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Lahar Bumi Mahardika; Triyanta Triyanta; Nabilatul Fanny

Journal of Educational Innovation and Public Health 2024 Pusat Riset dan Inovasi Nasional

Nosocomial infections are a serious problem that often occurs in hospitals and can have a negative impact on patient safety. The role of nurses, especially in inpatient rooms, is very important in preventing these infections. Preliminary studies found 0.34% of HAIs in hospitals, 0.00% of urinary tract infections, 0.86% of Phlebitis, 0.00% of Ventilator Associated Pneumonia. The aim of this study was to determine the relationship between knowledge and behavior of nurses regarding the prevention of nosocomial infections.This type of research is quantitative research with a cross sectional approach. Data collection was carried out through questionnaires. This population is all nurses in the Inpatient Room at PKU Muhammadiyah Sukoharjo Hospital. The sample for this research was 42 respondents who were selected using the total data saturated sampling technique used, namely univariate and bivariate analysis (Spearman rho test).The results of the univariate analysis research showed that the nosocomial infection prevention process variable, nurse knowledge was in the good category at 100% and the nosocomial infection prevention process variable, nurse behavior was in the good category at 100%. The results of bivariate analysis using the Spearman's rho statistical test show that there is a p-value of 0.000, where this value is smaller than 0.05 with a coefficient value of 0.528. So it can be said that there is a relationship between knowledge and behavior of inpatient room nurses in preventing nosocomial infections at the PKU Muhammadiyah Sukoharjo hospital.In conclusion, there is a relationship between knowledge and behavior in preventing nosocomial infections at the PKU Muhammadiyah hospital. Suggestions: Increase counseling and training on preventing nosocomial infections for nurses and health workers and non-health workers at the PKU Muhammadiyah Sukoharjo Hospital.

Clara Sartika; Kamidah Kamidah

Jurnal Riset Ilmu Farmasi dan Kesehatan 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Background: Menstruation is the process of shedding of the uterine wall (the inner layer of the endometrium) which is accompanied by bleeding that occurs repeatedly every month, except during pregnancy. Dysmenorrhea consists of primary and secondary dysmenorrhea. This study aims to determine the impact of giving sour turmeric infusion on changes in the level of dysmenorrhoea. Giving tamarind turmeric infusion on changes in desmenorrhea in female students at SMPN 19 Bandar Lampung. Research Objective: To determine the impact of giving sour turmeric infusion on changes in the level of dysmenorrhoea in female students at SMPN 19 Bandar Lampung Research Method: The type of research used is quantitative with a cross sectional approach. Pre-experimental research design with a one group pretest-posttest design without a control group. The sampling technique uses the Accidental Sampling technique. The data analysis technique used is the Wilcoxon test. Research result : Giving tamarind turmeric is a feasible intervention given to reduce dysmenorrhea pain experienced by young women. Suggestion for health workers to provide knowledge about treatment non-pharmacological dysmenorrhoea by administering tamarind turmeric drink. Conclusion : Giving tamarind turmeric is a suitable intervention to reduce dysmenorrhea pain experienced by young women. Suggestions for health workers to provide knowledge about non-pharmacological treatment of dysmenorrhoea by giving tamarind turmeric drinks

Iyo Iko Rasaki; Yasmirah Mandasari Saragih; Marice Simarmata

IJLS (International Journal of Law and Society) 2024 Asosiasi Penelitian dan Pengajar Ilmu Hukum Indonesia

Health services aim to maintain and improve the quality of health, as well as prevent and treat diseases in the community.This study aiming to analyze the legal certainty for health workers in health services, using the normative legal method. The data source comes from a literature review. The results of this study indicate that Law Number 17 of 2023 regarding Health brings significant changes to the legal certainty for health workers in Indonesia in terms of health services. Previously, legal certainty for health workers was spread across various separate laws. However, with the enactment of Law Number 17 of 2023, this legal protection has become more integrated and comprehensive. Updates regarding the protection of health workers include increasing the rights of health workers, including affirmation of compliance with professional standards and ethics. There are improvements in rights, salary, performance allowances, health insurance, and opportunities for self development. This protection is strengthened by giving health workers the authority to stop services if there is a violation of ethics. It is necessary to strengthen operational procedures and work standards that can be a reference for health workers in carrying out their duties, thereby reduce the risk of negligence that can result in criminal sanctions and additional regulations are also needed to ensure a fair legal mechanism for health workers in facing accusations of negligence, by considering ethics and professional aspects in their work.

