The Science Midwifery is a peer-reviewed open access bi-monthly Intitute of Computer Science (IOCS). This journal is published bi-monthly (August, October, December, February, April, June) since August 2022. This professional journal provides a venue for the publication of research relevant to midwifery and reproductive health practice by specialists and researchers in various disciplines including midwifery, reproductive health, maternal and child health, obstetrics and gynecology, sexual health promotion, women's health and nursing. It publishes quantitative and qualitative original articles, review articles, short communications, case reports and letters to the editor in a broad range of clinical and interdisciplinary topics. (Look at the scope)
The effectiveness of the use of operational health assistance funds in supporting the achievement of the antenatal care program at the X Community Health Center, Serdang Bedagai Regency
The Health Operational Assistance (BOK) program contributes to increasing the coverage of antenatal care services in an effort to reduce maternal mortality. This study aims to determine the effectiveness of BOK fund utilization in supporting the achievement of the Antenatal Care program. This study uses a qualitative method with a case study design. Informants involved in this study were the Head of the Community Health Center, BOK Treasurer, Coordinating Midwife, and ANC Program Implementer. Research informants were determined using a purposive sampling technique. Data analysis was conducted using the Nvivo data processing application version 15. The results of the study revealed that the utilization of BOK funds in the implementation of Antenatal Care is not fully optimal. At the input stage, the realization of BOK funds for ANC has reached 100%, but the utilization of funds is not directly proportional to the achievements of the ANC program. Human resources for BOK fund management are not held by employees with a financial background. The policy for fund utilization is in accordance with technical guidelines. At the process stage, planning has been carried out systematically and structured. In the implementation, there are still obstacles, namely delays in fund disbursement. Reporting on the use of BOK funds has been running well. Monitoring has not been fully optimal. Mini-workshop evaluations have been conducted once a month. At the output stage, ANC outcomes have not reached targets due to a lack of participation from pregnant women and not all ANC activities being budgeted.
Copyright (c) 2026 Fhidiana Sari, Fitriani Pramita Gurning, Dewi Agustina https://creativecommons.org/licenses/by-nc-sa/4.0
Effectiveness of the putri self-management module in improving knowledge, attitudes, and blood glucose levels among patients with type 2 diabetes mellitus
Poor glycemic control among patients with Type 2 Diabetes Mellitus (T2DM) is often associated with inadequate diabetes knowledge, low self-efficacy, and suboptimal self-management practices. The PUTRI (Pemberdayaan Untuk Tatalaksana dan Regulasi Individu) module was developed as a structured educational tool to support diabetes self-management in primary care settings. This study aimed to evaluate the effectiveness of the PUTRI module on patients’ knowledge, attitudes, and random blood glucose (RBG) levels. A quasi-experimental one-group pretest–posttest study was conducted among 50 patients with T2DM enrolled in a chronic disease management program at a primary healthcare center. Participants received a 7-day intervention using the PUTRI module. Knowledge and attitude were assessed using structured questionnaires, while RBG levels were measured using calibrated glucometers. Data were analyzed using the Wilcoxon Signed-Rank Test and Spearman’s correlation analysis. Significant improvements were observed in knowledge scores (0.176 ± 0.222 vs. 0.940 ± 0.121; p<0.001) and attitude scores (1.95 ± 0.505 vs. 2.91 ± 0.252; p<0.001) following the intervention. Mean RBG levels decreased from 267.54 mg/dL at baseline to 185.52 mg/dL on Day 7 (p<0.001). A moderate positive correlation was identified between post-test knowledge and attitude scores (rs=0.566, p<0.001), while self-efficacy was negatively correlated with Day-7 RBG levels (rs=-0.282, p=0.047). The PUTRI module was associated with improvements in diabetes-related knowledge, attitudes, and short-term glycemic outcomes among patients with T2DM. Further studies using randomized controlled designs and longer follow-up periods are recommended to confirm these findings.
Copyright (c) 2026 Ratna Indah Sari Dewi, Ramah Hayu, Herman Susilo, Putri Dafriani https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of the continuity of care (CoC) development model in midwifery care
The Continuity of Care (CoC) development model is designed to improve the quality and continuity of midwifery services during pregnancy, childbirth, the postpartum period, infant care, and contraceptive use. Ensuring that these services are safe, effective, timely, efficient, equitable, and woman-centered can enhance maternal and neonatal health outcomes. This study aimed to evaluate the implementation of the CoC development model in midwifery services. A descriptive research design was used to assess the application of the CoC development model in three health centers: Sikumana, Alak, and Bakunase. The study population consisted of midwives working in these areas, selected using purposive sampling. Data were analyzed using univariate analysis. The implementation of the CoC development model in midwifery services was carried out well, though with varying levels of achievement across the stages of care. The implementation during pregnancy was categorized as very good (14.87%), during childbirth as very good (11.30%), and during the postpartum period as good (13.42%). The CoC development model has been effectively implemented in midwifery services, contributing to improved continuity and quality of care for mothers and newborns, although further enhancement is needed to ensure consistency across all stages.
