Prevalence of and factors associated with female child marriage in Indonesia.

Statistics from the 2018 National Social and Economic Survey revealed that one out of nine young females in Indonesia have been in female child marriage, and the prevalence remains high. Considering the serious consequences of female child marriage and that Sustainable Development Goal 5 on gender equality has targeted the elimination of female child marriage by 2030, a study concerning the prevalence and determinants of female child marriage needs to be conducted in Indonesia. In this paper, we examined the prevalence of and factors associated with female child marriage in Indonesia using binary logistic regression. We examined data from the Indonesia Demographic and Health Survey conducted in 2017. A sample of 9,333 young females aged 15-20 years was included in the study. Our analysis involved descriptive and binary logistic regression analysis. The results are presented in percentages and odds ratios (OR), with their respective confidence intervals. Our findings indicate that health insurance and sex of household head did not significantly influence female child marriage. The prevalence of female child marriage in Indonesia was quite high, reaching about 12.53%. Females with no education [OR = 76.448; (CI = 29.73-196.70)], not working [OR = 1.662; (CI = 1.41-1.94)], those with the poorest wealth index [OR = 3.215; (CI = 2.336-4.425)], those living in the east of Indonesia [OR = 1.451; (CI = 1.132-1.862)], and those living in rural areas [OR = 0.718; (CI = 0.609-0.844)] had the higher odds of experiencing female child marriage. Meanwhile, females with a secondary education level [OR = 16.296; (CI = 11.098-23.930)], those with a rich wealth index [OR = 1.940; (CI = 1.404-2.681)], and those living in the middle of Indonesia [OR = 1.263; (CI = 1.074-1.487)] were less likely to experience female child marriage. Educational background was the most significant factor influencing the high prevalence of female child marriage in Indonesia. Female empowerment through education as well as poverty alleviation were factors that could be strengthened to ensure that female child marriage is reduced or eliminated in Indonesia. Equality of access to information and better quality of education also need to be prioritized.

Predictors of Mortality Among Children with Confirmed and Suspected Cases of COVID-19 in East Java, Indonesia.

Introduction: Coronavirus disease 2019 (COVID-19) increases rapidly and causes mortality in all groups, including children. However, the predictive risk factors of mortality among children remain inconclusive. This study aimed to analyse the predictors related to mortality among children with COVID-19. Methods: Secondary data analysis was conducted using provincial COVID-19 data from April 2020 to May 2021. We selected 6441 children under age 18 to be included in this study. Chi-square and binary logistic regression were used to evaluate the predictors of mortality in children with COVID-19. Results: This study showed that the prevalence of children who died COVID-19 was 2.7%. Age, case definition, treatment status, severity of illness, and travel history had a significant relationship with survival status in children with COVID-19. As the increasing age, the risk of death with COVID-19 will decrease [AOR=0.94; CI 95%=0.91-0.97]. Otherwise, suspected status [AOR=2.12; 95% CI=1.48-3.04], hospitalization with ventilators [AOR=22.25; 95% CI=5.73-86.42], severe illness [AOR=46.76; 95% CI=21.69-100.80], and travel history [AOR=1.78; 95% CI=1.22-2.60] were significantly related with an increased risk of death in children with COVID-19. Discussion: Severe illness in children was the strongest predictor of mortality. Disease prevention and health promotion programs are the key to preventing hospitalizations in children and decreasing the mortality rate.

Indonesian Nurses' Journey in Passing the Japan National Nursing Licensure Examination.

Background: Despite the significant number of Indonesian nurses joining the Japanese National Nursing Licensure Examination (JNNLE), only a few of those were successful. Indonesian nurses as one of active migration player to Japan's market remain a critical support in supporting human resources for health in Japan. However, the successful nurses' perspectives have yet to be understood entirely. This study aimed to explore the experiences of Indonesian nurses who successfully passed the JNNLE. Methods: This study used a descriptive qualitative approach. The participants were twenty Indonesian nurses who have passed the licensure examination. This study was carried out by semi-structured interviews conducted virtually. The data were analyzed using thematic content analysis. Results: Five themes were discovered in this study: language ability as the key to succeeding in the exam, strategies to passing the exam, supporting resources as factors to increase the passing rate, understanding the nature of nursing exam, and internal motivation to be recognized as a professional nurse in a foreign country. Conclusion: Indonesian nurses who passed the Japanese national nursing licensure examination tend to deploy planned strategies. Honing the language skills while working and living in Japan is very important, while structured support systems in the hospital, government, and social network are imperative to learning the new knowledge in the area of nursing care in Japan.

