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Mental health disorders, particularly depression and anxiety, remain major contributors to the global burden of disease and disability. Socioeconomic inequality, including differences in Gross National Income (GNI) per capita, is considered an important factor influencing mental health outcomes. This study aimed to analyze the relationship between GNI per capita and the prevalence of depression and anxiety disorders globally using data from the Global Burden of Disease (GBD) 2023 database. A descriptive ecological study design was conducted using secondary data from 187 countries and regions. Data were analyzed using descriptive statistics, Spearman correlation tests, and regional comparative analysis with ANOVA. The results showed substantial disparities in mental health burden and income distribution across regions. Africa had the highest average prevalence of depression, while Asia showed the greatest variability in anxiety disorders. A significant negative correlation was found between depression prevalence and income levels (r = -0.213; p = 0.003), indicating higher depression rates in lower-income countries. However, anxiety showed a weak and insignificant relationship with income (r = -0.079; p = 0.281). These findings emphasize the need to reduce socioeconomic inequalities and strengthen mental health systems through integrated healthcare services and multisectoral policies.

Stroke remains one of the leading causes of mortality and disability worldwide, including in Indonesia. The increasing prevalence of stroke and Years Lived with Disability (YLD) reflects its growing health burden. This study aimed to analyze trends in stroke prevalence and YLD in Indonesia during 2021–2023 using data from the Global Burden of Disease (GBD). A quantitative descriptive design with an ecological and time-trend approach was employed. Secondary data were obtained from the GBD Results Tool and analyzed using R version 4.4.1. The analysis focused on major geographical regions across Indonesia. The results showed a gradual increase in both stroke prevalence and YLD during the study period. Java recorded the highest prevalence and YLD, while Maluku and Papua showed lower prevalence but greater variation in YLD. These trends were associated with urbanization, unhealthy lifestyles, hypertension, diabetes, and unequal access to healthcare and rehabilitation services. Pearson correlation analysis demonstrated a very strong association between stroke prevalence and YLD (r > 0.99) across all years. The findings highlight increasing stroke burden and regional disparities, emphasizing the need for equitable healthcare access, risk factor control, and strengthened post-stroke rehabilitation programs.

Background: Low birth weight (LBW) remains a major public health concern worldwide due to its significant contribution to neonatal morbidity and mortality, as well as its long-term adverse health consequences. Pregnancy intention has been identified as a potential determinant of adverse birth outcomes; however, evidence regarding its association with LBW remains inconsistent. This study aimed to examine the association between pregnancy intention and low birth weight in Indonesia using data from the 2012 Indonesian Demographic and Health Survey (IDHS). A cross-sectional study was conducted using secondary data from the 2012 IDHS. The study included 8,922 married women aged 15–49 years who had a singleton live birth within five years preceding the survey. Pregnancy intention was categorized as intended, mistimed, and unwanted. Multivariable logistic regression analysis was performed to assess the association between pregnancy intention and LBW after controlling for potential confounding variables. The prevalence of LBW was 6.2%. After adjustment for maternal age and antenatal care (ANC) visits, no significant association was found between mistimed pregnancy and LBW (AOR = 1.055; 95% CI: 0.765–1.454). An interaction effect was identified between unwanted pregnancy and pregnancy complications. Women with unwanted pregnancies accompanied by pregnancy complications had a higher risk of delivering LBW infants compared with women whose pregnancies were intended and without complications. Nevertheless, pregnancy intention was not significantly associated with LBW overall after adjustment for confounding factors. Maternal age outside the optimal reproductive age range (<20 years or >35 years) and inadequate ANC utilization were significantly associated with an increased risk of LBW. Pregnancy intention was not independently associated with low birth weight among Indonesian women after controlling for maternal and healthcare-related factors. Maternal age and antenatal care utilization were more consistent determinants of LBW. Strengthening maternal health services, particularly adequate antenatal care and early detection of pregnancy complications, may contribute to reducing the burden of low birth weight in Indonesia.