Irwan Batubara; Sri Juwarni; Herawati Harahap

Jurnal Pelaksanaan Pengabdian Bergerak bersama Masyarakat 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Stunting in Tapanuli Selah district will be 39.4 percent in 2022, and in 2023 it will decrease by 15.6 percent. Community empowerment in the health sector develops Community Resource Health Efforts (UKBM) namely Posyandu. Posyandu organizers are health cadres, elected by the community. Increasing the ability of cadres to manage posyandu activities, especially regarding basic health services to the community, is carried out by training by health workers. Muaratais Health Center was inaugurated on July 15 2023, the newest sub-district expansion in South Tapanuli Regency. The Muaratais Health Center area has 15 villages, in each village there is a posyandu, an average of 4 cadres and there are new cadres who have never attended training. The service team agreed with the Community Health Center to carry out training for posyandu cadres on monitoring the growth of toddlers. Training materials, toddler growth, measuring body length, height and weight using tools available at the posyandu, infant ruler, microtoise, portable electric body weight. The training participants consisted of 20 health cadres, appointed by the community health center to represent the posyandu in their work area. Training activities were carried out for two days in the community health center meeting room. Lecture, question and answer, simulation and demonstration methods. Trainees' knowledge about monitoring toddler growth is getting better. Skills in using the growth monitoring tools available at posyandu category are sufficient. Skills at the advanced stage are continued by the posyandu supervisor.

Nurhabib Nurhabib; Retno Wahyuni; Rumondang Sitorus

Jurnal Ilmu Kesehatan dan Gizi 2024 Pusat Riset dan Inovasi Nasional

Early detection of high risk by health workers through quality antenatal care is one of the efforts to accelerate the reduction of MMR in Indonesia. The aim of this research was to determine "The Effectiveness of Health Education E-Booklets on Pregnant Women's Knowledge About Danger Signs of Pregnancy at the Sonomartani Labura Community Health Center in 2023. The research was conducted using a quasi-experimental research method." The design used is a one group pre test and post test design research design. The research was carried out by knowing the mother's knowledge (pretest) before being given a health education E-booklet for danger signs of pregnancy, then continuing with a final test (posttest) after being given a health education E-booklet. The research results show a P value of 0.000, meaning p 0.05, stating that the health education e-booklet is effective on pregnant women's knowledge about the danger signs of pregnancy at the Sonomartani Labura Community Health Center in 2023.

Kristoforus Marselinus; Yurita Mailintina; Ribka Sabarina Panjaitan; Ika Mustafida; Ria Efkelin Mose +2 more

Jurnal Kemitraan Masyarakat 2024 Lembaga Pengembangan Kinerja Dosen

Palliative care is a treatment approach that aims to improve the quality of life of patients facing serious illnesses, especially when the disease is no longer responsive to curative treatment. Palliative care not only focuses on controlling physical symptoms, but also provides psychological, social, and spiritual support to patients and their families. With this education, health workers are expected to: Increase Knowledge and Skills: Education will increase the knowledge of health workers about pain management, chronic symptom management, and psychosocial and spiritual support for home residents. From the data displayed in the table, it can be concluded that from 30 respondents obtained an N-Gain Score of 64.3, indicating that the method applied by the researcher in this activity is quite effective. In addition, the distribution of N-Gain Score with a value of 0.6 indicates that the strength or category in this study is at a moderate level, the results of the pre-test and post-test that have been carried out by the researcher have increased significantly, which is 50%.

