International Journal of Public Health Science (IJPHS)
International Peer-Reviewed • Open Access • Interdisciplinary Public Health Journal Addressing Global Public Health Challenges Through Research and Innovation From infectious diseases and health promotion to environmental health and health policy, IJPHS publishes interdisciplinary research that advances public health knowledge and practice across diverse populations and settings. Submit Research Read Latest Articles Explore Research Areas The International Journal of Public Health Science (IJPHS), with p-ISSN 2252-8806 and e-ISSN 2620-4126, is an interdisciplinary journal that publishes papers on all aspects of public health science. This journal is published by Intelektual Pustaka Media Utama (IPMU). The IJPHS provides an ideal forum for authors and readers from all over the world to discuss more sophisticated public health research and practice. The focus is on originality and excellence. The journal welcomes high-impact articles on emerging public health science, including epidemiology, biostatistics, nutrition, family health, infectious diseases, health services research, gerontology, child and adolescent health, behavioral medicine, rural health, chronic diseases, health promotion, evaluation, and intervention, public health policy and management, health economics, occupational health, and environmental health. This journal holds SINTA 2 accreditation from the Ministry of Education, Culture, Research, and Technology of the Republic of Indonesia.
Interregional stunting prevalence determinants from a regional perspective in Indonesia: multivariate and spatial analysis approaches
Stunting continues to be a significant public health issue globally, impacting millions of children and hindering long-term human capital development. Prior studies on stunting have predominantly focused on individual factors, neglecting the influence of regional characteristics. The majority of analyses depend on global regression models that presume consistent correlations across areas inclined to using many variables. This research applied Geographically Weighted Spatial Regression to analyze stunting risk factors across 514 districts in Indonesia. By identifying spatially variable determinants, this study supports more targeted and effective stunting reduction strategies. The research results using geographic information systems (GIS) and multivariate analysis show that stunting is highest in eastern Indonesia, where poor sanitation is the dominant factor causing stunting. The policy implemented by the local government is to enhance collaboration with various parties, including academics, government, private sector, and communities, in addressing stunting.
Copyright (c) 2026 Kikin Windhani, Fajar Hardoyono, Ratna Setyawati Gunawan, Dicky Satria Ramadhan, Anzar Alfat Firdaus http://creativecommons.org/licenses/by-sa/4.0
Developing an expressive writing program model for strengthening students’ mental resilience against bullying
Bullying remains a persistent issue in schools and continues to undermine students’ emotional and psychological well-being. This paper introduces a novel conceptual model of an expressive writing program specifically designed for Indonesian schools, addressing the current gap in structured resilience-building interventions. Using a qualitative design based on secondary data from books and journal articles, this study outlines how expressive writing can be systematically integrated into school settings to strengthen students’ mental resilience. The proposed model-illustrated in the program diagram-combines guided writing sessions, emotional literacy activities, and teacher-facilitated support mechanisms. The program also emphasizes teacher preparedness, safe classroom environments, and collaborative involvement from parents and counselors. Additionally, secure digital platforms are recommended to enhance accessibility and ensure confidentiality. This model is intended to guide schools in implementing proactive emotional support systems and to provide a foundation for future empirical evaluation of its effectiveness in reducing bullying and improving students' emotional well-being.
Copyright (c) 2026 Muraina Kamilu Olanrewaju, Febi Robianti, Obinna Augustine Anum, Atawodi Ibrahim, Kennedy Shuaibu http://creativecommons.org/licenses/by-sa/4.0
Behavioral intentions to stop consuming risky foods related to degenerative diseases among Indonesian university students: a descriptive study
Food consumption habits nowadays are diverse, particularly the many choices of processed and quick food at low prices, which, including among students, are unhealthy and unsafe, with unbalanced nutritional levels that can cause a variety of degenerative diseases. This study aimed to describe students' intentions to stop consuming risky foods, grounded in the theory of planned behaviour (TPB). This study is a quantitative descriptive study conducted with second- and fourth-semester students in the public health study program. The sample was selected using accidental sampling, resulting in 87 students participating in the questionnaire. The data were analyzed descriptively and presented in tables and narratives. The study shows that fatty meat/offal, canned foods, pickled foods, and dried sweets are consumed frequently. The non-intentional group comprised processed cheese, frozen sweets and ice cream, quick noodles, and fried foods. Among 10 dangerous foods, fried foods, processed cheese, pickles, and frozen desserts are the least likely to be substituted. Most responders were unsure of the quitting time. Students did not plan to quit unhealthy foods. Students did not have a firm intention to stop consuming hazardous foods such as processed cheese, frozen sweets, instant noodles, and fried foods.
Copyright (c) 2026 Sitti Nur Djannah, Lina Handayani, Intan Wahyuni Tukiyo, Trinur Afika Mandar http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of telerehabilitation versus home exercise in knee osteoarthritis: a quasi-experimental study in Indonesia
In Indonesia, osteoarthritis affects about 7.30% of the population, with its occurrence rising markedly as people age. The condition is found in 11.08% of individuals aged 45-54 years and increases to 18.85% among those older than 75 years. A large proportion of individuals with knee osteoarthritis (KOA) lead inactive lifestyles and often lack adequate encouragement to engage in physical activity. Exercise is known to be beneficial, as it helps regulate cytokine activity in synovial fluid while reducing inflammation and oxidative stress. This research aimed to evaluate the comparative effectiveness of telerehabilitation and home-based exercise interventions for individuals with KOA. A quasi-experimental approach with pre- and post-intervention assessments and a control group was applied. The study involved 120 participants diagnosed with osteoarthritis, who were assigned to either an intervention group receiving an 8-week telerehabilitation program or a control group performing standard exercises independently. Outcome measures: 30-CST, pain intensity, physical activity levels assessed using IPAQ, fear of movement measured by the Tampa Kinesiophobia Scale, and FSS. These variables were assessed before and after the intervention. Additionally, adherence to exercise (EARS) and patient satisfaction were recorded. Statistical analysis was conducted using the Mann-Whitney test and the Wilcoxon signed-rank test.
