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 TABLE OF CONTENT 2

Conference background 3

Organizing committee 4

Welcome message from Prof Emeritus Dato’ Dr Syed Mohamed Al-Junid 5

Speakers CV

Prof Emeritus Dato’ Dr Syed Mohamed Aljunid 7

Prof. Dr. Tippawan Liabsuetrakul 8

Prof. Dr. Supasit Pannarunothai 9

Prof. Dr Laksono Trisnantoro 10

Dr Lutfan Lazuardi 11

Brig General Dr. Mohd Arshil Moideen 12

Conference Programme 13-14

Keynote address 16

Evidence-Based Policy for Health Reform: A Path to Sustainable Healthcare

Systems

Plenary abstracts I 17

Evidence From Systematic Review and Network Meta-Analysis: Evidence-Based

Healthcare and Practice (Prof. Dr. Tippawan Liabsuetrakul)

Plenary abstracts II 18

Post-Covid Health System Reform (Prof. Dr. Laksono Trisnantoro)

Plenary abstracts III 19

Public Private Partnership as A Sustainable National Health Model (Brig Gen (Dr)
Mohd Arshil bin Moideen)

Plenary abstracts IV 20

Health Financing Reforms - Incorporating Strategic Purchasing (Prof. Dr. Supasit

Pannarunothai)

Panel discussion 21

The Healthcare Reform: Are We Really Serious?

Oral and Poster presentation list 22-28

Presenter abstracts 30-86

Acknowledgement 87

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CONFERENCE BACKGROUND
This forum marks the sixth iteration to be hosted at Universiti Kebangsaan Malaysia. It represents the
sixth round of collaborative forums held across three nations: Malaysia, Thailand, and Indonesia. The
inaugural event took place in Indonesia in 2007, followed by Thailand in 2008, 2010, 2013, 2017, and
2020; Malaysia in 2009, 2012, 2015, 2018, and 2021; and Indonesia again in 2011, 2014, 2016, 2019,
and 2022. The current forum will be conducted onsite over a duration of two days. The theme for this
year's forum is "Evidence-Based Policy for Health Reform." This concept entails the utilization of the best
available evidence to guide policy decisions that impact health outcomes. It encompasses the
understanding of policy adoption, the development of effective content, and the documentation of
outcomes.

Governments allocate significant resources to health-related research with the aim of facilitating
advancements through the application of evidence-based policy. Consequently, advocacy for evidence-
informed policy-making in public health is of paramount importance, as health and care research strives
to enhance healthcare outcomes, improve patient well-being, and influence policy formulation. The
incorporation of evidence in health policy making is also an important aspect of international public policy.
This forum is designed for postgraduate students (Masters and PhD) specializing in the field of Health
Policy and Management. Graduated and current PhD students from Malaysia and other countries are
invited to participate. The forum encompasses all relevant domains within public health, particularly
focusing on health policy and health management, including Health Management, Health Economics,
Health Finance, and Health Policy.

The primary objective of the forum is to provide a platform for postgraduate students to disseminate the
knowledge acquired thru their research on an international scale and to share their experiences with
newly enrolled PG candidates. Additionally, postgraduate students will have the opportunity to gain
updated knowledge from all invited speakers during the keynote, plenary, forum, and presentation
sessions.

The event will feature international speakers for plenary sessions, forums, oral presentations, and poster
presentations. Papers accepted for presentation will undergo a review process by an appointed editorial
board and will be published in a special issue of the Malaysian Journal of Public Health Medicine
(MJPHM) This journal is indexed by Scopus and possesses a commendable impact factor.

This conference will serve as a catalyst for innovation and collab in health policy for health reforms. Let
us seize this opportunity to advance our shared goal of creating health systems that are efficient,
equitable, and sustainable.

We look forward to a productive and inspiring event!

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ORGANIZING COMMITTEE
Advisor Prof. Emeritus Dato’ Dr. Syed Mohamed Al-Junid
Prof. Dato’ Ts. Dr. Ahmad Mujahid Ahmad Zaidi
Secretariat
Chairman Professor Dr. Mohd Rizal bin Haji Abdul Manaf
Members Dr Kiran Ganesh Balakrishnan
Finance
Chairman Professor Dr. Aniza bt Ismail
Members Dr Syuhada Hamzah
Dr Loo Hui Na
Scientific
Chairman Dr Siti Athirah Zafirah binti Abdul Rashid
Members Brig. Jen. Dr. Mohd Arshil Moideen
Dr Siti Hajar binti Adam
Dr Nor Faiza binti Mohd Tohit
Dr Nur ‘Adnin binti Ahmad Zaidi
Dr Zuraidah binti Che Man
Dr Haliza binti Hassan
Plenary and Symposium Speaker
Chairman Associate Professor Dr. Aznida Firzah bt Abdul Aziz
Member Associate Professor Dr. Mohd Fairuz Ali
Protocol
Chairman Dr Azizul Rahman bin Mohamad Jamil
Members Dr Sharifah Balqis bt Sayed Abdul Hamid
Dr Hanis bt Abdul Rani
Technical
Chairman Mr. Rosman bin Mat Rashid
Members Mr. Mohd Izhar Arif
Logistic and Accommodation
Chairman Dr Rashidi Mohamed
Members
Registration and Gift
Chairman Associate Professor Dr. Ezura Madiana
Members Associate Professor Dr. Aidalina Mahmud
Dr. Halila Mohamed
Dr. Yin Nwe Aung
Dr. Teh Rohaila binit Jamil
Pn Salwana
Pn Syakinah Ainan
Dinner and Entertainment
Chairman Dr. Adieza Farahain bt Ahmadi
Members Pn Masilawati Md Asim

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WELCOME MESSAGE FROM PROF.

EMERITUS DATO’ DR. SYED MOHAMED
ALJUNID
I am delighted to extend a warm welcome to all esteemed scholars, researchers, postgraduate students,
and participants attending the 18th Postgraduate Forum on Health Systems and Health Policies. This
forum serves as a vital platform for fostering dialogue, sharing insights, and advancing knowledge in the
critical fields of healthcare management, health systems, and health policy development.

In today's ever-evolving healthcare landscape, discussions surrounding health systems and policies play
a fundamental role in shaping the quality, accessibility, and effectiveness of healthcare services. This
year's theme, "Evidence-Based Policy for Health Reform," is particularly timely as countries in the region
are undergoing significant healthcare reforms in response to the aftermath of the Covid-19 pandemic.
As emerging scholars and seasoned experts come together in this forum, I am confident that our
collective expertise and diverse perspectives will make significant contributions to the ongoing discourse
in this crucial area. Throughout the conference, we will delve into key topics such as healthcare
governance, financing mechanisms, patient-centered care, technology integration, and the nexus of
policy and practice.

By actively participating, asking questions, sharing research findings, and engaging in meaningful
conversations with fellow participants, we aim to generate innovative ideas and actionable strategies that
can drive positive change in healthcare delivery and administration. Let us seize this opportunity to
collaborate, learn from one another, and inspire new approaches that can enhance our health systems
and policies for the betterment of society.

I invite all participants to partake in the Forum enthusiastically and make the most of this platform for
learning, collaboration, and exploration. May this event serve as a catalyst for valuable insights, new
connections, and transformative ideas. Thank you for joining us in this important endeavor towards
advancing healthcare systems and policies.

Prof Emeritus Dato' Dr Syed Mohamed Aljunid

Advisor
18th Postgraduate Forum on Health System and Policies
President of Malaysia Health Economics Association
Professor of Health Economics, Policy and Management
School of Medicine
IMU University

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PROF. EMERITUS DATO’ DR. SYED

MOHAMED ALJUNID
Professor Emeritus Dato’ Dr. Syed Mohamed Aljunid is a distinguished Public
Health Medicine Consultant and Professor of Community Medicine in
Department of Public Health and Community Medicine, International Medical
University, Malaysia. He is currently the President and Executive Director of
Casemix Solutions Sdn Berhad, a company specialising in training,
development and implementation of casemix system. He has a rich
academic background including a PhD in Health Economics and Financing
from the London School of Hygiene and Tropical Medicine, an MD from the
National University of Malaysia, and a Master of Science in Public Health
from the National University of Singapore.

With over 30 years of expertise in research and development in health policy, economics and financing,
he has held prominent positions such as Founding Head of the International Centre for Casemix and
Clinical Coding at the Faculty of Medicine UKM, Senior Research Fellow at the United Nations University
International Institute for Global Health and Founding Chair of Health Policy and Management, Faculty
of Public Health, Kuwait University. Notably, he was honoured with the title of Emeritus Professor in
Public Health by the Faculty of Medicine at the National University of Malaysia in November 2022. Dr.
Aljunid's international impact is evident through his consultancy work for prestigious organizations
including the WHO, World Bank, AUSAID, GIZ and Asian Development Bank, where he has contributed
to the development and implementation of casemix systems for provider payment methods in Social
Health Insurance programs across various countries.

Moreover, his involvement as Co-chair of the Morbidity Technical Advisory Group for the ICD-11 Revision
underscores his significant contributions to global health classification standards. With a prolific
publication record exceeding 300 journal articles, book chapters, and scientific reports, along with over
350 presentations at local and international conferences, and more than 89,000 citations with h-index of
70, Dr. Aljunid continues to be a leading figure in advancing the field of public health and health
economics on a global scale.

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PROF. DR. TIPPAWAN LIABSUETRAKUL

Tippawan Liabsuetrakul is a Professor at Faculty of Medicine, Prince of
Songkla University, Thailand. She received her MD, Diploma in Thai
Board of Obstetrics and Gynecology, and PhD in
Epidemiology,respectively. In addition, Dr. Liabsuetrakul had a short
course training in International Community Health and Optimal
allocation and Economic Evaluation for Health Resources and Health
Technologies.

She has the experiences of international consultancy on health care

reform and reproductive health, evidence-based medicine, surveillance
system on maternal and newborn health,proposal development, and
data analysis in several countries such as Bhutan, Cambodia,
China,Indonesia, Malaysia, Myanmar, Maldives, Mongolia, Nepal, Sri Lanka, and South Africa.

She received the Outstanding Royal Golden Jubilee Alumni Awards, the Exemplary Researcher Award
of Prince of Songkla University, the Exemplary Award for Academic Services of Faculty of Medicine.
Currently, Dr.Liabsuetrakul is a Head of Department of Epidemiology, the Director of WHO Collaborating
Centre for Research and Training on Epidemiology and Vice Dean for Research Affairs. So far, she has
more than 150 international publications on maternal health; adolescent health; communicable diseases;
non-communicable diseases; quality of care; cost estimation and economic evaluation as well as health
system and services.

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PROF. DR. SUPASIT PANNARUNOTHAI

Supasit Pannarunothai is currently Chair of Centre for Health Equity
Monitoring Foundation (CHEMF), an independent organization
undertaking research on health systems and policy. He earned his Doctor
of Medicine degree from Faculty of Medicine, Ramathibodi Hospital,
Mahidol University; his Master of Science (Public Health) from National
University of Singapore; and Doctor of Philosophy from London School of
Hygiene and Tropical Medicine (Health Planning and Financing).

Having worked as a surgeon and community physician at a regional

hospital (Buddhachinaraj Hospital) for over ten years, he then worked at
the Ministry of Public Health as a health planner and researcher. After
completion PhD degree, his main research focuses have been on health
care financing, casemix systems and universal health coverage. He joined the Faculty of Medicine,
Naresuan University in 1998, earned professorship of Community Medicine, then served as Dean of the
Faculty for nine years. Once retired from university he became CHEMF Chair to be active in researching
for health equity and payment methods for health and social services in Thailand with many other
institutions such as Thai Casemix Centre.

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PROF. DR. LAKSONO TRISNANTORO

Prof. Dr. Laksono Trisnantoro is a Professor in Health Policy and
Administration and a seniorlecturer and researcher at the Faculty of
Medicine, Public Health, and Nursing (FMPHN) at Universitas Gadjah
Mada (UGM), Indonesia. Renowned for his innovative teaching methods,
he has received several honors, including the Innovator in Management
award from FMPHN and the Innovator in Learning award in the Website
Menara Ilmu category from UGM in 2018.

Currently, he serves as Special Staff to the Minister of Health, focusing on

Pharmaceutical and Medical Device Industry Resilience since 2021. He
also holds the positions of Director of the Graduate Programme in Health
Policy and Management at Universitas Gadjah Mada, ChiefEditor of the
Indonesian Journal of Health Service Management, and is a member of
the Boardof Directors of the Asian Health System Strengthening Network (ANHSS). Prof. Dr. Laksono
obtained his MD from Universitas Gadjah Mada in 1987, his MSc in Health Economics from the
Department of Economics at the University of York, UK, and his Ph.D. from the London School of Hygiene
and Tropical Medicine. His research interests include health policy and administration, particularly
hospital management, decentralization, and equity in health services. In 2001, he was a visiting scholar
at Harvard Medical School's Department of Social Medicine in Boston.

Over the years, he has served as a consultant to the Minister of Health and local governments on various
health policy issues. In addition to his consultancy roles, Prof. Dr. Laksono has directed numerous
programs supporting health services in remote areas through collaborations between Universitas Gadjah
Mada, local governments, and the Ministry of Health. Notably, he led a robust team in supporting health
services in Aceh and North Sumatera for four years following the 2004tsunami. He also managed a
consortium of hospitals and medical schools to support remote hospitals in Nusa Tenggara Timur
province. Prof. Dr. Laksono has also worked as a short-termconsultant and technical advisor for various
international agencies, including the World HealthOrganization, AusAid, and the World Bank. His
dedication to advancing health policy andadministration, especially in underserved regions, highlights his
significant contributions to the field and his commitment to improving healthcare systems globally.

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DR. LUTFAN LAZUARDI

Lutfan Lazuardi is a dedicated academic and consultant specializing in
health policy and management at the Faculty of Medicine, Public
Health, and Nursing, Gadjah Mada University, Indonesia. He obtained
his Medical Doctor (MD) degree from Gadjah Mada University in 1999,
followed by a Master of Public Health/Health Service Management in
2002. He earned his Ph.D. from Innsbruck Medical University, Austria,
in 2007. Lazuardi's professional journey includes significant positions
such as a faculty member and consultant at Gadjah Mada University,
and a Research Fellow at the Austrian Academy of Sciences.

Lazuardi has led numerous impactful research projects, including the

"Digital Twin for Health System Resilience" in collaboration with
Middlesex University and the development of the Electronic Immunization Registry (EIR) in Indonesia.
His work spans across various aspects of digital health and telemedicine, such as the implementation of
the Portable Health Clinic for non-communicable diseases during the COVID-19 pandemic and the
technical support for developing telemedicine regulations in Indonesia. Lazuardi's research outputs are
related to studies on mobile health interventions, social media data analytics for outbreak communication,
and the evaluation of digital healthcare for maternal and neonatal programs.

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BRIG GENERAL DR. MOHD ARSHIL

MOIDEEN
Brig Gen Dr. Arshil, currently serve as the Dean of the Faculty of
Medicine and Defence Health, National Defence University
Malaysia. He is a results-oriented Military Medical Doctor, Public
Health Specialist, and Healthcare Administrator with over 20
years of experience. He holds a Doctorate in Public Health
(Epidemiology) from UPM, a Masters in Public Health from the
University of Sydney, and additional qualifications in Family
Medicine and Underwater Medicine.

Dr. Arshil has a robust background in health regulations,

personnel management, logistics, risk management, and health
planning. His extensive international experience includes
leading health services in military operations, participating in
United Nations missions, and advising NGOs. He has served as the Director General of the Health
Section at the Malaysian Army Headquarters, overseeing operations and health technical matters for the
entire Malaysian Army. He is also a key person in COVID-19 response efforts in Malaysia and has led
innovation projects in field water treatment systems.

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CONFERENCE PROGRAMME
Day 1: 6th August 2024 (Tuesday)

0800 – 0830 Registration

0830 – 9000 Opening Ceremony – Officiated by:

Pro Vice Chancellor UKM – Prof. Datuk Dr. Hanafiah Harunarashid

Photography Session

0930 – 1030 Keynote Address:

Evidence-Based Policy for Health Reform
Speaker: Prof. Emeritus Dato Dr. Syed Mohamed Al-Junid
(International Medical University, Malaysia)

Moderator: Prof. Dr. Mohd Rizal Abd Manaf

1030 –1100 Break

1100 –1200 Plenary I

Evidence from Systematic Review and Network Meta-Analysis:
Evidence-Based Healthcare and Practice
Speaker: Prof. Dr. Tippawan Liabsuetrakul (Prince of Songkla
University, Thailand)

Moderator: Dr. Nor Faiza

1200 – 1300 Oral & Poster Presentation: Concurrent 3 rooms

Auditorium Room B Room C

Moderator: Moderator: Moderator:
Dr. Wan Farhana Dr. Sarah Dr. Zuraidah
Azwanee

1300 – 1400 Lunch

1400 – 1500 Plenary II

Post Covid Healthcare Reform in Indonesia
Speaker: Prof. Dr. Laksono Trisnantoro (Universitas Gadjah Mada,
Indonesia)

Moderator: Dr. Nor Faiza

1500 – 1700 Free paper session: Concurrent 3 rooms

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Auditorium Room B Room C

Moderator: Moderator: Moderator:
Dr. Wan Farhana Pn. Wan Farizatul Dr. Sarah
Azwanee Shima

1700 End of Day 1

2000-2230 Gala Dinner

Day 2: 7th August 2024 (Wednesday)

0830 – 0930 Plenary III

Public-Private Partnership as a Sustainable National Health Model
Speaker: Brig. Jen. Dr. Mohd Arshil Moideen (National Defence
University Malaysia)

Moderator: Dr. Yin New Aung

0930 – 1000 Break

1000 – 1200 Free Paper Session 2: Concurrent 2 rooms

Auditorium Room B Room C

Moderator: Moderator: Moderator:
Dr. Sarah Dr. Wan Farhana Dr. Siti Hajar
Azwanee

1200 – 1300 Plenary IV

Health Financing Reforms – Incorporating Strategic Purchasing
Speaker: Prof. Dr. Supasit Pannarunothai (Centre for Health Equity
Monitoring Foundation, Thailand)

Moderator: Dr. Siti Athirah Zafirah

1300 – 1400 Lunch

1400 – 1600 Panel Discussion

Healthcare Reform: Are We Really Serious?
Speakers:
Prof Dr Supasit Pannarunothai (Thailand)
Dr Lutfan Lazuardi (Indonesia)
Prof Emeritus Dato’ Dr Syed Mohamed Aljunid (Malaysia)

Moderator: Assoc. Prof. Dato’ Dr Mohd Husni Jamal

1600 - 1700 Awards & Closing Ceremony

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KEYNOTE ADDRESS
Evidence-Based Policy for Health Reform: A Path to Sustainable Healthcare Systems

Professor Emeritus Dr. Syed Mohamed Aljunid

In the wake of global health crises and the ever-changing landscape of healthcare, the importance of
evidence-based policy in driving health reform initiatives has become increasingly prominent. In this
presentation, the critical role of evidence-based policy in shaping effective and sustainable healthcare
systems will be explored, focusing on key principles, challenges, and strategies for implementation.
Evidence-based policy for health reform centers around the utilization of rigorous research, empirical
data, and best practices to inform decision-making processes aimed at improving healthcare delivery,
quality, and outcomes. By grounding policy decisions in evidence, policymakers can ensure that
interventions are based on scientific merit, effectiveness, and cost-effectiveness, ultimately leading to
better health outcomes for populations. One of the fundamental principles of evidence-based policy in
health reform is the integration of research findings into policy development and implementation. This
requires collaboration between researchers, policymakers, healthcare providers, and other stakeholders
to ensure that decisions are guided by the most up-to-date and credible evidence available. By fostering
partnerships between academia and policymakers, evidence-based policy can bridge the gap between
research and practice, translating scientific knowledge into tangible policy actions. However, the adoption
of evidence-based policy in health reform is not without its challenges. Common barriers include data
limitations, conflicting research findings, political considerations, and resistance to change within
healthcare systems. Overcoming these obstacles requires a concerted effort to build research capacity,
improve data collection and analysis methods, enhance stakeholder engagement, and cultivate a culture
of evidence-informed decision-making within healthcare settings. To successfully implement evidence-
based policy for health reform, several strategies can be implemented. These include promoting
transparency in decision-making processes, conducting regular evaluations of policy interventions,
engaging with diverse stakeholders, fostering a culture of continuous learning and improvement, and
prioritizing equity and inclusivity in healthcare policy development. In conclusion, evidence-based policy
plays a vital role in driving health reform efforts towards more sustainable and efficient healthcare
systems. By leveraging research evidence, fostering collaboration between stakeholders, addressing
implementation challenges, and adopting innovative strategies, policymakers can pave the way for
transformative changes that improve healthcare access, quality, and equity for all.