Ratih Indriane Septiani; Kartawan Kartawan; Yusuf Abdullah

Jurnal Nuansa : Publikasi Ilmu Manajemen dan Ekonomi Syariah 2024 Asosiasi Riset Ilmu Manajemen Kewirausahaan dan Bisnis Indonesia

The aim of this research is to determine the effect of training, work experience, competence and motivation on performance. The study was conducted on mental health management employees at the Tasikmalaya Regency Regional Health Center. Sampling was carried out using census techniques, with a sample size of 97 samples, consisting of mental health management employees at the Tasikmalaya Regency Regional Health Center, which consists of 40 Community Health Centers. The research instrument used was a questionnaire with a Likert scale. The analysis technique used is path analysis using the SPSS application. The results of this research show that: 1) Training, work experience, competence, motivation and performance are in good condition. 2) Training, work experience and competence have a positive and significant effect on performance, motivation has a positive but not significant effect on performance. 3) Training, work experience, competency and motivation have a significant effect on the performance of mental health management health workers at the Tasikmalaya Regency Regional Health Center

Ismawan Adrianto; Sumarno Sumarno; T Riza Zarzani

International Journal of Sociology and Law 2024 Asosiasi Penelitian dan Pengajar Ilmu Hukum Indonesia

This research examines the implementation of legal protection for healthcare workers serving in remote areas, with a case study in Kapuas Hulu Regency. The main focus of the study is to analyze the effectiveness of existing legal protections and identify factors hindering their implementation. Through a qualitative approach using case study methods, this research reveals a significant gap between existing regulations and practices in the field. The case of Dr. I serves as a concrete example of weak legal protection, ranging from transfers without adequate consideration to eviction from official residences. Identified inhibiting factors include lack of understanding among local officials, weak inter-agency coordination, and discrepancies between central policies and local implementation. This study recommends the need for comprehensive reform in the legal protection system for healthcare workers in remote areas, including capacity building for local officials and strengthening oversight mechanisms.    

Puja Rahma Tifanni; Desi Pramita Sari; Renny Adelia Tarigan

Jurnal Ventilator: Jurnal riset ilmu kesehatan dan Keperawatan 2024 Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Breast milk dam is a swelling of the breast due to an increase in venous and lymph flow, causing breast milk dam. Data (SDKI) showed that 42% of mothers experienced breast milk dams. Breast milk dams are caused by discontinuous breastfeeding, the baby has not breastfed properly, improper breastfeeding position, wearing BH that is too tight, nipple abnormalities, absence of breast care before and after childbirth and lack of maternal knowledge about breast care. The aim is to determine the relationship between breastfeeding position and breast care with the incidence of breast milk dam in the working area of Sei.Langkai Health Center, Batam City 2023. The method in this study used quantitative research with analytical descriptive research and used a Cross Sectional research design, the sample in this study was 65 postpartum women, statistical tests using Chi-Square, purposive sampling technique. The distribution of breastfeeding positions was not correct as many as 36 postpartum women (55.4%), postpartum women did not perform breast care as many as 55 postpartum women (84.6%), the majority of postpartum women who experienced breast milk dams were 36 postpartum women (55.4%). The results of statistical analysis with Chi-Square found that there was no relationship between breastfeeding position and the incidence of breast milk dam with a value (P-Value) = 0.099 where (P < ?) = 0.05, and there was a relationship between breast care and the incidence of breast milk dam with a value (P-Value) = 0.030 where (P < ?) = 0.05. The conclusion is that there is no relationship between breastfeeding position and the incidence of breast milk dam and there is a relationship between breastfeeding position and breast milk dam. it is hoped that midwives and other health workers can teach mothers directly during breastfeeding how to do the correct breastfeeding position and breast care technique.

Bustamil Arifin; Ismail Efendy; Ramadhani Syafitri

Jurnal Ilmu Kesehatan 2024 Lembaga Pengembangan Kinerja Dosen

Toddler age is a period of rapid growth and development, a state that is vulnerable to nutrition and susceptible to disease. Diarrhea in toddlers if not treated seriously can cause pain, to severe dehydration or fluid loss that ends in death. The current diarrhea control program is more prioritized on diarrhea control programs for toddlers. This research method is cross-sectional with a population of mothers and toddlers with a sample size of 175 respondents. The results of this study showed the influence of the mother's education level (p-value 0.011), exclusive breastfeeding (0.003), socio-economic (0.008), hand washing habits (0.007) on the incidence of diarrhea in toddlers in the Tanjung Sekayam Health Center Area, Sanggau Regency. The conclusion of this study is that there is an influence of the mother's education level, exclusive breastfeeding, socio-economic, hand washing habits on the incidence of diarrhea. It is expected that health workers will carry out health promotion activities about the incidence of diarrhea in toddlers to prevent infectious diseases that will result in stunting.

