DESCRIPTION OF CLEAN
AND HEALTHY BEHAVIOR PROGRAM IMPLEMENTATION AT SCHOOL DURING COVID-19 PANDEMIC
AT DEPOK CITY HEALTH OFFICE IN 2021
Hadiah Ardiani*, Wiku Bakti Bawono Adisasmito
Faculty of Public Health,
Universitas Indonesia, Indonesia
Email:
[email protected]*
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Article
Information |
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ABSTRACT |
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Received:
January 12, 2023 Revised:
January 27, 2023 Approved: February 15, 2023 Online: February 24, 2023 |
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COVID-19
pandemic has had an impact on social activities, one of which is teaching and
learning activities in schools. This research aims to
discuss an overview of the implementation carried out by the Depok City
Health Office in order to increase the coverage of School PHBS during the
COVID-19 pandemic in 2021.This preliminary study is a qualitative research with a
descriptive approach.The data collection process was carried out
using in-depth interviews and document review methods. This research shows that the implementation
of the PHBS program in school settings is carried out through health human
resources who adapt to teamwork mechanisms, available facilities and
infrastructure, budgets and technical instructions that go through an
adaptation process during the COVID-19 pandemic as well as the dynamics of
school activities based on existing regulations. applies in Depok City
related to learning activities in schools. The obstacles experienced include
limited facilities in schools and the process of implementing online monitoring
and coaching activities has resulted in a gap in response in several schools
implementing the PHBS program.The implementation of the PHBS program for
schools during the COVID-19 pandemic at the Depok City Health Office, which
was reviewed through the structure, implementation process and applicable
regulations, experienced several obstacles in online activities and
supporting facilities that had not been fulfilled. However, the indicators
for the PHBS program in school settings can be implemented through various
adaptations of the activities that have been carried out. |
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Keywords |
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Implementation; PHBS; COVID-19; PTMT |
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INTRODUCTION
As
the nation's next generation, children's health is an important thing to guard
together. The health condition of children, especially in the school-age stage,
is related to one of the goals of sustainable development (SDGs), namely the
pillar of Quality Education. By increasing education for the Indonesian people
it is hoped that it will spur achievement of the goals and objectives of the
SDGs which are mutually sustainable with the development of human resources in
Indonesia, so that it is hoped that through the role of quality education it is
able to improve the quality of Indonesia's competitiveness in supporting the
SDGs 2030 goals (UNDP, 2022)
In
order to improve the quality of education and learning achievement of students
who pay attention to healthy behavior and living environment, it is necessary
to foster and develop school / madrasah health businesses in each school /
madrasah; Law Number 36 of 2009 concerning Health in Article 79 paragraph (1)
states that school health is organized to improve the ability to live a healthy
life of students in a healthy living environment so that students can learn,
grow, and develop harmoniously and as high as possible into quality human
resources.
According
to WHO, school children (7-15 years old) are still vulnerable to disease. In
school-age children, several diseases that often suffer include diarrhea, ISPA,
intestinal worms, caries, and anemia (Mamat, et al. 2016). Based on the WHO
report, 80% of children experience problems with diseases related to infection.
This percentage is much higher in developing countries and underdeveloped
countries (WHO, 2021). The incidence of infectious diseases in children in
Indonesia is still high when compared to other ASEAN countries. According to
the Indonesian Ministry of Health, 2 children in Indonesia are prone to
illnesses, such as respiratory infections, diarrhea, intestinal worms and other
types of respiratory infections (RI Ministry of Health, 2019). When compared to
developed countries, the percentage of morbidity of school-age children who do
not attend school for more than 11 days in the United States due to injury or
illness in 2018 is 4% (CDC, 2018).
In
2019 the pandemic hit the world through the COVID-19 virus which attacks the
respiratory system and failure of other organs (Bedford et al., 2020). The
spread of COVID-19 is very fast, for example when coughing, sneezing or
talking, through direct contact, and through objects around us. People who have
an infection usually have symptoms of cough, sore throat, fever, shortness of
breath and flu (corona.jakarta.go.id).
The
COVID-19 pandemic certainly has direct and indirect impacts on human life, one
of the conditions affected is social activity which in this research will focus
on teaching and learning activities in schools. Research by Jeffs et al., in
2020 stated that of 1,191 study participants, 721 (60%) expressed some level of
concern (14.5% were very or very worried) that their child would contract
COVID-19 at school. Most (79% or 941 respondents) think it is highly likely or
very likely that their child will catch COVID-19 at school if there is
widespread community transmission.
Various
diseases, especially during the COVID-19 Pandemic that were experienced by
school-age children in general, were related to individual and environmental
health behaviors. UN Habitat (2020) states that more than 1,430 cities in 210
countries are infected with COVID-19 and more than 95 percent of the total cases
occur in urban areas. This condition certainly has an impact on the health
conditions of children in urban areas.
There
is concern among parents, schools and related policy makers such as the health
office regarding the health status of school children regarding the risk of
transmission of COVID-19, the Clean and Healthy Behavior (PHBS) program is
accompanied by a special Health Protocol for preventing COVID-19 in Schools
echoed back. This is in line with research conducted by Novia (2021) where health
education is more focused on counseling on Clean and Healthy Behavior (PHBS)
and health protocols by conducting health education to students regarding PHBS
indicators, how to use masks, wash hands, brush teeth that's right, cutting
nails, and the importance of having breakfast before going to school, which is
done alternately by the UKS coach teacher and the local Public Health Center.
PHBS
is a government program launched in 2006 where there is one arrangement, namely
PHBS Schools. PHBS. There are 14 indicators in the two PHBS Schools, namely: keep hair clean and neat, wear clean and tidy clothes, keep nails
short and clean, wear clean and tidy shoes, wash hands with running water and
soap, do regular and measured exercise, don't smoke at school, don't use drugs,
eradicating mosquito larvae, using clean and healthy latrines, using clean
water, disposing of waste in segregated waste bins (wet, dry and hazardous
waste), consuming healthy snacks from the school canteen, and weighing and
measuring height every month. 14These
behavioral indicators are practiced by students, teachers, and the school
community on the basis of awareness as learning outcomes, so that they are
independently able to prevent disease, improve their health, and play an active
role in creating a healthy environment (Proverawati & Rahmawati, 2012).
The
habit of washing hands contained in the 14 indicators of School PHBS is a way
to implement clean and healthy living behaviors in children in addition to
being an effort to form clean and healthy behavior habits during the golden
period of children's lives (Drajatun, 2020),
because children also have a high risk of spreading viral infections (Kemendikbud, 2020). One
of the positive habits that can be trained in children is washing hands with
soap. This simple habit is often forgotten by children after playing, before
going to bed and before eating children (Rahmawati et al., 2020). In
line with research conducted by Burgess (2021) with the existence of a
hygiene insemination program in elementary schools to promote cleanliness and
sanitation in schools, stimulating healthy behaviors in teachers, students, and
families during the COVID-19 pandemic can reduce the pain caused by the virus.