Copyright (c) 2026 Ummi Saleh, Mareta B. Bakoil, Firda Kalzum Kiah, Wahidah Sukriani, Noordiaty Noordiaty, Chendy Sofianty Pelatta https://creativecommons.org/licenses/by-nc-sa/4.0
Analysis of factors affecting mothers' behavior in selecting nutritious food for toddlers from the perspective of sharia financial literacy
The selection of nutritious foods for toddlers is one of the key factors in stunting prevention and is strongly influenced by mothers' ability to manage household resources. This study aimed to analyze the relationship between Sharia financial literacy and mothers' behavior in selecting nutritious foods, as well as to identify the factors that most strongly influence such behavior. This study employed an analytic quantitative design with a cross-sectional approach involving 108 mothers with toddlers in Gresik Regency. The sample was selected using purposive sampling, and data were collected through a Google Form-based questionnaire. Data analysis was conducted through univariate, bivariable, and multivariable analyses using Spearman's rank test and logistic regression. The results showed that the majority of respondents had moderate Sharia financial literacy (59.3%) and fair nutritious food selection behavior (50.9%). There was a significant relationship between Sharia financial literacy and nutritious food selection behavior (p < 0.05). In the multivariable analysis, access to nutritious food and Sharia financial literacy were shown to have significant effects, with access to nutritious food emerging as the most dominant factor. This study indicates that strengthening Sharia financial literacy and improving access to nutritious food are important in supporting mothers' behavior in selecting nutritious foods for toddlers.
Copyright (c) 2026 Science Midwifery https://creativecommons.org/licenses/by-nc-sa/4.0
Dispensation for underage marriage: a legal analysis and its implications for adolescent reproductive health in indonesia
Child marriage, facilitated through judicial marriage dispensation mechanisms, constitutes a persistent public health and human rights crisis in Indonesia. Despite the enactment of Law No. 16 of 2019, which raised the minimum marriage age for women from 16 to 19 years, dispensation applications surged by approximately 171% between 2018 and 2020—from 23,700 to 64,211 cases—revealing a profound policy paradox. This study employs a normative juridical method with statute, conceptual, and case approaches to systematically analyze the adequacy of Indonesia's legal framework governing marriage dispensation in protecting adolescent reproductive health. The analysis reveals three compounding structural deficiencies: (1) normative inadequacy of Supreme Court Regulation (PERMA) No. 5 of 2019, which mandates health considerations without prescribing enforceable standards; (2) pervasive legal pluralism that subordinates child protection norms to customary and religious considerations; and (3) the absence of an interdisciplinary adjudicative framework integrating reproductive health evidence into judicial decision-making. Findings from five Religious Court jurisdictions demonstrate that premarital pregnancy dominates as the grant rationale (averaging 68.2% of cases), while substantive health consideration occurs in fewer than 7% of decisions. Provinces with the highest dispensation rates—including South Kalimantan and West Sulawesi—simultaneously record maternal mortality ratios and adolescent anemia prevalence significantly above national averages, indicating a structurally mediated relationship between legal permissiveness and reproductive health burden. This study proposes a four-dimensional health-responsive legal reform framework encompassing: legislative amendment of Article 7(2), mandatory health screening protocols in PERMA revision, judicial capacity building, and harmonization with CRC and CEDAW obligations.
The effectiveness of online media in reducing the plaque rate of elementary school children: A systematic literature review
The high prevalence of dental plaque in elementary school children is still a dental and oral health problem that can affect children's quality of life. The development of information technology encourages the use of online media as an alternative to dental and oral health education. This study aims to analyze the effectiveness of online media in reducing plaque rates in elementary school children through a bibliometric approach and literature review. Article searches were conducted through the Scopus database and the Web of Science in the 2020–2025 publications. The initial search results obtained 307 articles, then after the process of checking duplication, screening, and selection based on inclusion and exclusion criteria, 20 articles were obtained that were eligible for review. Data analysis was carried out using VOSviewer, Biblioshiny, and Rayyan.ai. The results of the study show that online media such as mobile applications, educational videos, gamification, chatbots, and web-based platforms are effective in improving dental and oral health knowledge, tooth brushing behavior, and plaque control in children. In addition, parental involvement through digital media also supports the improvement of children's oral hygiene. In conclusion, online media has the potential as a promotive and preventive media in reducing the number of plaques in elementary school children.