The Free Health Check-up (CKG) is a government program designed to strengthen promotive and preventive health efforts through the early detection of risk factors, pre-disease conditions, and diseases across the community according to the life-cycle approach. As a relatively new initiative, the implementation of the CKG program in primary healthcare settings still requires further evaluation to assess implementation readiness, digital support systems, and community participation. This literature review aimed to examine the implementation of the Free Health Check-up Program in primary healthcare services. Relevant literature was retrieved from the Google Scholar database using the keyword "implementation of the free health check-up program" and was limited to open-access, full-text articles published between 2025 and 2026. The search identified eight eligible articles, which were extracted and analyzed in this review. The synthesis revealed three major themes in the implementation of the CKG program: (1) primary healthcare service readiness, (2) digitalization and reporting systems, and (3) community participation and communication strategies. Primary healthcare readiness includes the availability of human resources, infrastructure, medical equipment, consumable medical supplies, funding, service workflows, and cross-sectoral coordination. Digitalization through the SATUSEHATplatform and integrated reporting systems has the potential to improve service efficiency; however, challenges remain regarding digital literacy, internet connectivity, and the technical capacity of healthcare personnel. Community participation is influenced by knowledge, attitudes, the roles of community health volunteers, teachers, healthcare workers, and communication strategies tailored to the characteristics of the target population. The successful implementation of the CKG program requires strengthening primary healthcare systems, optimizing digital health platforms, and adopting community-based communication strategies to ensure the program is more effective, inclusive, and sustainable.

Independent Nursing Practice (INP) is a form of healthcare service that provides direct care to the community, including Homecare services. Public interest in these services is influenced by various factors; however, the dominant factors affecting interest in the Tambah Rejo area have not been clearly identified. This study aimed to identify and analyze factors associated with interest in Homecare services at independent nursing practices and to determine the most influential factor. This study employed a quantitative approach using an analytical survey design with a cross-sectional method. A total of 153 respondents were selected through purposive sampling. Data were collected using questionnaires and analyzed using the Chi-square test and multiple logistic regression. The results showed significant relationships between economic factors (p = 0.023; OR = 2.187), distance (p = 0.003; OR = 0.361), comfort (p < 0.001; OR = 49.67), service quality (p = 0.009; OR = 0.404), family support (p < 0.001; OR = 52.62), patient satisfaction (p < 0.001; OR = 0.212), and interest in Homecare services. Multiple logistic regression analysis revealed that comfort was the most dominant factor influencing interest in Homecare services (p < 0.001; OR = 0.124). Comfort was identified as the strongest determinant affecting community interest in Homecare services at independent nursing practices. Therefore, improving comfort in service delivery should be a primary priority in the development of independent nursing practices.

The implementation of Electronic Medical Records (EMR) has become an essential part of digital transformation in the healthcare sector, aiming to improve the quality, effectiveness, efficiency, and continuity of healthcare services. In Indonesia, the implementation of EMR is supported by the Regulation of the Minister of Health Number 24 of 2022, which mandates healthcare facilities to adopt electronic medical records. However, the implementation process is often challenged by various technical and non-technical factors that may affect its success. This study aims to analyze the success factors and barriers to EMR implementation in hospitals through a literature review approach. The research method used was a literature review by examining and analyzing 11 scientific articles obtained from Google Scholar and other relevant scientific sources. The findings indicate that the success of EMR implementation is influenced by three main aspects, namely human, organizational, and technological factors. Supporting factors include management commitment, user readiness, continuous training, availability of information technology infrastructure, system quality, and organizational support. Meanwhile, common barriers include limited digital literacy among healthcare workers, insufficient information technology personnel, unstable internet connectivity, system errors, inadequate facilities and infrastructure, budget limitations, and the absence of specific standard operating procedures. Furthermore, EMR implementation provides significant benefits, such as improving service efficiency, facilitating access to patient information, enhancing documentation quality, supporting communication among healthcare professionals, and increasing patient safety. Therefore, successful EMR implementation requires synergy between human resources, organizational readiness, and technological infrastructure to achieve optimal healthcare service delivery.

