Time to Activate Breastfeeding Behavior Change and Intervention
Author : Wayan Suriastini | Dani Alfah | Bondan Sikoki | Roni Hermoko | LIStiono | Iip Umar Rifa’i | Dhanang PrasetyaThursday, 08/10/2020SurveyMETER
Prior to the COVID19 pandemic, Indonesia had become one of the countries with the highest burden of stunting and malnutrition in the world. UNICEF predicts that the COVID-19 pandemic has the potential to exacerbate the burden of malnutrition in Indonesian children due to an unbalanced dietary habit.
SurveyMETER conducted a telephone survey in a sub-district in Nganjuk Regency, East Java Province in June-July 2020 - with the support of the Knowledge Sector Initiative - to find out the dietary patterns of children under five during the COVID19 pandemic. This survey succeeded in recording 1,321 children under the age group of 25-45 months as much as 62% and the age group 6-24 months 38%.
The survey results showed that the percentage of toddlers aged 6-24 months who never consumed breast milk was still relatively high during the pandemic, namely 23%. Whereas parental awareness is the key to success in breastfeeding for two years to support the first 1,000 days of life and of course requires support from family, environment and society. Complete study results in the form of a Research Brief can be read and downloaded here.
Socialization of the Preparation of the Village and Regional Data Integration System for Nganjuk Regency
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SurveyMETER in collaboration with the Nganjuk district government through the Communications and Information (Kominfo) Service and the Health Service conducted a piece of disseminated information on the preparation of the village and regional data integration system in Nganjuk district.. It was held on Wednesday, September 30, 2020, at the Job Training Center Building of the Nganjuk district.
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Mental Health Disorders Rise sharply during the COVID-19 pandemic?
Author : Wayan Suriastini, Bondan Sikoki dan ListionoTuesday, 21/07/2020
COVID-19 gives multiple stress to people's lives. Starting from fears of contracting COVID-19, worrying about dying and losing family members and friends to stress due to layoffs and decreased income. On the other hand, media reports that constantly give insight of the numbers and circumstances patients regarding of illness and death add to fear and stress. Therefore people who did not experience anxiety or depression before the pandemic become overly worried and depressed at the time of the pandemic.
The above condition is a global picture from the results of an online survey about the Impact of the Covid-19 Pandemic on Mental Health Conditions conducted by SurveyMETER at the end of May 2020. The level of anxiety and depression based on demographic, geographic, social and economic conditions is correlated with changes in work status and changes in income during the COVID-19 pandemic.
More specifically, women experience higher levels of anxiety than men. The higher the education level of the respondents the lower the anxiety level. Respondents domiciled in the provinces with the top 5 highest number of COVID-19 cases before the survey were conducted (ie DKI Jakarta, West Java, Central Java, East Java and South Sulawesi), experienced a higher level of anxiety compared to other provinces.
The level of general anxiety (GAD) has the same pattern as depression. The correlation between the two is quite high and significant, reaching 0.76. As many as 58% of respondents reported depression. Similar to anxiety disorders, more women experience depression compared to men.
To find out more complete the results of the study including recommendations to the government and all of us, please download and read the results of the study in the form of a Research Brief here.
Survey on the Impact of the Covid-19 Pandemic on Mental Health Conditions Phase 2
The Covid-19 pandemic in Indonesia has been running for five months and certainly affects the mental condition of the Indonesian people.
The Fate of the Elderly Posyandu During the Covid-19 Pandemic
Friday, 10/07/2020YogyakartaHendri Setyo Nugroho, S.H., M.I.P.
Time is rolling past the fourth month since the Covid-19 case was first discovered in Indonesia. Based on data collected, the highest percentage of deaths due to Covid-19 in Indonesia was experienced by the age group ≥ 60 years. As we know, the elderly are one of the vulnerable and easily exposed groups of Covid-19.
Then how does the elderly posyandu play a role in the middle of a pandemic? The government is currently trying to break the chain of transmission of the Corona virus. The call for physical distancing, work, study and worship at home continues to be echoed. All activities that create crowds should be avoided including elderly posyandu activities. The role of posyandu elderly through cadres is very important to always monitor the condition of the elderly.
