e-ISSN: 2828-2809 (Online) DOI: 10.47134/inhis URL:http://inhis.pubmedia.id/index.php/inhis/index Indonesian Health Issue is one of the journals concerned with the health field. It was published in 2022 by the Indonesian Journal Publisher. Indonesian Health Issue is published twice a year (February and August). Indonesian Health Issue has been accredited SINTA 4 by the Ministry of Higher Education, Science and Technology with Decree Number 0173/C3/DT.05.00/2025. Indonesian Health Issue adopts a double-blind peer review policy and concerns in various health fields, for instance: NURSING (Fundamentals of Nursing, Management in Nursing, Medical-surgical Nursing, Critical Care Nursing, Emergency, and Trauma Nursing, Oncology Nursing, Community Health Nursing, Occupational Health Nursing, Mental Health Nursing, Holistic Nursing, Geriatric Nursing, Family Nursing, Maternity Nursing, Women's Health Nursing, Pediatric Nursing, Education in Nursing, Nursing Policies, Legal Nursing, Advanced Practice Nursing, and Nursing Informatics) MIDWIFERY (Pregnancy, Birth and maternity care for childbearing women, Their babies, And families, Clinical, Psycho-social, Sociological, Midwifery education, Organizational and Technological areas of practice in preconception, Maternal and Infant Care, Maternity Services, and Other Health Systems) NUTRITION (Community Nutrition, Clinical Nutrition, Nutrition Institutions, Food Technology Nutrition) MEDICAL LAB TECHNOLOGY (Food and beverage analysis, Microbiology, Hematology, Clinical chemistry, Parasitology, Immunoserology) PUBLIC HEALTH (Epidemiology, Preventing disease, Prolonging life, and improving the health of entire populations, Health Management, Health Promotion)
The Effect of Slow Stroke Back Massage (SSBM) on Breast Milk Production in Postpartum Mothers on Days 3–5
Background: Suboptimal breast milk expression in postpartum mothers remains a challenge in achieving exclusive breastfeeding, particularly in Kaliwates District, where the coverage is only 17.9%. Six out of ten postpartum mothers in the Puskesmas Kaliwates working area reported poor milk flow during the first week after delivery. Complementary therapies such as Slow Stroke Back Massage (SSBM) is a gentle, rhythmic massage technique applied from the upper to lower back, aimed at stimulating the release of oxytocin and endorphins, both of which play crucial roles in lactation. Purpose: This study aims to determine the effect of SSBM on breast milk expression in postpartum mothers on day 3–5 in the working area of Puskesmas Kaliwates. Methods: This research was conducted quantitatively using a one-group pretest-posttest design with a total sample of 23 respondents. Data were collected via questionnaires and analyzed using the Wilcoxon Signed-Rank Test. Results: Before the intervention, most respondents had smooth (60.9%) and poor (34.8%) milk output. After the intervention, most respondents experienced improvement, with 60.9% showing very smooth milk output and 30.4% showing smooth milk output. The analysis showed a significance value of 0.0000 (p<0.05), indicating a significant effect of SSBM on breast milk expression. Conclusion: SSBM can effectively improve breast milk expression in postpartum mothers on days 3–5 in the Puskesmas Kaliwates area in 2025.
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The Influence of E-Service Quality on Patient Satisfaction and Loyalty in Hospitals: A Systematic Literature Review Using the PRISMA Framework in 2020-2025
Background: The advancement of digital technology in the healthcare sector has driven hospitals to improve the quality of electronic services (e-service quality) in meeting patients’ expectations for convenience, speed, and service effectiveness. Objective: This study aims to analyze the influence of e-service quality on patient satisfaction and loyalty in hospitals. Methods: This research employed a Systematic Literature Review guided by the PRISMA framework and conducted in October 2025. Articles were collected from the ScienceDirect, PubMed, ProQuest, and Google Scholar databases, yielding a total of 14,273 articles, which were screened and filtered into eight relevant studies that met the inclusion criteria. Results: E-service quality has a significant effect on patient satisfaction through four factors: integrated digital services, emotional and trust dimensions, technical quality and user experience, and ease of use. Furthermore, patient loyalty is formed through two mechanisms improvement of electronic service quality and technological integration that encourages revisit intention. Conclusion: E-service quality plays an important role in enhancing patient satisfaction and loyalty in hospitals.
