time migrants to discontinue use of the same method. However, the differentials in the likelihood of discontinuing use of the same method among women migrants is eliminated after controlling for the quality of health centre/family planning programme and the degree of infrastructure development in a community. The results of this study will contribute important foundational knowledge about the extent of contraceptive use dynamics by women of different migration experiences in Indonesia. This knowledge will provide guidance to policymakers to employ effective means to incorporate migration and issues that are sensitive to women migrants in their family planning and reproductive health programmes. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | WOMEN | MIGRANTS | CONTRACEPTIVE METHOD SWITCHING | FAMILY PLANNING PROGRAMS | Developing Countries | Asia, Southeastern | Asia | Demographic Factors | Population | Migration | Population Dynamics | Contraceptive Usage | Contraception | Family Planning Document Number: 328048 |
| 6. Title: Mothers' community participation and child health. Author: Nobles J; Frankenberg E Source: Journal of Health and Social Behavior. 2009 Mar;50(1):16-30. Abstract: We use rich data from the Indonesia Family Life Survey to assess the relationship between mothers' access to social capital via participation in community activities and their children's health. We exploit the advantages of longitudinal data and community fixed effects to mitigate some of the concerns about spuriousness and reverse causality that predominate in this literature. We find that children from families with relatively low levels of human and financial capital fare better with respect to health status when their mothers are more active participants in community organizations. In fact, the association between maternal participation and child health is strong and positive only for children from relatively disadvantaged backgrounds, as measured by their mothers' educational and household economic resources. The results suggest that in poorer settings community involvement may benefit disadvantaged families, possibly by providing resources and information that would otherwise be inaccessible. Language: English Keywords: INDONESIA | RESEARCH REPORT | FAMILY LIFE SURVEYS | MOTHERS | COMMUNITY PARTICIPATION | HUMAN CAPITAL | CHILD HEALTH | INEQUALITIES | Developing Countries | Asia, Southeastern | Asia | Family Research | Family and Household | Sociocultural Factors | Parents | Family Relationships | Family Characteristics | Organization and Administration | Human Resources | Economic Factors | Health | Socioeconomic Factors Document Number: 341532 |
| 7. Peer Reviewed Title: Current HIV type 1 molecular epidemiology profile and identification of unique recombinant forms in Jakarta, Indonesia. Author: Sahbandar IN; Takahashi K; Djoerban Z; Firmansyah I; Naganawa S; Motomura K; Sato H; Kitamura K; Pohan HT; Sato S Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):637-46. Abstract: HIV infection is a major problem in Indonesia. The number of people living with HIV has been increasing from year to year, especially among injecting drug users (IDUs). Since there were only limited data about molecular epidemiology profiles of HIV/AIDS in Indonesia, a cross-sectional study involving 208 HIV-1-seropositive individuals was conducted in 2007 in Jakarta. The majority of participants were 16-30 years of age (64.9%) and 74.5% were male. The most frequent risk factor was injecting drug use (IDU) (45.7%) followed by heterosexual transmission (34.1%). Phylogenetic analysis of gag (p17 and p6) and env C2V3 regions showed 200 (96.2%) of 208 DNA samples were CRF01_AE and only 3 (1.4%) were subtype B. Five samples (2.4%) indicated discordant subtypes between the three aforementioned regions: three of them showed unique CRF01_AE/B recombination patterns in 2.3-kbp nucleotide sequences (from p17 to part of RT), including one sample showing similarity to CRF33_01B, reported previously in Malaysia. This study shows the current predominant subtype is CRF01_AE in every risk group, with a decreasing number of pure subtype B, and the first identification of CRF01_AE/B recombinant forms among HIV-1-seropositive Indonesians. Language: English Keywords: INDONESIA | RESEARCH REPORT | EPIDEMIOLOGY | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | HETEROSEXUALS | HIV INFECTIONS | HIV | LABORATORY PROCEDURES | Developing Countries | Asia, Southeastern | Asia | Public Health | Health | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Sex Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 342881 |
| 8. Title: Purchase of drinking water is associated with increased child morbidity and mortality among urban slum-dwelling families in Indonesia. Author: Semba RD; de Pee S; Kraemer K; Sun K; Thorne-Lyman A; Moench-Pfanner R; Sari M; Akhter N; Bloem MW Source: International Journal of Hygiene and Environmental Health. 2009 Jul;212(4):387-97. Abstract: In developing countries, poor families in urban slums often do not receive municipal services including water. The objectives of our study were to characterize families who purchased drinking water and to examine the relation between purchasing drinking water and child morbidity and mortality in urban slums of Indonesia, using data collected between 1999 and 2003. Of 143,126 families, 46.8% purchased inexpensive drinking water from street vendors, 47.4% did not purchase water, i.e., had running or spring/well water within household, and 5.8% purchased more expensive water in the previous 7 days. Families that purchased inexpensive drinking water had less educated parents, a more crowded household, a father who smoked, and lower socioeconomic level compared with the other families. Among children of families that purchased inexpensive drinking water, did not purchase drinking water, or purchased more expensive water, the prevalence was, respectively, for diarrhea in last 7 days (11.2%, 8.1%, 7.7%), underweight (28.9%, 24.1%, 24.1%), stunting (35.6%, 30.5%, 30.5%), wasting (12.0%, 10.5%, 10.9%), family history of infant mortality (8.0%, 5.6%, 5.1%), and of under-five child mortality (10.4%, 7.1%, 6.4%) (all P<0.0001). Use of inexpensive drinking water was associated with under-five child mortality (Odds Ratio [O.R.] 1.32, 95% Confidence Interval [C.I.] 1.20-1.45, P<0.0001) and diarrhea (O.R. 1.43, 95% C.I. 1.29-1.60, P<0.0001) in multivariate logistic regression models, adjusting for potential confounders. Purchase of inexpensive drinking water was common and associated with greater child malnutrition, diarrhea, and infant and under-five child mortality in the family. Greater efforts must be made to ensure access to safe drinking water, a basic human right and target of the Millennium Development Goals, in urban slums. Language: English Keywords: INDONESIA | SLUMS | RESEARCH REPORT | SAMPLING STUDIES | CHILDREN | HOUSEHOLDS | WATER SUPPLY | EXPENDITURES | CHILD MORTALITY | INFANT MORTALITY | DIARRHEA | MALNUTRITION | PREVALENCE | Developing Countries | Asia, Southeastern | Asia | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Family and Household | Sociocultural Factors | Natural Resources | Environment | Financial Activities | Economic Factors | Mortality | Population Dynamics | Diseases | Nutrition Disorders | Measurement Document Number: 342114 |
