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BKM Public Health and Community Medicine
Published by Universitas Gadjah Mada
ISSN : 02151936     EISSN : 26148412     DOI : https://doi.org/10.22146/bkm.v37i2.2320
Core Subject : Health,
Nursing Public Health
Berita Kedokteran Masyarakat (BKM Public Health and Community Medicine) is a peer-reviewed and open access journal that deals with the fields of public health and public medicine. The topics of the article will be grouped according to the main message of the author. This focus covers areas and scope related to aspects of: - Epidemiology - Infectious diseases control - Clinical Epidemiology - Environmental Health - Occupational Health - Healthy City - Public Health and Primary Health Care - School of Health Promotion - Healthy lifestyles - Health promotion - Health and Social Behavior - Tobacco and smoking - Adolescent Health - Public Health Nutrition - Maternal and Child Health - Reproductive Health - Population Health - Health of Vulnerable People - Social Determinants of Health - Water, Sanitation and Hygiene - Human Resource Management
Arjuna Subject : Kedokteran - Kesehatan Masyarakat, Kesehatan Lingkungan dan Pekerjaan
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HUBUNGAN TEMU MEDIA DENGAN PROMOSI PEMBERIAN ASI DI MEDIA MASSA Vita Aristyanita; Toto Sudargo; Kuskridho Ambardi
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.163 KB) | DOI: 10.22146/bkm.18092

Abstract

Media relations with breastfeeding promotion through mass mediaPurposeThis study aimed to evaluate the publication of coverage of media gatherings on promoting breastfeeding in the mass media organized by Wahana Visi Indonesia (WVI).MethodThe experimental study was conducted using primary data from the ongoing event which was the publication data of WVI media coverage.ResultThere was still inappropriate coverage in using the terminology associated with breastfeeding (30%). The main messages on the media gathering agenda have not been widely used as the main theme in liputan (30%). There was a difference in the quality of content coverage between mass media groups that have a target audience of women or families with mass media that have a general target audience in terms of the main theme, but there is no difference statistically from other facets. There was a strong correlation between the content quality of the coverage with the mass media group in terms of the main theme, but there is no difference from another side. ConclusionMedia gathering on breastfeeding topics can attract mass media to publish coverage. Groups of mass media that have a target audience of women or families and mass media that have a common target audience can be involved in breastfeeding promotion.
Pengetahuan ibu nifas tentang tradisi mararang dan dampaknya terhadap kesehatan ibu dan bayi di kabupaten Toba Samosir
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.26885

Abstract

Purpose: To explore the knowledge of postpartum mother about mararang tradition and its impact on mother and baby health in Toba Samosir Regency.Method: This research uses qualitative design, with focus ethnography approach. Determination of the sample size in this study using purposive sampling. Selection of informants was conducted based on the inclusion criteria according to the research topic. Informant in this research is data collecting done through in-depth interview and observation on 11 informant consisted of 4 maternal mothers, 3 husbands / family of postpartum mother, 3 midwife and 1 head of health service of mother and child in health office of Toba Samosir Regency , and Focus Group Disscussion on 6 midwives of Puskesmas.Results: Mararang tradition is believed to be a post-partum treatment that benefits health, where postpartum feels quick to recover from postpartum pain, strong backbone, warm body and sweating and facilitate puerperal expulsion. Informants know smoke from mararang is dangerous for mother and baby respiration. According to the parents of this mararang tradition should be done by postpartum so that make puerper mothers more confident to do mararang tradition. Specific education to stop the tradition of mararang never done, even there are still health workers who participate in mararang tradition.Conclusion: Mararang tradition is still difficult to be abandoned because it is still believed to be beneficial to health and not yet well understood that the impact of mararang tradition can disrupt the health of mother and baby. Families, especially mothers and husbands still strongly support the tradition of mararang. Health workers have not made efforts to provide information and knowledge about the risks and impacts of mararang tradition on maternal and infant health.
Analisis spasial temporal faktor lingkungan fisik dengan kejadian malaria di kabupaten Banjarnegara Rizki Wahistina; Lutfan Lazuardi; Sitti Rahmah Umniyati
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2014.343 KB) | DOI: 10.22146/bkm.27505