Copyright (c) 2026 Ana Riolina https://creativecommons.org/licenses/by-nc-sa/4.0
The relationship between platelet-lymphocyte ratio (plr) and mortality of sepsis patients in the intensive care unit of Waled Regional General Hospital in 2020-2023
Background: Sepsis is one of the leading causes of mortality worldwide, especially in patients treated in intensive care units. This condition is characterized by organ dysfunction due to a systemic inflammatory response to infection that can lead to death if not treated promptly. Platelet-Lymphocyte Ratio (PLR) is a simple inflammatory marker that can provide information about sepsis mortality. PLR is calculated by dividing the platelet count by the absolute lymphocyte count. Objective: This study aims to analyze the relationship between PLR and mortality of sepsis patients in the Intensive Care Unit of Waled Regional General Hospital (RSUD Waled) in 2020-2023. Methods: This study used an analytical method with a cross-sectional design. Data were obtained through medical records with a sample size of 65 people and the data collection method was total sampling. Data analysis used the Fisher Exact Test. Results: Most sepsis patients had high PLR values, with 52 patients dying, and sepsis patients with low PLR values, with 10 patients surviving and 3 patients dying. The results of data analysis using the Fisher's Exact test showed a p-value of <0.001. Conclusion: There is a significant relationship between PLR and mortality of sepsis patients in the Intensive Care Unit of Waled Regional Hospital.
Copyright (c) 2026 Khairunnisa Purwati, Donny Prasetyo Priyatmoko, Isti Noviani https://creativecommons.org/licenses/by-nc-sa/4.0
The relationship between nutritional status and the incidence of hypertension at primary health care facilities in the working area of bojongsoang community health center, bandung regency, 2025
Background: Hypertension is a major public health problem that increases the risk of cardiovascular disease, stroke, and renal failure. Nutritional status, particularly overweight and obesity, is one of the contributing factors to hypertension. The prevalence of hypertension and overnutrition in the working area of Bojongsoang Primary Health Care remains high, making it necessary to assess their relationship. Methods: This study used a cross-sectional design with secondary data obtained from a previous study. A total of 135 respondents who met the inclusion and exclusion criteria at primary health care facilities in the working area of Bojongsoang Health Center, Bandung Regency, in 2025 were included. Nutritional status was determined using Body Mass Index (BMI), and hypertension status was classified as controlled and uncontrolled. Data were analyzed using univariate analysis and bivariate analysis with the Chi-Square test. Results: Most respondents were classified as obese (42.2%) and overweight (17.8%). The majority of respondents had uncontrolled hypertension (65.9%). Bivariate analysis showed a significant association between nutritional status and the incidence of hypertension (p < 0.05), with overweight and obese respondents having a higher proportion of uncontrolled hypertension compared to those with normal or underweight nutritional status. Conclusion: There is a significant relationship between nutritional status and the incidence of hypertension in primary health care facilities in the working area of Bojongsoang Health Center, Bandung Regency, in 2025. Nutritional status control, particularly the prevention of overweight and obesity, should be an essential component of hypertension management and prevention strategies.
Copyright (c) 2026 Muhamad Rosyid Kusdiawan, Mia Miranda Sitti, Helmi Rosa Gunadi https://creativecommons.org/licenses/by-nc-sa/4.0
Analysis of factors influencing the occurrence of mental emotional disorders (med) among employees at penjaringan primary health center
Mental Emotional Disorders (MED) are prevalent among healthcare workers due to excessive workload and occupational stress. This study aimed to analyze factors associated with Mental Emotional Disorders among employees at Penjaringan Primary Health Center, Jakarta. A quantitative cross-sectional study was conducted involving 146 employees selected based on inclusion criteria. Data were collected using questionnaires and the Self Reporting Questionnaire-20 (SRQ-20). Variables analyzed included workload, managerial system, organizational culture, coping mechanism, psychological resilience, mental health history, and well-being. Data were analyzed using chi-square and multiple logistic regression tests. The prevalence of MED was 16.4%. Significant associations were found between workload (p=0.001), organizational culture (p=0.001), coping mechanism (p=0.001), and psychological resilience (p=0.001) with MED incidence. Multivariate analysis identified psychological resilience as the dominant factor associated with MED. The study concludes that excessive workload and low resilience increase the risk of Mental Emotional Disorders among healthcare workers. Organizational interventions focusing on workload management and resilience strengthening are recommended.