| 9. Peer Reviewed Title: Adolescent reproductive health in Indonesia: contested values and policy inaction. Author: Utomo ID; McDonald P Source: Studies in Family Planning. 2009 Jun;40(2):133-146. Abstract: This study examines the changing social and political context of adolescent sexual and reproductive health policy in Indonesia. We describe how, in 2001, Indonesia was on the brink of implementing an adolescent reproductive health policy that was consistent with international agreements to which the Indonesian government was a party. Although the health of young Indonesians was known to be at risk, the opportunity for reform passed quickly with the emergence of a new competing force, Middle Eastern fundamentalist Islam. Faced with the risk of regional separatism and competing politico-religious influences, the Indonesian government retreated to the safety of inaction in this area of policy. In the absence of a supportive and committed political environment that reinforces policy specifically targeted to young people's reproductive health, extremist approaches that involve considerable health risk prevailed. The sexual and reproductive values and behaviors that are emerging among single young people in contemporary Indonesia are conditioned by a political context that allows the conflicting forces of traditional Indonesian values, Westernization, and the strong emerging force of fundamentalist Islam to compete for the allegiance of young people. Language: English Keywords: INDONESIA | CRITIQUE | ADOLESCENTS | REPRODUCTIVE HEALTH | HEALTH POLICY | ISLAM | POLITICAL FACTORS | SOCIAL CHANGE | LEGISLATION | SEXUALITY | SEX EDUCATION | MASS MEDIA | VALUE ORIENTATION | Developing Countries | Asia, Southeastern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Policy | Sociocultural Factors | Religion | Personality | Psychological Factors | Behavior | Education | Communication Document Number: 341897 |
10.  Title: Indonesia Young Adult Reproductive Health Survey, 2007. Author: Indonesia. Badan Pusat Statistik [BPS]; Indonesia. National Family Planning Coordinating Board [BKKBN]; Indonesia. Ministry of Health; Macro International. MEASURE DHS Source: Calverton, Maryland, BPS and Macro International, 2008 Dec. xxiii, 199 p. Abstract: The IYARHS focuses on young women and men, ages 15-24, and covers topics including education, knowledge and attitudes about reproductive health and family planning, knowledge of HIV/AIDS and sexually transmitted infections, attitudes about sexual activity and marriage, smoking, and use of alcohol and drugs. Language: English Keywords: INDONESIA | RESEARCH REPORT | HEALTH SURVEYS | YOUTH | PERSONS LIVING WITH HIV/AIDS | REPRODUCTIVE HEALTH | SOCIOECONOMIC FACTORS | EDUCATIONAL STATUS | INFORMATION SOURCES | CONTRACEPTIVE USAGE | DRUG USE AND ABUSE | ALCOHOL USE AND ABUSE | HIV | AIDS | KNOWLEDGE | ATTITUDES | Developing Countries | Asia, Southeastern | Asia | Health | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Economic Factors | Socioeconomic Status | Information | Contraception | Family Planning | Behavior | Sociocultural Factors | Psychological Factors Document Number: 339980 |
| 11. Title: Indonesia Young Adult Reproductive Health Survey 2007. Preliminary report. Author: Indonesia. Statistics Indonesia; Indonesia. National Family Planning Coordinating Board [BKKBN]; Indonesia. Ministry of Health; Macro International. MEASURE DHS Source: Jakarta, Indonesia, Statistics Indonesia, 2008 Jul. 25 p. Abstract: The primary objective of the 2007 Indonesia Young Adult Reproductive Health Survey (IYARHS) is to provide policymakers and program managers with national-level and provincial-level data on knowledge, attitudes, and practices of young adults regarding human reproduction, relationships, HIV/AIDS, and sexuality. Specifically, the 2007 IYARHS was designed to: measure the level of knowledge of young adults about reproductive health issues, examine the attitudes of young adults on various issues in reproductive health, measure the level of tobacco use, alcohol consumption, and drug use, measure the level of sexual activity among young adults, explore young adults' awareness of HIV / AIDS and other sexually transmitted infections. The survey findings are expected to provide updated indicators on adolescent reproductive health covered in the 2002-2003 IYARHS. Language: English Keywords: INDONESIA | SUMMARY REPORT | SURVEYS | MEASUREMENT | YOUTH | REPRODUCTIVE HEALTH | KNOWLEDGE | SEX BEHAVIOR | ATTITUDES | ALCOHOL USE AND ABUSE | DRUG USE AND ABUSE | SEXUALLY TRANSMITTED DISEASES | AIDS | EVALUATION | Developing Countries | Asia, Southeastern | Asia | Sampling Studies | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Sociocultural Factors | Behavior | Psychological Factors | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases Document Number: 331579 |
| 12. Peer Reviewed Title: Use of evidence-based practices in pregnancy and childbirth: South East Asia Optimising Reproductive and Child Health in Developing Countries project. Author: South East Asia Optimising Reproductive and Child Health in Developing Countries [SEA-ORCHID]. Study Group Source: PLoS One. 2008 Jul;3(7):[7] p. Abstract: The burden of mortality and morbidity related to pregnancy and childbirth remains concentrated in developing countries. SEA-ORCHID (South East Asia Optimising Reproductive and Child Health In Developing countries) is evaluating whether a multifaceted intervention to strengthen capacity for research synthesis, evidence-based care and knowledge implementation improves adoption of best clinical practice recommendations leading to better health for mothers and babies. In this study we assessed current practices in perinatal health care in four South East Asian countries and determined whether they were aligned with best practice recommendations. We completed an audit of 9550 medical records of