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Chronic Energy Deficiency (CED) in pregnant women remains a major nutritional problem in Indonesia and contributes to various maternal and neonatal complications. CED reflects a long-term energy and macronutrient deficit, often influenced by inadequate nutritional intake and socioeconomic limitations. This study aims to analyze nutritional intake and economic status as risk factors for Chronic Energy Deficiency (CED) in pregnant women in the Patilanggio Community Health Center (Puskesmas) working area. This study used a quantitative observational design with a cross-sectional approach. The study sample consisted of 30 pregnant women selected using a total sampling technique. Data were collected through interviews using a respondent characteristics questionnaire and food recall to assess energy and protein intake, as well as Mid-Upper Arm Circumference (MUAC) measurements to determine CED status. Data analysis was conducted descriptively and cross-descriptively. The results showed that all respondents had energy and protein intakes below 90% of the Recommended Dietary Allowance (RDA) and all were categorized as CED based on the MUAC measurement. All respondents were also categorized as low economic status, reflecting a homogeneous socioeconomic condition. These findings indicate that CED in pregnant women at the study site is associated with inadequate nutritional intake and limited economic status. In conclusion, CED in pregnant women is a chronic nutritional problem influenced by nutritional and socioeconomic factors, necessitating comprehensive prevention and treatment efforts based on primary health care services.

Exclusive breastfeeding during the first six months of life is a key strategy for improving infant health and reducing morbidity and mortality. However, the coverage of exclusive breastfeeding remains suboptimal in many areas, often due to limited maternal knowledge, inadequate support, and insufficient lactation counseling. Intensive lactation counseling is expected to enhance mothers’ understanding, confidence, and commitment to exclusive breastfeeding. This study aimed to analyze the effect of intensive lactation counseling on exclusive breastfeeding practices up to three months postpartum at the Paguat Community Health Center (UPTD). This study employed a pre-experimental design with a one-group pretest–posttest approach. A total of 30 breastfeeding mothers were selected as participants using purposive sampling techniques. Data on exclusive breastfeeding practices were collected before and after the implementation of intensive lactation counseling using structured questionnaires and observation sheets. The counseling intervention was conducted intensively through individualized sessions focusing on breastfeeding techniques, benefits of exclusive breastfeeding, and problem-solving strategies. Data were analyzed using the Wilcoxon signed-rank test with a significance level set at p < 0.05. The results showed a significant effect of intensive lactation counseling on exclusive breastfeeding practices up to three months postpartum. The Wilcoxon signed-rank test yielded a p-value of 0.000, indicating a statistically significant improvement in exclusive breastfeeding behavior after the intervention. In conclusion, intensive lactation counseling has a significant positive effect on exclusive breastfeeding up to three months. Strengthening lactation counseling services at community health centers recommended to improve exclusive breastfeeding coverage and support maternal and infant health outcomes.

Growth and development disorders in children can have a significant impact on their overall well-being, manifesting in various forms such as delays in fine and gross motor development, speech and hearing impairments, and even intellectual disabilities. Early detection of these issues is crucial for initiating timely interventions that can improve the child's quality of life. With technological advancements, various applications have emerged, providing an accessible means for parents to independently monitor their children's growth and development. One such tool is the PrimaKu application, which enables parents to track and assess their children's growth and developmental milestones at home. The aim of this service is to empower parents by enhancing their understanding and knowledge regarding the monitoring of their children's development, thereby promoting early detection of potential growth issues. The approach utilized in this service involves providing counseling on child growth and development, alongside demonstrations on how to use the PrimaKu application effectively. A survey conducted during the service activities revealed that the majority of participants (70%) had limited knowledge about child development, while 20% demonstrated adequate knowledge, and only 10% exhibited good knowledge. These findings indicate a significant gap in parents' awareness of child development. As a result, it is recommended that ongoing educational efforts be made at posyandu centers to further educate parents about child development. Introducing the PrimaKu application at these centers could also facilitate better tracking of children's growth and developmental progress, as the app serves as a useful tool for both parents and healthcare providers in ensuring that children meet important developmental milestones. The continuous integration of technology, such as the PrimaKu app, into child healthcare services could significantly contribute to improving early intervention practices and overall child development outcomes.