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PLENARY I

Evidence From Systematic Review and Network Meta-Analysis: Evidence-Based Healthcare and
Practice

Prof. Dr. Tippawan Liabsuetrakul,

Research is the fundamental process for producing scientific knowledge in all professions. A lot of
research information on the same aspects and questions exists, with results that are sometimes either
consistent or contradictory due to insufficient data in individual studies. Nowadays, a systematic review
is essential to synthesize research on the same question systematically using comprehensive search
strategies, which are tremendously useful for making timely evidence-based healthcare and practice
decisions. Meta-analysis is a statistical method that combines the findings of individual studies, typically
limited to head-to-head intervention comparisons. A network meta-analysis, on the other hand, helps
compare multiple interventions across studies. A network meta-analysis provides direct estimates for
comparing interventions, indirect estimates for comparing two interventions via a common comparator,
and network estimates that combine direct and indirect estimates. It also offers a relative ranking of all
interventions for the studied outcome. The principles of network meta-analysis include transitivity,
inconsistency, heterogeneity, and the hierarchy of interventions, using the surface under the cumulative
ranking curve (SUCRA).
An example of the evidence from systematic reviews and network meta-analyses is the use of
medications for preventing preeclampsia. Preeclampsia is a common obstetric complication leading to
direct maternal death globally. So far, several medications have been studied for preventing
preeclampsia, and systematic reviews on this topic have been published. When the keywords “prevention
of preeclampsia,” “medications,” and “meta-analysis” were searched with the filter on “systematic review”
in PUBMED on July 11, 2024, 161 search results were found, of which 27 were finally identified. Among
these, there were 11 studies focusing on aspirin, two on pravastatin, three on vitamin D, one on
progesterone, four on low molecular weight heparin, one on multivitamins, three on calcium, one on folic
acid, and one on nitric oxide. When “network meta-analysis” was searched instead of meta-analysis, five
search results were found, of which three were finally identified. The network meta-analyses for
preventing preeclampsia, involving 93,864 women across global regions in 83 randomized studies,
showed that three medications, either alone or in combination, probably prevented preeclampsia in high-
risk pregnant women compared to a placebo or no treatment: antiplatelet agents with calcium, calcium
alone, antiplatelet agents alone, and antioxidants. However, evidence of one medication's superiority
over another was not found. From 51 included trials involving 69,669 pregnant women, antioxidants
slightly reduced placental abruption compared to placebo/no treatment. Antiplatelet agents probably
reduced the incidence of small-for-gestational-age infants but slightly increased neonatal intraventricular
hemorrhage.
In conclusion, the systematic review and network meta-analysis found no evidence of any one medication
being superior to others for the prevention of preeclampsia. Antiplatelet agents, calcium, and antioxidants
were found to be beneficial compared to placebo or no treatment; however, it is crucial in healthcare
practice to carefully monitor the risk of neonatal intraventricular hemorrhage when antiplatelet agents are
used.

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PLENARY II

Post-Covid Health System Reform

Prof. Dr. Laksono Trisnantoro

Following political reform in 1998 in Indonesia, health system shaped by various Laws on: (1)
Decentralization in 1999 and 2004; (2) Medical Practice in 2004; and (3) Social Security in 2004, followed
by BPJS Acts in 2011. Also there were around 10 Laws related to health system. These Laws did not
have synergistic results. In 2020, the health system was not in good condition, not effective, the equity
was worsening,government role was limited in some strategic issues, and financially not sustain.There
was no policy on health system reform. This weak health system in Indonesia was hit hard by Covid19
pandemic. During this pandemic Ministry of Health had strategic program as the following: accelerating
vaccination, ending the pandemic as soon as possible, and reforming health system. After Covid19
pandemic, Government of Indonesia preparing a new health Laws with a strong belief that without legal
basis the reform which uses transformation principles cannot take place. Therefore, an Omni Bus Laws
approach was used for providing an opportunity to create comprehensive reform-oriented laws by
combining 11 Laws in health sector, except the Social Security Laws (2004) and BPJS Laws (2011). In
August 2023, Government enacted Health Care Laws as a legal basis for health system reform and
transformation. The progress is still in the early phase of implementation.There are many challenges of
this reform-oriented Health Laws such as: financial capacity of government and community, human
resources aspect, rejections from various stakeholders, and decentralization policy.

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PLENARY III

Public Private Partnership as A Sustainable National Health Model

Brig Gen (Dr) Mohd Arshil bin Moideen

Public-Private Partnerships (PPPs) have emerged as a crucial strategy in healthcare systems worldwide,
aiming to achieve sustainable and equitable healthcare delivery. This paper explores the role of PPPs in
shaping national health models, focusing on their potential to enhance service accessibility, efficiency,
and innovation. Through a comprehensive review of literature and case studies, this study examines the
dynamics, challenges, and benefits associated with PPPs in healthcare. Key themes include governance
structures, financing mechanisms, and outcomes assessment, highlighting how effective partnerships
can mitigate resource constraints and foster resilience in healthcare systems. By evaluating diverse
international practices, this research contributes to understanding the strategic implementation of PPPs
as a cornerstone of sustainable national health frameworks. This abstract encapsulates the essence of
how PPPs contribute to sustainable healthcare models, emphasizing accessibility, efficiency, and
innovation while acknowledging the complexities and potential benefits for Malaysia.

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PLENARY IV

Health Financing Reforms - Incorporating Strategic Purchasing

Prof. Dr. Supasit Pannarunothai

Health financing reforms around 1990s emerged with creating ‘internal markets’ within public financed
and public managed health service systems despite the arguments of market failure in health care. From
2000, World Health Organization, the World Bank and the United Nations unanimously advocate
universal health coverage to member countries to achieve sustainable development goals of 2030. The
purchaser-provider-split model has transformed to strategic purchasing function of the social health
insurance body after revenue raising and pooling of resources fit to the national health needs.
Governance frameworks and institutional arrangements facilitate successful purchasing of integrated
health services for complex population health needs. Appropriate payment methods need to be designed
strategically for higher number of activities or utility or maximizing social welfare. In the multiple fund UHC
in Thailand, different degrees of strategic purchasing have proven different health system outcomes.
However, arguments on why strategic purchasing failed are basically based on asymmetries in
information, market power, financial and political power. More research is needed.

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PANEL DISCUSSION

The Healthcare Reform: Are We Really Serious?

Professor Emeritus Dr. Syed Mohamed Aljunid

The concept of healthcare reform has been a recurring theme in policy discussions worldwide, yet the
question remains: Are we truly serious about implementing meaningful and sustainable changes in our
healthcare systems? The complexities and challenges of healthcare reform, the underlying motivations,
political dynamics, and societal expectations might shape the reform agenda. By analysing past reform
efforts and current trends, we seek to unravel the gap between rhetoric and action, highlighting the
barriers to reform implementation and the critical need for genuine commitment from stakeholders.
Through a critical examination of the factors influencing healthcare reform, we need to provoke thought,
spark dialogue, and inspire collective action towards a more equitable, efficient, and patient-centric
healthcare system.

Prof. Dr. Supasit Pannarunothai

In my view, healthcare reforms get little attentions now as compared to two decades ago. Recent
attentions have focused on health disruptions from technologies and environments. Digital health
disruptions and unsustainable developments may be serious issues for discussions of health systems
and policy reforms in our Postgraduate Forum.

Dr. Lutfan Lazuardi

Digital transformation is playing a pivotal role in healthcare reform in Indonesia, enhancing access and
quality while reducing costs. For example, telemedicine and mobile health apps are bridging the gap
between patients and providers, especially in remote and underserved areas, by offering remote
consultations and increasing access to medical specialists.
Additionally, Electronic Health Records (EHRs) streamline information sharing, ensuring that healthcare
providers have accurate patient data, which improves care coordination and outcomes. Digital tools like
decision support systems and artificial intelligence (AI) enhance diagnostic accuracy and personalized
treatment plans. Big data analytics enable Indonesia's healthcare system to identify trends, predict
disease outbreaks, and manage population health more effectively. This data-driven approach not only
optimizes resource allocation but also supports the shift towards value-based care models, incentivizing
providers to achieve better patient outcomes.
These technologies facilitate preventive care by providing early warning signs and encouraging healthier
lifestyles, reducing chronic diseases and lowering healthcare costs. Addressing challenges such as data
privacy and interoperability is crucial for successful integration. With proper investment in training
healthcare professionals, digital transformation can create a more efficient, equitable, and patient-
centered healthcare system, leading to significant and sustainable reform.

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ORAL & POSTER PRESENTATION LIST

ORAL PRESENTATION

DAY 1: 6TH AUGUST 2024 (TUESDAY)

Auditorium
Presenter Title Time Page
ID slot

OO_UHC01 Impact Of the Indonesia National Health Insurance Program On Neonatal 1200 - 30
Survival 1215

Fathinah Ranggauni Hardy , Siswanto Agus Wilopo , Tunjung Wibowo

OO_HWF01 The Elements That Influence The Effectiveness Of Humanitarian Logistics 1215 - 31
During Flood In Rantau Panjang, Kelantan 1230

Zahimi Bin Zainol Abidin (B)

OO_HWF02 The Relation Between Employee Engagement and Health Workforce 1230 - 32
Satisfaction at Pertamina Cirebon Hospital Onsite Unit 1245

Iman Saeful, Sito Meiyanto, Haryo Bismantara

OO_HWF03 Budgeting for health program is not just a number: A Challenge for 1245- 33
Indonesia 1300

Diah Ayu Puspandari, Vini Aristianti

OO_HE01 The Hamas-Israel War 7th October War: Gazan Women Health Crisis under 1500-
Israel's War Policy 1515 34

Dr Nor Aishah Hanifa, Dato' Dr. Junaidah Kamarruddin

OO_HE02 A Systematic Review For Identifying Interventions To Improve The 1515-

Vaccination Among The Children Aged 12-23 Months In Slum Areas In Asia. 1530 35

Kazi Fayzus Salahin, Ricvan Dana Nindrea, Tippawan Liabsuetraku

OO_HE03 Association Between Cannabis Home Cultivation And Cannabis Use Among 1530 -
High School Students After Cannabis Legalization In Thailand 1545 36

Phonchai Thongwichian,Sawitri Assanangkorncha

OO_HE04 Spatiotemporal Relationship Between Cannabis-related and Pulmonary TB 1545 -

Hospitalization 1600 37

Kemmapon Chumchuen, Virasakdi Chongsuvivatwong

OO_HE05 Role Of Supply Chain And Logistics In The Field Hospital Operation 1600 -
38
1615
Haliza Mohd Zahari, Junaidah Kamarruddin

22
 23

OO_HE06 Challenge Of Health Service And System In Bangladesh: Geographical 1615 -

Disparity Of Under-5 Child Mortality 1630 39

Md. Nuruzzaman, Kyaw Ko Ko Htet, Wit Wichaidit,Tippawan Liabsuetrakul

OO_HE07 Indonesian Refractive Error Services: a Health System Perspective 1630 -

40
1645
Ester Febe, Krisna Dwi Purnomo Jati, Felicia Widyaputri, Muhamad Faozi
Kurniawan, Rima Afifah Putri, Muhammad Bayu Sasongko

OO_HE14 Inpatient Care Utilization Among Elderly Under National Health Insurance 1645-
Program In Indonesia 1700 41

Rizki Lestari, Diah Ayu Puspandari

Room B
OV_HE02 Difficulty Level of Prescribing Sick Leave and Frequency of Problems in 1200 - 42
The Prescription Among Public Primary Care Doctors in Perak. 1215

Shahirah Fathin Ab Rahim, Teh Rohaila Jamil

OV_HE03 An analysis of the factors influencing the income of disabled individuals 1215 - 43
compared to non-disabled individuals: Preliminary findings from Thailand 1230

Hansachon Fuenglikhit, Pudtan Phanthunane, Natthawudh Konglumpun

OV_HE04 Mortality audit of COVID-19 Omicron variant cases in Persahabatan 1230 - 44

Hospital 1245

Agus Dwi Susanto, Hanevi Djasri

OV_PHC07 Evaluating Health Outcomes and Healthcare Financing in Patients with 1245-
Diabetes Mellitus: Insights from Indonesia's Prolanis Program 1300 45

Diah Ayu Puspandari, Vini Aristianti, Maya, Wan Aisyiah Baros

OO_PHC01 Beyond Health Facility Walls: The Financial Forecasting and Costing For 1500-
Home-Based Palliative Care in Yogyakarta 1515 46

Tatik Hariyanti, Firdaus Hafidz, Muhammad Arif Budiarto

OO_PHC02 Evaluation of Nutrition Service Capacity for Stunting Prevention at 1515-

Posyandu and Puskesmas: A case study of four districts in Indonesia 1530 47

Candra Candra, Faisal Mansur, Mubasysyir Hasanbasri

OO_PHC03 Assessing Governance Practices in the Delivery of Maternal and Child 1530 - 48
Health (MCH) Programs at Puskesmas 1545

Muhamad Faozi Kurniawan, Mubasysyir Hasanbasri, Andreasta Meliala

OO_PHC04 User Acceptance Of Artificial Intelligence-Based Dental Screening 1545 - 49

Application In The School Dental Health Program At Kebayoran Baru 1600
Health Center

Dewi Arifahni, Hanevi Djasri, Annisa Ristya Rahmanti, Dhinintya Hyta

Narissi

23
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OO_PHC05 Health Transformation Strategy through Empowering POSBINDU Cadres: 1600 - 50

Increasing Knowledge and Communication Skills in Preventing Non- 1615
Communicable Diseases (NCDs)

Nia Lestari Muqarohmah, Bagas Suryo Bintoro

OO_PHC06 Study of Primary Service Integration Implementation in Yogyakarta, 1615 - 51

Indonesia: A Protocol 1630

Tri Siswati, Yustiana Olfah, Siti Nurhayah Isfandiari, and Lukman Waris

OO_PHC08 The Association between Quality of Life, BMI, Anxiety, and Stress level 1630 -
among University Staff workers 1645 52

Mohd Izhar Bin Ariff , Mohd Rizal Abdul Manaf, Nor Ba’yah Abdul Kadir

Room C
OV_HE01 Community Geriatric Telemedicine (CORTICAL©) in Malaysia: Identifying 1200 -
Patient criteria for Family Medicine Specialist-Geriatrician shared care 1215
53
initiatives

Sarinah Tamring, Aznida Firzah Abdul Aziz, Mohd Fairuz Ali

OV_HE05 Enhancing Immunization Success: Optimizing Cross-Sector Collaboration 1215 - 54

in Rural Indonesia 1230

Yunita Fitriah, Likke Prawidya Putri, Yodi Mahendradhata

OV_HE06 Difficulty in Adopting Electronic Medical Records Primary Health Care 1230 - 55
Facilities in Bantul Regency 1245

Dina Kristinawati, Guardian Yoki Sanjaya, Adhistya Erna Permanasari,

Toufik Sitompul, Nony Parmawati, Diah Puspitasari, Dian Sulistyowati

OV_HE07 Benefits Evaluation of an Implemented Clinical Pathway for Cesarean 1245-

Section at Bethesda Lempuyangwangi Hospital 1300 56

Ferni, Hanevi Djasri

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POSTER PRESENTATION

Room C
OP_HE02 Telemedicine Health Transformation in Optimizing National Hospital 1500-
Resources Based on ACHS 1505 57

Hendera Henderi, Lutfan Lazuardi,

OP_HE03 Tweets to Tables: Social Media Insights for Free Lunch Program 1505-
58
Initiative 1510
Lusha Ayu Astari, Sensa Gudya Sauma

OP_HE05 Analysis Of The Development Prospects Of Regional Maintenance 1515-

Centers (RMC) In Indonesia 1520 59

Fajrul Falah Farhany, Indra Komala, Ni Luh Putu Eka Andayani

OP_HE06 Patient Safety Attitude Among Healthcare Workers: A Systematic 1525-

Review 1530 60

Sharifah Balqis Sayed Abdul Hamid, Aniza Ismail

OP_HE07 The determinants of job stress among Navy personnel in East coast 1530-
peninsular Malaysia 1535 61

