Ahmar Metastasis Health Journal

Evaluation of the Quality of Midwifery Care Based on Continuity of Care for Pregnant Adolescents in Central Lombok: Qualitative Study

Nia Supiana — 2025-09-30

Adolescents who experience pregnancy are a vulnerable group in accessing reproductive health services. The implementation of continuous midwifery services or Continuity of Care (CoC) is believed to be able to improve the quality of services, but so far, its implementation in adolescent groups has not been widely studied. This research aims to explore perceptions, experiences and identify factors that support and hinder the implementation of CoC-based midwifery services. This study uses a qualitative design with a phenomenological approach. The research locations were in two Community Health Centers in the Central Lombok region, namely work areas that have a high prevalence of teenage pregnancy rates, namely the Sengkol and Batu Jangkih Community Health Centers. Involving 12 teenagers at various stages of pregnancy and 1 head of community health center, as well as 5 midwives implementing the CoC program. Purposive sampling technique was used to select informants. Data collection was carried out through in-depth interviews using semi-structured guidelines, observation of service interactions, and review of service documents conducted over 2 months. Data validity is strengthened by source triangulation and member checking. Data were analyzed using a thematic approach. The research results show that the CoC is implemented consistently and builds adolescent trust through ongoing relationships with midwives, however the quality of service is not optimal due to limited staff, lack of psychosocial approach, stigma, low health literacy, as well as transportation and economic barriers. To increase the effectiveness of the CoC, it is necessary to strengthen the service system and cross-sector support and requires in-depth studies for future researchers regarding the involvement of adolescents in the medical decision-making process, the impact of using digital technology, the relationship between socio-economic factors and the implementation of CoC, and comparing the implementation of CoC in rural areas with urban areas.

The Relationship Between Parenting Style on Toilet Training Achievement in Preschool Children: Evidence from Cirebon City, Indonesia

Sri Nurcahyati — 2025-09-30

Toilet training is a key developmental milestone in preschool-aged children, influenced by physical, psychological, and social factors. Poor parenting style, poor parental knowledge, and not good cultural and environmental factors play a significant role in the success of toilet training, with educational interventions shown to improve outcomes. This study aims to examine the relationship between parenting style and the success of toilet training among preschool-aged children (2–6 years). This cross-sectional quantitative study examined the relationship between parenting style and toilet training success among 50 parents of preschool-aged children (2–6 years) at UPT Majasem Community Health Center, Cirebon City, Indonesia, with the relatively small sample size noted as a limitation to generalizability. Data were collected via a validated and reliable structured questionnaire, and ethical approval was obtained from the Research Ethics Committee of Institut Teknologi dan Kesehatan Mahardika, with informed consent and confidentiality ensured for all participants. The findings of this study showed that most parents demonstrated a good parenting style (66%), and the majority of children achieved successful toilet training (80%). A significant association was found between parenting style and toilet training success (p = 0.009, Cramer’s V = 0.36), indicating a moderate relationship, with children of parents practicing a poor parenting style showing higher success rates (100%) than those with a good parenting style (69.7%). In sum, parenting style significantly affects toilet training success in preschool children, and culturally sensitive parental education is recommended to improve training outcomes and child well-being.

Formulation and Activity Test of Anti-Acne Toner Containing Lemongrass Essential Oil (Cymbopogon nardus) against Propionibacterium acnes Bacteria

Devi Nur Wijayanti — 2025-09-30

Acne (Acne vulgaris) is caused by colonization of Propionibacterium acnes bacteria on the skin. The use of natural ingredients with antimicrobial activity for acne medication is an attractive alternative because it is considered safer than chemical ingredients. Lemongrass shows antibacterial activity. Lemongrass acne gel preparations can inhibit the growth of Propionibacterium acnes bacteria. This study aims to formulate the preparation and antibacterial activity of lemongrass essential oil toner. The method used is an experimental method. Variations in the concentration of lemongrass essential oil (Cymbopogon nardus) were tested at 10%, 20%, and 30%. The essential oil was produced using steam distillation. The physical quality of the toner formulation was tested using organoleptic testing, homogeneity testing, pH testing, and viscosity testing. This was followed by irritation testing, hedonic testing, and antibacterial activity testing of the toner formulation. Data analysis was performed using One-way ANOVA and Post Hoc. The acne-fighting toner based on lemongrass essential oil exhibited good physical characteristics, including a slightly opaque white color, a distinctive lemongrass aroma, a liquid texture that absorbs easily into the skin, and visual homogeneity. pH and viscosity tests showed significant differences between formulations, but all remained within safe ranges. Irritation tests showed that all formulations are safe for use as they did not cause negative reactions on the volunteers' skin. Based on hedonic testing, the formulation with a 20% concentration was most preferred by panelists in terms of aroma and color. Antibacterial activity testing showed that all concentrations (10%, 20%, and 30%) were able to inhibit the growth of Propionibacterium acnes, with effectiveness increasing as the concentration increased. The 10% formulation already demonstrated moderate antibacterial activity, while the 20% and 30% formulations fall into the strong category. Therefore, the lemongrass essential oil toner is effective and safe for use as an acne treatment, with an optimal concentration of 20%.