Abstract

Spatial-temporal distribution of physical environmental factors of malaria cases in Banjarnegara of Central JavaPurposeThe study aimed to describe physical environmental factors (temperature, humidity, wind velocity and rainfall) statistically, using graphs/time trends and spatial analysis and to analyze its effect on malaria incidence.MethodThis study used the design of ecological studies with spatial-temporal approach. The data were time series data of months of malaria incident and physical environment factors in Banjarnegara period 2011-2015. Poisson and binomial negative regression models were used to analyze the influence of physical environmental factors with the incidence of malaria.ResultsStatistical, graph/time trend, and spatial analysis indicate that there were correlations between temperature, humidity, wind velocity and rainfall with malaria incidence. Negative binomial regression model was the best. It showed that the temperature in the same year (lag 0), the temperature in the previous two months (lag 2 ) and rainfall on the previous month (lag 1) affected the incidence of malaria.ConclusionThe local government of Banjarnegara needs to consider the physical environment factors in implementing the prevention program.
Distribusi kanker dan analisis faktor yang memengaruhi: analisis data Indonesia family life survey tahun 2014
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.645 KB) | DOI: 10.22146/bkm.28005

Abstract

Purpose: This study was to identify distribution of cancer and factors associated using Indonesia family life survey in 2014.Methods: This was descriptive study with cross sectional design using secondary data. The source of the data was Indonesia Family Life Survey (IFLS 5) in 2014. The total of study participants were 34,240 respondents obtained by inclusion and exclusion criteria. Bivariate analysis used chi-square test and multivariate analysis used logistic regression.Results: The best model in multivariate analysis showed that sex (OR=5.34; 95% CI=3.64-7.83), age (OR=5.41; 95% CI=2.88-10.13), consumption vegetable and fruits (OR=0.74; 95% CI=0.56-0.99), education level (OR=0.38; 95% CI=0.26-0.56), and overweight (OR=0,58; 95% CI= 0,36-0,94) were statistically related to cancer.Conclusions: The prevalence of cancer was 0.63%, the respondents diagnosed with cancer wre 205 respondents with the most types of cancer was breast cancer 35.61% followed by ovarian cancer with a proportion of 18.05%. Sex, age, and education and consumption of fruits and vegetables were significantly associated with cancer.
Analisis risiko kesehatan akibat pajanan timbal (Pb) dalam biota laut pada masyarakat sekitar teluk Kendari
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.28192

Abstract

Purpose: To understand the risk level of health problem because of the exposure to the lead metal found on fish and shellsfish consumed by community living around Kendari bay.Methods: This study was an analytical observational through a cross sectional study design by combining Environmental Health Risk Analysis (ARKL) and Environmental Health Epidemiology (EKL) approaches. Population of the study was community dwelling around Kendari bay and the sampling technique which qualified the proportional sampling criteria resulted 110 respondents. The marine biotas in this study were fish and shellfish from Kendari bay within 30 fish samples of 3 kind of most consumed fish and shellfish from 6 fishponds in Kendari bay. Measurement of lead content on fish and shellfish was made by Atomic Absorption Spectrometry (AAS).Results: The results of the study show that lead content on fish and shellfish were 0,0027-0,0095 mg/kg and 0,1026-0,1097 mg/kg respectively while intake rapidity of fish and shellfish 0,0051 mg/kg/day and 0,016 mg/kg/day respectively. The variables of lead content on fish and shellfish, intake rapidity, exposure frequency, exposure duration, body weight and intake level were used to draw the risk. Health risk level of consuming contaminated fish was 1.29 while the contaminated shellfish was 4.03. variables significantly associated with risk level of fish and shellfish consumption were lead content on fish, intake rapidity of shellfish, exposure frequency of fish and shellfish, exposure duration of fish and shellfish, and intake level of fish and shellfish. On the other hand, variables which were not associated with risk level of fish and shellfish consumption were lead content on shellfish, intake rapidity of fish and body weight.Conclusion: The community around Kendari Bay has a risk of health problems (RQ> 1) due to lead exposure, therefore it needs to be controlled.
Analisis Spasial Kejadian Malaria Dan Habitat Larva Nyamuk Anopheles spp di Wilayah Kerja Puskesmas Winong Kabupaten Purworejo
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.28528

