Window of Health : Jurnal Kesehatan

The Effect of Birth History on Speech Delay in Toddlers

2026-10-15T10:33:39+00:00

Speech delay is one of the most common developmental disorders among toddlers, Globally, speech and language delays affect approximately 5% to 12% of preschool-aged children, making communication disorders among the most prevalent neurodevelopmental concerns worldwide explicitly framed speech delay as a public health concern affecting long-term educational attainment and neurodevelopmentaffecting approximately 5–10% of preschool children in Indonesia, and it has the potential to negatively impact children’s intellectual functioning and social interaction. The high prevalence indicated by more than ten toddlers receiving speech therapy daily in services in Tegal and Brebes highlights the need to identify underrecognized risk factors, such as birth history. While prior work focuses on environmental and parenting factors, birth history variables (perinatal factors) remain understudied locally. This study aimed to analyze the relationship between birth history factors (gestational age, mode of delivery, birth weight, and maternal age at childbirth) and the occurrence of speech delay in toddlers. This quantitative analytic study employed a case control design (1:1 ratio) involving a total of 110 participants (55 cases and 55 controls), The inclusion criteria for mothers who had children aged 2–6 years with speech delay, whereas the control group were mothers who had children aged 2–6 years without speech delay, selected through purposive sampling at RSIA Permata Insani Brebes (cases) and KB Tabiyatul Khasanah (controls). Data were collected from June to August 2025. Birth history data were collected through interviews and questionnaires, adapted from a previously validated and reliable instrument, and data were analyzed using the chi-square test and multivariate logistic regression with the enter method. The results showed a significant association between gestational age (<37weeks or >40weeks) and speech delay (p=0.002;OR=3.586), cesarean section delivery (p=0.028;OR=2.260), and abnormal birth weight (<2500g or >4000g) (p=0.045;OR=2.286). However, no significant association was found between maternal age at childbirth (<20years or >35years) and the occurrence of speech delay (p=0.339). In conclusion, Birth history factors may assist clinicians in identifying toddlers at higher risk for speech delay and prioritizing developmental surveillance.

Integrated School-Based Intervention for Prevention and Control of Anemia among Pre-adolescent Girls Aged 10–12 Years

2026-10-08T06:39:31+00:00

Anemia remains a health problem in school-aged children, particularly pre-adolescent girls who face increased iron requirements during growth. This study aimed to evaluate changes in hemoglobin (Hb) concentration and anemia status following the implementation of a school-based integrated intervention package in girls aged 10–12 years. The study used a quasi-experimental pretest–posttest design with a control group involving 60 female students from two elementary schools in Central Kalimantan. Allocation was conducted at the school level, with one school as the intervention group and one school as the control group. The intervention package was delivered for 8 weeks and included health and nutrition education, promotion and monitoring of local food consumption sources of iron, Hb testing and follow-up, and monitored iron supplementation according to the study protocol, with parental involvement as a supporting strategy. Anemia status was determined based on the Hb threshold for the age group specified in the study protocol. The intervention group experienced a greater increase in Hb concentration than the control group (ΔHb +1.5 ± 0.6 vs +0.6 ± 0.5 g/dL; p<0.001) and showed a higher proportion of participants with non-anemic status after the intervention (76.7% vs 43.3%). The integrated school-based intervention package was associated with better improvements in Hb concentration and anemia status compared to routine school health services. The findings need to be interpreted considering the allocation at the school level and the involvement of only two schools.