Copyright (c) 2026 R. Muh. Ihsan Sasraningrat, Ernyasih Ernyasih, Munaya Fauziah, Rusdi Effendi https://creativecommons.org/licenses/by-nc-sa/4.0
Determinants of barriers to the implementation of the chronic disease management program (PROLANIS) among patients with diabetes mellitus in Indonesia: A systematic literature review
The Chronic Disease Management Program (PROLANIS) is a proactive healthcare service system developed by BPJS Kesehatan to manage chronic diseases, including diabetes mellitus (DM). Although the program has been implemented since 2014, its achievement remains far below optimal, with various barriers reported across different regions of Indonesia. This Systematic Literature Review aims to identify and synthesize the determinants of barriers to PROLANIS implementation among patients with diabetes mellitus in Indonesia. A literature search was conducted across PubMed, Scopus, and Google Scholar databases, covering the period 2021–2026. A total of 78 articles were identified, and following the PRISMA 2020 screening process, 22 studies met the inclusion criteria. Quality assessment was performed using the JBI Critical Appraisal Checklist. The results is barriers were identified across four principal dimensions: (a) the patient dimension, encompassing low knowledge levels, insufficient motivation, economic constraints, and distance to healthcare facilities; (b) the healthcare provider and primary care facility (FKTP) dimension, comprising limited human resources and inadequate infrastructure; (c) the BPJS system dimension, including frequently changing regulations and financing limitations; and (d) the environmental dimension, involving social support and cultural factors. The conclusion is barriers to PROLANIS DM implementation are multidimensional in nature. Comprehensive interventions targeting patient, provider, system, and environmental factors are required to improve program outcomes.
Copyright (c) 2026 Indah Koryah Indah, Elviera Gamelia, Suratman Suratman https://creativecommons.org/licenses/by-nc-sa/4.0
Development of an Android-Based E-Module on Hypnoprenatal Material for Diploma III Midwifery Students
Mobile technology has become increasingly important in health professions education, yet midwifery learning in Indonesia still relies largely on printed modules and conventional lectures. Hypnoprenatal is a relaxation technique that has been reported in the literature as a complementary approach to reduce antenatal anxiety and fear of childbirth; however, digital instructional resources covering this topic for midwifery students remain limited. This study aimed to develop an Android-based hypnoprenatal e-module for Diploma III Midwifery students and to assess its feasibility as a learning medium, using the ADDIE model (Analysis, Design, Development, Implementation, Evaluation) as the research and development (R&D) framework. Methods: Feasibility was evaluated by two material experts, one media expert, one lecturer, and 20 fourth-semester students through validated five-point Likert-scale questionnaires. Responses were analyzed descriptively by calculating the percentage of agreement for each respondent group, which was then interpreted against a predetermined feasibility category scale (e.g., 81–100% = "Highly Feasible," 61–80% = "Feasible," and lower ranges indicating reduced feasibility). Results: After two rounds of expert validation and revision, the e-module obtained mean feasibility scores of 90.0% from the media expert and 96.3% from the material experts, both falling within the "Highly Feasible" category. Student feedback yielded 84.1% in the small-group trial and 90.1% in the large-group trial, while the lecturer's assessment reached 95.3%, all within the "Feasible" to "Highly Feasible" range. Conclusion: Based on these descriptive feasibility scores, the Android-based hypnoprenatal e-module is feasible for use as a self-directed learning medium for midwifery students. This study did not evaluate the e-module's effect on student learning outcomes or anxiety-related measures; further research employing experimental designs is needed to examine its effectiveness. . The findings nonetheless support the potential of this e-module as a starting point for integrating complementary-care content into competency-based midwifery education.
Copyright (c) 2026 Sari Wahyuni, Nurul Komariah https://creativecommons.org/licenses/by-nc-sa/4.0
Aerobic exercise as a non-pharmacological intervention to reduce weight gain in 3-month injectable contraceptive users
Weight gain is identified as one of the most prevalent side effects among users of 3-month injectable contraceptives (Depot Medroxyprogesterone Acetate/DMPA), which significantly impacts user compliance and long-term health. This study aims to analyze the effect of a structured aerobic exercise intervention on weight reduction among DMPA users. This research employed a quantitative pre-experimental design with a pretest-posttest approach. The study was conducted in Tondomulyo Village, Pati District, Central Java, involving 50 women of reproductive age (15–49 years) who were current users of 3-month injectable contraceptives, selected through purposive sampling. Body weight was measured before and after the intervention using calibrated digital scales. Data were analyzed using a paired sample t-test via SPSS with a significance level of p < 0.05. The study found a statistically significant decrease in body weight following the aerobic exercise intervention (p=0.000). The mean body weight decreased from 61.92 kg at pre-intervention to 60.86 kg post-intervention, resulting in a mean difference of 1.06 kg. Most participants engaged in light-intensity exercise (58%), though regular exercise was associated with more optimal metabolic outcomes. Aerobic exercise is an effective non-pharmacological intervention for managing weight gain among DMPA users. Incorporating structured physical activity into reproductive health programs can serve as a holistic approach to mitigate contraceptive side effects and improve user continuation rates.