Nur 'Adnin Ahmad Zaidi, Halyna Lugova Noor, Dalila Binti Zulkhifli,
Shahidah Leong

OP_PHC01 Evaluating Patient Satisfaction in Private Primary Healthcare Centers 1540-

(PPHCs): A Study of Sixteen Indonesian Provinces 1545 62

Uswatunnisa Arfiningtyas, Ichlasul Amalia, Likke Prawidya Putri

OP_HWF01 Lean Management Reshaping Health Services Amid the COVID-19 1545-
Pandemic: A Scoping Review 1550 63

Azizul Rahman Mohamad Jamil, Mohd Rizal Abdul Manaf, Sharifa Ezat Wan
Puteh, Kiran Ganesh Balakrishnan

OP_BD01 The Importance of Mental Health in A Healthy Lifestyle 1550-

64
1555
Sensa Gudya Sauma Syahra & Center for Health Policy and Management,
Universitas Gadjah Mada

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DAY 2: 7TH AUGUST 2024 (WEDNESDAY)

Auditorium
Presenter Title Time
ID slot Page

OO_BD02 Understanding the Acceptability of Digital Healthcare Services in 1000- 65

Islamic Boarding Schools: A Qualitative Study in Semarang, Indonesia 1015

Ichlasul Amalia, Nailul Husna, Likke Prawidya Putri

OO_SDG02 “Catin Super” Policy Brief For Decreasing Stunting In Indonesia 1015- 66
1030
Safrina Oksidriyani,Nur Ahmad Habibi, Anastu Regita Nareswara

OO_HWF04 Defence Industry In Malaysia: An Assessment Of Government Policy And 1030- 67

Defence Procurement 1045

Lady Jamilla Khatimatur , Junaidah Kamarruddin

OO_BD01 Using Heuristic Evaluation to Improve Usability of Health Crisis Risk 1100- 68
Monitoring Information System 1115

Arief Tarmansyah Iman,Prof. Hari Kusnanto Josef, Ariani Arista Putri

Pertiwi

OO_HE17 Factors associated with household healthcare expenditure on 1115-

hypertension in Indonesia. 1130 69

Indriyati Oktaviano rahayuningrum, Warsi maryati, Yusuf Alam Ramadhan

OO_HE18 Implemented Knowledge Translation to Raise Health Policy Agenda: 1130-

Tackle SSB Consumption in Indonesia 1145 70

Tri Muhartini, Shita Listyadewi

OO_SDG01 Acupressure Intervention for Children: A Scoping Review 1145- 71

1200
Sri Ramdaniati, Prof. Mei Neni Sitaresmi, Dr. Fitri Haryanti, Arief
Tarmansyah Iman

Room B
Spatial Context of Diabetes Determinants in Malaysia: Insights from a 1000-
OO_HE08 Local Story 1015 72

Mohd Rizal Abdul Manaf, Kurubaran Ganasegeran, Nazarudin Safian,

Lance A. Waller, Feisul Idzwan Mustapha, Khairul Nizam Abdul Maulud &
Muhammad Faid Mohd Rizal

OO_HE09 Respite Care Perceptions among informal Malay stroke Caregivers in 1015-
Kedah: Preliminary Findings 1030 73

Ahmad Hazri Ilyas, Ching Ching Hii, Aznida Firzah Abdul Aziz , Mohd Fairuz
Ali

26
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OO_HE10 The Need to Strengthen District Level Cross-Sector Collaboration in 1030-

Rabies Control 1045 74

Tanrypada Thursina, Yodi Mahendradhata , Mubasysyir Hasanbasri

OO_HE11 Enhancing Maternal Nutrition in Temanggung: Evaluating the Impact of 1045-

Local Food-Based Supplementary Feeding Program 1100 75

Beti Herlina, Likke Prawidya Putri

OO_HE12 Strengthening the Role of Community Health Workers through 1100-

Community-Based Monitoring Mechanisms 1115 76

Agus Salim, Faisal Mansur, Mubasysyir Hasanbasri

OO_HE13 Establishing A Standardized Organizational Structure for Teaching 1115-

Hospitals in Indonesia 1130 77

Haryo Bismantara, Mubasysyir Hasanbasri

OO_HE15 Navigating Consent: The Opt-In vs. Opt-Out Debate in School-Based 1130-
Research Settings 1145 78

Deskantari Murti Ari Sadewa, Bagas Suryo Bintoro, Sharon Simpson

OO_HE16 How does the mental health system perform in terms of psychiatric 1145-
patients' non-clinical needs-Assessing the mental health system 1200
79
performance in Guangdong, China

Zhenzhu Qian, Jialong Chen, Yanyan Yang, Sawitri Assanangkornchai

Room C
OV_PHC01 Identification Of Barriers In Primary Health Care Integration System At 1000- 80
The Archipelagic And Island States: A Systematic Literature Review 1015

Nurlaila Marasabessy

OV_PHC02 Benchmarking The Quality of Antenatal Care Services in Public Health 1015- 81
Services in Timor Leste And Setabelan Health Center, Surakarta City, 1030
Indonesia Based on The Juran Trilogy

Frieda Ani Noor

OV_PHC03 Parental Knowledge Regarding Childhood Constipation: Questionnaire 1030- 82

Development and Validation 1045

Siti Nur Syafiqah binti Fazil, Ezura Madiana Md Monoto, Chai-Eng Tan,
Hana binti Azhari

OV_PHC04 Effectiveness Of The PAUSE© Flipchart Compared To Conventional 1045- 83

Method Of Premarital HIV Counselling: A Randomized Control Study 1100

Magaletchumi a/p Chelladorai, Aznida Firzah Abdul Aziz, Tan Chai Eng ,
Leelavathi a/p Muthupalaniappen

27
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OV_PHC05 Health Literacy and Intention to Utilise Pre-Pregnancy Care (PPC) 1115- 84
Services and its Association Among Married Adults in The Reproductive 1130
Age in Selangor.

Nurul Irma Muhamad Tahir, Zuhra Hamzah, Syahnaz Mohd Hashim

OV_PHC06 Lay Health Workers: Managerial Capabilities and Their Role in Stunting 1130- 85
Mitigation 1145

Gromiko, Mubasysyir Hasanbasri

OV_PHC08 Development of a caregiver guide for post discharge stroke patients 1145- 86
residing at home in the community: POSTCODE-MyTM Project 1200

Anwar Fazal bin Abu Bakar, Aznida Firzah binti Abdul Aziz, Wan Asyraf
bin Wan Zaidi

28
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PLENARY 1

29
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OO_UHC01

Impact Of The Indonesia National Health Insurance Program On

Neonatal Survival
Fathinah Ranggauni Hardy1 2 , Siswanto Agus Wilopo1 , Tunjung Wibowo1
1
Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
2
Public Health Program, Faculty of Health Sciences, Universitas Pembangunan Nasional Veteran Jakarta

Corresponding Author: [email protected]

We assessed the effect of Indonesia’s national health insurance programme (Jaminan

Kesehatan Nasional (JKN)) on effective coverage for maternal and child health
across geographical regions and population groups. We used four waves of the
Indonesia Demographic and Health Survey from 2017, The population in this study is
the total number of children born to the 2017 IDHS survey respondents in Indonesia
18.029. JKN introduction was associated with significant level increases in (1)
antenatal care (ANC) crude coverage (adjusted OR (aOR) 1.81, 95% CI 1.44 to 2.27);
(2) ANC quality-adjusted coverage (aOR 1.66, 95% CI 1.38 to 1.98); (3) ANC user-
adherence-adjusted coverage (aOR 1.80, 95% CI 1.45 to 2.25); (4) safe delivery
service contact (aOR 1.83, 95% CI 1.42 to 2.36); and (5) safe delivery crude coverage
(aOR 1.45, 95% CI 1.20 to 1.75). We did not find any significant level increase in ANC
service contact or caesarean section. Interestingly, increases in ANC service contact
and crude coverage, and safe delivery crude coverage were larger among the poorest
compared with the most affluent. No statistically significant associations were found
between JKN introduction and neonatal and infant mortality (p>0.05) in the first
3 years following implementation.Expansion of social health insurance led to
substantial improvements in quality of care for maternal health services but not in
child mortality. Concerted efforts are required to equitably improve service quality
and child mortality across the population in Indonesia.

Keyword : Neonatal, Survival, National Health Insurance

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OO_HWF01

The Elements That Influence The Effectiveness Of Humanitarian

Logistics During Flood In Rantau Panjang, Kelantan
Zahimi bin Zainol Abidin, Nurul Aliaa Mohd Zulkifli, Noor Azmi bin Mohd Zainol, Daud bin Mohamed Salleh

National Defence University of Malaysia

The purpose of this research study was to evaluate the efficiency of information
sharing, forecasting, and inventory management in relation to humanitarian logistics
during the flood in Rantau Panjang, Kelantan. This study used a non-experimental
research design and a quantitative method as well qualitative method to few target
group who was the victim of flood. The respondents, a community in Rantau
Panjang, were provided with the questionnaire and interview. SPSS Version 27.0 was
used to examine the data gathered for this study. Multiple regression analysis,
Pearson correlation analysis, and descriptive analysis were carried out. In addition
to inventory management, this study looked at how floods affected victims' morale,
particularly in terms of trauma, anxiety, and depression. The findings of this study
shows variable inventory management, forecasting, information sharing, and
humanitarian logistics are at moderate level when data are collected and analyzed.
Further data were analysed using Pearson Correlation analysis which showed that
there is a positive relationship between variable inventory management,
forecasting, information sharing, and humanitarian logistics. The results of the
analysis found that variables inventory management, forecasting and information
sharing showed moderate levels and it influenced humanitarian logistics. In addition
to that, the flood victims were also asked about their respective perception from a
moral and health point of view.

Keyword: Natural disaster, forecasting, victims morale and mental health

31
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OO_HWF02

The Relation Between Employee Engagement and Health Workforce

Satisfaction at Pertamina Cirebon Hospital Onsite Unit
Iman Saeful1, Sito Meiyanto2, Haryo Bismantara3
1
Pertamina Cirebon Hospital
2
Faculty of Psychology Universitas Gadjah Mada
3
Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Human resources are unique assets for hospitals, requiring special treatment to
maintain their loyalty. Employee engagement is key to fostering high loyalty among
staff. This research aims to examine the relationship between employee
engagement and workforce satisfaction at Pertamina Cirebon Hospital Onsite Unit.
A mixed-methods approach with an explanatory sequential design was employed.
Initially, 399 respondents participated in a survey using the Gallup Q12 questionnaire
to measure employee engagement, categorized as actively disengaged, not engaged,
and engaged. Additionally, an 18-item questionnaire by Umam (2020) and Luthans
(2012) assessed employee satisfaction, categorized into low, moderate, and high.
Quantitative data were analyzed descriptively. Subsequently, in-depth interviews
were conducted with seven informants identified as actively disengaged and low-
satisfaction employees. Qualitative data were analyzed by developing themes
through coding and categorizing.Results revealed that 26.6% of employees were
either not engaged or actively disengaged, while 81.2% had moderate satisfaction
levels. A significant relationship between employee engagement and satisfaction
was identified (P-value = 0.002). Qualitative findings indicated that limited
management support and lack of career growth were primary factors for low
engagement. Conversely, relationships with co-workers and promotion opportunities
were major factors for low satisfaction. Enhancing the involvement of the on-site
team in the Occupational Health and Industrial Hygiene program could lead to higher
employee satisfaction and engagement.

Keywords: employee engagement, employee satisfaction, Pertamina Cirebon

Hospital

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OO_HWF03

Budgeting for Health is not Just a Number: A Challenge for Health

Program Planning and Funding in Indonesia
Diah Ayu Puspandari, Vini Aristianti

Department of Health Policy Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah
Mada

The total health budget in Indonesia increasing yearly. Health budget in 2024 was
set at 5.6 % of the national government budget, an increase of 8.1 % compared to
2023. However, the funding gap between allocations and program needs is reported
to exist still. Even for a specific health program such as malaria, the budget gap is
filled by donors by 45%. The aim of the study is to analyse financial flows and budget
processes and reveal entry points through which interventions can be implemented
to optimizing government health budgets. A mixed methods approach was used for
data collection and analysis. Quantitative method was conducted in a descriptive
manner from National and Regional budget reports, District Strategic Plans from the
period of 2022 to 2023. Qualitative data was based on the results of Focus Group
Discussions and in-depth interviews of stakeholders within the Ministry at National
level and staffs at regional levels in three provinces. The result showed the budget
code and formula that have been prepared by the Ministry of Health and the Ministry
of Home Affairs applies the same to all regions in Indonesia, while conditions in each
region are varied, so the menu offered is not necessarily match with regional needs.
Complicated planning flows and funding transfer mechanisms hampered some
regions to implement activities in accordance with the plans. Delays in budget
distribution also make it difficult for regions to adjust program implementation. In
conclusion, due to varying needs between regions as well as their varying planning
abilities. A better coordination between central and regional levels and between
ministries is the key to successful planning and implementation of the health budget.
Accompanied by simpler procedures and flexible budget code and formula.
Keywords : health care budgeting, planning, challenges

33
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OO_HE01

Women Health Crisis In War Zones: Comparing Health Systems In

Three War Zones
Dr. Nor Aishah Hanifa, Dato’ Dr. Junaidah Kamarruddin, Felo Utama,

Faculty of Defence Studies and Management, UPNM

The aim of the study is to examine women health crisis in war zones with special
focus on three war zones: Sudan, Ukraine and Gaza. This study clearly fitting the
domain of security propagated by Barry Buzan (People, States, and Fear, 1991).
According to Buzan, the concept of security comprises of five sectors: military,
political, economy, societal and environmental. Buzan asserts these five sectors are
not working in isolation with each other; but they weave together a strong network
of interdependence. The collapse of military security in Sudan, Ukraine and Gaza
impacts political security, economy security, societal security, and environmental
security. Women health crisis is directly linked with societal security and
environmental security. The problem statement of this study is war policy in three
different zones created deadly health crisis condition to women and girls. Women
are killed, injured, displaced and at the risk of diseases, violence, exploitation and
abuse. Women security deteriorates with collapse of women health condition in the
war environment. The study presents two major questions; what are the implications
of war to women and girls in war zones? How war policies cause women health crisis
in war zones? The study is based on qualitative research method, data are collected
from the primary and the secondary sources. The primary sources are like the UNICEF
documents, the UNRWA documents, European Commission documents, the UNFPA
documents, the WHO documents, Israel, Sudan, Ukraine and Hamas’ official reports
which are available online. The secondary sources comprise of books, journal
articles, magazines, newspapers, and other online sources. The authors find that
war policies ignited severe health crisis to women and girls in war zones. The warring
parties failed to comply to International Humanitarian Law (IHL), Jus in bello in
protection of women during the war. The warring parties also interrupts the UN
agencies from carry out aid works to people in the war zones. Closing of the borders,
inclusive of air and sea are blocking necessary aids from reaching the war zones.
More women and girls are expected to be killed and more women are vulnerable to
women security issues like displacement, starvation, infections, diseases,
miscarriages, abortion, mental health issues, gender-based violence, no access to
safe water, no food, latrines, washrooms, and sanitary pads. Situation is worsening
for women with disabilities and chronic diseases.

Keywords: Women Health, Women Security, War Policy, international law, United
Nations

34
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OO_HE02

A systematic review for identifying interventions to improve the

vaccination among the children aged 12-23 months in slum areas in
Asia.
Kazi Fayzus Salahin1,2, Ricvan Dana Nindrea1,3, Tippawan Liabsuetrakul1
1
Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
2
Eminence Associates for Social Development, Dhaka, Bangladesh
3
Department of Public Health, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, Indonesia

The migration of people from rural to urban areas is rising in accordance with the
congested dwellers in slums in the urban areas. Low immunization coverage in
children living in poor urban areas, particularly in slums, is widely considered.
Despite studies recommending interventions to uptake childhood vaccination,
evidence has not been systematically reviewed. The objective of this systematic
review was to identify the interventions which effectively improve vaccination
coverage among children aged 12-23 months in slum areas in Asia. We conducted a
systematic review, searching Embase, PubMed, and The Cochrane Database using
specified search terms to identify studies published between 2010 to 2023. Two
investigators independently extracted the data and assessed methodological quality.
Among 217 records initially identified from the search, 13 studies were included for
review. These included studies were conducted in Bangladesh, India, Indonesia, and
Pakistan. The study designs of included studies varied from cross-sectional study to
randomized controlled trials involving a total of 41,075 children. The interventions
in the included studies were multicomponent, incentive, reminder/recall, and
educational intervention; however, some risks of bias in terms of selection,
performance, and detection biases were found. In conclusion, all the interventions
comparing to control group showed significant increasing of vaccine uptake which is
crucial for vaccine-preventable diseases and improving child health. In addition to
the availability of vaccine for children aged 12-23 months, multi-sectoral
engagement on establishment of interventions should be integrated in the vaccine
policy, particularly in slum areas in Asia.