Copyright (c) 2026 Grenda Aprilyawan, Inayah Ageng Izza, Lanendo Raufbar Ramdan Suwanda, Made Mahaguna Putra http://creativecommons.org/licenses/by-sa/4.0
Impact of an empathy-based mental health first aid intervention using the SUFA model on anxiety and depression among adolescents: a quasi-experimental study
This study evaluated the effectiveness of an empathy-based mental health first aid (MHFA) intervention through structured SUFA mentoring by peer counselors in reducing symptoms of anxiety and depression in adolescents. The design used was a quasi-experimental, one-group pretest-posttest study conducted over two weeks in middle and high schools. A total of 100 students were trained as peer counselors, and each mentored one adolescent (a 1:1 ratio). Symptoms were measured before and after the intervention using the Mini MINDHEAR Youth Scale V.1. Analysis included descriptive statistics (mean pre–post scores and changes in symptom categories of "mild/none" vs. "moderate") and McNemar test (α = 0.05) to assess changes in categories. Respondents were predominantly female (67%), in late adolescence (58.18%), and high school students (55%). The mean anxiety score decreased from 4.92 to 3.50 (Δ = 1.42), while depression decreased from 5.05 to 3.21 (Δ = 1.84). The proportion of mild/none anxiety increased from 13 to 56, and moderate decreased from 87 to 44 (p = 0.003). A similar pattern occurred for depression: mild/none increased from 13 to 61, while moderate decreased (p = 0.001). SUFA-based peer counseling interventions significantly reduce symptoms of anxiety and depression in adolescents. Schools should integrate structured peer counselor training programs into mental health frameworks, establish systematic early detection protocols, and establish clear referral pathways to professional services within school-based support systems. The limitations of this study were no control group and short duration, which must be addressed in subsequent research.
Copyright (c) 2026 Sulastri, Siti Fatonah, Yuniastini, Giri Udani, Allan Harris http://creativecommons.org/licenses/by-sa/4.0
Consumer preferences and marketing strategy for black pule (Alstonia spectabilis) antimalarial tablet prototypes in South Central Timor
Malaria remains endemic in eastern Indonesia, and resistance to conventional antimalarial drugs necessitates alternative treatments. Black pule (Alstonia spectabilis) is one of the plants that has been researched and claimed to be a natural ingredient that can treat malaria. Black pule prototype has been prepared for the downstream stage through commercialization. Before that, it is necessary to conduct marketing research to ensure the success of the marketing. Therefore, this study evaluates consumer preferences and formulates marketing strategies for black pule antimalarial tablets. This study involved 100 respondents selected using cluster and purposive sampling across three malaria-endemic sub-districts in South Central Timor Regency. Using a quantitative-descriptive approach, data were collected through questionnaires and analyzed with descriptive statistics. The results show that most consumer targets stated that the antimalarial tablet prototype of black pule has a good impression and characteristics. Approximately 69-77% of respondents rated the product positively across shape, color, taste, aroma, size, and overall organoleptic attributes. The results indicate that the majority of respondents gave positive evaluations and expressed a preference for the product’s shape, color, taste, aroma, size, and overall organoleptic characteristics. Findings support aggressive marketing strategies for herbal antimalarial tablets in endemic regions. Based on these findings, an aggressive S-O marketing strategy is recommended, emphasizing product promotion, participation in health-related expos, strengthened digital outreach, and concise educational initiatives to improve public acceptance of the herbal antimalarial tablet.
Copyright (c) 2026 Novia Maulina, Sari Dewi Setyowati, Salma Rizqika Irwanadi, Hajar Sugihantoro, Riza Ambar Sari, Ziyana Walidah, Maximus M. Taek, Burhan Ma’arif http://creativecommons.org/licenses/by-sa/4.0
Migrant worker mental health in Southeast Asia: a bibliometric analysis of public health research (2005–2025)
Southeast Asia hosts an estimated 10-14 million intraregional labor migrants who face disproportionate mental health burdens. No bibliometric study has systematically mapped the intellectual landscape or knowledge gaps of migrant worker mental health research specific to this region. A bibliometric analysis was conducted on peer-reviewed literature indexed in Web of Science and Scopus (January 2005-December 2025), following the BIBLIO checklist. VOSviewer and Bibliometrix (R v4.4) were used for keyword co-occurrence network mapping and publication trend analysis, respectively. A total of 487 eligible records were identified. Annual output grew from fewer than 10 publications per year before 2010 to over 60 per year from 2021 onward. Thailand dominated as the primary study setting (38.6%) and top-producing country (31.4%). Five thematic clusters emerged: i) depression and anxiety screening, ii) occupational stressors, iii) acculturation and social support, iv) healthcare access barriers, and v) social determinants of health. Symptom-prevalence research declined from 68% to 31% while equity-focused research grew from <1% to 14% over two decades. The field has grown substantially but remains geographically concentrated. Equity-focused, structurally informed research agendas are urgently needed to reduce mental health disparities among the region's most vulnerable workers.
Copyright (c) 2026 Suamuang Ruangrit http://creativecommons.org/licenses/by-sa/4.0
Association between educational level and diabetes knowledge among older adults with type 2 diabetes in Bandung City: a cross-sectional study
Diabetes mellitus (DM) is a major non-communicable disease among older adults and a growing public health problem in Indonesia. Older people often have limited health literacy, which may affect their knowledge and self-management of DM. This study aimed to analyze the relationship between education level and knowledge about DM among the elderly in Bandung City, West Java. A descriptive cross-sectional study was conducted on 150 elderlies with type 2 DM using purposive sampling at primary health care facilities with high DM cases. Data were collected through structured interviews using a demographic questionnaire and a 15-item multiple-choice questionnaire on DM knowledge that had been tested for validity and reliability previously, adapted from an Indonesian diabetes self-management instrument. Knowledge scores were categorized into good and poor. Data were analyzed using the Chi-square test. Most respondents had an elementary or high-school education. The majority of the elderly with higher education levels had good knowledge about DM, while those with lower education levels tended to have poorer knowledge. There was a statistically significant association between education level and elderly knowledge about DM (p<0.001). Education level is significantly associated with DM knowledge among the elderly in Bandung. These findings highlight the need for a tailored continuity of care diabetes program, especially for the elderly with lower educational attainment, in order to improve self-management and glycemic control.
