Laila Mahmudah’s research while affiliated with Ministry of Health, Indonesia and other places

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Publications (2)


Visual representation of the study findings
Challenges to integrating programs for the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B into antenatal care: Experiences from Indonesia
  • Article
  • Full-text available

March 2024

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65 Reads

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2 Citations

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Virginia Wiseman

The WHO’s Asia-Pacific framework for triple elimination recommends that countries evaluate their programs for the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B (EMTCT), including identifying gaps to improve program planning and the implementation of elimination strategies in antenatal care (ANC) services. In 2022, the Indonesian Ministry of Health reported that only 39% of pregnant women were tested for HIV, 14% for syphilis, and 28% for hepatitis B, respectively. We conducted a qualitative study involving a focus group discussion (FGD) and in-depth interviews with 25 key stakeholders in Bali and West Nusa Tenggara Provinces to identify specific challenges to testing for HIV, syphilis, and hepatitis B in ANC settings. Thematic analysis was used to identify the themes generated from the data. Health system bottlenecks experienced by stakeholders included supply chain management issues involving stock forecasting and stock monitoring, stock-outs of rapid test reagents which were particularly most frequent and for longer durations for syphilis and hepatitis B, high staff turnover, lack of staff training on how to perform the test, the complexity and time needed to record the data on women’s characteristics, risk behaviours, and testing in both paper format and into the computer-based surveillance systems, discrepancies in program coverage data from different divisions of the district health office involved in the reporting system, high levels of stigma that prevented women from being followed up, challenges in notifying partners, and inadequate reporting and referral of women from private providers to public ones for testing. Interventions addressing the above challenges are worthy of consideration to improve the health system function and integrate EMTCT into the ANC settings.

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Antenatal care visit and basic characteristics of respondents
Proportion of adequate ANC according to socioeconomic status and region
Logistic regression analysis: factors associated with ANC six and eight visit
Socioeconomic Difference and Adequate Antenatal Care in Indonesia: Evidence from a Nationwide Household Survey

June 2023

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47 Reads

Open Access Macedonian Journal of Medical Sciences

BACKGROUND: Inadequate antenatal care (ANC) has been identified as a risk factor for poor pregnancy outcomes in low-income nations. The World Health Organization recommends adequate ANC for a minimum of eight visits. While universal health coverage has been implemented since 2014, Indonesia as fourth largest populous country encounters challenge on socioeconomic disparities. AIM: This study aims to explore the socioeconomic difference of adequate ANC in Indonesia. METHODS: Data from the Indonesia Demographic and Health Survey 2017 was used for the analysis and includes 15,313 mothers age 15–49 who had a last live birth in the 5 years preceding the survey. Multivariate logistic regression was employed to assess correlation between socioeconomic status and adequate ANC. RESULTS: About 20.8% of mothers had adequate ANC and the proportion ranging between 11.4% in the poorest group and 34.5% in the richest group. Poorest (adjusted odds ratio [AOR]: 0.68; 95% CI: 0.54–0.86) and poorer (AOR 0.79; 95% CI: 0.64–0.97) mothers are less likely to have adequate ANC compared to the richest mothers. In addition, mothers who lived in Java-Bali region, had better knowledge on danger sign of pregnancy, exposed to internet every day, health insurance ownerships, and having ANC at health facilities were more likely to have adequate ANC. CONCLUSION: Socioeconomic status was significantly associated with adequate ANC, where inequality was profound among poor mothers. Therefore, specific intervention to expand universal health coverage for poor mothers is essential to reduce socioeconomic disparities.

Citations (1)


... 5 Additionally, reasons for women refusing testing and medication include stigma. 15 Therefore, frontline workers may need to provide care that is sensitive to those experiencing stigma. ...

Reference:

QUALITY OF CARE AND TREATMENT ON EMERGENT THREATS FOR MATERNAL AND NEWBORN
Challenges to integrating programs for the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B into antenatal care: Experiences from Indonesia