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Advances in Social Sciences Research Journal – Vol.7, No.7
Publication Date: July 25, 2020
DOI:10.14738/assrj.77.8692.
Irab, S. P., & Togodly, A. (2020). Limitations of Rural Health Services and Assessment Pregnant Mothers in the Pandemic Covid-19 of the
Papua Province Indonesian. Advances in Social Sciences Research Journal, 7(7) 723-731.
Limitations of Rural Health Services and Assessment Pregnant
Mothers in the Pandemic Covid-19 of the Papua Province Indonesian
Semuel Piter Irab
Faculty of Public Health,
Cenderawasih University Jayapura
Arius Togodly
Faculty of Public Health,
Cenderawasih University Jayapura
ABSTRACT
Background: Pandemic infectious diseases cause morbidity and deaths
to increase over time globally. Corona virus disease-19 (Covid-19) is an
infectious disease found in China in Wuhan City, and spread very quickly
to Indonesia and Papua Province. The purpose of this study was to
determine limitations of the rural health services, and assessment of
the pregnant mothers in the pandemic covid-19 Papua Province of
Indonesian. Methods: The cross sectional study design, is a type of
research to see the relationship between the limitations of rural health
services, according to the assessment pregnant mothers in the
pandemic covid-19 Papua Province. Jayapura City and Jayapura Regency
research sites, which represents all Cities/Regencies in Papua Province.
The population is all pregnant mothers in Jayapura City and Jayapura
Regency. The samples was 89 pregnant mothers living in rural areas.
Data analysis using the Chi-Square test (χ2). Results: The limitation of
integrated health service post was very less 38,2% and very good 22,5%.
The community health center is very less 41,6% and good 22,5%.
Hospitals are very less 31,5% and very good 25,8%. The practice of
doctors / midwife is less 30,3% and very good 31,5%. The limitations of
antenatal care were very less 38,2% and good 22,5%. The limitation
treatment of the sick pregnant mothers was 39,3% and good 22,5%. The
prevalence covid-19 rural is very high 40,4% and low 20,2%.
Assessment of the significant pregnant mothers with prevalence covid- 19 of rural, the limitations of integrated health service posts, community
health centers, hospitals, doctor/midwife practices, limitations in
pregnant mothers, and limitations of treatment for sick pregnant
mothers. Conclusion: The adverse effects of the pandemic covid-19 are
increasing day by day, the provincial government of Papua implements
health protocols to protect the public, in other parts of pregnant
mothers who don't suffer from corona virus, but suffering from other
illnesses and wanting to visit a health service unit is limited.
Keywords: Limitations of rural health services, assessment pregnant
mothers
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URL: http://dx.doi.org/10.14738/assrj.77.8692 724
Irab, S. P., & Togodly, A. (2020). Limitations of Rural Health Services and Assessment Pregnant Mothers in the Pandemic Covid-19 of the Papua Province
Indonesian. Advances in Social Sciences Research Journal, 7(7) 723-731.
BACKGROUND
December 2019, Mysterious pneumonia cases were first discovered in Wuhan city, Hubei Province
of China. According to reports from China that the transmission of mysterious diseases comes from
markets fish and animals[1]. From 18 to 29 December 2019, there ware five patients suffering from
mysterious illnesses. Strange symptoms caused by a respiratory disorder called Acute Respiratory
Distress Syndrome (ARDS) [2].
In January 2020 the prevalence of respiratory disorders increased, or spread very quickly from
Hubei Province, China, Japan, Korea, Thailand, Singapore, Indonesia, Europe, America, Africa,
Australia, and become a serious problem in the world[3]. Based on the first World Health
Organization research, this mysterious disease, called the novel 2019 coronavirus (2019-nCov). On
February 11, 2020, World Health Organization announced the official name of this mysterious
disease is Corona Virus Disease-19[2].
Pandemic infectious diseases cause morbidity and death to increase over time globally. Corona
virus disease-19 (Covid-19) was infectious disease found in China in Wuhan City, and spread very
quickly to Indonesia and Papua Province. Up to June 16, 2020 the prevalence of covid-19 in Papua
Province increased.
Data source for Papua Province Covid-19 Control, Prevention and Handling Task Force (16 June
2020). Peoples in Monitoring 52,9%, Patients in Monitoring 6,0%, patients positive 20,5%, and
treated 12,3%, while 8,0% patients recovered and 0,2% dieds. Province Papua of positive patients
increased 19 while those who recovered and died were lower than in March - June 2020. This causes
a very large influence covid-19 on socioeconomic status in the Regencies/City in Papua Province of
Indonesia[4].
