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The incidence of hypertension at the Tadoy Community Health Center reached 29.4%, with 78 cases reported among pregnant women in 2023, half of which were pregnancy-induced hypertension (HDK). Hypertension during pregnancy poses short-term risks to both mother and fetus. In addition to pharmacological treatment, non-pharmacological therapies such as warm water foot soaking and Ambon banana consumption are considered beneficial. This study aimed to examine the effects of these two interventions on reducing blood pressure in pregnant women with hypertension. This research employed a qualitative method with a case study approach involving two pregnant women diagnosed with hypertension. The results showed that warm water foot soaking significantly reduced blood pressure from 150/90 mmHg at the first visit to 130/85 mmHg at the second visit, and further to 120/75 mmHg. Similarly, Ambon banana consumption reduced blood pressure from 150/90 mmHg to 140/90 mmHg, and eventually to 120/80 mmHg. Although both interventions were effective, warm water therapy demonstrated greater effectiveness in lowering blood pressure compared to banana consumption. These findings suggest that simple, non-pharmacological interventions can help manage hypertension in pregnancy. It is recommended that pregnant women apply warm water foot soaking independently to help control blood pressure and reduce pregnancy-related risks.

The healthcare sector is increasingly confronted with a VUCA environment (Volatility, Uncertainty, Complexity, and Ambiguity), requiring hospitals to adopt adaptive, resilient, and innovative strategies. This study aims to systematically review the evidence on smart hospital strategies in responding to uncertainty, particularly in improving service quality, operational efficiency, and patient satisfaction. A systematic literature review was conducted using major academic databases, including Scopus-indexed sources, Google Scholar, and Semantic Scholar, covering publications from 2020 to 2026. Articles were selected based on predefined inclusion criteria focusing on hospital management strategies in dynamic and uncertain environments. A total of 10–15 relevant studies were included and analyzed using thematic synthesis. The findings indicate that key strategies in addressing VUCA challenges include digital transformation (e.g., electronic medical records and telemedicine), adaptive and transformational leadership, agile management approaches, and patient-centered care. Digital technologies significantly improve efficiency and decision-making processes, while agile and adaptive leadership enhances organizational responsiveness and resilience. However, several studies highlight that technological advancement alone is insufficient without integrating humanistic values such as empathy, communication, and trust. In conclusion, the most effective hospital strategies in a VUCA world are those that integrate technological innovation with human-centered care. Hospitals must develop flexible, data-driven, and patient-oriented systems to ensure sustainability and competitiveness in uncertain environments. Future research should focus on longitudinal and experimental designs to strengthen causal evidence and explore the integration of digital systems with humanistic healthcare values.

Hyperemesis gravidarum is a common complication in early pregnancy characterized by excessive nausea and vomiting that can negatively affect maternal health and quality of life. Although pharmacological management is widely used, concerns regarding medication safety during pregnancy have increased interest in complementary and non-pharmacological interventions. One such approach is aromatherapy, particularly the use of lavender essential oil, which is known for its calming and antiemetic properties. This study aimed to evaluate the effectiveness of lavender aromatherapy in reducing the frequency of hyperemesis gravidarum among pregnant women at RSUD Tikep. This research employed a quantitative quasi-experimental design with a pretest–posttest approach. A total of 30 first-trimester pregnant women experiencing hyperemesis gravidarum were selected using purposive sampling. The intervention involved inhalation of lavender aromatherapy administered for a predetermined duration and frequency. The frequency of nausea and vomiting was measured before and after the intervention using observation sheets and self-reported records. Data were analyzed using SPSS software, including descriptive statistics, normality tests, and paired sample t-tests. The results demonstrated a significant reduction in the mean frequency of hyperemesis gravidarum following the administration of lavender aromatherapy. Statistical analysis revealed a p-value of less than 0.05, indicating a significant difference between pre-intervention and post-intervention measurements. These findings suggest that lavender aromatherapy effectively reduces the frequency of nausea and vomiting in pregnant women. In conclusion, lavender aromatherapy is a safe, low-cost, and effective complementary therapy for managing hyperemesis gravidarum. Its integration into routine antenatal care may enhance maternal comfort and support holistic, patient-centered maternity services, particularly in regional healthcare settings.