Copyright (c) 2026 Citra Windani Mambang Sari, Hartiah Haroen, Neti Juniarti, Lisda Amalia, Jerico Pardosi http://creativecommons.org/licenses/by-sa/4.0
Development of a supportive-educative health education intervention for family caregivers of diabetes mellitus patients: a quasi-experimental study
Despite growing evidence on family involvement in diabetes management, few studies have developed and tested structured educational programs targeting family caregivers as active companions in resource-limited settings. This study aimed to evaluate the effectiveness of a comprehensive family support education program based on the five pillars of diabetes mellitus (DM) management in enhancing family knowledge and educational support capacity. A quasi-experimental design with non-probability sampling was employed, involving 157 respondents (intervention group: 72; control group: 85). Social support was measured using a modified Diabetes Social Support Questionnaire-Family. Data were analyzed using independent and paired t-tests. The intervention group demonstrated a significant increase in mean educational support scores from 61.81 to 90.85 (mean difference = 29.04; p < 0.001; Cohen's d = 1.82), indicating a large effect size. The control group showed negligible changes. Poor knowledge decreased from 45.8% to 26.39% in the intervention group, while intermediate knowledge increased substantially. The structured family education program produced a large and statistically significant improvement in caregiving capacity. These findings underscore the need for public health policies to integrate family-centered educational interventions into routine diabetes care, particularly in settings with limited healthcare infrastructure, to reduce disease burden and improve patient outcomes.
Copyright (c) 2026 Siti Fatonah, Sulastri, Yuniastini http://creativecommons.org/licenses/by-sa/4.0
Validation of Si-HIPO mHealth application for hypertension-obesity education in Surakarta
Hypertension and obesity represent significant global public health challenges requiring innovative educational interventions. The Si-hypertension and obesity information system (HIPO) application was developed as a context-specific digital health education medium targeting Indonesian community health center populations, distinguishing it from existing generic mHealth tools by integrating comorbid hypertension-obesity education within a culturally appropriate single platform. This study aimed to assess the content validity of the Si-HIPO application through expert and respondent validation. A quantitative descriptive cross-sectional design was employed at Sibela Community Health Center, Surakarta, Indonesia. Expert validation involved two assessors using Aiken's V coefficient methodology, while respondent validation included 66 participants with hypertension and overweight/obesity. Respondent characteristics revealed predominantly female participants (60.61%), aged > 40 years (39.39%), with stage 2 hypertension (51.52%) and obesity (59.09%). Respondent evaluation demonstrated 72.73% positive acceptance. Expert validation yielded high validity coefficients for nine of ten items (V = 0.802-0.833), with one item showing moderate validity (V = 0.667). The aggregated validity coefficient was 0.802, indicating high overall content validity. The Si-HIPO application demonstrates strong content validity and user acceptability as an educational medium for hypertension and obesity management. However, further effectiveness testing through experimental or quasi-experimental designs is warranted before implementation in clinical practice.
Copyright (c) 2026 Sunarsih Rahayu, Ros Endah Happy Patriyani http://creativecommons.org/licenses/by-sa/4.0
The effect of emotion card games on emotional intelligence among elementary school-aged children: a quasi-experimental study in Mataram, Indonesia
Emotional intelligence is a key skill influencing adaptation, communication, and personal growth in elementary school-aged children. Emotional card games offer a promising interactive approach to enhance children's emotional competencies. To analyze the effect of emotional card games on the emotional intelligence of elementary school-aged children. A quasi-experimental pretest-posttest control group design was conducted among 77 first-grade students at MI Mambaul Khair NW Bertais Mataram in 2025. The intervention group (n = 39) participated in three sessions of an emotional card game, while the control group (n = 38) received no intervention. Emotional intelligence was measured using a validated 24-item questionnaire. The intervention group demonstrated a significant increase in emotional intelligence scores from pre-test to post-test (p = 0.007), whereas the control group showed no significant change. Between-group comparison confirmed significantly higher post-test scores in the intervention group (p = 0.006). After adjusting for confounding variables and baseline scores, the intervention effect remained statistically significant (p < 0.001). Emotional card games effectively improve emotional intelligence among elementary school-aged children. These findings support the integration of game-based social-emotional learning strategies into elementary school curricula. School health practitioners and educators can utilize this low-cost, engaging intervention to promote children's emotional well-being and support holistic child health development.
Copyright (c) 2026 Moh. Arip, Sri Susantini, Martha Meti Kodi, Melati Inayati Albayani, Novi Enis Rosuliana http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of HIPO Android-based application in improving hypertension self-management literacy among obese patients
Hypertension in obese patients requires comprehensive management through enhanced health literacy. Android-based applications represent a promising innovation for improving hypertension control literacy. To analyze the effectiveness of the Android-based hypertension and obesity information system (HIPO) application in improving hypertension control literacy among obese patients. This quasi-experimental study employed a one-group pretest-posttest design without a control group, conducted at Sibela Community Health Center, Surakarta, from June to December 2025. Seventy-six respondents were selected through purposive sampling, meeting criteria of primary hypertension (≥ 140/90 mmHg) and BMI ≥ 25 kg/m². The intervention involved four weeks of HIPO application use. Data were analyzed using the Wilcoxon Signed Rank Test. Respondents were predominantly female (67.11%), aged 46-55 years (31.58%), with a genetic predisposition to hypertension (57.89%). Systolic blood pressure significantly decreased from 159.53 ± 14.19 to 144.48 ± 11.44 mmHg (p < 0.001), and diastolic from 95.20 ± 6.55 to 88.50 ± 4.58 mmHg (p < 0.001). Good knowledge increased from 35.53% to 55.26%, and good hypertension control increased from 35.53% to 61.84%. The HIPO application significantly improved blood pressure, knowledge, and hypertension control. However, the absence of a control group limits causal inference. This application may serve as a supplementary educational tool in primary healthcare chronic disease management programs.