The
spread of COVID-19 that can and is easy to do in school settings is a clean and
healthy lifestyle (PHBS) such as washing hands with soap (Saida et al., 2020).
This was reinforced in research conducted by Cahyorini (2021) that
with the increasingly widespread spread of COVID-19, the Clean and Healthy
Behavior (PHBS) that has been carried out so far needs to be increased in
information and implementation, especially with the implementation of PHBS
which is related to preventing disease transmission.
Several
studies have revealed that the practice of hand washing can reduce the number
of microorganisms on the hands, thereby reducing the incidence of respiratory
diseases (Patel et al., 2012).
This is related Hand hygiene is considered one of the most effective ways to
reduce health care-related infections (Gould et al., 2017).
Hand hygiene can be done by washing hands either with soap and water or hand
sanitizer which is now widely available in all health care settings (Ridley, 2020).
Clean
and healthy living behavior during the COVID-19 pandemic is a form of
embodiment to create a conducive condition for individuals, groups and
communities to improve behavior by implementing healthy ways of life and
complying with health protocols in order to maintain, maintain and improve the
health of one what can be done most often is by washing hands (Gani et al., 2015). In this
regard, hand
hygiene is an act of washing which is interpreted as a sanitary act by cleaning
the fingers using water, soap or other liquids with the aim of being clean (Desiyanto &
Djannah, 2013).
The
Central Statistics Agency (BPS) for 2021 stated that the child morbidity rate
due to the COVID-19 pandemic in urban areas was 13.26 percent higher than in
rural areas, namely 9.87 percent. In West Java provincial data,Data from the West Java Committee for Handling Covid-19
and Economic Recovery as of 7 February 2022 stated that the highest number of
confirmed cases in West Java were in Depok City, with 117,499 cases. Of that
number there were 11,324 active cases, 103,998 recovered and 2,177 died. The
journey of the COVID-19 case in Depok City has also been in the spotlight because
the trend of new confirmed cases is very high. This condition has an impact on
learning and teaching activities in schools. Meanwhile, 34 schools in Depok
City have temporarily suspended face-to-face learning (PTM) with a classroom
capacity of 100 percent. an increase in active cases of school age children in
Depok City as many as 239 new cases of COVID-19 in the school environment by
the end of 2021 (Depok City Covid Task Force, 2021).
The
2018 Public Health Development Index (IPKM) shows a national average PHBS
percentage of 35.7% and at the educational institution level only 67.52%.
According to Basic Health Research Data (Riskesdas) for 2018, the proportion of
household members over 10 years of age who had the correct behavior to wash
their hands properly in Indonesia was only 49.8%. Likewise, what happened in
the implementation of PHBS in schools was still not optimal because many
indicators from PHBS had not been implemented.In Depok City itself, the coverage of PHBS in 2021, where
in that year the number of COVID-19 reached a high number of cases, reached
85.56% where this figure consisted of PHBS coverage of Elementary Schools of
83.55% from 304 schools there are 33 elementary schools with a coverage of
below 70%, while for the junior high school level of 84.34% of 142 schools
there are 16 junior high schools with a coverage of below 70%, and then the
senior high school level of 83.09 % of 91 high schools there are 19 schools
with PHBS coverage below 70%. The achievement indicators for 2021 have
increased from the previous year, namely 80.98% in 2020 and 58.9% in 2019.
Given
the importance of increasing awareness of clean and healthy living behavior or
PBHS, especially in school settings and reducing the rate of spread of the
COVID-19 virus, it is important to study an implementation or implementation of
PHBS in school settings during the COVID-19 pandemic carried out by the person
in charge of a region or urban areas where in this study is the Health Service.
This study aims to discuss the implementation carried out by the Depok City
Health Office in order to increase the coverage of PHBS in Schools during the
COVID-19 pandemic in 2021.
METHODS
This research is a qualitative
research with a descriptive approach that aims to identifyan
overview of the implementation of the PHBS program in schools during the
COVID-19 pandemic by the Depok City Health Office in 2021. The approach in this
study looks at the implementation components through the structure, processes
and outcomes of implementing PHBS in schools by the Depok City Health Office
and the dynamics of learning activities in schools are reviewed of the
regulations in effect in Depom City in 2021. The structures that will be
discussed in this study are health human resources, facilities and
infrastructure, activity budgets and technical instructions. The process will
discuss the implementation of PHBS Monitoring activities in schools during the
COVID-19 Pandemic by the Health Office/ Public Health Center. The
output will discuss indicators of achievement of PHBS in schools during the
COVID-19 pandemic in 2021. The data collection process was carried out using
in-depth interviews and document review with related informants, namely the
Depok City Health Office, namely the Head of the Health Promotion Section (Code
D1) and Promkes Officers from the District Health Center (Code P1) and Promkes
Officers from the Kelurahan Health Center (Code P2) in the City Depok. In-depth
interviews were conducted using interview guidelines that had been prepared.
Data triangulation by confirming the secondary data obtained, namely data on
PHBS coverage at the Depok City Health Service School in 2021 and the person in
charge of health promotion at the Public Health Center and published policies
related to school activities during the pandemic in Depok City in 2021.
RESULTS
Depok
City has 537 schools consisting of 304 public and private elementary schools,
142 public and private junior high schools and 91 public and private senior
high schools. The results of this study include structural variables, namely
health human resources, facilities and infrastructure, and activity budgets,
and technical instructions. Next is the process variable, namely the technical
implementation of PHBS Monitoring activities in schools during the COVID-19
Pandemic by the Health Office/ Public Health Center. The
final variable is the output, namely the achievement indicator of PHBS in
schools and the report on the number of positive cases of COVID-19 in schools.
STRUCTURE
Human Resources of Health Worker
The
results of in-depth interviews with informants found that the SDMK involved in
implementing the PHBS School Order program in 2021 worked as a team. This is
done as a cross-program coordination step and also in anticipation when team
members experience problems such as being exposed to COVID-19 who have to
self-isolate. So that the activities of implementing PHBS monitoring of School
Orders are still carried out with these limitations.