women and their 9665 infants at nine hospitals; two in each of Indonesia, Malaysia and The Philippines, and three in Thailand between January- December 2005. We compared actual clinical practices with best practice recommendations selected from the Cochrane Library and the World Health Organization Reproductive Health Library. Evidence-based components of the active management of the third stage of labour and appropriately treating eclampsia with magnesium sulphate were universally practiced in all hospitals. Appropriate antibiotic prophylaxis for caesarean section, a beneficial form of care, was practiced in less than 5% of cases in most hospitals. Use of the unnecessary practices of enema in labour ranged from 1% to 61% and rates of episiotomy for vaginal birth ranged from 31% to 95%. Other appropriate practices were commonly performed to varying degrees between countries and also between hospitals within the same country. Whilst some perinatal health care practices audited were consistent with best available evidence, several were not. We conclude that recording of clinical practices should be an essential step to improve quality of care. Based on these findings, the SEA-ORCHID project team has been developing and implementing interventions aimed at increasing compliance with evidence-based clinical practice recommendations to improve perinatal practice in South East Asia. (author's) Language: English Keywords: INDONESIA | MALAYSIA | PHILIPPINES | THAILAND | RESEARCH REPORT | EVALUATION REPORT | MATERNAL-CHILD HEALTH SERVICES | CHILDBIRTH | INTERVENTIONS | CAPACITY BUILDING | QUALITY OF HEALTH CARE | DELIVERY OF HEALTH CARE | BEST PRACTICES | Developing Countries | Asia, Southeastern | Asia | Evaluation | Primary Health Care | Health Services | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Programs | Organization and Administration | Program Sustainability | Health Services Evaluation | Program Evaluation Document Number: 327570 |
| 13. Peer Reviewed Title: Obstetric near miss and deaths in public and private hospitals in Indonesia. Author: Adisasmita A; Deviany PE; Nandiaty F; Stanton C; Ronsmans C Source: BMC Pregnancy and Childbirth. 2008;8:10. Abstract: Falling numbers of maternal deaths have stimulated an interest in investigating cases of life threatening obstetric morbidity or near miss. The purpose of this study was to document the frequency and causes of near miss and maternal deaths in four hospitals in West Java, Indonesia. Cross sectional study in four hospitals in two districts in Banten province, Indonesia. We reviewed registers and case notes to identify the numbers and causes of near miss and death between November 2003 and October 2004. Near miss cases were defined based on organ dysfunction, clinical and management criteria. Near miss were categorized by whether or not the woman was at a critical state at admission by reviewing the final signs at admission. The prevalence of near miss was much greater in public than in private hospitals (17.3% versus 4.2%, p=0.000). Hemorrhage and hypertensive diseases were the most common diagnoses associated with near miss, and vascular dysfunction was the most common criterion of organ dysfunction. The occurrence of maternal deaths was 1.6%, with non-obstetric complications as the leading cause. The majority (70.7%) of near miss in public hospitals were in a critical state at admission but this proportion was much lower in private hospitals (31.9%). This is the first study to document near miss in public and private hospitals in Indonesia. Close to a fifth of admissions in public hospitals were associated with near miss; and the critical state in which the women arrived suggest important delays in reaching the hospitals. Even though the private sector takes an increasingly larger share of facility-based births in Indonesia, managing obstetric emergencies remains the domain of the public sector. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | MATERNAL MORTALITY | MORBIDITY | PREVALENCE | HOSPITALS | PUBLIC SECTOR | PRIVATE SECTOR | QUALITY OF HEALTH CARE | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Diseases | Measurement | Health Facilities | Delivery of Health Care | Health | Macroeconomic Factors | Economic Factors | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 325052 |
| 14. Peer Reviewed Title: Can we predict neuropathy risk before stavudine prescription in a resource-limited setting? Author: Affandi JS; Price P; Imran D; Yunihastuti E; Djauzi S; Cherry CL Source: AIDS Research and Human Retroviruses. 2008 Oct;24(10):1281-4. Abstract: A toxic sensory neuropathy associated with exposure to inexpensive nucleoside analogue reverse transcriptase inhibitors (NRTIs) [particularly stavudine (d4T)] causes dilemmas in the management of patients with HIV, especially in resource-poor settings. Here patients (n = 96) attending Pokdisus AIDS Clinic at the Cipto Mangunkusumo Hospital, Jakarta who had been treated with d4T were screened for symptomatic neuropathy. Clinical, demographic, and genetic factors were considered as possible neuropathy risk factors. DNA from saliva was used to examine alleles of TNFA-308, BAT1 (intron 10), TNFA-1031, IL1A+4845, and IL12B (3' UTR). The prevalence of neuropathy (symptoms and signs) was 34%. On multivariate analysis, neuropathy following d4T exposure was associated with increasing age, increasing height, and TNFA-1031*2 (model p = 0.0009). Isoniazid exposure (present in 56% of patients) was not associated with neuropathy in this cohort, where all patients had received pyridoxine coadministration. These data suggest that a simple algorithm based on patient age, height, and TNF genotype could be used to predict the individual's risk of symptomatic neuropathy prior to prescription of d4T. Language: English Keywords: INDONESIA | RESEARCH REPORT | MULTIVARIATE ANALYSIS | CLIENTS | LOW INCOME POPULATION | SCREENING | EXPOSURE | TOXICITY | GENETICS | RISK ASSESSMENT | DRUGS | SIGNS AND SYMPTOMS | Asia, Southeastern | Asia | Developing Countries | Data Analysis | Research Methodology | Program Activities | Programs | Organization and Administration | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Factors | Biology | Physiology | Evaluation | Treatment | Diseases Document Number: 329409 |
