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The increasing complexity of competition in the healthcare industry requires hospitals to adopt adaptive and strategic management practices to enhance organizational competitiveness. This study aims to analyze the role of strategic management in improving hospital competitiveness through a Systematic Literature Review (SLR) approach. A total of 41 national and international scientific articles published between 2014 and 2025 were reviewed, sourced from Scopus, Web of Science, Google Scholar, and Sinta databases, following the PRISMA guidelines for literature selection. The synthesis of findings indicates that strategic management plays a significant role in strengthening hospital competitiveness through clear strategy formulation, consistent implementation, and continuous performance evaluation. Key factors contributing to competitive advantage include strategic leadership, adaptive organizational culture, effective human resource management, utilization of information technology, and integration between strategic planning and operational processes. The results emphasize that hospitals implementing strategic management comprehensively are better equipped to respond to environmental dynamics, improve service quality, and sustain competitive advantage in the long term. This study highlights the importance of strategic management as a foundational element in modern hospital governance and provides a conceptual basis for future empirical research in healthcare management.

The increasing complexity of competition in the healthcare industry requires hospitals to adopt adaptive and strategic management practices to enhance organizational competitiveness. This study aims to analyze the role of strategic management in improving hospital competitiveness through a Systematic Literature Review (SLR) approach. A total of 41 national and international scientific articles published between 2014 and 2025 were reviewed, sourced from Scopus, Web of Science, Google Scholar, and Sinta databases, following the PRISMA guidelines for literature selection. The synthesis of findings indicates that strategic management plays a significant role in strengthening hospital competitiveness through clear strategy formulation, consistent implementation, and continuous performance evaluation. Key factors contributing to competitive advantage include strategic leadership, adaptive organizational culture, effective human resource management, utilization of information technology, and integration between strategic planning and operational processes. The results emphasize that hospitals implementing strategic management comprehensively are better equipped to respond to environmental dynamics, improve service quality, and sustain competitive advantage in the long term. This study highlights the importance of strategic management as a foundational element in modern hospital governance and provides a conceptual basis for future empirical research in healthcare management.

Immunization is a preventive measure used to protect against Tuberculosis, Diphtheria, Pertussis, Polio, Hepatitis B, and Measles. Immunization administration must be continuous, comprehensive, and conducted according to standards to provide effective health protection. The objective of this study was to determine the correlation between paternal support and the immunization status of children aged 0 to 1 year in the Tamban Baru Community hEalth Center area, Kapuas Regency. This study used a cross-sectional correlation design. The independent variable was paternal support, and the dependent variable was immunization status. The sample was selected using total sampling technique, consisting of 50 respondents. Data collection was performed using a questionnaire. The results showed a significant correlation between paternal support and the immunization status of children aged 0 to 1 year, indicated by p = 0.000017 < 0.005; thus, the null hypothesis (H0) was rejected and the alternative hypothesis (H1) accepted. This means that there is a correlation between paternal support and the immunization status of children aged 0 to 1 year. It is recommended that that cross-sector collaboration and Community Health Center authorities enhance efforts so that every immunization officer provides health education, such as counseling about immunization, and that family involvement in spreading immunization programs is increased to achieve targeted coverage through cooperation with health professionals.

Immunization is one of the most cost-effective efforts to improve maternal and child health. The proper use of Buku Kesehatan Ibu dan Anak (KIA) – Mother and Children Health Manual can server as an indicator of the quality of care provided to children in health center services. This study aims to determine the correlation between the use of KIA towards basic immunization compliance in Ulee Kareng Publich Health Center, Banda Aceh. This study employed a quantitative research design using a cross-sectional approach. The population consisted of 521 mothers with babies. The sample was 84 respondents chosen using the probability cluster sampling technique. This study was conducted in Ulee Kareng Publich Health Center from May 27 to June 24, 2025. The data were analyzed using the Chi-Square test.The results showed a correlation between the use of KIA and basic immunization compliance, with a p-value of 0.008 (P<0.05) at Ulee Kareng Public Health Center, Banda Aceh. These results indicated that mothers who used the KIA books had a better understanding of the importance of basic immunization compliance, compared to those who did not utilize them properly. It can be concluded that there is a correlation between the use of KIA books and basic immunization compliance. This study suggests that health workers provide information on the importance of the KIA books and advise mothers to use it properly.