Theresia Salmabela Patria; Nella Vallen I.P; Resa Nirmala Jona

Jurnal Ilmu Kesehatan 2024 Lembaga Pengembangan Kinerja Dosen

Background: Many pregnant women experience sleep disorders in the second and third trimesters, which can lead to poor sleep quality. This study aimed to determine the effect of effleurage massage with aromatherapy oil on improving the quality of nighttime sleep for pregnant women in the second and third trimesters at Anugrah Clinic. This type of research is a quasi-experiment with a control group pretest-post-test design. The population was all second- and third-trimester pregnant women at Anugrah Clinic, with as many as 46 pregnant women. The sampling technique was total sampling, with 23 pregnant women in the experimental group and 23 in the control group. The data collection tool used the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Data analysis used the McNemar test. The experimental group study showed an effect of effleurage massage with aromatherapy oil on the quality of night sleep for pregnant women in the second and third trimesters, with a value of p = 0.001. The control group study showed an effect of massage effleurage on the quality of night sleep for pregnant women in the second and third trimesters, with a value of p = 0.016. Analysis of the chi-square test data to see the difference between the experimental and control groups yielded a p-value of 0.049, meaning that there was a significant difference in the post-test sleep quality of the experimental and control groups. In conclusion, the increase in sleep quality for pregnant women was more common in the experimental group; the quality of sleep for pregnant women increased to 87%, while in the control group, the quality of sleep for pregnant women increased only 56.5%. The suggestion is that it is hoped that pregnant women and health workers, in overcoming sleep disturbances in the second and third trimesters of pregnant women, can apply effleurage massage interventions with aromatherapy oils.

Sanjayanto Nugroho; Beklie Beklie; Reynu Dwi Kalvisa Noor; Beby Sulistya; Salma Aulia Putri Suherman +11 more

Jurnal Pelaksanaan Pengabdian Bergerak bersama Masyarakat 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Stunting is a chronic nutritional problem that has serious impacts on children's physical, cognitive, and socio-emotional development, especially in Indonesia. This study aims to increase public awareness about stunting prevention through a socialization and intervention program in Tumbang Baringei Village, Gunung Mas Regency. This program involves KKN students, health workers, and educational institutions in various activities, including stunting socialization, cooking demonstrations of Supplementary Feeding (PMT) made from patin fish, and implementation of nutritious food provision in Kindergartens (TK). The results of the activities showed a significant increase in the knowledge and awareness of young mothers regarding the importance of balanced nutritional intake, as well as behavioral changes in maintaining children's health and nutrition. This intervention succeeded in building healthy eating habits from an early age and is expected to significantly reduce stunting rates in the village. In conclusion, cross-sector collaboration and empowerment of local communities are effective strategies in preventing stunting in Indonesia.

Ulfi Jefri; M.Nassir Agustiawan; Defi Selvianita; Silvi Filya Sava; Hujatul Arifin +2 more

Publikasi Hasil Pengabdian dan Kegiatan Masyarakat 2024 Asosiasi Periset Bahasa Sastra Indonesia

The main aim of this social service is awareness and deeper understanding of the dangers of drugs, their legal and health impacts, as well as inspiring positive changes in attitudes and behavior in social settings among the younger generation and the general public. The service method used is legal advice, including legal sources from the police, doctors and public health workers. Activities carried out through communication include discussions, presentations and comparisons of legal aspects related to drugs. The results of this service show that anti-fraud training has succeeded in achieving its goals. Participants saw increased awareness of illegal drugs, their negative impact on health, and the legal consequences they face. Participants felt more responsible for their personal and community health. Information provides insight into prevention strategies to help participants develop healthy lifestyle skills and avoid high-risk behaviors.