Keywords: interventions; vaccination coverage; children aged 12-23 months; slum-

like areas; Asia

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OO_HE03

Association Between Cannabis Home Cultivation And Cannabis Use

Among High School Students After Cannabis Legalization In Thailand
Phonchai Thongwichian1,2, Sawitri Assanangkornchai1
1
Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
2
Office of Disease Prevention and Control Region 12 Songkhla, Department of Disease Control, Ministry of Public
Health, Songkhla, Thailand

On 9 June 2022, Thailand removed cannabis from the narcotics list, raising concerns
regarding adolescent use due to the lack of appropriate control regulations.
Cannabis remains the most common drug of abuse worldwide, and the prevalence is
higher among adolescents.Using cannabis at an earlier age may affect brain
development and lead to impaired learning and memory. Moreover, early use can
result in an earlier onset and more severe symptoms of psychosis. This study aimed
to identify the association between cannabis home cultivation and cannabis use
among high school students following cannabis legalization in Thailand. Using an
anonymous self-administered paper-pencil questionnaire, a stratified cluster
sampling survey was conducted among 3,663 senior high-school students (10th-12th
grades) in Songkhla Province, Thailand. Of all, 13.39% reported cannabis home
cultivation and about 7.88% used cannabis. We found a significant relationship
between cannabis home cultivation and cannabis use (Adjusted odds ratio = 5.51,
[95% confidence interval: 3.16, 9.62]). Other variables with positive relationships
with cannabis use included affectionless control and neglectful parenting styles of
the father. Cannabis home cultivation is strongly associated with cannabis use among
Thai adolescents, indicating the role of physical availability in increasing the use of
cannabis. This is one of the few studies after cannabis legalization in Thailand that
provides a reference point for further monitoring of the changes in cultivation and
adolescent use to define the comprehensive regulation of cannabis cultivation.
Keywords: Cannabis home cultivation, Cannabis use, Parenting styles, Cannabis
legalization

36
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OO_HE04

Spatiotemporal Relationship Between Cannabis-related and

Pulmonary TB Hospitalization
Kemmapon Chumchuen1 and Virasakdi Chongsuvivatwong1
1
Department of Epidemiology, Faculty of Medicine, Prince of Songkla University

Tuberculosis (TB) is a communicable lung disease caused by Mycobacterium

tuberculosis. Up till now, several risks factors for TB have been identified including
cigarette smoking, poor hygiene, and low socioeconomic status. Cannabis, currently
the most consumed drug in the world. After gaining the momentum from a political
intended to push domestic economy, recreational cannabis was legalized in Thailand
in June of 2022. As those prone to TB may overlap with cannabis consumer, this
study objective is to investigate increased TB risk from cannabis usage. Using a
national databank of Thailand in-patients, we assessed the relationship between the
admission incidence of in-patients admitted with cannabis-related causes and those
of pulmonary TB. Relationship between the two admission types were assessed in
both temporal and spatial aspects. We aggregated admission frequency to monthly
unit and assessed the temporal relationship using cross correlation function and
autoregressive distributed lag model, while provincial aggregation and choropleth
map were used to investigate spatial pattern. For the temporal sequence, while the
trend of TB admission dropped throughout the years, the trend of cannabis-related
admission steadily increased, drastically after legalization. Initially, there was a
crude correlation between the two problems. However, the correlation turned
statistically non-significant after lags were accounted for. Geographically, although
there was no evidence of causality between the two admission type, they shared the
admission hotspot in Northeastern region of Thailand. While we did not detect any
association between the two admission incidences, past study has reported and
increased TB risk from shared cannabis smoking. To safeguard against possible TB
burdens in cannabis consumer, further studies conducted in individual-level
association is needed, as increasing trend of cannabis consumption were indirectly
detected.

Keywords: tuberculosis, cannabis, national databank, temporal and spatial

relationships

37
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OO_HE05

Role of supply chain and logistics in the field hospital operation

Haliza Mohd Zahari1, Junaiddah Kamaruddin2
1
HADR Research Center, Strategic & Security Studies Institute, National Defence University of Malaysia, Kem
Perdana Sg Besi, 57000 Kuala Lumpur, Malaysia
2
National Defence University of Malaysia, Kem Perdana Sg Besi, 57000 Kuala Lumpur, Malaysia

A field hospital is a temporary medical facility set up to provide medical care in

situations where conventional hospitals may be overwhelmed or unavailable, such
as during natural disasters, war zones, or pandemics. The occurrence of the Corona
Virus disease has prompted health systems nationwide to prepare for the
establishment of field hospitals, which will provide medical care to patients in non-
traditional healthcare settings. The field hospitals are designed to be quickly
deployable however it created a range of unforeseen unprecedented challenges in
handling a wide range of medical needs. Considering of these challenges, it is
obvious that the supply chain plays a pivotal role in the effectiveness and efficiency
of a field hospital. A total of 106 articles were screened and only 27 articles were
deemed eligible for inclusion due to their specific focus on role of supply chain and
logistics in field hospital operation. This research conducts a comprehensive analysis
to examine the prevailing themes found in the literature, specifically focusing on
the the challenges associated with operating a field hospital, the roles of supply
chain in a field hospital and the strategies employed in managing a field hospital.
This article provides a comprehensive set of recommendations that are highly
relevant for the efficient and timely operation of field hospitals, as indicated by the
review.
Keywords: Field Hospital, Supply Chain, Systematic Literature Review, Disaster

38
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OO_HE06

Challenge Of Health Service And System In Bangladesh: Geographical

Disparity Of Under-5 Child Mortality
Md. Nuruzzaman, Kyaw Ko Ko Htet, Wit Wichaidit, Tippawan Liabsuetrakul

Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

Under-5 mortality is a vital indicator to understand a country’s overall child health

as well as health sector progress. Although Bangladesh demonstrated an excellent
progress during a 20-year period with national 66% reduction of under-5 mortality
rates, some divisions of Bangladesh still faced high under-5 mortality rates.
Therefore, this study aimed to identify the disparity of under-5 deaths in different
geographical regions of Bangladesh using the data from Bangladesh Demographic and
Health Survey (BDHS) conducted in the years 2007, 2011, 2014 and 2017-18.
Descriptive statistics as well as effect modification and multivariate logistic
regression were used to observe association between under-5 mortality and
geographical regions. The study considered six (6) administrative “divisions” of
Bangladesh as geographic regions. A total of 31,473 children were included in the
analysis. The findings showed that Sylhet division had consistently highest rate of
Under-5 mortality throughout the decade. Effect modification by ‘year of survey’
adjusted for known confounders revealed that regional variation became narrower
over time and finally non-significant. However, beyond statistical significance, the
study underscored consistently higher mortality rates in Sylhet division. Other
studies observed factors such as religious belief and superstitions, inadequate
awareness about maternal and child healthcare, home-based child delivery without
skilled birth attendant, low rate of vaccination, and hard-to-reach areas. The health
system of Bangladesh required small area estimation of the challenges, and need to
ensure necessary maternal and child healthcare services and promotion in Sylhet
division to achieve SDG target to lowering under-5 mortality rate to ≤25 by 2030.

Keywords: Under-5 mortality, geographical disparity, health system, effect

modification

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OO_HE07

Indonesian Refractive Error Services: a Health System Perspective

Ester Febe1 , Krisna Dwi Purnomo Jati2 , Felicia Widyaputri2 , Muhamad Faozi Kurniawan1 , Rima Afifah
Putri3 , Muhammad Bayu Sasongko4
1
Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Gadjah Mada
University, Yogyakarta
2
Ophthalmology Specialist Clinician at Department of Ophthalmology, Faculty of Medicine, Public Health and
Nursing, Gadjah Mada University, Yogyakarta
3
Research Assistant at Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Gadjah
Mada University, Yogyakarta
4
Head of Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Gadjah Mada
University, Yogyakarta

This study aims to explore the availability of refractive error (RE) services in
Indonesia, highlight the challenges of providing services, and advocate for the
development. A situational analysis of Indonesia's existing RE services was conducted
based on three health system building blocks: governance, service delivery, and
workforce. Based on the available data, a strengths, weaknesses, opportunities, and
threats analysis of RE services was carried out. Indonesia's health system struggles
to ensure universal coverage for RE services due to weak monitoring and evaluation.
Current National Health Insurance only covers RE service by ophthalmologists and
subsidizes a pair of spectacles based on class membership. The cross-subsidization
scheme of a pair of spectacles has already been established in Indonesia but there’s
limited evidence, thus suggesting a need for cost-benefit analysis in the future. Only
16% of primary health care supports basic RE examination tools, resulting in limited
eyeglass prescriptions. Most eye care services are hospital-centered, but not all
optic stores are partnered with national health insurance. This makes it difficult for
JKN members to fill prescriptions for eyeglasses. Additionally, there is a shortage of
ophthalmologists and optometrists, especially in less developed regions, making it
difficult to obtain one-stop RE services. The government should review regulations
for a one-stop RE service, strong primary care must be the direction of the
Indonesian health systems such as UK, ensure equitable ophthalmologist and
optometrist distribution, create a more accessible spectacle prescription system,
and monitor and evaluate RE services through data collection and monitoring of
prescriptions and quality.

Keyword: Health System, Refractive Error, Indonesia

40
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OO_HE14

Inpatient Care Utilization Among Elderly Under National Health

Insurance Program In Indonesia
Rizki Lestari, Diah Ayu Puspandari

Department of Health Policy Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah
Mada

The elderly population in Indonesia which tends to increase in number, has

challenges in providing adequate costs for health services. This research aims to
examine the utilization of in-patient care for elderly under the National Health
Insurance (JKN) program in Indonesia in terms of burden of diseases, trends in JKN
costs and patterns of utilization of in-patient care for the elderly in Indonesia.
Non-experimental research was used in this study with an observational analytical
research type using a retrospective approach. The research subjects were
participants aged more than 60 years that was obtained from BPJS Kesehatan (Social
Health Security body) claims data to determine the types of diseases and health
costs of elderly participants as well as cost trends and health service utilization
patterns for elderly participants in the 2018-2022 service year. The results of this
study showed that the most common diseases suffered are diseases related to
physical changes that come with aging. Cardiovascular diseases was the highest
(1,655,144 cases), followed by respiratory diseases (1,413,438 cases) and digestive
diseases (1,207,240 cases). During the COVID-19 pandemic in 2020, the cost of
inpatient service extremely decreased. Significant increase was seen in 2022,
reflecting the rebounding of utilization during post pandemic. Elderly who
accessed inpatient health care were dominated by the lowest economic status
(56%), followed by the highest (28.2%), and the middle class (15.6%). During 2018-
2022, the cost of inpatient health care for participants aged over 60 years increased
drastically to 56.982 billion rupiah. Continuous increases occur every year, reaching
a peak in 2022 with 7.625 billion rupiah for men and 6,287 billion rupiah for women.
Based on economic status, the total costs reached 56.982 billion rupiah, with the
highest class reaching 21.846 billion rupiah, middle class at 9.285 billion rupiah, and
the lowest class at 25.851 billion rupiah. The number of elderly cases with access to
in-patient services was 16.9% of the total cases, costing 21.10% of the total JKN
expenditure. The increasing trend in the proportion of health expenditures for the
elderly requires a funding readiness strategy in the coming years

Keywords : elderly, inpatient, National Health Insurance, health expenditure,

utilization

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OV_HE02

Difficulty Level of Prescribing Sick Leave and Frequency of Problems in

The Prescription Among Public Primary Care Doctors in Perak
Shahirah Fathin Ab Rahim1,Teh Rohaila Jami2
1
Sungai Buloh Health Clinic, Lot, 1853, Kg Melayu Sg.Buloh, Sungai Buloh, 47000, Gombak, Selangor, Malaysia
2
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff,
56000 Cheras, Kuala Lumpur, Malaysia

Primary care doctors are key prescribers of sick leave certificates, facing complex
challenges that require multifaceted assessments. Despite this, no studies have
investigated this issue in the Malaysian context. This study aimed to explore the
difficulty level in prescribing sick leave and the frequency of encountered problems.
A cross-sectional study was conducted among primary care doctors in Perak’s public
primary health clinics from February to April 2023. The difficulty level of each step
in prescribing sick leave and the frequency of encountered problems were assessed
using a self-administered online Google® Form questionnaire. Additionally, the
association between sociodemographic background factors and the difficulty level
in prescribing sick leave was analyzed. Using a stratified random sampling method,
291 doctors participated; 64.3% (n = 187) reported no difficulties when prescribing
sick leave, while 49.1% (n = 143) encountered challenges. The top three reasons for
difficulty were ‘determining optimal sick leave duration’, ‘addressing psychosocial
problems’, and ‘resolving conflicts during consultation’. The most common problem
encountered was ‘patients who came with unrelated needs for sick leave’. There
were no significant associations between sociodemographic factors and perceived
difficulty levels. The findings demonstrated that while most doctors did not report
general difficulties in prescribing sick leave, they do encounter specific issues and
problems. Targeted training addressing these issues would be worthwhile to improve
primary care doctors’ practice.
Keywords: Sick Leave Prescription, Difficulty Level, Primary Care

42
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OV_HE03

An analysis of the factors influencing the income of disabled

individuals compared to non-disabled individuals: Preliminary findings
from Thailand
Hansachon Fuenglikhit, Pudtan Phanthunane, Natthawudh Konglumpun

Naresuan University

This study specifically examines the elements related to disability, with a particular
focus on the disability of the household head, that have an impact on the level of
income within the family. The study utilized the Mincer's Earning Equation to analyze
the data. The estimation was done using the Three-Stage Least Squares Method
(3SLS), which incorporated instrumental factors into the model. The educational
attainment of the home head was utilized as an auxiliary variable to influence the
educational attainment of other members of the family. The data utilized in this
study was obtained from the Household Socio-Economic Survey (SES) conducted by
the National Statistical Office (NSO) in 2021. The research sample consisted of
46,690 individuals who were employed. The findings demonstrated that non-disabled
household heads would experience greater financial gains from education compared
to those with disabilities. Specifically, each additional year of education resulted in
a 2.6% higher increase in income for non-disabled household heads compared to the
disabled group. Curiously, experiences did not impact the growth of income among
disabled individuals. Nevertheless, this discrepancy was significantly less than the
true magnitude. The Disability Survey Report revealed that a mere 34.7 percent of
individuals aged 5-24 with disabilities were enrolled in educational institutions,
while a mere 40.6 percent of individuals aged 15-59 with disabilities were gainfully
employed. The study demonstrates the presence of inequality. Income variables
have a significant impact on the accessibility of health services for individuals with
disabilities. Further comprehensive research is required to fully understand this
issue.
Keywords: Household income, Years of Education, Disabled individuals

43
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OV_HE04

Mortality Audit Of Covid-19 Omicron Variant Cases In Persahabatan

Hospital
Agus Dwi Susanto1 , Hanevi Djasri 2
1
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of
Indonesia - Persahabatan Hospital
2
Department of Health Policy and Management, Faculty of Medicine, Public Health and
Nursing, Gadjah Mada University

The deaths of COVID-19 omicron variant cases were relatively fewer, but this
cannot be ignored. The aim of the research is to conduct an audit of death cases
of COVID-19 Omicron variant patients in 2022 at the Persahabatan Hospital. This
research is an audit study. Data was taken from medical records of COVID-19
patients who died at Persahabatan Hospital from January to December 2022.
Qualitative data was obtained by interviewing the doctor in charge to explore
the root cause of the problem. The three most common immediate causes of
death were respiratory failure in 49 cases (38.58%), multiple organ failure in 33
cases (25.98%) and septic shock in 21 cases (16.54%). There were 54 patients
(42.52%) died due to COVID-19 and 73 patients (57.48%) died from causes other
than COVID-19. The most common root causes of late detection of the cause of
death are lack of alertness (33.3%), mismatch between the Early Warning System
assessment and the patient's clinical condition (16.67%) and delay in detection
of COVID-19 infection (16.67%). Meanwhile, the 3 most common root causes of
inadequate management are the full capacity of intensive care unit (13.04%),
end stage patient condition (8.69%) and insufficient facilities for special
management of COVID-19 patients (6.52%). The root causes for avoidable deaths
is lack of alertness, Early Warning System mismatch, late detection of COVID-19
infection, full capacity of intensive care unit, end stage patient condition, and
insufficient facilities for special management of COVID-19 patients.

Keywords : mortality audit, COVID-19, omicron, root cause

44
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OO_PHC01

Beyond Health Facility Walls: The Financial Forecasting and Costing

for Home-Based Palliative Care in Yogyakarta
Tatik Hariyanti1, Firdaus Hafidz1, Muhammad Arif Budiarto2
1
Departement of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas
Gadjah Mada, Yogyakarta, Indonesia
2
STIE YKPN Yogyakarta, Yogyakarta, Indonesia

Home-based palliative care (HBPC) is essential but not part of Indonesia's National
Health Insurance, only local insurance schemes in Yogyakarta since 2020. Still, the
services are poorly funded and known. This study aims to determine the appropriate
scheme for calculating the unit cost of HBPC and to design optimal and effective
financing strategies.This study employs a mixed-method approach with an
explanatory sequential design. Quantitative data were collected using total sampling
from 38 HBPC claims between 2020 until 2023 to determine unit cost estimation
using Time-Driven Activity-Based Costing. Purposive sampling was used for in-depth
interviews with 14 informants including policymakers, purchasers, specialist
healthcare providers, gatekeepers and community members to obtain
comprehensive insights into practical implementation and the challenges
encountered. Over a five-year projection, the target population requiring care is
expected to grow from 142 to 158 individuals annually. The cost per patient was
$219. The estimated five-years budget grow from $31,776 to $34,625. Interviews
revealed widespread support among healthcare providers and policymakers for
enhancing HBPC services, with high satisfaction reported by patients and families.
However, challenges such as the need for clearer service standards and regulations,
and increased public awareness and education about palliative care were identified.
Community engagement and government assistance were deemed essential for
improving service availability and standard.Home-based palliative care in
Yogyakarta offers significant cost savings and high-quality care, cost-effective
alternative to expensive hospital care and preventing catastrophic health
expenditures.

Keywords:
home-based palliative care, normative costing, TDABC, financial planning,
healthcare policy

45
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OO_PHC02

Evaluating Nutrition Service Capacity for Stunting Prevention at

Posyandu and Puskesmas: A Case Study of Four Districts in Indonesia
Candra Candra¹, Faisal Mansur¹, Mubasysyir Hasanbasri²

Center for Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah
Mada

¹Center for Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah
Mada

²Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health, and
Nursing, Universitas Gadjah Mada

Stunting remains a pressing public health concern in Indonesia. This study assessed
the capacity of nutrition services at Posyandu (integrated health service posts) and
Puskesmas (community health centers) to prevent stunting in four districts across
West Java and East Nusa Tenggara. To evaluate the capacity of nutrition services
provided at Posyandu and Puskesmas for stunting prevention and identify barriers
and opportunities for improvement. A qualitative rapid assessment and action
planning approach was utilized. Data collection involved 16 focus group discussions
with stunting intervention target groups and 28 in-depth interviews with cadres,
Puskesmas staff, and district-level program coordinators. The analysis employed
both inductive and deductive reasoning.Several barriers to effective service delivery
were found, including weak interagency coordination, lack of program integration,
overlapping activities, insufficient focus on vulnerable populations, and limited
resources and capacity. Cadre work overload, inadequate training, and reliance on
national programs were also identified. However, opportunities for improvement
were noted, such as active involvement of village heads, youth organizations, and
the formation of stunting management teams at Puskesmas. Strengthening Posyandu
cadre capacity, improving cross-sector coordination, and providing adequate tools
are crucial for enhancing nutrition services at Posyandu and Puskesmas, leading to
more effective stunting prevention.