Copyright (c) 2026 Zulhijriani Zulhijriani, Nur Cahyani Ari Lestari, Salwa Annisaa; Luluk Yuliati https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of implementation 10 steps to successful breastfeeding program at Dukuh Klopo Community Health Center
Various regulations regarding programs that support breastfeeding already exist, but their coverage and other practices related to breastfeeding such as IMD have not reached the set targets, especially in Community Health Centers (Puskesmas) because so far the focus of implementation has only been on hospitals. The purpose of this study was to evaluate the implementation of the success of the 10 LMKM program at the Dukuh Klopo Community Health Center, Jombang. This research is a qualitative study with a case study research design. The data collection method used in-depth interviews. The sample in this study was 3 providers and 10 mothers who received the program. The place and time of the research were at the Dukuh Klopo Community Health Center from October to November 2025. The research analysis used the Miles and Hubberman model. The results showed that all midwives supported breastfeeding activities including discussions since pregnancy, all midwives assisted with early breastfeeding initiation (IMD) and joint care for mothers who gave birth. All breastfeeding mothers never received gifts that included the logo of a breast milk substitute (PASI) brand and mothers were sensitive to signs that their babies wanted to breastfeed. However, one aspect of the program remains incomplete: the lack of breastfeeding support groups (KP-ASI). A written policy regarding the 10 LMKMs is needed, and it is hoped that all midwives will participate in lactation management training to optimize their implementation.
Copyright (c) 2026 Niken Grah Prihartanti, Diah Wijayanti Sutha https://creativecommons.org/licenses/by-nc-sa/4.0
The relationship between knowledge about earwax cleaning with the grade of impacted cerumen in medical students
The practice of using cotton buds for ear cleaning is common in the community. However, the use of cotton buds will cause various ear health problems. This study is needed to determine whether there is a relationship between knowledge about ear cleaning using cotton buds and the grade of cerumen impaction. Quantitative research using an observational analytic design with a cross-sectional approach. Sampling was carried out by simple random sampling using 37 respondents. The instrument used was a questionnaire and cerumen grade using otoscopy examination. The data were analyzed using chi square. Respondents who have a good level of knowledge (97.3%) have a sufficient level of knowledge (2.7%). The grade of cerumen in the right ear was grade 1 (13.5%), grade 2 (73.0%), grade 3, (10.8%), and grade 4 (2.7%). The left ear has the same as the right ear. There is no relationship between knowledge about the cleaning ears habits and the grade of cerumen with a p-value (0.381 > 0.05). Most respondents have a good level of knowledge. The knowledge about earwax cleaning not related with cerumen impaction grade.
Analysis of pharmacy logistics planning and control using the pareto and balanced scorecard method at Bekasi District Hospital
Hospital pharmaceutical logistics management faces complex challenges where conventional planning methods often result in disparities between financial indicators and service quality. This study applies an integrated diagnostic approach combining ABC-Pareto analysis with Balanced Scorecard to reveal systemic performance gaps. Using a descriptive-analytical research design with mixed-methods approach, this research encompasses comprehensive analysis of 1,127 pharmaceutical products (January-December 2024 period) accompanied by extensive interviews with 20 strategic informants. Main findings reveal that ABC categorization identified 41 products (3.64%) in Category A contributing 80% of total value (IDR 12.8 billion), while 1,003 items (89%) showed zero ending balance—indicating substantial formulary expansion. BSC assessment revealed a fundamental contradiction: Financial dimension scored 76.67% (indicating adequacy) inversely proportional to Customer dimension at 59.38% (showing inadequacy)—with a 17 percentage point gap. Investigation identified three interrelated causal factors: formulary expansion eroding working capital allocation, procurement lead time variability requiring excessive safety stock accumulation, and ABC stratification that has been implemented but without operational execution. Unrecorded cost burden was calculated at IDR 4-6.7 billion annually (representing 3-5% of budget), including emergency procurement surcharges, drug substitution cost differentials, and lost opportunity costs. This study establishes that traditional measurement approaches create an 'illusion of adequacy' that masks underlying system dysfunction. Five empirically-based recommendations include: formulary optimization, operationalization of ABC framework enabling differentiated inventory control, systematic lead time performance tracking, expansion of financial measurement parameters, and integrated governance architecture.