The coverage of Complete Basic Immunization (Imunisasi Dasar Lengkap or IDL) in Maharani Village remains low at 38.8%, falling short of the national target of 95%. This condition increases the health risk of toddlers contracting Vaccine-Preventable Diseases (PD3I). This study aimed to determine the relationship between mothers' knowledge and husbands' support regarding the completeness of basic immunization for toddlers in Maharani Village, within the working area of Rumbai Bukit Public Health Center. This research employed a quantitative analytic method with a cross-sectional design. The population in this study comprised all mothers with toddlers in the area, with a sample of 73 respondents selected using the purposive sampling technique. Data collection was conducted using validated questionnaires and observation of Maternal and Child Health (KIA) books, followed by univariate and bivariate analysis using the Chi-square statistical test. The results indicated that the majority of toddlers had incomplete immunization status (61.6%), mothers had a low level of knowledge (61.6%), and respondents did not receive support from their husbands (58.9%). Statistical test results confirmed a very significant relationship between mothers' knowledge (p-value = 0.000) and husbands' support (p-value = 0.000) with the completeness of basic immunization. The conclusion confirms that knowledge and husband's support are the main determinant factors. It is suggested that Rumbai Bukit Public Health Center implement a more inclusive health promotion strategy by involving the active role of husbands in monitoring child health.

Basic immunization helps to prevent infectious diseases in toddlers. It increases immunity and reduces morbidity and mortality. However, full basic immunization coverage is low in several areas, including the Darul Imarah Health Center, Aceh Besar. Family support is considered one of the influencing factors. This support can be emotional, informational, instrumental, or appraisal. The purpose of this study was to determine the relationship between family support and the completeness of basic vaccinations for toddlers in the service area of ​​the Darul Imarah Community Health Center in Aceh Besar. This study used a quantitative cross-sectional design. Using a probability random sampling method, the sample size was 90 respondents out of 817 respondents in the population. The research was conducted from May 5th to 24th, 2025. The study used both bivariate and univariate analyses. The data collection was analyzed using the Chi-Square test. The results showed a relationship between family support and toddler immunization completion, with a P-value of 0.003 (p<0.05). The conclusion indicates a relationship between family support and immunization completion. Therefore, this research provides insight for the family's role in improving basic immunization coverage for toddlers. The findings may help the Darul Imarah Health Center and healthcare workers design strategies for socialization and family support to reach complete immunization targets.

Background: Globally, stunting in children under five years old in 2022 is around 22.3% or 148 million children under 5 years old. In Southeast Asia alone, the prevalence of stunting is 26.4% or 14.4 million. Objective: This study was to determine the correlation complete basic immunization and the incidence of stunting in toddlers in the Working Area of UPT Puskesmas Batu Aji Batam City. Methods: This research is a quantitative study observational analytic design with a case control approach. The sample is 42 toddlers and using purposive sampling technique. Data collection tools use observation sheets and the chi-square test. Findings: The results of the chi square statistical test obtained a p-value of 0.005 <0.05 (OR = 6.400 (95% CI (1.654 - 24.770)). There is a significant relationship between complete basic immunization and the incidence of stunting in toddlers in the Working Area of UPT Puskesmas Batu Aji Batam City. Implication: Complete basic immunization has a significant impact on the growth and development of toddlers

