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Infant nutritional status is an important indicator of child health that is influenced by various factors, including maternal characteristics. Maternal education is often considered to play a role in determining infant care and feeding practices. This study aims to analyze the relationship between the mother's education level and infant nutritional status. The study uses a quantitative approach with a cross-sectional analytical observational design. The study sample consisted of 30 mothers and infants aged 0–12 months selected using purposive sampling. Maternal education level was categorized as elementary, secondary, and higher education, while infant nutritional status was determined based on anthropometric indicators according to WHO standards and the position of the Health Card (KMS). Data analysis was performed bivariately using Spearman's rho correlation test with a significance level of p < 0.05. The results of the study indicate that there is no significant relationship between the mother's level of education and the nutritional status of the infant (p = 0.575; r = −0.098). The correlation coefficient value indicates a very weak and statistically insignificant relationship. The conclusion of this study indicates that the mother's education level is not a factor directly related to the nutritional status of infants. The nutritional status of infants is likely to be more influenced by other more proximal factors, such as feeding practices, the quality and quantity of food intake, the child's health condition, and the family's environmental and socioeconomic factors.

Health issues are complex and require new ideas for their resolution. Public health focuses on disease prevention, health promotion, and physical, mental, and social therapy. Maternal and Child Health (MCH) and women’s health throughout their life cycle are crucial public health issues as they have a significant impact on the quality of human resources in a generation. In Pukdale Village, East Kupang District, Kupang Regency, problems such as the lack of knowledge among pregnant women about Chronic Energy Deficiency (CED), pregnancy anemia, Exclusive Breastfeeding (EBF), balanced nutrition, and weaning have been identified. To address these issues, a Community Midwifery Care program based on community service was carried out, which included counseling, training, demonstrations, and simulations. The results of this activity showed a positive response and active participation from the community in Pukdale Village in the programs implemented by the students. There was a significant improvement in the knowledge of pregnant women about CED, pregnancy anemia, EBF, as well as the knowledge of mothers of infants about balanced nutrition and weaning. This is expected to improve the overall health status of the community in the village.

Empowering pregnant women in their third trimester through Respectful Maternity Care-based childbirth preparation counseling is a relevant promotive and preventive strategy for improving maternal health. This counseling not only provides knowledge about the signs of labor, stages of labor, pain management options, and birth planning, but also equips mothers with an understanding of their rights in midwifery care. Childbirth preparation education often focuses solely on clinical aspects and fails to fully address the psychosocial aspects and the rights of mothers as service recipients. This has the potential to lead to an unpleasant childbirth experience and even contribute to disrespect and abuse during labor. This counseling can equip mothers with an understanding of their rights in midwifery care. With an empathetic, participatory, and woman-centered approach, pregnant women are expected to be able to recognize their needs, convey their preferences, and communicate effectively with health workers. The purpose of this counseling is to improve pregnant women's knowledge before and after being empowered in their third trimester through Respectful Maternity Care-based childbirth preparation counseling.

Interoperability remains one of the most persistent challenges in digital health systems globally, affecting the continuity, quality, and efficiency of care. Electronic Medical Records (EMR) managers are central to implementing and sustaining EMR systems, yet their experiences navigating interoperability challenges are poorly understood. This study aimed to explore the lived experiences of EMR managers and to develop a conceptual understanding of the barriers and coping strategies involved. A qualitative phenomenological approach was employed, guided by van Manen’s interpretive framework. The study involved 21 EMR managers from public and private hospitals across three major healthcare networks. Participants were selected through purposive and snowball sampling, with inclusion criteria requiring at least two years of EMR management experience and involvement in interoperability efforts. Data were collected via in-depth, semi-structured interviews conducted virtually between September and November 2025. Each interview lasted 45–60 minutes, was audio-recorded, transcribed verbatim, and member-checked. Data were analyzed thematically using NVivo 14, following Braun and Clarke’s six-step method. Reflexivity, triangulation, and peer debriefing ensured methodological rigor, in accordance with COREQ and SRQR standards. Four overarching themes emerged: (1) Fragmented Systems, reflecting technical and architectural incompatibilities across platforms; (2) Role Strain and Isolation, describing limited authority and institutional support; (3) Adaptive Workarounds, highlighting informal coping strategies such as manual data tracking; and (4) Systemic Barriers, pointing to policy volatility and vendor resistance. A conceptual “feedback loop of fragmentation” was developed, illustrating how these themes interact to perpetuate interoperability challenges. EMR managers operate as critical yet often overlooked actors in the pursuit of health system interoperability. Supporting their role through policy stability, resource investment, and participatory system design is essential. Future digital health reforms must integrate managerial perspectives to build resilient and connected health information systems.