Maternal mortality remains a major global health concern and an important indicator of health system performance. The World Health Organization reported in 2023 that approximately 290,000 maternal deaths occurred worldwide, highlighting persistent challenges in maternal health services. In the ASEAN region, the maternal mortality rate in 2023 was recorded at 16.85 per 1,000 live births. In Indonesia, the Maternal Mortality Rate in 2023 reached 189 per 100,000 live births according to the Ministry of Health of the Republic of Indonesia. Significant progress has been observed in Central Java Province, where the rate decreased from the United Nations Sustainable Development Goals target of 226 per 100,000 live births to 88.11 per 100,000 live births in 2023. At the district level, Brebes Regency recorded 54 cases per 100,000 live births in 2023 and reported 54 maternal deaths in 2024. Meanwhile, the Kaliwadas Community Health Center reported no maternal deaths during 2023 and 2024, indicating relatively effective maternal health services at the local level.

Malaria remains a significant public health problem in several endemic areas in Indonesia. Understanding temporal and epidemiological changes at the local level is crucial for effective malaria control and elimination. This study aims to analyze changes in malaria epidemiological patterns based on routine surveillance data at the Yaro Community Health Center, Indonesia, during the period 2023–2025. This is a retrospective, longitudinal descriptive study using routine malaria surveillance data. Variables analyzed include temporal trends, Plasmodium species distribution, demographic characteristics, spatial distribution, and case-finding strategies. Data were analyzed descriptively using frequencies and proportions. A total of 9,677 malaria examinations were recorded, with 546 confirmed cases. Malaria cases showed a significant increase in 2025. Plasmodium vivax was the most dominant species, with a steadily increasing proportion of mixed infections. Adults aged 15–64 years and men were the most affected groups. Spatial analysis showed regional heterogeneity with persistent hotspots at the village level. Passive case detection remains the primary method, while active surveillance is increasingly contributing to case identification. Malaria epidemiology in the Yaro region exhibits dynamic temporal, demographic, and spatial patterns. Strengthening integrated surveillance and targeted interventions is essential to address persistent transmission and support malaria elimination efforts.

The highest mortality cases during pregnancy until the postpartum period are caused by several factors such as hypertension, infection, bleeding, anemia and KEK. Data obtained from pregnant women at the Bumiayu Community Health Center in 2023 were 30 cases, in 2024 there was an increase of 183 cases and in 2025 from January to February there were 30 KEK cases (Bumiayu Community Health Center profile, 2025). The purpose of the study was to provide comprehensive midwifery care to pregnant women, childbirth, newborns, postpartum and family planning (KB) using the Varney and SOAP management approaches. The method used in this study is a qualitative descriptive method with a comprehensive case study approach. The results of the study of comprehensive midwifery care to Mrs. S found problems in pregnancy with KEK have been given management according to the mother's needs. In labor, newborns, postpartum to KB Mrs. S there were no complications. Conclusion Comprehensive midwifery care to Mrs. S with KEK has been carried out in accordance with Standard Operating Procedures with the condition of the mother and baby being good.  

Teenage pregnancy remains a reproductive health issue in Indonesia, including in Batam City. According to data from the Batam City Health Office in 2024, there were 18 cases of teenage pregnancy (0.06%) with the Lubuk Baja Health Center being one of the highest areas. Pregnant teenagers are at high risk of complications such as anemia, malnutrition, and low birth weight (LBW), which contribute to high rates of maternal and infant morbidity. This study used a descriptive method with a case study approach on Ny. S, an 18-year-old teenager with a pregnancy in the Lubuk Baja Health Center area of Batam City in 2025. Data collection was conducted through interviews, observations, physical examinations, and SOAP documentation following the 7-step Varney obstetric management. The findings revealed that Ny. S experienced mild complaints such as nausea, reduced appetite, and anxiety about her pregnancy. After three visits, the mother's complaints decreased, appetite improved, anxiety decreased, and nutritional status was within normal limits. Comprehensive midwifery care with a biopsychosocial approach was proven effective in improving both the physical and mental health of pregnant teenagers and preventing pregnancy complications.

Patient-Centered Care (PCC) is a healthcare approach that places the patient at the center of every interaction and clinical decision-making. However, a preliminary study at Tarumajaya Hospital showed that 58% of healthcare workers had not yet optimally implemented the PCC approach. This study aimed to analyze the influence of self-efficacy and social support on the implementation of Patient-Centered Care, with safety culture as a mediating variable, at Tarumajaya Hospital. The research method used was quantitative analytic with a cross-sectional design. The study sample used a saturated sampling technique of 132 healthcare workers, consisting of doctors, nurses, and medical support staff. Data analysis used Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results showed that self-efficacy and social support had a positive and significant effect on safety culture and PCC implementation. Safety culture also had a positive and significant effect on PCC implementation. Furthermore, safety culture was shown to mediate the influence of self-efficacy and social support on PCC implementation. The coefficient of determination value indicates that the model has strong ability to explain variations in PCC.