Copyright (c) 2026 Ros Endah Happy Patriyani, Sunarsih Rahayu http://creativecommons.org/licenses/by-sa/4.0
Therapeutic adherence and somatic symptom perception in patients with heart failure: a scoping review
Heart failure is a chronic condition associated with high morbidity and frequent hospital readmissions, requiring effective self-management strategies. Therapeutic adherence and somatic symptom perception are essential components of self-management, enabling early symptom recognition and timely intervention. However, evidence regarding the relationship between these two factors remains limited. This scoping review aimed to map current evidence on the relationship between therapeutic adherence and somatic symptom perception in patients with heart failure and to identify influencing factors. The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Literature searches were conducted in ProQuest, ScienceDirect, Springer, and Google Scholar for studies published between 2016 and 2025. Eligible studies involved adult patients with heart failure and assessed therapeutic adherence and somatic symptom perception using validated instruments. Eight studies were included, comprising four cross-sectional studies, three randomized controlled trials, and one quasi-experimental study. Findings indicated a positive association between adherence to self-care behaviors and improved somatic symptom perception. Patients with consistent symptom monitoring demonstrated better recognition of early deterioration signs. However, a greater symptom burden was associated with lower adherence in several studies. Integrating symptom perception training, motivational strategies, and caregiver involvement may improve adherence, enhance early symptom detection, and reduce hospital readmissions.
Copyright (c) 2026 Tri Andayani, Kumboyono, Lilik Supriati http://creativecommons.org/licenses/by-sa/4.0
Oxytocin massage and clary sage aromatherapy on lactation and uterine recovery
The postpartum period is a critical phase in maternal health, during which inadequate lactation and delayed uterine involution may contribute to an increased risk of complications. This study aimed to determine the effectiveness of combined oxytocin massage and clary sage aromatherapy on lactation and uterine involution in women during the postpartum period. A quasi experimental study was conducted among 30 participants (15 controls; 15 intervention). In the control group, mean breast milk volume increased from 32.00 ± 14.74 mL to 105.33 ± 18.07 mL (Δ = 73.33 ± 17.29; p < 0.001). In the intervention group, it increased from 37.00 ± 24.04 mL to 98.33 ± 40.39 mL (Δ = 61.33 ± 36.62; p<0.001), with no significant intergroup difference (p = 0.265). However, uterine involution differed significantly between groups (Mann-Whitney U = 43.000, Z = -2.932, p = 0.003). The combined intervention may serve as a complementary strategy to enhance uterine recovery, although its effect on breast milk production was not statistically superior to standard care.
Copyright (c) 2026 Rahmadini Faricha Hakim, Dyan Permata Rachim, Hindun Mila Hudzaifah, Ulfa Farrah Lisa, Dina Taufia, Fathiya Ilma Shabrina http://creativecommons.org/licenses/by-sa/4.0
Boiled ginger and honey intervention for hyperemesis gravidarum
Hyperemesis gravidarum is excessive vomiting which can cause dehydration, lack of carbohydrate and fat reserves in the body, and Mallary Weiss syndrome due to gastrointestinal bleeding. Boiled ginger and honey were administered as an initial complementary treatment to reduce nausea and vomiting in pregnant women with hyperemesis gravidarum. This study aims to determine the effect of giving ginger and honey decoction on the frequency of hyperemesis gravidarum in pregnant women. This study employed a quasi-experimental design with a one-group pretest-posttest approach. The population was all pregnant women who experienced nausea and vomiting, outpatients, and inpatients at Inche Abdoel Moeis Hospital. The sample consisted of 18 people using consecutive sampling technique. The severity of nausea and vomiting was measured using the pregnancy-unique quantification of emesis and nausea (PUQE) questionnaire. Statistical analysis was performed using the Wilcoxon signed-rank test to compare pretest and posttest scores. The Wilcoxon Test results obtained a significance value of 0.000 < 0.05. There is an effect of giving ginger and honey decoction on the frequency of hyperemesis gravidarum. Pregnant women are advised to use a decoction of ginger and honey, apart from that, other researchers are advised to use a control group in subsequent studies.
Copyright (c) 2026 Nursyahid Siregar, Ega Ersya Urnia, Jasmawati, Irma Mustika Ningsih, Rahmawati Wahyuni, Rosalin Ariefah Putri, Dewi Rinda, Heni Suryani, Elisa Goretti Sinaga http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of a breastfeeding self-efficacy intervention on BSES-SF scores and exclusive breastfeeding: a quasi-experimental study in postpartum mothers
Despite Indonesia's national breastfeeding promotion efforts, exclusive breastfeeding rates remain below the 80% target, with limited evidence on structured breastfeeding self-efficacy (BSE) interventions in low-resource Indonesian settings. To evaluate the effectiveness of a BSE intervention on BSES-SF scores and exclusive breastfeeding continuation during the first six months postpartum. A quasi-experimental pretest-posttest design with a control group was conducted on 104 postpartum mothers (52 intervention, 52 control). Measurements were conducted longitudinally at baseline, weeks 2, 6, 12, and 24 postpartum. Data were analyzed using independent t-test, Chi-square, Cox proportional hazard regression, and linear mixed model (LMM). The intervention group's BSES-SF score increased significantly from 42.35 to 59.73 compared to the control group (41.88 to 48.06, p < 0.001). Exclusive breastfeeding at 24 weeks was significantly higher in the intervention group (71.2% vs. 40.4%, RR = 1.76, p = 0.001). Cox analysis identified the intervention as the strongest protective factor (HR = 0.41, p = 0.001), followed by husband's support (HR = 0.54, p = 0.039), while employment was a risk factor (HR = 1.72, p = 0.034). The non-randomized design and single-site setting may limit generalizability. The BSE intervention effectively increased self-efficacy scores and exclusive breastfeeding rates, suggesting integration into routine postpartum care as a scalable public health strategy.
Copyright (c) 2026 Arifarahmi, Asrial Asrial, Muhammad Rusdi, Solha Elrifda http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Afigel therapy in reducing urinary incontinence among premenopausal women: a quasi-experimental study in rural Indonesia
Urinary incontinence (UI) affects millions globally, predominantly women, significantly impacting quality of life. This study evaluated Afigel as a novel intervention for reducing UI symptoms. A quasi-experimental pre-posttest design was employed with 93 premenopausal women randomly assigned to intervention (n = 31) and control (n = 62) groups. Data collection utilized personal data sheets, Afigel therapy standard operating procedures, observation sheets, and the questionnaire for urinary incontinence diagnosis (QUID). Dependent and independent t-tests analyzed the data. Among participants, 43% experienced stress incontinence, 47% experienced urge incontinence, and 10% mixed incontinence. Severity was mild (41%), moderate (45%), and severe (14%). The intervention group demonstrated a significant reduction in incontinence scores from 6.30 to 1.53 (p = 0.000), while the control group showed minimal change from 6.30 to 6.18 (p = 0.21). Afigel demonstrates potential as an effective UI management therapy. These findings suggest Afigel could substantially improve quality of life by reducing UI-related social embarrassment, activity limitations, and psychological distress. For primary health care settings, Afigel offers a potentially accessible, non-invasive treatment option that community health nurses and primary care providers could implement, reducing referral burdens on specialist services while addressing this prevalent yet often underreported condition.
