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Digital transformation in public services represents a strategic shift in integrating information technology into governmental administrative systems to enhance service efficiency, transparency, and accountability. One prominent innovation in this effort is the adoption of electronic land certificates initiated by the Ministry of Agrarian Affairs and Spatial Planning/National Land Agency (ATR/BPN) as part of land service modernization. This policy is formally regulated under Ministerial Regulation No. 3 of 2023 concerning electronic documents in land registration. This study employs a descriptive qualitative approach to examine the implementation process, identify enabling and constraining factors, and assess the impact of electronic land certificates on the quality of land services. Data were obtained through interviews, field observations, and document analysis at the Tulungagung Regency Land Office and analyzed using the interactive model proposed by Miles and Huberman. The findings indicate that electronic land certificates contribute significantly to improving service efficiency, administrative speed, and data security. Nonetheless, several challenges persist, including inadequate network infrastructure in rural areas, limited public digital literacy, and insufficient information technology personnel. Despite these constraints, the initiative has been positively received and reflects the local government’s commitment to advancing digital governance and good governance principles. The effectiveness of this transformation largely depends on institutional readiness, technological support, and community engagement.

Decision-making under uncertainty is a major challenge in management, economics, and public policy, where outcomes cannot be accurately predicted due to limited information and environmental dynamics. This article conducts a systematic literature review of risk and probability approaches to decision-making under uncertainty, focusing on rational theory synthesis (such as expected utility theory, decision tree analysis, and Bayesian decision theory) and behavioral perspectives (prospect theory and heuristics). The review covers reputable literature from the last ten years to the present. The results show that the probabilistic approach provides a strong and adaptive rational framework, but has significant limitations due to cognitive biases such as loss aversion, overconfidence, and ambiguity aversion, which cause deviations from normative rationality. The integration of rational approaches with behavioral elements, through hybrid models, has proven to be more comprehensive and realistic for dealing with true uncertainty (Knightian uncertainty). These findings emphasize the need for a multidimensional decision-making paradigm in organizational and policy practices.

The use of information technology is a crucial element in improving the effectiveness of village government administration. One implementation of e-government at the village level is the use of the Village Apparatus Information System (Sipede) as a medium for managing village apparatus data. This study aims to analyze the effectiveness of Sipede's implementation in supporting village apparatus data management in Candi District. The study used a descriptive qualitative approach with data collection techniques through in-depth interviews, observations, and system document reviews. Data analysis was conducted using the Agile Response in E-Governance framework, which includes nine effectiveness indicators: Ease of Use, Usefulness, System Quality, Technology Mindfulness, Software Reliability, Communication Transparency, Trust, Collaboration Efficiency, and Traceability. The results show that Sipede is quite effective in improving data accuracy, information integration, and coordination between government agencies. This effectiveness is evident in the ease of use of the system, the clarity of the workflow, and the level of apparatus trust in the data generated. However, the use of Sipede still faces obstacles in the form of limited system access and suboptimal usage practices. Therefore, efforts are needed to develop systems and increase user capacity to support more accountable and sustainable village apparatus administrative governance.

Social protection programs in Indonesia play a strategic role in poverty alleviation and supporting economic development. One form of social protection implementation at the regional level is the Depok Prosperity Card (KDS) Program, implemented by the Depok City Government as a means of ensuring food security for underprivileged communities. However, the program's implementation has been deemed incompletely transparent and poorly targeted, as expressed by several members of the Depok City Council (DPRD). Therefore, this study aims to analyze the implementation of the city's food security policy through the Depok Sejahtera Card Program in Tanah Baru Village, Depok City. This study uses Charles O. Jones's policy implementation theory, which encompasses three main indicators: organization, interpretation, and implementation. The research method used is descriptive with a qualitative approach. The results indicate that, from an organizational perspective, the Depok Sejahtera Card Program has been implemented quite well, characterized by a clear division of tasks among relevant stakeholders. From an interpretive perspective, the program has a strong legal basis through Depok Mayor Regulation Number 79 of 2022 and aims to reduce poverty. However, various obstacles remain in the implementation aspect, resulting in program implementation not being optimal and efficient. Nevertheless, the program is considered beneficial for recipient communities, although an increase in the amount of assistance is still needed to meet food needs for a period of one month.