Christian leadership can be understood as leadership rooted in the truth of God’s Word and exemplified through the life and ministry of Jesus Christ. In the Gospel narratives, Jesus consistently displayed leadership qualities that were grounded in service, sacrifice, humility, and the nurturing of His disciples. However, in today’s context, many church environments face a crisis of leadership characterized by corruption, arrogance, lack of integrity, and resistance to constructive criticism, all of which deviate from the biblical image of Christ as the Good Shepherd. This study aims to explore the biblical foundation of Jesus Christ’s leadership, focusing on both its character and technical dimensions as reflected in the Gospel of John, and to examine its implementation in the local ministry setting of GPdI Bethesda Kabanjahe. The research employs a qualitative method with two primary dimensions: a theological-biblical approach and a case study approach. The findings reveal that, first, the pastoral leadership model in the Gospel of John presents Jesus as the Good Shepherd who builds intimate relationships, willingly sacrifices, and develops the character of His followers. While these values are normatively acknowledged by church ministers, their implementation in GPdI Bethesda remains partial, fragmented, and not yet systematically embedded into the overall ministry structure. Second, theological reflection and practical implications highlight the urgent need for renewal that encompasses both organizational systems and the personal spiritual formation of leaders. Recommendations emerging from this study include leadership training grounded in Christlike character, developing an organizational structure that ensures regeneration, cultivating a healthy spiritual community, and contextually internalizing Gospel values into ministry practices. Strengthening these areas is essential for building authentic, sustainable, and Christ-centered leadership that responds to contemporary challenges and restores the church’s witness to the surrounding community.

Tuberculosis (TB) is a contagious illness triggered by Mycobacterium tuberculosis, with transmission influenced by not only personal behaviors but also by the physical condition of the home environment. Environmental risk factors include flooring, wall material, ceiling structure, indoor temperature, humidity levels, air ventilation, habits of opening windows, and housing density. This research aimed to explore the correlation between individual behavior and the quality of home environmental conditions with pulmonary TB incidence in the Sematang Borang Health Center’s coverage area, Palembang, in 2025. A descriptive observational design was employed, involving 91 participants from Lebung Gajah Subdistrict. The sample consisted of both confirmed pulmonary TB patients (PCR positive) and individuals without TB (PCR negative), selected through purposive sampling. Data were processed using univariate analysis to describe frequency distributions and respondent characteristics. The study found that 35.2% of respondents were diagnosed with pulmonary TB, while 64.8% were not. Most participants were between 46 and 65 years old (42.9%), predominantly female (59.3%), and had a senior high school education (40.7%). In terms of TB-related knowledge and behavior, 59.3% had good knowledge, 63.7% held a positive attitude, and 50.5% practiced proper prevention measures. Nevertheless, more than half (56.0%) of the housing conditions failed to meet health standards for a safe home environment. These findings highlight that while the community shows generally good awareness and preventive behavior regarding TB, many still reside in environments that may contribute to TB transmission. Therefore, continuous health education, proactive contact tracing, and targeted health campaigns for at-risk groups—especially among those with lower educational backgrounds—should be prioritized.