Satisfaction of Outpatient Services at Sarkies Asyiyah Hospital Kudus Regarding the Frequency of BPJS PRB
Background: The BPJS Referral Program (PRB) is intended for patients with stable chronic diseases who require long-term care at FKTP. The frequency of PRB is influenced by patient satisfaction with the referral hospital's services. Objective: to analyze the effect of satisfaction with outpatient services at Sarkies Asyiyah Kudus Hospital on the frequency of BPJS PRB utilization. Method: A correlational analytical study with a quantitative approach was conducted on 30 outpatient respondents participating in BPJS at Sarkies Aisyiyah Kudus Hospital who were selected by Quota Sampling from 14 polyclinics. The research instrument was a patient satisfaction questionnaire based on five dimensions of SERVQUAL (Tangible, Reliability, Responsiveness, Assurance, Empathy). Data analysis used descriptive statistics, the Shapiro-Wilk normality test, Spearman correlation, and ordinal logistic regression. Results: All service quality dimensions are in the good–very good category. Spearman's test showed a significant positive relationship between patient satisfaction and the frequency of reverse referrals (p < 0.01) with the largest contribution being Tangible (ρ = 0.884). Ordinal logistic regression produced a Nagelkerke R-Square of 0.97, confirming that satisfaction explains 97% of the variation in reverse referrals. The Tangible dimension has a significant effect (p = 0.026), while the other dimensions are not significant. Conclusion: Outpatient satisfaction influences the frequency of BPJS PRB with the Tangible dimension as the dominant factor. Improvement of physical facilities and service comfort needs to be prioritized to support the effectiveness of the referral system.
The Effect of Motivation, Supervision, and Patient Safety Training on the Implementation of Patient Safety Culture in Hospitals
Background:The implementation of patient safety culture by nurses reflects their performance behavior and is influenced by nurses’ motivation. With good motivation, nurses are expected to effectively apply patient safety culture. Nursing supervision activities are carried out in accordance with hospital nursing management guidelines.Objective:This study aimed to determine the effect of motivation, supervision, and training on the implementation of patient safety culture in hospitals.Methods:This study adopted a quantitative research approach with a cross-sectional design. The population consisted of all nurses working in inpatient units at Dr. R. Soedjono Selong Regional General Hospital, totaling 415 nurses. A sample of 204 nurses was selected for the study. Data analysis was conducted using path analysis to examine the proposed model, and the relationships among constructs were assessed by evaluating the path coefficients.Results:Motivation (p-value = 0.003 < 0.005), supervision (p-value = 0.000 < 0.005), and nurse training (p-value = 0.001 < 0.005) had a positive and significant effect on the implementation of patient safety culture in hospitals. Conclusion:Nurses’ motivation, supervision, and training have a positive and significant effect on the implementation of patient safety culture in hospitals.