Copyright (c) 2026 R. Yuliyana Kusaeri, Eka Yoshida Syofian , Yanuar Jak https://creativecommons.org/licenses/by-nc-sa/4.0
Analysis of administrative-pharmaceutical completeness on patient prescriptions at Puskesmas X, Sorong City
Prescription completeness is an important indicator in pharmaceutical services because it is related to therapeutic accuracy and patient safety. Incomplete prescriptions may increase the risk of medication errors during drug preparation and administration. This study aimed to determine the level of administrative and pharmaceutical completeness of patient prescriptions at Puskesmas X, Sorong City. This research used a descriptive observational method with a retrospective approach involving 1,572 patient prescriptions selected using a total sampling technique. The assessment was conducted based on the standards of the Indonesian Ministry of Health Regulation Number 73 of 2016 and Number 58 of 2014. The results showed that all prescriptions (100%) were categorized as incomplete. In the administrative aspect, patient name and prescription date reached 100% completeness, while patient height, doctor’s practice license number, and doctor’s phone number showed 0% completeness. Doctor’s initials/signature were found in 60.8% of prescriptions. In the pharmaceutical aspect, drug name, stability, and compatibility reached 100% completeness, while dosage form and drug strength reached 70.6% and 69.3%, respectively. The study concluded that pharmaceutical completeness was better than administrative completeness; however, prescription writing at Puskesmas X, Sorong Citis still, did not meet pharmaceutical service standards.
Copyright (c) 2026 Carmel Josuhua Paulus, Lukman Hardia, Angga Bayu Budiyanto https://creativecommons.org/licenses/by-nc-sa/4.0
The relationship between knowledge levels and the use of soursop leaf tea among housewives with hypertension in the village of suku Sara Tangke
Hypertension remains a major global health problem due to its increasing prevalence and risk of serious complications. In addition to pharmacological treatment, health promotion efforts are needed to improve community awareness and encourage the use of safe complementary therapies. Soursop leaf tea (Annona muricata L.) has been widely recognized as a traditional herbal remedy; however, evidence regarding the effectiveness of educational interventions in promoting its utilization among hypertensive individuals remains limited. This study aimed to evaluate changes in knowledge and utilization of soursop leaf tea among hypertensive housewives in Suku Sara Tangke Village following a health education intervention. A one-group pretest–posttest pre-experimental design was employed from June to November 2025. A total of 46 respondents were selected through purposive sampling. Data were collected using a structured questionnaire and analyzed using the Wilcoxon signed-rank test. The findings demonstrated significant improvements in respondents’ knowledge and utilization of soursop leaf tea after the educational intervention. The obtained p-value of 0.000 (p < 0.05) indicates that the intervention was not only statistically significant but also practically meaningful in encouraging positive behavioral changes toward the adoption of herbal-based complementary therapy for hypertension management. The novelty of this study lies in integrating community-based health education with local herbal resources, highlighting the potential of soursop leaf tea utilization as a culturally relevant health promotion strategy among hypertensive housewives. These findings suggest that educational approaches can effectively support the acceptance and utilization of traditional herbal therapies within community health promotion programs.
Copyright (c) 2026 Saipullah Saipullah, Andi Pratama Putra, Muzaffar Muzaffar, Rahmiati Tagore Putri, Maulina Iriyanti https://creativecommons.org/licenses/by-nc-sa/4.0
The effect of amaranthus tricolor on hemoglobin levels in adolescent girls: Literature reviewe
Iron deficiency anemia remains a major health problem among adolescent girls, often caused by low iron intake and poor absorption. Amaranthus tricolor (red spinach) is a local vegetable known to contain high levels of iron, vitamin C, and antioxidants that support iron absorption. This literature review aimed to analyze the effect of Amaranthus tricolor on hemoglobin levels in adolescent girls. The literature search followed the PRISMA flow using databases such as PubMed, Google Scholar, SpringerLink, and Science Direct for studies published between 2015–2025. Inclusion criteria were full-text articles in Indonesian or English with randomized controlled trial or quasi-experimental designs involving adolescent girls aged 10–18 years. Four studies met the eligibility criteria. Results showed that administration of red spinach extract, tea, or capsule forms significantly increased hemoglobin levels. One study reported, while others demonstrated higher hemoglobin improvements in the intervention group compared to controls receiving Fe tablets (p < 0.05). Overall, red spinach effectively improves hemoglobin levels through its iron, vitamin C, and antioxidant content, indicating its potential as a functional food for anemia prevention among adolescents. Further high-quality studies are recommended to determine optimal dosage, form, and duration of intervention.