This study aimed to analyze the effect of parent empowerment in optimizing tummy time on head control in infants aged 0–6 months at community health posts in Jatisampurna, Bekasi. Early motor development requires adequate sensory–motor stimulation, yet many parents have limited knowledge and practice of prone positioning activities. A quasi-experimental one-group pretest–posttest design was employed involving nine healthy infants selected through purposive sampling. Parents received education and practical training on tummy time and were instructed to implement a home program for two weeks with a minimum duration of 30 minutes per day. Head control was assessed before and after the intervention using the Head Control Scale across prone, supine, pull-to-sit, and supported sitting positions. The results demonstrated improvements in head control scores in all positions, with the most notable gains observed in infants who had lower baseline abilities. The findings indicate that repeated prone stimulation enhances postural control through increased neck and trunk muscle activation and improved sensory–motor integration. Parent empowerment also increased knowledge, adherence to home stimulation, and active participation in child development monitoring. This community-based intervention shows potential as a promotive and preventive strategy to support early motor development through family-centered approaches at primary health services.

Artificial Intelligence (AI) is increasingly recognized as a transformative enabler of early disease detection, with the potential to improve diagnostic accuracy, support predictive risk stratification, and advance preventive healthcare. Despite rapid methodological progress, many existing reviews remain performance-centric, offering limited insight into generalizability, ethical governance, and real-world implementation constraints. This paper presents a narrative and integrative review with an adoption-focused, translational perspective, synthesizing recent developments in AI-driven early disease detection across oncology, cardiology, neurology, and infectious disease surveillance. Drawing on peer-reviewed literature published primarily between 2016 and 2025, the review examines reported performance gains alongside persistent limitations related to data heterogeneity, population bias, explainability, and regulatory fragmentation. Through cross-sectional synthesis, we identify three recurring gaps in prior reviews: (i) overgeneralization of AI’s diagnostic superiority, (ii) insufficient consideration of ethical and legal accountability, and (iii) a lack of actionable guidance for scalable clinical implementation. Integrating technical, ethical, and policy dimensions into a unified conceptual framework, this review demonstrates that while AI systems can consistently enhance diagnostic accuracy and early risk stratification in well-defined tasks, sustained clinical adoption depends on aligning technical performance with governance readiness, interpretability, and workflow integration. The analysis further highlights how implementation mechanisms—such as explainable AI, continuous post-deployment monitoring, and clinician-centered deployment strategies—mediate the translation of algorithmic innovation into real-world healthcare impact. Overall, this review provides a critical reference for researchers, clinicians, and policymakers seeking to translate AI innovation into safe, equitable, and trustworthy clinical practice.

Hypertension is a major non-communicable disease, particularly challenging in regions with extensive service areas. Community health volunteers are essential for prevention and management through blood pressure measurement. Existing training programs focus primarily on knowledge, highlighting the need to integrate cognitive learning with small-group skills practice to enhance practical competencies and community-based hypertension control. A quasi-experimental design with a pretest–posttest design was conducted to evaluate the effectiveness of combined lecture and small-group training. Knowledge was assessed before and after training, while skills were evaluated post-intervention. Thirty volunteers from the Public Health Center Selakau participated. The results showed that knowledge of blood pressure measurement improved significantly, with pretest scores of 74.67 ± 16.34 rising to posttest scores of 90.00 ± 10.50 (p < 0.005). Posttest evaluation of practical skills showed a mean score of 80.93 ± 13.35, indicating proficient performance in most assessed items. Combined lecture and small-group training effectively enhanced both knowledge and practical skills of community health volunteers in blood pressure measurement. Integrating cognitive learning with hands-on practice strengthens theoretical understanding and field competencies, supporting more effective community-based hypertension control programs.

This study aims to determine the level of patient satisfaction with pharmaceutical services at the Bobotsari Community Health Center. Patient satisfaction is an important indicator that reflects the quality of healthcare services. This research employed a quantitative descriptive method using a SERVQUAL-based questionnaire, consisting of five dimensions: tangible, reliability, responsiveness, assurance, and empathy. A total of 100 outpatient respondents were selected through accidental sampling. Data were analyzed using descriptive statistics to determine satisfaction scores for each dimension. The results showed that the tangible dimension achieved 80.57% and the reliability dimension achieved 82%, both categorized as very satisfied. Meanwhile, responsiveness (79.02%), assurance (79.05%), and empathy (77.95%) were categorized as satisfied. The overall average satisfaction level was 79.72%, indicating that patients were generally satisfied with the pharmaceutical services. However, several aspects such as service speed, communication clarity, and personal attention from staff still require improvement. The findings emphasize the importance of maintaining service quality to achieve better patient experiences and public trust.

