Background
Indonesia faces significant maternal and child health challenges, including a high maternal mortality ratio. The country’s vast geography results in disparities in healthcare facility availability. This study aimed to identify factors influencing maternal delivery choices in health facilities across Indonesia’s rural and urban areas.
Methods
This cross-sectional study analyzed data from the 2017 Indonesia Demographic Health Survey. The study population included women aged 15–49 who had given birth within 5 years preceding the survey. A total of 14,162 women were included, with 6,339 from urban and 5,009 from rural areas. Logistic regression was performed to identify factors associated with maternal delivery locations.
Results
The findings showed that 91.37% of urban and 69.33% of rural mothers delivered in healthcare facilities. All analyzed variables were significantly correlated with maternal delivery in health facilities across both areas. In rural areas, the sex of the household head (adjusted odds ratio [AOR], 1.32; 95% confidence interval [CI], 1.02–1.71; P=0.031) and the absence of barriers to healthcare access (AOR, 1.31; 95% CI, 1.07–1.60; P=0.008) were significant factors. Conversely, in urban areas, only maternal age was significantly associated with delivering in health facilities.
Conclusion
Determinants of maternal delivery choices vary between rural and urban settings. In rural areas, healthcare access and household head sex are key factors, while maternal age is significant in urban areas. The government should prioritize equitable healthcare facility distribution, particularly in rural areas, and promote family involvement, especially among husbands, during antenatal care to encourage facility-based deliveries.

Background
Few studies have reported on the trends in influenza vaccination rates among cancer survivors in Korea. We investigated these trends over a recent 11-year period (2005–2015).
Methods
Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) III– VI (2005–2015). After excluding individuals younger than 40 years of age, the participants included 2,210 cancer survivors (861 men and 1,349 women). We categorized these study participants into four groups according to age and sex.
Results
The influenza vaccination rate decreased significantly among male cancer survivors, with rates of 74.8, 64.7, 56.2, and 55.2% (β coefficient=-0.257, P for trend <0.001) in KNHANES III, VI, V, and VI, respectively. While influenza vaccination rates decreased significantly among older male cancer survivors (≥65 years) (β coefficient=-0.359, P for trend=0.017), they increased among older female cancer survivors (β coefficient=0.375, P for trend=0.011) from 2005 to 2015.
Conclusion
Influenza vaccination rates in older cancer survivors significantly decreased in men but increased in women in successive KNHANES phases. Efforts are needed to improve immunization education and awareness, especially in older male cancer survivors.

Citations

• Influenza vaccine effectiveness in immunocompromised patients with cancer: A Danish nationwide register‐based cohort study
  Lau Amdisen, Lars Pedersen, Niels Abildgaard, Christine Stabell Benn, Deirdre Cronin‐Fenton, Signe Sørup
  Cancer.2025;[Epub]     CrossRef
• Disentangling behavioral determinants of seasonal influenza vaccination in post-corona era: An integrated model approach
  So-Hyun Kim, Minsoo Jung, Hani Amir Aouissi
  PLOS One.2025; 20(5): e0323184.     CrossRef
• The coverage of influenza vaccination and predictors of influenza non-vaccination in Danish cancer patients: A nationwide register-based cohort study
  Lau Amdisen, Lars Pedersen, Niels Abildgaard, Christine Stabell Benn, Mikael Rørth, Deirdre Cronin-Fenton, Signe Sørup
  Vaccine.2024; 42(7): 1690.     CrossRef
• Vaccination uptake among post-treatment cancer survivors: A multi-vaccine scoping review
  Kavita Renduchintala, Mariana Arevalo, Gabriella Fonseca, Mary Katherine Haver, Clement K. Gwede, Smitha Pabbathi, Shannon M. Christy
  Vaccine.2024; 42(22): 125995.     CrossRef
• Seasonal influenza vaccination among cancer patients: A systematic review and meta-analysis of the determinants
  George N. Okoli, Otto L.T. Lam, Tiba Abdulwahid, Christine J. Neilson, Salaheddin M. Mahmud, Ahmed M. Abou-Setta
  Current Problems in Cancer.2021; 45(2): 100646.     CrossRef
• A cross‐sectional study of factors associated with influenza vaccination in Korean cancer survivors
  Ji Eun Lee, Dong Wook Shin, Jinyoung Shin, In Young Cho, Jungkwon Lee, JiHye Hwang, BeLong Cho, Yun‐Mi Song
  European Journal of Cancer Care.2021;[Epub]     CrossRef
• Influenza Vaccination Status and Its Affecting Factors among Stroke Survivors: Findings from the Korea National Health and Nutrition Examination Survey
  Eung-Joon Lee, Oh Deog Kwon, Seung Jae Kim
  Vaccines.2021; 9(7): 763.     CrossRef

