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Anemia during pregnancy is a significant maternal health issue with serious impacts on maternal and perinatal outcomes, including complications such as severe preeclampsia, postpartum hemorrhage, and low birth weight (LBW), all of which contribute to increased morbidity and mortality rates. This literature review aims to analyze the clinical impacts of pregnancy anemia, related complications, and effective management strategies based on the latest scientific evidence (2020-2024). The study examines the relationship between anemia and preeclampsia, LBW, and postpartum hemorrhage, as well as the importance of nutritional fulfillment in prevention and management. Five research articles from indexed journals were collected from the Scopus database, with inclusion criteria of studies with clear designs, focusing on pregnancy anemia, and published in Indonesian or English. The analysis results show that pregnancy anemia is a predisposing factor for preeclampsia through mechanisms such as placental hypoxia and oxidative stress. Anemia is also closely related to an increased incidence of LBW and postpartum hemorrhage, particularly due to lower hemoglobin reserves and uterine contractility issues. Adequate nutritional fulfillment is influenced by socioeconomic barriers, supplementation side effects, and lack of family support. Anemia management requires a comprehensive approach, including routine screening, prophylactic supplementation, nutritional education, and effective referral systems for complex cases. Prevention through early detection and timely intervention is crucial in reducing maternal and perinatal morbidity.

The ability to write scientific papers is an essential competency for students in supporting academic achievement and readiness to face the world of work and research. However, many students still experience difficulties in compiling scientific papers, especially in the aspects of writing systematics, the use of academic language, and reference management. In response to this problem, the service team carried out a Scientific Writing Preparation Training for PASIM National University students as a form of implementation of the Tri Dharma of Higher Education in the aspect of community service. The training method uses an andragogy approach through interactive lectures, discussions, and hands-on practice. The activity was attended by around 50 students across study programs. The training material includes an introduction to scientific papers, writing rules, topic determination techniques, reference search and management, and outline preparation. Evaluation was carried out through observation, assessment of written products, and satisfaction questionnaires. The results showed an increase in participants' understanding by 30–40% based on the comparison of pre-test and post-test. All participants succeeded in compiling an outline of scientific papers, and the majority expressed satisfaction with the training. This activity has proven to be effective in improving students' scientific writing skills and fostering academic motivation and culture. It is recommended that similar training be carried out on an ongoing basis with intensive mentoring to support the improvement of the quality of human resources and contribution to student scientific publications.

The implementation of digitalization in the healthcare sector through the Integrated Referral sistem (Sistem Informasi Rujukan Terintegrasi/SISRUTE) offers significant opportunities to expand access and improve the quality of healthcare services, especially in remote and underserved areas of Indonesia. This paper aims to analyze the challenges of implementing SISRUTE from a legal perspective, focusing on the principle of equitable healthcare access. The study uses a normative juridical approach combined with literature analysis, examining national regulations, including Law No. 17 of 2023 on Health, Government Regulation No. 47 of 2021 on Hospital Administration, and supporting ministerial policies. The research identifies several barriers that hinder the effectiveness of SISRUTE implementation, such as uneven distribution of digital infrastructure, limited internet connectivity, lack of adequately trained healthcare personnel, and the absence of supporting local regulations that align with national policy frameworks. These challenges create disparities in the utilization of SISRUTE, particularly in rural and remote areas, undermining the constitutional mandate for equal access to health services. From a legal standpoint, the principle of equity in healthcare has yet to be fully realized through SISRUTE due to these systemic gaps. The study concludes that strategic efforts are needed to improve intergovernmental coordination, harmonize health and digital regulations, strengthen healthcare workers' digital competencies, and invest in robust infrastructure development. Only through an integrated legal, technological, and human resource approach can SISRUTE fulfill its intended function in supporting a fair, inclusive, and effective healthcare referral system nationwide. This paper contributes to ongoing discourse on legal reforms for digital health equity in Indonesia.