The Contribution of Optometrists to Preventive Eye Health Care in Indonesia

2026-10-08T06:52:02+00:00

Optometrists have an important role in preventive eye health through refractive error screening, early detection, and community education. However, evidence regarding their contribution to preventive eye health care in Indonesia remains limited. This study aimed to examine the association between optometrists’ contributions and preventive eye health care in Indonesia. A cross-sectional quantitative study was conducted among 97 optometrists in Indonesia. Data were collected using a structured questionnaire and analyzed using descriptive statistics, Pearson correlation, and simple linear regression with SPSS version 20. Statistical significance was set at p < 0.05. Most respondents were aged 31–45 years (55.7%), had a Diploma III qualification (74.2%), had 0–5 years of practice experience (47.4%), and worked in optical practices (72.2%). The highest positive responses concerned refractive error screening (87.5%) and community eye health education (86.5%). A strong positive association was found between optometrists’ contribution and preventive eye health care (r = 0.919, p < 0.001). Regression analysis showed a significant positive association (B = 0.963, β = 0.919, p < 0.001), with the model accounting for 84.5% of the variance in the measured preventive eye health care score. Optometrists’ contribution was strongly associated with preventive eye health care. Strengthening competencies, interprofessional collaboration, referral systems, and integration into primary and community eye-care services is recommended.

BMI-for-Age Z-Score, Waist-to-Height Ratio, and Physical Activity Across High School Grades in West Aceh

2026-10-08T10:24:09+00:00

Adolescent nutritional status and physical activity may vary across school grades, yet evidence integrating BMI-for-age z-score (BAZ), waist-to-height ratio (WHtR), and physical activity among Indonesian senior high school students remains limited. This study aimed to compare BAZ, WHtR, and physical activity across Grades 10, 11, and 12 at SMA Negeri 3 Meulaboh, West Aceh, Indonesia. An analytical cross-sectional study included all 158 students in the defined population through complete enumeration. Physical activity was assessed using an adapted IPAQ-SF-derived seven-day recall and expressed as a study-specific score in MET-minutes/week. BAZ was calculated using WHO AnthroPlus according to the WHO 2007 Growth Reference, and WHtR was derived from waist circumference and height. Physical activity and WHtR were compared using Kruskal–Wallis tests with Bonferroni-adjusted Mann–Whitney U comparisons, while BAZ was analyzed using one-way ANOVA with Tukey HSD. Median physical activity scores were 2965, 1647.5, and 1127.5 MET-minutes/week in Grades 10, 11, and 12, respectively (H(2)=54.595, p<0.001, ε²=0.339), with all pairwise comparisons significant after correction. Median WHtR values were 0.528, 0.520, and 0.460, respectively (H(2)=44.445, p<0.001, ε²=0.274); Grade 12 differed from Grades 10 and 11, whereas Grades 10 and 11 did not differ after correction. Mean BAZ values were −0.136, −0.177, and −0.669, respectively (F(2,155)=3.163, p=0.045, η²=0.039), but no Tukey-adjusted pairwise comparison was significant. Physical activity showed the clearest between-grade pattern, WHtR differences were concentrated in Grade 12, and evidence for BAZ differences was weaker. These findings represent cross-sectional between-grade differences and should not be interpreted as developmental or causal effects of advancing school grade.

The Relationship Between Health Workers’ Perceptions of OSH and Compliance with OSH Protocols in Community Health Centers

2026-10-09T09:20:47+00:00

Community health centers in Indonesia face high occupational risks as the frontline of health care. From January through May 2024, there were 162,327 reported cases of workplace accidents, while work-related illnesses were fewer but continue to rise. In Lumajang Regency, more than 50% of potential occupational safety and health hazards at the Sukodono Community Health Center are classified as high to very high risk, and at the Rogotrunan Community Health Center, patient safety incidents such as medical record errors and near misses involving needle sticks were identified. This study analyzed health workers’ perceptions of Occupational Safety and Health (OSH) knowledge, attitudes, and support, and their influence on compliance with OSH (Occupational Safety and Health) protocols in Lumajang Regency. A quantitative study with a cross-sectional design was conducted at the Sukodono and Rogotrunan Community Health Centers with 84 respondents using simple random sampling. The research instruments consisted of questionnaires and interviews. Univariate and bivariate analyses using the chi-square test showed no significant association between knowledge and compliance (p=0.501); however, there were significant associations between attitude (p=0.000) and institutional support (p=0.000) and compliance with the occupational safety and health (K3) protocol. These findings confirm that compliance is more strongly influenced by attitude and institutional support than by knowledge alone.