Citations

• The Association of Health-Related Quality of Life (HINT-8) with Health Behaviors and Metabolic Diseases among Korean Adults: Results from the Korea National Health and Nutrition Examination Survey, 2023
  Namkuk Son
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• Effects on older adult Women's precision, strength and flexibility from resistance training and handicrafts practice
  Vitória Maria Francisqueti Nardelli, Victor Hugo Alves Okazaki, Anderson Nascimento Guimarães, Vitor Bertoli Nascimento, Juliana Bayeux Dascal
  Journal of Bodywork and Movement Therapies.2024; 40: 1356.     CrossRef
• The association of physical activity and sedentary behaviour on health-related quality of life: a cross-sectional study from the physical activity at work (PAW) trial
  Katika Akksilp, Falk Müller-Riemenschneider, Yot Teerawattananon, Cynthia Chen
  Journal of Activity, Sedentary and Sleep Behaviors.2023;[Epub]     CrossRef
• The Relationship between Physical Activity and Health-Related Quality of Life in Korean Adults: The Eighth Korea National Health and Nutrition Examination Survey
  Mun-Gyu Jun, Se-Hyeon Han
  Healthcare.2023; 11(21): 2861.     CrossRef
• Association between physical activity and health-related quality of life in middle-aged and elderly individuals with musculoskeletal disorders: Findings from a national cross-sectional study in Korea
  Jung Hyun Lee, Il Yun, Chung-Mo Nam, Suk-Yong Jang, Eun-Cheol Park, Chung-Ying Lin
  PLOS ONE.2023; 18(11): e0294602.     CrossRef
• Physical activity and sedentary behavior trajectories and their associations with quality of life, disability, and all-cause mortality
  Aarón Salinas-Rodríguez, Betty Manrique-Espinoza, Rosa Palazuelos-González, Ana Rivera-Almaraz, Alejandra Jáuregui
  European Review of Aging and Physical Activity.2022;[Epub]     CrossRef
• Associations between Food Groups and Health-Related Quality of Life in Korean Adults
  Shamirah Nabbosa, Sunghee Lee
  Nutrients.2022; 14(17): 3643.     CrossRef
• The Relationship of Sitting Time and Physical Activity on the Quality of Life in Elderly People
  Jung In Choi, Young Hye Cho, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Hye Rim Hwang, Seung Hun Lee, Eun Ju Park, Young In Lee, Young Jin Ra, Su Jin Lee
  International Journal of Environmental Research and Public Health.2021; 18(4): 1459.     CrossRef
• Association between type of exercise and health-related quality of life in adults without activity limitations: a nationwide cross-sectional study
  Min-Jung Choi, Yong Gyu Park, Yang Hyun Kim, Kyung Hwan Cho, Ga Eun Nam
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• Physical activity and quality of life in people living with HIV
  Kevin Martin, Fernando Naclerio, Bettina Karsten, Jaime H. Vera
  AIDS Care.2019; 31(5): 589.     CrossRef
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  Mythily Subramaniam, Yunjue Zhang, Jue Hua Lau, Janhavi Ajit Vaingankar, Edimansyah Abdin, Siow Ann Chong, Eng Sing Lee
  BMC Public Health.2019;[Epub]     CrossRef
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  Duan-Rung Chen, Yi-Ching Lin
  Health & Place.2016; 41: 1.     CrossRef
• The relationship between stroke and quality of life in Korean adults: based on the 2010 Korean community health survey
  Ki-Jong Kim, Myoung Heo, In-Ae Chun, Hyun-Ju Jun, Jin-Su Lee, Hyuk Jegal, Young-Sik Yang
  Journal of Physical Therapy Science.2015; 27(1): 309.     CrossRef
• Effects of Autogenic Training on Stress Response and Heart Rate Variability in Nursing Students
  Seung-Joo Lim, Chunmi Kim
  Asian Nursing Research.2014; 8(4): 286.     CrossRef