Keywords: Stunting prevention, Nutrition services, Posyandu, Puskesmas, Indonesia

46
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OO_PHC03

Assessing Governance Practices in the Delivery of Maternal and

Child Health (MCH) Programs at Puskesmas
Muhamad Faozi Kurniawan1, Mubasysyir Hasanbasri2, Andreasta Meliala3

1
Doctoral Program, Faculty of Medicine, Public Health and Nursing, University of Gadjah Mada
2
Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and
Nursing, University of Gadjah Mada
3
Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, University of
Gadjah Mada

This study aims to assess the governance processes applied in Puskesmas regarding
the intention of improving the delivery of MCH Programs. This evaluation will
identify areas where service changes may be made to better serve the at-risk
population. The study takes a qualitative descriptive approach to investigate the
implementation of governance practices in delivering health services at Puskesmas,
with a focus on addressing MCH problems. According to the results, enhanced
medical equipment and medication availability, higher budgets, and continuous
fulfilment of healthcare personnel needs are not enough to ensure successful
program implementation for MCH. For example, pregnant women who live in rural
places are not eligible to attend antenatal classes; only those who can visit the
Puskesmas are eligible. Furthermore, the national data and information centre uses
broad criteria rather than particular conditions to select populations to receive
maternal and child health services. This leads to a homogeneous target population
that fails to provide priority to at-risk populations like the impoverished, those
residing in remote areas from healthcare facilities, or those in precarious situations.
The results suggest that the MCH programs implementor in Puskesmas fail to address
the unique requirements of vulnerable people. There are a lack of a personalized
strategy that targets distinct requirements in order to resolve health issues; instead,
all target groups get the same interventions. In an effort to accomplish preferable
outcomes, it is imperative to set priorities and focus on particular MCH interventions
options.

Keywords: Governance Practices, Maternal and Child Health, Service Delivery

47
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OO_PHC04

User Acceptance Of Artificial Intelligence-Based Dental Screening

Application In The School Dental Health Program At Kebayoran Baru
Health Center
Dewi Arifahni1,2,4, Hanevi Djasri1,3, Annisa Ristya Rahmanti1,3, Dhinintya Hyta Narissi4
1
Center for Health Policy and Management, Universitas Gadjah Mada, Indonesia
2
Student of Master of Health Policy and Management Faculty of Medicine, Public Health and Nursing, Universitas
Gadjah Mada
3
Department of Health Policy and Management, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
4
Oral and Dental Health Care, Kebayoran Baru Health Center

The Senyumin application, an AI-based dental screening tool, was introduced within
the School Dental Health Program but faced limited adoption. This study aimed to
evaluate the acceptance of the Senyumin application, focusing on perceived ease of
use and perceived usefulness. An action research sequential exploratory design was
employed from April 24th to May 21st, 2024, at Kebayoran Baru Health Center and
3 elementary schools. The research involved 30 health workers and 351 parents of
students. Initial thematic analysis of Senyumin 1.0 identified issues related to
complexity and user adaptation, guiding the development of Senyumin 2.0 with a
redesigned user interface, new functionalities, and enhanced features. Quantitative
analysis, using linear regression and guided by the Technology Acceptance Model
(TAM), examined the relationships between perceived ease of use, perceived
usefulness, and user acceptance.Senyumin 1.0 encountered significant challenges
due to its complexity and inadequate service coverage, necessitating the
development of Senyumin 2.0. The new version includes features such as automatic
reporting, a hotline number, and AI detection in parent accounts, with simplified
steps. Perceived ease of use and perceived usefulness showed the strongest
correlation to user acceptance according to parents data (r= 0.923, F-test=
1008.431, p-value= 0.000) and strong correlation according to staff data (r= 0.631,
F-test= 8.921, p-value= 0.001), both with p-values <0.05, indicating significant
relationships.Senyumin 2.0,developed based on user feedback from version 1.0,
demonstrated that perceived ease of use and perceived usefulness significantly
positively influenced its acceptance.

Keywords: Artificial Intelligence, Dental Screening, User Acceptance.

48
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OO_PHC05

Health Transformation Strategy through Empowering POSBINDU

Cadres: Increasing Knowledge and Communication Skills in Preventing
Non-Communicable Diseases (NCDs)

Nia Lestari Muqarohmah1, Bagas Suryo Bintoro1,2

1
Center of Health Behavior and Promotion, Faculty of Medicine, Public Health, and Nursing, Universitas
Gadjah Mada, Indonesia
2
Department of Health Behaviour, Environmental Health and Social Medicine, Faculty of Medicine, Public
Health, and Nursing, Universitas Gadjah Mada, Indonesia

The prevalence of Non-Communicable Diseases (NCDs) cases has increased,

especially in Low- and Middle-Income Countries (LMICs), creating significant global
health challenges, straining healthcare systems and economies. POSBINDU
(Integrated Development Post) is a community-based health program in Indonesia
aimed at early NCDs detection and prevention. Yogyakarta City has a high prevalence
of NCDs. Although Tegalrejo Village increased POSBINDU activities since 2021, cadres
still lack of sufficient knowledge and effective communication skills. This study aims
to enhance NCDs prevention by improving knowledge and communication skills of
cadres for enhancing primary prevention and early detection of NCDs risk factors at
the grassroots level. Experimental study used a pre- and post-test control design
followed by skill training. Participants included 29 representative cadres from
Tegalrejo Village. Surveys and Focus Group Discussions were conducted before
training to assess the needs of POSBINDU cadres. Training sessions provided
information about NCDs and focused on enhancing knowledge and skills in
persuasive, result-oriented, and advocacy communication. Cadres' knowledge scores
on 'NCDs risk factors' and 'NCDs prevention and control (safe physical activity)'
increased by 3.45% and 6.9%, respectively. Knowledge about communication media
improved from 89.66% to 93.1%. Understanding of 'advocacy communication
considerations' increased from 65.52% to 93.1%. Additionally, cadres showed
improved attitudes towards skills such as expressing opinions, effective
communication, and providing input. Hence, enhancing knowledge about NCDs and
improving communication skills not only promotes better personal health but also
strengthens the implementation of effective health policies within the community.

Keywords: posbindu, health transformation, prevention, empowerment,

communication

49
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OO_PHC06

Study of Primary Service Integration Implementation in Yogyakarta,

Indonesia: A Protokol

Tri Siswati1, Yustiana Olfah2, Siti Nurhayah Isfandiari3, and Lukman Waris4

1
Nutrition Department, Politeknik Kesehatan Yogyakarta, Jalan Tata Bumi no 3, Banyuraden,
Gamping,nSleman, Yogyakarta, 55295, Indonesia
2
Caring Department, Politeknik Kesehatan Yogyakarta, Jalan Tata Bumi no 3, Banyuraden, Gamping, Sleman,
Yogyakarta, 55295, Indonesia
3
Health Office of Yogyakarta Province, Jl Gondosuli No. 6 Yogyakarta, Indonesia
4
Magister Program of Public Health, Faculty of Health Science, Universitas Faletehan, Jl Raya Cilegon,
Tangerang, West Java, Indonesia.

Indonesia faced triple-burden diseases. One potential solution to this issue was the
implementation of health transformation through Primary Service Integration (or
Integrasi Layanan Primer, ILP) concerning health prevention and promotion aspect.
The study explores how ILP was implemented in Yogyakarta, including: a) how
socialized the ILP program; b) how ILP was conducted from Puskesmas to Posyandu;
c) how primary services were integrated into each life cycle; d) health laboratories
support; e) education and counselling; f) obstacle and support ILP implementation;
and g) alternatives models.This study employs an operational research approach
using a mixed-method design, conducted in Yogyakarta during 2024. The research
locations encompass regions, cities, health centres, Pustu, Poskesdes, and villages,
each of which reflects the unique characteristics of rural and urban areas,
specifically KulonProgo Regency and Yogyakarta City. We conducted quantitative
research by reviewing report documents and conducting structured questionnaires
(self-administered and interviews) about the program. Meanwhile, we conducted
qualitative research using Rapid Assessment Procedures (RAP) through Focus Group
Discussions (FGD) and in-depth interviews. The informants of this research are the
head of the health office, health centre, village, programmer, cadres, and
community. We elaborate quantitative and qualitative data to provide a more
holistic understanding of the information and its implications.Expected results are
policy recommendations regarding most appropriate model of ILP based on setting
area and evidenced.

Keywords: health transformation, integrasi layanan primer, primary service

integration, Posyandu integrasi.

50
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OO_PHC08

Evaluating Quality of Life Indicator in Overweight and Obese UKM

Staff

Mohd Izhar Bin Ariff1, Mohd Rizal Abdul Manaf1, Nor Ba’yah Abdul Kadir2
1
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000,
Malaysia
2
Centre for Research in Psychology and Human Well-being, Faculty of Social Sciences and Humanities, Universiti
Kebangsaan Malaysia, Bangi 43600, Malaysia

This study evaluates the quality of life (QoL) among overweight and obese staff at
Universiti Kebangsaan Malaysia (UKM), focusing on physical health, psychological
well-being, social relationships, and environmental conditions. Using a quasi-
experimental design, 142 overweight and obese permanent staff from the UKM Bangi
campus participated, completing the WHOQOL-BREF questionnaire. Data were
analyzed with SPSS, covering demographic information and QoL scores. The sample
included 27.46% males and 72.54% females, with 57.04% under 40 years old and
42.96% over 40. All participants were Malay and Muslim, with varied educational
backgrounds. QoL scores were positive: Physical Health (mean = 68.22) and
Environment (mean = 68.94) were rated moderately, while Social Relationships
(mean = 71.94) had the highest scores. The overall QoL score was 72.02, indicating
a generally favorable perception. Findings reveal a positive QoL among overweight
and obese UKM staff, with strong social relationships contributing significantly to
well-being. No significant differences were found across socio-demographic
variables, suggesting a balanced representation. However, the homogeneity in
ethnicity and religion limits generalizability, highlighting the need for more diverse
studies. The results emphasize the importance of social support and suggest that
targeted interventions could improve physical health and environmental conditions.
Future research should explore diverse populations and specific interventions to
enhance QoL further.
Keywords: Quality of Life (QoL),Overweight,Obesity,WHOQOL-BREF

51
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OV_PHC07
Evaluating Health Outcomes and Healthcare Financing in Patients
with Diabetes Mellitus: Insights from Indonesia's Prolanis Program
Diah Ayu Puspandari1, Vini Aristianti2, Maya3, Wan Aisyiah Baros3
1
Department of Health Policy Management, Faculty of Medicine, Public Health and Nursing, Universitas
Gadjah Mada
2
Center for Health Financing Policy and Health Insurance Management, Faculty of Medicine, Public Health,
and Nursing, Universitas Gadjah Mada
3
BPJS Kesehatan

Abstract
Diabetes mellitus is a significant global public health issue that affects millions of
people. In Indonesia, the prevalence of diabetes continues to rise. Effective
strategies are needed to manage this disease and improve patient treatment
outcomes. In response to this escalating burden, Indonesia's National Health
Insurance (JKN) scheme introduced the Prolanis Program (Integrated Chronic Disease
Management Program), aimed at enhancing the management of chronic conditions,
particularly DM.This research aims to conduct a comprehensive evaluation of the
Prolanis Program's impact on health outcomes and healthcare financing among
patients with DM in Indonesia. By assessing key indicators such as glycemic control,
incidence of complications, as well as utilization and health expenditure from all
participants of the Prolanis JKN throughout Indonesia, data were sourced from BPJS
Kesehatan from 2018 to 2022. This study utilizes a mixed-methods approach,
combining quantitative analysis with qualitative insights.The findings indicate that
patients with diabetes mellitus enrolled in the Prolanis program exhibit better
average blood sugar control compared to those not enrolled. Additionally, diabetic
patients participating in the Prolanis program experience lower annual healthcare
service costs compared to their non-participating counterparts.
Keywords: Prolanis, Integrated Chronic Disease Management Program, JKN,
Diabetes mellitus, National Health Insurance Program

52
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OV_HE01

Community Geriatric Telemedicine (CORTICAL©) in Malaysia:

Identifying Patient criteria for Family Medicine Specialist-
Geriatrician shared care initiatives
Sarinah Tamring1,2, Aznida Firzah Abdul Aziz1, Mohd Fairuz Ali1
1
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur.
2
Klinik Kesihatan Putatan, Penampang, Sabah

The expanding senior population in Malaysia does not correspond to increased access
to geriatric specialists in the public healthcare system. Shared care between primary
care and geriatricians via telemedicine is a way to support gatekeeping and access
to specialist care for people in the community. Guidelines or consensus which
formalise shared care between Family Medicine Specialists in the community and
hospital-based geriatricians are scarce. This study aimed to identify patients suitable
for geriatric telemedicine consultation and shared care between Family Medicine
Specialists and geriatricians. A qualitative study using modified Delphi method was
conducted. Purposive sampling and snowball technique were used to recruit FMS
with special interest in community geriatric and Geriatricians from public and
university hospitals. Phase 1 involved an online questionnaire to identify evidence-
guided and best practices for geriatric telemedicine. These findings were analysed
and presented during Phase 2 i.e., a virtual focus group discussion (FGD) to
consolidate consensus among an expert panel. Transcribed FGD recording was
analysed using deductive framework analysis, and confirmed by research team
members. Total of eleven FMS and six Geriatricians were recruited as experts for
CORTICAL . Non communicable disease care prevention and monitoring measures by
©

FMS and Geriatricians were identified, and shared care was needed for complex
cases and initiation of List A* Ministry of Health (MOH) formulary medications.
CORTICAL provides evidence based and best care practices for managing elder care
©

via geriatric telemedicine with identified shared care potential between FMS and
Geriatricians in Malaysia’s public healthcare system.
Keywords: Geriatric, Telemedicine, Shared care, primary care, gatekeeper

53
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OV_HE05

Enhancing Immunization Success: Optimizing Cross-Sector

Collaboration in Rural Indonesia
Yunita Fitriah1, Likke Prawidya Putri2, Yodi Mahendradhata3
1
Department of Health Policy and Management; Faculty of Medicine, Public Health and Nursing; Universitas
Gadjah Mada, Yogyakarta, Indonesia

Despite the national increase in immunization coverage over the past two years,
rural areas in Indonesia, particularly in eastern regions like Central Sumba Regency,
still lag behind urban areas. This gap is influenced by individual socio-economic
factors, geographical access, and health systems and governance issues. This study
explores strategies for optimizing cross-sectoral collaboration to improve complete
basic immunization coverage in Central Sumba Regency using a qualitative case-
study with a multiple case embedded design. We interviewed 33 purposively-
selected informants from two villages, one with high coverage and one with low
coverage, using the collaborative governance framework to classify the information
obtained. Results indicate a shared motivation to achieve high immunization in their
areas. However, capacity for action varied; the high-coverage village had clear
cooperation policies and sanctions for non-attendance at the posyandu, and better
communication and supervision from the district and health center. This village also
had regular communication forums between the health department, health center
and community, initiated by immunization coordinator. Also, the health center staff
were involved in village budget planning, allowing stronger multi-sectoral
collaboration. The study suggests that program effectiveness can be enhanced
through strategies like regular inter-sectoral communication forums, capacity
building for officers and cadres, and using information technology for real-time
monitoring. Additionally, formal district-wide policies significantly influence cross-
sectoral collaboration and equitable support for immunization programs in rural
Indonesia. The study concludes that a collaborative governance approach,
characterized by regular communication and formal policies, significantly impacts
the improvement of basic immunization coverage in Central Sumba Regency.

Keywords : Immunization, Collaborative, Cross-Sector, Rural Areas.

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OV_HE06

Difficulty in Adopting Electronic Medical Records Primary Health

Care Facilities in Bantul Regency
Dina Kristinawati1, Guardian Yoki Sanjaya1, Adhistya Erna Permanasari2,
Toufik Sitompul3, Nony Parmawati3, Diah Puspitasari4, Dian Sulistyowati4
1
Department of Health Policy and Management; Faculty of Medicine, Public Health and Nursing; Universitas
Gadjah Mada, Yogyakarta, Indonesia
2
Department of Electrical Engineering and Information Technology, Faculty of Engineering, Gadjah Mada
University Yogyakarta, Indonesia
3
Country Health Information Systems and Data Use (CHISU)-USAID, Jakarta
4
Data and Information Center Team of the Ministry of Health of the Republic of Indonesia, Jakarta

This research aims to assess the level of digital maturity of primary care and
adoption of EMR Method Mixed method explanatory sequential design, quantitative
digital maturity model self-assessment instrument developed by the Ministry of
Health in collaboration with CHISU USAID and FK KMK UGM with respondents in one
healthy 195 health service facilities, 150 of whom were willing to fill out the survey
consisting of 27 Public health canter, 67 Clinic, 22 Doctor, 24 Dentist and 10 Midwife,
followed Qualitative research Results DMI at primary care was lower (2.89 out of 5
scale) and the EMR adoption was 1.55 (out of 7 scale). PHC have higher digital
maturity (DMI) compared to other types of primary services (DMI=3,55), It was
consistently similar to the EMR adoption was higher at PHC compared to other
primary cares (RME=2.22) Compared with Primary Health care The majority of other
primary services still use paper medical records. Several factors such as lack of
experience using EMR, availability of ERM providers that suit your needs, financing,
connectivity with other information systems, availability of internet networks are
several factors that hinder the implementation of digital technology in primary care.
Conclusion Primary health care are still experiencing delays in adopting EMR,
especially in independent practices.
Keywords: Digital Maturity, EMR, Primary care, Adoption of EMR

55
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OV_HE07

Benefits Evaluation of an Implemented Clinical Pathway for

Cesarean Section at Bethesda Lempuyangwangi Hospital
Ferni1*; Hanevi Djasri2
1,2
Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Gadjah
Mada University

Cesarean section (CS) is one of the most frequently performed surgical procedures
globally and at Bethesda Lempuyangwangi Hospital (RSBL). This procedure is
categorized as high-volume, high-cost, and high-risk, necessitating a guide to reduce
variations in patient care. The clinical pathway (CP) is a tool designed to improve
the preparation, management, and clinical outcomes of patients. RSBL developed a
CP for CS in 2019, but its benefits have not been evaluated since its
implementation.Our objective is to evaluate the benefits of CS CP implementation
on laboratory test compliance, prophylactic antibiotic prescribing compliance,
incidence of surgical wound infection (SWI), length of stay (LOS), and Apgar
scores.This observational analytic study included all patients who underwent
elective CS surgery at RSBL and met the inclusion criteria, both before and after the
implementation of the CS CP. In-depth interviews were conducted with midwives
and obstetricians to supplement the quantitative data. The evaluated variables were
compliance with laboratory tests, compliance with prophylactic antibiotic
prescribing, incidence of SWI, LOS, and Apgar scores.Compliance with laboratory
tests increased from 6.7% to 100%, and compliance with prophylactic antibiotic
prescribing increased from 3.4% to 83.1%. Variation in LOS decreased from 2-4 days
to 3 days (100%). There were insignificant changes in the incidence of SWI and the
proportion of Apgar scores >7.In conclusion, the implementation of the CS CP
improved laboratory test compliance, prophylactic antibiotic prescribing
compliance, and reduced variation in LOS. However, it did not significantly reduce
SWI or improve Apgar scores.