Basic immunization is one of the main pillars in the effort to control infectious diseases, which is important for the health of children from an early age. In order to achieve optimal health, immunization helps prevent diseases such as diphtheria, tetanus, whooping cough, polio, and measles that can cause serious complications or even death. The immunization program implemented at Posyandu Terkini 1 in Mario Village has a positive impact on public health, with an immunization coverage rate showing 97.90% in the South Sulawesi region. This study focuses on factors that influence the utilization of basic immunization at Posyandu Terkini 1 in Mario Village. In a quantitative research design with a cross-sectional approach, researchers involved the entire population consisting of 89 infants and toddlers in Mario Village through a total sampling method. Using the Chi Square test, this study identified factors related to the utilization of immunization services, namely maternal knowledge, maternal attitudes, family support, and support from health workers. The results showed that these factors significantly influenced the utilization of basic immunization, while access to immunization services did not show a significant relationship. This research makes an important contribution to the development of public health policies, particularly in increasing community participation in immunization programs. With a more integrated approach, particularly in educating the community about the benefits of immunization and the importance of support from families and health workers, it is hoped that immunization coverage in villages will be broader and more equitable. These findings will be published in the Jurnal Kesehatan (Health Journal) to provide further insights for relevant stakeholders in improving the quality of immunization services. Furthermore, this study also emphasizes the importance of the active role of health workers in educating parents, especially mothers, about the benefits of immunization and the vaccine schedule.

The high mortality and morbidity rates of infants in Indonesia remain a serious public health problem. One of the main causes of this condition is the emergence of infectious diseases that can actually be prevented through basic immunization. Diseases such as diphtheria, pertussis, tetanus, tuberculosis, poliomyelitis, measles, and hepatitis B are types of diseases that can be prevented by immunization, yet many children still have not received complete immunizations. This study was conducted to determine the relationship between maternal knowledge levels and the completeness of basic immunization status of children aged 12–24 months in RW 13 Kp. Sapan, Sumbersari Village. This study used a quantitative approach with a cross-sectional design and was conducted in August 2024. A total of 39 mothers with children aged 12–24 months became the study respondents through a total sampling technique. Data collection was carried out using a questionnaire, and the data obtained were analyzed using the Chi-square test. The results showed that the majority of mothers had a sufficient level of knowledge, namely 21 mothers (53.8%). In addition, the majority of toddlers, 28 children (71.85%), had received complete basic immunizations. The results of statistical analysis showed a significant relationship between maternal knowledge and the completeness of children's basic immunizations with a p value of 0.006 (p < 0.05). This indicates that the higher the mother's knowledge regarding the importance of immunization, the greater the likelihood of the child receiving complete basic immunizations. Therefore, it is important for mothers to continue to increase their knowledge about immunizations through various sources of information such as books, counseling, or consultations with health workers, so that efforts to prevent infectious diseases in children can be optimally achieved.

Immunization is the basis for effective disease prevention in children under the age of five to protect a person from dangerous diseases before coming into contact with disease-causing agents, Efforts to actively increase a person's immunity to a disease so that if one day they will get sick or only experience mild illness. The purpose of this study was to determine the Relationship between Completeness of Basic Immunization and Children Aged 1-5 Years in Sukomulyo Village. This study uses the Correlational Analytical method using the Cross-sectional approach where data collection is only carried out at one time or once. The sample is some children aged 1-5 years, totaling 137 using the Random Sampling Technique. The instrument used is the KIA book record. The results of this study indicate that the status of completeness of basic immunization in Sukomulyo village is mostly complete (33.8%), and the health status of children in Sukomulyo village is mostly sick (50.4%). based on the results of the chi-square statistical test, a p-value of 0.000 was obtained, which means that there is a Relationship between Completeness of Basic Immunization and the Health of Children Aged 1-5 Years in Sukomulyo Village. Advice for people who have children to carry out complete basic immunization so that they know the importance of children's health and the knowledge of mothers in immunizing their children.