| 15. Peer Reviewed Title: Malnutrition and morbidity among children not reached by the national vitamin A capsule programme in urban slum areas of Indonesia. Author: Berger SG; de Pee S; Bloem MW; Halati S; Semba RD Source: Public Health. 2008 Apr;122(4):371-378. Abstract: The objective was to determine whether vitamin A capsule programmes fail to reach children who are at higher risk of malnutrition and morbidity. Although it has been suggested that there are health disparities between children who are reached or not reached by these programmes, little quantitative work has been undertaken to characterize this relationship. As part of a national surveillance system, nutritional status and other factors were compared in 138,956 children, aged 12-59 months, who had and had not received vitamin A supplementation in urban slum areas in Indonesia. In total, 63.1% of children had received a vitamin A capsule within the previous 6 months. Among children who had and had not received vitamin A supplementation, respectively, the proportion with weight-for-age and height-forage Z scores less than -3 were 7.8% vs 8.6% (P less than 0.0001) and 9.4% vs 10.7% (P less than 0.0001), and with a history of diarrhoea in the previous week was 8.1% vs 10.7% (P less than 0.0001). In families where a child had or had not received vitamin A supplementation, the proportion with a history of infant death less than 12 months was 5.2% vs 7.2% (P less than 0.0001) and child death less than 5 years was 6.7% vs 9.2%, respectively (P less than 0.0001). Children who had not received vitamin A supplementation were also significantly more likely to be anaemic and have diarrhoea or fever on the survey day compared with children who had received supplementation. In the urban slums of Indonesia, children who do not receive vitamin A supplementation tend to be slightly more malnourished and ill, and are more likely to come from families with higher child mortality than children who receive vitamin A. Higher rates of child mortality in non-participating households suggest that reaching preschoolers could yield a disproportionate survival benefit. Importantly, children who are not reached by the vitamin A programme are also unlikely to be reached by vaccination and other services, emphasizing the need to identify and extend efforts to reach non-participants. (author's) Language: English Keywords: INDONESIA | SLUMS | RESEARCH REPORT | NUTRITION SURVEYS | CHILDREN | MALNUTRITION | MORBIDITY | VITAMIN A | ANEMIA | DIARRHEA | IMMUNIZATION | FOOD SUPPLEMENTATION | Developing Countries | Asia, Southeastern | Asia | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Nutrition | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Nutrition Disorders | Diseases | Vitamins and Minerals | Physiology | Biology | Primary Health Care | Health Services | Delivery of Health Care | Nutrition Programs Document Number: 325094 |
| 16. Title: Do coresidency and financial transfers from the children reduce the need for elderly parents to works in developing countries? Author: Cameron LA; Cobb-Clark D Source: Journal of Population Economics. 2008 Oct;21(4):1007-1033. Abstract: Do elderly parents use coresidence with or financial transfers from children to reduce their own labour supply in old age? This paper is one of only a few studies that seeks to formally model elderly labour supply in the context of a developing country while taking into account coresidency with and financial transfers from children. We find little evidence that support from children-either through transfers or coresidency-substitutes for elderly parents' need to work. Thus, as in developed countries, there is a role for public policy to enhance the welfare of the elderly population. (author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | INDONESIA | RESEARCH REPORT | ESTIMATION TECHNIQUES | MATHEMATICAL MODEL | OLDER ADULTS | CHILDREN | LIVING ARRANGEMENTS | INTERGENERATIONAL TRANSFERS | DEMOGRAPHIC AGING | LABOR FORCE | Asia, Southeastern | Asia | Research Methodology | Theoretical Models | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Youth | Residence Characteristics | Population Distribution | Geographic Factors | Microeconomic Factors | Economic Factors | Population Dynamics | Human Resources Document Number: 327975 |
| 17. Peer Reviewed Title: Assessing debt-to-health swaps: a case study on the Global Fund Debt2Health Conversion Scheme. Author: Cassimon D; Renard R; Verbeke K Source: Tropical Medicine and International Health. 2008 Sep;13(9):1188-95. Abstract: The Debt2Health Conversion Scheme of the Global Fund to Fight AIDS, Tuberculosis and Malaria is used to reassess a range of recent initiatives that propose debt relief in exchange for spending in the health sector. The experience with debt swaps in the mid 1990s was far from positive, and recent improved insight in the economics of debt relief suggests extreme caution. We argue that the recent spade of debt swap proposals, even if targeting countries and debt titles that fall outside current major international debt relief mechanisms, share most of the design faults of previous initiatives. Proposals such as Debt2Health do not constitute efficient vehicles to increase net transfers to poor countries, to reduce the economic disadvantages of indebtedness, or to strengthen public health systems of partner countries. For debt relief to constitute a valuable mechanism to provide aid, it should be designed as a large-scale and comprehensive operation, with spending earmarked to broad country-established priorities, and reinforce rather than undermine national implementation systems. Language: English Keywords: INDONESIA | KENYA | PAKISTAN | PERU | RESEARCH REPORT | HUMANITARIAN ASSISTANCE | DEVELOPMENT PLANNING | HIV PREVENTION | AIDS PREVENTION | TUBERCULOSIS | MALARIA | FUNDS | INTERNATIONAL AGENCIES | Asia, Southeastern | Asia | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Asia, Southern | South America, Western | South America | Latin America | Americas | Financial Activities | Economic Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Infections | Parasitic Diseases | Organizations | Political Factors | Sociocultural Factors Document Number: 328615 |