Photoprotective lip formulation optimization methods: A systematic review
Photoprotective lip preparations such as balms and tints containing natural ingredients are increasingly being developed as an alternative protection against ultraviolet radiation. The complexity of the formulation composition requires an appropriate optimization method to produce products with optimal effectiveness and stability. This review aims to analyze and compare optimization of various methods used in photoprotective lip preparations, evaluating their advantages and limitations in determining optimum conditions. This study uses a systematic review approach by searching scientific articles from databases like Google Scholar and other relevant sources within a specific time frame of years. The extracted data includes active ingredient type, optimization method, formulation variables, trial numbers, and response parameters like Sun Protection Factor (SPF), pH, and physical properties. Analysis results show that optimization methods based on experimental design, such as Response Surface Methodology (RSM), provide superior and robust capabilities in evaluating variable interactions and modeling nonlinear relationships to determine optimum conditions simultaneously. In contrast, conventional methods like one factor at a time (OFAT) combined with ANOVA still dominate but have limitations in evaluating variable interactions and generating predictive models. Most studies report that material composition variations, particularly wax bases and active ingredients, significantly influence the formulation's SPF value and physical characteristics. Experimental design-based optimization methods, particularly RSM, are strongly recommended for developing photoprotective lip formulations because they provide more efficient, accurate, and predictive results. However, their practical application is still limited. Therefore, further research is greatly needed to increase the widespread adoption of this advanced method in developing future natural product-based innovative pharmaceutical preparations.
Copyright (c) 2026 Imelda Matruty, Dzakiyya Nur Dhiya, Garnadi Jafar, Fenti Fatmawati https://creativecommons.org/licenses/by-nc-sa/4.0
Factors related to the prevention of early marriage in adolescents RP SNC Fannaz Sunggal Deli Serdang: A cross-sectional study
Early marriage is a public health problem that has an impact on reproductive health, education, psychology, and adolescent welfare. Early marriage prevention needs to be supported by knowledge, attitudes, the role of parents, and access to good reproductive health information. This study aims to determine factors related to the prevention of early marriage in adolescents at RP SNC FANNAZ Sunggal Deli Serdang. This study uses a quantitative design with a cross-sectional approach. The research sample was 85 adolescents. Data were collected using questionnaires and analyzed univariate and bivariate using chi-square tests. The results showed that there was a relationship between adolescents' knowledge of early marriage and prevention of early marriage with a value of p=0.002, adolescents' attitudes with a value of p=0.004, the role of parents/families with a value of p=0.006, and access to reproductive health information with a value of p=0.001. Therefore, reproductive health education and family involvement need to be improved to prevent early marriage.
Copyright (c) 2026 Ida Lestari Tampubolon, Yetti Dynaria Siregar, Dwiana Kartika Putri, Nayodi Permayasa https://creativecommons.org/licenses/by-nc-sa/4.0
In vitro study the effect of flavonoid routine in cassava leaves (manihot esculenta c.) on the replication of dengue virus serotype 1 strain new guinea C
Dengue hemorrhagic fever (DHF) is an infectious disease caused by the dengue virus with clinical manifestations of fever, muscle pain and joint pain accompanied by leukopenia, rash, lymphadenopathy and thrombocytopenia. According to WHO, DHF is still a major health problem in Indonesia, while dengue antiviral therapy does not yet exist, but several studies have found the potential of cassava leaves because they contain routine flavonoid compounds that function as antivirals. Objective: To determine the effect of routine flavonoids from cassava leaves (Manihot esculenta C.) on the replication of Dengue virus serotype 1 strain New Guinea C in Vitro by analyzing the 50% inhibitory concentration (IC50), 50% cytotoxic concentration (CC50), and selectivity index. Method: The research was experimental with a post-test control group design. This study used 7 groups, namely 1 control group and 6 treatment groups. The treatment group consisted of routine administration of Flavonoids from cassava leaves (Manihot esculenta C.) with concentrations of 50 µg/ml, 25 µg/ml, 12.5 µg/ml, 6.25 µg/ml, 3.125 µg/ml and 1.5 µg/ml. The control group (K) was given 0.2% Dimethyl sulfoxide (DMSO). Data were tested using the Kruskal Wallis test. Results: In the Kruskal Wallis test, there was an effect of routine Flavonoids on dengue virus replication (p value = 0.006). The IC50 value obtained at a concentration of 3.36 µg/ml was declared very strong inhibition, and the CC50 at a concentration of 17.48 µg/ml was declared toxic, for the Selectivity Index obtained a value of 5.2 declared safe in its use. Conclusion: Routine flavonoids in cassava leaves (Manihot esculenta C.) have an effect on the replication of Dengue virus Serotype 1 Strain New Guinea C in Vitro.