Association of Consumption Patterns and Eating Habits with Household Nutritional Status in Mountainous and Coastal Areas of Banyuwangi
Family nutritional status remains a major public health concern, particularly in regions with diverse geographical characteristics that influence food availability and dietary behavior. Variations in dietary patterns and eating habits between mountainous and coastal areas may contribute to differences in nutritional outcomes at the household level. This study aimed to examine the association between dietary patterns and eating habits with family nutritional status and to identify regional differences in these associations in Banyuwangi Regency, Indonesia. A quantitative cross-sectional study was conducted from August to September 2025 involving 110 families selected using multistage sampling. Data were collected through a locally adapted Food Frequency Questionnaire (FFQ), structured eating habit questionnaires, and anthropometric measurements based on WHO standards. Statistical analyses included descriptive statistics, Chi-Square tests, and multivariate logistic regression. The results indicated that a substantial proportion of families exhibited inadequate dietary patterns and unhealthy eating habits, alongside significant differences in nutritional status between mountainous and coastal regions. Both dietary patterns and eating habits were significantly associated with family nutritional status after adjusting for potential confounders, with inadequate dietary patterns emerging as the strongest determinant. Stratified analysis revealed regional-specific determinants, where dietary patterns were more influential in mountainous areas, while eating habits played a greater role in coastal areas. In conclusion, improving family nutritional status requires region-specific nutrition interventions that address local food systems and promote balanced dietary practices through targeted nutrition education.
Copyright (c) 2026 Indonesian Health Issue https://creativecommons.org/licenses/by-sa/4.0
The Relationship Between Nutritional Status (BMI) and Age at Menarche Among Junior High School Adolescent Girls
Menarche is the first menstrual period experienced by adolescent girls. In recent decades, the age of menarche has tended to occur earlier, which may negatively affect health. Nutritional status, measured by Body Mass Index (BMI), is considered an important factor influencing the age of menarche. This study aimed to determine the relationship between nutritional status (BMI) and age at menarche among adolescent girls at SMPN 3 Sungai Penuh. This quantitative study used a cross-sectional design and was conducted from July to August 2025. A total of 97 adolescent girls were selected using proportional random sampling. Data were collected through measurements of height and weight and questionnaires, and analyzed using the Chi-square test. The results showed that most respondents had a normal age of menarche (81.4%) and normal nutritional status (63.9%). Statistical analysis indicated a significant relationship between BMI and age at menarche (p = 0.000). In conclusion, nutritional status is significantly associated with age at menarche among adolescent girls. Maintaining normal nutritional status is important to support healthy reproductive development.
The Relationship Between Medical Records Employee Performance And Patient Satisfaction
Background: The best patient care in healthcare facilities is essential to achieve patient satisfaction. Objective: To determine the relationship between medical records staff performance and patient satisfaction in the Outpatient Admissions Area (TPPRJ) in an effort to improve the quality of healthcare services at Nur Hidayah Hospital, Bantul. Method: This study used a quantitative, cross-sectional, observational approach, involving 93 patient respondents selected via simple random sampling. Data were collected through observation and questionnaires using five dimensions of medical records staff performance: reliability, responsiveness, assurance, tangibles, empathy, and patient satisfaction. Results: The study shows the percentage of scores for each assessment dimension. The highest percentage was for patients who were satisfied with the staff's performance (64 respondents (68.8%), followed by patients who were very satisfied with the staff's performance (23 respondents (24.7%), then the category of patients who were only quite satisfied with the staff's performance (6 respondents (6.5%), and the lowest was for those who were dissatisfied and very dissatisfied with the staff's performance (0 respondents (0%). Based on the results of the analysis using the chi-square test conducted on patient satisfaction with employee performance, the p-value obtained was 0.001 (p <0.05), so Ho in the study was rejected, and H1 was accepted, which means there is a relationship between patient satisfaction and the performance of TPPRJ employees at Nur Hidayah Hospital, Bantul. Conclusion: Improving the quality of service must be done comprehensively, covering all aspects of service, facilities, and communication.
