The increasing of Independent National Health Insurance (NHI) membership is one of the indicators to achieve Universal Health Coverage. One of the challenges in extending such coverage is reaching it out to the informal sector. This study was aimed to analyze the determinants of Independent NHI ownership in Indonesia. This study used cross-sectional design, and the data were derived from Indonesian Family Live Survey (IFLS) 2014. 6,888 individuals aged ≥40 years were the sample of this study. To analyze the data, chi-square analysis and logistic regression were used. Based on the analysis, the proportion of respondent with Independent NHI is 16.6%. The ownership of independent NHI is influenced by the following factors: age 40-55 (PR=1.72 95%CI 1.41-2.09, p-value <0.001), Sumatra Island (PR=7.67 95%CI 5.55-10.59 p-value<0.001), very rich (PR = 2.26 95%CI 1.85-2.75 p-value <0.001), history of chronic disease (PR=1.33 95%CI 1.15-1.53 p-value<0.001), junior high school (PR = 2.21 95%CI 1.92-2.55 p-value<0.001), and urban (PR=1.79 95%CI 1.57-2.04 p-value <0.001). Region is the most dominant variable related to NHI ownership (p-value <0.001; Exp B= 7.03; 95% CI: 5.06-9.77). Independent NHI membership has not been maximal, yet. To increase this participation, the Social Security Administrator should approach each region with low NHI membership through promotion, socialization, and education about registration and the benefits of independent NHI.

Immunization has effectively reduced the burden of infectious diseases, mortality, morbidity, and saved resources. This study aims to identify factors that are associated with the completeness of immunization among children aged 0-59 months in Indonesia. This research is a quantitative study with a cross-sectional design. The source data used secondary data from the 2018 Indonesia Basic Health Research. The sample of this study consisted of 64,455 women who had children aged 0-59 months. The data were analyzed using a logistic regression test. The results revealed only 10% respondents have a complete immunization status for their children aged 0-59 months. This study also showed that the mother’s age, antenatal care visit, access to health care, residence and place of birth had a significant relationship with the completeness of immunization in children. Mother’s age ≥ 21 is the most dominant variable related to immunization completeness in children with a prevalence ratio (PR) value of 1.613 (95% confidence interval (CI): 1.269-2.052) after being controlled by other variables. Age, antenatal care visit, access to health service, residence, and place of birth were associated with completeness of immunization among children aged 0-59 months. Policy makers may take these factors into account to increase complete immunization coverage for this group.
Immunization

Demographic transition presents a significant challenge to the world. People experience longer life because the aging population is increasing rapidly. Organizations of integrated care for older people confirmed that the elderly were more prone to being victims of chronic diseases and serious issues. Factors related to the utilization of outpatient services generally have been explored, but there are limited studies on the elderly with hypertension. This study aims to analyze the elderly population using outpatient services for hypertension, in Indonesia. The cross-sectional study is used as the study. We obtained data from the Indonesian Family Life Survey (IFLS) in 2014. There were 2,308 elderly. Bivariate analysis was using chi-square, and multivariate analysis using multiple logistic regression. It was found that 24.1% of the elderly with hypertension used outpatient services. Variables significantly associated with the utilization of outpatient services were gender, insurance status, health status, economic status, the number of chronic diseases, marital status, self-limited activity, and region. The main predictor of the utilization of outpatient services is the number of chronic diseases. In conclusion, the number of chronic diseases was significantly influenced among the elderly with hypertension by using outpatient services. More effort by the government is needed to expand the policy of promotion and prevention in chronic diseases.
Aged

Introduction: Depression is one of the mental illnesses that affect adolescents worldwide. This study analysed the factors associated with depressive symptoms among adolescents in Indonesia. Methods: A quantitative cross-sectional study was conducted using secondary data from the Indonesian Family Life Survey 2014. The sample included 3,603 adolescents aged 10-19 years. Data were analysed using logistic regression statistical tests. Results: Of the adolescents, 29.1% had depressive symptoms. The bivariate analysis showed that sex, region, economic status, chronic illness history, sleep quality, smoking habit, and personality type were associated with a higher probability of depressive symptoms among the adolescents. Conclusion A history of chronic diseases contributes the most to the occurrence of depressive symptoms among adolescents. To reduce the prevalence of chronic diseases associated with depression, the Indonesian government must make preventive efforts through early detection among young people.
Depression ; Adolescent ; Indonesia

Introduction: Delays in case-based surveillance are a significant obstacle to eliminating malaria. This study aims to optimise the current electronic malaria information system (eMIS), which uses an eMIS android-based mobile. Method: Qualitative research was conducted in the Lahat District, South Sumatra Province. We select informants directly involved in, or playing a role in, malaria control activities, such as program managers at community health centres (Puskemas) and health services. The system is built using the Framework for the Application of Systems Techniques (FAST), a structured method for analysing complex systems. It helps professionals break down problems, uncover hidden relationships, and make better decisions. FAST is widely used in engineering, project management, and business process optimisation to tackle complex challenges and improve problem-solving. Results: The paper revealed suggestions for designing and optimising the current eMIS. One recommended method for overcoming the obstacles is to optimise an eMIS Android-based mobile for malaria reporting. Eight key informants participated in the interviews. The main obstacles by key informants are the free time available for giving deep information and annoyance from outside during interviews due to their other activities. Hence, the researchers made appointments with informants and interviewed in a particular room, not the informant’s office. Conclusion: Our study demonstrates that eMIS android-based mobile is a better refinement of the current eMIS based on PC to support malaria surveillance for malaria elimination programs in an endemic area. Data entry with an eMIS android-based mobile is faster, more accurate, and allows real-time collaboration, outperforming sheet applications.

Many countries are trying to achieve Universal Health Coverage. Indonesia wanted to do this by implementing National Health Insurance in 2014. The purpose of this study is to explore the demand for health services based on visits to service providers, for both outpatient and inpatient care. This study used secondary data from wave five of the Indonesia Family Life Survey (IFLS). The sample used in this study comprised 34,177 individuals who were aged >15 years old. In this study, the demand for health services was measured based on whether respondents had visited a healthcare facility and their number of visits to healthcare facilities. Data was analysed using bivariate analysis with chi-square and multivariate analysis using the negative binomial regression model and probit model. The proportion of respondents visiting healthcare facilities for outpatient care was 16%, while for inpatient visits it was 5%. Both models produced almost the same effect in indicating the probability of individuals visiting a healthcare facility and their number of visits. Age, gender, marital status, education level, economic level, having health insurance, region, health status, chronic disease, and the number of diseases were statistically significant (P < 0.001) in influencing outpatient service demand. Age, gender, marital status, education level, economic level, having health insurance, regional status, health status, and the number of diseases were statistically significant (P < 0.001) in influencing inpatient service demand. Individual characteristics, demographics, and health status were independent factors associated with demand for healthcare services. The government should consider these factors in expanding health service demand in Indonesia.
Health Services