Independent Nursing Practice (INP) is a form of healthcare service that provides direct care to the community, including Homecare services. Public interest in these services is influenced by various factors; however, the dominant factors affecting interest in the Tambah Rejo area have not been clearly identified. This study aimed to identify and analyze factors associated with interest in Homecare services at independent nursing practices and to determine the most influential factor. This study employed a quantitative approach using an analytical survey design with a cross-sectional method. A total of 153 respondents were selected through purposive sampling. Data were collected using questionnaires and analyzed using the Chi-square test and multiple logistic regression. The results showed significant relationships between economic factors (p = 0.023; OR = 2.187), distance (p = 0.003; OR = 0.361), comfort (p < 0.001; OR = 49.67), service quality (p = 0.009; OR = 0.404), family support (p < 0.001; OR = 52.62), patient satisfaction (p < 0.001; OR = 0.212), and interest in Homecare services. Multiple logistic regression analysis revealed that comfort was the most dominant factor influencing interest in Homecare services (p < 0.001; OR = 0.124). Comfort was identified as the strongest determinant affecting community interest in Homecare services at independent nursing practices. Therefore, improving comfort in service delivery should be a primary priority in the development of independent nursing practices.

The rapid advancement of Internet of Things (IoT) technologies has transformed conventional residential environments into intelligent smart housing systems capable of enhancing energy efficiency, security, comfort, healthcare services, and environmental sustainability. However, existing studies remain fragmented, focusing on specific technologies or applications rather than providing a comprehensive understanding of the smart housing ecosystem. Therefore, this study aims to systematically review the major technologies employed in IoT-based smart housing systems, examine their contributions to residential benefits, and identify the challenges and future opportunities associated with their implementation. This research adopted a Systematic Literature Review (SLR) approach using the Scopus database as the primary source of literature. The review process followed a structured screening and selection procedure, resulting in the inclusion of 26 studies that met the predefined eligibility criteria. The findings indicate that Artificial Intelligence, Blockchain, Edge Computing, Fog Computing, Cloud Computing, Digital Twin, Smart Grid technologies, renewable energy systems, and advanced sensor infrastructures constitute the primary technological foundations of modern smart housing systems. The reviewed studies indicate that these technologies contribute to energy optimization, cybersecurity enhancement, intelligent automation, healthcare monitoring, safety improvement, and sustainable resource management. However, challenges related to security, privacy, interoperability, scalability, computational complexity, and implementation costs remain important barriers to widespread adoption. In conclusion, IoT-based smart housing systems have evolved into integrated and intelligent residential ecosystems, and future development is expected to be driven by the convergence of Artificial Intelligence, distributed computing, Digital Twin technologies, and sustainable smart infrastructure solutions.  

Diabetes Mellitus (DM) is a chronic metabolic disease characterized by persistently high blood sugar levels, which can lead to complications such as diabetic foot issues. A crucial aspect for healthcare professionals providing care to DM patients is assessing the patient's level of adherence and understanding regarding self-care and disease management. Data from the 2023 SKI (Indonesian Health Survey) indicates there were 118,184 cases of Diabetes Mellitus in Central Java. Foot care education delivered via remote services assists patients in performing proper foot care to prevent complications associated with the condition. This study aimed to determine the effectiveness of an animated video based on the Theory of Planned Behavior in improving the knowledge and adherence of patients with diabetic ulcers. A quasi-experimental design was employed, utilizing a one-group pre-test and post-test approach with a control group. Incidental sampling was used to select 60 respondents. The Mann-Whitney test yielded a p-value of < 0.05 (0.017), demonstrating that the animated video based on the Theory of Planned Behavior was effective in enhancing both adherence and knowledge among patients with diabetic ulcers. The findings suggest that this animated video, leveraging audiovisual media, can be implemented in educational settings to help prevent foot complications in patients with diabetes.

This study aims to analyze the effectiveness of the Free Medical Treatment Program Using Identity Cards (KTP) at Wedomu Community Health Center, East Tasifeto District, Belu Regency. The research employed a qualitative approach with a descriptive method. Data were collected through interviews, observations, and documentation and analyzed using the Miles and Huberman interactive model, consisting of data reduction, data display, and conclusion drawing. The analysis was based on Richard M. Steers' (1985) effectiveness theory, which includes goal attainment, system approach, and strategic constituencies approach. The findings indicate that the program has been fairly effective in improving public access to healthcare services and reducing medical expenses. From the goal attainment perspective, the program has facilitated easier access to healthcare services for the community. From the system approach perspective, the program is supported by funding, healthcare personnel, and service facilities, although limitations in human resources and supporting infrastructure remain. From the strategic constituencies perspective, beneficiaries expressed a high level of satisfaction with the services received. Supporting factors include local government commitment, healthcare workers’ dedication, and strong public demand for affordable healthcare services. Meanwhile, the main obstacles include limited healthcare personnel, inadequate service facilities, and insufficient public understanding of program procedures. Therefore, strengthening human resources, improving healthcare facilities, and enhancing program socialization are necessary to ensure sustainable improvements in healthcare service effectiveness.