Immunization is one of the most effective and efficient public health efforts in preventing diseases and reducing mortality rates in children such as smallpox, polio, tuberculosis, hepatitis B, diphtheria, measles, rubella, congenital rubella syndrome (CRS), tetanus, pneumonia (lung inflammation) and meningitis (inflammation of the brain membrane) (Nandi & Shet, 2020). Data from the Indonesian Ministry of Health in 2020 showed that vaccination coverage in the 3rd and 4th months was months. However, efforts can be made to increase child vaccination coverage to 80% and that does not include DT, MR2, and HPV vaccinations. As, measles data is only 45%, diphtheria-tetanus (DT) is around 40% (Indonesian Ministry of Health, 2021). To determine the relationship between maternal knowledge and the completeness of basic immunization in children at the Raden Omas Posyandu. This study uses a quantitative research design with a cross-sectional method. The population in this study consisted of mothers who had children aged 12 to 18 months at Posyandu Raden Omas, totaling 36 mothers. The statistical results showed a relationship between maternal knowledge and the completeness of basic immunization in children p-value (0.048). Most respondents had good knowledge, as many as 13 respondents (36.1%). Sufficient knowledge, as many as 13 respondents (36.1%). Insufficient knowledge, as many as 10 respondents or 27.8%. Most respondents had incomplete immunization, namely 18 respondents (50%).

Background: In 2021, there were 38 deaths for every 1000 live births in the world's under-five population. Predisposing factors, enabling resources, need, and health service usage are the three primary elements that make up Andersen's theory and have an impact on health care utilisation. Goal: To ascertain how patient trust and service quality relate to Sekanak Raya Village's whole basic immunisation program. Method: This study is quantitative in nature and uses a cross-sectional, analytical observational methodology. The mothers who had children in Sekanak Raya Village made up the study's population. Tools for gathering data include questionnaires and observation sheets. In data analysis, the chi-square test was employed. Result: The findings indicate that 15 out of 100 underdog moms believe in complete basic immunisation status, whereas 18 out of 100 underdog mothers believe that the quality of service is good with complete basic immunisation status. For patient confidence, the chi square statistical test yielded a p-value of 0.022 < 0.05, whereas for service quality, the p-value was 0.004 < 0.05. In Sekanak Raya Village, UPTD Working Area, Puskesmas, Rear Padang, Batam City, total basic immunisation quality and patient trust are significantly correlated in 2024.

Stunting is a chronic nutritional problem in toddlers caused by a lack of nutritional intake for a long time so that the child becomes too short for his age. Based on the results of the Indonesian Nutrition Standards Survey (SSGI) in 2022 in Riau province, it reached 17.0%. The prevalence rate of stunting in Pekanbaru reached around 16.8% in 2022. According to the Health Office in 2022, Lima Puluh Health Center recorded the highest prevalence of stunting at 4.47% or 60 cases. One of the risk factors that contributes to stunting is the low coverage of complete basic immunization, which can prevent infectious diseases that can interfere with children's growth and development. However, the lack of public knowledge and awareness of the importance of complete basic immunization increases the risk of infection. The long-term impacts of stunting include cognitive impairment, developmental delays, and low productivity in the future. Knowing the relationship between the completeness of basic immunization and the incidence of stunting in toddlers aged 24-36 months in the Lima Puluh Health Center work area, Pekanbaru City. to determine the relationship between the completeness of basic immunization and the incidence of stunting in toddlers aged 24-36 months in the Lima Puluh Health Center work area, Pekanbaru City. From the results of data analysis, a relationship has been found between the completeness of immunization and the incidence of stunting in toddlers aged 24-36 months in the Lima Puluh Health Center work area (p-value = 0.03; OR of 11.66; (95% CI = 1.22-110.95). Completeness of basic immunization is related and is a risk factor for stunting in toddlers aged 24-36 months in the Limapuluh Health Center work area.