Muhammad Muzakky Zain Ali; Noenik Soekorini; Syahrul Borman

Desentralisasi : Jurnal Hukum, Kebijakan Publik, dan Pemerintahan 2024 Asosiasi Peneliti dan Pengajar Ilmu Hukum Indonesia

Law Number 17 of 2023 concerning Health brings significant changes in the handling of medical professional errors in Indonesia. This research aims to analyze the mechanism for the formation and authority of the Medical Dispute Settlement Council as well as the role of the state in Gustav Radbruch's legal perspective. The research method used is a normative juridical approach with descriptive analysis. The research results show that this law integrates various previous regulations, establishing a permanent or ad hoc assembly to uphold ethical standards and professionalism for health workers. The Assembly is tasked with handling complaints and alleged disciplinary violations before they enter the realm of criminal law, offering fairer and more efficient dispute resolution through a restorative and non-litigation approach. The role of the state is very important to guarantee justice, legal certainty and benefits, ensure that the assembly operates fairly and transparently, and provides fair legal protection for patients and medical personnel.

Sry Rizki; Nurromsyah Nasution; Asmima Yanti

International Journal of Health and Social Behavior 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Nurses' compliance in carrying out hand hygiene is very important because infection and disease transmission can be caused by health workers who are not compliant in carrying out hand hygiene every time they carry out health service actions. Health workers' compliance in carrying out hand hygiene both before and after carrying out procedures for providing health services can be a problem that must be considered due to various factors that are closely related to compliance in carrying it out. This research was conducted to analyze factors related to health workers' compliance in implementing hand hygiene at the Peulumat Health Center, South Aceh. The design used is descriptive correlation with a cross sectional approach. The total sample was 80 health workers. Data was obtained by interview using a questionnaire. There is an influence on attitudes with results (p 0.003) and length of service (p 0.002) the availability of hand hygiene facilities (p 0.000) which influences the compliance of health workers in implementing hand hygiene at the Peulumat Health Center in South Aceh. Based on statistical tests, it was found that factors that can influence the health of workers in carrying out hand hygiene consist of attitude, length of service, availability of facilities for carrying out hand hygiene. The implication for recommended services is that supervision and motivation of health workers need to be increased to carry out hand hygiene in accordance with recommendations. The research implication is that it is hoped that there will be research with a larger sample size, involving other people as researchers and using video.

Astaria Br Ginting; Ade Rachmat Yudiyanto; Cris Anggelina Br Manik; Deby Febriani Saputri

Jurnal Pelaksanaan Pengabdian Bergerak bersama Masyarakat 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Background: Cervical cancer is the most common cancer in Indonesia. Cancer has a high mortality rate caused by delays in diagnosis and treatment. Nearly 70% of cancer patients are detected at an advanced stage. This is very unfortunate, because cervical cancer can be found at a stage before cancer occurs (precancerous lesions) which can be treated so that it does not become cancer. The early detection program for cervical cancer in Indonesia is carried out using the Acetic Acid Visual Inspection (IVA) method carried out by trained health workers. In three years (2020-2022), as many as 3,914,885 women aged 30-50 years or 9.3% of the target have undergone early detection of cervical cancer using the IVA method. The highest early detection of targets has undergone early detection of cervical cancer using the IVA method. Early detection was reported by West Nusa Tenggara Province at 34.1%, followed by South Sumatra at 33.5%, and Bangka Belitung Islands at 27.8%. Meanwhile, the province with the lowest early detection coverage is Papua at 0.1%, followed by West Papua at 0.4%, and North Sulawesi at 0.7%. In 2022, of the 2,175,314 women aged 30-50 years who had early detection of cervical cancer, 7,869 (0.36%) had positive VIA examination results and 1,232 (0.06%) were suspected of cervical cancer.

Fidzah Nurfajrina Murad; Zahrawi Astrie Ahkam; Amirah Maritsa; Hasrini Hasrini; Dwi Rezky Aulyah

Jurnal Pengabdian dan Kesejahteraan Masyarakat 2024 Lembaga Pengembangan Kinerja Dosen

Cross-infection prevention is a crucial aspect of health services, especially in dental clinics that often face high risks of infection transmission. This community service program aims to improve the knowledge and skills of health workers and the community in preventing cross-infection in dental clinics. These activities include counseling, practical training, and evaluation in several dental clinics, with a focus on the implementation of hygiene protocols, the use of personal protective equipment (PPE), and sterilization of medical devices. The results of this program showed a significant increase in the understanding and implementation of cross-infection prevention procedures, as measured by questionnaires before and after the program implementation.

