Penugasan Evidence Based Public Health (EBPH)

BLOK 4.4 Kesehatan Masyarakat

Oleh :
Siti Solichatul Makkiyyah

13711082

Tutorial 1

Fakultas Kedokteran
Universitas Islam Indonesia
Yogyakarta
2016

DAFTAR ISI

Halaman Judul.............................................................................................................................i
Daftar Isi.....................................................................................................................................ii
Kasus...........................................................................................................................................1
Rumusan PICO...........................................................................................................................1
Searching Keywords...................................................................................................................2
Artikel Jurnal...............................................................................................................................3
Form Isian Critical Appraisal

1. Kasus
Kasus 3. Memutus Mata Rantai Kematian Ibu
Dokter Nina adalah seorang kepala puskesmas di Kecamatan Banyuasin, baru saja
menghadiri rapat koordinasi dengan dinas kesehatan terkait laporan kematian ibu di
wilayah kerja puskesmasnya. Ibu yang meninggal tersebut merupakan
multigrandegravida, kehamilan ke-8, saat persalinan hanya ditolong suami. Keluarga
menganggap kematian adalah hal yang natural dan sudah kehendak Tuhan. Kematian
ibu melahirkan terjadi di sebuah wilayah yang terdapat ssebuah pesantren di
dalamnya. Pesantren tersebut dipimpin oleh tokoh agama yang sangat disegani oleh
masyarakat sekitar, dan bersikap menolak program KB. Petugas kesehatan terkait
pernah melakukan edukasi ke wilayah tersebut, namun gagal. Dokter Nina tergerak
lebih lanjut untuk mengetahui faktor apa saja yang menyebabkan penolakan terhadap
KB dan bagaimana strategi pendekatan yang efektif bagi kelompok masyarakat yang
menolak KB.
2. Rumusan PICO
Question Part
Patient

Question Term
Contraception Refusal

Intervention/Exposure

Approach strategy
Socio cultural factor
Religion factor

Comparison
Outcome

Community Leader
Family planning use

Synonyms
Contraception Rejection
Anti-contraception
Anti-community
Socio cultural determinant
Socio cultural issue
Religion determinant
Religion issue

Contraception use
Contraceptive method use

3. Searching Keywords
a. (anti-community OR contraception refusal OR contraception rejection) AND
(approach strategy) AND (family planning use)
b. (anti-community OR contraception refusal OR contraception rejection) AND
(socio cultural factor OR religion factor) AND (family planning use)
c. (anti-community OR contraception refusal OR contraception rejection) AND
(community leader) AND (family planning use)

5. Form Isian Critical Appraisal

a. Was there a clear statement of the aims of the research? YES
Pada introduction, paragraf 11, kalimat ke-1
Therefor, it is important to analyze the perceptions of opinion leaders regarding
maternal and chlid health and, in particular, regarding FP.
b. Is a qualitative methodology appropriate? YES
Pada introduction, paragraf 12, kalimat ke-1
In the present study, the opinion leaders were asked about their beliefs and
perceptions regarding FP and practices of birth spacing, current use of modern
contraceptives amongst married women of reproductive age 15-49 years residing in
their areas, ...
c. Was the research design appropriate to address the aims of the research? Cant tell
Tidak ada diskusi yang ditulis mengenai mengapa penelitian kualitatif sesuai untuk
tujuan penelitian.
d. Was the recruitment strategy appropriate to the aims of the research? YES
Pada materials and methods, paragraf 1, kalimat ke-2, 4 dan paragraf 2, kalimat ke-1,
3
Paragraf 1
... The reason for recruiting these three types of opinion leaders is that they have a
major influence in all the decisions taken in the community, and their opinions are
considered an authority on the religious aspects of all matters (including FP), whereas
the nonallopathic health professionals are sought for health advice. ... All respondents
were male, as the researcher could not locate any female opinion leader in the target
area for research study.
Paragraf 2
A purposive sampling approach was employed, and the participants were recruited
through community contacts and a local nongoverment organization. ... The most
commonly used form of nonprobabilistic sampling is purposive sampling.
e. Was the data collected in a way that addressed the research issue? YES
Pada materials and methods, paragraf 1, kalimat 1, paragraf 2, kalimat ke-1, 5,6 dan
paragraf 4, kalimat ke-1, 3, 4, 6
Paragraf 1
..., was based on the theory of qualitative research, utilizing in-depth interview for
data collection ...
Paragraf 2
... interview were continued to the point of information saturation. ... , the author
systematically documented the degree of data saturation and variability over the
course of thematic analysis. Based on the study data set, it was found that saturation
occured within the firts 35 interviews, although basic elements for metathemes were
present as early as 16 interviews, ...
Paragrag 4
All the interviewees were recorded and transcribed in Urdu and then translated into
English by the researcher, who was fluent in both language. ... Recordings were made
where study participants allowed this. Out of the 45 total interviews, 14 interviewees
refused to record their interviews due to personal reasons. ... transcription and
translation of data provided us with a descriptive record. The final interview notes
were shared with the interviewees for validation.
f. Has the relationship between researcher and participants been adequately considered?
YES