Baby massage is a form of multisensory stimulation that involves touch, movement, as well as auditory and visual stimuli, which is known to provide various physiological and psychological benefits for babies, including increased breastfeeding frequency. This study aims to determine the relationship between infant massage and the frequency of breastfeeding in babies aged 1–6 months in the working area of the Lambai Health Center, North Kolaka Regency. The type of research used is an analytical survey with a cross-sectional approach. The sampling technique was carried out in total sampling, involving the entire population of infants aged 1–6 months who met the inclusion criteria. Data collection was carried out through observation and structured interviews with infant mothers, as well as recording breastfeeding frequencies before and after infant massage interventions. Data analysis uses relevant statistical tests to test the relationships between variables. The results showed a significant relationship between infant massage and increased breastfeeding frequency, with a p-value of 0.000 (p < 0.05), indicating that infant massage had an effect on increasing breastfeeding activity in infants. The conclusion of this study is that infant massage has a positive relationship with the frequency of breastfeeding in infants aged 1–6 months. These findings support the use of infant massage as a simple but effective intervention in supporting breastfeeding success, especially in the early stages of life. This study recommends that the practice of infant massage can be socialized more widely to health workers and parents as part of the promotion of maternal and child health. The implementation of regular baby massage has the potential to improve the nutritional status and optimal growth and development of the baby.

Stunting is a chronic nutritional problem in toddlers that remains a global concern, including in Indonesia. This condition is characterized by height that is not appropriate for age due to long-term malnutrition, repeated infections, and environmental and social factors. The impact of stunting not only affects physical growth but also cognitive development, future productivity, and increases the risk of degenerative diseases in adulthood. Various factors contribute to stunting, including biological factors such as the child's gender and behavioral factors such as maternal knowledge about nutrition and health. This study aims to analyze the relationship between child gender and maternal knowledge and the incidence of stunting in toddlers. The research design used a quantitative cross-sectional approach. A sample of 73 respondents was selected using a stratified proportional sampling technique. Data collection was conducted through structured interviews using questionnaires and anthropometric measurements of toddlers. Data analysis was performed using univariate analysis to describe frequency distributions, and bivariate analysis using the chi-square test with a 95% confidence level. The results showed no significant association between child gender and stunting (p > 0.05). This indicates that biological factors such as gender are not the primary determinant of stunting in the study area. Conversely, there was a significant relationship between maternal knowledge and the incidence of stunting in toddlers (p < 0.05), indicating that mothers with low levels of knowledge are at greater risk of having stunted children. These findings emphasize the importance of improving maternal knowledge through ongoing nutrition education programs, health counseling, and promotive-preventive activities at community health centers. These interventions are expected to prevent stunting and other health problems in toddlers and support the achievement of the national stunting reduction target.

In recent years, rapid advancements in digital technology have significantly transformed global healthcare delivery. The COVID-19 pandemic acted as a catalyst, accelerating the integration of information technology into healthcare systems, particularly through the increased adoption of telemedicine. In the field of internal medicine, which often involves long-term care and management of chronic illnesses, telemedicine presents a promising solution to enhance service accessibility, improve care efficiency, and sustain favorable clinical outcomes. This study aims to conduct a narrative review to explore the impact of telemedicine on patient clinical outcomes, healthcare worker workload, and healthcare system efficiency within internal medicine practice. The review is based on an analysis of peer-reviewed literature published between 2020 and 2025, sourced from major databases including PubMed, Scopus, and Web of Science. Article selection was based on relevance to the topics of telemedicine and internal medicine, contextual applicability, and full-text availability. The findings of the review reveal that telemedicine contributes positively by expanding access to care, reducing travel time and logistical barriers for patients, accelerating clinical response times, and decreasing patient congestion in healthcare facilities. These outcomes are particularly beneficial for patients with chronic conditions who require regular monitoring and consistent communication with healthcare providers. However, the implementation of telemedicine also introduces new challenges, including increased administrative responsibilities and digital workload for healthcare professionals. The study underscores the importance of equipping healthcare systems with adequate digital infrastructure, implementing supportive and flexible policies, and providing comprehensive training for healthcare workers. These measures are crucial to ensure the successful and sustainable adoption of telemedicine in internal medicine. Overall, telemedicine holds strong potential to reshape the future of internal medicine, provided that its integration is strategically managed to balance technological advancement with human-centered care.