Analysis of Modifiable, Non-Modifiable, and Physiological Risk Factors of Non-Communicable Diseases in Indonesia: Evidence from the 2018 Indonesian Basic Health Research.

Purpose: Indonesia is facing an increasing occurrence of non-communicable diseases (NCDs) every year. We assessed the modifiable, non-modifiable, and physiological risk factors of NCDs among the Indonesian population. Methods: Secondary data was analyzed from the 2018 Indonesian basic health research (RISKESDAS). The national survey included participants aged 15-54 years and obtained 514,351 responses. Linear systematic two-stage sampling was conducted by RISKESDAS. Furthermore, chi-square and binary logistic regression were utilized to explore the determinant of NCDs with a significance level of 95%. Results: We found that almost 10% respondents in Indonesia had NCDs. We observed that depression has a higher odd (aOR: 2.343; 95% CI: 2.235-2.456) contributed to NCDs and followed other factors such as no education (aOR: 1.049; 95% CI: 1.007-1.092), passive smoking (aOR: 0.910; 95% CI: 0.878-0.942), fatty food (aOR: 1.050; 95% CI: 1.029-1.073), burnt food (aOR: 1.033; 95% CI: 1.005-1.062), food with preservatives (aOR: 1.038; 95% CI: 1.002-1.075), seasoned food (aOR: 1.057; 95% CI: 1.030-1.084), soft drinks (aOR: 1.112; 95% CI: 1.057-1.169), living in an urban area (aOR: 1.143; 95% CI: 1.119-1.168), living in central Indonesia (1.243; 95% CI: 1.187-1.302), being female (aOR: 1.235; 95% CI: 1.177-1.25), and obese (aOR: 1.787; 95% CI: 1.686-1.893). Conversely, people in Indonesia who undertook vigorous activity (aOR: 0.892; 95% CI: 0.864-0.921), had employment (aOR: 0.814; 95% CI: 0.796-0.834), had access to improved sources of drinking water (aOR: 0.910; 95% CI: 0.878-0.942), and were aged 35-44 years (aOR: 0.457; 95% CI: 0.446-0.467) were less likely to develop NCDs. Conclusion: Modifiable, non-modifiable, and physiological risk factors have a significant influence on NCDs in Indonesia. This finding can be valuable information for Indonesian Government to arrange a cross-collaboration between government, healthcare workers, and society through advocacy, partnership, health promotion, early detection, and management of NCDs.

Resilience-based Islamic program as a promising intervention on diabetes fatigue and health-related quality of life.

Psychological problems commonly experienced by patients with type 2 diabetes mellitus (T2DM) cause diabetes fatigue conditions that can further worsen the treatment prognosis. We conducted this investigation to determine the effectiveness of a resilience-based Islamic program on diabetes fatigue and health-related quality of life (HRQoL) by measuring the biochemical indicators of T2DM. This was a quasi-experimental study performed from May to August 2021, in which 80 respondents aged 18-64 years diagnosed with T2DM were included through purposive sampling at a male:female sex ratio of 1:1 in the control group and 17:23 in the treatment group. A resilience-based Islamic program (a combination of stress management, mindfulness, prayer, and dhikr (the ritual formula of Sufi brotherhood recited devotionally in praise of Allah and as a means of attaining ecstatic experience)) was implemented in the treatment group for six sessions by blended online and offline interventions. Multidimensional Fatigue Inventory-20 and World Health Organization Quality of Life, Brief Form were used to evaluate diabetes fatigue and HRQoL. Blood tests were performed to measure HbA1c, total antioxidant serum, insulin, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) levels from baseline to 3 months. Statistical analyses were conducted using paired t test, Wilcoxon signed-rank test, independent t test, and Mann-Whitney U test. The resilience-based Islamic program had a beneficial impact on the levels of HbA1c (p < 0.001), lipid profile (triglyceride) (p = 0.011), HDL-c (p = 0.01), LDL-c (p < 0.001), total antioxidant serum (p = 0.001), insulin (p < 0.001), diabetes fatigue (p < 0.05), and HRQoL (p < 0.05) in patients of the treatment group. The results of biochemical tests related to T2DM also indicated a reduction in diabetes fatigue and an increase in HRQoL due to the resilience-based Islamic program. Considering that a patient's resilience to diabetes is an important factor in the management of diabetes fatigue, the resilience-based Islamic program can be applied at public health centers and community levels to increase T2DM resilience.