Determinant Factors Affecting Psychological Well-being of Pregnant Mothers

2026-10-13T02:08:13+00:00

Globally, approximately 10–20% of pregnant women experience mental health disorders. In Indonesia, approximately 12.6% of pregnant women experience common mental disorders, making maternal psychological well-being an important public health concern. Although previous studies have examined individual psychosocial factors, comprehensive analyses integrating physical, psychological, and social determinants remain limited, particularly in Indonesian primary healthcare settings. Therefore, this study aims to identify the determinants of psychological well-being among pregnant mothers. This quantitative study with a cross-sectional design was conducted in 20 public health centers in Tangerang City from January to March 2023. A total of 196 pregnant mothers were selected using cluster random sampling. Data were collected using structured questionnaires, including validated instruments for eating behavior, domestic violence, perceived stress, and psychological well-being. Data analysis used multiple linear regression tests, ANOVA tests, and regression coefficients. Data were analyzed using multiple linear regression in SPSS version 26. Data were analyzed using multiple linear regression in SPSS version 26. Multiple linear regression showed that the model was statistically significant (F = 4.267, p < 0.001), explaining 21.9% of the variance in psychological well-being (R² = 0.219; adjusted R² = 0.167). Acceptance of pregnancy (B = 15.94, β = 0.233, 95% CI: 5.25–26.64, p = 0.004), domestic violence (B = -12.51, β = -0.230, 95% CI: -21.30 to -3.72, p = 0.006), and attitudes toward pregnancy care (B = 0.37, β = 0.167, 95% CI: 0.07–0.66, p = 0.016) were significantly associated with psychological well-being among pregnant women. These findings may inform future psychosocial interventions, although longitudinal studies are required to establish causal relationships.

HIV/AIDS Services at Padang City Community Health Centers: A Qualitative Study of Voluntary Counseling and Testing (VCT)

2026-10-13T05:36:31+00:00

Indonesia is estimated to have approximately 570,000 people living with HIV (PLHIV). However, only 31% have accessed antiretroviral therapy (ART), and 14% have achieved viral suppression. Padang City is the city with the highest number of new HIV/AIDS cases in West Sumatra over the past four years. The number of cases was 225, 227, 286, and 333 in 2020, 2021, 2022, and 2023, respectively. Although HIV testing coverage has increased, evaluating the implementation of VCT services remains important to identify barriers affecting service quality and program performance. This study aims to analyze the VCT HIV/AIDS services in several health centers in Padang City, using the input, process, and output (IPO) systems framework. A qualitative descriptive study was conducted in four Community Health Centers selected purposively based on HIV case burden, comprising two with the highest and two with the lowest numbers of cases. Participants were selected purposively based on their involvement in VCT service delivery. Data were collected through in-depth interviews, observation, documentation review, and focus group discussions, with source and method triangulation used to ensure data credibility. The results showed that VCT inputs were generally adequate. Human resources were sufficient and trained, and facilities were in good condition. However, funding was sufficient for Community Health Centers with lower case numbers but insufficient for those with higher case numbers. In terms of process, planning, implementation, and evaluation generally followed the guidelines. In terms of output, Andalas Health Center did not reach the target for examinations, while health centers with the lowest cases reached the target. In conclusion, the implementation of VCT at health centers in Padang city was generally adequate. However, funding limitations, unclear task distribution, and the failure to achieve the HIV testing target at one of the highest case health centers indicate that several aspects of service implementation still need improvement.