Abstract

ABSTRAKLatar Belakang : Malaria merupakan penyakit yang disebabkan oleh Plasmodium sp dan ditularkan melalui gigitan nyamuk Anopheles spp betina. Di Purworejo kasus malaria mengalami peningkatan dari API 0,98‰ (2013) menjadi API 1,98‰  (2015).Tahun 2016 jumlah kasus sebanyak 423 kasus.Tujuan :  Menganalisis faktor-faktor risiko dengan kasus malaria, memetakan distribusi  spasial kasus malaria dan  mengetahui tipe habitat larva nyamuk Anopheles spp di wilayah kerja Puskesmas Winong Kabupaten Purworejo.Metode Penelitian : Penelitian merupakan observasi analitik dengan rancangan penelitian case control.Variabel bebas adalah faktor cuaca, faktor lingkungan rumah dan faktor sosial budaya, sedangkan variabel terikat adalah kejadian (kasus) malaria. Hubungan variabel bebas dan terikat dianalisis dengan menggunakan uji korelasi Pearson dan Chi square, uji  regresi logistik dan analisis spasial.Hasil : Hasil uji korelasi Pearson menunjukan variabel suhu, kelembaban dan curah hujan tidak memiliki hubungan dengan kejadian malaria. Uji Chi square menunjukan ada hubungan kejadian malaria dengan keberadaan breeding site (p=0,02;OR 2,5 ), kondisi dinding rumah (p=0,004; OR 0,29) dan kebiasaan keluar malam hari (p=0,01;OR 3,6 ), sedangkan keberadaan hewan ternak, jarak breeding site, kebiasaan memakai kelambu, penggunaan kawat kasa, pemakaian anti nyamuk dan kebiasaan mengunjungi daerah endemis tidak memiliki hubungan dengan kejadian malaria. Berdasarkan uji regresi logistik, kebiasaan keluar malam hari merupakan faktor risiko yang paling dominan berhubungan dengan kejadian malaria. Pada analisis spasial kebanyakan kasus berada di dalam area buffer zone pada radius 1000 m dari habitat larva nyamuk Anopheles spp.Kesimpulan : Tidak ada hubungan faktor cuaca dengan kejadian malaria. Ada hubungan antara keberadaan habitat perkembangbiakan larva, kondisi dinding rumah dan kebiasaan keluar malam hari dengan kejadian malaria. Kasus berada di area buffer zone pada radius 1000 meter. 
Pengetahuan, sikap, dan faktor risiko lingkungan pada rumah tangga dengan riwayat leptospirosis di kota Yogyakarta dan kabupaten Bantul Defryana Rakebsa; Citra Indriani; Widagdo Sri Nugroho
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (419.309 KB) | DOI: 10.22146/bkm.28562