Keywords: Clinical pathway, cesarean section, laboratory testing, prophylactic

antibiotics, length of stay

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OP_HE02

Telemedicine Health Transformation in Optimizing National Hospital

Resources Based on ACHS (Australian Council On Healthcare
Standards) Standards

Hendera Henderi, Lutfan Lazuardi.

Master Program of Health Policy and Management Faculty of Medicine, Gadjah Mada University,Yogyakarta,
Indonesia

Digital transformation and disruptive innovation describe a comprehensive

reorientation of industry including its business models due to the arrival of the digital
technology era in the form of digitization of products, services and processes.
Meanwhile, digital health products can be in the form of electronic health. The low
utilization of Telemedicine visits is 2.90% of total visits as well as the conformity of
NH Apps telemedicine products with ACHS standards. Analyzing the use of
Telemedicine from Resource Paramete based on Australian Council On Healthcare
Standards (ACHS) Standards at the National Hospital The method for this research
uses systems theory (Input, Process and Output) and is descriptive research with a
qualitative approach. By gathering information from 33 respondents who carried out
analysis and assessment regarding the implementation of telemedicine in
accordance with ACHS information. All telemedicine implementation in each
department is going well except in the pharmacy department which is considered
less good. The implementation of Telemedicine is in accordance with and meets the
requirements in terms of the Use of Telemedicine Applications from the Australian
Council on Healthcare Standards (ACHS) Requirements Aspect. Process Flow of Using
Telemedicine in Hospitals. National Hospital Surabaya is running well and is
systemized using the NH Apps application, divided into 2, namely the outpatient
flow and the emergency treatment flow. Resources for Using Telemedicine
Applications in Hospitals. National Hospital Surabaya has strong modalities regarding
units and docto are all involved in integrated services and have good assessments in
system quality, information quality, service quality, structure and environment

Keywords: NH Apps, Telemedicine, Compliance with service standards. ACHS

57
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OP_HE03

Tweets to Tables: Social Media Insights for Free Lunch Program

Initiative
Lusha Ayu Astari1, Sensa Gudya Sauma Syahra2
1
Department of Health Policy and Management, Universitas Gadjah Mada
2
Center for Health Policy and Management, Universitas Gadjah Mada

The free lunch program, a flagship initiative of the winning presidential campaign in
the 2024 Indonesian election, aims to provide nutritious meals to school children
and is currently in development for upcoming implementation. This program was
prominently featured during the campaign as a strategic effort to improve national
nutrition and educational outcomes. This study utilizes social media data to explore
community reactions, identifying critical concerns and suggestions to inform
policymakers and enhance policy formulation. Data collection spanned from the
campaign period through the post-election phase, sourced from social media
platform X. Analysis employed k-means clustering algorithms, revealing 7 distinct
clusters. Thematic analysis complemented this, interpreting public sentiment and
focal areas to uncover diverse beneficiary patterns and key themes.Community
aspirations and needs emerged prominently, particularly concerning nutritious foods
such as milk. Public feedback highlighted concerns over funding and political
aspects, including debates over budget allocations and political discourse. Scrutiny
of program implementation and public responses underscored challenges in
effectiveness and rollout. Furthermore, themes encompassed nutrition and
educational support for children and expectant mothers, addressing issues of
malnutrition and educational support. Views on policy transformation advocated
changes and political involvement, reflecting on basic needs and governmental
roles, stressing the program's necessity and public expectations.Clustering outcomes
pinpointed specific community needs and concerns, offering actionable insights to
refine the free lunch program. Addressing these clusters aims to better meet
nutritional and educational needs of school children, enhancing efficacy and
garnering public support. Continuous monitoring and data-driven adjustments are
crucial for ensuring the program's success and long-term sustainability.

Keywords: Free Lunch Program, Social Media Analysis, Clustering, Public Health
Policy

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OP_HE05

Analysis Of The Development Prospects Of Regional Maintenance

Centers (Rmc) In Indonesia
Fajrul Falah Farhany1*, Indra Komala1, Ni Luh Putu Eka Andayani1
1
Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas
Gadjah Mada, Yogyakarta, Indonesia

Malfunctioning devices may lead to adverse events and even patient death. To
ensure that medical devices are safe and reliable, there must be a team responsible
for developing and managing the medical device management program. This study
aims to identify the medical device management system in primary health facilities,
the role of the established RMCs, and the prospects for RMC development in other
regions in Indonesia. This action research employs a mixed-method approach with
an explanatory sequential research design, using desk review, questionnaire survey,
and in-depth interview methods using prepared guidelines. The questionnaire were
sent to other 92 RMCs through google form link. From 92 registered RMCs, 66
completed the questionnaire. Limited human resources, infrastructure, logistics,
and budget are the constraints were identified. Infrastructure deficiencies include
inadequate calibration tools for life-support equipment, technicians relying on
personal maintenance tool sets due to RMCs lacking the necessary equipment, and
space constraints for spare parts. These challenges are similar to findings in Zambian
hospitals, highlighting the correlation between equipment sophistication and
required technician skills. Problems include outdated tools that cause frequent
breakdowns, poor record-keeping that hinders maintenance tracking, bureaucratic
delays in obtaining replacement parts, inadequate management commitment, and
poorly trained technicians. Overcoming these challenges is critical to optimizing
technician performance and improving the quality of healthcare services. Adequate
infrastructure and equipment are essential for effective and efficient equipment
maintenance. Improving maintenance processes will ultimately raise the standard of
healthcare delivery. Conclusion: The results of mapping the RMC situation and local
government support can be used as a basis for preparing a road map for RMC
development in Indonesia.

Keywords: RMC, maintenance, medical devices, primary health facilities.

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OP_HE06

Patient Safety Attitude Among Healthcare Workers : A Systematic

Review
Sharifah Balqis Sayed Abdul Hamid1, Aniza Ismail1
1
Department of Community Health Science, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala
Lumpur, Malaysia

Good patient safety culture in healthcare facilities are indicated by the better the
patient safety attitude among the healthcare providers. A safe culture that is
targeted at reducing errors can be further engineered into daily work practices. By
improving safety culture in healthcare facilities, medical error will be reduced, the
better outcomes of treatment served to patients and more resources will be saved.
Electronic searches was performed using the two search engines which are Ovid and
PubMed by using specific keywords related to assessment, patient safety attitude
and healthcare providers. We included studies that were using Safety
Attitude Questionnaire as an assessment tool to measure patient safety culture in
their healthcare facilities. We independently verified that the studies met the
inclusion criteria and critically assessed the quality of the studies. 15 studies met
our inclusion criteria. From the review we identified that working condition and
perception of management are seen as a serious issue which needs to be improved.
This composite is defined as the extent to which staff feel that there is no proper
channel for them to direct questions regarding patient safety, difficulty of discussing
errors and also the lack of culture to learn from errors. There is a need to promote
patient safety culture as a strategy for improving the patient safety internationally.
Improving patient safety culture should include all stakeholders, like policymakers,
healthcare providers and those responsible for medical education.

Keywords : Patient Safety Attitude, Patient Safety, Patient Safety Culture

60
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OP_HE07

The determinants of job stress among Navy personnel on the East

Coast of Peninsular Malaysia
Nur 'Adnin Ahmad Zaidi 1, Halyna Lugova2, Noor Dalila Binti Zulkhifli1, Shahidah Leong1
1
Faculty of Medicine and Defence Health, National Defence University of Malaysia
2
Faculty of Medicine and Health Sciences, UCSI University

Health equity could be attained when every person, despite their differences, can
reach their full potential for well-being. The social determinants of health
encompass the non-medical factors that influence health outcomes, including work
and physical environment. Among military personnel, these determinants might be
overlooked by the military researchers and policy makers. This study aimed to
measure the association between social determinants affecting mental health,
particularly job stress, among Navy personnel on the East Coast of Peninsular
Malaysia. A total of 256 personnel from HQ Naval Region 1 were chosen via a
universal sampling method to take part in this analytical cross-sectional study. The
study was conducted from February till June 2023. Data were collected using a self-
administered online questionnaire adapted from the validated Job Stress Level
Inventory (JSLI) and the Occupational Stress Inventory Revised (OSI-R)
questionnaires. A Chi-square test was chosen to examine the association between
possible job stress factors and job stress levels. Afterwards, a multivariate logistic
regression model was introduced to identify the independent predictors of job stress
level.This study revealed that both occupational role factors (role overload, role
insufficiency, role ambiguity, role boundary, responsibility, and vocational strain)
and work experience factors (military units and total days of operation) were
associated with job stress levels. Five independent predictors were found to be
significantly associated with job stress: role overload (p<0.05), role insufficiency
(p<0.05), role boundary (p<0.001), vocational strain (p<0.05), and total days of
operation (p<0.05). The findings in this study are similar to previous studies whereby
despite different working environments and gender, these social determinants have
an effect on job stress level.

Keywords : job stress, military, mental health, work, stress

61
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OP_PHC01

Evaluating Patient Satisfaction in Private Primary Healthcare

Centers (PPHCs): A Study of Sixteen Indonesian Provinces
Uswatunnisa Arfiningtyas, Ichlasul Amalia, Likke Prawidya Putri

Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas
Gadjah Mada, Yogyakarta, Indonesia.

Patient satisfaction is a critical measure of healthcare quality, reflecting both the

service system's effectiveness and public health outcomes. Primary healthcare
facilities are pivotal in shaping patients' perceptions and satisfaction, making it
essential to evaluate it for assessing service quality.This study aimed to assess
patient characteristics and overall satisfaction with the services quality at Private
Primary Healthcare Centers (PPHCs) in sixteen Indonesian provinces.A retrospective
cross-sectional study utilized secondary data from 285 PPHCs were collected via
Customer Satisfaction Index (CSI) survey. The survey was developed per Indonesian
regulations on public service satisfaction surveys, conducted from January to March
2024. The survey covered nine domains: requirements, procedures, service time,
costs, service specifications, staff competency, staff behavior, facilities, and
complaint handling. The study included 31,884 participants, predominantly female
(57%) and high school graduates (41.8%). Most participants were private sector
employees (56.6%), with an average satisfaction score of 3.85 out of 4 (96.1%). The
average satisfaction score in the complaint handling domain decreased monthly
(3.85, 3.84, 3.66), possibly due to the new barcode-based online complaint system.
The highest satisfaction was in staff behavior (97.3%), related to the hospitality of
PPHCs staff, while facilities scored the lowest (94.4%), related to parking lot
management.The study found high overall patient satisfaction, particularly with
healthcare providers, underscoring the importance of professional interactions in
patient experiences. Future research should include participant age and conduct
more in-depth analyses to identify additional factors influencing patient satisfaction
with PPHCs services in Indonesia.
Keywords: patient satisfaction, primary healthcare, Indonesia

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OP_HWF01

Lean Management Reshaping Health Services Amid the COVID-19

Pandemic: A Scoping Review

Azizul Rahman Mohamad Jamil, Mohd Rizal Abdul Manaf, Sharifa Ezat Wan Puteh, Kiran Ganesh Balakrishnan

Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan
Yaacob Latiff, 56000 Cheras, Kuala Lumpur

Lean Healthcare originates from Lean Thinking; it focuses on identifying sources of

waste and then applying methods, tools, and techniques to eliminate them. This
study aims to conduct a scoping review to identify Lean implementation in various
settings during pandemic COVID 19the COVID-19 pandemic, the tools applied in the
process, and the results of the interventions. Two databases were searched for
research papers published between 2020 and 2023, from which 20 articles were
retained for analysis. The criteria used to select articles include: 1) Lean is the main
methodology applied in the research 2) The research involves management of COVID
19 pandemic in hospital or non-hospital setting, and 2) The research involves
management of the COVID-19 pandemic in hospital or non-hospital settings, 3) the
full text is available in English and 4) it must be published in a peer-reviewed journal
or conference proceeding.. Of the 225 articles identified, 38 were examined in
detail, and only twenty met the inclusion criteria. Seven studies were from academic
institutions. Most of the studies were done to manage issues in the hospital setting
occurring during COVID 19COVID-19 pandemic. This review consists of studies done
in North America, Europe and Asia. Lean methodology is beneficial for enhancing
performance, particularly in challenging circumstances such as the pandemic.
Among the tools that are commonly used in lean implementation are value stream
mapping (VSM) and the value stream mapping (VSM) and the Define-Measure-
Analyse-Improve-Control (DMAIC) cycle. In conclusion, there were disruption of
healthcare service and increased in demand that need to be addressed during this
period. The review emphasizes widespread interventions for healthcare
improvement, focusing on enhancing patient flow through methods like value stream
mapping. Telemedicine is crucial, especially during COVID-19, enabling social
distancing in outpatient settings and curbing contagion in overloaded healthcare
facilities.
Keywords: Healthcare; COVID19; Lean Management

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OP_BD01

Mental Health, Key to Controlling Diabetes: A Review of the

Relationship Between Mental Health and Diabetes
Sensa Gudya Sauma Syahra

Center for Health Policy and Management, Universitas Gadjah Mada

In order to support the ideals of realizing Indonesia Emas in 2045, the golden
generation of Indonesia, ideally, is not only physically healthy, but also mentally
healthy. This study tries to further examine the issue of mental health in Indonesia
by utilizing Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan sample data. This
study uses sample data from hospital level. Identification was carried out by looking
at the increase in cases throughout 2015 to 2022. The decrease in mental health
cases that were claimed to BPJS in 2020, from 226,125 to 186,762, which may have
occurred due to the effects of the pandemic. Diagnoses related to mental health
that is most claimed to BPJS is Schizophrenia about 82,358 . The case occurred in
70% of the male participants and in the age range of 35-44 years which is a productive
age. It was found that participants also suffered from type 2 diabetes mellitus
(78%). This finding is something that needs to be considered in mental health issues.
It turns out to be quite an influence on diabetes mellitus sufferers, especially type
2 diabetes mellitus, where the mental health sufferers can be diagnosed with
diabetes. This can certainly affect healthy behaviour patterns that have been
programmed, especially for diabetes sufferers. Therefore, policies related to mental
health should not be separated from policies related to nutrition.

Keywords: Mental Health, Diabetes, Nutrition, BPJS, Data Sample

64
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OO_BD02

Understanding the Acceptability of Digital Healthcare Services in

Islamic Boarding Schools: A Qualitative Study in Semarang, Indonesia
Ichlasul Amalia1, Nailul Husna2, Likke Prawidya Putri1
1
Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas
Gadjah Mada, Indonesia
2
Impressive Santri Non-Governmental Organization, Semarang, Indonesia

Studies showed that students in Islamic Boarding School (IBS/pesantren) are more
prone to infectious diseases due to crowding, shared use of lavatories, intense
interaction, and limited access to healthcare facilities. Digital healthcare service
could help address this vulnerability, yet IBS students often have limited exposure
and access to such services due to stricter regulations. A qualitative study was
conducted in Semarang, Indonesia, to understand the acceptability of digital
healthcare services among the IBS community. Following workshops on digital health
literacy and services such as telemedicine (YohSehat), electronic medical records
(SatuSehat), and National Health Insurance (BPJS) application (mobileJKN), focus
group discussions were held with students, teachers, and staff from 24 IBS.Using the
Theoretical Framework of Acceptability, several facilitators and barriers were
identified. Facilitators included positive attitudes towards their potential to improve
health outcomes and access to care. Some participants were confident in allocating
resources to digital health, supported by stakeholders and the availability of digital
tools. However, before the workshop, some participants were unaware of their
limited understanding of the BPJS scheme and digital health literacy. Additional
barriers included limited BPJS ownership, insufficient knowledge about
collaborating with primary healthcare centers, limited mobile phone memory and
data, and lack of personal access to phones among students. Despite notable efforts
towards digital health integration in Semarang’s IBS, further support in training,
policy development, and stakeholder engagement is needed. The study’s urban
setting limits the generalizability of its findings, as IBS in Semarang mainly consist
of college students with better digital access.

Keywords: Acceptability, Community Health, Digital Healthcare, Islamic Boarding

Schools, Universal Health Coverage

65
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OO_SDG02

Catin Super Policy Brief For Decreasing Stunting In Indonesia

Safrina Oksidriyani1*, Nur Ahmad Habibi2, Anastu Regita Nareswara3

1
Nutrition Study Program, Faculty of Medicine, Universitas Negeri Semarang, Indonesia
2
Nutrition Department, Health Ministry Polytechnic of Padang, Indonesia
3
Nutrition Department, Health Polytechnic of Health Ministry Jakarta II, Indonesia

Stunting is a condition of chronic malnutrition in children that results in impaired

growth and development, particularly during the first 1000 days from conception to
the age of two. Children with stunting have lower cognitive abilities, reduced
productivity, and, in the long term, an increased risk of chronic diseases due to
future nutritional issues. Objective: To assess “CATIN SUPER” program for
decreasing stunting in Indonesia. Methods: Root cause analysis using Ishikawa and
Pareto methods, the dominant factors contributing to nutritional and health
problems among prospective brides and grooms include inadequate food intake,
insufficient health screening, lack of knowledge about nutrition and health,
inadequate nutrition services, lack of iron-folic acid supplementation, and the
absence support from the Office of Religious Affairs. The result of the root cause
analysis is a planned program to tackle stunting, targeting prospective brides and
grooms, called "CATIN SUPER." Based on a SWOT analysis, the program is deemed
aggressive and feasible for implementation with government support. The details of
the program are: S: Screening of nutritional status, U: Utilization of technology, P:
Provision of supplementary food, iron-folic acid supplementation, and Vitamin D, E:
Empowerment of nutrition graduates as additional nutrition staff in every village, R:
Revitalization of the KUA with nutrition training.