The adoption of Hospital Information Systems (HIS) is a crucial step toward improving healthcare service delivery, especially in public hospitals in developing countries. RSUD Prof. Dr. H. Aloei Saboe, a referral hospital in Gorontalo, Indonesia, has implemented the SIMRS Khanza system to digitize inpatient registration and medical documentation. However, limited evaluation has been conducted to assess its effectiveness beyond technical performance. This study aims to evaluate the implementation of SIMRS Khanza using the Human-Organization-Technology Fit (HOT-Fit) framework, which examines the alignment between users, institutional support, and system quality. A qualitative descriptive method was employed, involving in-depth interviews, non-participatory observations, and document reviews with eight informants, including medical record officers, system coordinators, and hospital management. The findings reveal that although most users reported improved efficiency and satisfaction, several issues persist: incomplete training, limited adherence to SOPs, and system performance lags during peak hours. Organizational support was present but inconsistent, and documentation policies lacked specificity for digital contexts. Technologically, the system demonstrated stable output, but responsiveness and integration require enhancement. The synthesis of findings suggests that success in HIS implementation is contingent upon not only system reliability but also continuous user engagement, structured training, and dynamic policy support. Therefore, a holistic strategy integrating human, organizational, and technological components is essential to optimize SIMRS performance and sustainability.

The Maternal Mortality Rate (MMR) in Indonesia is still high and is a major challenge in the health system, especially in the labor phase. This study aims to analyze the implementation of the BPJS patient labor referral system in reducing MMR at the Gunung Tinggi Health Center. The study used a qualitative method with a case study approach to health workers at the Gunung Tinggi Health Center. The results of the study showed that the availability of competent health workers, adequate facilities and infrastructure, and a referral system integrated with BPJS have made a positive contribution to labor services. However, challenges were still found in the form of late responses from referral hospitals, geographical constraints, and low public health literacy regarding the importance of referrals. This study concludes that strengthening the coordination system between facilities and educating the community is very important in increasing the effectiveness of the referral system and reducing maternal mortality.  

Non-formulary drug utilization in Harapan Kita Children’s and Mother’s Hospital presents a substantial challenge in healthcare cost management, especially for patients enrolled in the BPJS health insurance program. Given its status as a national referral hospital, Harapan Kita Children’s and Mother’s Hospital encounters a high prevalence of complex maternal and child health cases requiring the use of medications beyond the scope of the national formulary. This research endeavor seeks to examine the patterns and consequences of non-formulary drug use within this context. This study adopted a quasi-experimental design, incorporating both quantitative and qualitative methods, to evaluate the impact of an sosialisation intervention and audit clinic on physician compliance with formulary drug use. A pre-test and post-test design was employed to measure changes in non-formulary drug utilization. Findings indicated a statistically significant decrease in non-formulary drug use from 18% to 13% post-intervention. The integration of a clinical pathway and tailored physician training was instrumental in achieving improved formulary adherence. Given these results, it is recommended to broaden training and surveillance programs, strengthen technological support through the implementation of formulary information systems, and undertake longitudinal research to assess the long-term sustainability of the intervention's effects..

Pending claims in Indonesia’s National Health Insurance (JKN) system pose a significant challenge, affecting hospital cash flow and administrative efficiency. A high rate of pending claims is often caused by incomplete documentation, misfiled medical records, and delays in verification processes. Optimizing manual administrative procedures may provide a solution to this issue. This study aims to evaluate the effectiveness of a standardized manual administration model in reducing pending claims in a hospital setting. A quasi-experimental pretest-posttest design without a control group was employed. Data were collected from a referral hospital in Indonesia from July to September 2024. A total of 138 inpatient claims were selected using simple random sampling. The intervention involved implementing a standardized manual administration system in August and September. Statistical analysis was conducted using Fisher’s Exact Test with a significance level of p < 0.05. The implementation of the standardized manual administration model significantly reduced pending claims from 70.3% (97/138) in July (pre-intervention) to 36.2% (50/138) in August and further to 11.6% (16/138) in September (post-intervention) (p = 0.000 and p = 0.003, respectively). Additionally, improvements were observed in medical record completeness, supporting examination documentation, and administrative accuracy. A standardized manual administration system effectively decreases pending claims in JKN by improving documentation and claim verification processes. Further research is needed to explore the long-term sustainability of this model and the potential benefits of digitalization.