Copyright (c) 2026 Siti Fatonah, Sulastri http://creativecommons.org/licenses/by-sa/4.0
Hemodynamic stabilization in cesarean section patients administered spinal anesthesia: a quasi-experimental study comparing ephedrine and phenylephrine
This quasi-experimental research aimed to compare the effects observed following the administration of ephedrine 10 mg and phenylephrine 50 mg administered as therapeutic bolus doses for the management of intraoperative hypotension due to spinal anesthesia in cesarean section. The study involved 60 parturients who developed intraoperative hypotension during spinal anesthesia, who were divided into two groups treated with either phenylephrine or ephedrine. Maternal blood pressure, including systolic and diastolic values, was assessed pre- and post- vasopressor administration and analyzed using descriptive statistics, normality testing, and independent-samples t-tests. Both vasopressors were associated with increased maternal blood pressure following intervention, with no significant differences observed at baseline. However, between-group comparisons revealed statistically significant differences in post-intervention systolic and diastolic blood pressure (p < 0.05), indicating distinct hemodynamic response profiles. These findings demonstrate the effectiveness of both ephedrine and phenylephrine in treating hypotension associated with spinal anesthesia; vasopressor selection influences maternal blood pressure outcomes. From a practical perspective, this study provides clinically relevant evidence to inform anesthetic decision-making in maternal healthcare services, particularly in settings where therapeutic bolus administration is routinely utilized for the management of hypotension associated with spinal anesthesia.
Copyright (c) 2026 Sindu Sintara, Annes Rindy Permana, Widigdo Rekso Negoro, Suryanto, Reko Priyonggo, Muhammad Rodli http://creativecommons.org/licenses/by-sa/4.0
Effectiveness of hypnotherapy as complementary intervention in reducing post-cesarean pain: A PRISMA-based systematic review of literature released during the 2015-2024 period
Cesarean section is a common surgical procedure often associated with moderate to severe postoperative pain. Hypnotherapy has been proposed as a complementary, non-pharmacological intervention; however, evidence specific to post-cesarean pain management remains limited. The purpose of this PRISMA-based systematic review was to evaluate hypnotherapy as an intervention for reducing postoperative pain associated with cesarean section. Literature searches were conducted in Google Scholar and PubMed for studies published between 2015 and 2024 using predefined inclusion and exclusion criteria. From 326 identified records, four studies met all eligibility criteria and were included in the qualitative synthesis. Despite heterogeneity in study design and intervention protocols, all included studies consistently reported reductions in postoperative pain intensity among participants receiving hypnotherapy compared with standard postoperative care, with pain outcomes primarily measured using validated scales such as the Numerical Rating Scale. These findings suggest that hypnotherapy may support conventional analgesic strategies as an adjunctive intervention during early postoperative recovery. Nevertheless, the scarcity of existing research and the presence of methodological limitations suggest the need for rigorously designed randomized controlled trials to provide more robust evidence.
Copyright (c) 2026 Annes Rindy Permana, Widigdo Rekso Negoro, Sindu Sintara, Muhammad Rodli, Suryanto, Reko Priyonggo http://creativecommons.org/licenses/by-sa/4.0
Empowerment-based ToT HIV intervention among Indonesian construction workers: a quasi-experimental study
Preventing HIV/AIDS in high-risk workplaces remains a public health priority, particularly in the construction sector. However, empirical evidence on structured, sustainable, and empowerment-based Training-of-Trainers (ToT) interventions for HIV prevention in Indonesian construction workplaces remains limited. This study evaluated a ToT-based intervention designed to build internal peer-facilitator capacity among construction workers and to strengthen workplace HIV prevention through a feasible, scalable, and participatory model. MA quasi-experimental single-group pre-test-post-test study was conducted among 30 construction workers attending a two-day facilitator training. HIV/AIDS knowledge was assessed before and immediately after training using a structured questionnaire. Paired-sample t-tests, Wilcoxon signed-rank test, Cohen’s dz, and thematic content analysis were applied. Results: Mean knowledge scores increased significantly from 60.00 (SD = 12.66) to 91.33 (SD = 7.65), with a mean difference of 31.33 (95% CI: 26.76-35.90; p < 0.001). These findings suggest that peer-facilitator training may be a promising workplace health promotion strategy to strengthen HIV prevention capacity in construction settings, although further controlled studies are needed. Qualitative findings highlighted increased confidence, perceived relevance, and stronger peer networking. The ToT-based intervention was associated with substantial short-term gains in HIV/AIDS knowledge among construction workers and may help strengthen internal workplace prevention capacity. Further controlled studies with longer follow-up are needed to confirm its effectiveness and sustainability.
Copyright (c) 2026 Anisful Lailil Munawaroh, Fatma Lestari, Baiduri Widanarko http://creativecommons.org/licenses/by-sa/4.0
Operation type and phase specific compliance with WHO surgical safety guidelines checklist at the mother and child hospital
The surgical safety checklist (SSC) is a recognized tool for enhancing patient safety by reducing surgical complications and mortality. While its benefits are well established, effective implementation depends on consistent adherence by the medical team. This study examined the relationship between surgical procedure type and team compliance with SSC in the central operating room of a maternal and child hospital in Yogyakarta. Using a quantitative cross-sectional design, data were collected from 65 observed operations out of 148 total procedures, including elective and emergency cases. Compliance was evaluated in three SSC phases: sign-in, time-out, and sign-out. Correlation was analyzed using chi-square tests. The results showed no significant relationship in the sign-in phase (p = 0.195), but significant correlations were found in the time-out (p = 0.004) and sign-out (p = 0.011) phases. Overall, a significant association was identified between type of surgery and SSC compliance (p = 0.006). This study concludes that SSC compliance remains suboptimal, particularly in the initial phase. Elective procedures demonstrated higher compliance than emergency cases. Strengthening a culture of safety and promoting interdisciplinary training are essential strategies to improve SSC adherence and elevate surgical care quality.