Although the Posyandu for the elderly was temporarily inactive, the role of cadres is still ongoing. The cadre's role is to provide information to the elderly about healthy living behavior and maintaining health during the pandemic. This information is given when the cadre meets with the elderly on the street or in the mosque. The cadres also distributed masks to the elderly, both of which were bought from posyandu’s fund and from the help of other institutions. Another important role is cooperation between stakeholders, such as with the RT. Because the coverage area is small and close together, it will be easier to monitor the condition of the elderly.
Then do the elderly feel the effects of the Covid-19 pandemic? The social impact is felt by the elderly in the absence of an elderly posyandu, which in turn reduces psychological health. Elderly Posyandu activities not only maintain physical health to always be in shape, but it is also a place to meet with peers, the elderly can communicate with each other. During this pandemic they felt lonely because they could not meet each other.
In addition to social impacts, the economic impact is also felt by the elderly. As experienced by Mbah Marto (70) who usually sells rice at Yogyakarta City Gede Market. But during the pandemic he is no longer dared to go to the market. He only sells rice at home which results in reduced income. The same story is also experienced by many other elderly who are in the same fate with Mbah Marto.
Another impact that is no less important is the low level awareness of the elderly to protect themselves during this pandemic. A concrete example is seen when the elderly do the activity outside their home, many do not use masks. And a lot of them still ask why they have to wear a mask, why they have to stay at home.
Elderly families themselves cannot convey information clearly, many elderly do not watch the news on television, posyandu cadres cannot play a large role in this situation. This proves that the information they received about Covid-19 is still lacking while they are vulnerable to contracting it.
What needs to be done to help the elderly affected by Covid-19?
The elderly are the groups that need special attention. In accordance with the mandate of the "Guidelines for the Protection of the Elderly" by the KPPPA, the role of the elderly posyandu cadre at the community level is needed to help overcome the problems faced by the elderly during the Covid-19 pandemic by involving and cooperating across sectors.
Posyandu cadres hope for assistance in the form of groceries and nutritious food. Elderly is still lacking attention, there is no specific assistance targeting them. Other assistance received by the elderly is cloth masks, basic necessities, hand sanitizers. However, this assistance has not yet been received by all the elderly in posyandu. It is hoped that if it distributes assistance the village government can work together with Posyandu cadres in its distribution.
It is also important to consider how the elderly can get precise and clear information about Covid-19. According to posyandu cadres, they should be given information from competent sources, such as officers from the puskesmas. But in a pandemic like this, health workers already have many tasks to deal with patients at the forefront. One wise step that can be taken is to document information about Covid-19 from various trusted sources such as those published by the relevant ministries.
The village government can help coordinate documentation, then convey it through youth clubs, RT, RW, or posyandu cadres. Cadres with extensive networking will convey information to the elderly. Also involve families and the community to actively explain information about Covid-19 to the elderly. In line with the general guidelines for dealing with Covid-19 issued by the Ministry of Home Affairs, ensure that the elderly obtain awareness and personal protection related to Covid-19.
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* The article was first published in Bahasa, in the rubric "INSPIRATION FOR POLICY" SKH Kedaulatan Rakyat, Friday Edition July 10, 2020.
‘Negative COVID-19 but positive pregnancy’: Best to delay new baby
Tuesday, 07/07/2020Dwi Oktarina, S.Si., M.P.H.
As more people stay home during this pandemic, concerns of rising numbers of pregnancies have emerged. West Java Governor Ridwan Kamil recently posted on his Instagram account a screenshot of an article relating to an increase in pregnancies in Cirebon regency, and urged men to “take it slow” with their wives. “Negative COVID-19 but positive pregnancy,” Ridwan posted.
Limited access to health services during this pandemic has led to worries that less people are receiving contraceptives. According to the National Population and Family Planning Board’s (BKKBN) latest figures, 28 million Indonesian couples receive contraception services. However, the board noticed a 20 to 30 percent decline in recipients from February to March, with variations among provinces.
Concerns of a baby boom and population increase are not the only reasons experts are advising couples to delay pregnancies. Head of BKKBN, Hasto Wardoyo, said pregnant mothers were vulnerable during the first trimester and tended to have health discomforts such as nausea. Their immune systems are also weaker than usual, and thus they are at increased risk of infection. We have yet to fully understand the effects of COVID-19 infection on fetuses, nor the effects of medication on the infected mother and fetus.
Pregnant mothers also face more restrictions in prenatal check-ups during the pandemic. Well before the pandemic, Indonesia’s maternal mortality rate was already a major issue, with a high national rate of 305 per 100,000 live births.