Stunting is a chronic nutritional disorder characterized by a child’s height being below the age-standard growth curve. One contributing factor is the mother’s knowledge regarding proper complementary feeding (MP-ASI). This study aims to determine the correlation between maternal knowledge of complementary feeding and stunting among children under five at Posyandu in the Bangetayu Health Center working area, Semarang. This research employed an analytical observational design with a case-control approach. A total of 60 respondents were selected using purposive sampling, consisting of 30 stunted and 30 non-stunted children. Data were collected using a structured questionnaire and analyzed using the Chi-Square test. The findings indicated that most mothers possessed good knowledge of complementary feeding (80%). Stunting prevalence among respondents was 41.7%. The Chi-Square test revealed a p-value of 0.000 (p < 0.05), demonstrating a significant relationship between maternal knowledge of complementary feeding and stunting. Mothers with poor knowledge were more likely to have stunted children compared to those with adequate understanding. These results highlight the crucial role of improving maternal nutrition knowledge to prevent stunting and support optimal child growth and development.

Measles Rubella (MR) immunization coverage in Indonesia remains below the national target of 95%, with coverage in 2024 reaching only 82.3% and showing a decline compared to the previous year. A lower coverage was observed in the working area of Pekanbaru Kota Public Health Center, where only238 out of 547 eligible children (41.3%) received MR immunization. Low immunization coverage may reduce herd immunity and increase the risk of measles and rubella outbreaks. This study aimed to analyze factors influencing MR immunization uptake among children under five in the working area of Pekanbaru Kota Public Health Center in 2025. This quantitative study employed a cross-sectional design involving 40 mothers of children aged 9–60 months selected through accidental sampling. Data were collected using structured questionnaires assessing maternal knowledge, attitudes, family support, support from health workers, and travel time to health facilities. Univariate and bivariate analyses were performed using the Chi-Square test at a 95% confidence level (α = 0.05). The results showed that 67.5% of respondents had provided MR immunization to their  children.  Significant associations  were  found  between  maternal knowledge (p = 0.033), maternal attitudes (p = 0.037), family support (p = 0.002), and health worker support (p = 0.015) with MR immunization uptake, while travel time to health facilities was not significantly associated (p = 0.053). In conclusion, maternal knowledge and attitudes, family support, and health worker support are significant factors influencing MR immunization uptake, highlighting the need to strengthen health education and family involvement to improve MR immunization coverage.

Background: The prevalence of Chronic Energy Deficiency (CED) among pregnant women in West Papua remains very high, reaching 40.7%. The provision of manufactured supplementary food (PMT) in the form of biscuits often faces challenges due to low compliance caused by monotonous taste and nausea-triggering flavors. Sweet potato (Petatas) is a potential local food source with an energy content of 123 kcal/100g that could serve as an alternative PMT. Objective: To analyze the acceptability (taste, color, aroma, and texture) of sweet potato-based PMT products among pregnant women with CED. Methods: A quantitative study with a cross-sectional design was conducted from September to October 2025 at the Ransiki Health Center. The sample consisted of 22 pregnant women with CED. The research instrument used a 5-point hedonic scale questionnaire. Results: Respondent characteristics were dominated by the ideal age range of 20-35 years (81.8%) and low family income (63.6%). The acceptability test results showed high overall acceptance with an average score of 4.23 (Highly Liked). The color attribute obtained the highest score (4.27), followed by taste (4.18), texture (4.18), and aroma (4.14). Conclusion: Sweet potato-based PMT products have excellent acceptability and significant potential to be integrated into local nutritional intervention programs for pregnant women with CED.

Nosocomial infections, also known as Healthcare-Associated Infections (HAIs), are infections acquired by patients during their stay in healthcare facilities. These infections remain a serious problem because they can increase morbidity and mortality rates, prolong the length of hospital stay, and raise healthcare costs. One classical yet highly relevant approach to preventing nosocomial infections is Florence Nightingale’s Environmental Theory. This theory emphasizes the importance of maintaining a clean environment, adequate ventilation, proper lighting, effective sanitation, and good personal hygiene to support patient recovery and reduce infection risks. Nightingale believed that environmental factors play a crucial role in improving patient health outcomes and preventing disease transmission. In modern nursing practice, the principles of Nightingale’s theory are still widely applied through infection prevention and control programs, environmental cleanliness standards, and patient-centered care. Therefore, understanding and implementing environmental management in healthcare settings remain essential strategies to reduce nosocomial infection rates and improve the overall quality of healthcare services.