g.

h.

i.

j.

Pada materials and methods, paragraf 2, kalimat ke-1, paragraf 4, kalimat ke-7 dan
paragraf 6, kalimat ke-2, 3, 4
Paragraf 2
..., and the participants were recruited through community contacts and a local
nongovernment organization.
Paragraf 4
Another check of the validity of transcriptions and the translations was done by a
colleague who had not participated in the study until then.
Paragraf 6
... The author was employed at Marie Stopes Society (MSS) Pakistan from August
2008 onwards. Therefore, the author and this study have no relationship with MSS
Pakistan. The author, who was the principal investigator of this study, conducted all
45 interviews himself.
Have ethical issues been taken into consideration? YES
Pada materials and methods, paragraf 4, kalimat ke-3 dan paragraf 5, kalimat ke-6,8
Paragraf 4
Recordings were made where study participants allowed this.
Paragraf 5
... Participants provided informed written consent prior to submitting to the
interviews in private rooms. ... The ethical approval for this study was obtained from
the School of Public health, The Secretary, Human Research Ethics Committee,
Office of Research and Development, Curtin University of Technology, Perth,
Western Australia, and the City District Government Karachi.
Was the data analysis sufficiently rigorous?
Pada materials and methods, paragraf 5, kalimat ke-1-5
Transcript were coded thematically utilizing Nvivo software (v8; QSR International
Pty, Doncaster, Australia). These codes were then refined, combined and further
categorized accross transcripts to develop more general codes for furhter analysis by
the researcher, in accordance with the themes that were frequently and consistently
emerging from the data. This was done via an adapted constant comparison analysis
process, as described by Strauss and Corbin. Key findings and responses were
aggregrated as subnodes and later analyzed to develop the thematic areas. Information
gathered from the interview was then triangulated with literature to find similarities
and differences on the issues aroud FP and maternal health.
Is there a clear statement of findings?
Pada materials and methods, paragraf 4, kalimat ke-7,8, dan paragraf 5, kalimat ke-5
Paragraf 4
The final interview notes were shared with the interviewees for validation. Another
check of the validity of transcriptions and the translations was done by a colleague
who had not participated in the study until then.
Paragraf 5
Information gathered from the interviews was then triangulated with literature to find
similarities and differences on the issues around FP and maternal health.
Pada results, paragraf 1, kalimat ke-1-3
Seven key themes were derived from the ind-depth interviews. Five themes provide
insight into the opinion leaders perceptions of barriers to FP and modern
contraception methods. Two themes offered opportunities for more effective
development and implementation of FP programs.
How valuable is the research?
Pada discussion, paragraf 3, kalimat 1, 2 dan paragraf 4, kalimat ke-2

Paragraf 3
This study provides insight into the perspectivves of celergymen/mosque imams,
health professionals/physiacians (nonallopathic), and social workers regarding
maternal health and FP. ..., the current research provides insight to a consentient call
for religious and other opinion leaders to take more personal responsibility for
maternal health and FP.
Paragraf 4
harnessing the potential influence of opinion leaders on health-related issues is seen
as a way forward that will definitely contribute toward improving the acceptability of
contraceptive use and misperceptions related to birth spacing to some extent.