Keywords: Stunting, Prospective brides and grooms, Health Programs, SDGs

66
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OO_HWF04

Defence Industry In Malaysia: An Assessment Of Government Policy

And Defence Procurement
Lady Jamilla Khatimatur, Roza Hazli binti Zakaria,Nurulhuda binti Mohd Satar, Junaidah Kamarruddin,

Faculty of Business and Economics, University of Malaya

Faculty of Defence Studies & Management, National Defence University of Malaysia

When the Malaysian Government published its first Defence White Paper (DWP) in
2020,embedded within these strategies are the implementation components, in
which the industry plays a prominent role to maintain a high state of readiness for
the military, law and enforcement agencies. The defence and security industry has
lacked specific laws and regulations to administer the industry effectively over
years. The instability in policy direction affects confidence among local industry
players and investors on how to strategically move forward. This study intends to
achieve three main objectives which are: (1) to analyze the existing government
procurement policies related to the defence industry and assess their effectiveness
in promoting technological advancements and self-reliance; (2) to develop
comprehensive policy recommendations to improve government procurement
strategies and support the growth of the domestic defence industry; and finally (3)
to investigate how advancements in the defence industry can contribute to national
security while simultaneously improving public health infrastructure and resilience.
This research proposal is based on qualitative study through semi-structured
interviews, expert interviews, focus groups study and case studies. Data also were
gathered from literature, policy documents, government reports, white papers,
procurement guidelines and industry publications to provide a comprehensive
understanding of government policies in the defence industry and procurement
sector. Through detailed analysis, this research also examines the mechanisms by
which defence -related R&D contributes to technological innovations, initially
developed for military use but subsequently adapted for public health purposes. This
paper concludes that by examining the problem, this study hoped to provide a
comprehensive understanding and identification of real issues in policy regarding
defence industry and the necessity to review current policy, as well as mechanisms
of adapting defence R&D for civilian healthcare.

Keywords: Malaysian Defence Industry, Defence Self-reliance, Defence Policy,

Procurement Policy, Research & Development (R&D) in Defence, Public Health

67
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OO_BD01
Using Heuristic Evaluation to Improve Usability of Health Crisis Risk
Monitoring Information System
Arief Tarmansyah Iman1,2, Hari Kusnanto Josef 3, Ariani Arista Putri Pertiwi4
1
Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
2
Department of Medical Records and Health Information, Poltekkes Kemenkes Tasikmalaya
3
Department of Family and Community Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas
Gadjah Mada, Yogyakarta, Indonesia.
4
Department of Basic Nursing and Emergency, Faculty of Medicine, Public Health, and Nursing, Universitas
Gadjah Mada, Yogyakarta, Indonesia.

A Health Crisis Monitoring Information System (HCR-MIS) is being developed In

Tasikmalaya District, a high disaster-risk area in Indonesia, with a prototype ready
for testing. This study aims to determine the usability results of the HCR-MIS
prototype and provide recommendations for system development.The study design
involved qualitative research with a non-interventional study using a heuristic
evaluation by Jacob Nielsen, which used ten heuristic principles. Four experts as
evaluators meticulously evaluated the system according to the previously created
scenarios, assigning a score to each heuristic principle from 0=no usability problem
to 4=usability catastrophe in two rounds. Each expert evaluated the system by
themselves in the first round. Then, the second round was conducted to discuss any
disagreements among them upon the first-round result.The first round showed all
principles, each with a different value range between experts, ranging from 0-1 to
0-3. After second round, the score changed to five heuristic principles (50%) given a
score of 0, two principles (20%) score of 2, and the other two principles (20%) each
with a score of 1, and 1 remaining principle (10%) score of 0-2. These scores indicate
there are significant usability issues. Improvements must be made, especially for
visibility of system status and flexibility (3) and efficiency of use (0-2).Significant
findings underscore the need for system usability improvements in monitoring health
crisis risk. For this reason, the developer must prioritize the suggestions and
recommendations from the heuristic evaluation results to enhance the system's
usability.

Keywords: heuristic evaluation, Jacob Nielsen, health crisis risk, monitoring,

information system

68
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OO_HE17

Factors associated with household healthcare expenditure on

hypertension in Indonesia.
Indriyati Oktaviano Rahayuningrum1, Warsi Maryati1, Yusuf Alam Ramadhan2
1
Faculty of Health Sciences, Universitas Duta Bangsa, Indonesia. 2Faculty of medicines, Universitas
Muhammadiyah Surakarta

Hypertension affects one in three adults worldwide. Hypertension leads to serious

complications and contributes to high healthcare expenditure. This study
investigated factors associated with household expenditure on hypertension in
Indonesia. Panel data from the Indonesian Family Life Surveys IFLS wave 4/2007 and
wave 5/2014 were used. The analyses included 19.089 respondents. Chi-squared and
logistic regression were conducted in this study. The results showed the prevalence
of hypertension was 41.1% and the highest household healthcare expenditure was in
the second quartile (29.1%). Respondents aged 45-59 (OR-0.03; 95%CI=0.02-0.05);
p<0.001), with income in the third quartile (OR=-0.10; 95%CI=-0.13-0.07); p<0.01)
and having health insurance (OR=-0.04; 95%CI=-0.05- -0.02; p<0.01) had the
strongest association with household healthcare expenditure. Furthermore, the
higher level of education, the higher body mass index, and the higher number of
household members were significantly associated with household healthcare
expenditure.Factors associated with household healthcare expenditure were age,
level of education, health insurance, income, body mass index, and number of
household members. Identifying the factors associated with health household
healthcare expenditure on hypertension is valuable for policymakers to conduct
appropriate programs to leverage health promotion, decrease the prevalence of
hypertension, and minimize household healthcare expenditure.
Keywords: Household healthcare expenditure, Hypertension, IFLS

69
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OO_HE18
Implemented Knowledge Translation to Raise Health Policy Agenda:
Tackle SSB Consumption in Indonesia

Tri Muhartini and Shita Listyadewi

Center for Health Policy and Management, Gadjah Mada Univeristy

Indonesia ranks among the top three consumers of sugar-sweetened beverages (SSBs)
in Southeast Asia, which negatively impacts population health and increases
healthcare costs, making this a major public health concern. This paper employs a
Knowledge Translation (KT) approach to address the issue of excessive SSB
consumption in Indonesia and provides evidence-based strategies and measures to
tackle this escalating public health issue. We adopted an impact-oriented approach
employing the following KT tools (1) conducting priority setting exercise and an in-
depth situation analysis, (2) developing a policy brief, (3) conducting focus-group
discussions and key-informant interviews with key stakeholders, (4) performing two
virtual policy dialogues, (5) developing of a media bite and extensive media
engagement and (6) conducting an impact evaluation and analysis. Implementation
KT through the in-depth situation analysis, focus group discussions, and key
informant interviews shaped the development of the policy brief that was utilized
as a basis for the policy dialogues and knowledge uptake activities. The results of
its implementation received a positive response from the Indonesian government to
be used as a policy agenda in handling SSB consumption. This policy brief was also
used to engage media that had an impact on social movements, where civil society
organizations (CSOs) initiated campaigns and discussions about SSB. The policy brief
that we provide also be one of the foundations for the Ministry of Health in
formulating policies regarding the consumption of salt, sugar, and fat in Indonesia.
The development and dissemination of a policy brief as knowledge translation
product regarding the consumption of sugar-sweetened beverages (SSB) in Indonesia
has driven significant progress in addressing this pressing public health problem.

Keyword: Knowledge translation, policy brief and SSB consumption.

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OO_SDG01
Acupressure Intervention for Children: A Scoping Review

Sri Ramdaniati1,2, Mei Neni Sitaresmi3, Fitri Haryanti4, Arief Tarmansyah Iman1,5
1
Medical and Health Science, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada,
Yogyakarta Indonesia.
2
Department of Pediatric Nursing, Poltekkes Kemenkes Bandung
3
Department of Pediatrics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada,
Yogyakarta Indonesia.
4
Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas
Gadjah Mada, Yogyakarta Indonesia
5
Department of Medical Record and Health Information, Poltekkes Kemenkes Tasikmalaya

Acupressure, a traditional Chinese medicinal practice employed for centuries,

stimulates the body's self-healing processes by enhancing energy flow, or "qi," along
meridian channels. Although acupressure has existed for centuries, research on
applications of acupressure for children remains limited. This review aims to
categorize and synthesize the research conducted over the last 30 years on
acupressure in children. This review followed The Joanna Briggs Institute Manual
Methodologies. The databases searched were Pubmed, Proquest, Scopus, Science
Direct, Wiley, Medline EBSCO, and Google Scholar. Inclusion criteria were original
peer-reviewed articles in English or Indonesian, using acupressure as an intervention
on children in any setting. From 2733 identified articles, 55 were retained after
review with the decision process depicted in a PRISMA flow diagram. Of the 55
articles, 68% came from the Asian continent, 70% were published within the last
decade and 56% were randomized controlled trials. Acupressure is most used (68%)
by school-age children (7-12 years) with commonly targeted points being LI 4 (Hegu),
P6 (Neiguan), ST36 (Zusanli), and Shenmen. Acupressure on children can be
administered by acupuncturists, nurses, doctors, caregivers, and parents, offering
five main benefits: alleviating nausea and vomiting, relieving pain, decreasing
anxiety, relieving fatigue, and increasing visual function. Acupressure has numerous
advantages for children with various conditions. Parents and children can do
acupressure independently following proper guidance. It is recommended that
healthcare professionals consider using it as an intervention to address issues and
problems in both healthy and sick children.
Keywords: Acupressure, children, scoping review.

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OO_HE08
Spatial Context of Diabetes Determinants in Malaysia: Insights from
a Local Story

Mohd Rizal Abdul Manaf1, Kurubaran Ganasegeran1,2, Nazarudin Safian1, Lance A. Waller3, Feisul Idzwan
Mustapha4, Khairul Nizam Abdul Maulud5 & Muhammad Faid Mohd Rizal5
1
Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur,
Malaysia.
2
Clinical Research Center, Seberang Jaya Hospital, Ministry of Health Malaysia, Penang, Malaysia.
3
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta,
USA.
4
Non-Communicable Disease Section, Disease Control Division, Ministry of Health, Malaysia.
5
Earth Observation Centre, Institute of Climate Change, Universiti Kebangsaan Malaysia, Bangi, Malaysia.

Type 2 diabetes (T2D) rates are at epidemic proportions throughout Malaysia;

however, rates vary across different geographies. We aimed to understand the
spatial context of T2D determinants through locally explicit geographical
regressions. This ecological study included 271,553 active T2D cases sampled from
914 primary care clinics between 2016-2020 from the National Diabetes Register
(NDR). Neighbourhood demographic, socio-economic, safety, fitness, and access to
build environments were sourced from various agencies through census data.
District-wise logged T2D crude rates (N=144) were computed, choropleth maps were
built, spatial autocorrelation, and local clusters were yielded. Ordinary Least
Squares (OLS) regression coupled with Geographical Weighted Regression (GWR),
and extensions to Multiscale GWR bandwidth interpretations were synthesized. The
Global Moran’s I of logged T2D rates was 0.437 (p = 0.001) indicating of positive
spatial autocorrelation. The local beta coefficients yielded from the GWR model
confirmed variations of the local T2D pattern. Significance of the problem was seen
to be of local to global, being affected by neighbourhood’s demography, socio-
economic status, safety, and access to build environments for fitness activities
(bandwidth range 59 to 143; ENP significance range 1.208 to 3.993). Pattern
distributions enable interventions to shift from generic to targeted approaches
across areas. Areas of global problem directs interventions based on health
promotions, whereas local policy-level strategies such as police involvement,
revitalization of active neighbourhood watch programs, and installation of CCTVs
would boost confidence to local safety, motivating urban socio-economically
vulnerable groups to be physically active, thus reducing T2D.

Keywords: spatial, type 2 diabetes, geography, local regression, neighbourhoods

72
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OO_HE09
Respite Care Perceptions among informal Malay stroke Caregivers in
Kedah: Preliminary Findings

Ahmad Hazri Ilyas 1,2, Ching Ching Hii 1,2 , Aznida Firzah Abdul Aziz1 , Mohd Fairuz Ali 1
1
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia
2
Ministry of Health, Malaysia

There is limited research exploring the perceptions of respite care among informal
caregivers in Malaysia, despite its benefits for caregivers' well-being and overall
patient care.This study aimed to investigate the perspectives of respite care among
Malay informal stroke caregivers in Kedah, Malaysia. The goal is to comprehend their
awareness, experiences, and attitudes towards respite care services. Semi-
structured interviews were conducted among 8 Malay informal caregivers
responsible for stroke patients. The methodology involved inductive thematic
qualitative analysis of the interview transcripts to identify key themes and insights.
Findings reveal a general lack of awareness about respite care options and significant
misconceptions, with many equating it to permanent institutionalization rather than
temporary relief. Caregivers expressed concerns about the quality, reliability, and
cost of care in respite care were prevalent despite strong need of relief. Caregivers
highlighted the necessity for trained professionals in respite care to ensure the well-
being of their loved ones. The study also identified a gap in government support and
the limited availability of such services, particularly in rural areas like Kedah.
Additionally, strong filial attitude among caregivers contributes toward reluctance
to use respite care services due to cultural expectations of family responsibility.In
conclusion, the study calls for policy interventions and public health strategies to
address the misconceptions, financial concerns, and improving the infrastructure
and quality of respite care services, ensuring caregivers can access much-needed
respite care without compromising the quality of care for their family members and
improving the overall caregiving experience.
Keywords: Respite care, informal caregivers, Malaysia, post stroke care, caregiver
support.

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OO_HE10

The Need to Strengthen District Level Cross-Sector Collaboration in

Rabies Control
Tanrypada Thursina, Yodi Mahendradhata , Mubasysyir Hasanbasri

Department of Health Policy and Management; Faculty of Medicine, Public Health and Nursing; Universitas
Gadjah Mada, Yogyakarta, Indonesia

Cross-sector collaboration, aligned with national regulations, is essential for

controlling rabies in Indonesia. Despite national guidelines emphasizing
multisectoral collaboration and the One Health concept, implementation at the sub-
national level remains limited. This study evaluates cross-sector collaboration in
rabies control management in Kubu Raya District, West Kalimantan Province. We
conducted a qualitative descriptive study with an evaluation method using a case
study approach. Primary data was obtained through in-depth interviews with 24
informants from health officers, livestock officer, and community members selected
through purposive sampling. Data analysis was performed using thematic analysis,
using inductive-deductive reasoning. The findings indicate that each sector involved
has carried out its duties according to their roles and functions. However, the cross-
sector collaboration is still incidental and reactive to animal bites in humans, with
case reports first coming through community health centers rather than being
proactive through joint promotive and preventive efforts. Current efforts are based
on conditions where there’s a spike in dog bite cases, particularly in West
Kalimantan Province. Additionally, integrated capacity building related to rabies
control involving health and animal health sectors hasn’t yet been implemented.
The absence of regulations governing cross-sector rabies control at the district level
despite the existence of national regulations is the main reason. The study
concludes, that enhancing rabies control requires transforming current incidental
cross-sector cooperation into a regular and systematic process. District regulations
are essential to ensure consistent communication, collaboration, and coordination
among sectors, addressing barriers for more integrated and efficient rabies
management response.

Keywords: Case report, Cross-sector collaboration, One health, Rabies control,

Inter-Regional regulation.

74
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OO_HE11
Enhancing Maternal Nutrition in Temanggung: Evaluating the Impact
of Local Food-Based Supplementary Feeding Program
Beti Herlina1, Likke Prawidya Putri2
1
Department of Health Policy and Management; Faculty of Medicine, Public Health and
Nursing; Universitas Gadjah Mada, Yogyakarta, Indonesia

The Indonesian government implemented the community-based Supplementary

Feeding Program using local food (PMT-lokal) sources to address Chronic Energy
Deficiency (CED) among pregnant women, a major risk factor for stunting in
children. In 2022, prevalence of CED in this area was 12.39%, motivating increased
efforts to improve maternal nutrition and reduce stunting risks. This study aims to
evaluate impact of PMT-lokal and identify factors influencing its success in
Temanggung District, a district with high CED prevalence.We conducted qualitative
methods were employed to gather data through in-depth interviews with 28
informants, including local government officials, health center staff, community
members, health volunteers, and beneficiaries. Participants were selected through
purposive sampling from areas with varying levels of program success. The CIPP
(Context-Input-Process-Product) framework was utilized for data analysis. The
research found that implementation of PMT-lokal based on local food sources
successfully reduced prevalence of CED from 94.35% to 36.58%. This success wasn’t
only measured by the decline in CED rates but also by increased community
awareness and participation in program. Key factors supporting the program's
success included adequate human resources at health centers, sufficient funding,
program adaptation to the local social and cultural context, and proactive local
leadership. The presence of PMT-lokal Task Force's organization and implementation
at the district, sub-district, and village levels also significantly contributed,
highlighting the importance of a strong and coordinated organizational
structure. The study concludes that the success of PMT-lokal in Temanggung District
is significantly influenced by cross-sectoral collaboration, culturally responsive
program adaptations, and effective local leadership.

Keywords: CED, PMT-lokal, community participation, cross-sector collaboration,

local food sources

75
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OO_HE12
Strengthening the Role of Community Health Workers through
Community-Based Monitoring Mechanisms
Agus Salim¹, Faisal Mansur¹, Mubasysyir Hasanbasri²

¹Center for Health Policy and Management Faculty of Medicine, Public Health and Nursing, Universitas Gadjah
Mada, Yogyakarta, Indonesia

²Master of Public Health Study ProgramFaculty of Medicine, Public Health and Nursing, Universitas Gadjah
Mada, Yogyakarta, Indonesia

This study aims to analyze the role of Community-Based Monitoring Mechanisms

(CBMM) in supporting Community Health Workers (CHW) and enhancing the quality
of health services at the community level. This study used a literature review
method with a PRISMA approach to assess the benefits, effectiveness, and
implementation of the Community-Based Monitoring Model (CBMM) in supporting the
performance of Community Health Workers (CHW). Keywords such as "supervisor,"
"community health worker," and "qualitative" were used to search relevant literature
in the PubMed database. Community-Based Monitoring Mechanisms (CBMM) have
proven effective in enhancing community safety and well-being. CBMM involves
active community participation in supporting CHW tasks, such as maintaining safety,
assisting in identifying health cases, and mobilizing resources. This improves access
to and quality of health services at the community level. CBMM also enhances the
accountability and quality of health services. Both CHWs and the community view
CBMM as a tool to improve support, service quality, and accountability. The
implementation of CBMM provides valuable lessons on accountability, service
quality, community empowerment, full participation, and program sustainability.
CBMM is an effective tool for supporting CHWs, improving access to and quality of
health services, and ultimately enhancing community health and well-being.
Building a strong CBMM with active community participation is key to achieving
better public health outcomes.