In order to raise the standard of healthcare services in the contemporary period, digital transformation in hospital management has become a phenomena. The purpose of this study is to investigate the adoption, advantages, difficulties, and success aspects of digital transformation in healthcare facilities. A literature review employing a narrative review system was the methodology. 14 papers that met the inclusion requirements were found using data sources from Google Scholar, PubMed, and ScienceDirect databases with publication years ranging from 2020 to 2025. To determine the primary study themes, data analysis was carried out utilising a thematic synthesis approach. According to the study's findings, digital transformation can enhance operational effectiveness, service quality, and patient safety by using technology including electronic health records (EHR), telemedicine, and hospital management information systems. However, there are still a number of obstacles to its adoption, such as inadequate infrastructure, inadequate human resource competency, expensive investment costs, and data security threats. Significant barriers also include a lack of system integration and opposition to change. Government policies and regulatory assistance have an impact on the success of digital transformation in hospital administration.

This study aims to develop a more systematic system for evaluating the performance of Community Health Centers (Puskesmas) based on the Health Center Management cluster. Performance evaluation of Puskesmas plays an important role in improving the quality of public healthcare services, particularly in Sragen Regency. However, the current evaluation process has not been integrated into a computerized system, making it less effective in supporting decision-making. Therefore, this study develops a decision support system by integrating the Analytic Hierarchy Process (AHP) and the *Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) methods. The AHP method is used to determine the weight of each criterion based on its level of importance, while the TOPSIS method is applied to generate an objective ranking of Puskesmas performance. The results indicate that the system is capable of utilizing nine evaluation criteria to produce a ranking of Puskesmas within the Health Center Management cluster, from the highest to the lowest score. The developed system is expected to support a more effective evaluation process and improve decision-making. Future research may enhance the system by incorporating additional evaluation clusters, expanding the number of assessment criteria, and optimizing its features and security.

Patient satisfaction with healthcare services remains a major concern in the delivery of healthcare. The behavior of healthcare workers, including friendliness, politeness, and communication skills, plays an important role in improving patient satisfaction. Preliminary data indicated that the number of BPJS patient visits at BLUD UPTD Puskesmas Mokoau had decreased annually, while the results of the patient satisfaction survey were still not optimal because several health programs had not achieved the targeted service standards. This study aimed to analyze the relationship between the quality of healthcare services and BPJS patient satisfaction in the working area of Puskesmas Mokoau in 2025. This research applied a quantitative method with a descriptive-analytic approach using a cross-sectional study design. The study involved 306 respondents selected through a random sampling technique, ensuring that each member of the population had an equal opportunity to be chosen as a research sample. Data were collected using questionnaires and analyzed through the Chi-Square test. The findings revealed significant relationships between facilities, procedures, interaction, and communication with BPJS patient satisfaction, with each variable obtaining a P-value of 0.000 (<0.05). Therefore, the quality of healthcare services is closely associated with the level of patient satisfaction, indicating that healthcare workers need to improve service quality effectively and professionally.

Patient trust is a crucial variable in hospital management, determining clinical success, treatment adherence, and institutional loyalty. In the increasingly competitive and digitalized modern healthcare landscape, hospitals face unique challenges stemming from the inherent characteristics of healthcare services. This article presents a systematic literature review exploring the determinants of patient trust through the lens of hospital service characteristics: intangibility, inseparability, variability, and perishability. This study followed the PRISMA protocol and analyzed 150 articles published between 2010 and 2026 from Scopus, Web of Science, and Google Scholar databases. The review results indicate that assurance and empathy are the most significant service quality dimensions in mitigating perceived risk due to intangibility. Meanwhile, the quality of therapeutic communication is a key factor in managing inseparability, and standardization of operational procedures is necessary to address variability. The study also identifies the role of digital technology and the physical environment as "tangible evidence" that strengthens hospital credibility. The managerial implications of this research emphasize the need for organizational culture transformation oriented toward humanitarian values ​​and transparency to rebuild public trust that has eroded in the post-pandemic era.