Abstract

Epidemiology of leptospirosis in Yogyakarta and BantulPurposeThe purpose of this study was to determine the relationship knowledge, attitude, and environmental factors with the incidence of leptospirosis.MethodsA case-control study was conducted in November 2016 in Yogyakarta city and Bantul district on 242 respondents. The case was leptospirosis patients that recorded in the Yogyakarta and Bantul District health offices within the period of June 2014 to June 2016. Controls were households in the same neighborhood as the case and had no history of leptospirosis, with case and control comparisons 1:1.  Rat-catching was done inside the house and in the rice fields. ResultsKnowledge (OR: 1, 95% CI: 0.58-1.71, p-value: 1) and attitude (OR: 0.8, 95% CI: 0.47-1.40, p-value: 0 .44) had no significant association with leptospirosis incidence. The presence of rats in the home has no significant relationship with leptospirosis incidence (OR: 0.7, 95% CI: 0.15-3.78, p-value: 0.73). The multivariate analysis found that the distance of house to open sewer (OR: 2.96, 95% CI: 1.22-7.14) and the presence of in-house waste (OR: 2.03, 95% CI: 1.14-3.62) had a significant association with leptospirosis incidence.ConclusionThere was no statistically significant relationship between knowledge and attitude with leptospirosis incidence. Environmental factors such as the distance of house to open sewer and the presence of in-house waste have a statistically significant relationship with the incidence of leptospirosis. Two of the 4 serum mice examined with a positive MAT method contained Leptospira sp. with Benjamin serovar Benjamini strain.
Karakter enumerator yang diinginkan responden untuk penelitian yang bersifat longitudinal: kasus HDSS Sleman Wahyuni Harahap; Fatwa Sari Tetra Dewi
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (314.369 KB) | DOI: 10.22146/bkm.29338

Abstract

Tujuan: Mengetahui karakter enumerator yang diinginkan responden penelitian longitudinal (HDSS Sleman).Metode: Penelitian ini menggunakan pendekatan case study dengan menggunakan data primer dan sekunder. Data sekunder berupa transkrip wawancara penelitian “Desain Sistem Reward bagi Responden Penelitian HDSS Sleman” dari kategori responden attrition sample pada pengambilan data siklus II. Dilengkapi dengan data primer berupa hasil observasi saat pengambilan data HDSS Sleman siklus III.Hasil: Responden penelitian menginginkan enumerator yang menyampaikan identitas penelitian, mencakup penjelasan tujuan penelitian, prosedur dan manfaat penelitian, serta instansi, dan enumerator. Kejelasan tujuan penelitian merupakan alasan utama responden untuk tetap termotivasi berpartisipasi dalam penelitian HDSS Sleman.Simpulan: Responden penelitian HDSS Sleman menginginkan enumerator yang mengkomunikasikan identitas penelitian berupa tujuan penelitian, prosedur dan manfaat penelitian, serta instansi, dan enumerator.
Perbedaan Berat Badan Bayi dan Hormon Prolaktin Dengan Breast Care Pada Ibu Nifas Normal (Studi di RSU Sarila Husada Kabupaten Sragen) Winnie Tunggal Mutika; Ari Suwondo; Runjati Tangwun
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (84.992 KB) | DOI: 10.22146/bkm.30272

Abstract

Effect of breast care among postpartum women on baby weight and prolactin hormones: preliminary studyPurposeThe aim of this study was to assess effectivity of breast care among postpartum women on baby weight and prolactin hormones.MethodThe study used quasi experimental with non equivalent time samples design. The sample was postpartum women in Sarila Husada hospital, Sragen and the sampling was performed by purposive sampling. The analysis was bivariate analysis using a paired t-test.ResultsThe average baby's weight before breast care was 3.1 kg with a standard deviation of 0.3. After breast care the average baby's weight was 3.0 kg with a standard deviation of 0.2. Statistical test obtained a p-value of 0.024, thus there was a significant difference between baby's weight before and after breast care. The average of prolactin hormone before breast care was 66.4 ng/ml with a standard deviation of 15.2. After breast care, the average prolactin hormone was 112.1 ng/ml with a standard deviation of 21.0. Statistical test obtained a p-value of 0.000, thus there was a significant difference between prolactin hormone before and after breast care.ConclusionThere were significant differences in baby weight with a decrease of 2.2% and prolactin hormone with an increase of 72.1% before and after breast care in postpartum women. In the breast care group, baby’s weight decreased by 2.2% but the baby’s weight loss did not exceed the maximum baby’s weight loss in the first week at 7%.  
An increasing trend and impact of non communicable diseases in Vanuatu Wesley Donald
Berita Kedokteran Masyarakat (BKM) Vol 34, No 4 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.454 KB) | DOI: 10.22146/bkm.34851