Investigation of discriminatory attitude toward people living with HIV in the family context using socio-economic factors and information sources: A nationwide study in Indonesia.

Background: The well-being of people living with HIV (PLHIV) remains a concern. In addition to facing discrimination in their communities, many PLHIV have family members who have a discriminatory attitude. This study analyzes the discriminatory attitude toward PLHIV in the family context using socio-economic factors and information sources in Indonesia. Methods: A cross-sectional study design was adopted using secondary data from the 2017 Indonesian Demographic Health Survey (IDHS). A total sample of 28,879 respondents was selected using two-stage stratified cluster sampling. The study variables are information sources, sex, age, education, residence, earnings, and familial discriminatory attitude. We used the STATA 16.1 software to analyze Chi-square and binary logistics with a 95% confident interval (CI) with a significance of 5% (p-value < 0.05). Results: In Indonesia, familial discriminatory attitude has a prevalence of 72.10%. In the survey, the respondents with access to some information about HIV (AOR: 0.794; 95% CI [0.722-0.873]), women (AOR: 0.768; 95% CI [0.718-0.820]), and those living in rural areas (AOR: 0.880; 95% CI [0.834-0.929]) were the least likely to have a familial discriminatory attitude. Meanwhile, the respondents aged 15-24 years (AOR: 1.329; 95% CI [1.118-1.581]) and those with a secondary level of education (AOR: 1.070; 95% CI [1.004-1.142]) were the most likely to have a familial discriminatory attitude. Conclusion: In the study, we found that, the younger the age and the lower the educational level of the respondent, the more likely they were to have a familial discriminatory attitude. The government may consider these factors when designing policies to tackle familial discrimination faced by PLHIV; in particular, education on HIV and AIDS should be promoted.

Improving the Accuracy of Rainfall Prediction Using Bias-Corrected NMME Outputs: A Case Study of Surabaya City, Indonesia.

Generating an accurate rainfall prediction is a challenging work due to the complexity of the climate system. Numerous efforts have been conducted to generate reliable prediction such as through ensemble forecasts, the North Multi-Model Ensemble (NMME). The performance of NMME globally has been investigated in many studies. However, its performance in a specific location has not been much validated. This paper investigates the performance of NMME to forecast rainfall in Surabaya, Indonesia. Our study showed that the rainfall prediction from NMME tends to be underdispersive, which thus requires a bias correction. We proposed a new bias correction method based on gamma regression to model the asymmetric pattern of rainfall distribution and further compared the results with the average ratio method and linear regression. This study showed that the NMME performance can be improved significantly after bias correction using the gamma regression method. This can be seen from the smaller RMSE and MAE values, as well as higher R 2 values compared with the results from linear regression and average ratio methods. Gamma regression improved the R 2 value by about 30% higher than raw data, and it is about 20% higher than the linear regression approach. This research showed that NMME can be used to improve the accuracy of rainfall forecast in Surabaya.

Utilization of Postnatal Care Service in Indonesia and its Association with Women's Empowerment: An Analysis of 2017 Indonesian Demographic Health Survey Data.

