Background Substance use is prohibited in Indonesia; however, adolescents continue to consume these substances, creating a significant public health challenge. This study examines behavioral and demographic factors associated with general drug use, including cannabis and amphetamine use, among Indonesian adolescents, using nationally representative data.
Methods A cross-sectional study used data from the 2023 Indonesia Global School-based Student Health Survey, which included 10,059 students aged 13 to 17 years. A two-stage cluster sampling was applied, and descriptive and regression analyses were conducted to identify factors associated with substance use.
Results Overall, 3.03% of students reported drug use, 1.45% reported cannabis use, and 1.33% reported amphetamine use. Age and school level were not significantly associated with substance use. However, male sex, residence outside the Java-Bali region, alcohol use, and tobacco use were consistently linked to higher odds of drug, cannabis, and amphetamine use. Alcohol consumption was the strongest predictor for all types of substance use. These findings indicate that risky behaviors tend to cluster, supporting the pattern of polysubstance use among youth.
Conclusion The study findings highlight the need for risk-specific, gender-responsive, school-based prevention programs that actively involve parents and regulate adolescents’ access to alcohol and tobacco. Enhancing life skills and character education in both school and family settings may also help students avoid risky behaviors.
Background This study investigates disparities in the utilization of primary health care (PHC) between urban and rural populations in Indonesia, focusing on socioeconomic and demographic determinants. Understanding these patterns is essential for promoting equity under the National Health Insurance (Jaminan Kesehatan Nasional, JKN) program.
Methods Data were obtained from the 2023 National Socioeconomic Survey, which included 334,887 individuals. Binary logistic regression was used to examine the association between individual characteristics and PHC utilization.
Results Overall utilization rates were similar across urban and rural areas, but significant disparities were observed. Women were more likely to use PHC than men (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.10–1.13). The association between higher education and PHC utilization was negative (OR, 0.78; 95% CI, 0.75–0.81), while access to information technology slightly reduced utilization (OR, 0.98; 95% CI, 0.96–0.99). Wealth effects diverged sharply: affluent urban residents were less likely to use PHC (OR, 0.84; 95% CI, 0.81–0.87), whereas wealthier rural residents were more likely to utilize PHC (OR, 1.09; 95% CI, 1.05–1.13). Dual insurance ownership had a strong positive effect in rural areas (OR, 1.56; 95% CI, 1.25–1.94).
Conclusion These findings highlight structural inequalities in PHC utilization. Policy efforts must prioritize enhancing the quality and attractiveness of PHC in urban areas, improving financial protection and infrastructure in rural areas, and addressing the digital divide. Such targeted measures are essential for achieving equitable and inclusive health coverage under JKN.
Background Pre-elderly families experience a significant impact on their quality of life as they transition to old age. This study aimed to identify and analyze the preparatory measures taken by families as they enter aging and develop an index to measure their readiness for aging based on physical, economic, and social aspects.
Methods This study employed a quantitative approach, drawing secondary data from the 2019 Performance Accountability Survey of the Family Planning and Family Development Program. Binary logistic regression was used to examine the bivariate relationships between demographic characteristics and family readiness.
Results Physical readiness was the most prevalent among pre-elderly families (88.1%), followed by economic (74.0%) and social (50.2%) readiness. Higher readiness was significantly associated with higher education (adjusted odds ratio [AOR], 3.39), urban residence (AOR, 1.39), health insurance ownership (AOR, 1.95), unemployment (AOR, 1.22), and awareness of aging programs (AOR, 1.62), whereas sex, family structure, and number of children were not significantly associated.
Conclusion To increase physical readiness, families should be encouraged to use health services such as community health centers and perform regular medical check-ups. Additionally, this study suggests government intervention through outreach and guidance on all dimensions of old-age preparation.
Background Smoking affects human health and healthcare systems worldwide, particularly in Indonesia. We used secondary data from the 2021 Global Adult Tobacco Survey (GATS) to analyze Indonesian smoking cessation determinants.
Methods We analyzed data from 2,877 individuals aged 15 years and older from the 2021 GATS Indonesia, selected through multistage clustering. We used multiple logistic regression analysis adjusted for the complex survey in STATA 17.0 to examine Indonesian smokers’ intention to quit including age, sex, education, occupation, household wealth, place of residence, perceptions that smoking causes serious illness, efforts to stop smoking in the past, abstinence days in the past, health-related reason, social reason, environmental reason, and financial reason).
Results Weighted adult intention to quit smoking within 12 months was 17.8%. Factors associated with intention to quit smoking among current smokers in Indonesia included adults age 45 years or older (adjusted odds ratio [AOR], 1.69; 95% confidence interval [CI], 1.12–2.54), completed higher education (AOR, 1.85; 95% CI, 1.01–3.42), working status (AOR, 0.72; 95% CI, 0.55–0.96), perception that smoking causes serious illness (AOR, 2.88; 95% CI, 1.96–4.22), abstinence days in the past >30 days (AOR, 3.10; 95% CI, 2.18–4.41), social reason (AOR, 1.48; 95% CI, 1.05–2.09), and environmental reason (AOR, 1.67; 95% CI, 1.23–2.28).
Conclusion Intention to quit smoking depends on several factors. Smoking cessation guidelines must be widely and often implemented, especially for high-risk smokers. Pharmacological and non-pharmacological smoking cessation strategies require cooperation among healthcare providers, public health actors, and the government.
Background The Physical Activity Readiness Questionnaire (PAR-Q)+ 2020 has been utilized to measure readiness for physical activity (PA). However, it is unavailable in the Indonesian language. We aimed to adapt and evaluate the validity and reliability of the PAR-Q+ 2020 culturally for the Indonesian population and its application in general and family medicine.