Copyright (c) 2026 Agus Budi Prasetyo, Ircham Saifudin, Widigdo Rekso Negoro, Muhammad Rodli, Sindu Sintara, Annes Rindy Permana http://creativecommons.org/licenses/by-sa/4.0
User-centred socio-technical requirements for telehomecare in hospital-based homecare services in Indonesia: a qualitative study
The increasing number of homebound and bedridden patients in Indonesia illustrates the importance of effective hospital-based telehomecare. While telehomecare can improve access and continuity of care, its implementation depends on alignment with user needs. This study aimed to identify user-centered socio-technical requirements for telehomecare in hospital-based homecare services in Indonesia. A qualitative descriptive study was conducted using in-depth interviews and a focus group discussion with 12 purposively selected stakeholders. A telemonitoring device was used as a contextual probe. Data were analyzed using inductive thematic analysis with stakeholder triangulation. Three main areas of needs were identified: i) functional needs, which include constant monitoring, settings for specific diseases, early warning alerts, organized communication, and access to long-term data; ii) technical needs, like ease of use for older people, access through mobile devices, support for location tracking, easy-to-read dashboards, and compatibility with hospital information systems; and iii) data security, privacy, and making sure everyone can use the system, which involves dealing with. These findings help shape the design and growth of fair telehomecare systems in health settings with limited resources and provide real-world evidence from a low- and middle-income country.
Copyright (c) 2026 Iman Permana, Moch Zihad Islami, Winny Setyonugroho, Ika Puspita Sari, Janatarum Sri Handono, Sentagi Sesotya Utami http://creativecommons.org/licenses/by-sa/4.0
Association of body mass index and age as risk factors for post-anesthetic shivering in mastectomy patients under general anesthesia in East Java, Indonesia
Intraoperative hypothermia and post-anesthetic shivering (PAS) remain frequent complications in oncologic surgery under general anesthesia, yet evidence integrating intraoperative temperature changes with PAS severity in mastectomy patients is limited. This study aimed to evaluate intraoperative temperature profiles, determine the incidence and severity of PAS, and analyze the association between age, body mass index (BMI), and PAS among radical mastectomy patients. A cross-sectional observational study was conducted involving 36 women undergoing radical mastectomy with endotracheal general anesthesia. Core temperature was measured at 30 and 60 minutes intraoperatively, and PAS was assessed using the bedside shivering assessment scale (BSAS) upon admission to the recovery room. Moderate intraoperative hypothermia was observed in 72.2% of patients at 60 minutes, while PAS occurred in 30.6% of cases. Significant associations were identified between PAS and BMI (p = 0.001), as well as age (p = 0.026). Moderate-to-severe shivering (BSAS scores 2-3) was more frequently observed among underweight and elderly patients. This study provides novel evidence by linking intraoperative hypothermia patterns with PAS severity using BSAS in mastectomy patients. Clinically, the findings support structured perioperative temperature monitoring and the implementation of risk-based warming protocols, particularly for patients with low BMI and advanced age.
Copyright (c) 2026 Reko Priyonggo, Muhammad Rodli, Suryanto, Annes Rindy Permana, Widigdo Rekso Negoro, Sindu Sintara http://creativecommons.org/licenses/by-sa/4.0
Comparative effects of desflurane and sevoflurane on recovery time in patients undergoing modified radical mastectomy: a cross-sectional study
Fast and predictable recovery is essential in breast cancer surgery, yet comparative evidence on inhalation anesthetics within Indonesian clinical settings remains limited. This study compared the effectiveness of desflurane and sevoflurane on early recovery time after modified radical mastectomy. A cross-sectional design was applied to 76 ASA I-II female patients who received standardized induction, maintenance, and Aldrete-based recovery assessment. Recovery was categorized as fast (≤10 minutes) or delayed (>10 minutes). Statistical analysis used Chi-square testing, supported by effect size and risk ratio estimation. Desflurane demonstrated significantly faster recovery than sevoflurane (97.4% vs 78.9%, p = 0.014). The association showed a moderate effect size (Cramér’s V = 0.30), and patients receiving sevoflurane were substantially more likely to experience delayed recovery (RR = 8.3). These results align with recent studies highlighting desflurane’s lower blood-gas solubility and faster elimination profile. The homogeneous sample and standardized anesthetic protocol strengthen internal validity. However, the non-randomized design, purposive sampling, and absence of documented adverse events limit generalizability. Desflurane may offer practical benefits in improving post-anesthesia care unit (PACU) efficiency and surgical throughput in high-volume settings. Further multicenter randomized studies are recommended to confirm these findings and explore broader clinical implications.
Copyright (c) 2026 Muhammad Rodli, Suryanto, Reko Priyonggo, Sindu Sintara, Annes Rindy Permana, Widigdo Rekso Negoro http://creativecommons.org/licenses/by-sa/4.0
Determinants of community perception on food technology-based shallot waste management for nutritional security: a cross-sectional study
Shallot production in Indonesia, particularly in Brebes Regency, generates substantial agricultural by-product waste that poses significant environmental and public health risks due to inadequate community-level management. This cross-sectional quantitative study investigated the influence of government role, infrastructure availability, and public knowledge on perceptions of shallot by-product waste management among 180 respondents selected through proportional random sampling. Data were collected using structured Likert-scale questionnaires and analyzed through multiple linear regression, Spearman's rank correlation, and gap analysis. Gap analysis revealed critical deficiencies in public knowledge (50.6-76.1%) and infrastructure (69.2%), despite universally positive perceptions toward waste management. Multiple linear regression demonstrated that government role (β = 0.342, p < 0.001), infrastructure availability (β = 0.298, p < 0.001), and public knowledge (β = 0.152, p = 0.007) significantly predicted waste management perceptions, collectively explaining 37.8% of the variance (Adj. R² = 0.378). The government's role contributed the largest effective contribution at 18.74%. These findings carry substantial public health implications, as improved waste management can reduce disease vectors, minimize environmental contamination, and enable by-product valorization for nutritional supplementation. The study recommends strengthening government intervention, expanding waste infrastructure, and enhancing community health literacy as integrated policy strategies to optimize agricultural by-product management and safeguard community nutritional well-being in shallot production centers.