Background: Anemia is a public health problem among adolescent girls in Indonesia, with a prevalence reaching 32%. Iron supplementation programs have been implemented, but compliance remains low. Knowledge about anemia is thought to influence adherence to iron supplementation. Objective: To analyze the relationship between knowledge about anemia and compliance in consuming iron tablets in adolescent girls at the Bonepantai Community Health Center. Methods: This quantitative study with a cross-sectional design involved 30 adolescent girls aged 12-19 years selected by purposive sampling. Data were collected using a structured questionnaire covering knowledge about anemia and adherence to iron supplement consumption. Data were analyzed using univariate and bivariate analysis with the Chi-Square test at a significance level of α = 0.05. Results: The majority of respondents were aged 15-17 years (50.0%) and had a high school education (60.0%). The level of knowledge was good at 43.3%, sufficient at 33.3%, and poor at 23.4%. Compliance with iron supplement consumption was 46.7% and non-compliance at 53.3%. The results of the Chi-Square test showed a significant relationship between knowledge about anemia and iron supplement compliance (p=0.013; χ²=8.742). Respondents with good knowledge had higher compliance (76.9%) compared to respondents with poor knowledge (14.3%). Conclusion: There is a significant relationship between knowledge about anemia and adherence to iron supplementation in adolescent girls. Intensifying comprehensive and sustainable health education programs is needed to improve knowledge and adherence to iron supplementation as an effort to prevent anemia.

Anemia in pregnant women is a significant global public health issue, with a prevalence of 35.5% in 2023, according to the Global Anemia Estimates 2025 from the World Health Organization (WHO). The prevalence of anemia among reproductive-aged women is 30.7%, while it is 30.5% in non-pregnant women. This indicates that anemia is more prevalent among pregnant women compared to the general female population, highlighting the need for greater attention to this health issue. This study aims to identify and evaluate the risk factors or causes of anemia in pregnant women using an observational analytical approach. The research design employed is cross-sectional, which allows for the observation of the relationship between maternal knowledge about anemia and the occurrence of anemia in pregnant women at the same point in time. The study population consists of all pregnant women who visit the community health center (Puskesmas) for checkups. The results indicate that there is no significant relationship between parity (number of previous births) and the occurrence of anemia in pregnant women, with an Odds Ratio (OR) of 1.58. This means that women with higher parity are 1.58 times more likely to experience anemia compared to women with lower parity. However, the study found a significant relationship between maternal knowledge about anemia and the occurrence of anemia in pregnant women. Mothers with better knowledge about anemia are less likely to experience it. This study is expected to provide important information about the importance of improving maternal knowledge regarding anemia, which can contribute to the prevention and control of anemia in pregnant women. By enhancing maternal knowledge, it is hoped that the prevalence of anemia in pregnant women can be reduced, improving the overall health of both mothers and their unborn children.

Baby massage performed by parents provides benefits that can foster parental self-confidence, improve the growth and development of babies. Lack of knowledge about the importance of implementing baby massage, so parents need to be provided with counseling about the benefits and correct techniques in baby massage. The purpose of this study was to determine the effect of baby massage counseling on the knowledge and attitudes of mothers in massaging babies at the Community Health Center. This study is a quantitative study, with the method used being a pre-experiment with a one-group pre-test and post-test design approach, with a total sample of 40 respondents using total sampling. Data collection techniques with observation sheets and questionnaires. Data were analyzed using the Wilcoxon signed-rank test. The results of this study obtained a value of þ = 0.000 < from α = 0.05 there indicating a significant difference in maternal knowledge before and after counseling, namely, from most of the mothers' knowledge of 70% less, increasing to the knowledge of most of the mothers of 72.5% who have good knowledge. The attitude of mothers before and after counseling was given, namely, the majority of mothers' attitudes 77.5% were negative, increasing to the majority of mothers' attitudes 70% were positive. The conclusion of this study is the influence of infant massage counseling on the knowledge and attitudes of mothers in massaging babies at the Community Health Center. The study is expected to provide benefits for the development of nursing science, provide an overview of the benefits of infant massage and how to massage babies correctly, and for further researchers to conduct infant massage counseling more than twice, so that all respondents who participate in infant massage counseling are not only motivated but skilled in massaging babies.