| 18. Title: Public funding for community-based skilled delivery care in Indonesia: to what extent are the poor benefiting? Author: Ensor T; Nadjib M; Quayyum Z; Megraini A Source: European Journal of Health Economics. 2008 Nov;9(4):385-92. Abstract: Since the early 1990s, the Government of Indonesia has addressed high maternal mortality by attempting to ensure skilled attendance at delivery through access to trained village midwifery services in every village. Yet access to skilled services at delivery continues to prove problematic, with low levels of skilled attendance and high mortality. Making use of a funding flow analysis and population-based survey in two districts, we investigate to what extent funding allocated for maternal services enables access to skilled services by rich and poor households. The results suggest that, although resources reach remote poor areas, the poor obtain unequal access to skilled delivery services. Because rural midwives must earn a significant fraction of their income from private fees this acts to deter women from seeking their help. A new system of targeting poor women utilising the existing state insurance company (ASKES) is an important step in helping to reduce these barriers, but may not be sufficiently generous to protect all those that are considered vulnerable. Language: English Keywords: INDONESIA | RESEARCH REPORT | INCIDENCE | MATERNAL HEALTH | HEALTH SERVICES | DELIVERY OF HEALTH CARE | FUNDS | Asia, Southeastern | Asia | Developing Countries | Measurement | Research Methodology | Health | Financial Activities | Economic Factors Document Number: 330106 |
| 19. Title: Do women respond to expansions in reproductive health care? Author: Frankenberg E; Buttenheim A; Sikoki B; Suriastini W Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2008 Mar. 28 p. (MEASURE Evaluation Working Paper Series WP-08-103) Abstract: We use data from the Indonesia Family Life Survey to investigate the impact of a major expansion in access to midwifery services on use of prenatal care and delivery assistance for women of reproductive age. Between 1991 and 1998, Indonesia trained some 50,000 midwives, placing them in relatively poor communities that were relatively distant from health centers. We show that regardless of a woman's educational level, additions of village midwives to communities are associated with significant increases in receipt of iron tablets and in choices about care during delivery, which reflect a movement away from reliance on traditional birth attendants. For women with relatively low levels of education, village midwives have the additional benefits of increasing use of any prenatal care and use of prenatal care during the first trimester. The results are robust to the inclusion of fixed effects at the individual level, a strategy that addresses many of the concerns about biases because of non-random program placement. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | LONGITUDINAL STUDIES | SURVEYS | WOMEN | MIDWIVES AND MIDWIFERY | ANTENATAL CARE | PROGRAM ACCEPTABILITY | UTILIZATION OF HEALTH CARE | PROGRAM EFFECTIVENESS | SOCIOECONOMIC STATUS | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Sampling Studies | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Program Evaluation | Programs | Organization and Administration | Socioeconomic Factors | Economic Factors Document Number: 325777 |
| 20. Peer Reviewed Title: Marriage is not a safe place: Heterosexual marriage and HIV-related vulnerability in Indonesia. Author: Jacubowski N Source: Culture, Health and Sexuality. 2008 Jan;10(1):87-97. Abstract: This paper examines the link between heterosexual marriage and women's vulnerability to HIV in Indonesia. In this country, gender relations are currently dominated by traditional beliefs and practices and by religious morality. Data for the current study were collected by means of documentary analysis and archival research as well as by means of expert informant interviews. Findings suggest that traditional practices such as polygamy, early marriage and contract marriage (mut'a) play an important role in enhancing women's likelihood of acquiring HIV within the Indonesian context. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | INTERVIEWS | WOMEN | HETEROSEXUALS | MARRIAGE | RISK FACTORS | HIV INFECTIONS | AIDS | POLYGAMY | BELIEFS | AGE FACTORS | BEHAVIOR | CULTURE | Developing Countries | Asia, Southeastern | Asia | Data Collection | Research Methodology | Demographic Factors | Population | Sex Behavior | Nuptiality | Biology | Viral Diseases | Diseases | Marriage Patterns | Sociocultural Factors | Population Characteristics Document Number: 322451 |
| 21. Peer Reviewed Title: Malaria morbidity in Papua Indonesia, an area with multidrug resistant Plasmodium vivax and Plasmodium falciparum. Author: Karyana M; Burdarm L; Yeung S; Kenangalem E; Wariker N Source: Malaria Journal. 2008 Aug;7(148):[32] p. Abstract: Background: Multidrug resistance has emerged to both Plasmodium vivax and Plasmodium falciparum and yet the comparative epidemiology of these infections is poorly defined. Methods: All laboratory-confirmed episodes of malaria in Timika, Papua, Indonesia, presenting to community primary care clinics and an inpatient facility were reviewed over a two-year period. In addition information was gathered from a house-to-house survey to quantify the prevalence of malaria and treatment-seeking behaviour of people with fever. Results: Between January 2004 and December 2005, 99,158 laboratory-confirmed episodes of malaria were reported, of which 58% (57,938) were attributable to P. falciparum and 37% (36,471) to P. vivax. Malaria was most likely to be attributable to pure P. vivax in children under one year of age (55% 2,684/4,889). In the household survey, the prevalence of asexual parasitaemia was 7.5% (290/3,890) for P. falciparum and 6.4% (248/3,890) for P. vivax. The prevalence of P. falciparum infection peaked in young adults aged 15-25 years (9.8% 69/707), compared to P. vivax infection which peaked in children aged 1 to 4 years (9.5% 61/642). Overall 35% (1,813/5,255) of people questioned reported a febrile episode in the preceding month. Of the 60% of people who were estimated to have had malaria, only 39% would have been detected by the surveillance network. The overall incidence of malaria was therefore estimated as 876 per 1,000 per year (Range: 711-906). Conclusions: In this region of multidrug-resistant P. vivax and P. falciparum, both species are associated with substantial morbidity, but with significant differences in the age-related risk of infection. Language: English Keywords: INDONESIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | HEALTH SURVEYS | HOUSEHOLDS | DRUG RESISTANCE | MALARIA | PREVALENCE | UTILIZATION OF HEALTH CARE | AGE FACTORS | FEVER | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Health | Family and Household | Sociocultural Factors | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Parasitic Diseases | Diseases | Measurement | Population Characteristics | Demographic Factors | Population | Body Temperature | Physiology | Biology Document Number: 308030 |
