Riris Andono Ahmad
Department of Public Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.

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Apa yang dapat kita pelajari dari tesis MPH: pengalaman dari Universitas Gadjah Mada Mawarni, Dian; Ahmad, Riris Andono; Hasanbasri, Mubasysyir
Berita Kedokteran Masyarakat (BKM) Vol 32, No 11 (2016)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (344.617 KB) | DOI: 10.22146/bkm.27651

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What do MPH student theses tell us? Experience from Universitas Gadjah MadaPuposeThis study aimed to evaluate MPH professional performance through thesis writing. MethodWe review 103 MPH student theses in health policy and management tract from data library of Faculty of Medicine Universitas Gadjah Mada since 2013 to 2015. We extract topic and reference from each thesis with a questionnaire.ResultsSeventy percent of students choose subject relevant to health policy and management tract. Sixty percent of theses are located in quadrant 3 because they have relevant topic but weak on use of appropriate reference. Only several journals in health policy and management are cited in theses such as health policy and planning, health policy, BMC health services research and human resources for health. More references related to other multidisciplines and published over 5 years. ConclusionMPH students are in need of clear understanding of the domain and scope of work they are interested in. Their theses showed limited evidence about references focus that has practical relevance to their future work or to the job they currently have.
EVALUATION OF LEPTOSPIROSIS CONTROL MANAGEMENT BASED ON ONE HEALTH IN BOYOLALI DISTRICT Fitriana, Vivin; Ahmad, Riris Andono; Djasri, Hanevi
Berita Kedokteran Masyarakat (BKM) Vol 35, No 8 (2019)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.46839

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Background: Leptospirosis is serious problem in various countries. Boyolali Regency have implemented one health concept  for leptospirosis control program since 2017. Leptospirosis cases increased every years. It had reported 34 cases and 9 deaths in 2017. The study aims to evaluate the control of leptospirosis in Boyolali Regency.Method: This study was descriptive observational. Samples were conducted with purposive sampling technics for Boyolali District Health Office, Boyolali District Animal Husbandry Office, Boyolali District Agricultural Service, and 9 health centers with findings of leptospirosis cases in 2017-2018. Variables  that evaluated included inputs (human resources, funds, facilities, and tools), planning, implementation, output (number of cases, the scope of management, reported, of accuracy. Data were collected throught Observational and interviews.Results: Seventy percent of health workers have received training. Rapid diagnosis tests (RDTs) are not available at the primary health care, case were diagnosed with RDTs in Health Office. Data collection is reported passively. Animal husbandary office did not have objective finding cases livestock. Examination of leptospirosis cases in livestock if there are findings in humans. However, the main reservoir (rat) was not inspected by the Agriculture Office. Rats control were implemented through killed, burned, arrested and given drugs. Every case that found was reported to the Boyolali District Health Office and received treatment.Conclusion: Leptospirosis control in Boyolali Regency has not successful. It was depicted by cases of death in a year after the adoption of the one health concept. Improving both quality of human resources on a regular basis and increasing collaboration between various sectors such as community leaders, religious leaders, the Livestock Service Office, the Agriculture Service, and other relevant agencies were needed.
BIAYA LANGSUNG DAN TIDAK LANGSUNG PASIEN TUBERKULOSIS DI KABUPATEN KULON PROGO Ratnawati, Dewi; As Shiddieq, Firdaus Hafidz; Pramono, Dibyo; Ahmad, Riris Andono
Jurnal Manajemen Pelayanan Kesehatan Vol 18, No 1 (2015)
Publisher : Jurnal Manajemen Pelayanan Kesehatan