OBJECTIVE: The coverage of postnatal care (PNC) is among the lowest globally when compared with other maternal and child interventions. This study aims to assess PNC utilisation in Indonesia and its association with women's empowerment indicators to provide evidence for the need for policy change. METHODS: Data from the 2017 Indonesian Demographic Health Surveys was analyzed for any use of PNC, early first PNC (within 2 days of birth) and PNC after discharge for newborns. Women's empowerment factors were calculated using a principal component analysis of 17 indicators. The association between women's empowerment factors and PNC was assessed using logistic regression adjusted for covariates and complex survey design. RESULTS: The prevalence of any PNC by skilled professionals in Indonesia was high but PNC after discharge was very low. Labor-force participation and women's knowledge level were associated with any PNC, but the association between women's knowledge level and any PNC was modified by place of birth. Disagreement towards justification of wife beating and women's knowledge level were associated with early PNC but the association was modified by place of birth. Decision-making power was also associated with early PNC but modified by infant's gender. Disagreement towards justification of wife beating was negatively associated with PNC after discharge, but the association between decision-making power and PNC after discharge was modified by the infant's size at birth. CONCLUSIONS FOR PRACTICE: PNC coverage after discharge in Indonesia needs improvement. Women's empowerment indicators need to be addressed in improving PNC coverage.

Going Global: Insights of Indonesian Policymakers on International Migration of Nurses.

BACKGROUND: The Indonesian policymakers need to respond to the current challenges, particularly the excess of nurses and the increased demand for nurses in the global market. OBJECTIVE: This study aimed to present the perception of policymakers and stakeholders on the management of overseas migration of Indonesian nurses. METHODS: This study is a descriptive qualitative design where data were collected through structured interviews with key stakeholders representing the Indonesian government, namely the Ministry of Health (MOH), the Ministry of Labour (MOL), Ministry of Education (MOE) and the Indonesian Migrant Workers Protection Agency (BP2MI). The in-depth interviews involved participants who were responsible for managing Indonesian nurses' migration. The qualitative data were analyzed thematically using a content analysis approach. RESULTS: The issues involving nurses' migration policy are quite complex and sectoral. Themes emerging from this study include the move towards global market orientation, addressing challenges on international nurse migration, strengthening coordination among stakeholders and making the most of opportunities. All the themes reflect that the country should work hard to achieve the balance between quantity and quality of nursing resources for the international market. CONCLUSION: As regulator and executor of Indonesian nurse migration, various government policies have responded to the low number of Indonesian nurses' migration overseas, emphasizing the three cycles of migration: pre-migration, migration and post-migration. The preparation of resources, regulations and placements for Indonesian nurses abroad open the opportunity to the international nursing labour market. Hence, the policies need to be strengthened from upstream to downstream to make Indonesian nurses more competitive and adaptive in global market.

Drought Analysis in East Nusa Tenggara (Indonesia) Using Regional Frequency Analysis.

Drought is a condition of a shortage of water that has an impact on economic activity. This research studies the severe drought area in Indonesia using Regional Frequency Analysis (RFA), based on daily precipitation data recorded at nine stations. The analysis reveals five homogeneous regions, based on discordancy and heterogeneity tests. Furthermore, the L-moment approach is applied to investigate the regional distribution and suggests that the Pearson type III distribution is the distribution that best fits the five regions. This distribution is also used to calculate the regional growth curve that is employed in the drought analysis. The drought return period analysis, for conditions of 40% of normal rainfall, concludes that the region containing the Fransiskus Xaverius, Gewayantana, and Mali stations has the highest drought risk, indicated by the fastest return period estimate of 2 years and 4 months. Moreover, the extreme drought analysis shows that two of the regions have the potential to experience the return of extreme drought, with less than 20% of normal rainfall, in less than four years.

Women's Empowerment and Determinants of Early Initiation of Breastfeeding: A Scoping Review.