The coverage of complete basic immunization in Indonesia in 2020 during the Covid-19 pandemic had not yet reached the expected target. The province with the lowest coverage was Aceh, with only 41.8%, indicating a significant gap from the national target. This study aims to determine the relationship between parental roles and the coverage of complete basic immunization for infants during the Covid-19 pandemic in the Banda Sakti area. This research used a cross-sectional design with a cluster sampling technique. The univariate analysis showed that most of the children were male, totaling 48 (51.6%). The age of the fathers was mostly between 26–35 years (52 respondents or 55.9%), and the mothers’ age was also mostly between 26–35 years (63 respondents or 67.7%). The majority of both fathers and mothers had a senior high school education, with 49 (52.7%) and 39 (41.9%) respectively. Most of the basic immunization coverage in the Banda Sakti area was incomplete, amounting to 74 infants (79.6%), and the parental role was categorized as poor. The bivariate analysis using the Chi-square test and its alternatives showed a p value < 0.05, indicating a significant relationship between the roles of fathers, mothers, and parents in general, and the coverage of complete basic immunization. The conclusion of this study is that there is a significant relationship between parental roles and the coverage of complete basic immunization for infants during the Covid-19 pandemic in the Banda Sakti area.

 Immunisation is the stage of prevention of infectious diseases such as ‘hepatitis, tuberculosis, polio, tetanus, diphtheria, pertussis, and measles’ Knowledge of parents, especially mothers, plays an important role in the success of immunisation programmes, where education level affects knowledge about the importance of immunisation. The following study aimed to analyse the correlation between parents' education level and knowledge in providing complete basic immunisation to children. The following quantitative approach uses a Cross Sectional design, on 88 respondents selected through Purposive Proportional Random Sampling using a questionnaire in the form of a questionnaire and obesrvasion. Data were collected through questionnaires and analysed using the Chi-Square test. The results showed a significant relationship between education level and parental knowledge in providing complete basic immunisation at Bangetayu Health Centre, Semarang City (p-value <0.05). Thus, the higher the level of education of parents, the better their knowledge in providing complete basic immunisation to children. This study highlights the importance of complete basic immunisation to prevent disease. Health offices and health centres need to improve education through counselling and information distribution. Parents' awareness plays an important role in ensuring children are fully immunised. This study is useful for parents in increasing knowledge, health centres in improving services, and researchers as a reference for further studies.  

Basic immunization is one of the prevention programs for communicable diseases to children. Immunization coverage rates in regions have not yet reached the target. This is caused by many factors. This study aimedto analyze factorsthatinfluencingto maternal behavior in fulfilling basic immunization for children aged 0-12 months in the Work Areaof the Sumobito Health Center in Jombang.The factors analyzed are not only internal factors of the individual, but also external factors, both family environment and the availability ofservices, whichare also determinants ofbehavior.This research was observational analytic with cross sectional approach. Data analysis used logistic regressiontest. The results of this study indicated that factorsinfluencedmaternal behavior in fulfilling childbasic immunization wereattitude (p = 0,000), trust (p = 0,002), family support (p = 0.006), access (p = 0,000), and information (p=0,000), while age (0,718) and work status (0,844) did not influence to maternal behavior in fulfilling child basic immunizationThis is because, during the COVID-19 pandemic, mothers worked at home so they had time to deliver their children to immunization

Background: Basic immunization services for children in Indonesia have been integrated starting from Posyandu, Community Health Centers and hospitals, however the overall basic immunization coverage is still below the target set by the government. Data from the Hamparan Perak Community Health Center shows that coverage of all types of complete basic immunization did not reach the target, and Deli Serdang Regency with the lowest IDL coverage in North Sumatra Province is Deli Serdang Regency. Objective: This study aims to analyze the factors that influence maternal compliance in providing complete basic immunization in Hamparan Perak sub-district, Deli Serdang district. Method: The research used quantitative research methods with a cross sectional study design which was carried out in the work area of ​​the community health center in Hamparan Perak sub-district, Deli Serdang district, starting from preparing the thesis to obtaining research results. The population in this study were mothers aged ≥ 18 years in the working area of ​​the health center in Hamparan Perak sub-district, Deli Serdang district. The sampling technique used in this research is probability sampling using simple random sampling with a sample size of 73 respondents. Results: The results of the study showed a significant influence between knowledge (p=0.03) and maternal compliance in providing immunizations, and there was no influence between perception (p=0.47), quality of immunization services (p=0.10), number children (p=0.46), distance to health services (p=0.74) and maternal compliance in providing complete basic immunization in Hamparan Perak sub-district, Deli Serdang district. Conclusion: the factor that most influences maternal compliance in providing complete basic immunization is knowledge. Suggestion: It is necessary to increase the role of health workers in providing good information to the public about the importance of immunization for babies, and it is hoped that this can also increase the public's positive perception of immunization.