"Resources
related to implementing the health promotion work together between health
promotion workers at the Health Office and at the Public Health Center, because
the Public Health Center holds their respective territories so that the
community is more accessible" – D1
"There
is 1 health promotion officer at the sub-district health center. For school
PHBS, I work with the PJ UKS. For junior high schools, there are PJ NUTRITION
and PKPR working together, for SD, the PJ UKS is often the PJ Kesling." – P1
"To
go down alone, it's not promoting health itself, so there are a lot of other
PJs who help for sure, of course from PJ UKS, from PJ Kesling who help get off,
yes, to get off the field. Because our activities coincide with the screening
activities.” - P2
In overcoming the constraints of limited HRK,
the staff or team in charge of the Health Promotion section at the Depok City
Health Office implemented a rolling system for employee WFH. At the Public
Health Center itself, to face obstacles related to the lack of staff or teams
involved in carrying out field trips by implementing a cross-program
coordination system, as conveyed by informants as follows:
"Not
only at the Health Office, but also at the Public Health Center to maintain
sanity and health, we implement a rolling WFH system, so first to avoid crowds,
second to maintain the immunity of each employee, which is regulated by each Public
Health Center and the Health Office" – D1
“But if we really have to be alone, so far we are
not going alone. At least the two of us or just reschedule the schedule. If for
example there is an incident, one of our officers is a team, the positive ones
are usually we ask for help from others who have more or less free time” – P2
Related to increasing the competency of Health
Promotion staff in monitoring PHBS School Order during the COVID-19 Pandemic,
based on the information obtained there was no special training regarding this
condition. As for information that is dissemination of regulations or the
latest information, it will still be carried out through limited meetings or
via online such as webinars.
“PHBS training actually doesn't exist…” – D1
“It just seems like 2021 specifically for prokes
schools doesn't exist. Sometimes, yes, from the service, if there is training
for schools, UKS officers are often invited, and webinars, there are lots of
webinars, we can participate at any time, there are many choices. But for
training, there isn't any” – P1
"As
for special training, there isn't any special training. It's just that we have
a meeting, a meeting of all PJ Promkes in the Office, we discuss what problems
in the field we discuss together” – P2
Facilities and infrastructure
Based
on information obtained through in-depth interviews with informants, related to
the fulfillment of facilities and infrastructure for implementing the
activities of the School Order PHBS program, it is considered sufficient for
several sectors, for example the provision of hand washing facilities in
several school areas, especially for private schools.The involvement of the
private sector in CSR (Corporate Social Responsibility) activities or social
responsibility from companies also colors the fulfillment of PHBS facilities,
especially for hand washing facilities. However, there are also gaps in several
sectors such as healthy latrines according to the PHBS indicator criteria.
Meanwhile, school readiness in fulfilling the facilities and infrastructure for
PHBS activities during the COVID-19 pandemic was carried out by improving
health facilities such as providing hand washing equipment with soap and
running water. The Public Health Center itself has a role in completing technical
facilities such as providing promotional media in the form of leaflets, posters
and electronic media such as videos.
"Incidentally,
yesterday's pandemic apart from getting used to washing hands, there are also
many CSR CSR programs that donate hand washing facilities, so in my opinion the
facilities related to PHBS are sufficient, especially yesterday with the
pandemic conditions everyone, all companies, all institutions are competing how
to get people to have PHBS” – D1
"We
make educational media, through videos-flyers-flyers, also directly with
counseling" – D1
"In
terms of facilities and infrastructure, the condition of the buildings is still
a lot of concern" – P1
"If
it's from school, I'm ready. What about us, from the Public Health Center? For example,
when we visit, we bring leaflets or posters, of course the Health Office will
provide them for that, we will bring them to school, we will distribute
posters.” – P2
Activity Fund Budget
Based
on the results of in-depth interviews with informants, there were no
significant obstacles to the implementation of the PHBS program in the school
setting. Even though it says there is a refoconsidering the budget in several
budget lines for COVID-19 3T (Testing, Tracing, Treatment) activities, PHBS
monitoring activities in the school setting can still be carried out with some
adjustments related to the activity budget.
"So,
that's enough. There is definitely a shift in funds, even in 2020 all budgets
are shifted. There is no promotion budget at all, 2020 was the start of the
pandemic, so we didn't have any budget at all, the promo workers at the Health
Office were diverted to help the call center. But in 2021 the budget is rolled
out again even though there are also many shifts, so yes, we are really sorting
and selecting activities that are really useful and related to this pandemic” -
D1
"PHBS
funds from BOK, especially in 2021, will not be available because the funds are
focused on COVID-19. There is only a budget for germas socialization at the
sub-district level. In 2020 there will still be socialization of PHBS in 4
schools, for 2020 there will only be meetings at the beginning of the year,
while in 2021 health promotion will only be for GERMAS" – P1
"As
for the actual budget, we don't need to spend a lot of money for school PHBS, actually it's more about our time."– P2
Regarding financial support
or donors from external parties, other than the Health Office or from the
center, namely the Ministry of Health, it is known that there is no flow of
support in the form of money but it is delivered in the form of activity
facilities carried out by the Health Office and Public Health Center such as
hand washing facilities donations for several selected schools, distribution of
hand sanitizers and hand washing soap.
"So
they support more for the activities we carry out, such as when the GGS was
held in 2021 yesterday, to be precise during World CTPS Day on October
15." – D1
Technical Instructions
Based
on information obtained through in-depth interviews with informants, there were
no specific technical instructions that were handed down during PHBS monitoring
in school settings during the COVID-19 pandemic. In terms of handling COVID-19,
the technical instructions socialized by the Depok City Health Office are derivatives
from the Ministry of Health which were adapted to the issuance of the Mayor's
Decree related to COVID-19 Management in the School environment.
"Yes,
actually for school PHBS technical guidelines during the COVID-19 pandemicnew
normal and our health protocols refer to the Ministry of Health, now from the
Ministry of Health derivatives we break into socializations in the form of
webinars to reach the community, we also accept invitations from schools for
socialization of the new normal adaptation” – D1
"Regarding
Prokes, I have received it, but I forgot whether it was in the form of a book
or a manual in PDF form, but not specifically related to PHBS. In PHBS meetings
at the Office, a complete technical guideline has been given regarding PHBS
indicators, starting from the PHBS guidelines for households, schools, PTUs,
workplace institutions, and health agencies, but specifically discussing PHBS
during a pandemic and there was no health program." – P1
"If
there is this guide, the name is Prokes at school, so it's not the title PHBS.
During the COVID-19 pandemic” – P2
The
Health Service carried out a strategy in disseminating PHBS technical
guidelines in schools and other settings by coordinating across sectors. This
is also carried out by the Public Health Center who take the initiative in
various ways and media such as holding webinars and interactive communication
through social media.
"So
usually this activity is the first socialization to the Depok City COVID-19
Task Force which in 2021 routinely holds coordination meetings to explain all
kinds of developments not only related to school PHBS, but also for example
what the development of COVID-19 was like at that time, what was the management
like. , because the management of COVID-19 itself is very dynamic following the
existing guidelines” – D1
"In
2021 the socialization will be carried out to children concurrently with
official immunization (BIAS), and even then, the budget is limited and the
conditions cannot meet face to face due to COVID-19 so it is also carried out
viazoom webinars”– P1
"Pastthat
zoom. But at that time, the one who provided information regarding the zoom was
at our Public Health Center with an internship doctor” – P2
PROCESS
Implementation of the PHBS
Program in School Settings
Overall,
the description of the process of implementing the PHBS program in School
Orders in 2021 which is known based on in-depth interviews and document review
can be said to be good with the limitations and obstacles that occurred in the
field during the COVID-19 pandemic. However, with the adaptation process that
has been carried out, there are still some gaps in the process of implementing
School PHBS to be improved againi like in terms of facilities that allow it to
be held by the school and Public Health Center.