Formulation of Fish Egg Snacks Substituting Tuna (Euthynnus affinis) Protein Concentrate: Sensory, Proximate, and Amino Acid Characteristics
Background: Tuna is a fish known for its high protein content and is widely consumed by the community. “Fish egg snacks” are popular among people from diverse backgrounds. Purpose: This study was to determine the acceptability, nutritional content, and amino acid profile of “fish egg snack” formulations with tuna protein concentrate substitution. Methods: This study used an experimental design. The subjects used in the organoleptic testing were 25 semi-trained panelists. The stages of this study included the production of tuna protein concentrate and the production of fish egg snack. The analyses conducted included organoleptic analysis, nutritional content analysis, and amino acid profile analysis. The data were analyzed descriptively. Results: F4 was the best formula based on the De Garmo assessment of organoleptic testing and protein content. F4 was found to have a total energy of 496.86 kcal, ash content of 2.35%, moisture content of 2.51%, carbohydrates of 50.97%, and total fat content of 23.26%. In addition, the most abundant amino acid found in F4 was L-glutamic acid. Conclusion: F4 is the best fish egg snack formulation, and L-glutamic acid is the most abundant amino acid found in F4.
TAK-003 Dengue Vaccine Efficacy and Safety: A Systematic Literature Review Using PRISMA
Background: Dengue is a global public health problem with a high disease burden in both endemic and non-endemic regions. Although dengue vaccines have been developed, evidence regarding the efficacy and safety of the TAK-003 vaccine remains fragmented, with variations across serotypes, age groups, baseline serostatus, and study designs. Objective: This study aims to analyze and synthesize scientific evidence on the efficacy and safety of the tetravalent dengue vaccine TAK-003 based on clinical trial data and real-world evidence. Methods: A Systematic Literature Review was conducted in January 2025 in accordance with PRISMA guidelines. Literature searches were performed in the ScienceDirect, PubMed, ProQuest, and ClinicalKey databases, yielding a total of 1,011 initial records. After duplicate removal, title and abstract screening, and full-text eligibility assessment, studies were included if they: (1) explicitly investigated TAK-003, (2) reported outcomes related to efficacy, immunogenicity, and/or safety, (3) employed clinical trial, observational, or post-marketing surveillance designs, and (4) were available as full-text articles in English. Non-empirical studies, animal studies, commentaries, and narrative reviews were excluded. Results: Five high-quality articles from Scopus Q1 journals met the inclusion criteria. The thematic analysis identified five main themes: the safety and immunogenicity of TAK-003 when co-administered with other vaccines, manufacturing consistency with stable immune responses, long-term effectiveness in preventing dengue infection and hospitalization for up to 4.5 years, tetravalent protection against all four dengue serotypes, and a favorable safety profile based on post-marketing data, with most adverse events being mild. Conclusion: The TAK-003 vaccine demonstrates favorable efficacy and safety profiles in both clinical trials and real-world settings. Although variability in effectiveness across serotypes and age groups persists, the available evidence supports TAK-003 as a promising strategy for dengue prevention.
Effectiveness of a Digital Pocketbook in Improving Knowledge of Long-Acting Contraceptive Methods among Women of Reproductive Age
Background: Limited understanding among women of reproductive age regarding Long-Acting Reversible Contraceptive (LARC) methods, particularly implants and intrauterine devices (IUDs), remains a major barrier to the success of family planning programs. Objective: This study aimed to improve the knowledge of women of reproductive age regarding long-acting contraceptive methods, especially implants and IUDs, through digital pocket book-based education. Methods: This study employed a quantitative approach using a pre-experimental one-group pretest-posttest design involving 15 women of reproductive age at Mutiara Hati Clinic. The intervention was conducted through participatory educational counseling using an Android-based digital pocket book, beginning with a pre-test, followed by material delivery, interactive discussion, and ending with a post-test. Data analysis using the Shapiro-Wilk test indicated that pre-test data were normally distributed (p = 0.600), while post-test data were not normally distributed (p = 0.002); therefore, the Wilcoxon Signed Ranks Test was applied. Results: The results showed that all respondents (100%) experienced an increase in post-test scores compared to pre-test scores, with a Z value of -3.450 and a significance level of p < 0.001. Participants’ knowledge levels improved from predominantly moderate and low categories at baseline to entirely good after the intervention. Conclusion: The findings show that digital pocket books are effective educational media for increasing knowledge of women of reproductive age regarding implant and IUD long-acting contraceptive methods.
