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  • Title: Health practices and indices of a poor urban population in Indonesia. Part I: Patterns of health service utilization.
    Author: Kaye K, Novell MK.
    Journal: Asia Pac J Public Health; 1994; 7(3):178-82. PubMed ID: 7794657.
    Abstract:
    This first section in a two-part study of health indices and practices among residents living in a Jakarta slum describes the use of public and private primary health care services in relation to socioeconomic and health status. As problems associated with urban poverty rapidly increase in developing countries, it is important to study the ethnic and economic diversity which exists in slums and shanty towns: results of such studies should inform the development of effective strategies for outreach and service delivery. Through a survey of 690 mothers and 593 children, we found that 1) poorer residents were more likely than relatively affluent ones to rely on local government clinics (posyandus) for primary health care; 2) regular posyandu users were more likely than non-users to be fully immunized and to use ORT correctly; 3) delivery in hospital was common among all residents, but especially among the more affluent; and 4) prevalence of contraception was high and not associated with socioeconomic status or type of primary health care service used. Strengthening primary health care services at the government's local health posts could benefit all groups in the community if wealthier residents participated more in the posyandus. Standards of care in the private sector should also be improved. A study conducted in two urban slum communities in Indonesia--Duri Utara and Jelambar Baru--found that the newly established government primary health care posts (posyandus) are having a beneficial impact on child health status, yet are not being utilized by more affluent residents. Selected from residents enrolled in the Save the Children Health Information System were 375 mothers who had used the posyandu for the care of all their children in the 12 months preceding the study and 305 non-users, most of whom obtained care from the private sector. 33% of the Duri Utara sample and 19% of the Jelambar Baru were classified as poor (US$50/month), while 16% and 30%, respectively, were categorized as rich (US$115/month). 68% of poor mothers compared with 30% of rich mothers were regular posyandu users. Regular users were significantly more likely than non-users to know how to prepare oral rehydration solution (90% versus 77%), to use this during their children's diarrhea episodes (79% versus 68%), and to have children under-three years old who were completely immunized (83% versus 65%). There were no significant differences according to posyandu use or socioeconomic status in contraceptive prevalence (74% overall). Recommended are interventions aimed at either improving the quality of preventive health care services in the private sector or attempts to encourage more affluent residents to utilize posyandu services.
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