The circulation of illegal cigarettes constitutes a serious problem that results in state financial losses and disrupts legal certainty in the excise sector. Although criminal provisions related to the circulation of illegal cigarettes have been explicitly regulated in statutory laws, law enforcement practices demonstrate a tendency to apply administrative sanctions rather than criminal sanctions. This study aims to analyze the regulation of criminal law concerning illegal cigarette circulation and to examine the implications of the dominance of administrative sanctions on the effectiveness of criminal law. The research employs a normative juridical method using statutory and conceptual approaches through library research on primary and secondary legal materials. The findings indicate that the main problem does not lie in the absence or contradiction of legal norms, but in the emergence of vague norms at the implementation level due to inconsistent application of criminal sanctions. This condition weakens legal certainty, reduces the deterrent effect of criminal law, and undermines the protection of public interests. This study emphasizes the importance of consistent application of criminal sanctions to ensure that criminal law functions effectively in addressing illegal cigarette circulation.

The research approach used in this study is qualitative descriptive, aiming to provide a clear and systematic description of the existing conditions related to village financial management. This research was conducted in Serba Jadi Village, Sunggal Subdistrict, Deli Serdang Regency, as a case study to understand the implementation of financial management at the village level. The type of data used in this study is secondary data obtained from official village documents, reports, and other relevant administrative records. Data collection techniques include observation and documentation, which were carried out to ensure the accuracy and completeness of the information analyzed. The data analysis technique employed is descriptive research, which functions as a systematic method of thinking or review to describe, interpret, and present conditions that occurred during the research period. The analysis focuses on assessing financial performance using efficiency and effectiveness indicators. The results of the study indicate that the Efficiency Ratio shows the financial management of Serba Jadi Village falls into the category of inefficient, reflecting the imbalance between costs incurred and outputs achieved. Meanwhile, the Effectiveness Ratio demonstrates that the financial management of Serba Jadi Village is categorized as effective, indicating that revenue targets and planned objectives were generally achieved despite efficiency limitations.

Article 170 paragraph (1) of Law Number 1 of 2022 concerning HKPD emphasizes the synchronization of fiscal planning and policy for integrated national development. However, in the APBA (Aceh Provincial Budget) planning, discrepancies persist between the Aceh Government’s documents and the central fiscal policy direction, leading to synchronization that remains administrative rather than substantive. This issue is further complicated by Aceh's special status under Law No. 11 of 2006, which results in differences in macro indicators, program structure, and a lack of substantive participation from Aceh, creating epistemological inequality and structural injustice in central-regional financial relations. The research aims to understand why APBA management planning is not fully synchronized with government policy and to explore the ideal procedure for achieving synchronization, considering Aceh’s unique autonomy. This study is a normative juridical analysis using a legislative, conceptual, historical, and futuristic approach, with the application of authority theory, policy suitability theory, asymmetric decentralization theory, and good governance principles. The findings reveal that the lack of synchronization is caused by procedural issues, such as the absence of integration between RKPD (Regional Government Work Plan) and RKP (National Government Work Plan) schedules, the lack of a mechanism for reducing KEM-PPKF indicators, unclear fiscal support evaluation, and absence of guidelines and sanctions. Additionally, there are substantial issues like the incompatibility of Aceh's macro indicators with national targets. To achieve ideal synchronization, normative legality, equal central and regional authority, and integrated planning systems are needed.

Postpartum depression is a mood disorder that occurs in mothers after childbirth, with symptoms that can appear from pregnancy until 4 weeks postpartum. This condition negatively impacts the psychological health of the mother and the development of the baby. This study aims to analyze factors associated with the risk of postpartum depression. The method used was quantitative with an analytical survey design through a cross-sectional approach. Data collection was carried out using the Edinburgh Postnatal Depression Scale (EPDS) questionnaire consisting of 10 questions. The results of the validity test showed a calculated r value of > 0.3610 and the reliability test obtained a Cronbach's alpha value of 0.67. The study sample consisted of 42 respondents selected using a total sampling technique, with inclusion criteria of mothers aged ≥18 years, in the period <6 weeks postpartum, and willing to be respondents. Data analysis used the chi-square test. The results showed that all variables had a significant relationship with the risk of postpartum depression (p < 0.05). These variables include age (p=0.040), education (p=0.018), occupation (p=0.011), history of depression (p=0.024), complications (p=0.017), economic status (p=0.048), parity (p=0.016), type of delivery (p=0.006), husband's support (p=0.000), and family support (p=0.028). Therefore, it can be concluded that demographic, obstetric, and social support factors play an important role in the risk of postpartum depression. These results are expected to form the basis for prevention efforts and early intervention to improve postpartum maternal mental health.