INTRODUCTION: Early initiation of breastfeeding (EIBF), the immediate provision of mothers' breast milk to infants within the first hour of life, has been recommended by the WHO. However, EIBF is not widely practiced, thereby increasing infant mortality risk. This review explored the available and published studies that identified interventions that empower mothers to practice EIBF. METHOD: We conducted a scoping review to answer the aforementioned aims. Empowerment, Women, Breastfeed, and Initiation were used as initial keywords, which were further developed using Medical Subject Headings by the National Center for Biotechnology Information. Five databases, namely: Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature via EBSCO, ProQuest, and MedLine via PubMed, were searched for potential articles. We also searched the references in addition to the main search. FINDINGS: We included 28 articles in this review. Education was mostly used as women's empowerment indicator in EIBF intervention. Additionally, we identified barriers (C-section and postoperative pain, lactation problems and pregnancy complications, mothers' social and demographic factors, mothers' lack of professional support, babies' condition preventing EIBF) and facilitators (mothers' positive behavior in relation to educational level, completion of antenatal care, poor economic situations of mothers, babies' size at birth) of EIBF. DISCUSSION: Education is the widely used intervention to promote mothers' participation in improving EIBF rate. Furthermore, mothers' and babies' deferring conditions and traditional practices are barriers for EIBF. This review recommends future research and empowerment efforts that sensitively address the identified barriers.

Determinants of safe delivery utilization among Indonesian women in eastern part of Indonesia.

Background: Improving maternal health and reducing maternal mortality are part of the United Nations global Sustainable Development Goals for 2030. Ensuring every woman's right to safe delivery is critical for reducing the maternal mortality rate. Our study aimed to identify determinants of safe delivery utilization among women in the eastern Indonesia. Methods: This study was cross-sectional and used a secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). A total of 2,162 women who had their last child in the five years preceding the survey and lived in the eastern part of Indonesia were selected as the respondents. Chi-squared test and binary logistic regression were used to understand the determinants of safe delivery. Results: Higher child rank and interval ≤2 years (OR: 0.30, 95% CI: 0.19-0.47), unwanted pregnancy at time of becoming pregnant (OR: 1.48, 95% CI: 1.05-2.08), richest wealth quintile (OR: 5.59, 95% CI: 3.37-9.30), more than four antenatal care visits (OR: 3.62, 95% CI: 2.73-4.79), rural residence, good composite labor force participation, and a good attitude towards domestic violence were found to be significantly associated with delivery at health facility. Higher child rank and interval ≤2 years (OR: 0.49, 95% CI: 0.29-0.83), husband/partner having completed secondary or higher education (OR: 2.18, 95% CI: 1.48-3.22), being in the richest wealth quintile, and four other factors were found to be significantly associated with the assistance of skilled birth attendants. Conclusions: This research extends our knowledge on the determinants of safe delivery among women in the eastern part of Indonesia. This study revealed that the economic status of household remains an important issue in improving safe delivery among women in eastern part of Indonesia. An open innovation and partnership process to improve safe delivery program that engages the full range of stakeholders should be developed based on economic situation.

Survey data on students' online shopping behaviour: A focus on selected university students in Indonesia.

The data presented in this paper is used to examine the factors influencing students' online shopping behaviour and to identify the students' segmentation on the important factors. The survey was conducted in the Institut Teknologi Sepuluh Nopember (ITS) Surabaya, the biggest science and technology university in East Indonesia, with multicultural and diverse socio-economic students' backgrounds. The total number of population is 20448 students. Using Yamane's formula, a sample size of 393 students was surveyed online, and 83 of them experienced doing online shopping. A quantitative method with a descriptive research design was adopted to explore insights in the data related to the objective of the research. The survey data were analyzed by linear regression and hierarchical clustering. The conceptual framework of the variables are given, and reliability and validity have been confirmed. Data were analyzed with MINITAB and SPSS software.

Perception of weather and seasonal drought forecasts and its impact on livelihood in East Nusa Tenggara, Indonesia.

A cross-sectional study was conducted in 2018 to assess the perception of households on drought forecasts and its impact on crop and livestock losses. A total of 300 households from seven districts in East Nusa Tenggara Indonesia were considered. The study indicated that the majority of the households are poor families with low education background. They sold poultry for income generation during drought events. The survey revealed that only small percentage of the households usied forecast to support their livelihood management. The statistical test confirmed that the use of forecast did not necessarily impacted the crop loss. However, the crops were significantly affected by the response to drought forecast. Households that changed their agricultural practice experienced significantly different losses than households that did not do anything differently to their crops. The households argued that the accuracy of the forecasts issued by the government was very low. Therefore, it is recommended that policymakers and government authorities provide more accurate forecasts and a better strategy to increase household awareness of using drought forecasts.