Children with disabilities live with one or more conditions, physical, cognitive, sensory, or social, that limit their daily activities. These conditions necessitate specialized care and attention tailored to their specific needs. This study aims to explore how parents come to terms with their child’s condition, the factors that influence this acceptance, and its overall impact on family well-being. The results suggest that parental acceptance is rarely a straightforward process. It involves a complex emotional journey, often moving through stages of denial, anger, bargaining, and depression before reaching a point of acceptance. The speed and depth of this process are heavily influenced by both internal and external factors. Internally, spiritual values, educational background, and effective coping strategies play a vital role. Externally, the presence of social support and access to healthcare services are crucial. When parents embrace their child’s condition with unconditional love and focus on their potential, it significantly enhances the child’s developmental outcomes. Conversely, a lack of acceptance can increase the burden of caregiving and hinder the child’s progress.

Maternal reproductive health is a critical factor in reducing Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR). Data from Deli Tua Primary Health Center shows that K4 coverage reached only 78% with prenatal class participation at 40%, still below the national target. Low knowledge among pregnant women about reproductive health is one of the main causes. This Community Service Student Creativity Program (PKM-M) aims to improve reproductive health knowledge through innovative and interactive prenatal class improvement. The implementation method includes developing educational media (modules, posters, videos), conducting classes with participatory learning methods, and evaluation through pre-post tests. The program was conducted over 5 months targeting 30 pregnant women divided into 3 groups, each attending 6 sessions. Materials covered physiological changes during pregnancy, nutrition, reproductive hygiene, danger signs, childbirth preparation, and postpartum care. Results showed a knowledge score increase of 42.5% (from 58.3±12.4 to 83.1±8.7) with significance p<0.001. Participation reached 86.7% with satisfaction level of 4.3/5.0. The program proved effective in improving reproductive health knowledge and can be replicated in other primary health centers with local context adaptation.

Schizophrenia is a chronic mental disorder that requires long-term medication adherence to prevent relapse and improve patients’ quality of life. Caregivers play a crucial role in encouraging medication adherence through emotional, informational, instrumental, and supervisory support. This descriptive quantitative study with a cross-sectional design aimed to describe caregiver support and medication adherence among schizophrenia patients at the South Denpasar Public Health Center. A total of 100 respondents, who were family members or caregivers of schizophrenia patients, were selected using a consecutive sampling technique. Data were collected through structured interviews using questionnaires and analyzed descriptively. The results showed that most caregivers provided good support (63%), particularly in accompanying patients during medication intake, actively interacting with them, and following health workers’ recommendations. Furthermore, patients’ medication adherence was mostly in the moderate (45%) and good (35%) categories. These findings indicate that caregiver support plays a significant role in improving medication adherence among schizophrenia patients. Strengthening caregiver knowledge and optimizing health education by healthcare workers are essential to further enhance adherence.

Background: Hypertension remains a major public health problem, particularly in primary health care settings. The coexistence of diabetes mellitus may contribute to increased hypertension severity; however, evidence from primary care data in Indonesia remains limited. Objective: This study aimed to examine the association between diabetes mellitus and hypertension severity among patients attending a primary health care center in Indonesia. Methods: A cross-sectional study was conducted using secondary data obtained from medical records at a primary health care center in 2025. A total of 84 patients with hypertension were included using total sampling. Hypertension severity was classified into stage 1 and stage 2. Bivariate analysis was performed using the Chi-square test or Fisher’s exact test as appropriate, with statistical significance set at p < 0.05. Data were analyzed using SPSS version 26. Results: Of the 84 participants, 33.3% had diabetes mellitus. Stage 2 hypertension was more prevalent than stage 1 hypertension. Diabetes mellitus was significantly associated with hypertension severity (p = 0.029), with a higher proportion of patients with diabetes mellitus presenting with stage 2 hypertension. Conclusion: Diabetes mellitus was significantly associated with greater hypertension severity in a primary health care setting. These findings highlight the importance of integrated management of diabetes mellitus in patients with hypertension at the prizary care level.