Low levels of maternal knowledge and appropriate nutritional practices, combined with limited continuity of nutrition education from health workers, remain significant risk factors for maternal and child health problems, including stunting. The GEMPITA Program (Gerakan Edukasi MPASI Tepat dan Aman / Safe and Appropriate Complementary Feeding Education Movement) was implemented as a community service initiative to improve nutritional knowledge, skills, and practices among families in the working area of Teratak Public Health Center. The program employed structured methods, including socialization, education, training, demonstrations, mentoring, and non-formal monitoring and evaluation. The target participants were mothers with children aged 6–24 months, as well as health workers and community health cadres. Program effectiveness was assessed using pretest posttest measurements and direct observation of behavioral changes. The results demonstrated a significant improvement in maternal knowledge regarding appropriate complementary feeding, enhanced skills in age-appropriate food preparation, and improved hygienic and nutritious feeding practices. In addition, the capacity of health workers to deliver nutrition education was strengthened. Overall, the GEMPITA Program proved effective in improving family nutrition practices and reinforcing the role of the public health center in stunting prevention through a sustainable community empowerment approach.

Data from the 2020 LFSP (Long Form Population Census) recorded a maternal mortality ratio of 189 per 100,000 live births, while the infant mortality rate was recorded at 16.85 per 1,000 live births. The causes of maternal mortality were hemorrhage, preeclampsia/eclampsia, infection, prolonged labor, and miscarriage. Meanwhile, the majority of infant deaths were due to low birth weight, asphyxia, and infection at birth. Stunting remains a particular concern in Tegal City. Various measures have been taken, and the stunting rate has decreased to around 13.8% according to data from early 2025. This PKM is expected to increase public knowledge on caring for pregnant women, women in labor, postpartum women, and newborns, as well as preventing stunting in children, thereby reducing maternal and infant mortality rates. The methods used in this activity include health education and outreach with a promotive and preventive approach, targeting pregnant women and mothers with infants and toddlers. Community service was held on Wednesday, December 17, 2025, from 8:30 a.m. to 12:00 p.m. at the Boegenvil Health Center in Cabawan Village, Tegal City, with 53 participants. The results of this activity showed an increase in the level of knowledge of the participants, from 11 people with a good level of knowledge to 41 people after receiving counseling, with 3 participants still having a low level of knowledge.

Data from the 2020 LFSP (Long Form Population Census) recorded a maternal mortality ratio of 189 per 100,000 live births, while the infant mortality rate was recorded at 16.85 per 1,000 live births. The causes of maternal mortality were hemorrhage, preeclampsia/eclampsia, infection, prolonged labor, and miscarriage. Meanwhile, the majority of infant deaths were due to low birth weight, asphyxia, and infection at birth. Stunting remains a particular concern in Tegal City. Various measures have been taken, and the stunting rate has decreased to around 13.8% according to data from early 2025. This PKM is expected to increase public knowledge on caring for pregnant women, women in labor, postpartum women, and newborns, as well as preventing stunting in children, thereby reducing maternal and infant mortality rates. The methods used in this activity include health education and outreach with a promotive and preventive approach, targeting pregnant women and mothers with infants and toddlers. Community service was held on Wednesday, December 17, 2025, from 8:30 a.m. to 12:00 p.m. at the Boegenvil Health Center in Cabawan Village, Tegal City, with 53 participants. The results of this activity showed an increase in the level of knowledge of the participants, from 11 people with a good level of knowledge to 41 people after receiving counseling, with 3 participants still having a low level of knowledge.

Psychology personnel in primary healthcare centers (Puskesmas) play a strategic role in delivering mental health services at the primary level; however, they are frequently confronted with complex and multifaceted job demands. This study aims to examine the effects of workload and work stress on the job performance of psychology personnel in Puskesmas in Surabaya City. A quantitative approach with a correlational cross-sectional design was employed. The study population comprised all psychology personnel working in Puskesmas in Surabaya City, with total sampling applied, resulting in 63 respondents. Workload and work stress were measured using five-point Likert scales, while job performance was assessed based on monthly psychology service reports. Data were analyzed using multiple linear regression analysis. The results indicate that the majority of psychology personnel experienced high workload levels and relatively high work stress, whereas overall job performance was predominantly categorized as good. Regression analysis revealed that workload and work stress simultaneously had a significant effect on job performance, and partially both variables exerted a negative effect on performance. These findings suggest that although psychology personnel are generally able to maintain adequate performance, excessive workload and elevated work stress may potentially undermine performance in the long term if not properly managed. Therefore, this study highlights the importance of systematic workload management and work stress intervention strategies to sustain the quality of psychological services in primary healthcare settings.