"Due
to the pandemic, PHBS has increased because there are moreaware,
yes, the teachers are also parents too, from before it was just sober." – D1
"In
2021, because there are still an average of not face-to-face meetings, so the
school's PHBS has not maximized supervision and guidance. For public schools,
the facilities are generally similar, but for private schools, you can see the
gap. If the school entrance fee is expensive, the facilities are good, but if
it's normal, then the facilities are also ordinary.” – P1
"Yes,
it's definitely different, there were a lot of shortcomings last year, even
though the PHBS program was running during the pandemic. Yes, that's the only
benefit, maybe it's made by children at school. We can't say 100% for sure it's
not enough for the benefits” – P2
The
informants also explained that the most influential factor in the success of
implementing the PHBS program in school settings was inseparable from the
ability of the SMDK itself to be able to convey PHBS messages and carry out
maximum monitoring amid the COVID-19 pandemic. Apart from the SDMK factor, the
informants also assessed the importance of providing facilities and
infrastructure to support PHBS activities in a better school order.
"The
most influential thing is the joint determination of all elements in the school
and the health service, it can be implemented if all elements in the school
also support, starting from human resources, resources, facilities and
infrastructure, everything moves, everything supports" – D1
"The
first, in addition to knowledge from the school, is the school's commitment to
implementing PHBS. Then the availability of resources and budget. Because there
are schools that have a budget, but it is allocated for other things” – P1
"The
most influential thing, maybe it's from us who provide information. If we give
counseling more often, we meet more often with school officials. That can
possibly improve behavior change at school” – P2
The
real role of the Health Office and the Public Health Center in the process of
implementing PHBS in schools was identified based on in-depth interviews with
informants, namely by conducting cross-sectoral coordination, supporting PHBS
activities in schools with available facilities and infrastructure by distributing
them evenly to schools and innovating face-to-face activities. with various
activities through online platforms such as webinars and interactive
communication through social media so that the PHBS message continues to reach.
"Coordinate
with the school, so record which schools start to attend to be visited on the
first day of admission to monitor the health program, besides that if we
receive an invitation to socialize the health program to schools, for example,
those who have never been on live IG have now become live IG" – D1
"In accordance with the health promotion strategy, such as
counseling for the implementation of the PHBS program to school from the Public
Health Center. How do we build an atmosphere with schools that definitely use
available media, videos, posters, leaflets or stickers like that. Continue
advocating for school principals who are sometimes really important for
leadership in their schools. We want to have PHBS counseling, approach it to
school principals” – P2
Achievement
Indicators of PHBS School Order
Based on
in-depth interviews and document reviews, the data obtained regarding the
Coverage of PHBS School Arrangements was only 475 schools out of 537 schools
that were surveyed in 2021 or around 88.45% with the following coverage:
Table 1. Coverage of PHBS Data for Schools at the Depok
City Health Service in 2021
|
Indicator |
Elementary School |
Junior High School |
Senior High School |
|
in percent (%) |
|||
|
93.42 |
92.60 |
93.40 |
|
|
2. Wear clean and tidy
clothes |
94,24 |
94.71 |
95.60 |
|
3. Keep your nails
short and clean |
78.94 |
79,92 |
74,17 |
|
4. Wear clean and
neat shoes |
93.91 |
94.01 |
95.05 |
|
5. Washing hands
with running water and soap |
94.81 |
95.95 |
95.32 |
|
6. Exercise
regularly and measured |
87,28 |
84,27 |
81.68 |
|
7. No smoking in
school |
88.15 |
90.61 |
88.64 |
|
8. Do not use drugs |
97,69 |
97.88 |
96.70 |
|
9. Eradicate
mosquito larvae |
83,22 |
91.19 |
92.85 |
|
10. Using clean and
healthy latrines |
87.30 |
89,29 |
87,91 |
|
11. Using clean
water |
98.84 |
99.64 |
100 |
|
12. Dispose of waste in segregated waste bins (Wet, Dry and
Hazardous waste) |
69,29 |
66,43 |
68,49 |
|
13. Consuming
healthy snacks from the school canteen |
69,73 |
72,76 |
71,79 |
|
14. Weigh and
measure height every month |
67,59 |
63,20 |
56,86 |
The policies issued in 2021
related to the implementation of learning activities in schools during the
COVID-19 pandemic in Depok City are:
Table 2. Policies
Applicable in the City of Depok Regarding
School Learning in 2021
|
No |
Policy |
Date of issue |
Number |
About |
|
Joint Decree
of the Minister of Education and Culture, Minister of Religion, Minister of
Health, Minister of Home Affairs of the Republic of Indonesia |
March 30,
2021 |
No.
03/KB/2021, No. 384 of
2021, no. HK.01.08/MENKES/4242/2021, No. 440-717 Year 2021 |
Guidelines
for Organizing Learning During the COVID-19 Pandemic |
|
|
2 |
Circular
Letter (SE) of the Mayor of Depok |
July 10, 2021 |
No.
420/367/Huk/Disdik |
Learning for the 2021/2022 Academic Year
During the COVID-19 Pandemic in Depok City, PTM was abolished |
|
4 |
Instruction of the Minister of Home Affairs
of the Republic of Indonesia |
August 2, 2021 |
No. 27 of 2021 |
Implementation
of PPKM. Depok Level 4 |
|
5 |
Depok Mayor Regulation |
September 20, 2021 |
No. 66 |
Implementation of Limited Face-to-Face
Learning |
|
6 |
Decree of the Mayor of Depok |
October 19, 2021 |
No. 443/463/Kpts/Satgas /Huk/2021 |
Implementation of Restrictions on Community
Activities Level 2 of the COVID-19 Pandemic |
|
7 |
Circular
Letter (SE) of the Mayor of Depok |
November 18, 2021 |
8.02/648/SATGAS/2021 |
Limited
Temporary Suspension of the Implementation of PTMT |
|
8 |
Instruction of the Minister of Home Affairs
of the Republic of Indonesia |
December 13, 2021 |
No. 67 Year 2021 |
Implementation
of PPM Level 1,2,3. Depok Level 1 |
|
9 |
Joint Decree of the Minister of Education
and Culture, Minister of Religion, Minister of Health, Minister of Home
Affairs of the Republic of Indonesia |
December 21, 2021 |
05/KB/2021, 1347, HK.01.08/ MENKES /6678/2021, 4943-5847 |
COVID-19
Pandemic Learning Guide, Level 1,2,3 is possible for limited face-to-face
learning. |
Based
on the results of a document review in the form of the results of the coverage
of PHBS indicators for school settings and regulatory documents stipulated in
Depok City regarding learning activities in schools, it appears that the
dynamics of schools to carry out limited face-to-face learning activities
(PTMT) have an effect on survey activities carried out by officers. Health
Promotion to supervise schools in implementing PHBS. The Health Promotion
Officer conducts an online survey through an online form provided to UKS teachers,
and direct monitoring when schools carry out PTMT activities. As for students
undergoing Distance Learning activities, PHBS monitoring surveys were not
carried out at home, this was recognized as an obstacle for Health Promotion
Officers to supervise PHBS School Orders which were carried out at each
student's home.