Anxiety in third-trimester pregnant women is a common condition that may negatively affect psychological readiness for childbirth. One effective non-pharmacological intervention to reduce anxiety is progressive muscle relaxation therapy. This community service activity aimed to reduce anxiety levels among third-trimester pregnant women through health education and practical training on progressive muscle relaxation therapy. The activity was conducted at PMB Lina Contesa and involved 25 third-trimester pregnant women. The intervention consisted of health education sessions, demonstrations, and guided practice of progressive muscle relaxation therapy. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS) before and after the intervention. The results showed a decrease in the mean anxiety scores after the intervention, shifting from moderate anxiety to mild anxiety levels. These findings indicate that progressive muscle relaxation therapy is effective in reducing anxiety among third-trimester pregnant women. In conclusion, health education combined with progressive muscle relaxation therapy is a safe, simple, and effective non-pharmacological approach to reduce maternal anxiety and is recommended to be integrated into antenatal care services at midwifery private practices.

The goal of continuous midwifery care is to use the SOAP documentation technique to provide comprehensive care to pregnant women up to birth control according to care standards. From May 2 - July 14, 2025, Mrs.C, G2P1A0, 32 years old received continuous midwifery care from pregnancy until get contraception methods, starting at 34 weeks of gestation. The mother complained of back pain during prenatal check-ups. The labor process went smoothly. With the assistance of a midwife, the baby was born on June 10, 2025. Birth weight: 3000 grams; length: 50 cm; head circumference: 34 cm; chest circumference: 33 cm; received Hb0 vaccine two hours after birth, eye ointment, and vitamin K shortly thereafter. The baby did not experience any problems or complaints during the first visit. Mrs. C received four visits during the postpartum period. The mother did not feel anything during the first visit up to the following visits. She continued to breastfeed exclusively, and her vital signs and fundal height returned to normal. The mother used a three-month injectable contraceptive so as not to interfere with the exclusive breastfeeding program. Mrs.C has received continuous midwifery care during pregnancy and contraceptive use, and her health is normal. It is expected that the midwife will be able to provide continuous midwifery care so that in the event of an emergency, it can be immediately identified and promptly handled.

Background: Hypertension remains a major public health problem, particularly in primary health care settings. The coexistence of diabetes mellitus may contribute to increased hypertension severity; however, evidence from primary care data in Indonesia remains limited. Objective: This study aimed to examine the association between diabetes mellitus and hypertension severity among patients attending a primary health care center in Indonesia. Methods: A cross-sectional study was conducted using secondary data obtained from medical records at a primary health care center in 2025. A total of 84 patients with hypertension were included using total sampling. Hypertension severity was classified into stage 1 and stage 2. Bivariate analysis was performed using the Chi-square test or Fisher’s exact test as appropriate, with statistical significance set at p < 0.05. Data were analyzed using SPSS version 26. Results: Of the 84 participants, 33.3% had diabetes mellitus. Stage 2 hypertension was more prevalent than stage 1 hypertension. Diabetes mellitus was significantly associated with hypertension severity (p = 0.029), with a higher proportion of patients with diabetes mellitus presenting with stage 2 hypertension. Conclusion: Diabetes mellitus was significantly associated with greater hypertension severity in a primary health care setting. These findings highlight the importance of integrated management.

Dysmenorrhea is one of the most common reproductive health problems among women of reproductive age and can interfere with daily activities and productivity, while limited knowledge regarding proper management often leads to ineffective handling of menstrual pain. This community service activity aimed to improve the knowledge of women of reproductive age regarding dysmenorrhea management through health education at PMB Lina Contesa. The activity employed a pre-experimental design with a one-group pretest–posttest approach involving women of reproductive age visiting PMB Lina Contesa. Health education was delivered through counseling and interactive discussions using leaflet media. Knowledge levels were measured before and after the intervention using a structured questionnaire and analyzed descriptively and comparatively. The results showed an increase in participants’ knowledge after the educational intervention, with most respondents shifting from low to moderate knowledge levels before education to good knowledge levels after education. These findings indicate that health education on dysmenorrhea management is effective in improving women’s understanding, highlighting the importance of continuous educational programs in midwifery care settings as a promotive and preventive strategy for women’s reproductive health