Early pregnancy among adolescents remains a significant public health problem and contributes to long-term medical, psychological, and social risks. Low knowledge and preventive attitudes towards reproductive health are among the factors contributing to the high rate of early pregnancy. This study aims to analyze the effect of peer education on adolescent attitudes towards early pregnancy prevention in the Ibu Community Health Center (Puskesmas Ibu) working area of West Halmahera Regency. The study design used a quasi-experimental approach with a pretest–posttest with a control group involving 40 respondents, consisting of 20 respondents in the intervention group and 20 respondents in the control group. The research instrument was an attitude questionnaire with a Likert scale that had undergone validity and reliability testing. Analysis was performed using the Wilcoxon test and the Mann–Whitney U Test at a significance level of 0.05. The results showed a significant increase in attitudes in the intervention group after receiving peer education, while the control group showed no significant change. Comparison of score changes between the two groups also showed a significant difference. These findings indicate that peer education is effective in improving adolescent attitudes towards early pregnancy prevention. This program is recommended as a community-based intervention strategy in primary health care and schools to support adolescent pregnancy prevention efforts.

One of the vulnerable groups facing the double burden of malnutrition is children living in Child Social Welfare Institutions (LKSA), such as the LKSA Christian Orphanage Foundation in Malang City. This LKSA holds a C-level accreditation status, indicating limited resources and inadequate facilities to support children's well-being. Preliminary research revealed that many children are unaware of their nutritional status and have not received regular health check-ups or nutritional monitoring. To address this issue, the GAES Program (Grow And Eat Smart) was developed with the goal of increasing awareness about the double burden of malnutrition and enhancing education on the importance of regular nutritional status monitoring for children. The GAES Program consists of three main activities: distribution of nutritional measurement tools (scales and height measuring instruments), education on the importance of routine nutritional monitoring, and training in anthropometric screening techniques. The program's results showed that out of the 13 participating children, 7 children (54%) were identified as undernourished, while 6 children (46%) had good nutritional status. In addition, all participants successfully understood the educational material delivered during the sessions and were able to perform anthropometric measurements independently as an initial step in screening their nutritional status. Through this initiative, it is expected that both the children and the LKSA management will become more aware of the importance of regular nutritional monitoring and take early preventive actions. Furthermore, health professionals and local health centers (Puskesmas) are encouraged to provide continuous support and interventions at the LKSA to improve the nutritional status of children and adolescents. Such efforts are essential to prevent the long-term health impacts of the double burden of malnutrition and to ensure a healthier future for children living in social welfare institutions.

Moringa leaves (Moringa oleifera) are known to contain flavonoids that function as natural antioxidants, playing an important role in preventing the oxidation of body cells and maintaining health. However, the results of observations and interviews show that the people of Baet Village still do not understand the health benefits of moringa leaves and how they are processed into food with nutritional value. This community service activity aims to increase public understanding of the health benefits of moringa leaves and skills in processing them into food, vegetables, and various cakes. Partners in this activity are the Kaju Health Center and the people of Baet Village, with a total of 15 participants. The methods used include counseling on the nutritional content and benefits of moringa leaves, as well as the direct practice of processing moringa leaves into food products such as sponge cakes and puddings. The results of the activities showed success which was marked by the enthusiasm and active participation of the community in the evaluation sessions and processing demonstrations. The community is able to answer evaluative questions well and show skills in processing moringa leaves independently. In addition to increasing knowledge, the community also shows a commitment to implementing the results of counseling in daily life, including in efforts to reduce high blood pressure through the consumption of processed moringa leaves. This activity ran smoothly and had a positive impact on improving nutrition literacy and public health. It is hoped that this activity can be a model of sustainable community empowerment based on local potential.