"The
activity of monitoring the PHBS survey and the outreach of the juknis-juknis
because it is also related to the president's institution, we have also adopted
the Ministry of Home Affairs regarding the level in Depok City, so that will
affect the activities that can be carried out as previously the day was open
only 4 days, the number of students 50% is adjusting the field or not " -D1
"Monitoring
activities cannot be carried out directly, look at schools that have PTMT. If
we have a survey. Only a few schools in 2021, less than 50 percent of the total
schools in the working area of our Public Health Center” - P1
"We
gave an online form, so the UKS teacher filled it out. Just a sample of
students, for example, 10-20 students. If there is one checklist that is not
fulfilled, the indicator cannot be filled. For students who are not surveyed at
home, it's just an appeal to carry out prokes " -P2
The
incompleteness of the school survey conducted was related to the obstacles
experienced by those in charge of Health Promotion who were at the Public
Health Center to conduct field work due to the conditions of the COVID-19
pandemic. Problems with health workers who were exposed and also the condition
of the Public Health Center which had to work hard with the 3T COVID-19
activities, where all Public Health Center staff were deployed to manage the 3T
activities. As is known above, in 2021, Depok City will experience a sharp
increase in COVID-19 cases. So that the workload at the Public Health Center
indirectly affects the performance of other programs such as monitoring the
implementation of this school's PHBS.
"The
space for outreach and monitoring is also limited because we at the Public
Health Center are preoccupied with 3T activities so the focus is divided" – P1
"So
our (Public Health Center) monitoring of school PHBS is not optimal, most of
the Public Health Center only carry out technical work from the Office,
especially in 2021 where school PHBS is shifted by COVID-19 because it is
currently at a high level, so Public Health Center staff are directed to focus
on 3T" – P1
"Data
collection in 2021 will be carried out by direct observation with a sampling of
9 schools (out of 21 schools), not half of which has yet been reached. This is
because the Public Health Center hasoverloaded
with 3T activities”– P2
There
are several conditions that cause low school PHBS achievement rates when viewed
from the indicators above, there is a checklist regarding the availability of
facilities and whether the operation of these facilities is carried out or not.
Based on the document review, for the indicators of weighing, there are several
schools that have provided rooms for measuring weight and height but are not
recorded regularly so that the scores for these indicators cannot be filled in.
It is a different case with the condition of healthy latrines, where there is
an indicator of the use of healthy latrines with a ratio of the total
population of the school community where not all schools can meet this number
of comparisons. In the end, the number of school PHBS indicators decreased.
"Because
of the pandemic, PHBS at this school has greatly increased because they
(schools) are so strict about implementing the health protocol, in my opinion
it is very strict, but it is undeniable that there are still school
clusters" – D1
"As
for the infrastructure, if it comes from school, I can see that it's complete,
even if it's from elementary school, they look like it's already thereBe
prepared to face face-to-face learning, which at the start of 2021 is like a
hand washing facility” – P2
"The
indicators of PHBS in 2021 as a whole that are not fulfilled are bathrooms and
trash cans, while for washing hands due to a pandemic, the average is still
good. But like the bathroom with comparisons for students, there are many that
are not fulfilled, also the trash cans are separated by plastic lining,
covered, there are no plastic bags. The infrastructure at school is still
rather minimal” - P1
"Then
there is a canteen, only the canteen is provided, but it seems like there is
not enough supervision from the school either. Sometimes there are people,
traders from outside, selling in the canteen.” – P1
DISCUSSION
Health
human resources is an important instrument for the implementation of a health
service or program. To achieve the success of a service, health human
resources, both at the Health Service and Public Health Center, must be able to
adapt to the conditions of the COVID-19 pandemic that hit by forming teamwork.
As quoted in the book Tips for Successful Work Team Management what is meant by teamwork isa collection of individuals with specific skills who work
together and interact to achieve common goals (Ilyas,
2003). The COVID-19 pandemic has not necessarily stopped the steps of
the health promotion unit at the Health Office and the Public Health Center in
Depok City from continuing to carry out their performance in terms of
monitoring PHBS in the school setting. Work team is a group of people with complementary abilities and are committed
to the same goals, performance, and approach and feel mutually responsible for
achieving them (Ballangrud
et al., 2017).
The Public Health Center, in carrying out field trips to monitor
PHBS in the School Order as an effort to prevent COVID-19, often encounter
obstacles that limit the space for officers to move. This is becausePublic Health Center are the community's first line in
breaking the chain of transmission of COVID-19 where the location of the Public
Health Center is close to the community in each sub-district and has its own
working area concept (Umpung et al., 2020). The obstacle often faced by health center staff is the risk
of exposure to COVID-19 between fellow health center staff. Regardless of the
obstacles encountered, in line withthe
results of research by Hasanah (2020) note
that the Public Health Center continues to carry out its functions as UKP and
UKM in accordance with what is stated in Permenkes No. 43 of 2019 during the
COVID-19 Pandemic. Therefore, forming a good work team helps the Public Health
Center to better organize the activities to be carried out.
The work team that has been formed is considered capable of
supporting Public Health Center to
continue to carry out its function as UKP during the COVID-19 pandemic by
continuing to make efforts to prevent and treat patients who are exposed due to
the very fast spread of COVID-19. These efforts include changing the flow of
patients, utilization of facilities and infrastructure, tight prokes,
disinfection before and after service. Whereas in SME
services apart from forming a work team,Public Health Center carry out
their functions using more social media and strengthening cross-sector
relations in disseminating information in the community from the RT to
sub-district levels including the health network (Hasanah et al., 2020).
Through a good work team in terms of the quality of human
resources that have been adapted by the Health Service and Public Health Center
in Depok City, the availability of facilities and infrastructure has also
become one of the success factors in fulfilling the 14 indicators of PHBS in
school settings. The Depok City Health Office and Public Health Center have
provided and distributed various facilities and infrastructure such as
educational media, PHBS supporting facilities such as proper handwashing facilities,
distribution of health protocol instruments such as masks and hand sanitizers.
However, in several work areas, schools experience disparities in terms of
facilities, such as a lack of handwashing facilities, availability of clean
water and availability of healthy latrines according to indicators.