Methods We conducted a cross-sectional study to adapt the PAR-Q+ 2020 to the Indonesian language. A face validity interview with 20 participants followed the translation and back-translation processes. Subsequently, an online questionnaire was distributed between June and October 2022, with 378 participants responding and a 72.2% response rate for the second test. Cohen’s kappa was calculated to determine the intra-rater reliability of each item. Intra-class correlation (ICC) and Cronbach’s alpha analyses were conducted to examine the first and second parts of the questionnaire and the overall intra-rater reliability and internal consistency of the questionnaire.
Results The median age of the participants was 27 years (range, 18–61 years), and 63% (n=172) were female. The Cohen’s kappa value of each item ranged from to 0.801–1.000 (almost perfect to perfect agreement). The ICC values for the first and second parts and the overall questionnaire were 0.957, 0.993, and 0.987, respectively. Cronbach’s alpha was adequate for the first part (α=0.958), second part (α=0.993), and overall questionnaire (α=0.987).
Conclusion The Indonesian version of the PAR-Q+ 2020 demonstrated reliability and preliminary evidence of its validity in measuring individual readiness for PA. Further studies involving a broader population and employing more comprehensive validation methods are necessary to establish its validity and applicability fully.
Background Malnutrition is common among children under 5 years of age in Indonesia, with the rates varying between urban and rural areas. The minimum acceptable diet (MAD) assesses nutrient quality and quantity. This study aimed to identify the potential variables for MAD in 6–23-month-old children in both urban and rural Indonesia.
Methods We used the data from the 2017 Indonesia Demographic and Health Survey to conduct this nationally representative study. A total of 4,688 children aged 6–23 months were included in the study. MAD was classified using the 2017 World Health Organization global nutrition monitoring framework. The determinants of MAD were analyzed using multiple logistic regression.
Results Overall, 45% of children aged 6–23 months received the required MAD, with 47.4% receiving the MAD in urban areas and 35.7% in rural areas. Children’s age, fathers’ age, parents’ education level, mothers’ employment, and wealth index were strongly linked to MAD in both rural and urban homes. The factor specifically related to MAD in urban areas was mother living with her husband. For rural households, mothers’ involvement in decisionmaking and a minimum of four antenatal care (ANC) visits significantly increased the likelihood of their children’s MAD status.
Conclusion MAD status was determined by increased child age, higher parent education, younger father, working mother, and higher wealth index in children aged 6–23 months in both urban and rural settings. Mothers living with a spouse determined the MAD status only in urban areas. More frequent ANC visits and mother participation in household decisions were other factors related to MAD status in rural areas.
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Background Although Indonesia has a considerable proportion of adolescent smokers, nationally representative studies of its determinants remain limited. The 2015 Indonesian Global School-Based Student Health Survey (GSHS) was conducted with school-age adolescents and provided information about smoking behavior. This study aimed to examine the prevalence, determinants, and correlates of tobacco use among adolescents in Indonesia using the GSHS survey.
Methods A secondary data analysis of a cross-sectional study was conducted using data from the 2015 Indonesian GSHS. Multivariate logistic regression was used to assess the determinants and correlates of tobacco use.
Results Our analysis showed that 9.1% of school-age adolescents had used tobacco products in the past 30 days. Most were 13–15 years (61.7%) and had attempted to stop smoking (92.4%). After adjusting for covariates, significant risk factors associated with tobacco smoking were older age groups (prevalence odds ratio [POR], 3.01–9.40; 95% confidence interval [CI], 1.71–23.1), male (POR, 13.7; 95% CI, 8.71–21.5), psychological distress (POR, 1.41; 95% CI, 1.05–1.90), smoking exposure (POR, 1.98–2.15; 95% CI, 1.35–3.42), and when both parents smoked (POR, 2.96; 95% CI, 1.78–4.94). In addition, tobacco use was associated with other risky behaviors, including sex with multiple partners, using drugs, drinking alcohol, and being involved in physical fights.
Conclusion Tobacco use is high among Indonesian adolescents. This prevalence highlights the need for a more stringent tobacco control policy and tailored cessation programs for adolescents by considering important modifiable determinants of tobacco use among adolescents, including risky smoking-related behaviors.
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Background It is a well-known fact that exclusive breastfeeding benefits both mothers and their babies. The aim of this study is to assess the associated factors influencing exclusive breastfeeding of babies until 6 months of age.
Methods The study used data from the 2017 Indonesia Demographic and Health Survey. Overall, 1,542 women who had infants aged below 6 months were included in the study. Sociodemographic and maternal health service utilization factors were examined for association with exclusive breastfeeding, using logistic regression for a complex sample design.
Results The proportion of exclusive breastfeeding was 52.3% (95% confidence interval [CI], 0.498–0.548). Parity, antenatal care visits, early initiation of breastfeeding, low-income households, and rural areas were significant factors associated with the increased likelihood of exclusive breastfeeding. However, working status (adjusted odds ratio [aOR], 0.70; 95% CI, 0.57–0.86) and caesarean delivery or C-section (aOR, 0.75; 95% CI, 0.57–0.99) were factors for a lower likelihood of exclusive breastfeeding.
Conclusion Working women are at risk of discontinuation of exclusive breastfeeding. Mothers who had a normal vaginal delivery and practiced early initiation of breastfeeding had a higher rate of exclusive breastfeeding. These findings have important implications for developing comprehensive guidance and resources for women regarding the importance of exclusive breastfeeding during the early postpartum period.
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