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Latar belakang : Penyakit tuberkulosis (TB) masih menjadi masalah di Kabupaten Kulon Progo dan menyerang semua kelompok umur dengan persentase kasus tertinggi pada kelompok umur produktif. Angka kematian kasus selama tiga tahun terakhir mengalami kenaikan. Informasi tentang biaya langsung dan tidak langsung pasien TB di Kabupaten Kulon Progo sampai saat ini masih terbatas. Berbagai penelitian menunjukkan bahwa pasien TB menghadapi sejumlah kendala finansial. Metode : Tools to Estimate Patient Costs yang telah dialihbahasakan ke dalam bahasa Indonesia diadaptasi dalam penelitian ini. Survei dilakukan terhadap seluruh pasien DOTS dari puskesmas, rumah sakit,dan BP4. Hasil survei pada pasien dikumpulkan, dimasukkan ke dalam database dan dilakukan analisis. Hasil : Rerata biaya pasien TB pada fase diagnosis di Kabupaten Kulon Progo sebesar Rp. 2.508.881,00 sedangkan pada fase pengobatan sebesar Rp. 1.882.395,00. Komponen biaya yang paling besar pada fase diagnosis adalah biaya rawat inap diikuti biaya medis langsung selama diagnosis dan biaya tambahan makanan sedangkan pada fase pengobatan adalah biaya tambahan makanan diikuti biaya perjalanan dan biaya medis langsung selama rawat inap. Strategi mengatasi masalah biaya bagi pasien TB di Kabupaten Kulon Progo adalah dengan asuransi, sumbangan, dan melakukan pinjaman atau penjualan aset. Pembebasan biaya pengobatan dan pemberian jaminan kesehatan bagi penduduk belum dapat membebaskan pasien TB dari pengeluaran biaya yang tinggi. Kesimpulan : Pemberian jaminan untuk diagnosis dan pengobatan TB belum dapat menyelesaikan permasalahan biaya pada pasien TB. Pemerintah masih perlu meningkatkan pelayanan kesehatan kepada masyarakat melalui peningkatan program promosi pemanfaatan jaminan kesehatan serta pemberian bantuan makanan tambahan dan bantuan biaya perjalanan. Kata kunci : tuberkulosis, evaluasi pembiayaan, biaya langsung, kulon progoMahasiswa Program Pasca Sarjana KPMAK, FakultasKedoteran, Universitas Gadjah Mada.Bagian Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada.Bagian Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Gadjah Mada. 
Community’s perception of measles immunization in Sleman Wahyunarni, Yulia Irene; Ahmad, Riris Andono; Ratnawati, Atik Tri
Berita Kedokteran Masyarakat (BKM) Vol 32, No 8 (2016)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (355.504 KB) | DOI: 10.22146/bkm.6896

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Community perception of measles immunization in SlemanPurposeThis study conducted to explore the community’s perception of measles immunization in Sleman.MethodsA phenomenological study was conducted involving interviews of the head of neighborhood’s ladies who were highly respected by their citizens, mothers with toddlers but refused immunizations, immunized toddler mothers, health workers who did not immunize their children based on information from FGDs of mothers who refused immunization, a toddler father who does not allow his child to be immunized, community leaders and religious leaders, in the village of Sukoharjo whose area has been infected with measles outbreaks. ResultsThe study found that first, people perceived that immunization has no benefit and even causes side effects for children’s under-five health. Second, the community perceives that immunization of measles is not mandatory because of the lack of the government's role in enforcing regulations related to measles immunization. Third, the perception of people against measles immunization is influenced by the behavior of health workers and religious leaders. ConclusionsThe side effects of measles immunization, the influence of health workers' behavior and religious figures related to non-immunization against measles, and the lack of government's role in enforcing regulations related to the appeal of measles immunization are the factors that influence community's perception and a decision of not doing measles immunization. Government appeals related to immunization need to be improved, and in addition, education related to measles hazard should be done to the community, religious leaders and health workers to increase awareness and awareness of the dangers of measles.
HUBUNGAN ANTARA PENGETAHUAN TENTANG BAHAYA MEROKOK DENGAN STATUS MEROKOK DI “RW DENGAN RUMAH BEBAS ASAP ROKOK” KOTA YOGYAKARTA TAHUN 2016 Setiawan, Agus Heri; Prabandari, Yayi Suryo; Ahmad, Riris Andono
Berita Kedokteran Masyarakat (BKM) Vol 33, No 6 (2017)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (478.038 KB) | DOI: 10.22146/bkm.18016

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Implementation of the smoke-free neighborhood program in YogyakartaPurposeThis study aimed to identify the successfulness of smoke-free neighborhood and to understand the relationship between the householders' knowledge and household smoking status. MethodsAn observational analytic study was conducted using cross-sectional surveys. Chi-square, Fisher exact and logistic regression tests were used to analyze the correlation between variables. ResultsFrom those numbers, qualified households which fulfill the program criteria were 76.1% and 75.9%, respectively. To be more specific, in smoke-free neighborhood, about 56.8% householders were under smoking status and 43.2% householders were identified as ex- or non-smoker. Bivariable analysis showed that there was a significant correlation between educational background, age, knowledge, and perception of householder with smoking status. The last model of multivariable analysis showed that knowledge, and age of householders was related to household smoking status. ConclusionThis study shows that smoke-free neighborhood program has not yet affected passive smoker protection significantly. A more specific controlling program to improve the knowledge especially for elderly (> 45 years old) has to be increased in smoke-free neighborhood of Yogyakarta.
Ketahanan hidup 2 tahun pasien tuberkulosis resisten obat di RS. Moewardi Surakarta tahun 2010-2014 Firnawati, Artika Fristi; Ahmad, Riris Andono; Retnowulan, Heni
Berita Kedokteran Masyarakat (BKM) Vol 33, No 8 (2017)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (688.662 KB) | DOI: 10.22146/bkm.22462