The Changes in the body weight of toddlers after the implementation of Responsive Feeding Plus in the Work Area of Tawiri Community Health Center, Ambon City

2026-10-16T07:13:09+00:00

Malnutrition among children under five remains a public health concern, particularly in Maluku, where the prevalence of underweight exceeds the national estimate. This study aimed to compare changes in body weight among underweight children receiving Responsive Feeding Plus (RF Plus) and routine nutrition services in the working area of the Tawiri Community Health Center, Ambon City. A quasi-experimental pretest–posttest control-group design was conducted among 30 children aged 12–59 months recruited through total sampling, with 15 children allocated non-randomly to the RF Plus group and 15 to the control group. RF Plus consisted of three main meals and two energy-dense snacks per day, caregiver education on hunger and satiety cues, responsive feeding without coercion or distraction, and twice-weekly monitoring. Body weight was measured at baseline and after 40 days. Within-group changes were analyzed using the Wilcoxon signed-rank test, while differences in weight change between groups were assessed using the Mann–Whitney test. Mean body weight increased from 10.09±2.05 to 11.42±2.02 kg in the RF Plus group and from 9.95±1.39 to 10.31±1.31 kg in the control group. Mean weight gain was 1.33±0.53 kg (95% CI: 1.04–1.62) in the RF Plus group compared with 0.35±0.22 kg (95% CI: 0.23–0.48) in the control group. The difference in weight change between groups was statistically significant (p<0.001). RF Plus was associated with greater short-term weight gain than routine services among underweight children. However, these findings should be interpreted cautiously because of the small sample size, non-random allocation, potential residual confounding and clustering at the Posyandu level, and short follow-up period.

The Effect Of Herbal Therapy Compress Ball On Primary Dysmenorrhea Among Adolescent Girls

2026-10-14T06:08:30+00:00

Primary dysmenorrhea is a prevalent reproductive health problem among adolescent girls and may contribute to reduced quality of life and school absenteeism. In Surakarta, its prevalence reaches 89.8%, indicating a substantial public health concern. This study evaluated the effect of herbal therapy compress ball application on primary dysmenorrhea pain intensity in adolescent girls. A pretest–posttest control group design was employed in this quasi-experimental study involving 34 adolescent girls from Posyandu Remaja Puspa Muda in Surakarta. The participants were allocated to two study groups: an intervention group and a control group. The intervention consisted of a herbal compress ball containing ginger, turmeric, lemongrass, and salt, which was applied during menstruation. Pain severity was evaluated using the WaLIDD score before and after the intervention. Statistical analyses were conducted using the Wilcoxon signed-rank test, paired-samples t-test, and Mann–Whitney U test, with a significance level of 0.05. The intervention group showed a substantial reduction in mean pain score from 6.65 ± 2.234 at pretest to 2.76 ± 2.513 at posttest, a mean reduction of 3.89 points (95% CI: 2.89–4.88; p < 0.001), while the control group decreased from 6.71 ± 1.863 to 5.00 ± 1.658. The between group analysis showed a statistically significant difference in posttest pain scores (p = 0.005), with a moderate effect size (r = 0.48). In conclusion, herbal therapy compress ball can effectively reduce primary dysmenorrhea pain intensity among adolescent girls.

Incidence of Dengue Disease Rate Based on Spatial Analysis in Metro City

2026-10-16T05:55:25+00:00

Dengue Hemorrhagic Fever (DHF) remains a public health problem in Metro City, Lampung Province. This study aimed to describe the village-level distribution of DHF incidence in Metro City during January–April 2024 and to determine whether DHF cases exhibited a clustered pattern using Average Nearest Neighbor (ANN) analysis. This quantitative study used two data sources: (1) secondary surveillance data from the Metro City Health Office for 2018–2022, used only to describe the historical trend of DHF; and (2) primary data on the residential coordinates of all DHF cases reported from January to April 2024 (n = 248), collected using GPS, which served as the main dataset for spatial analysis. Village-level incidence rates were mapped, and the spatial pattern of cases was assessed using Average Nearest Neighbor (ANN) analysis. Historical surveillance data showed fluctuating case numbers, peaking at 192 cases in 2019 and declining to 88 cases in 2022 (IR 51.40 per 100,000 population), with no DHF deaths recorded (CFR 0%; 0 deaths/88 cases). Among the 248 cases in January–April 2024, most occurred in the 6–59-year age group (83.1%), and 54.8% were female. The highest village-level IRs were found in Sumbersari Bantul, Margorejo, Tejoagung, Yosomulyo, Karang Rejo, and Purwosari. ANN analysis showed a statistically significant clustered pattern (NNR = 0.013; p < 0.01), indicating that cases were not randomly distributed. This clustered pattern warrants further investigation into environmental, behavioral, and health service–related factors that may contribute to the concentration of cases. These findings can support location-based prioritization of DHF prevention and control in Metro City.