Adolescents face significant barriers in accessing reproductive health services due to fears of privacy breaches and social stigma. In primary healthcare facilities, healthcare professionals are often trapped in a dilemma between the obligation to maintain medical confidentiality based on professional ethics and national regulatory demands requiring parental involvement for underage patients. This study aims to analyze the practice of protecting adolescent patient data privacy at Mardi Saras Primary Clinic and identify the gap between practical implementation and the norms of medical ethics and applicable legal regulations. This study employs a socio-legal research method with a qualitative approach. Data were collected through in-depth interviews with doctors and nurses, observation of service procedures, and study of the clinic's Standard Operating Procedures. The results indicate that although Mardi Saras Primary Clinic has implemented basic confidentiality protocols such as closed consultation rooms, there are substantial weaknesses in informed consent management, which still heavily relies on parental presence for all adolescent cases. This practice is driven by healthcare professionals' fear of legal risks, thereby ignoring the principle of developing autonomy in adolescents. These findings indicate a disparity between rigid administrative compliance and the spirit of protecting adolescent health rights within national regulations. The implication of this study underscores the urgency of developing specific SOPs that are sensitive to adolescent rights, as well as the need for continuous training for healthcare professionals regarding the legal and ethical boundaries of maintaining confidentiality for underage patients without compromising legal safety aspects.

Background: Acute pharyngitis is an inflammation of the pharynx caused by viral or bacterial infections, frequently resulting in sore throat, fever, and dysphagia. This condition is among the most prevalent acute respiratory tract infections in children and adolescents worldwide, contributing significantly to morbidity and the burden of healthcare services. Objective: This case study aimed to describe the comprehensive nursing care provided to patient An. F with acute pharyngitis at Ward Anggrek 1, RSUD dr. Soeselo, Tegal Regency. Methods: A descriptive study design with a nursing process approach was employed. Data were collected through anamnesis, physical examination, observation, and documentation review. The nursing process encompassed assessment, nursing diagnosis, intervention planning, implementation, and evaluation. Results: Assessment revealed chief complaints of throat pain (NRS scale 5), fever (38.8°C), erythematous tonsils, and nutritional deficit. Three nursing diagnoses were established: acute pain related to physiological injury, hyperthermia related to disease process, and knowledge deficit related to insufficient information exposure. Interventions included pain management, hyperthermia management, and health education. Following two days of nursing care, the patient’s condition significantly improved, with pain scale reduced from 5 to 3 and body temperature normalized to 37.7°C. Conclusion: Comprehensive nursing care incorporating pharmacological and non-pharmacological approaches effectively reduced pain and fever, and improved patient and family health literacy regarding acute pharyngitis.

Patient satisfaction represents the comparison between expectations before receiving health services and perceptions of the quality of services provided. The assessment of healthcare service quality generally uses the five SERVQUAL dimensions, namely tangibles, reliability, responsiveness, assurance, and empathy. A preliminary survey showed that the reliability dimension obtained the lowest average score compared to other dimensions. This study employed an observational analytic design with a cross-sectional approach. The study population consisted of BPJS (National Health Insurance) patients who received services. A total of 386 respondents were selected using purposive sampling. Data were collected through a SERVQUAL-based questionnaire and analyzed using univariate, bivariate (chi-square test), and multivariate (logistic regression) analyses to identify the dominant factors related to patient satisfaction. The results indicated that the variables of age (p < 0.05) and all five SERVQUAL dimensions (tangible, reliability, responsiveness, assurance, and empathy) were significantly associated with patient satisfaction levels. It can be concluded that most BPJS patients were satisfied with the services provided. The assurance dimension was found to be the most influential factor. Therefore, efforts to improve service quality should focus on strengthening aspects of assurance, trust, and service reliability.