Keywords: community-based monitoring mechanism, community health worker,

health services, service quality, community participation

76
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OOHE_13
Establishing A Standardized Organizational Structure For Teaching
Hospitals In Indonesia

Haryo Bismantara1, Mubasysyir Hasanbasri2

1
Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing Universitas
Gadjah Mada
2
Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health and
Nursing Universitas Gadjah Mada

Teaching hospitals in Indonesia are among the least regulated, with only two specific
regulations since their recognition in 2013. The lack of standardized organizational
structure leads to variations that could impact overall performance. This study
aimed to capture these variations and propose a standardized model for teaching
hospitals in Indonesia.A document study was conducted from May 1 to June 1, 2024,
gathering organizational structures from hospital by-laws (n=440). Benchmarking
was done using BrandFinance’s 10 best academic medical centers of 2024. Data were
analyzed descriptively based on Mintzberg’s organizational structure theory and
categorized by hospital type (vertical, provincial, district/city, private, and
university hospitals).Results showed variations in strategic apex, middle-line, techno
structure, and support staff across hospitals. University and teaching hospitals,
especially primary academic ones, tend to have more complex structures. Both
provincial and district/city hospitals need to introduce joint clinician-academics
boards and stronger techno structures for academic and research missions.
Additionally, most teaching hospitals require specific supporting staff such as
support service coordination teams and centralized administration departments.In
conclusion, standardizing the organizational model of teaching hospitals in Indonesia
is urgent, emphasizing the need to strengthen their techno structures and support
staff. This standardization should be included in regulations and certification
processes. The university hospital model could serve as a benchmark for other
hospital types in Indonesia.

Keywords: Teaching hospitals, Organizational structure, Mintzberg’s Theory

77
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OO_HE15
Literature Review: Navigating Consent on The Opt-In vs. Opt-Out
Debate in School-Based Research Settings
Deskantari Murti Ari Sadewa1 , Bagas Suryo Bintoro1, 2 , Sharon Simpson3
1
Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health, and Nursing, Universitas
Gadjah Mada, Indonesia
2
Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health, and
Nursing, Universitas Gadjah Mada, Indonesia
3
MRC/CSO Sosial&Public Health Sciences Unit, University of Glasgow, UK

Obtaining consent in research is crucial for contributing to the ethical conduct and
integrity of the study as it was also strengthened by Law No.27 of 2022 on Personal
Data Protection in Indonesia. The concept of opt-in (active) and opt-out (passive)
consent mechanisms in school settings may have different implications for
participation rates. Opt-out consent, less familiar in Indonesia, has been suggested
as a viable method for obtaining participant approval. This study aims to explore
opt-in and opt-out consent by determining each challenge and advantage to enhance
the inclusivity and effectiveness of school-based interventions in similar contexts. A
literature review was carried out in the PubMed databases for articles published
from 2014 to 2024 using keywords “(opt out OR opted-out OR opt-out) AND consent
AND research AND school AND student)”. A total of 6 articles were selected based
on the inclusion and exclusion criteria and PRISMA guidelines for systematic review.
The majority of the studies were from high-income countries including US(2), UK(1),
and Australia(3). Evidence demonstrates that adopting opt-out models leads to
increased response rates, is cheaper, and less burdensome, but it is potentially
ethically challenging. Meanwhile, the opt-in model leads to limiting participation,
but it is thought to be more ethically justifiable. Opt-in consent can be given to the
students who are ‘Gillick competent’ and opt-out consent for parents. In the future,
developing guidelines for the implementation of a consent mechanism in school-
based research settings is needed to ensure ethical conduct and enhance
participation rates.

Keywords: consent mechanism, opt-in, opt-out, schools-based research, research

ethics.

78
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OO_HE16
How does the mental health system perform in terms of psychiatric
patients' non-clinical needs-Assessing the mental health system
performance in Guangdong, China
Zhenzhu Qian1,2, Jialong Chen3, Yanyan Yang2, Sawitri Assanangkornchai1*
1
Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
2
Department of hospital management, Guangdong Medical University, China.
3
School of Public Health, Guangdong Medical university, China.

Health system responsiveness is a concept put forward by the WHO, measuring the
extent to which health systems meet patients' legitimate expectations from non-
clinical perspectives. The quality of mental health services warrants significant
attention, yet evaluation data in this area are currently lacking. Our study aimed to
measure the perceived level of health system responsiveness and identify factors
associated with the experience of health system responsiveness among psychiatric
patients in Guangdong, China. A Chinese version of the health system responsiveness
questionnaire for mental health services was adapted from the original WHO version.
A total of 1,067 adult psychiatric patients were recruited from three psychiatric
hospitals in Guangdong, China. Descriptive statistics summarized participants’ socio-
demographic characteristics and ratings of responsiveness. Censored ordered probit
regression models were constructed to identify factors associated with patients'
perceived health system responsiveness. Our results revealed that 73.47% of
participants rated overall health system responsiveness as good or very good. Among
the seven domains of health system responsiveness, the lowest-rated domains were
prompt attention, autonomy, and communication. Key factors associated with
patients' experienced responsiveness of prompt attention included the distance to
the mental health center, type of insurance, and type of disease. Additionally,
individuals with a high level of stigma or shorter consultation times perceived worse
responsiveness in the domains of dignity, communication, and autonomy. More
attention should be paid to improving prompt attention and communication. Health
services should be more tailored to the needs of patients with mental illness.

Keywords: Health system, responsiveness, associated factors

79
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OV_PHC01

Identification Of Barriers In Primary Health Care Integration System

At The Archipelagic And Island States: A Systematic Literature
Review
Nurlaila Marasabessy

Faculty of Public Health, University of Indonesia, Indonesia

Many countries in the world have implemented various forms of healthcare

integration. Integrated care is a core component of health policy, intended to
reduce health service use and costs, support primary care, and deliver improved
outcomes. The integration of the primary health care system can encounter many
risks and obstacles, because it involves many elements and elements of work in it.
It is better to analyze potentials barriers that may be faced. This study aims to
identify barriers faced by archipelagic states in implementing integrated primary
health care. Research conducted is a systematic literature review using PRISMA
(Preferred Reporting Items for Systematic reviews and Meta-Analyses). Selected
articles from countries included in The Archipelagic and Island States Forum. Main
barriers are: lack of good coordination between central and local governments,
uneven distribution of resources in the health system, both human resources, as well
as health tools and materials, condition of archipelagic states separated by water
areas, makes the accessibility of services and reporting systems dependent on the
availability of transportation facilities and also natural conditions, therefore the
need for information technology to support primary health services, the provision of
incentives as a form of appreciation for health workers in remote areas needs to be
provided to encourage work motivation. There are health workers who practice but
have not been recorded, so there is a need for a data collection system for health
workers, and different health care financing systems between government-owned
health facilities and private health facilities.

Keyword: barriers, integrated, primary care, archipelagic

80
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OV_PHC02
Benchmarking The Quality of Antenatal Care Services in Public
Health Services in Timor Leste And Setabelan Health Center,
Surakarta City, Indonesia Based on The Juran Trilogy
Frieda Ani Noor, Anggi Putri Aria Gita, Ajeng Maharani Pratiwi, Aris Prastyoningsih, Wahyuningsih Safitri,
Oliva Virvizat Prasastin, Nella Tri Surya

Kusuma Husada University, Surakarta

The achievement of the K4 visit in the Public Health Service in Timor Leste is still
low. One factor that may play a role in successfully achieving the 4th visit target is
the quality management factor. Therefore, this research aims to provide
recommendations for improving the quality of antenatal services through Juran
Trilogy. This research uses a descriptive and cross sectional observational approach.
There were 17 respondents in this study, consisting of 15 midwives and 2 people in
charge of Maternal and Child Health. Based on the data obtained, the
implementation of quality planning, quality control and quality improvement is
good. However, there is a lack of implementation of customer knowledge survey
indicators and customer expectation surveys, so that customer expectations and
needs cannot be met. Furthermore, in quality control, there are deficiencies in the
implementation of customers as service assessors. Thus, customer satisfaction
cannot be identified. In quality improvement, there is no quality improvement team.
Without a quality improvement team, service improvements cannot be implemented
optimally. At the very least, it is recommended that the Public Health Service in
Timor Leste carry out customer knowledge surveys, customer expectations surveys,
customer satisfaction surveys, and form a quality improvement team to increase the
achievement of the 4th visit percentage. Conclusion. It is recommended that the
Public Health Service in Timor Leste carry out customer knowledge surveys,
customer expectations surveys, customer satisfaction surveys, and form a quality
improvement team to increase the achievement of the K4 visit percentage.

Keywords: antenatal care, quality control, quality improvement, quality planning

81
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OV_PHC03
Parental Knowledge Regarding Childhood Constipation:
Questionnaire Development and Validation

Siti Nur Syafiqah binti Fazil1,2, Ezura Madiana Md Monoto1, Chai-Eng Tan1,Hana binti Azhari1
1
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia
2
Klinik Kesihatan Taman Intan, Sungai Petani, Kedah, Malaysia

Childhood constipation is a common complaint encountered in primary care.

Unfortunately, most parents had inadequate knowledge about childhood
constipation. Currently, there are no validated instruments to measure parental
knowledge related to childhood constipation. This study aimed to develop and
validate a Malay-language questionnaire to assess parental knowledge regarding
childhood constipation among Malaysian parents. A questionnaire comprising 30
true-false items was developed based on a thorough literature review. The items
questionnaire underwent content validation by a panel of 6 experts. The content
validity index for each item and the overall scale were determined. The resulting
25-item version was administered via an online survey among 219 Malay-literate
parents of children aged 0 to 18 years old. Principal components analysis (PCA) was
conducted to identify the factor structure of the questionnaire and its internal
consistency reliability was determined using Cronbach alpha. The item-content
validity index (I-CVI) ranged from 0.833 to 1. The scale-content validity index (S-
CVI) was 0.97. Following preliminary checking for normality and linearity, only 20-
items were included for PCA. The Kaiser-Meyer-Olkin measure of sampling adequacy
was 0.619, and Bartlett’s test of sphericity was significant (p<0.001). PCA using
orthogonal rotation revealed 4 distinct factors in the questionnaire: toilet training
(3 items, α = 0.718), withholding (2 items, α = 0.776), investigation for constipation
(2 items, α = 0.535), and definition of constipation (2 items, α = 0.519). This 9-item
questionnaire which underwent a robust validation process proves to be a valid and
reliable tool to evaluate parental knowledge regarding childhood constipation and
suitable to be used in clinical and research application.

Keywords: childhood constipation, parental knowledge, questionnaire validation,

validation study

82
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OV_PHC04
Effectiveness Of The PAUSE© Flipchart Compared To Conventional
Method for Premarital HIV Counselling: A Cluster Randomized
Control Study at selected public primary healthcare clinics in Johor
Bahru District, Malaysia.
Magaletchumi a/p Chelladorai1,2, Aznida Firzah Abdul Aziz1, Chai Eng Tan1, Leelavathi a/p
Muthupalaniappen1,3
1
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
2
Klinik Kesihatan Sultan Ismail, Ministry of Health, Johor Bahru, Malaysia
3
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Kuala Lumpur, Malaysia.

Premarital HIV testing was made mandatory for Muslim couples in Malaysia as an
effort to curb the transmission of HIV. The PAUSE flipchart is a Malay language
©

counselling tool to facilitate consistent and effective pre-test counselling for

premarital couples. This study evaluates the effectiveness of the PAUSE flipchart ©

versus conventional methods in enhancing HIV knowledge at public health clinics in

Johor Bahru. A parallel cluster randomized controlled trial was conducted
among adult Malay-literate clients who registered for mandatory premarital HIV
testing. Cluster randomisation was used to select eight primary care clinics to be
allocated into intervention and control groups. Clients in the intervention group
(n=90) received counselling using the PAUSE flipchart, whereas clients in the control
©

group (n=90) received routine verbal counselling. HIV knowledge was assessed using
the Malay HIV Knowledge Questionnaire before and after counselling.
Understandability of the PAUSE flipchart was evaluated using the Patient Education
©

Materials Assessment Tool for Printable Materials (PEMAT-P) among clients in the
intervention group. Post-counselling HIV knowledge scores were significantly higher
in the intervention group compared to the control group [mean score 19.99 (SD=1.26)
vs 16.69 (SD=4.41), p<0.001]. The mean change in total HIV knowledge scores were
also higher in the intervention group [6.99 (SD=4.66) vs 3.99 (SD=5.25), p<0.001].
The PAUSE flipchart demonstrated high understandability with a median PEMAT-P
©

score of 100 (IQR: 6.0).The PAUSE flipchart significantly enhances HIV knowledge
©

compared to conventional methods, with high levels of understandability.

Keywords: HIV Infections, health education, counselling, patient education

83
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OV_PHC05

Health Literacy and Intention to Utilise Pre-Pregnancy Care (PPC)

Services and its Association Among Married Adults in The
Reproductive Age in Selangor.
Nurul Irma Muhamad Tahir1,2, Zuhra Hamzah1, Syahnaz Mohd Hashim1
1
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia
2
Klinik Kesihatan Batu 9, Hulu Langat, Selangor, Malaysia

Pre-pregnancy care (PPC) is essential but inadequately utilized. Research on PPC,

particularly in health literacy and intention to use, is limited, with no local studies
available. This study evaluated health literacy and the intention to use PPC services
among married adults attending clinics in Selangor. A cross-sectional study involved
420 married adults in Hulu Langat, Selangor, using a validated self-administered
questionnaire. Only 27.9% had previously received PPC counselling. The median
health literacy (HL) scores for PPC skills and behaviour were 54 (IQR=10), and for
knowledge, it was 9 (IQR=3). About 61.9% intended to use PPC services in the future.
The median score for skills and behavior in female were higher at 54 (10) compared
to male 53.5 (9). Moreover, the median knowledge score for female is much higher
at 10 (3) while male only 9 (3) and it is statistically significant at p-value <0.001.
Additionally, 137 females exhibited strong intention to PPC use (65.2%) in contrast
to just 123 males (58.5%). Significant association with intention of PPC use were ever
received PPC (p=<0.001), willingness to receive PPC (p=<0.001) and higher
knowledge score (p=<0.001). Health literacy and the intention to use PPC services
were suboptimal. Early PPC counselling for all reproductive women and involving
men is crucial. This highlights a need for interventions and continuous educational
programs to improve PPC health literacy.

Keywords: pre-pregnancy care, health literacy, intention to use

84
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OV_PHC06
Lay Health Workers: Managerial Capabilities and Their Role in
Stunting Mitigation

Gromiko 1, Mubasysyir Hasanbasri1

1
Department of Health Policy and Management; Faculty of Medicine, Public Health and Nursing; Universitas
Gadjah Mada, Yogyakarta, Indonesia

This study aims to explore the role of Community-Based Organizations (CBOs) in

addressing stunting in Mentaya Hilir Selatan Subdistrict, East Kotawaringin Regency,
Indonesia.This research employs a qualitative design with a case study approach,
using data collection techniques such as in-depth interviews with 33 informants,
observation, and document analysis. The research subjects consist of midwives,
health volunteers, members of the Family Welfare Empowerment Team (TP-PKK),
family planning volunteers, community mothers, and program managers at the
subdistrict/village level. Data were analyzed using content and thematic analysis
.The results show that CBOs in Mentaya Hilir Selatan Subdistrict lack proper synergy
between the government, community, and multi-sectors. Stunting prevention is
carried out through various programs such as Posyandu, Pos Gizi Bunting, Aksi Cegah
Stunting (ACS), Dahsyat Program (Healthy Kitchen to Overcome Stunting), and
Family Assistance Teams (TPK). These programs involve activities such as nutrition
education, cooking demonstrations, child weighing, and home visits to monitor the
condition of pregnant women and young children. However, it was found that the
workload of health volunteers is too heavy, as they not only serve as field
implementers but also perform managerial functions. One village volunteer also
doubles as a program manager, significantly contributing to the success of stunting
prevention efforts. Community-based approaches through CBOs have proven
effective in addressing stunting in Mentaya Hilir Selatan Subdistrict. The sustained
success of community programs is inseparable from the role of health volunteers.
However, there is a need to review the role structure and workload of volunteers to
ensure the sustainability and effectiveness of the programs.

Keywords: Community-Based Organization, managerial, Community Empowerment,

Lay Health Workers, Stunting

85
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OV_PHC08

Development of a caregiver guide for post discharge stroke patients

residing at home in the community: POSTCODE-MyTM Project.
Anwar Fazal1,2, Aznida Firzah Abdul Aziz3, Wan Asyraf WZ4
1
Ministry of Health Malaysia
2
Kyour, Malaysia
3
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur,
Malaysia
4
Medical Department, Faculty of Medicine Universiti Kebangsaan Malaysia

Navigating post discharge stroke care is challenging for both the patient and the
caregivers in Malaysia. The literature on unmet needs of local carers indicates a
need for support and knowledge to help them care for stroke survivors as well as for
themselves. Guides for stroke caregivers are often discipline oriented and lack
orientation for overall caregiving delivery. The objective of this study is to develop
a carer guide that would assist individuals in the transition from the hospital to their
home while they are undergoing rehabilitation. A combination of expert panel
opinion i.e., Family Medicine Specialists with interest in long term stroke care,
stroke survivors and caregivers’ opinion would be sought via focus group discussions,
as well as triangulation from international and local literature will be used to
determine the content for POSTCODE-My caregiver guide. Instructions will be
TM

accompanied by graphics and pictorial aides, and will be written in simple Malay
language comprehensible to individuals in primary school level. POSTCODE-My TM

guide would include information such as illustrated and pictorial guide on how to
facilitate safe and effective care from therapists’ recommendations, guide to
maintain good oral health, checklist to guide caregivers on follow up for long term
stroke care at primary care/neurologist, link with social welfare services and
resources available in the community.The POSTCODE-My will be a comprehensive
TM

guide developed to assist stroke caregivers and survivors navigate the post stroke
care continuum. The impact of its usability in enhancing the quality of life of stroke
caregivers needs further evaluation.

Keywords: stroke, post stroke, rehabilitation, caregiver, carer

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ACKNOWLEDGEMENT

The Organizing Committee of the 18th PGF2024 would like to thank the following:

All participants and presenters of the conference

Speakers and judges

All our sponsors

Anyone else who has contributed to the conference

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