Oral Antidiabetic Activity on Dietary Patterns of Urban and Rural Patients

2026-10-16T13:21:15+00:00

Diabetes mellitus is a metabolic disease with a steadily rising global prevalence; its management is influenced by various factors, including dietary habits and pharmacological therapy. This study aimed to identify the use of oral antidiabetic therapies, dietary patterns, and blood glucose levels among diabetes mellitus patients in urban and rural areas. This cross-sectional observational study involved 60 patients with type 2 diabetes mellitus, evenly distributed between Cirebon City (urban) and Majalengka Regency (Munjul Village). Dietary data were collected using a Food Frequency Questionnaire (FFQ), while data on therapy (metformin, glibenclamide, glimepiride) and blood glucose levels were obtained from medical records. Data analysis employed the Mann-Whitney test to compare differences between the groups. The results revealed significant differences in dietary patterns (mean ranks: 19.97 vs. 41.03; p<0.001) and the types of oral antidiabetic therapy used (mean ranks: 21.42 vs. 39.58; p<0.001) between the two regions; urban patients exhibited more controlled dietary habits and a higher frequency of monotherapy, whereas rural patients tended to use combination therapy. However, no significant difference was found regarding the reduction in blood glucose levels (mean ranks: 31.38 vs. 29.62; p=0.695) between the two groups. The study concludes that despite differences in dietary patterns and therapeutic regimens, glycemic control among diabetic patients in both regions was relatively comparable.

A Maternal Empowerment, Family Support, and Breastfeeding Practices: A Mixed-Methods Study in Pematangsiantar, Indonesia

2026-10-18T12:18:07+00:00

Early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) are vital infant-feeding practices, but their implementation can be influenced by clinical factors, healthcare routines, maternal confidence, and family environment. However, the extent to which maternal empowerment interventions improve breastfeeding outcomes in community settings remains uncertain. This study aimed to evaluate a maternal empowerment intervention in relation to EIBF, EBF, breastfeeding knowledge, and self-efficacy, and to explore perceived barriers to breastfeeding and sources of family. This convergent mixed-methods study was conducted in Pematangsiantar, Indonesia, from March to November 2024. The quantitative component used a quasi-experimental pretest–post-test control-group design involving 54 pregnant women: 27 received breastfeeding counseling, a pocketbook, video-based education, and follow-up support, while 27 received only the pocketbook. The qualitative component involved semi-structured interviews with 14 mothers. Quantitative findings were analyzed using between-group comparisons and logistic regression; interview data were examined thematically. EIBF was reported by 74.1% of the intervention group and 85.2% of the control group (p=0.311). EBF proportion was 70.4% in both groups (p=1.000). Between-group differences in post-intervention knowledge and breastfeeding self-efficacy were not significant. Cesarean delivery was associated with lower adjusted odds of EIBF (aOR = 0.047, 95% CI 0.006–0.377; p=0.004), while EIBF was associated with earlier lactation onset (OR = 9.0, 95% CI 2.07–39.19; p=0.004). Interviews identified delivery-related barriers, perceived insufficient milk, family influence, employment demands, and supportive family involvement. The intervention didn’t demonstrate statistically significant improvements in breastfeeding outcomes. Breastfeeding promotion should integrate maternal education with supportive maternity-care practices and family engagement.