Digital Public Sentiment Toward Out-of-Wedlock Pregnancy and Its Implications for Health Policy in Indonesia
Background: Unmarried pregnancy in Indonesia remains closely associated with gendered moral norms and social stigma, which may limit women’s access to equitable maternal health services. Digital platforms such as YouTube function as public arenas where these norms are reproduced, contested, and potentially influence informal policy environments. Purpose: This study aims to analyze digital public sentiment toward unmarried pregnant women and to examine its implications for gender-responsive and intersectional maternal health policy in Indonesia. Methods: A qualitative descriptive study was conducted using content analysis of publicly available YouTube comments posted between January 2024 and 2026. Comments from highly engaged videos discussing unmarried pregnancy were anonymized and categorized into negative, positive, and neutral sentiment groups. Descriptive statistics were used to present proportional distributions. Results: Negative sentiment dominated the discourse (47.25%), followed by positive sentiment (39.32%) and neutral sentiment (13.44%). Although moral judgment and stigma remain prominent, a substantial proportion of comments express empathy and support. Conclusions: Digital public sentiment reflects persistent gender stigma surrounding unmarried pregnancy, alongside emerging supportive narratives. Integrating intersectional and rights-based approaches aligned with WHO recommendations is essential to strengthen inclusive maternal health policy and ensure equitable access to care for all women, regardless of marital status.
Factors Associated with Shoulder Pain in Office Workers
Background:Shoulder pain is a common musculoskeletal complaint among office workers due to monotonous work activities, static postures, and long work hours. Factors such as age, tenure, daily work hours, and work posture are thought to contribute to shoulder pain.Objective:This study aims to analyze the relationship between age, length of service, length of work, and work posture with the incidence of shoulder pain in office workers.Method:This research is a quantitative analytical study with a cross-sectional design. The sample consisted of 40 office workers at Kesdam II Sriwijaya who experienced shoulder pain, selected using a total sampling technique. Data collection was conducted using a structured questionnaire to obtain data on age, length of service, daily work hours, shoulder pain complaints, and work posture assessment based on respondents' self-reports. Data analysis was performed bivariately using the chi-square test to determine the relationship between variables..Results:As many as 75% of respondents reported complaints of shoulder pain.The results of the bivariate analysis showed a significant relationship between age (p = 0.023), length of service (p = 0.012), and length of service (p = 0.041) with shoulder pain. However, no significant relationship was found between work posture and shoulder pain (p > 0.05), either individually or after combining the p-values (p = 0.507).Conclusion:There was a significant association between age, length of service, and length of work with the incidence of shoulder pain in office workers, while work posture did not show a statistically significant association. Preventive measures through ergonomic interventions, work duration management, and increased awareness of work posture are still needed to reduce the risk of shoulder pain in office workers.
Bibliometric Analysis of Social Media Marketing and Hospital Brand Credibility: A Systematic Mapping Review
Background: The development of social media has driven a transformation in hospital healthcare marketing strategies, making the formation of brand credibility through digital platforms an important issue. Objective: This study aims to systematically map and analyze the development of research on social media marketing and its relationship with the formation of hospital brand credibility, with a focus on the roles of brand awareness, brand trust, and parasocial relationships. Methods: This study employed a systematic mapping review approach guided by PRISMA stages in the processes of literature identification and selection. Data were obtained from the Scopus database on June 26, 2025. A total of 26 scientific articles were selected through identification, title and abstract screening, and eligibility assessment based on inclusion criteria. The reviewed studies were predominantly quantitative, employing survey-based methods and structural equation modeling, with a smaller proportion using mixed-method approaches. Data analysis was conducted using a bibliometric approach with VOSviewer software to map publication trends and conceptual relationships among variables. Results: The analysis indicates an increase in the number of publications since 2021, with dominant themes related to digital branding, consumer trust, and emotional interaction through social media. Keyword mapping shows that brand awareness and brand trust are key conceptual nodes closely connected to parasocial interaction and brand credibility. The reviewed studies indicate positive relationships between social media marketing activities, increased brand awareness and brand trust, and the formation of brand credibility, although the strength of these relationships varies across studies. Conclusion: Social media marketing plays a role in strengthening hospital brand credibility through enhanced brand awareness, trust formation, and the reinforcement of psychological relationships with audiences. These findings represent a synthesis based on literature mapping and do not yet reflect direct causal measurement; therefore, further empirical research is still required.