Umbilical cord infection is one of the leading causes of neonatal mortality in Indonesia. Appropriate umbilical cord care is essential to accelerate separation and prevent infection. In the working area of UPT Puskesmas Alai, variations in cord care practices and delayed separation cases were still found. This study aimed to analyze the effect of umbilical cord care using sterile gauze method on cord separation duration at UPT Puskesmas Alai. The study employed quasi-experimental design with one-group pre-test post-test approach on 32 respondents selected through purposive sampling. Pretest data were obtained from medical records, while posttest data through direct observation. Analysis used Wilcoxon Signed Rank Test (α=0.05). Results showed mean cord separation time in pretest group was 9.2 days (SD=1.08) and posttest group 6.0 days (SD=0.84). Wilcoxon test showed Z=-4.94 with p-value=0.000, indicating significant difference. Umbilical cord care using sterile gauze method effectively accelerates separation time compared to conventional methods. Healthcare workers are recommended to implement this method as standard care.

Perineal wounds are commonly experienced by postpartum mothers after vaginal delivery and may cause pain and increase the risk of infection if not properly managed. Appropriate perineal wound care, including the use of non-pharmacological methods, requires adequate maternal knowledge and skills. This program aimed to improve postpartum mothers’ knowledge and skills in perineal wound care through education on betel leaf compresses at PMB Lina Contesa. A community empowerment approach was applied through health education combined with demonstrations and hands-on practice. Evaluation was conducted by assessing changes in maternal knowledge and skills and by observational monitoring of perineal wound conditions. The results showed improvements in maternal knowledge and skills in performing perineal wound care using betel leaf compresses. In addition, postpartum mothers reported reduced pain and no signs of infection during the observation period. These findings indicate that education on betel leaf compresses has the potential to serve as an applicable promotive and preventive approach to support accelerated perineal wound healing among postpartum mothers in primary midwifery care setting.

The biggest challenge faced by the community, especially vulnerable and poor groups, is the cost of managing chronic diseases. Even though there is national health insurance, non-medical costs, costs arising from self-medication, and limitations on certain benefits are still often obstacles that cause high out-of-pocket expenses for the community. The high costs of curative and rehabilitative care indicate that preventive and promotive efforts must be significantly improved, and one way to support the sustainability of these efforts is through a pre-emptive health financing scheme. Community service activities are carried out using a participatory approach so that community members are actively involved in the activities. The activities are carried out in three stages, that is preparation or needs identification, implementation and evaluation. The results of the activity show that the community's knowledge increased significantly because of the community service activity. Participants who took part in the activity also successfully designed a community-based financing scheme involving health savings, whereby each member makes agreed monthly contributions. This community service project demonstrates that community empowerment through the establishment of a pre-emptive financing scheme for chronic diseases can provide an effective, sustainable solution for improving public health.

Early Childhood Education (ECE) plays a crucial role in providing safe, comfortable, and child-friendly educational services for young children. However, as the second environment after the family, the potential for violence against children may still occur in ECE institutions if they are not managed optimally. Therefore, efforts to prevent violence against young children need to be implemented comprehensively through a holistic approach that integrates education, caregiving, and early prevention strategies. This study aims to analyze how ECE institutions, such as kindergartens and daycare centers, can function as the first line of defense in detecting, preventing, and addressing various forms of violence, including physical, emotional, and sexual abuse, among children aged 0–6 years. The research method employed is a literature review and policy analysis related to child protection and the implementation of Early Childhood Education. The findings indicate that capacity building through teacher training, the implementation of child protection–sensitive curricula, and strengthened collaboration among schools, families, and communities have proven effective in reducing the risk of violence by up to 40%, based on case studies in Indonesia. The conclusion emphasizes the importance of strengthening regulations, ensuring continuous supervision, and investing in human resource development to reinforce the role of ECE as a key agent in violence prevention and in creating a safe, healthy, and supportive environment for optimal early childhood development.