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Two year survival of drug resistant tuberculosis patients in Moewardi hospital in Surakarta in 2010-2014PurposeThe purpose of this study was to determine the two year survival rate and predictor factors of mortality in drug resistant tuberculosis patients during treatment at the Moewardi Hospital in Surakarta.MethodsThis research was a retrospective cohort study of 250 drug resistant tuberculosis patients receiving treatment in the Moewardi Hospital in January 2011-September 2014. Data were analyzed using survival analysis to find factors affecting the 2 year survival. Our variables were demographic factors, disease characteristics and treatment history. We used Cox regression test with 5% significance level.Results2-year survival rates of drug resistant patients was 74.82%. age, the type of patient, HIV status, side effects of medications and culture conversion were significant to survival rate in bivariate analysis. Cox regression test showed that aged ≥ 40 years (HR 3.221; 95% CI 1.037 to 10.001) and have HIV-positive status (HR 18.086; 95% CI 1.958 to 167.073) were related with reduction of two year survival rate in drug resistant tuberculosis patient. ConclusionAge above 40 years old and HIV positive status for drug-resistant tuberculosis patients may accelerate their death. The screening of HIV in drug resistant tuberculosis patients is needed in order to increase two year survival rate of patients during treatment.
DAMPAK PENERAPAN CLINICAL PATHWAY TERHADAP BIAYA PERAWATAN PASIEN STROKE ISKEMIK AKUT DI RS BETHESDA YOGYAKARTA Iroth, Jemsner Stenly; Ahmad, Riris Andono; Pinzon, Rizaldy
Berkala Ilmiah Kedokteran Duta Wacana Vol 2, No 1 (2016): Berkala Ilmiah Kedokteran Duta Wacana
Publisher : Medical Faculty of Duta Wacana Christian University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (287.402 KB) | DOI: 10.21460/bikdw.v2i1.38

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Latar Belakang dan Tujuan: Stroke bukan hanya menyebabkan beban dalam dunia kesehatan akan tetapi juga membebani baik dari segi ekonomi suatu negara, dan juga secara psikologis, terutama pada keluarga dengan pasien yang mengalami kecacatan total. Biaya langsung maupun tidak langsung dari perawatan stroke diperkirakan mencapai lebih dari 65 miliar US dollar, sehingga stroke dapat digolongkan sebagai penyakit termahal setara dengan penyakit kronis diabetes dan gangguan depresi. Adanya variasi dalam pelayanan kesehatan diperkirakan membawa dampak terhadap biaya yang tidak tetap dan bahkan berlebihan. Panduan tertulis berupa Clinical Pathway (CP) diharapkan mampu mengurangi variasi biaya ini, dengan tetap mempertahankan kualitas yang baik. Metoda Penelitian: Penelitian ini merupakan penelitian observasional inferensial, dengan metoda Retrospektif Kohort. Data yang diambil adalah data sekunder di RS Bethesda Yogyakarta, berupa database komputer. Sampel yang diambil berjumlah 130 orang, baik pada kelompok kontrol (Perawatan tanpa CP), maupun pada kelompok observasi (Perawatan dengan CP). Hasil: Terdapat perbedaan signifikan terhadap biaya perawatan stroke iskemik akut setelah penerapan CP (p=0,004), dimana rerata biaya perawatan pada kelompok dengan CP sebesar Rp 8.212.656,02 dan pada kelompok tanpa CP sebesar Rp 10.659.617,72 (setelah penyesuaian dengan tingkat inflasi dari BPSI sebesar 19,08%) dengan beda rerata sebesar Rp 2.446.961,70. Kesimpulan: Clinical Pathway mampu memberikan penurunan biaya perawatan terhadap perawatan stroke iskemik akut di RS. Bethesda Yogyakarta.
Internal Stigma of an HIV-Infected Housewife: a Phenomenological Study Wisotowardono, Ossie Sosodoro; Ahmad, Riris Andono; Prabandari, Yayi Suryo; Hakimi, Mohammad
KEMAS: Jurnal Kesehatan Masyarakat Vol 13, No 2 (2017)
Publisher : Department of Public Health, Faculty of Sport Science, Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v13i2.9970