Background: Compliance with routine infant immunization is essential for the success of vaccination programs and the prevention of vaccine-preventable diseases. However, adherence to immunization schedules remains suboptimal due to limited parental knowledge, concerns about vaccine safety, and the limited effectiveness of conventional health education. Audio-visual media offer a promising solution by delivering information in a more engaging, clear, and consistent manner. Objective: This study aimed to evaluate the effectiveness of audio-visual educational media in improving adherence to basic immunization among infants in the service area of the Rum Balibunga Community Health Center. Methods: A quasi-experimental design with a one-group pretest-posttest approach was used. The sample included 40 mothers with infants aged 0-12 months selected through purposive sampling. Participants received an educational video on basic immunization. Adherence was assessed before and after the intervention based on completeness and timeliness according to the national schedule. Data were analyzed using univariate and bivariate methods, with the McNemar test for paired categorical data. Results: There was a significant improvement in immunization adherence after the intervention. Statistical analysis confirmed a meaningful difference before and after exposure, indicating the effectiveness of audio-visual media. Conclusion: Audio-visual education is an effective strategy to improve infant immunization adherence and can be widely applied in primary healthcare settings.

Background: Most premature infants experience feeding difficulties, including difficulty getting food into their mouths, limited oral capacity, and impaired tongue movement in transferring the bolus toward the posterior part of the oral cavity. This condition underscores the need for special attention in the care of premature infants, particularly in meeting their nutritional needs, which play a crucial role in supporting growth and survival. Purpose: To implement oral motor stimulation interventions for premature infants with feeding problems in the Perinatology Room of Charitas Hospitals Palembang. Method: This case study was conducted on 3 premature infants who received oral motor stimulation interventions for 3 days, with a training frequency of 2 times a day, morning and evening, for 15 minutes. Results: After oral motor stimulation interventions were performed on the three premature infants, good improvement data were obtained, namely in the strength of sucking and swallowing reflexes, and improvement in sucking movements as preparation for the transition from enteral to oral feeding. Conclusion: Providing oral motor stimulation interventions to premature infants helps improve their feeding abilities by enhancing sucking and swallowing reflexes and supporting optimal nutritional intake.

Indonesia, as a country with a high level of disaster vulnerability, faces an increased risk of communicable diseases during the emergency response phase due to disrupted sanitation, limited access to clean water, overcrowded evacuation shelters, and weakened health services. This study aims to analyze the strategic role of health workers in health education and the prevention of communicable diseases during disaster emergency response. The method used is a literature review of relevant national and international scientific articles. The findings indicate that health workers have a multidimensional role, not only as providers of curative services but also as educators, change agents, advocates, and collaborators in promotive and preventive efforts. Effective health education, participatory risk communication, strengthened epidemiological surveillance, and the implementation of Infection Prevention and Control (IPC) are key strategies to reduce the risk of communicable disease outbreaks. However, implementation in the field still faces challenges, including limited resources, cross-sectoral coordination constraints, heavy workloads, and suboptimal disaster-related policy systems and standard operating procedures (SOPs). Therefore, strengthening the capacity of health workers through training, policy support, and community-based approaches is necessary to enhance health system resilience in responding to disaster crises.

Nutritional problems in adolescents are complex, as evidenced by the high rate of iron deficiency anemia, especially among girls (23%), as well as malnutrition and overnutrition. According to SKI (2023), nutritional problems in adolescents include thinness and extreme thinness reaching 7.6%, while adolescents who are overweight reach 12.1%, and those who are obese reach 4.1%. The objectives are to determine the knowledge of balanced nutrition and eating habits of students in their daily lives and to identify the relationship between knowledge and eating habits with nutritional status. This study used a cross-sectional design with a population of 45 students from the Midwifery Study Program at Harkat Negeri University. The sampling technique used was total sampling. The research instrument was a questionnaire distributed via Google Form, while nutritional status was obtained by measuring BMI. Univariate and bivariate analyses were used. The majority of respondents were aged 20 years (44.5%), had good nutritional knowledge (59.1%), poor eating habits (63.6%), and normal nutritional status (68.2%). In the bivariate analysis, there was no significant relationship between nutritional knowledge and eating habits with the nutritional status of students (p-value >0.05). Conclusion The majority of students had good understanding of nutrition, but not of eating habits. It is hoped that students can maintain eating habits with balanced nutrition in order to achieve normal nutritional status. Keywords: Nutrition Knowledge; Eating Habits; Nutritional Status