Copyright (c) 2026 D. Yan El Rizal Unzilatirrizqi, Riska Arsita Harnawati http://creativecommons.org/licenses/by-sa/4.0
Effect of red beet flour substitution on iron content and acceptability of functional muffins: an experimental study for anemia prevention
Iron deficiency anemia (IDA) remains a critical global public health burden, affecting approximately 1.8 billion people worldwide, disproportionately impacting children under five and women of reproductive age in developing countries. Conventional iron supplementation often suffers from low compliance due to gastrointestinal side effects. Thus, food-based interventions utilizing widely accepted bakery products represent a sustainable and culturally appropriate strategy for addressing micronutrient deficiencies. A completely randomized design with five red beet flour proportions(0-40%). In muffin formulations was employed, analyzing proximate, physicochemical, antioxidant, and sensory parameters were analyzed across three replications. Results: increasing red beet flour significantly (p < 0.05) enhanced Fe content (1.42-5.06 mg/100 g), total betalains, total phenolics, and antioxidant activity. Treatment T2 (20%) demonstrated an optimal balance between functional properties and sensory acceptability. The T2 formulation can contribute approximately 28% of the recommended dietary allowance for iron per serving, positioning it as a viable functional food for community nutrition interventions. This product could be integrated into supplementary feeding programs targeting vulnerable populations prone to anemia. The food-based approach offers superior compliance and sustainability compared to conventional tablet supplementation, thereby strengthening population-level strategies for IDA prevention.
Copyright (c) 2026 Yeni Tutu Rohimah, Dwi Retna Prihati, Titik Lestari http://creativecommons.org/licenses/by-sa/4.0
Nutritional status and diabetes knowledge as predictors of healthy lifestyle behaviors for prediabetes prevention in adolescents
Prediabetes prevalence among adolescents has increased substantially worldwide, with estimates indicating that approximately 18-20% of adolescents in certain populations exhibit impaired glucose metabolism, paralleling the global rise in adolescent obesity. In Indonesia, the prevalence of diabetes mellitus continues to escalate, with North Kalimantan representing an underserved region where adolescent metabolic health remains poorly characterized. Identifying modifiable factors associated with prediabetes prevention behavior is essential for developing targeted interventions. To analyze factors associated with prediabetes prevention behavior in adolescents, focusing on nutritional status and knowledge about diabetes mellitus. A cross-sectional analytical design was employed among 316 adolescents aged 13-15 years in Tarakan City, North Kalimantan, Indonesia, selected through proportional stratified random sampling. Data were collected using a demographic questionnaire, an adapted diabetes knowledge questionnaire (DKQ-24), and a prediabetes prevention behavior questionnaire. Chi-square tests and binary logistic regression were performed. Most respondents (53.2%) demonstrated positive prevention behavior, and 70.9% had high knowledge. Nutritional status (p = 0.000) and knowledge (p = 0.033) were significantly associated with prevention behavior. Multivariate analysis confirmed nutritional status (Exp(B) = 1.320; 95% CI: 1.017-1.714) and knowledge (Exp(B) = 0.583; 95% CI: 0.352-0.965) as significant predictors (Nagelkerke R² = 0.052). Nutritional status and diabetes knowledge significantly predict prediabetes prevention behavior, although their contributions remain relatively small.
Copyright (c) 2026 Nur Indah Noviyanti, Reza Bintangdari Johan, Rusmiati, Cici Ismuniar, Ruqaiyah, Hukmiyah Aspar, Rahmi Padlillah http://creativecommons.org/licenses/by-sa/4.0
Community-based turmeric tea intervention for hyperuricemic elderly in Manado, Indonesia
Hyperuricemia, with a global prevalence of approximately 14.0% in the general population and rising to 24.0% among the elderly, represents the second most prevalent metabolic disease after diabetes and constitutes a significant public health burden. This study aimed to determine the effectiveness of turmeric tea in reducing blood uric acid levels in hyperuricemic elderly. A quasi-experimental design with a pretest-posttest control group approach was employed, involving 140 respondents equally divided into an intervention group (n = 70) receiving 1000 mg/day of turmeric tea and a control group (n = 70) receiving standard health education. Blood uric acid levels were measured using a portable uric acid meter. Data were analyzed using the Paired Sample t-test, the Independent Sample t-test, and multiple linear regression. The intervention group demonstrated a significant reduction in mean uric acid levels from 8.46 ± 1.32 mg/dL to 6.78 ± 1.18 mg/dL (mean difference = 1.68 mg/dL; p = 0.000), while the control group showed no significant change (8.39 ± 1.28 to 8.21 ± 1.25 mg/dL; p = 0.137). The effect size was large (Cohen's d = 1.23). Multiple regression confirmed turmeric tea as the strongest predictor of uric acid reduction (B = 1.472; p = 0.000). Turmeric tea effectively reduces blood uric acid levels in hyperuricemic elderly and holds potential for integration into community-based elderly health programs as an accessible and affordable complementary therapy for hyperuricemia management.
Copyright (c) 2026 Ellen Pesak, Ni Luh Jayanthi Desyani, Tinneke A. Tololiu, Jane Annita Kolompoy, Herlina P. Memah, Bongakaraeng, Rommy David Watuseke, Yanni Karundeng, Lorrien Grace Runtu, Debora Yuriska Rau http://creativecommons.org/licenses/by-sa/4.0
Water quality assessment of the Banong River receiving effluent from Sleman Public Hospital
Hospital effluent has the potential to release both chemical substances and pathogenic microorganisms into surrounding water bodies, creating hazards for the environment and human health. There is a scarcity of studies in Indonesia that assess the impact of hospital wastewater on river ecosystems using benchmark regulations. This study measured the quality of wastewater at a point 50 meters before discharge and 50 meters after the wastewater treatment plant by analyzing six main parameters of temperature, potential of hydrogen (pH), Biochemical oxygen demand (BOD), chemical oxygen demand (COD), total dissolved solids (TDS), and total suspended solids (TSS), then compared with the water quality standards according to the Regulation of the Governor of the Special Region of Yogyakarta No. 20/2008. This study found that although temperature and pH remained within acceptable ranges, higher BOD, COD, and TDS levels downstream indicated that hospital wastewater was adding to the river's organic and chemical pollution. Improved wastewater treatment processes and consistent monitoring are essential to protect ecosystem integrity and public health.