Children at the elementary school level are in a phase of rapid growth, encompassing intellectual, physical, and social development. Within the age range of 6–12 years, children are expected to begin managing their own self-care, including maintaining daily personal hygiene. Personal hygiene refers to a set of self-care practices performed to maintain physical health and psychological well-being. Independence in personal hygiene can be defined as a child’s ability to carry out personal hygiene activities independently without reliance on others, related to both physical cleanliness and psychological comfort. This study aimed to describe the level of personal hygiene independence among school-age children at SD Negeri 1 Gianyar. The research employed a quantitative descriptive design with a cross-sectional approach. The study population consisted of 376 students from grades I to III, with a sample of 194 students selected using proportionate stratified random sampling. The results showed that the majority of respondents demonstrated good independence in personal hygiene, with 186 children (95.9%) categorized as independent, while 8 children (4.1%) were categorized as moderately independent. Children’s independence tended to increase with age, and no significant differences were found between male and female students. These findings indicate that the role of families and schools, through consistent habituation and support, plays a crucial role in fostering children’s independence in maintaining personal hygiene.  

Soil-transmitted helminth (STH) infections remain a public health problem among children in tropical regions with high environmental exposure. One potential but underexplored transmission route is toenails, which may serve as a mechanical medium for helminth egg contamination. This study aimed to analyze the association between personal hygiene and STH contamination on children’s toenails in Polimak 1, Jayapura City. An observational analytic study with a cross-sectional design was conducted among school-aged children selected based on inclusion criteria. Personal hygiene data were collected using a structured questionnaire, including handwashing practices, footwear use, and nail care habits. STH contamination on toenails was examined microscopically, and statistical tests were applied to assess associations. The results showed that STH contamination on toenails was still present in a considerable proportion of children, with Ascaris lumbricoides eggs being the most frequently detected. Statistical analysis revealed a significant association between personal hygiene and STH contamination on toenails (p < 0.05), including handwashing habits, footwear use, and nail care practices. This study concludes that personal hygiene plays a crucial role in STH contamination on children’s toenails, and toenails can be used as an indicator of environmental exposure. These findings highlight the importance of consistent personal hygiene practices in preventing helminth infections among children.

This research examines the disproportionate allocation of legal responsibility between doctors and nurses in Indonesia’s health care system and proposes measures to reorganize accountability in a more fair and proportional way. The issue addressed stems from shortcomings in existing regulations, which have not yet ensured legal certainty or balanced legal protection for both professions in clinical practice. The study uses a normative juridical method, applying both statutory and conceptual approaches. The statutory approach reviews laws and regulations that govern professional authority and legal liability of doctors and nurses, while the conceptual approach analyzes legal principles, doctrines, and concepts related to professional responsibility in health services. Legal materials are collected through library research, including primary, secondary, and tertiary legal sources, and are analyzed using qualitative descriptive methods. The results show that although statutory provisions formally regulate the distribution of authority and responsibility between doctors and nurses, there are still normative uncertainties, overlapping regulations, and legal gaps. These issues may lead to an unequal burden of legal responsibility, particularly in cases involving medical errors or negligence. Such conditions weaken legal protection for nurses and can negatively affect the quality of health care delivery. The study concludes that regulatory reform is needed to clarify legal responsibility in accordance with professional authority and to implement a more just and proportional system of accountability. The findings are expected to enrich health law studies and provide guidance for policymakers in developing a fairer legal responsibility framework for health professionals.  

Pulmonary tuberculosis (TB) remains a major public health problem in Indonesia. Despite the implementation of national TB control programs through the Directly Observed Treatment Shortcourse (DOTS) strategy, treatment success continues to face significant challenges, particularly related to patient adherence to anti-tuberculosis drug (ATD) therapy. Non-adherence to TB treatment can lead to treatment failure, disease relapse, and the development of drug-resistant tuberculosis, thereby increasing the overall burden of the disease.Treatment adherence in TB patients is influenced not only by medical factors but also by social and behavioral determinants. Family support plays a crucial role in encouraging patients to comply with treatment regimens by providing motivation, reminding medication schedules, and offering emotional support throughout the long duration of therapy. Patients who receive adequate family support tend to demonstrate higher levels of treatment adherence compared to those with limited support.In addition, the use of herbal medicine as a preventive and supportive health measure is common among the Indonesian population. Herbal medicine is often utilized to enhance immune function, reduce medication side effects, and improve patient comfort during TB treatment. However, the use of herbal remedies without proper medical guidance may lead to misconceptions regarding standard TB therapy.Therefore, it is important to examine the relationship between family support and the use of herbal medicine as preventive measures with treatment adherence among pulmonary TB patients in primary healthcare settings. Such evidence is expected to support a comprehensive family medicine approach and strengthen TB control programs in primary care services.