| 22. Title: Key findings from the WHO collaborative study on substitution therapy for opioid dependence and HIV/AIDS. Author: Lawrinson P; Ali R; Buavirat A; Chiamwongpaet S; Dvoryak S; Habrat B; Jie S; Mardiati R; Mokri A; Moskalewicz J; Newcombe D; Poznyak V; Subata E; Uchtenhagen A; Utami DS; Vial R; Zhao C Source: Addiction. 2008 Sep;103(9):1484-92. Abstract: AIMS: Opioid substitution treatment has been studied extensively in industrialized countries, but there are relatively few studies in developing/transitional countries. The aim of this study was to examine the effectiveness of opioid substitution treatment (OST) in less resourced countries. DESIGN: Longitudinal cohort study. SETTING: Purposively selected OST sites in Asia (China, Indonesia, Thailand), Eastern Europe (Lithuania, Poland, Ukraine), the Middle East (Iran) and Australia. PARTICIPANTS: Seven hundred and twenty-six OST entrants. MEASUREMENTS: Participants were interviewed at treatment entry, 3 and 6 months. Standardized instruments assessed drug use, treatment history, physical and psychological health, quality of life, criminal involvement, blood-borne virus (BBV) risk behaviours and prevalence of human immunodeficiency virus (HIV) and hepatitis C. FINDINGS: Participants were predominantly male, aged in their early 30s and had attained similar levels of education. Seroprevalence rates for HIV were highest in Thailand (52%), followed by Indonesia (28%) and Iran (26%), and lowest in Australia (2.6%). Treatment retention at 6 months was uniformly high, averaging approximately 70%. All countries demonstrated significant and marked reductions in reported heroin and other illicit opioid use; HIV (and other BBV) exposure risk behaviours associated with injection drug users (IDU) and criminal activity, and demonstrated substantial improvement in their physical and mental health and general wellbeing over the course of the study. CONCLUSIONS: OST can achieve similar outcomes consistently in a culturally diverse range of settings in low- and middle-income countries to those reported widely in high-income countries. It is associated with a substantial reduction in HIV exposure risk associated with IDU across nearly all the countries. Results support the expansion of opioid substitution treatment. Language: English Keywords: CHINA | INDONESIA | THAILAND | LITHUANIA | POLAND | UKRAINE | IRAN | AUSTRALIA | RESEARCH REPORT | LONGITUDINAL STUDIES | MEN | LOW INCOME POPULATION | MIDDLE INCOME POPULATION | DRUG USE AND ABUSE | QUALITY OF LIFE | EDUCATIONAL STATUS | MENTAL HEALTH | RISK BEHAVIOR | HIV INFECTIONS | HEPATITIS | TREATMENT | EVALUATION | Asia, Eastern | Asia | Developing Countries | Asia, Southeastern | Europe, Eastern | Europe | Europe, Central | Middle East | Developed Countries | Oceania | Studies | Research Methodology | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Behavior | Social Welfare | Health | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 329285 |
| 23. Peer Reviewed Title: Iron supplementation of iron-replete Indonesian infants is associated with reduced weight-for-age. Author: Lind T; Seswandhana R; Persson LA; Lonnerdal B Source: Acta Paediatrica. 2008 Jun;97(6):770-775. Abstract: General iron supplementation to prevent iron deficiency in infants who are iron sufficient when starting supplementation may adversely affect their health. The objective was a secondary analysis to explore the effect of iron supplementation on iron-replete (IR; Hb greater than or equal to 113 g/L and S-ferritin greater than or equal to 33 microg/L) or non-iron-replete 6-month-old Indonesian infants participating in a large, randomized trial on iron and zinc supplementation. Among the iron-supplemented IR (Fe-IR, n = 80) infants S-ferritin was, compared to non-iron-supplemented (NS) IR infants (NS-IR, n = 74), significantly higher (47.5 vs. 20.7 microg/L, p = 0.04), and S-zinc significantly lower (9.7 vs. 10.5 micromol/L, p = 0.04). Haemoglobin concentration (Hb) did not differ between the Fe-IR and NS-IR groups. Change in weight-for-age z-score (WAZ) from 6 to 12 months and mean WAZ at 12 months was lower in the Fe-IR group compared to the NS-IR group (-1.45 vs. -1.03, p less than 0.001 and -1.97 vs. -1.60, p less than 0.001, respectively). There was no difference in morbidity between groups. Iron supplementation of non-iron-replete infants increased Hb and S-ferritin, but did not affect S-zinc or anthropometrical indices. In our study, iron supplementation of IR infants affected WAZ adversely, whereas iron supplementation to non-iron-replete infants did not affect growth. These results support a cautious approach to iron supplementation of IR infants. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | CLINICAL TRIALS | INFANT | FOOD SUPPLEMENTATION | SERUM IRON LEVEL | BODY WEIGHT | Developing Countries | Asia, Southeastern | Asia | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Hemic System | Physiology | Biology Document Number: 326113 |
| 24. Peer Reviewed Title: Test of the 'healthy migrant hypothesis': a longitudinal analysis of health selectivity of internal migration in Indonesia. Author: Lu Y Source: Social Science and Medicine. 2008 Oct;67(8):1331-9. Abstract: Previous studies show migrants are generally healthier than the populations in receiving societies, a result generally attributed to the positive selection of migrants on health. This hypothesis, however, has not been adequately evaluated due to lack of adequate data. In this article, using high-quality longitudinal data from Indonesia, the health selectivity hypothesis, also referred to as the healthy migrant hypothesis, is examined with respect to internal migration. Specifically, this study explores whether pre-migration health status affects the likelihood of migration by comparing those from the sending population who do and do not move. Results show that migrants in Indonesia tend to be selected with respect to health and that this selection is robust to household unobserved heterogeneity. However, the strength and direction of the health-migration association vary by types of migration and dimensions of health. Language: English Keywords: INDONESIA | RESEARCH REPORT | LONGITUDINAL STUDIES | MIGRANTS | MIGRATION | HEALTH | AGE FACTORS | OCCUPATIONS | ANEMIA | MORBIDITY | Asia, Southeastern | Asia | Developing Countries | Studies | Research Methodology | Population Dynamics | Demographic Factors | Population | Population Characteristics | Human Resources | Economic Factors | Diseases Document Number: 330022 |