Abstract

Non Communicable Diseases (NCDs) continue to elevate in the western pacific regions, including Vanuatu. Much efforts have been made in reducing the disease burden, however the challenges remains due to certain sociocultural behaviours, globalization, and urbanization which promotes unhealthy lifestyles such as eating lifestyles (unhealthy diet), physical inactivity, harmful use of alcohol and tobacco use. All these contributing factors tends to give rise to common risks for the intermediate factors such as raised in blood pressure, raised in the level of glucose in the blood, the unhealthy lipid profiles, and obesity.Comparing this disease in low-income countries and high-income countries it seem that the rate of NDC are higher in low-income countries, more specifically the countries in the western pacific regions. Even that there are few South East Asian countries such Vietnam, Malaysia, Philippines, and Cambodia which were also regarded as having high mortality rates of NCD (1). According to the profile in 2008 it was estimated that it's the western pacific region that has more of the effect, showing more than a quarter of the 36 million deaths were due to NCD alone.Furthermore it continue to states that the trend will continue to increase by 15% between 2010 and 2020, meaning an estimation (from baseline) from an elevation of up to 44 million deaths will be cause by NCD alone (1). And if we divide the figures up it will then show that the highest proportion will be from the Western Pacific regions, of 12.3 million of deaths, while South-East Asian regions on the other hand is estimated to reach 10.4 million. This is also supported by a report on economic-cost of NCD in the Pacific Island countries which states that NCD is already a challenge in the Pacific, leading to account for 70% or more of the deaths. And the most common cause is of cardiovascular disease, which accounts for between 29% and 38% of death from all other causes (2). In Vanuatu NCD is in the top 10 disease agenda due to fast escalating trend, and similarly are Cardiovascular diseases, including diabetes and hypertension. According to the reported it was estimated that 18% of deaths were due to circulatory heart diseases (7).Another study been conducted in 2008 showed a record of 0.5% and 0.3% deaths were respectively caused by NCD in male and female. The current daily tobacco smoking as a form of behavioural risk factor constitute of 12.3%, where 21.3% in male and 3.1% in female. Additionally from the study record it showed that males are more risks than female in having high blood pressure above normal. This is supported by showing 44.5% of males in the study have raised blood pressure, while female on contrary have 39.1% raised blood pressure. Other contributing factor in the metabolic risks factors are overweight and obesity. From the study it showed that 21% of both male and female are overweight, while 34.2% is of obesity (3).From the findings we have to know that there are unprecedented changes in our environment – cultural, economic, physical, political and social – pose new risks and threats to health. And from most reports and future focus it is predicted that NCD will continue to elevate globally, whether it is urbanization and the built environment, severe air pollution, climate change, unregulated marketing of tobacco and other harmful food products, or easy access to nutrient-poor and calorie dense food (4). In some countries, for instance Vanuatu still accepts more imported and processed food and is predicted to upscale further should the climate conditions such as the current El Nino continue to place threats on garden crops. There is additionally a weak monitoring on food regulations on imported food products and where most labelling are in languages. Lack of proper laboratory analysis of the content against the labelling is another contributing factor. Thus it is imperative that leaders in both Government and related Non-Government Organizations (NGOs) find innovative solutions to complex health challenges in ever-changing common practices and environments. Only then will the population be safe and healthy from the disease. On the other hand we have to understand that at each developmental stage of life, human beings exhibit different vulnerabilities and are exposed to different risks, placing them more vulnerable to contracting those diseases.According to WHO report in 2008 on prevention and control of non-communicable diseases (Annex 1-B) (5), in year 2000 the WHO's Member States adopted a global strategy for prevention and control of NCDs during the fifty-third World Health Assembly. The Global Strategy on Diet, Physical Activity and Health was endorsed in 2002. In 2003, the WHO launched the Framework Convention on Tobacco Control, and this treaty came into force in 2005. Even that in 2008 the Member States endorsed the Action Plan for the Global Strategy for the Prevention and Control of non-communicable Diseases at the Sixty-first World Health Assembly. And the Regional Committee for the Western Pacific called for action to combat non-communicable diseases and their related risk factors in specific resolutions. There are also