Research
conducted by Messakh et al., on elementary school students found that the
implementation of PHBS was still lacking due to several factors such as the
human resources of educators and facilities (Messakh et al., 2019). Deficiency in
fulfilling these facilities is certainly an obstacle in the process of
implementing PHBS in school settings. This does not only occur in the Depok
City area, but the results of a literature study by Poague (2022) stated
that of the 18,456 schools described based on 65 articles from 30 countries, it
indicated a lack of appropriate water, sanitation and hygiene conditions in
schools. Even though the infrastructure is available, the amount is inadequate
and cannot guarantee the health of school residents. The majority of schools do
not meet WHO/UNICEF standard ratio sanitation facilities. These facilities
tended to be dirty, unusable, and in poor condition. Poague (2022) also found that during
the COVID-19 pandemic as it is today, the condition of the school's
infrastructure prevented students from practicing hand-washing behavior which
is a basic strategy to stop the spread of COVID-19 in the school environment.
To
overcome the gap in the provision of facilities according to WHO standards,
UNICEF and the Ministry of Health itself, the government should also pay
attention to the condition of the facilities available in schools, both public
and private schools. As is the fact found in literature studies in Japan that
basic education and school environmental hygiene have a legal basis, namely the
School Health and Safety Law (Gakko hoken anzen hou) and the Health Promotion
Law (Kenkou zoshin hou), then more detail will be provided in the notification.
public MEXT called School Environmental Health Standards (Gakkou kankyou eisei
no kijyun). Regarding the obligation to provide high quality clean water in
schools, it is regulated in the Water Supply Law (Suido hou) and several
related ministerial regulations such as the Ministry of Health, Labor and
Welfare (MHLW) (Sugita, 2022).
Meanwhile in Indonesia the regulations set out in PMK No. 25 of 2014 concerning
Children's Health Efforts, has not regulated the standardization of health
support facilities available in schools such as regulations regarding clean
water and sanitation, although the PMK has mentioned school children's health
efforts such as the operation of the UKS (School Health Business) and PKPR
(Adolescent Care Health Services).
The
availability of adequate facilities and infrastructure is of course inseparable
from the budget for supporting activities. During the COVID-19 Pandemic,
several budget items were refocused for the prevention and handling of
COVID-19. This has had an impact on program implementation in which the budget
line has shifted including PHBS activities in the school children setting.
Regarding budget refocusing, this is regulated in Perppu no. 1 of 2020 followed
by the issuance of Presidential Instruction No. 4 of 2020 which is used as an
instrument for refocusing K/L budgets including the Ministry of Health as the
coordinating center for the Health Office and also the Public Health Center.
Budget refocusing also occurs as a resultdecreased
budget transfers from the central government to regional governments due to
decreased overall revenue during the COVID-19 pandemic (Martania, 2022). Refocusing
the budget is carried out in order to focus its financing on tackling the
COVID-19 pandemic and overcoming economic problems and preventing Indonesia
from falling into an economic recession (Sopanah et al., 2022).
The Depok City Health Office cooperates with companies in CSR
(Corporate Social Responsibility) activities to get around constraints on
activity budget factors. Although not in the form of funds, CSR in its role
provides support for the implementation of PHBS activities by providing hand
washing facilities which are technically distributed by the Health Office to
schools or public facilities that need these tools. Implementation
of the CSR program is the realization and actualization of the company's efforts
to maintain close contact with the community which is basically an important
factor for sustainability which includes economic, environmental and
socio-cultural aspects (Setyaningrum &
Prastiwi, 2011).The literature study also
reveals that the CSR focus of most companies during this pandemic has almost
all been diverted to optimizing the handling of COVID-19 through the
distribution of Personal Protective Equipment and also other health equipment,
such as prokes support facilities, one of which is hand washing equipment which
can also be followed for moving the wheels of the community's economy through
integrated MSMEs so that they can remain empowered during the COVID-19
pandemic.
The
implementation of activities was carried out during the COVID-19 Pandemic,
apart from the human resource factor, facilities and infrastructure as well as
the budget, technical instructions were an engine driving the implementation of
an activity or program. The technical instructions contain details of the flow
of activities to what needs must be met by the implementer for the continuation
of the program. During the COVID-19 pandemic, starting from the President, the
Ministry of Health, the National COVID-19 Task Force and also layers of
community stakeholders managed the information that was later needed to be used
as a technical guide for activities. This is aimed at organizing joint steps to
create a real and simultaneous national movement for the prevention and
treatment of COVID-19. Related to PHBS activities in the School Order, no
standard technical guidelines were issued during the pandemic. However, the
National COVID-19 Task Force in collaboration with Ministries/Institutions such
as the Ministry of Education and Culture, Ministry of Health, Ministry of
Religion, Ministry of Home Affairs, BNBP issued Guidelines for Adjusting
Learning Implementation during the COVID-19 Pandemic on August 7 2020, in the
guide there are additional technical instructions such as managing Health
Protocols in the School Order which complements the indicators in the PHBS
school order which refers to the Joint Decree of 4 Ministers.
The
Depok City Health Office in its commitment during the COVID-19 pandemic to
continue providing health services to the community. The socialization strategy
is carried outas a real step by carrying out various
innovations such as replacing face-to-face socialization meetings with online
ones that utilize information technology, also through print and electronic
media. This is in line with research which says that in an online environment learning
is obtained which aims to reach massive and broad community groups by utilizing
the internet network (Assidiqi & Sumarni, 2020).The hope with this
socialization is that the process of delivering policies and technical
guidelines that have been published will later be received by health workers
and the public as up to date information.
The
involvement of the structure for the implementation of the school-order PHBS
program during the COVID-19 pandemic in Depok City ultimately gave birth to a
good implementation process through limited face-to-face and online activities.
However, it was foundthe limitations of program
implementation during this pandemic, which were mostly carried out online,
turned out to have an impact on the information provider, in this case the
health promotion officer and the health center, to the recipient of the
information, in this case the community at school, starting from school principals,
students and also other educators.
The feedback on information conveyed online is certainly different
compared to direct monitoring. Research conducted in Sweden found thatchanges
in the work methods of health workers with students/guardians such as chatting
about health using digital platforms and recording video information about
health with school staff such as meetings held online can facilitate
coordination, but can also have a negative impact because the information
shared digitally is not very detailed (Kleynhans et al., 2021). The
phenomenon of the impact of online monitoring provides learning for Promkes
officers at the Health Service and Public Health Center where they are aware
that the biggest influence on the success of the School PHBS program is the
ability of human resources to provide information and process the information
provided. In addition to the ability of health promotion officers, the school's
acceptance is also a factor that increases the achievement of PHBS indicators
in the school setting.
In
this case the involvement of all the school community in the importance of PHBS
during the pandemic was able to provide a school climate to practice PHBS
properly. Furthermore, through active methodological learning, where students
are the center of the learning process by promoting PHBS activities to students
to then process in groups for other students (Brivio et al., 2021).
In this study, elementary school teachers also agreed that the topic of
COVID-19 prevention and health promotion related to PHBS and its implementation
process was even more important during the COVID-19 pandemic.