| 25. Peer Reviewed Title: Barriers for introducing HIV testing among tuberculosis patients in Jogjakarta, Indonesia: a qualitative study. Author: Mahendradhata Y; Ahmad RA; Lefevre P; Boelaert M; Van der Stuyft P Source: BMC Public Health. 2008;8:385. Abstract: BACKGROUND: HIV and HIV-TB co-infection are slowly increasing in Indonesia. WHO recommends HIV testing among TB patients as a key response to the dual HIV-TB epidemic. Concerns over potential negative impacts to TB control and lack of operational clarity have hindered progress. We investigated the barriers and opportunities for introducing HIV testing perceived by TB patients and providers in Jogjakarta, Indonesia. METHODS: We offered Voluntary Counselling and Testing (VCT) to TB patients in parallel to a HIV prevalence survey. We conducted in-depth interviews with 33 TB patients, 3 specialist physicians and 3 disease control managers. We also conducted 4 Focus Group Discussions (FGDs) with nurses. All interviews and FGDs were recorded and data analysis was supported by the QSR N6 software. RESULTS: Patients' and providers' knowledge regarding HIV was poor. The main barriers perceived by patients were: burden for accessing VCT and fear of knowing the test results. Stigma caused concerns among providers, but did not play much role in patients' attitude towards VCT. The main barriers perceived by providers were communication, patients feeling offended, stigmatization and additional burden. CONCLUSION: Introduction of HIV testing among TB patients in Indonesia should be accompanied by patient and provider education as well as providing conditions for effective communication. Language: English Keywords: INDONESIA | RESEARCH REPORT | QUALITATIVE RESEARCH | CLIENTS | TUBERCULOSIS | TESTING | VOLUNTARY COUNSELING AND TESTING | STIGMA | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Infections | Diseases | Measurement | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Social Problems | Sociocultural Factors Document Number: 330207 |
| 26. Peer Reviewed Title: Voluntary counselling and testing uptake and HIV prevalence among tuberculosis patients in Jogjakarta, Indonesia. Author: Mahendradhata Y; Ahmad RA; Kusuma TA; Boelaert M; Van der Werf MJ Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Oct;102(10):1003-1010. Abstract: We aimed to establish HIV prevalence and uptake of unlinked anonymous testing and voluntary counselling and testing (VCT) among tuberculosis (TB) patients in Jogjakarta, Indonesia. We introduced unlinked anonymous HIV testing for TB patients attending directly observed treatment, short-course services between April and December 2006. Patients were additionally offered VCT services. Of 1269 TB patients who were offered unlinked anonymous testing, 989 (77.9%; 95% CI 75.6-80.1%) accepted. HIV prevalence was 1.9% (95% CI 1.6-2.2%). HIV infections were less frequently diagnosed among TB patients who attended a public health centre [odds ratio (OR) 0.15; 95% CI 0.03-0.70] rather than public hospital. They were more frequent in TB patients with a university education background (OR 5.16; 95% CI 1.01-26.63) or a history of HIV testing (OR 57.87; 95% CI 9.42-355.62). Of the 989 patients who accepted unlinked anonymous testing, only 133 (13.4%; 95% CI 11.5-15.7%) expressed interest in VCT. Of these, 52 (39.1%; 95% CI 31.2-47.6%) attended VCT, but interest was higher among students and those offered VCT by public health centres. The HIV prevalence in Jogjakarta is higher than expected and needs to be monitored cautiously. Unlinked anonymous HIV testing is well accepted and can be implemented with modest additional efforts. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | TUBERCULOSIS | VOLUNTARY COUNSELING AND TESTING | HIV TESTING | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | BLOOD | LABORATORY EXAMINATIONS AND DIAGNOSES | INFORMED CONSENT | Asia, Southeastern | Asia | Developing Countries | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Hemic System | Physiology | Biology Document Number: 328172 |
| 27. Peer Reviewed Title: Midwifery provision in two districts in Indonesia: How well are rural areas served? Author: Makowiecka K; Achadi E; Izati Y; Ronsmans C Source: Health Policy and Planning. 2008 Jan;23(1):67-75. Abstract: Attention has focused recently on the importance of adequate and equitable provision of health personnel to raise levels of skilled attendance at delivery and thereby reduce maternal mortality. Indonesia has a village-based midwife programme that was intended to increase the rate of professional delivery care and redress the urban/rural imbalance in service provision by posting a trained midwife in every village in the country. We present findings on the distribution of midwifery provision in our study area: 10% of villages do not have a midwife but a nurse as a midwifery provider; there is a deficit in midwife density in remote villages compared with urban areas; those assigned to remote areas are less experienced; midwives manage few births and this may compromise their capacity to maintain professional skills; over 90% of non-hospital deliveries take place in the woman's (64%) or the midwife's (28%) home; three-quarters of midwives did not make regular use of the fee exemption scheme; midwives who live in their assigned village spend more days per month on clinical work there. We conclude that adequate provider density is an important factor in effective health care and that efforts should be made to redress the imbalance in provision, but that this can only contribute to reducing maternal mortality in the context of a supportive professional environment and timely access to emergency obstetric care. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | QUESTIONNAIRES | MIDWIVES AND MIDWIFERY | RURAL AREAS | RURAL HEALTH SERVICES | MATERNAL HEALTH | MATERNAL MORTALITY | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | Developing Countries | Asia, Southeastern | Asia | Health Personnel | Delivery of Health Care | Health | Geographic Factors | Population | Health Services | Mortality | Population Dynamics | Demographic Factors | Program Evaluation | Programs | Organization and Administration | Health Services Evaluation Document Number: 314034 |