Background : Self-management of hyperglycemia refers to a series of efforts carried out independently by individuals suffering from diabetes or hyperglycemia to manage and control their health condition. These efforts include regulating diet, physical activity, medication adherence, blood glucose monitoring, and preventive measures to avoid complications. Such complications may include vascular issues like heart disease and stroke, as well as neuropathic problems such as nerve damage. Proper implementation of self-management practices can help stabilize blood glucose levels and significantly improve the overall quality of life for patients. General Objective : This study aims to examine the effect of self-management on the risk of complications in patients with hyperglycemia in the working area of the Kandangan Health Center, Kediri Regency.Research Method : This research utilized a quasi-experimental design with a one-group pretest-posttest approach accompanied by a control group. The sampling technique applied was probability sampling using simple random sampling, involving a total of 45 respondents. The research instruments included the Diabetes Self-Management Questionnaire (DSMQ) and observation sheets to assess the risk of complications. The study population consisted of all hyperglycemic patients residing in Putuk Hamlet, Banaran Village, Kandangan District, Kediri Regency. Data processing was carried out through editing, coding, and tabulation, followed by data analysis using the Wilcoxon statistical test. Results : The Wilcoxon test results showed a significance value of p = 0.000 (p < 0.05), indicating a significant effect of self-management on reducing the risk of complications in hyperglycemic patients. Therefore, the alternative hypothesis (H1) was accepted. Recommendation : The implementation of self-management in hyperglycemic patients is essential to prevent long-term complications. Thus, healthcare professionals, especially nurses, are encouraged to provide continuous education regarding diabetes self-management. This will enable patients to manage their health conditions independently and reduce the risk of further complications.

Pharmacist professionalism is a key component in ensuring the quality of pharmaceutical services, encompassing not only compliance with technical and scientific standards but also a deep commitment to moral and ethical principles. In the Indonesian cultural context, the concept of "medicine as a trust" (obat sebagai amanah) reflects a profound sense of responsibility, where medicine is viewed not merely as a commodity, but as a mandate that must be preserved with integrity and accountability in health care practices. This article conceptually explores the relationship between pharmacist professionalism and the moral value of trust within the framework of the Nusantara constitutional theory. This theory emphasizes the integration of legal, cultural, and moral dimensions in shaping professional conduct in Indonesia. Using a descriptive-critical approach through literature review, this study investigates how trust functions as both a legal expectation and a cultural imperative in the practice of pharmacy. The findings highlight that trust must be internalized as a core value in pharmaceutical services—manifested through ethical decision-making, transparency in drug management, and a commitment to prioritizing patient welfare. Pharmacists are not only required to uphold professional standards, but also to carry out their duties as custodians of public trust. To realize this vision, the integration of the value of trust into pharmacy education, legal regulations, and clinical practice is essential. Educational institutions, professional organizations, and regulatory bodies must work collaboratively to instill this value as part of a pharmacist’s identity. In doing so, the profession can contribute more effectively to building a health care system that is just, culturally grounded, and centered on the well-being of the people.

Anxiety often arises during pregnancy due to both physical and psychological changes that can negatively impact the health of both the mother and the fetus. These changes may include hormonal fluctuations, fear of labor, and concerns about the baby’s wellbeing. In Indonesia, approximately 28.7% of 373,000 pregnant women in their third trimester experience anxiety as they approach labor. If left untreated, anxiety during pregnancy can lead to complications such as prolonged labor, low birth weight, and postpartum depression. Therefore, early and appropriate intervention is crucial. This study aims to describe the application of Islamic mindfulness meditation therapy as a non-pharmacological intervention to reduce anxiety in pregnant women at Puskesmas Purbaratu, Tasikmalaya. Anxiety is a condition in which an individual feels uneasy, worried, or uncomfortable. Islamic mindfulness meditation therapy is a relaxation technique that integrates spiritual practices with mental focus through meditation, allowing the soul and mind to be calm, centered, and connected with God. It includes dhikr (remembrance of Allah), controlled breathing, and contemplation of positive thoughts. The method used in this study is a case study involving two primigravida pregnant clients experiencing moderate anxiety. Data were collected through interviews, observations, and measurements using the Hamilton Anxiety Rating Scale (HARS). The results indicate that Islamic mindfulness meditation therapy significantly reduced anxiety levels from moderate to mild after five consecutive days of implementation. This was achieved through a combination of breathing exercises, spiritual reflection, and relaxation. This study concludes that Islamic mindfulness meditation can be an effective, affordable, and spiritually enriching alternative therapy to reduce anxiety in pregnant women, especially during the vulnerable third trimester. It is recommended that health workers consider incorporating this method into antenatal care programs.