The
outputs from a series of program support structures to the process of
implementing PHBS monitoring activities at school settings were stated to be
capable enough to implement PHBS activities at school settings during the
COVID-19 Pandemic.However, conditions were also found
where not all schools were successful in carrying out monitoring surveys, this
was due to the dynamics of school activities based on applicable regulations,
such as changes in regulations from Limited Face-to-Face Learning (PTMT)
activities to Distance Learning regarding the development of the COVID-19 case.
19, there is also overlapping activities at the Public Health Center related to
the 3T series for the prevention of COVID-19.
If
seen in Table 1, school PHBS numbers tend to have high scores. This is known as
the impact of a pandemic, where schools, with their respective abilities,
prepare facilities to reduce the rate of transmission of COVID-19 in the school
environment. However, there are several facilities and infrastructure that
schools have not been able to fulfill in terms of facilities to support PHBS,
such as healthy latrines that are in accordance with the ratio of the number of
students and teaching staff at the school.At the
elementary, middle and high school levels, the highest achievements were found
in using clean water, not using drugs and washing hands with soap. Low coverage
gains are found in the indicators of throwing garbage into segregated bins,
consuming healthy snacks, weighing and measuring height every month.
The activities listed in the PHBS indicator for school settings
included in the COVID-19 Health Protocol are washing hands with soap with clean
running water and the condition of proper toilets being cleaned every day (PTMT
FAQ Pocket Book, 2020). As for the differences in the indicators of toilets
available in schools listed in the school health protocol regulations and
school indicators, it is best to conduct a deeper study so that the survey
results can also describe the condition of the feasibility of toilets in
schools during the COVID-19 pandemic. Meanwhile, activities with low coverage,
such as consuming healthy snacks, are influenced by the regulations contained
in SKB 4 of the Minister concerningGuidelines
for Organizing Learning During the COVID-19 Pandemicwhere
the closure of canteens was carried out both at schools that carried out PTMT
or Distance Learning (PJJ). Activities with a high scope are supported by a
good structure and process implementation in line with research conducted by Odone (2021) where the awarding processeducational
interventions (66.6%) and provision of sanitation (82.5%) have a big role and
have a very good impact on students' healthy behavior.
With
regard to school learning methods that are carried out face-to-face or remotely
online, the regulations that apply in Depok City are based on the issuance of
SKB 4 MinistersaboutGuidelines for Organizing
Learning During the COVID-19 Pandemic in March 2021. To maximize the process of
limited face-to-face learning activities, the health and safety factors of the
community in schools are taken into consideration, then evaluate the need to
carry out limited face-to-face learning for students who experience problems in
carrying out distance learning, as well as health priorities for all school
members, interventions in the form of vaccinations for educators and teaching
staff are needed as an effort to accelerate the implementation of limited face-to-face
learning. Apart from that, the behavior of maintaining and following strict
health protocols is still carried out in the school environment. By going
through this process, it is hoped that schools can restart Limited Face-to-Face
Learning, so that teaching and learning activities can be carried out back in
school. Having an impact on this, the supervision and implementation of the
school order PHBS survey will be more reliable if it is carried out by
observation and direct activities at school rather than using the online
method.
However, seeing the conditions on the ground, in July 2021,
school activities are also required to undergo Distance Learning on the basis
of case developments.as of July 9, 2021 which reached high numbers, where the positivity
rate was 41.65%, child cases were 19.05% (ages 0 to 5 years were 3,136 cases
and ages 6 to 19 years were 9,933 cases). Then the Bed Occupancy Rate (BOR) at
the hospital averaged 95 to 100% and the discovery of Covid-19 Variant Delta
B1.671.2 in Depok City(Depok City COVID-19
Coordination and Information Center, 2021). Noticing the incident in this case,
the government adopted a policy to temporarily stop PTMT through the Mayor of
Depok Circular Letter No. 420/367/Huk/Disdik as of 10 July 2021. This certainly
affected the monitoring activities of PHBS in school settings carried out by
Health Promotion Officers, by returning to conduct online surveys via online
forms.
In
September, the Depok City government again issued Mayor Regulation No. 66 of 2021
concerning Implementation of Limited Face-to-Face Learning, which contains
guidelines for implementing health protocols in the context of PTMT during the
Covid-19 Pandemic in Schools. The regulation also regulates PTMT procedures in
educational units, starting from the condition of the classroom, the minimum
distance between student seats is 1.5 meters and a maximum of 20 students in
one classroom. The implementation of the health program is also something to
pay attention to in this regulation, which is to continue to actively use masks
that cover the nose, mouth to chin, then wash hands with soap with running
water or hand sanitizer and apply cough and sneeze etiquette. PHBS indicators
that are included in health protocol activities experience a high tendency for
financing, schools support these activities one of which is by providing
handwashing facilities with soap. Sports and extracurricular activities are
also not permitted by this regulation, so that during the survey in the PHBS
indicator column related to physical activity, several schools were unable to
fulfill the existing checklist.
CONCLUSION
The
management of health human resources by forming teamwork by the Depok City
Health Office and Puskemas in carrying out PHBS monitoring at school settings
is considered an effort to maintain the quality of services provided during a
pandemic as well as adaptation for officers who are at risk of exposure to
COVID-19. The facilities and infrastructure that support the implementation of
PHBS in school settings have been provided and distributed to schools that are
considered unable to fulfill PHBS facilities. This was done to increase the
awareness of school residents about PHBS behavior and the implementation of the
Health Protocol. However, there are still problems with facilities and
infrastructure in several schools, this is due to the limited budget for
implementing PHBS. Budget refocusing is an issue in fulfilling PHBS facilities
and infrastructure in school settings. Regardless of the implementation of PHBS
in school settings during the pandemic with existing limitations, technical
instructions regarding health protocols that complement each other's PHBS
indicators are still being disseminated to related institutions or agencies so
that information can reach the community as a whole.
There
are obstacles encountered in the field related to the implementation of
monitoring activities and the information provided online in the implementation
of PHBS monitoring in school settings is considered to have advantages and
disadvantages. The response rather than receiving information becomes a
critical point of how the information provided can finally be processed into a
PHBS behavior in the school environment.
REFERENCES
Assidiqi, M. H., & Sumarni, W. (2020). Pemanfaatan
platform digital di masa pandemi covid-19. Prosiding Seminar Nasional
Pascasarjana (PROSNAMPAS), 3(1), 298–303.
Ballangrud, R., Husebø, S. E., Aase, K., Aaberg, O. R.,
Vifladt, A., Berg, G. V., & Hall-Lord, M. L. (2017). “Teamwork in
hospitals”: a quasi-experimental study protocol applying a human factors
approach. BMC Nursing, 16, 1–7.
Bedford, J., Enria, D., Giesecke, J., Heymann, D. L.,
Ihekweazu, C., Kobinger, G., Lane, H. C., Memish, Z., Oh, M., & Schuchat,
A. (2020). COVID-19: towards controlling of a pandemic. The Lancet, 395(10229),
1015–1018.