Maternal hypertension remains one of the major contributors to maternal morbidity and mortality in Indonesia and globally. This study aimed to analyze the prevalence, mortality trends, and geographical disparities of maternal hypertension in Indonesia during the 2022–2023 period. The research employed a descriptive design using secondary data obtained from official reports of the Indonesian Ministry of Health, national health surveys, and Maternal Perinatal Death Notification (MPDN) data. Data analysis was conducted descriptively by examining prevalence rates, maternal mortality due to hypertension, regional distribution, and temporal trends across provinces in Indonesia. The findings showed a slight but consistent decline in both the prevalence and mortality rates of maternal hypertension from 2022 to 2023 in most provinces. However, significant regional disparities remained evident. Provinces in eastern Indonesia, including Papua Barat, Nusa Tenggara Timur, Maluku, and several provinces in Sulawesi and Kalimantan, consistently recorded higher prevalence and mortality rates compared to provinces in Java and Bali. Meanwhile, provinces with better healthcare infrastructure and maternal referral systems demonstrated lower mortality outcomes. The study also revealed a strong association between high prevalence and increased maternal mortality, indicating the importance of healthcare accessibility, antenatal care quality, and emergency obstetric services in reducing maternal health burdens. These findings emphasize the need for region-specific maternal health interventions, improved healthcare distribution, early detection programs, and strengthened referral systems to reduce maternal hypertension disparities and improve maternal health outcomes in Indonesia.

Telepharmacy is a digital-based pharmaceutical service innovation aimed at improving access to healthcare services and enhancing the quality of pharmaceutical care, particularly in areas with limited healthcare resources. This study aimed to evaluate the implementation of telepharmacy services at Sehat Plus Pharmacy based on the six healthcare quality dimensions established by the World Health Organization (WHO), namely safety, effectiveness, timeliness, efficiency, equity, and patient-centeredness, and to analyze their association with respondent characteristics. A quantitative descriptive-analytic study with a cross-sectional design was conducted. The study involved 35 respondents selected using a total sampling technique. Data were collected through a structured Likert-scale questionnaire and analyzed using univariate analysis and Spearman correlation tests with a significance level of α = 0.05. The results indicated that the overall implementation of telepharmacy services was categorized as very good (88.8%), with the safety dimension achieving the highest evaluation score among all quality dimensions. Most respondents were female and aged between 21 and 25 years. Statistical analysis revealed a significant association between age and perceptions of telepharmacy implementation (p = 0.004; r = -0.471), indicating a moderate negative correlation. In contrast, gender, educational level, and occupation showed no significant association with service implementation (p > 0.05). It can be concluded that telepharmacy services at Sehat Plus Pharmacy have met WHO healthcare quality standards and provide positive user experiences, while age remains an important factor influencing service perception and acceptance.

Drug logistics management is a critical component of pharmaceutical services that ensures the availability, quality, safety, and rational use of medicines. Inadequate logistics management may lead to stock shortages, overstocking, increased operational costs, and disruptions in healthcare services. This study aimed to analyze the drug logistics management system at Altara Simalingkar Clinic, encompassing planning, budgeting, procurement, receiving, storage, distribution, utilization, recording and reporting, as well as monitoring and evaluation. This study employed a descriptive qualitative approach. Data were collected through in-depth interviews, observations, and documentation involving a pharmacy assistant technician as the key informant directly responsible for the daily technical operations of drug logistics management. Data were analyzed thematically by comparing interview findings, observations, and supporting documents. The results showed that the drug logistics management system at Altara Simalingkar Clinic generally complied with pharmaceutical logistics management principles. Drug planning was based on previous utilization data, disease patterns, and evaluations of fast-moving and slow-moving medicines. Storage practices implemented the First Expired First Out  method, while recording and reporting activities were supported by a pharmacy management information system. However, three structural challenges were identified: delays in drug delivery from distributors, limited storage capacity that does not meet WHO Good Storage Practice standards, and discrepancies between physical stock and administrative records arising from the dual manual-digital recording system. To enhance the effectiveness and sustainability of pharmaceutical services, it is recommended to diversify distributors for critical medicines, fully digitize inventory recording through barcode implementation, and optimize storage infrastructure in accordance with applicable regulatory standards.