Dhea Alfiya Ningsih; Relita Buaton; Anton Sihombing

Saturnus: Jurnal Teknologi dan Sistem Informasi 2024 Asosiasi Riset Teknik Elektro dan Informatika Indonesia

Stunting is a growth and development disorder in children caused by chronic malnutrition over a long period of time, especially in the first 1,000 days of life, namely from pregnancy to the first 2 years of life. There are more than 149 million (22%) toddlers worldwide who are stunted, of which 6.3 million are Indonesian toddlers. Based on data from the Ministry of Health, the stunting rate in Indonesia in 2023 was recorded at 21.5 percent, only down 0.1 percent from the previous year which amounted to 21.6 percent. Predicting the number of stunted toddlers is very important and necessary to know the stunting rate in Langkat Regency in 2024, and the prediction results can help health workers in handling and preventing the spread of stunting. The method applied to this prediction system is Multiple Linear Regression where this analysis determines whether each independent variable is positively or negatively related, the direction of the relationship between variables, and estimates the value of the dependent variable will increase or decrease.  The prediction system is carried out using the RapidMiner application because this application is very appropriate to produce information output in the form of prediction results for the coming year. The prediction results obtained are an increase and decrease in 2024 in each sub-district and there are sub-districts that do not experience an increase and decrease. The sub-district with the highest number was Secanggang with approximately 177 people, and the sub-district with the lowest number of stunted children was West Berandan with approximately 55 people. Then Stabat sub-district became the sub-district that experienced the most increase in the number of stunting, which was around 15 people, and the sub-district that experienced the most decrease was Kuala sub-district with a total of approximately 23 people. From the overall results it can be calculated that the number of stunting in all districts in Langkat Regency amounted to approximately 2453 people in 2024. And testing the error rate of prediction results using RMSE in the RapidMiner application of 7.63%, where the level of accuracy in the prediction of child stunting in Langkat Regency is 92.46%.

Wanda Aprilyasari; Fitriyatus Sholikha; Irvan Ardiansyah; Moch Abdillah Islami; Suratmi Suratmi +1 more

Jurnal Ilmu Keperawatan dan Kebidanan 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Work life balance is a problem experienced by health workers, one of which is in the nurse group. Nurses are faced with high role demands, where the tasks and responsibilities of activities that need to be completed at the same time, this will cause an imbalance in their personal lives. The purpose of this study was to determine the relationship between workload and work-life balance in nurses at the hospital. This correlation research design uses a crossectional approach. The research sample taken using total sampling amounted to 41 nurses. The research data was taken with a questionnaire sheet, then analyzed using the Spearman Rho test. The results showed that most (63.4%) nurses experienced heavy workload, and most (56,1%) nurses experienced currently work-life balance. Based on the results of the analysis using an ordinal scale with the Spearman Rho test, the p value = 0.000 (p <0.05) and the value = ─0.517, then H1 is accepted. There is a relationship between workload and work life balance in nurses at the hospital. Based on the results of the study, it is hoped that the hospital will pay attention in handling the tasks and responsibilities experienced by nurses so that nurses are able to manage time in completing their work to be maximized and directed without thinking about matters outside of their work.

Wiyanti Wiyanti; Puput Dewi Anggraeni; Hana Yulinda Fitriyani

Jurnal Pengabdian Sosial 2024 Lembaga Pengembangan Kinerja Dosen

The success of a hospital in carrying out its functions is marked by the results of quality service. In order for this to be realized, a hospital should be managed professionally by competent human resources and the availability of supporting facilities and infrastructure. One of the factors that influences the success of a hospital is good service quality. Quality health services are health services that can satisfy every user of health services. Another problem faced by partners is negative views of nurses, such as being rude, unfriendly, or unprofessional, which still often appear in the community. When friendliness and attention are absent, a climate of discomfort and reluctance to interact is created, resulting in suboptimal service. Health service providers, in addition to having professional ethics, also need to have good "manners" or etiquette in providing services to service users in this case patients or their families. The importance of the manners possessed by health workers in supporting service quality at Kardinah Hospital, Tegal City because health workers are the spearhead of services provided by the hospital to customers. The success of a hospital in carrying out its functions is marked by the results of quality service quality, one of which is the service provided by health workers