Determinants of Facility-Based Childbirth in Indonesia.

BACKGROUND: Reducing maternal mortality remains a significant challenge in Indonesia, especially for achieving the country's Sustainable Development Goals (SDGs) by 2030. One of the challenges is increasing delivery at healthcare facilities to ensure safe and healthy births. In Indonesia, research on factors affecting women's use of facility-based childbirth services is scarce. OBJECTIVE: This study was conducted to identify the determinants of facility-based deliveries in Indonesia. METHODS: This study used data from the Indonesia Demographic and Health Survey of 2012, with a cross-sectional design. An odds ratio with 95% confidence intervals (CI) was employed to outline the independent variables for the determinants, including maternal age and education, place of residence, involvement in decision-making, employment status, economic status, and number of antenatal care visits. The dependent variable in this study was the place of delivery: whether it took place in healthcare or nonhealthcare facilities. The statistical significance was set at p<0.05 using bivariate analysis and binary logistic regression. RESULTS: This study showed that a high level of education (OR: 3.035, 95% CI: 2.310-3.987), high economic status (OR: 6.691, 95% CI: 5.768-7.761), urban residence (OR: 2.947, 95% CI: 2.730-3.181), working status (OR: 0.853, 95% CI: 0.793-0.918), involvement in decision-making (OR: 0.887, 95% CI: 0.804-0.910), and having more than four visits to antenatal care centers (OR: 1.917, 95% CI: 1.783-2.061) were significant determinants of delivery at healthcare facilities. CONCLUSION: Efforts to improve facility-based childbirth in Indonesia must strengthen initiatives that promote women's education, women's autonomy, opportunities for wealth creation, and increased uptake of antenatal care, among others. Any barriers related to maternal healthcare services and cultural factors on the use of health facilities for childbirth in Indonesia require further monitoring and evaluation.

Evaluation of performance of drought prediction in Indonesia based on TRMM and MERRA-2 using machine learning methods.

East Nusa Tenggara Province is one of the most vulnerable regions in Indonesia to drought. Drought prediction is definitely needed as a mitigation action to minimize the risk of drought. However, a sparse dataset has led to difficulties in accurately predicting future droughts in areas without meteorological stations, and hence a dataset with a finer resolution is required. This research investigates the performance of a 3-month Standardized Precipitation Index (SPI) derived from the Tropical Rainfall Measuring Mission (TRMM) and Modern-Era Retrospective analysis for Research and Applications (MERRA-2) to predict drought. CART and Random Forest are applied as the classification methods. Using several predictors, the analysis finds that CART has lower predictability than Random Forest. The average accuracy of the prediction using Random Forest reaches 100% with an average Area Under Curve (AUC) of about 0.8. The analysis also shows that predictions using the MERRA-2 dataset lead to higher accuracy and AUC than those using the TRMM. Therefore, using the MERRA-2 dataset predicted by Random Forest can be an optimal way to predict drought in East Nusa Tenggara. The methods confirmed that average soil surface temperature (day and night), Multivariate ENSO Index (MEI), Arctic Oscillation Index (AOI) and Normalized Difference Vegetation Index (NDVI) are strong predictors of drought. The performance of CART and Random Forest is improved with the Synthetic Minority Over-Sampling Technique (SMOTE). The techniques described: •translate drought information and predictors of drought into a base classifier that optimizes the AUC;•allow drought to be predicted for many grid points efficiently and with high accuracy; and•are computationally efficient and easy to implement.

Survey data of household perceptions of drought, mitigation and adaptation practices in East Nusa Tenggara, Indonesia.

A comprehensive and detailed description of household survey data that were collected in East Nusa Tenggara, Indonesia in 2018 is provided in this article. The survey was conducted using a structured questionnaire administered among 300 households in East Nusa Tenggara as one of the regions experiencing severe drought for more than a decade. The information about perceptions of drought and mitigation and adaptation strategies was collected from the head of household or household member. The survey comprises comprehensive information about household socio-demographic characteristics, household resources, agricultural activities, knowledge and perceptions of drought, experience with drought and adaptation strategy, mitigation of the impact of drought, future drought and the participation of women in decision making. The data are provided with this article.