various regional action plans related to NCD prevention and control (e.g. Regional Plan for Integrated Prevention and Control of Cardiovascular Diseases and Diabetes for the Western Pacific Region 1998–2003, Tobacco Free Initiative Regional Action Plans 2000–2004 and 2005–2009, Plan of Action 2006–2010 for the Western Pacific.Declaration on Diabetes, and the Regional Strategy to Reduce Alcohol-related Harm) were developed over the past decade, sharing a focus on policy and planning, surveillance, health promotion and clinical prevention. Furthermore WHO developed a Pacific Framework for the Prevention and Control of Non-communicable Diseases in 2007 to serve as a guide in addressing NCDs among Pacific island countries and areas, and this framework was adopted by the Secretariat of the Pacific Community (SPC). Augmenting these action plans and frameworks is a Region-wide interest and commitment to fostering health systems change, particularly in relation to the prevention and control of NCDs. In November 2007, the WHO-supported meeting on "Strengthening Health Systems to Improve Chronic Disease Prevention and Control" culminated in a set of recommendations for reducing the health burden from non-communicable diseases through health systems improvements. The Western Pacific Regional Action Plan for NCDs is a collaborative effort by the WHO Regional Office for the Western Pacific and Member States to establish a shared vision and strategic actions to reduce the NCD burden (5).However despite of all these developed global and regional framework, strategies, planning, and action plans it is still recognized that countries still have less capacities and some are still at different stages of progress in the fight against non-communicable diseases. Therein it is suggested that more plenary discussions, consultations, and a support networking collaborations be established between the Government and private sectors, including the partners and associated stakeholders, and the affected communities. Moreover the Regional Action Plan also aims to operationalize the objectives of the Global Action Plan within the Western Pacific context, thereby adding value through concrete and relevant guidance. In other words the member states need to reconsider and rectify these further to be able to absorb perfectly into the country settings and the environmental contexts. Vanuatu on the other hand has also the capacity to address and respond to NCDs as it has its funding available for Cardiovascular diseases, NCD treatment for control, prevention and health promotion messages, and NCD surveillance and M&E. Additionally the health reporting system also includes information on screening of patients at health peripheries, NCD cause specific –morbidity, and the risks factors. Further to that the country has an integrated or topic-specific policy, programme, and action plan which is currently operational for these mentioned NCD diseases, including Alcohol, unhealthy diet, overweight, and obesity. Physical inactivity and Tobacco were other areas that the policy and action plan covers (1).Furthermore the member states need to strictly consider and implement WHO global NCD action plan which is a road map from 2013 to 2025 (6). In the road map are six global objectives that clearly states to make prevention and control of NCDs a priority, strengthening national capacities and leaderships, reduce modifiable risks factors, promote high-quality research, and finally is to monitor the impact and the trend of the disease. Additionally are nine major and more specific targets along the road map towards 2025. These are to be able to establish 80% availability of affordable technology and medicine to treat NCDs, ensuring that at least 50% of the patients receive preventive therapy for heart attacks and stroke, be able to pause the rise in diabetes and obesity, at least a 30% drop in sodium chloride (salt) intake, a 10% reduction in the harmful in the use of alcohol, to at least also receive 25% drop in premature death of people age 30-70 from cardiovascular diseases, cancers, diabetes, or chronic respiratory diseases, be able to reduce 10% in the prevalence of insufficient physical activity, reduce by 30% in tobacco use, and finally is to drop by 20% in the prevalence of high blood pressure (6). All these can be adopted and implemented strategically and effectively only when adequate resources such as adequate human resource, access to appropriate technology at all levels of implementations, adequate financial support, good working collaborations with partners and NGOs, including the communities, other associate stakeholders such as community leaders, and a very motivated and action-oriented personals are in place. Moreover is the health systems, political commitment, good network with shop entrepreneurs, and private sector that can contribute in the prevention and promotion of these mentioned health lifestyles.It is therefore strongly believed that unless all these are identified and notified then will there be some changes expected, and thus meet most of the target indicators as stated in the 2013-2025 target objectives.

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