Many factors related to the virus remain unknown. While researchers are still striving to discover a vaccine, a few cases of newborns being infected with the virus have been reported. In Wuhan, China, where the world’s first cases were found, a newborn became the youngest individual to be infected with the SARS-CoV-2 virus, reports in early February said, similar to another newborn in mid March in London. The mother in Wuhan had tested positive for COVID-19 before delivery.
Transmission of the virus to newborns is still a matter of speculation, as it is unknown if it occurs in the womb, or is transmitted during delivery or soon after birth as a result of close contact with the mother. A Canadian baby was tested several times following birth in mid May, and its nasopharyngeal swab, plasma and faeces were found to be positive. Yet, the baby was delivered through caesarean section, which means the newborn was protected from vaginal secretion and the amniotic membrane was unharmed. In addition, a sample from a nasopharyngeal swab was taken before the baby had skin contact with the mother. Doctors suggested transmission was likely to occur inside the womb, reports on May 16 said.
However, The Lancet journal recently published a study on nine pregnant women with COVID-19 suggesting that intrauterine transmission was highly unlikely. The samples of amniotic fluid, umbilical cord, breastmilk and the newborns’ throat swab had tested negative for the virus.
In terms of nutrition, the pandemic may limit a mother’s choice of nutritious food, with many families facing increasingly lower incomes. Unmet nutritional needs during pregnancy may impair a newborn’s growth and development. This may lead to stunting, which is already a major national health problem.
The BKKBN has deployed field counselors to provide services to couples through home visits. It also plans to provide contraceptives to 1 million recipients in June. The program is aimed at increasing contraceptive use among those who have stopped using contraceptives during the pandemic.
Despite the government’s efforts, it is still missing the urgent need to target the many more people who are staying home. More educational campaigns are needed to advise couples to delay pregnancies through media such as television and radio. The latter medium would target audiences in more remote areas where television transmission is limited.
Although the health system is overwhelmed in this time of pandemic, extra efforts can be made by empowering and strengthening midwives as counselors in educating couples to delay pregnancy. The National Midwives Association (IBI) lists more than 300,000 midwives in 34 provinces. It would surely be challenging, but small efforts in delaying pregnancies can help to lessen the burden on healthcare providers as well as on mothers and their families during the pandemic.
Volunteers from the nation’s village and subdistrict-based women’s and family welfare groups (PKK) can also be empowered. Volunteers across the country have been mobilized to distribute food assistance to eligible households in their community. They can also help raise awareness among mothers and young couples about maternal health and the importance of avoiding pregnancy during the pandemic by relaying the right information with pamphlets or posters while distributing food supplies.
Every woman has the right to be pregnant and bear a child and every child has the right to grow up healthily in the best possible environment. Still, in this time of uncertainty and limitations, it would be wise to delay pregnancy and wait until the pandemic has subsided. Decisions should be taken with caution, taking into account not only the mothers’ health, but also that of the baby, the wellbeing of the family and the capacity of the health system.
*This article was first published in:
Little Acts of Kindness for Older People in a Pandemic Situation
Monday, 06/07/2020SurveyMETERAstrid Nikijuluw, Bach. Of Business., M.M.
The COVID-19 pandemic has influenced our social system and make the world in a standstill. In Indonesia, as of June 19, 2020, the number of COVID-19 cases reached 43,803. Of these, 14% were elderly (aged 60 and older) and 44% of the mortality rate (2,373 cases). This shows that the highest number of deaths was experienced by the age group ≥ 60 years.
As we get older, our immune system weakens. This makes the elderly more vulnerable to all types of infections. Therefore, it is very important to support and protect the elderly during this pandemic, especially those who live alone. The government must be supported to provide interventions to ensure the elderly get what they need. This support can include nutritious food, basic needs such as food, medicines to support physical health and access to social and mental health support.
In the Special Region of Yogyakarta, as the province with the highest life expectancy in Indonesia, several actions and activities have been taken by various parties in supporting the elderly during the pandemic. We also try to do small activities according to our capacity as a research institution.
Our small activity was a documentation interview about Posyandu service initiatives and breakthroughs by elderly Posyandu cadres during the pandemic in 5 regencies / cities, namely Bantul, Gunungkidul, Kulon Progo, Sleman and Yogyakarta. In the interview we found that among their small activities during the pandemic included distributing masks and knowledge through flyers and posters about how to wear masks and wash hands properly.