Copyright (c) 2026 Muchsin Maulana, Didik Setiawan, Wonder N. Dlamini http://creativecommons.org/licenses/by-sa/4.0
“Diabetic foot” in Oman: A systematic review and COM-B public health intervention framework
Diabetic foot disease (DFD) is a preventable but rapidly growing complication of diabetes in Oman. The individual and societal consequences of DFD are catastrophic; however, best practices in its management remain underreported. This review aimed to identify, appraise, and synthesize the available evidence on DFD in Oman and to map findings onto the capability, opportunity, motivation, behaviour (COM-B) model to guide public health interventions. Five databases (PubMed, Scopus, Cochrane Library, WHO EMRO repository, Google Scholar) and two Omani journal archives were searched from inception to March 2026. Records were screened independently by two reviewers, and methodological quality was appraised using an adapted Newcastle-Ottawa scale. Findings were mapped deductively onto the six COM-B sub-domains and to the behaviour change wheel intervention functions. Ten publications met inclusion criteria. Diabetes related lower limb amputations account for 47% of all amputations nationally. Concurrent deficits were found across capability (55% lacked knowledge of DFD causes), opportunity (no multidisciplinary foot teams outside Muscat; 50 to 54% barefoot walking), and motivation (38% performed regular foot examination). Limitations include lack of interventional studies, urban concentration, and self-reported outcomes. Policy priorities are a national DFD registry, multidisciplinary foot care beyond Muscat, and integration of behaviour change techniques into primary care.
Copyright (c) 2026 Saud Al Harthi, Thamra Al Ghafri, Nahal Afifi, Aisha Al Mehrazi http://creativecommons.org/licenses/by-sa/4.0
Assessing the effectiveness of a semi-annual monitoring model for data analysis and use in routine immunisation in Benin
Routine immunisation programmes generate large volumes of data, yet their effective analysis and use for decision-making remain limited at the operational level. For over three decades, Benin has institutionalized a semi-annual monitoring system to assess effectiveness, quality, and develop problem resolution plans (PRPs). This study evaluated its effectiveness in fostering data analysis and use within vaccination services. A descriptive cross-sectional study using mixed methods was conducted from January to June 2025 in eleven health centers across four departments. Data collected via direct observation, semi-structured interviews (n = 38), and document review underwent descriptive and qualitative analysis. Input availability and service accessibility remained optimal (100%). Variability persisted in utilisation, continuity, and quality, with recurrent over-coverage rates. During self-monitoring, technical tasks were frequently performed, whereas in-depth analysis and PRP development were limited (9.09%). Although 90.9% of centers had PRPs, their quality was mostly acceptable, with low innovation and weak follow-up mechanisms. Community participation was irregular. Nevertheless, 81.82% of managers perceived PRPs as contributing to improved vaccination performance. Semi-annual monitoring remains functional and relevant; however, strengthening analytical capacity, digital tools, follow-up mechanisms, and community engagement is essential to institutionalise a sustainable culture of data use for decision-making.
Copyright (c) 2026 Lamidhi Salami, Yolaine Glele Ahanhanzo Hessou, Jean Pierre de Lamalle, Alphonse Biaou, Moussiliou Noël Paraïso http://creativecommons.org/licenses/by-sa/4.0
Ethnomedicinal plants traditionally used in treating measles in the Philippines: a review
Measles, despite the continuous significant advancements in the field of science, still poses a major health threat worldwide. While vaccines have significantly reduced measles-related morbidity and mortality, access to alternative treatments remains critical for populations unable to receive immunization due to medical, cultural, or socioeconomic barriers. With that, looking into some readily available, cost-effective, and safe alternatives for the treatment of measles is necessary. Given the therapeutic potential of medicinal plants, the main objective of this study is to conduct an ethnobotanical review on the medicinal plants that have been traditionally used in the Philippines for measles treatment. In this review, findings reveal a wide array of plant species that have been traditionally used for measles treatment. A total of 45 medicinal plant species belonging to 25 families were found to have been used in the Philippines to traditionally treat measles. Moreover, data show that Poaceae has the highest number of plant species, which constitutes 11.11% of medicinal plant species in the Philippines, with therapeutic potential against measles. This consolidated data highlights potential low-cost alternatives to conventional therapies and underscores the need for further pharmacological validation of these remedies to enhance their integration into public health strategies.
Copyright (c) 2026 Angel Mae Frias Luga, Cesar Guinanao Demayo http://creativecommons.org/licenses/by-sa/4.0
Honey as an alternative wound healing therapy: a systematic review of clinical and preclinical evidence (2020-2024)
Wound management remains a significant global public health challenge, contributing to substantial morbidity, mortality, and healthcare costs. Honey has been increasingly investigated as a complementary wound care agent due to its antimicrobial, anti-inflammatory, and wound-healing properties. This systematic review aimed to synthesize and critically evaluate the current evidence on the use of honey as an alternative wound treatment. A systematic review was conducted following PRISMA guidelines. Six electronic databases (Scopus, Nature, ProQuest, EBSCO, SpringerLink, and ScienceDirect) were searched using predefined search terms for studies published between 2020 and 2024. Inclusion criteria encompassed human studies, mixed-methods or quantitative designs, and interventions using honey for wound care. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. From 302 initially identified articles, 16 studies met the inclusion criteria after removing duplicates and screening. The included studies comprised randomized controlled trials, prospective controlled studies, case series, and in vitro investigations. Three themes emerged: i) Honey as a wound-healing therapy, demonstrating antimicrobial, anti-inflammatory, and biofilm-inhibiting properties; ii) Benefits of medical-grade honey (MGH), including accelerated epithelialization, reduced infection rates, and shorter recovery times; and iii) Recommendations for honey as a cost-effective, accessible alternative treatment. The evidence supports honey as a promising adjunctive therapy for wound management, particularly in resource-limited settings. However, the heterogeneity in study designs, honey types, and wound categories limits definitive conclusions. Future large-scale randomized controlled trials with standardized outcomes are needed to establish clinical guidelines for honey-based wound care.
Copyright (c) 2026 Eni Kusyati, Dwi Indah Iswanti, Sa’adah Mujahidah, Dewi Mayangsari http://creativecommons.org/licenses/by-sa/4.0