This meta-review evaluates the effectiveness of diverse mental health programs targeting Syrian refugees in Turkey over the period 2015-2023 through a systematic synthesis of 47 studies involving a total of 12,847 participants. Meta-regression results demonstrate a statistically significant reduction in Post-Traumatic Stress Disorder symptoms, with a large effect size (d = -0.86, 95% CI [-1.02, -0.70], p < .001), as well as a significant reduction in depressive symptoms (d = -0.72, 95% CI [-0.88, -0.56], p < .001) following intervention. Among the therapeutic approaches examined, Cognitive Behavioral Therapy exhibited the strongest therapeutic effect (β = 0.45, p < .001), followed by Eye Movement Desensitization and Reprocessing (β = 0.38, p < .001). Further moderator analysis revealed that group-based interventions were more effective than individual approaches (OR = 1.86, 95% CI [1.42, 2.30]). At the same time, program duration of 12-16 weeks showed a strong correlation with optimal clinical outcomes (r = 0.67, p < .001). These findings extend the results of Acarturk et al. (2022) regarding the effectiveness of CBT and reinforce the argument advanced by Shehadeh et al. (2016) concerning the superiority of group-based approaches, while also indicating a longer optimal intervention duration than previously reported. In contrast to the meta-analysis by Antuña-Camblor & Hernández (2025), which emphasized EMDR, this study identifies CBT as superior to EMDR among Syrian refugees in Turkey. The novelty of this study lies in its comprehensive analysis of program moderator factors and the identification of the most effective intervention duration parameters for the target population.

This study examines the transformation of family structures among Syrian refugees in Gaziantep, Turkey, using a meta-synthesis of 47 studies published between 2015 and 2024. The research focuses on changes in relational, economic, and normative aspects due to prolonged displacement. The findings reveal significant shifts in family dynamics, with 73.8% of families redefining traditional gender roles and 64.2% of women becoming the primary breadwinners. The divorce rate increased by 42.6%, with 38.7% of cases linked to economic pressures. Logistic regression shows a strong correlation (r = 0.78, p < 0.001) between displacement duration and family structure transformation. The study supports Heger, Boyle, and Ali’s (2010) argument about the fluidity of gender roles in forced migration but challenges Buscher’s (2011) view on the persistence of patriarchal structures. Additionally, 82.3% of families adopted more egalitarian parenting, and children's participation in education rose to 67.4%, reducing the gender gap to 8.2%. The study also identifies adaptive strategies, such as the use of communal support systems by 58.6% of families and the integration of local cultural values by 45.2%, offering insights into resilience and adaptive capacity in prolonged crises.

The postpartum period is a critical transitional phase during which women are vulnerable to psychological disturbances, particularly postpartum depression. Psychological distress may undermine maternal confidence, including the perceived ability to breastfeed effectively. This study aimed to examine the relationship between breastfeeding self-efficacy and postpartum depression among postpartum mothers. A quantitative cross-sectional design was employed involving 45 respondents selected through total sampling. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS), while breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale-Short Form (BSE-SF). Data were analyzed using Spearman’s Rank correlation test with a significance level of 0.05. The results demonstrated a statistically significant and strong negative correlation between breastfeeding self-efficacy and postpartum depression (r = –0.616; p < 0.05). Mothers with higher depressive symptoms tended to report lower levels of breastfeeding self-efficacy. These findings highlight the importance of integrating mental health screening and breastfeeding support into postpartum care to strengthen maternal confidence and improve breastfeeding outcomes.  

Background: The Maternal and Child Health (MCH) Book plays an essential role in enhancing pregnant women's knowledge of pregnancy health and labor preparation. However, its utilization remains suboptimal, which may affect a mother's readiness for childbirth. Objective: This study aims to analyze the relationship between pregnant women's knowledge of the MCH Book and their birth preparedness at the Mamajang Health Center in Makassar in 2025. Method: This research employs a quantitative design using purposive sampling with 86 pregnant women as respondents. Data were collected using a knowledge questionnaire about the MCH Book and a birth preparedness questionnaire. Data analysis was conducted using the Chi-Square statistical test. Results: The majority of pregnant women demonstrated good knowledge of the MCH Book (75.6%) and were categorized as prepared for childbirth (70.9%). Statistical testing indicated a significant relationship between pregnant women's knowledge of the MCH Book and their birth preparedness (p = 0.001). Conclusion: There is a significant relationship between pregnant women's knowledge of the MCH Book and their birth preparedness at the Mamajang Health Center in Makassar. Health workers are expected to enhance education and optimization of MCH Book utilization to support birth preparedness.