Immunization Completeness base is an immunization that must be given to children from birth so that their bodies are protected from dangerous diseases. Complete basic immunization coverage in Suka Raya Village, Pancur Batu District reached 80.7%: the low coverage of basic immunization is related to the knowledge and attitudes of mothers. This study aims to determine the relationship between maternal knowledge and attitudes and the completeness of basic immunization in infants . Data collection from primary and secondary data, data were analyzed using the chi-square test with a 95% confidence level. This type of research is analytical with a Cross Sectional approach , the population in this study were all mothers who had babies aged 9-12 months who visited Suka Raya Village, namely 42 people. The sampling technique is Total Sampling . Collection data For about complete basic immunization data analysis with Chi Square statistical test . The results of the study showed that there was a relationship between maternal knowledge and attitudes with the completeness of basic immunization with a p value for the knowledge variable of 0.003 and a p value for the attitude variable of 0.000. Then, maternal knowledge and attitudes influenced the completeness of basic immunization in infants, mothers with good knowledge and positive attitudes were more likely to complete their infants' basic immunization according to the specified schedule. It is recommended for Pancur Batu Village to further improve the provision of counseling to mothers about complete basic immunization and for health workers in Pancur Batu Village to improve maternal knowledge about the completeness of basic immunization  

Knowledge and the role of posyandu (integrated service post) cadres are crucial and strategically important in providing health education to the community. According to 2023 data, the coverage of complete basic immunization at posyandu is significantly below the target. Surveys revealed that some cadres have insufficient knowledge and a minimal role in immunization services, such as providing counseling, encouraging, and motivating mothers to immunize their children. This study aims to determine the relationship between knowledge and the role of posyandu cadres in achieving complete basic immunization in the working area of Puskesmas Bahaur Hilir, Pulang Pisau District. Method: This research is a correlational study with a quantitative method using a cross-sectional approach. The sampling technique employed was total sampling, with 65 respondents. Data were collected using a questionnaire, and statistical analysis was performed using the Spearman correlation test. Results: The data analysis revealed a significant relationship between knowledge and the role of cadres, with a significance value (p-value) of 0.000 < 0.05 and a strong correlation coefficient of 0.642. Conclusion: There is a significant relationship between knowledge and the role of cadres, with a strong correlation coefficient. It is recommended that posyandu cadres enhance their knowledge and active participation in posyandu activities and communicate information to the community to improve health outcomes.

Accination actively seeks to create/enhance a person's immunity to disease. Vaccination protects children from several immunisation-preventable diseases (VPDs). Some of the infectious diseases included in VPDs are tuberculosis, diphtheria, tetanus, hepatitis B, whooping cough, measles, polio, and meningitis. Vaccinated children will be protected from dangerous diseases that can cause injury or death. This study is included in analytical observational research, which does not conduct treatment on research subjects with the aim of providing a clearer picture of the problem in the subject. This type of research is a type of survey with a cross sectional design or where the data collection process is carried out at the same time between independent variables, namely factors that influence the provision of complete basic immunisation in infants. Based on the table, it can be seen that the majority of mothers have a high school education as many as 30 people, the majority of mothers who work as housewives as many as 46 people, the majority of mothers have less knowledge as many as 52 people, the majority of mothers with incomplete basic immunisation as many as 56 people.