Brivio, F., Fagnani, L., Pezzoli, S., Fontana, I.,
Biffi, L., Mazzaferro, A. D., Velasco, V., & Greco, A. (2021). School
health promotion at the time of COVID-19: An exploratory investigation with
school leaders and teachers. European Journal of Investigation in Health,
Psychology and Education, 11(4), 1181–1204.
Burgess, R. A., Osborne, R. H., Yongabi, K. A.,
Greenhalgh, T., Gurdasani, D., Kang, G., Falade, A. G., Odone, A., Busse, R.,
& Martin-Moreno, J. M. (2021). The COVID-19 vaccines rush: participatory
community engagement matters more than ever. The Lancet, 397(10268),
8–10.
Cahyorini, R. W., Komalyna, I. N. T., & Suwita, I.
K. (2021). Hubungan Pola Makan, Aktivitas Fisik dan Konsumsi Fast Food terhadap
Kejadian Gizi Lebih pada Remaja. AgriHealth: Journal of Agri-Food, Nutrition
and Public Health, 2(2), 123–146.
Desiyanto, F. A., & Djannah, S. N. (2013).
Efektivitas mencuci tangan menggunakan cairan pembersih tangan antiseptik (hand
sanitizer) terhadap jumlah angka kuman. None, 7(2), 24934.
Drajatun, B. (2020). Edukasi Perilaku Hidup Bersih
dan Sehat Terhadap Anak-anak KKN UNNES BMC Kabupaten Cilacap 202.
Gani, H. A., Istiaji, E., & Pertiwi, P. E. (2015).
Perilaku hidup bersih dan sehat (PHBS) pada tatanan rumah tangga masyarakat
Using (Studi Kualitatif di Desa Kemiren, Kecamatan Glagah, Kabupaten
Banyuwangi). Jurnal Ilmu Kesehatan Masyarakat, 11(1).
Gould, D. J., Creedon, S., Jeanes, A., Drey, N. S.,
Chudleigh, J., & Moralejo, D. (2017). Impact of observing hand hygiene in
practice and research: a methodological reconsideration. Journal of Hospital
Infection, 95(2), 169–174.
Hasanah, Y., Dai, R. M., & Sari, D. S. (2020).
Implementasi kebijakan fungsi puskesmas selama pandemi COVID 19 di Puskesmas
Margahayu Selatan Kabupaten Bandung. Responsive: Jurnal Pemikiran Dan
Penelitian Administrasi, Sosial, Humaniora Dan Kebijakan Publik, 3(4),
223–239.
Ilyas, Y. (2003). Kiat sukses manajemen tim kerja.
Gramedia Pustaka Utama.
Kemendikbud, K. P. (2020). Buku saku panduan
penyesuaian penyelenggaraan pembelajaran pada tahun ajaran 2020/2021 dan tahun
akademik 2020/2021 di masa pandemi coronavirus disease 2019 (covid-19):
keputusan bersama 4 menteri: menteri pendidikan dan kebudayaan, menteri agama,
menteri kesehatan, dan menteri dalam negeri.
Kleynhans, J., Tempia, S., Wolter, N., von Gottberg,
A., Bhiman, J. N., Buys, A., Moyes, J., McMorrow, M. L., Kahn, K., &
Gómez-Olivé, F. X. (2021). SARS-CoV-2 Seroprevalence in a rural and urban
household cohort during first and second waves of infections, South Africa,
July 2020–March 2021. Emerging Infectious Diseases, 27(12), 3020.
Martania, E. D. P. (2022). Perencanaan Dan Pengalokasian
Anggaran Penanganan Covid-19 Di Dinas Kesehatan Kabupaten Tanah Datar. Institut
Pemerintahan Dalam Negeri.
Messakh, S. T., Purnawati, S. S., & Panuntun, B.
(2019). Gambaran perilaku hidup bersih dan sehat siswa Sekolah Dasar Negeri di
Kecamatan Bancak. Jurnal Ilmu Keperawatan Dan Kebidanan, 10(1),
136–145.
Odone, A., Bricchi, L., & Signorelli, C. (2021).
COVID-19 control school-based interventions: characteristics and impact of a
national-level educational programme in Italy. Acta Bio Medica: Atenei
Parmensis, 92(Suppl 6).
Patel, M. K., Harris, J. R., Juliao, P., Nygren, B.,
Were, V., Kola, S., Sadumah, I., Faith, S. H., Otieno, R., & Obure, A.
(2012). Impact of a hygiene curriculum and the installation of simple
handwashing and drinking water stations in rural Kenyan primary schools on
student health and hygiene practices. American Journal of Tropical Medicine
and Hygiene, 87(4), 594–601.
Poague, K. I. H. M., Blanford, J. I., & Anthonj, C.
(2022). Water, sanitation and hygiene in schools in low-and middle-income
countries: a systematic review and implications for the COVID-19 pandemic. International
Journal of Environmental Research and Public Health, 19(5), 3124.
Proverawati, A., & Rahmawati, E. (2012). Perilaku
hidup bersih dan sehat (PHBS). Yogyakarta: Nuha Medika, 2–105.
Rahmawati, N. V., Utomo, D. T. P., & Ahsanah, F.
(2020). Fun handwashing sebagai upaya pencegahan covid-19 pada anak usia dini. JMM
(Jurnal Masyarakat Mandiri), 4(2), 217–224.
Ridley, N. (2020). Effective hand hygiene—wash your
hands and reduce the risk. British Journal of Nursing, 29(1), 10.
Saida, I. Ben, Ennouri, E., Nachi, R., Meddeb, K., Mahmoud,
J., Thabet, N., Jerbi, S., & Boussarsar, M. (2020). Very severe COVID-19 in
the critically ill in Tunisia. The Pan African Medical Journal, 35(Suppl
2).
Setyaningrum, D. A., & Prastiwi, A. (2011). Pengaruh
Implementasi Corporate Social Responsibility Terhadap Kesejahteraan Hidup
Masyarakat (Studi Kasus pada PT. APAC INTI CORPORA, Bawen). UNDIP: Fakultas
Ekonomika dan Bisnis.
Sopanah, A., Tsarwa, N. A., & Anggarani, D. (2022).
Analisis Efektivitas Refocusing Anggaran Pada Pemerintah Kota Malang Di Masa
Pandemi Covid-19. Owner: Riset Dan Jurnal Akuntansi, 6(4),
3927–3938.
Sugita, E. W. (2022). Water, Sanitation and Hygiene
(WASH) in Japanese elementary schools: Current conditions and practices. Pediatrics
International, 64(1), e15062.
Umpung, F. D., Pertiwi, J. M., & Korompis, G. E. C.
(2020). Faktor-faktor yang mempengaruhi motivasi kerja tenaga kesehatan di
puskesmas Kabupaten Minahasa Tenggara pada masa pandemi Covid 19. Indonesian
Journal of Public Health and Community Medicine, 1(4), 18–27.
UNDP. (2022). What Are the Sustainable Development
Goals?