Background: Breastfeeding is a crucial practice that provides optimal nutrition and immunity for infants while supporting maternal health. However, inadequate knowledge and limited understanding about the importance of breastfeeding often lead to low motivation among pregnant women in preparing for breastfeeding. Providing structured education is expected improve pregnant women’s readiness and commitment to breastfeeding after childbirth. Objective: This study aimed to determine the effect of providing education about the importance of breastfeeding on the motivation of pregnant women in preparing to breastfeed at the Paguat Community Health Center UPTD. Methods: This study employed a pre-experimental design with one-group pretest–posttest approach. A total of 30 pregnant women were selected as the sample using purposive sampling techniques. Data on mothers’ motivation to prepare for breastfeeding were collected before and after the educational intervention using a structured motivation questionnaire. The data were analyzed using the Wilcoxon signed-rank test to assess differences in motivation levels before and after the intervention. Results: The results of the Wilcoxon signed-rank test showed a p-value of 0.000 (p < 0.05), indicating a statistically significant effect of breastfeeding education on the motivation of pregnant women in preparing breastfeed. The findings demonstrate that educational interventions significantly increased maternal motivation following the provision of education. Conclusion: Providing education about the importance of breastfeeding has a significant positive effect on the motivation of pregnant women in preparing to breastfeed. Therefore, breastfeeding education should be strengthened and routinely implemented during antenatal care services to improve maternal readiness and support successful breastfeeding practices.

Background: Anxiety in postpartum mothers is a psychological problem that can negatively impact maternal mental health, marital relationships, and the lactation process. This psychological disorder can inhibit the production and let-down of breast milk, which, if not addressed promptly, can lead to physical complications such as breast engorgement or mastitis, as well as hinder the fulfillment of the infant's nutritional needs. Objective: This study aimed to determine the relationship between anxiety levels and delayed breast milk let-down in postpartum mothers at Prof. Dr. R.D. Kandou General Hospital Manado. Methods: This research is an analytical survey with a cross-sectional design. The sample consisted of 30 postpartum mothers selected using non-probability sampling. Research instruments included questionnaires and interviews, with data analysis using the chi-square test. Results: The majority of respondents experienced moderate anxiety (60.0%) and had non-smooth breast milk let-down (53.3%). Statistical test results showed a p-value = 0.030, indicating a significant relationship between anxiety levels and delayed breast milk let-down. Conclusion: High anxiety levels in postpartum mothers contribute to delayed breast milk let-down. Psychological support for postpartum mothers is needed to maintain the smoothness of the breastfeeding process.

Pregnancy is a physiological process that occurs in women, approximately 50% of women at the beginning of their pregnancy experience nausea and vomiting to varying degrees. Nausea and vomiting usually occur in the morning during early pregnancy or the first trimester, which is called morning sickness. There are many methods of treating nausea. and vomiting in pregnant women in the first trimester, both pharmacological and non-pharmacological. One non-pharmacological way is to use lemon, lavender and peppermint aromatherapy. This research method uses a literature review which includes a systematic search study of computerized databases (Google School and PubMed) taken within the last 5 years from 2019-2024. The articles obtained in the search were 12 journals, but after reviewing the articles and adjusting them to the titles, there were 5 journals. Conclusion: Lemon and peppermint aromatherapy have the same effectiveness in reducing nausea and vomiting in pregnant women, while lemon aromatherapy is more effective than lavender aromatherapy.

The high cost of colloid fluids and the large number of patients are concerns in determining which treatment standard should be chosen from several treatment alternative, where the total cost for 43 cases with a combination of crystalloid colloid fluids is IDR 209.370.993 while the total cost for 45 cases of crystalloid fluids is only UDR 146.492.268 which causes hospital losses. This study aims to determine the difference in the cost-effectiveness between crystalloid fluids and crystalloid-colloid combinations in hospitalized dengue fever patients without shock at Tangerang City Hospital. The research design used was cross-sectional with a comparative quantitative analysis method, where cost effectiveness was analyzed using the Average Cost Effectiveness Ratios (ACER) method. There were two groups of study samples: the first group, 25 patients who received crystalloid fluids, and the second group, 23 patients who received crystalloid-colloid combination fluids. This study showed a difference in the average hospitalization costs for dengue patients between crystalloid fluid therapy and crystalloid-colloid combination therapy. Hospitalization costs for dengue patients were lower in the crystalloid fluid group, with a significant difference (p=0.000). It was also found that crystalloid fluids were more cost-effective than the crystalloid-colloid combination. The implications of the study results consist of theoretical implications and practical implications. Based on the results of the analysis carried out, the crystalloid solutions are more cost-effective than crystalloid-colloid combinations. This finding can be used as a consideration in making decisions and policies that are in accordance with quality control and cost control for patients covered by the National Health Insurance (BPJS Health insurance).