Covid-19 has a big influence globally, December 2019 - June 2020. The impact of covid-19 limits
health services to the community, which is not positive covid-19. However, peoples who have other
diseases do not get maximum health services in the health service unit. However, peoples who have
other diseases do not get maximum health services in the health service unit. Such as integrated
health service posts, community health centers, hospitals, doctor/ midwife practices, weighing
toddlers, antenatal care, toddlers and pregnant mothers sick is limited treatment to the health
service unit[5].
The health protocol is made by the government, to protect its peoples from covid-19 transmission.
Thus the community stays at home, works at home, does not carry out social activities in general or
in groups, not gather in large numbers in public places, public places are closed or restricted. This
is bad for pregnant mother, breastfeeding mothers, infants, and toddlers who are sick or not sick.
So that those who visit the health service unit, do not get maximum health services[6].
Large-scale social restrictions on society globally, causing the mother and child morbidity to
increase, even though the mother and toddlers are not sufferers covid-19[7]. All health services for
the general public were restricted, the government only focuses on health services for covid-19
patients. The impact of covid-19 caused world-class health services, very low quality of health
services, to the community from December 2019 to June 2020[8].
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Advances in Social Sciences Research Journal (ASSRJ) Vol.7, Issue 7, July-2020
The quality of health services to the community is low, an important part of this research, to see the
limitations of health services for pregnant women, breastfeeding mothers, infants and toddlers in
the Indonesian Papua Province.
METHODS
A cross sectional study design, is a type of research to see the relationship of the impact of the
pandemic covid-19, and limited health services for rural pregnant mothers in Papua Province[9].
The covid-19 impact caused restrictions on human activities and transportation, so that rural
pregnant mothers health services decline. Thus pregnant mothers in rural areas lack the maximum
health services, before the pandemic covid-19 in Papua Province.
The Jayapura City and Jayapura Regency research sites represent all the Cities and Regencies in
Papua Province. The population is all pregnant mothers living in Papua Province, while the samples
were 89 pregnant mothers living in rural areas. Data analysis using the Chi-Square test (χ2).
RESULTS
Emergency alert status by applying the rules Lock down, physical distancing, social distancing,
promotive, prevenstif, Insider Monitoring, Patients in Monitoring [10]. So that the adverse impact
on public health services, thus the community who are not sufferers covid-19, but peoples suffering
from other diseases are limited, to carry out checks in the health service unit. This causes many sick
peoples who do not go to the health service unit. Such as hospitals, community health centers,
integrated health service posts, doctor/midwife practices[11].
Covid-19 has a big influence globally. Much damage to the economies of countries in the world. So
many peoples do not work, do not have money, it is difficult to get food, and state income falls[12].
Covid-19 is one of the diseases that limits all the activities of state governments in the world,causing
unemployment to increase, peoples losing their jobs, and poverty increasing, health services are
restricted to the general public, and the community stays at home[13].
Covid-19 pandemic in Papua Province March - June 2020. The government applies lock down, social
distancing, physical distancing, works from home, regional quarantine, large-scale social
restrictions, go outside using a mask, personal hygiene, hygiene and sanitation at home. The health
protocol, developed by the Papua Provincial government, causes differences in health services
between urban and rural areas. So that health services integrated health service posts, community
health centers, hospitals, doctor/midwife practices, antenatal care, and sick pregnant mothers, do
not get maximum health services in Papua Province.
Limitations of rural health services in the pandemic covid-19, integrated health service post very
less 38,2% and very good 22,5%. Community health centers were very less 41,6% and good 22,5%.
Hospitals were very less 31,5% and very good 25,8%. Doctor/midwife practice is very less 30,3%
and very good 31,5%. Antenatal care is less 38,2% and good 22,5%. Treatment of sick pregnant
mothers is very less 39,3% and good 21,3%. The prevalence covid-19 of rural is very high 40,4%
and low 20,2%.
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URL: http://dx.doi.org/10.14738/assrj.77.8692 726
Irab, S. P., & Togodly, A. (2020). Limitations of Rural Health Services and Assessment Pregnant Mothers in the Pandemic Covid-19 of the Papua Province
Indonesian. Advances in Social Sciences Research Journal, 7(7) 723-731.