Tuberculosis (TB) is an infectious disease caused by infection with bacteria from the Mycobacterium tuberculosis complex group. TB prevention efforts are crucial, especially for individuals at high risk of exposure, to disrupt the chain of transmission of this disease. The intervention aimed to increase community understanding of TOSS TB (Find, Treat, Treat Until Cured) so that it can be applied in daily life. It is expected that after the intervention, participants' knowledge will increase, as will their ability to demonstrate the practices taught appropriately. Data collection was conducted through a mini-survey of the community in the local Community Health Center (Puskesmas) working area. The data obtained were then analyzed using the Blum Paradigm to identify factors contributing to the problem. Problem prioritization was carried out using the non-scoring Delphi method, while root cause analysis was conducted using a fishbone diagram. During the intervention process, pre- and post-tests were conducted to evaluate changes in the level of knowledge of villagers before and after the intervention. For program monitoring and evaluation, the PDCA (Plan-Do-Check-Act) cycle approach and a systems approach were used. The analysis using the Blum Paradigm showed that lifestyle was the primary contributing factor to the problem. After the intervention, three participants were able to repeat the material effectively, demonstrating a better understanding of TB prevention. Based on these results, it can be concluded that the intervention was successful and is expected to encourage improvements in public health in the village. Furthermore, this program is also expected to serve as a model for other public health interventions, thereby expanding the positive impact of TB control efforts in other areas. Thus, public awareness and knowledge about TB can continue to increase, which in turn will contribute to reducing TB incidence in Indonesia and improving the overall quality of life of the community.

According to WHO (2015), TT immunization coverage in Africa reached 50%, with TT2 at 60%. In Indonesia, the Making Pregnancy Safer (MPS) program set a target of 95% Antenatal Care (K1) coverage, including TT2 by 2019. Puskesmas data in 2016 showed K1 coverage of 880 with TT1 at 27 (3.1%), and K4 at 739 with TT2 at 64 (8.6%). This study aims to assess premarital knowledge of TT immunization based on age, education, and occupation. Using a descriptive design and total sampling, 32 respondents were involved. Results showed most were under 20 years old (41%), had junior high school education (25%), and worked as entrepreneurs (19%). The lowest knowledge level was found among respondents with primary education (19%) and farmers (3%). It is recommended that midwives at Puskesmas Bestari intensify education to improve premarital knowledge about TT immunization.

X Health Center has implemented EMR on SIMPUS since 2009-2010. However, from the preliminary study, it was found that there were obstacles such as network trouble, long loading when many users were pulling data on the system, and there was no SOP for down time: The purpose of this study is to analyze the implementation of Electronic Medical Records at X Health Center, Semarang City in the aspects of Human, Organization, Technology, Net-benefit.  Methods: This study used a descriptive qualitative approach with interviews, observations and documentation studies. Results: The results of research at X Health Center show that there are problems in implementing EMR at X Health Center, in the human aspect, namely system training is still given only to representative officers such as IT and SIK staff. In the organizational aspect, namely limited facilities and lack of manpower. On the technology aspect, namely internet network instability, inconsistent electricity supply and generator unpreparedness and hardware limitations. While in the net-benefit aspect, the implementation of EMR has an impact on increasing the efficiency and effectiveness of X Health Center services. Conclusion: The implementation of electronic medical records at X Health Center is not yet fully optimal, namely in the aspects of human, organization and technology.