Evaluation on the Quality of Case Management, Follow Up Compalince, and Death Risk in Infants/ Children Under Five,A Studv in Areas with MTPA Intervention and Non-MTPA Intervention in District of Cianjur

Myrnawati, (2001) Evaluation on the Quality of Case Management, Follow Up Compalince, and Death Risk in Infants/ Children Under Five,A Studv in Areas with MTPA Intervention and Non-MTPA Intervention in District of Cianjur.

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Abstract

In the effort to accelerate the reduction of IMR (Infant Mortality Rate) and CMR (Child Mortality Rate) in West Java Province, particularly in District of Cianjur, a study on the Integrated Management of Childhood Illness [Manajemen Terpadu Penyakit Anak (MTPA)] was conducted. This approach has been recommended by WHO to be implemented in developing countries with IMR more than 40 per1000 life births. The objectives of this study were to determine the quality of case management and the follow up complience at Primary Health Centers with MTPA intervention compared with the quality of case management at Primary Health Centers without MTPA intervention, and to determine the extent of death risk in infants/children under five who took advantage of the services provided by Primary Health Centers with MTPA intervention compared with those who did not. In addition, this study was intended to determine other factors related to the above three objectives. It is hoped that results of this study can provide valuable input to Ministry of Health in assisting the reduction of tire infant/children under five mortality rate, such that one of the objectives of Ministry of Health, i.e. to achieve the ability of health, life for all citizens, may be realized immediately. Since the prehrniriarv data on the quality of case management and follow-up compliance were not available, and randomization could not be performed, the design used to evaluate the above two aspects was a preexperiment with Static Group Comparison Type. Because death did not occur frequently, the design used to evaluate death risk in infants/children under five was case control. This method was most suitably used to measure insignificant end results. Three studies were performed prior to this investigation : (1) Base line survey to determine IMR and CMR, (2) Rapid health service assessement to determine the quality of case management performed by health providers, and (3) Rapid ethnography assessment to examine the detail social interactions between community, i.e. community's beliefs and habits in relation with treatment of infants/children under five at health facilities.Multiple linear regression analysis, multiple logistic regression analysis and polytoiny logistic regression analysis were used to identify the relationship between a number of risk factors and variables of end results. To detect multicolinearity, Pearson correlation matrix was used. Receiver Operating Characteristic (ROC) curve was made to establish optimal category of continous scales variables. The investigator attempted to make end models robust (accurate) and parsimonious (simple).Based on summarized theories, conceptual frame work, the results of analysis, and the discussion, three main theses and eleven subtheses were established. The quality of case management was found to be affected by MTPA intervention and provider's knowledge. Follow Up complience was not affected by MTPA intervention, but by the severity of disease, decision to seek treatment and mother's availability. While infants/ children under five death is affected by access to treatment at Primary Health Centers with MTPA intervention, severity of disease, and application of immunization.Based on the results of this study, the investigator concluded that in order to accelerate the reduction of IMR and CMR, Ministry of Health should apply MTPA approach immediately in the management of infants/ children under five in all Primary Health Centers in Indonesia. This approach is suitably conducted in this era of monetary crisis since the facilities and medications to be made available are relatively simple such that they may be provided in remote areas.

Item Type: Article
Subjects: Collections > Koleksi Perpustakaan Di Indonesia > Perpustakaan Di Indonesia > JKPTYARSI > S3-PhD Theses > Kedokteran
Divisions: Universitas Komputer Indonesia > Perpustakaan UNIKOM
Depositing User: M.Kom Taryana Suryana
Date Deposited: 16 Nov 2016 07:37
Last Modified: 16 Nov 2016 07:37
URI: https://repository.unikom.ac.id/id/eprint/2425

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