Copyright (c) 2026 Dery Handaiana Putra Galuh Pangestu, Dadan Ramadhan Apriyanto, Sri Marfuati, Beti Ernawati Dewi https://creativecommons.org/licenses/by-nc-sa/4.0
The effectiveness of foot exercises and trigona honey on type 2 DM neuropathy
Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder with a steadily increasing number of cases globally. The International Diabetes Federation (IDF) reported in 2021 that 10.5% of the global population, or approximately 537 million adults, live with diabetes, and this figure is projected to increase to 12.2%, equivalent to 783 million people, by 2045. One of the chronic complications often experienced by people with T2DM is diabetic neuropathy. This condition is characterized by decreased peripheral nerve function and increased pain intensity. Foot exercises are a non-pharmacological intervention that can increase blood flow, strengthen muscles, and stimulate peripheral nerves, potentially improving neuropathy symptoms. The purpose of this study was to analyze the effectiveness of foot exercises in reducing pain and increasing sensitivity in the feet of people with type 2 DM. The method used was a quasi-experimental pretest-posttest design. A sample of 30 respondents was divided into two groups. Data analysis used the Wilcoxon Signed Rank Test. The results showed a significant reduction in pain between the first and fourth weeks (p=0.014). Right foot sensitivity increased significantly in the first week (p=0.013), the second week (p=0.001), and the fourth week (p=0.008), while the left foot showed a significant increase in the first week (p=0.013). In conclusion, foot exercises are effective in reducing pain and increasing foot sensitivity in patients with type 2 diabetes.
Copyright (c) 2026 Heny Marlina Riskawaty, Baik Heni Rispawati, Raudatul Jannah https://creativecommons.org/licenses/by-nc-sa/4.0
Overview of pregnant women’s satisfaction with antenatal care services using the customer satisfaction index (CSI)
Background: The Maternal Mortality Ratio (MMR) in Indonesia remains high at 189 per 100,000 live births in 2020. One contributing factor to this condition is low compliance among pregnant women in attending antenatal care (ANC) visits, which is presumed to be influenced by their level of satisfaction with antenatal services. This study aimed to describe and analyze pregnant women’s satisfaction with the quality of antenatal care services at BaliMed Karangasem Hospital. This study employed a descriptive analytic design using the SERVPERF questionnaire, which evaluates five service quality dimensions: tangibles, reliability, responsiveness, assurance, and empathy. Data were analyzed using the Customer Satisfaction Index (CSI). The results showed that all service quality dimensions had high levels of satisfaction and importance. The highest satisfaction score was observed in the responsiveness dimension (4.57), while the lowest was in tangibles (4.48). The highest importance score was found in the assurance dimension (4.68), whereas the lowest importance score was in tangibles (4.52). The CSI value of 90.5% indicated a “very satisfied” category.
Copyright (c) 2026 Fitriani I Nengah Prama Baswara Andakara Yasa, Putu Arya Suryanditha, Luh Gede Pradnyawati https://creativecommons.org/licenses/by-nc-sa/4.0
The effect of consuming banana blossom (musa paradisiaca) on breast milk production in postpartum mothers
Background: Breast milk (ASI) contains essential nutrients needed for infant growth, immunity, disease prevention, and cognitive development. Banana flower is known to contain lactagogum compounds that stimulate the hormones oxytocin and prolactin, which can help increase and facilitate breast milk production. Objective: This study aimed to determine the effect of banana flower consumption on breast milk production in postpartum mothers at PMB Krasak Bangsri Jepara. Method: This study used a quasi-experimental design with a one-group pretest-posttest approach without a control group. The sample consisted of 30 postpartum mothers selected using a total sampling technique. Data were collected through questionnaires and observations. The research instruments included a breast milk production questionnaire and a standard operating procedure (SOP) for administering banana flower. Validity testing showed all questionnaire items were valid with r-count values ​​greater than r-table (0.514), while reliability testing using Cronbach's Alpha obtained a value of 0.906, indicating high reliability. Data were analyzed using the Paired Sample t-Test. Result: Statistical analysis showed a p-value of 0.000 (p<0.05), indicating a significant effect of banana flower consumption on breast milk production in postpartum mothers. Conclusion: Banana flower consumption has a significant positive effect on breast milk production in postpartum mothers at PMB Krasak Bangsri Jepara.
Copyright (c) 2026 Gina Kusuma Nigrum, Ummi Kulsum, Fania Nurul Khoirunnisa https://creativecommons.org/licenses/by-nc-sa/4.0