An Overview of the Double Burden of Malnutrition in Toddlers and Its Implications for Cardiovascular Disease Risk in Adulthood
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The Effect of Website-Based Information on Pregnant Women’s Knowledge of High-Risk Conditions and Birth Preparedness
Background Childbirth readiness and complication readiness are strategies to encourage the timely use of skilled maternal and infant health services. The low rate of early detection is a challenge, which is suspected to be influenced by the level of knowledge. Website media provides health information that is easily accessible anywhere and anytime. Purpose: This study aims to analyze the influence of information through websites on maternal knowledge about high risk in pregnancy and childbirth preparation. Methods: This type of research is a quantitative research using a pre-experimental approach with one group pre-post design. The population in this study is all pregnant women who are at risk in pregnancy at the Ringinarum Health Center. The study was conducted in August 2022, the number of pregnant women who are at risk is 36 people. Sampling uses the total sampling technique. Independent variables are the interventions provided, namely the provision of information about pregnancy risks and childbirth preparations submitted on the website media. The dependent variable is the knowledge of pregnant women. The analysis was carried out bivariate test using the Wilcoxon Test. Results: The results of the wilcoxon statistical test obtained a P-value of 0.000 or < 0.05 this shows that there is a significant influence of information through the website on the level of knowledge of pregnant women facing childbirth in the Ringinarum Health Center area. Conclusion: Providing education to pregnant women using website media to increase pregnant women's knowledge about high risk and childbirth preparation. It is hoped that pregnant women who experience a high risk of pregnancy can increase the knowledge that can be obtained through internet media.
Characteristics Of Patients With Lymphoma Diagnosis At Gunung Jati Cirebon Hospital In 2022-2024
ABSTRACT Background: Lymphoma is a malignancy of the lymphoid system that can involve lymph nodes and extranodal sites and remains a public health problem with an increasing incidence. Data on the characteristics of lymphoma patients in regional hospitals are still limited. Objective: To describe the characteristics of patients diagnosed with lymphoma at Gunung Jati Regional Hospital, Cirebon. Methods: This was a retrospective descriptive study using medical record data of lymphoma patients treated at Gunung Jati Regional Hospital during the period 2022–2024. Total sampling was applied. The variables analyzed included age, sex, clinical manifestations, tumor location, histopathological and immunohistochemical findings, treatment, and recurrence. Results: Of the 90 patients, most were male and belonged to the older age group. The most common clinical manifestation was a lump or mass, with predominant extranodal involvement. Most patients were diagnosed with Non-Hodgkin Lymphoma, with Diffuse Large B-Cell Lymphoma as the most frequent immunohistochemical subtype. Chemotherapy was the most commonly administered treatment, and no recurrence data were found during the observation period. Conclusion: Lymphoma patients at Gunung Jati Regional Hospital, Cirebon, during 2022–2024 were predominantly older males with extranodal involvement and Non-Hodgkin Lymphoma, particularly Diffuse Large B-Cell Lymphoma. These findings are important as a basis for clinical mapping and planning of lymphoma services in regional hospitals.