In one village in Kulon Progo Regency, an initiative from an elderly posyandu cadre that was quite solutive was to encourage the elderly to continue to carry out additional activities such as gardening. Apart from living in the village and generally their profession is farmers, gardening activities can help economic and social conditions and maintain their immunity. Thus, during these activities they can also interact with each other while still observing the health protocol.
In another village in Bantul Regency, the village youth organization took the initiative to collect funds from local residents that were used to buy food that would be distributed to underprivileged people, including the elderly.
From the small interview activities during the pandemic, there are actually many lessons that we can learn. That the small concern of people in all sectors and ages can have a big impact on the health and happiness of others. We need to realize that the responsibility to maintain a healthy and safe environment rests with all of us. As President Joko Widodo said on Monday 18 May 2020, the most effective way to control the spread of Covid-19 was at the lowest community unit. We will be able to overcome this pandemic, but for that we must make active efforts to stay healthy both mentally and physically for ourselves and for those around us, including the elderly.
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Thus a glimpse of the lessons we learned from our documentation. We also write notes in another version in the Active Aging Consortium Asia Pacific (ACAP) Bulletin June-July 2020 Edition (pp. 10-11), with the hope of learning from society and the global community. The full note can be read and downloaded here.
Impact of Covid-19 on Child Education
Friday, 03/07/2020SurveyMETERSetyo Pujiastuti, S.Sos., M.Si.
At present the world is stirred by the Corona Virus outbreak or COvid-19, Indonesia is no exception. The Indonesian government has taken a number of policies to break the chain of transmission of Covid-19. Its main policy is to prioritize people's health and safety. Work, worship and study from home.
UNESCO said that Pandemic Covid-19 threatened 577,305,660 students from pre-primary to high school education and 86,034,287 students from tertiary education worldwide. Like the policies adopted by various countries affected by Covid-19 disease, Indonesia closed all education activities. This makes the government and related institutions present alternative educational processes for students by learning from distance or study from home with the assistance of parents.
The implementation of long-distance teaching and learning policies from home or online learning does not seem to be a problem for some universities that already have online-based academic systems. It became a problem for some other universities that do not have the system.
At the level of primary, secondary and higher education technically the distance learning process also experiences many obstacles. Students from families who do not have internet access or even do not have mobile phones would likely miss learning when learning assignments are delivered through the WhatsApp application or others. Preparing for such conditions, the school should provide policy, for example by giving assignments in the form of working papers.
Another impacts felt by students from learning from home is too much learning burden. At the same time students are required to be able to examine and learn the material themselves quickly. Even if given a time to ask the teacher through the message via WhatshApp application it was still felt not enough time. And, the most easily observed by students' parents, teaching and learning from home also makes students easily bored because they cannot interact directly with the teacher and their friends.
Therefore, by learning from home, parents are required to maximize their role in accompanying their children. Especially if they are still in elementary preschool and elementary school. Because at their age, their nature is unique, energetic, active, spoiled and ego-centric (ego is high). This is where parents should be able to explore the character of their children so that the learning process from home takes place well and fun.
Learning from home allows some parents to experience stress in accompanying children if they do not understand the child's character. Parents feel that children are difficult to manage, just want to play, and lazy. In addition to dealing with children's behavior in accompanying learning at home, parents are also demanded to be able to explain many things related to the subject matter, while not all parents are ready for it. Not to mention if they have many children and parents have to work to make a living, parents become more dizzy.
It is not uncommon to find parents providing assistance to their sons and daughters by means of a hard, threatening, forced will, or even by hitting if the child does not comply. If this happens every day then it will be a scourge for children in learning, even though the parents' goals are good so that the child is disciplined and smart. Such parenting will shape children to be timid, shy, quiet, fond of breaking rules, vindictive and lacking in initiative.
Therefore parents must be careful in approaching when accompanying study at home. Parents should be able to treat children with affection, patience, accept children as they are, do not judge, do not force the will, give freedom and respect, and tolerance of their children. Thus the frightening specter of education will not be found otherwise it will create a pleasant learning atmosphere while studying at home.
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The article was first published in Bahasa, in the rubric "INSPIRATION FOR POLICY" SKH Kedaulatan Rakyat, Friday Edition July 03, 2020.