Although vulnerable population such as cancer survivors, terminal patients, caregivers and immigrants have greater health needs, they don't receive enough health care services in our health care system. Continuous advances in cancer treatment have led to a marked improvement in cure rates and thus, an increased population of long-term cancer survivors. Due to both original and treatment-related risk factors, survivors are at increased risk for second primary cancers. In addition, pre-diagnosis smoking, alcohol, obesity and insulin resistance, which are well-known risk factors for cancer development, also appear to affect cancer outcome. To improve the health promotion of cancer survivors, developing shared care model between oncologist and primary care physician is needed. Chronic disease has not only a great effect on the affected patients but also on their caregivers. Caregiving burden was associated with impaired physical function and increased emotional distress. Caregiving burden also increase the risk of cardiovascular disease incidence among caregivers. More attention should be focused on these caregivers to improve their health. Recently, as increasing social needs to develop the health care system for terminal patients, Korean Government began to support palliative care units with implementing the National Cancer Control Program for Terminal Cancer Care. With these social movements, the needs for human resources in the area of palliative care are continuosly increasing, and active participation of primary care physician is needed. Due to rapid changes of population structure in South Korea, the number of multi-cultures family has continuously increased. Especially, more than 15,000 North Korean defectors settled in South Korea in 2008. North Korean defectors are more likely to have unhealthy behaviors, poor quality of life and comorbidities, while they have poor primary care accessibility. Good primary health requires a population perspective, and there has been great change of population structure in South Korea. As prevalence of vulnerable population is seemed to continuously increasing, the planning and development of tailored primary care program for this population to reflect their actual unmet needs is essentially required.

Citations

• The association of education in a new society and social support from the education with the health of North Korean defectors: a cross-sectional study
  Jihyun Lee, Yui Park, Dong-Hun Han, Ji Won Yoo, Wenlian Zhou, Pearl Kim, Jay J. Shen
  BMC Public Health.2021;[Epub]     CrossRef
• Risks of cancer in the Rohingya community of Bangladesh: An issue still remains unaddressed
  Fahad Jubayer, Shahidullah Kayshar, Tariqul Islam Limon
  Public Health in Practice.2020; 1: 100040.     CrossRef
• Social Accountability of Medical Schools: Concept and Implementation
  Yoon Min Gil, Woo Taek Jeon
  Korean Medical Education Review.2019; 21(3): 127.     CrossRef
• Health literacy and use of preventive health services among North Korean defectors in the Republic of Korea
  In Gyu Song, Haewon Lee, Jinseon Yi, Min Sun Kim, Ichiro Kawachi, Sang Min Park, Markus M. Bachschmid
  PLOS ONE.2018; 13(6): e0195964.     CrossRef
• Influenza Vaccination Coverage and Its Associated Factors among North Korean Defectors Living in the Republic of Korea
  In Gyu Song, Haewon Lee, Jinseon Yi, Min Sun Kim, Sang Min Park
  Journal of Korean Medical Science.2015; 30(9): 1226.     CrossRef
• Factors associated with the frequency of physician visits among North Korean defectors residing in South Korea: a cross-sectional study
  Bo-Ram Wang, Young Dae Kwon, Wootack Jeon, Jin-Won Noh
  BMC Health Services Research.2015;[Epub]     CrossRef
• Preference and Awareness of Telemedicine in Primary Care Patients
  Sung-Gwon Jung, Hyuk-Jung Kweon, Eun-Tae Kim, Seun-Ah Kim, Jae-Kyung Choi, Dong-Yung Cho
  Korean Journal of Family Medicine.2012; 33(1): 25.     CrossRef

Background
Numerous studies have identified that physical activity influences decrements of both mortality and morbidity. Besides these objective indices, positive influences of physical activity on individuals' lives are being studied upon various populations. The purpose of this study was to evaluate the association of physical activity on health-related quality of life (HRQOL) in relatively healthy adults of Korea. Methods: Questionnaires were sent by mail to one thousand examinees who were scheduled for health check-up. We analyzed data from 214 men and 195 women. The physical activities were measured using the International Physical Activity Questionnaraire (IPAQ)-short form and the HRQOL was assessed by the CMCHS ver 1.0. The subjects were separated by gender and into either a recommended level of physical activity group or a lower physical activity group according to the physical activity scale. Results: The group with physical activity beyond the recommended level had better HRQOL measures than those who did not. After revising the factors that affected the HRQOL, cognition of present heath status, satisfaction for health status, bodily pain, physical function, emotional function, social function and general health measure scores were significantly higher in the female group with physical activity beyond recommended quantity than those who did not. However, there were no statical significance in the male group. Conclusion: Physical activity was associated with health related quality of life in middle aged women.