Empowering Reproductive Age Women through Interactive Modern Contraception Education for Healthy Families at Puskesmas Segiri, Samarinda
Background: Limited knowledge among Women of Reproductive Age (WRA) regarding modern contraception remains a challenge in the Family Planning program. Objective: This study aimed to improve WRA understanding of modern contraceptive methods through an interactive digital media-based educational approach. Methods: This community-based intervention employed an educational design involving 28 WRA in the working area of Puskesmas Segiri, Samarinda. Data collection was conducted using educational counseling supported by interactive video and a digital pocketbook, followed by pre-test and post-test assessments to measure knowledge changes. The activity was implemented through preparation, implementation, and evaluation phases, and data were analyzed descriptively using mean, percentage, and standard deviation comparisons. Results: The findings revealed a significant improvement in participant knowledge, with the proportion of good knowledge increasing from 61% during the pre-test to 100% in the post-test. The mean score increased from 85.00 to 97.14, while the standard deviation decreased from 15.396 to 3.951, showing improved consistency in participant understanding. The digital pocketbook also proved effective as a sustainable educational medium that participants could access repeatedly. Conclusion: Interactive digital education is highly effective in improving contraceptive knowledge among WRA and is recommended for replication in other regions with similar characteristics to support sustainable family planning education.
The Role of Physical and Rehabilitation Medicine in Preventing Musculoskeletal Complications in Pediatric Hemophilia
Background: Pediatric hemophilia is a hereditary bleeding disorder that leads to progressive musculoskeletal complications due to recurrent hemarthrosis, thereby increasing the risk of long-term disability and reduced quality of life. Objective: To examine the role of medical rehabilitation in preventing musculoskeletal complications in pediatric hemophilia. Methods: This study was conducted as a narrative literature review by searching articles through PubMed, Scopus, and Google Scholar using keywords related to pediatric hemophilia, musculoskeletal complications, hemarthrosis, hemophilic arthropathy, and preventive rehabilitation and management. The selected literature included original research articles, clinical guidelines, and systematic reviews relevant to children and adolescent populations. A descriptive-synthesis approach was used to integrate findings related to musculoskeletal complications and phase-based preventive rehabilitation strategies. Results: Complications include hemarthrosis, chronic hemophilic synovitis, hemophilic arthropathy, joint deformities, and muscle hematomas, which contribute to decreased muscle strength, limited joint range of motion, chronic pain, activity restriction, and reduced quality of life. Preventive rehabilitation integrated with coagulation factor prophylaxis includes functional assessment (HJHS and FISH), the acute-phase RICE protocol, hydrotherapy, isometric strengthening exercises, range of motion exercises, joint protection education, and the use of orthoses and mobility aids. Conclusion: Medical rehabilitation represents an essential non-pharmacological prophylactic pillar in preventing musculoskeletal complications in pediatric hemophilia.
Association Between Nutritional Status and Anemia Incidence Among High School Adolescent Girls
Anemia remains a critical global health issue among adolescent girls, often theoretically linked to underweight nutritional status; however, the phenomenon of hidden hunger indicates that micronutrient deficiencies are not always reflected in anthropometric parameters, thus the actual correlation between nutritional status and anemia incidence needs to be empirically demonstrated. This study aimed to analyze the relationship between nutritional status and the incidence of anemia among adolescent girls at SMA Negeri 20 Pangkep. This observational analytic study employed a cross-sectional design and was conducted in December 2025. A total of 92 adolescent girls from grades X-XII were selected using the total sampling technique. Data were collected through anthropometric measurements to determine Body Mass Index for Age (BMI-for-Age) and capillary hemoglobin testing using a POCT device, then analyzed using the Chi-Square test (α = 0.05). The findings revealed an anemia prevalence of 23.9%, classifying it as a significant public health problem. Statistical analysis showed that the proportion of anemia in underweight adolescent girls (31.3%) was not significantly different compared to adolescent girls with normal nutritional status (22.4%). The bivariate test confirmed no significant relationship between nutritional status and the incidence of anemia (р = 0.449). Macro-nutritional status (BMI) is not a primary determinant of anemia in this population, implying that adolescent girls with proportional bodies share an equal risk of iron deficiency; therefore, anemia prevention programs and Iron Supplementation Tablet (TTD) distribution must target all adolescent girls evenly, accompanied by continuous education.
