Analysis of water, sanitation, and hygiene facilities using the WASH-FIT approach and its relation to patient satisfaction and maternal mortality at hospitals in Indonesia

Introduction

The provision of Water, Sanitation, and Hygiene (WASH) is critical to reducing infection and enhancing the quality of health care services. The study aims to assess WASH facilities in Indonesian hospitals using the Water, Sanitation, and Hygiene Facility Improvement Tool (WASH-FIT) approach and examine their association with customer satisfaction and maternal mortality owing to infection.

Methods

We utilized the national scale Health Facilities Research dataset in Indonesian hospitals in 2019. WASH status is determined using WASH-FIT indicators, i.e., water, sanitation, waste management, hand hygiene, environmental cleaning, and management services, and then divided into three levels: poor, adequate, and good categories.

Results

The majority of hospitals in Indonesia had a good category, i.e., the range of hospitals with a good category was 79-97% nationally, in 6 aspects: water, sanitation, hand hygiene, environmental cleaning, and management services, except for waste management services (13%). Good WASH service facilities are more frequently found in government hospitals than in private and specialized hospitals, while lower-level hospitals tend to have poor levels of all WASH-FIT indicators. There are significant relationships between adequate sanitation services (β = 0.724), adequate and good categories of hand hygiene services (β = 0.712 and 0.866, respectively), environmental cleaning (β = -0.501 and -0.503, respectively), and management (β = -0.645 and 0.446, respectively), with the proportion of maternal mortality owing to infection. Furthermore, there was no relationship between WASH-FIT indicators and patient satisfaction, except for good hand hygiene services (β = 0.453).

Discussion

Despite good conditions in almost all WASH-FIT indicators, the improvement of waste management is urgently needed to improve the WASH services in hospitals in Indonesia, as also found in other developing countries.

HUBUNGAN PENGETAHUAN MAKANAN SUMBER ZAT BESI DENGAN STATUS ANEMIA PADA IBU HAMIL

Latar Belakang. Anemia menentukan status kesehatan wanita. Ibu hamil perlu mengetahui masalah anemia, sebab akibat, termasuk sumbe r makanan pencegah anemia. Pada tahun 2013 ibu hamil di Indonesia menderita anemia sebesar 37,1 persen, naik menjadi 48,9 persen tahun 2018. Tujuan. Mengetahui hubungan tingkat pengetahuan ibu hamil tentang makanan sumber zat besi dengan status anemia pada ibu hamil. Metode. Desain penelitian cross-sectional dengan analisis regresi logistik. Responden sebanyak 96 ibu hamil merupakan responden pada database (populasi 134 ibu hamil) studi kohort pada tahun 2012 di Kecamatan Ciwaringin dan Kebon Kelapa, Kota Bogor. Hasil. Terdapat hubungan yang bermakna antara status anemia pada ibu hamil dengan pengetahuan makanan sumber zat besi kelompok daging (0,037), kelompok sayuran (0,036), dan tablet Fe (0,024). Sebaliknya tidak terdapat hubungan yang bermakna pada kelompok serat buah (1,000) dan kacang-kacangan (0,762). Hasil analisis multivariat menunjukkan dua variabel yang berhubungan yaitu pengetahuan makanan sumber zat besi kelompok sayuran dan tablet Fe. Variabel yang paling dominan berhubungan dengan status anemia pada ibu hamil adalah pengetahuan makanan sumber zat besi kelompok sayuran. Efek dari hubungan pengetahuan konsumsi sayur dengan anemia ibu hamil tidak berbeda pada mereka yang berpengetahuan dan tidak berpengetahuan konsumsi tablet Fe. Kesimpulan. Pengetahuan tentang makanan sumber zat besi berhubungan dengan status anemia. Dua variabel yang paling signifikan berhubungan adalah pengetahuan konsumsi sayuran dan konsumsi tablet Fe.