Table 1. Distribution of Limitations of Rural Pregnant Mothers Health Services, in the Pandemic
Covid-19 Papua Province Indonesia
Limitation
Rural Health Services
Very less Less Good Very good
n % n % n % n %
- Integrated post health
service
- Community helth centers
- Hospital
- Doktor/midwife practice
- Antenatal care
- Treatment of sick
pregnant mothers
34
37
28
27
34
35
38,2
41,6
31,5
30,3
38,2
39,3
17
17
16
15
17
22
19,1
19,1
18,0
16,9
19,1
24,7
18
20
22
19
20
19
20,2
22,5
24,7
21,3
22,5
21,3
20
15
23
28
18
13
22,5
16,9
25,8
31,5
20,2
14,6
Pandemic
Very high High Low Very low
n % n % n % n %
- Prevalance covid-19 of
rural 36 40,4 19 21,3 18 20,2 16 18,0
Explanation : Pandemic covid-19 Papua Province, which causes the limitations of rural health services
Health protocol from the government in social restrictions on the community with lock down, social
distancing, physical distancing, work from home, large-scale restrictions on society, and regional
quarantine, have a negative impact on the limitations of pregnant mothers health services in Papua
Province.
Based on the Government of the Republic of Indonesia Regulation, number 21 of 2020 regarding
large scale social restrictions, in the context of accelerating the handling of corona virus disease
2019 (Covid-19). Pandemic covid-19 with the number of cases and/number of deaths has increased
and spread across regions and across countries. Impacts on the political, economic, social, cultural,
defense and security aspects, as well as the welfare of the peoples in Indonesia[14].
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Advances in Social Sciences Research Journal (ASSRJ) Vol.7, Issue 7, July-2020
Table 2. Relationship between the Limitation of Rural Health Services and the Assessment
Pregnant Mothers in the Pandemic Covid-19 Province Papua of Indonesian
Assessment Pregnant Mothers
Rural Likelihood Ratio
Limited Health Services Less Good 95 CI
n % n % Sig RP Lower Upper
Prevalance covid-19 of rural
- High
- Low
Integrated post health service
- Less
- Good
Community health centers
- Less
- Good
Hospital
- Less
- Good
Doktor/midwife practice
- Less
- Good
Antenatal care
- Less
- Good
Treatment of sick pregnant
mothers
- Less
- Good
35
15
39
11
39
11
36
14
31
19
33
17
36
14
64,8
42,9
76,5
28,9
72,2
31,4
81,8
31,1
73,8
40,4
78,6
36,2
65,5
41,2
19
20
12
27
15
24
8
31
11
28
9
30
19
20
35,2
57,1
23,5
71,1
27,8
68,6
18,2
68,9
26,2
59,6
21,4
63,8
34,5
58,8
**
0,041
***
0,000
***
0,000
***
0,000
**
0,001
***
0,000
**
0,025
2,456
7,977
5,673
9,964
4,153
6,471
2,707
1,027
3,073
2,239
3,693
1,686
2,509
1,122
5,873
20,710
14,370
26,885
10,229
16,685
6,529
Explanation : 1. Assessment of rural pregnant mothers (a. Lack: Different health services before the pandemic covid-
19, b. Good: Health services were not different before the pandemic covid-19) 2. Chi-Square Statistical test (χ2 ) 3.
Significan ( *** < 0,00, ** <0,05, dan * <0,1)
The relationship between the limitations of rural health services and the assessment pregnant
mothers in the pandemic covid-19 Papua Province of Indonesia. Assessment of the rural pregnant
mothers was significant with the prevalence of the covid-19, limitations of integrated health service
posts, community health centers, hospitals, doctor/midwife practices, antenatal care, and treatment
of sick pregnant mothers. Health services are the primary needs of the community, so that peoples
can live healthy. The impact covid-19 was very bad in the province of Papua, resulting in limited
health services to pregnanat mothers in the rural areas, thus the health status of pregnant mothers
is not controlled by health workers, in the health service unit.
Health promotion and prevention of corona virus are very important, to provide health protection
to the community. Health promotion is very important in changing people's behavior, from bad
health behavior, to good health behavior. Changes in behavior become an important part in
preventing infectious diseases. However transmission of infectious diseases can be limited by the
community implementing health protocols[15].
Health, politics and health policy services are a unity in health services. But the role of government
is very large in preparing the planning, implementation, and evaluation of health programs. To
assess success in the development of national health[16]. Human Resources for health, is a very
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Irab, S. P., & Togodly, A. (2020). Limitations of Rural Health Services and Assessment Pregnant Mothers in the Pandemic Covid-19 of the Papua Province
Indonesian. Advances in Social Sciences Research Journal, 7(7) 723-731.
important element and influences the improvement of all aspects, such as the health service system
for all levels of society. Implementing health insurance policies are health service units, starting
from the basic level to the advanced level[17].