The Effect of Health Education Videos on Knowledge of Food Additives
Background: School snacks remain a public health concern because some products do not meet food safety standards and may contain unsafe food additives. Limited student knowledge regarding preservatives, colorants, sweeteners, and flavor enhancers increases the risk of unhealthy snack consumption. Purpose: This study aimed to analyze the effectiveness of animated health education videos in improving elementary school students’ knowledge of food additives. Methods: A pre-experimental design with a one-group pre-test and post-test approach was conducted among 23 fifth-grade students selected through purposive sampling at SDN Karangrejo 6 in 2025. A structured knowledge questionnaire was administered before and after the animated video intervention. Data were analyzed using the Wilcoxon signed-rank test with a significance level of 0.05. Results: The proportion of students with good knowledge increased from 43% to 61%, while the proportion in the poor knowledge category decreased from 35% to 13%. Statistical analysis showed a significant difference between pre-test and post-test scores (p = 0.004). Conclusion: Animated video media is effective in improving students’ knowledge of food additives and is recommended as an innovative school-based health education strategy to strengthen food safety literacy from an early age.
Relationship Between Spousal Support And Exclusive Breastfeeding In Mothers Of 0-6 Month Old Infant
Background: Breast milk is the best life-giving fluid that is essential for babies up to 6 months of age because it has the most complete and ideal nutritional composition for the growth and development of babies, which can meet their nutritional needs during the first 6 months. However, only 39 percent of all babies in the world are exclusively breastfed. Breastfeeding is a natural process, but many mothers are still unable to breastfeed or stop breastfeeding early. Many reasons are cited by mothers who do not breastfeed their babies, including being busy with work, fear of gaining weight, and insufficient milk production (Damanik, 2020). A study proved that husband’s support was an important aspect of exclusive breastfeeding (DelCoreetal. 2018). Purpose: To determine correlation between husband’s support and exclusive breastfeeding mothers at Siti Hajar Clinic Medan Marelan. Methods: The type of research used was quantitative with a cross sectional approach. The study population consisted of 30 mothers who were breastfeeding their children aged 0-6 months at husband’s exclusive breastfeeding assistance center at Siti Hajar Clinic od Medan Marelan. Data analyisis using chi-square. Results: From a survey of 30 breastfeeding mothers, 83.3% of respondents were suppored by their husband’s and 16.7% were not supported by their husband’s. 100% of mothers brestfeed their babies exclusively. This, it means that the p-value = 0.000, p-value <0.05 between the husband’s support for exclusive breastfeeding. Conclusion: Based on the research, it can be seen that there was correlation between husband’s support for exclusive breastfeeding and the behavior of the husband’s to spport, encourage and support the practice of ecxlusive breastfeeding for mothers during breastfeeding.
Analysis Of The Management Of Essential Care In Newborn
Essential care in newborns is an important intervention to prevent complications and lower neonatal mortality. This study aims to analyze the implementation of essential care procedures for newborns at H. Adam Malik Hospital Medan City in 2025, including skin contact measures, umbilical cord care, infant bathing, vitamin K, eye ointment, and Hepatitis B (HB-0) immunization. : The study used a cross sectional design with a quantitative approach and involved 76 samples taken using the Slovin technique from a total population of 329 infants. Data were collected through observation, document analysis, and questionnaires on health workers, then analyzed univariately. The results showed that all essential care measures had been carried out with 100% coverage, except for HB-0 immunization which was only given to 90.8% of infants due to several clinical factors such as low birth weight. The implementation of essential care in general is in accordance with the Standard Operating Procedures (SOP) and WHO guidelines. There is a need to increase consistency in the administration of HB-0 immunization as well as continuous education for health workers and parents to improve the quality of neonatal services.