| 28. Peer Reviewed Title: The changing relationship between family size and educational attainment over the course of socioeconomic development: Evidence from Indonesia. Author: Maralani V Source: Demography. 2008 Aug;45(3):693-717. Abstract: Many studies from developed countries show a negative correlation between family size and children's schooling, while results from developing countries show this association ranging from positive to neutral to negative, depending on the context. The body of evidence suggests that this relationship changes as a society develops, but this theory has been difficult to assess because the existing evidence requires comparisons across countries with different social structures and at different levels of development. The world's fourth most populous nation in 2007, Indonesia has developed rapidly in recent decades. This context provides the opportunity to study these relationships within the same rapidly developing setting to see if and how these associations change. Results show that in urban areas, the association between family size and children's schooling was positive for older cohorts but negative for more recent cohorts. Models using instrumental variables to address the potential endogeneity of fertility confirm these results. In contrast, rural areas show no significant association between family size and children's schooling for any cohort. These findings show how the relationship between family size and children's schooling can differ within the same country and change over time as contextual factors evolve with socioeconomic development. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | FAMILY LIFE SURVEYS | THEORETICAL MODELS | FAMILY SIZE | CHILDREN | EDUCATIONAL STATUS | URBAN AREAS | RURAL AREAS | ECONOMIC DEVELOPMENT | SOCIAL CHANGE | Asia, Southeastern | Asia | Developing Countries | Family Research | Family and Household | Sociocultural Factors | Research Methodology | Family Characteristics | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Geographic Factors Document Number: 327987 |
| 29. Peer Reviewed Title: Adverse pregnancy outcomes in an area where multidrug-resistant Plasmodium vivax and Plasmodium falciparum infections are endemic. Author: Poespoprodjo JR; Fobia W; Kenangalem E; Lampah DA; Warikar N Source: Clinical Infectious Diseases. 2008;46(9):1374-1381. Abstract: Plasmodium falciparum infection exerts a considerable burden on pregnant women, but less is known about the adverse consequences of Plasmodium vivax infection. In Papua, Indonesia, where multiple drug resistance to both species has emerged, we conducted a cross-sectional hospital-based study to quantify the risks and consequences of maternal malaria. From April 2004 through December 2006, 3046 pregnant women were enrolled in the study. The prevalence of parasitemia at delivery was 16.8% (432 of 2570 women had infections), with 152 (35.2%) of these 432 infections being associated with fever. The majority of infections were attributable to P. falciparum (250 [57.9%]); 146 (33.8%) of the infections were attributable to P. vivax, and 36 (8.3%) were coinfections with both species. At delivery, P. falciparum infection was associated with severe anemia (hemoglobin concentration, less than 7 g/dL; odds ratio [OR], 2.8; 95% confidence interval [95% CI], 2.0-4.0) and a 192 g (95% CI, 119-265) reduction in mean birth weight (P less than .001). P. vivax infection was associated with an increased risk of moderate anemia (hemoglobin concentration, 7-11 g/dL; OR, 1.8; 95% CI, 1.2-2.9; P = .01) and a 108 g (95% CI, 17.5-199) reduction in mean birth weight (P less than .019). Parasitemia was associated with preterm delivery (OR, 1.5; 95% CI, 1.1-2.0; P = .02) and stillbirth (OR, 2.3; 95% CI, 1.3-4.1; P = .007) but was not associated with these outcomes after controlling for the presence of fever and severe anemia, suggesting that malaria increases the risk of preterm delivery and stillbirth through fever and contribution to severe anemia rather than through parasitemia per se. These observations highlight the need for novel, safe, and effective treatment and prevention strategies against both multidrug-resistant P. falciparum and multidrug-resistant P. vivax infections in pregnant women in areas of mixed endemicity. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | MALARIA | INFECTIONS | RISK FACTORS | PREGNANCY COMPLICATIONS | SAFETY | CONTRACEPTIVE USE-EFFECTIVENESS | NEEDS | TREATMENT | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Biology | Public Health | Health | Contraceptive Effectiveness | Contraception | Family Planning | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 325913 |
| 30. Title: Abortion in Indonesia. Author: Sedgh G; Ball H Source: Issues In Brief. 2008 Sep;New York, New York, Guttmacher Institute, 2008 Sep. (2):1-6. 6 p. (In Brief. 2008 Series No. 2) Abstract: Each year in Indonesia, millions of women become pregnant unintentionally, and many choose to end their pregnancies, despite the fact that abortion is generally illegal. Like their counterparts in many developing countries where abortion is stigmatized and highly restricted, Indonesian women often seek clandestine procedures performed by untrained providers, and resort to methods that include ingesting unsafe substances and undergoing harmful abortive massage. Though reliable evidence does not exist, researchers estimate that about two million induced abortions occur each year in the country and that deaths from unsafe abortion represent 14-16% of all maternal deaths in Southeast Asia. Preventing unsafe abortion is imperative if Indonesia is to achieve the fifth Millennium Development Goal of improving maternal health and reducing maternal mortality. Current Indonesian abortion law is based on a national health bill passed in 1992. Though the language on abortion was vague, it is generally accepted that the law allows abortion only if the woman provides confirmation from a doctor that her pregnancy is life-threatening, a letter of consent from her husband or a family member, a positive pregnancy test result and a statement guaranteeing that she will practice contraception afterwards. This report presents what is currently known about abortion in Indonesia. The findings are derived primarily from small-scale, urban, clinic-based studies of women's experiences with abortion. Some studies included women in rural areas and those who sought abortions outside of clinics, but none were nationally representative. Although these studies do not give a full picture of who is obtaining abortions in Indonesia or what their experiences are, the evidence suggests that abortion is a common occurrence in the country and that the conditions under which abortion takes place are often unsafe. Language: English Keywords: INDONESIA | RESEARCH REPORT | WOMEN | PREGNANT WOMEN | PREGNANCY, UNPLANNED | ABORTION | RISK FACTORS | CAUSES OF DEATH | RELIGION | Developing Countries | Asia, Southeastern | Asia | Demographic Factors | Population | Population Characteristics | Reproductive Behavior | Fertility | Population Dynamics | Fertility Control, Postconception | Family Planning | Health | Mortality | Sociocultural Factors Document Number: 329135 |
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