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In connection with the transmission of the HIV virus, housewives may have experienced internal stigma, which can have an effect on HIV prevention and the treatment of AIDS. Twenty-three HIV-infected housewives were interviewed in a qualitative study conducted in North Jakarta. The data were analyzed using a phenomenological approach. Seven themes emerged to explore internal stigma housewives and to compose the essence of the internal stigma. The essence of an HIV-infected housewife who has internalized the stigma can be illustrated as an Indonesian proverb which is Hidup Segan Mati Tak Mau or in English can be interpreted as having lost the will to live, but not wanting to die. This could explain that AIDS forces them to live in anxiety in all aspects of life but as housewives, they must keep thinking about continuing life especially with regard to the future of their beloved children.
Faktor risiko kematian akibat dengue di RSUP Dr. Sardjito Yogyakarta Trisasri, Ruri; Arguni, Eggi; Ahmad, Riris Andono
Berita Kedokteran Masyarakat (BKM) Vol 34, No 1 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (508.072 KB) | DOI: 10.22146/bkm.26801

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Latar Belakang: Dengue Shock Syndrome (DSS) merupakan penyakit yang terjadi karena infeksi virus dengue dan sangat berhubungan dengan kematian DBD. Di RSUP Dr. Sardjito, kematian DBD meningkat dari 11 orang tahun 2014 menjadi 35 orang pada tahun 2015. Tujuan dari penelitian ini yaitu untuk mengetahui faktor risiko kematian akibat dengue di RSUP Dr. Sardjito Yogyakarta.Metode: Desain studi yang digunakan matched case control dengan perbandingan kasus dan kontrol 1:2.  Kasus adalah pasien DSS rujukan meninggal dunia yang berusia ≤18 tahun. Kontrol adalah pasien DSS rujukan sembuh yang berusia ≤18 tahun. Data diambil dari rekam medis pasien di RSUP dr. Sardjito Yogyakarta tahun 2015-2016 dan wawancara dengan kuesioner kepada orangtua pasien. Tehnik pengambilan sampel dengan metode totality sampling dengan kriteria inklusi dan eksklusi. Data dianalisis dengan menggunakan uji simple dan multiple conditional logistic regression dengan α 5%.Hasil: Dilaporkan 87 anak terdiri dari 29 meninggal dan 58 sembuh. Probabilitas terjadinya kematian pada anak dengan obesitas 6,29 kali lebih besar dibandingkan dengan anak yang tidak obesitas (OR = 6,29; 95% CI  = 1,14 - 34,57; p-value = 0,03) dan probabilitas kematian pada anak yang mengalami prolonged shock 12,14 kali lebih besar dibandingkan dengan anak yang tidak mengalami prolomged shock (OR = 12,14; 95% CI  = 3,22 - 45,82; p-value = 0,00). Variabel lain seperti pekerjaan keluarga, pendapatan keluarga, zona tempat tinggal, transportasi, pembiayaan pengobatan, ketepatan diagonosis di fasilitas kesehatan sebelumnya, dan resusitasi cairan sebelum rujukan tidak memiliki hubungan yang bermakna terhadap kematian akibat dengue.Kesimpulan: Status gizi dan prolonged shock merupakan faktor risiko terjadinya kematian akibat dengue pada anak. Meningkatkan edukasi kepada orangtua terkait bahaya syok sindrom pada penderita DBD khusunya pada anak obesitas. Penelitian lebih lanjut terkait determinan sosial pada kasus kematian akibat dengue juga perlu dilakukan.
Peran kepala puskesmas SKM dan non SKM dalam meningkatkan kemampuan manajerial puskesmas di kabupaten Oku Timur Aulawi, Aulawi; Ahmad, Riris Andono; Hasanbasri, Mubasysyir
Berita Kedokteran Masyarakat (BKM) Vol 32, No 9 (2016)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (421.454 KB) | DOI: 10.22146/bkm.7552

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Role of the head of public health centers from public health graduates and others on improving managerial skills in East OkuPurposeThis study aimed to understand how public health and non-public health backgrounds affect management skill of primary health care heads, based on ten managerial roles. MethodsThis study was a descriptive study with case-series method, using qualitative methods supported by quantitative data. Eight people were recruited as respondents. They consisted of 4 people that were primary healthcare heads with public health background and 4 people that were primary healthcare heads with non-public health background. Respondents were recruited by purposive sampling. Data collection was performed using in-depth interviews and questionnaire. ResultsPrimary healthcare head with public health background owned more work experience than those with non-public health background. Period of employment in primary health care had an influence on managerial capabilities. There were no significant differences of period of employment in primary health care head positions among the longest with the least to the managerial capabilities. Primary health care heads who had been trained with PIM IV training and other structural positions were known to have better management capabilities, especially compared to the leadership role of those who had not been trained.ConclusionThere was no significant difference in managerial capacity between primary health care heads with public health and those with non-public health background.