Prevalence and Risk Factors of Dementia and Caregiver’s Knowledge of the Early Symptoms of Alzheimer’s Disease
The number of people with dementia in Indonesia is projected to increase significantly. However, there are no valid data that explain the prevalence of dementia. The study, which was carried out in the Special Province of Yogyakarta in December 2015, is the first study to find the prevalence, risk factors for dementia and to describe caregiver knowledge about early symptoms of Alzheimer's disease (AD).
Pandemic and Environment Burden
Friday, 26/06/2020YogyakartaIka Yulia Wijayanti, S.E., M.Sc.
Regional quarantine and activity restrictions in response to the Covid-19 pandemic had a positive impact on improving air quality globally. However, the real pandemic shows the fundamental problems being faced by the environment.
For example, Jakarta had experienced a decrease in levels of carbon dioxide (CO2) sourced from motor vehicles during the period from February to March. Unfortunately, this only lasted a short time. Motor vehicle congestion with the introduction of new normal conditions will bring CO2 levels back to the normal range.
Improved air quality during the quarantine of the region is difficult to maintain for longer because the changes that occur are not structural in nature such as the shift in the use of fossil-based high energy pollutants to energy sources that are more environmentally friendly. The fall in world oil prices due to reduced demand also confirms this fact.
Even if the reduction in pollution levels can be maintained, the benefits will be far greater. Research by Marshall Burke, a Stanford University professor, shows that decreasing air pollution during regional quarantine will save humans from premature deaths due to pollution exposure in greater numbers than deaths caused by Covid-19 in China. The results of the study are expected to be an evaluation of human behavior in normal conditions that burden the environment.
During the pandemic, the movement to reduce plastic waste tends to be ruled out because of people's fear that the virus can survive on certain objects for some time. The use of masks and disposable gloves by the general public also contributes to increasing household waste.
Meanwhile, the handling of Covid-19 patients has consequences for the abundance of medical waste. The Indonesian Ministry of Environment predicts an increase in infectious waste by 30 percent compared to pre-pandemic conditions. In the midst of the lack of hazardous waste treatment facilities such as incinerators, the increase in medical waste in Indonesia has the potential to cause serious problems such as the processing of illegal medical waste.
If examined further, the mystery of the cause of the pandemic is very likely related to the current environmental crisis. Covid-19 became a global pandemic because of its rapid transmission from human to human through fluids (droplets). However, according to the World Health Organization (WHO) collaborative mission report and the Chinese Government, SARS-CoV-2 as a trigger for Covid-19 is a zoonotic virus. That is, the virus was initially transmitted from animals to humans.
The emergence of zoonotic viruses is closely related to environmental ecosystem conditions where humans and animals share a place of life. Damaged biodiversity and climate change encourage the emergence of pathogens that are increasingly strong due to the process of adaptation to environmental pressures. Meanwhile, wildlife contact with humans increases the potential for human transmission.
New normal for the environment
The experience of fighting new diseases, for a moment feeling changes in pollution levels, and the potential increase in waste that must be managed should raise awareness of the impact of the environmental crisis and what to do in the future. A number of steps need to be considered so that the environment can enjoy a better new normal.
First, changes in production and consumption behavior to achieve continuous improvement in air quality. Efforts to find environmentally friendly energy to replace high energy pollutants need to be prioritized as a long-term investment. Meanwhile, the management of industrial pollutants and the provision of public transportation to reduce the use of private vehicles is quite urgent to do.
Second, the treatment of rubbish and waste, both medical waste and household waste. The movement to reduce plastic waste must continue to be carried out by the whole community while maintaining hygiene. The data collection of people undergoing isolation at home should be followed by a mechanism for collecting household waste that is potentially dangerous if managed under normal conditions. Of course this must also be accompanied by an increase in the capacity of medical waste treatment through incinerators and other alternative processors to be able to meet the needs of waste treatment from health service facilities and household waste at risk.
Third, maintaining the health of ecosystems, among others, by allowing wild animals to remain in their habitats and maintain the biodiversity that supports them. Regulation and law enforcement related to wildlife trade and land use play an important role in minimizing the possibility of contact with humans.
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The article was first published in the rubric "INSPIRATION FOR POLICY" SKH Kedaulatan Rakyat, Friday Edition June 26, 2020.