Quality service will result in a high level of patient satisfaction. Conversely low quality service, will
result in a low level of patient satisfaction. The attitude of health workers plays an important role
in achieving quality health services, so consumers are satisfied with health services[18].
Strengthening quality primary health care efforts is one of the health policy directions in the 2015-
2019 RPJMN. However, access and quality of basic health services at this time still does not reach
the entire population, especially disadvantaged, remote, and archipelago areas. Basic health
services are needed to achieve the MDG,s targets that have not been achieved, Sustainable
Development Goals (SDGs) 2030 and Minimum Service Standards(MSS). The success of promotive
and preventive health services, will increase more and more healthy peoples, thus the greater the
coverage of successful health programs in the country [19].
Basic health services are also called basic health services, consisting of several types of health
services that are considered essential, to maintain a person's health, family, community, so that they
can live productively socially and economically[20].
Public health is an important part of the strength of the country in European countries. Like the
European Public Health Association (EUPHA), the Association of Schools of Public Health in the
European Region (ASPHER) and the European Observatory on Health Systems and Policies. This
institution is an institution and structure of the Association of public health services in Europe,
which provides health services, health system, and health policy to the community. Through these
institutions and health association structures, ensuring the quality life peoples in Europe[21].
Based on 194 WHO members who are Regian of the American, African Region, European Region,
Eastern Mediterranean Region, South-East Asia Region, and Western Pacific Region. The world
health organization (WHO) is to builds a better and healthier future for peoples throughout the
world. WHO has work offices in more than 150 countries, and Secretariat staff. WHO works side by
side with the government and other partners for the benefit of everyone's health. Together with
WHO and countries in the world, fighting infectious diseases. Such as providing polio immunization
to children, prevention of yaws, nutritious food, reduce the percentage of obese children, develop
mental health of children, and build a good public health system in the world[22].
Prevention of corona virus disease-19 (civid-19) infection in Indonesia. Based on the Government
of the Republic of Indonesia Regulation, number 21 of 2020 regarding large scale social restrictions,
in the context of accelerating the handling of corona virus disease 2019 (Covid-19). Pandemic covid- 19 with the number of cases and/number of deaths has increased and spread across regions and
across countries. Impacts on the political, economic, social, cultural, defense and security aspects,
as well as the welfare of the peoples in Indonesia[14].
Impact of Covid-19 in other fields. As in agriculture and global food security. In the agriculture
sector, employment declined from 40,2% to 26,8%. Counting 60,4% are families with low
income[23]. But the impact covid-19 on the European workforce has decreased drastically, due to
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Advances in Social Sciences Research Journal (ASSRJ) Vol.7, Issue 7, July-2020
the closing of employment in hundreds thousands of seasonal workers. This happened in France,
Germany, Italy, Spain and Poland. Thus, many peoples do not work, do not have income, and do not
have sufficient food supplies[24].
The impact of covid-19 on the limitation community food ingredients, where peoples have difficulty
getting enough foods, to improve nutritional status. One of the main factors in society is the socio- cultural relations of society and community behavior, utilizing food ingredients. This relates to how
to provide food for the family, and how to prevent infectious diseases in the culture of the
community[25].
Increasing body immunity, is closely related to nutritious foods. In addition nutritious foods provide
immunity against infectious diseases, such as corona virus disease-19 (covid-19). Low immune
system, which is obtained from foods low in nutrients, makes it easy for someone to be infected with
covid-19, whose transmission is already global.
Pathogenesis of malnutrition consists of 5 stages. First, the inadequacy of nutrients lasts for a long
time. Second, the nutrient reserves in the tissues are used to meet inadequacy. This situation lasts
a long time, will be a deterioration of tissue, which was characterized by weight loss. Third, there
was biochemical change that can be detected by laboratory examination. The fourth was occurrence
of changes in bodily functions in the presence of distinctive signs. The fifth is the occurrence of
anatomic changes, which can be seen from the appearance of classical signs, so that it has an impact
on malnutrition[26].
CONCLUSION
Impact of the pandemic covid-19 from Marth to June 2020 on the Regencies/ City of Papua Province
and the limitations of rural health services. Assessment pregnant mothers rural is significant with
the prevalence covid-19, limitations of integrated health service posts, community health centers,
hospitals, doctor/midwife practices, antenatal care, and limitations on Treatment of sick pregnant
mothers.
The bad impact of the pandemic covid-19 is increasing day by day, the Papua Provincial government
is implementing health protocols to protect the public, in other parts of pregnant mothers who
don't have corona virus, but suffering from other illnesses and wanting to visit health service unit
is limited.
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Indonesian. Advances in Social Sciences Research Journal, 7(7) 723-731.
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