Background: For more than ten years, Indonesia has health law, one of which states that local governments are mandated to establish Smoke Free Area (SFA). The results of 2018 National Basic Health Research shows tobacco consumption is still quite high and increasing compared to the results of 2007 and 2013 National Basic Health Research. The burden of disease in Indonesia is increasing every year. Methods: This study aims to describe SFA regulation and analyze the relationship between the percentage of smokers and the prevalence of smoking attributable morbidity. Data from the 2018 Basic Health Research in Indonesia with the number of units of analysis were 514 districts and cities level. The design of the study was cross-sectional study. The variables analyzed were the percentage of smokers, the prevalence of diabetes, hypertension, upper respiratory tract infections (URTI), pneumonia, lung tuberculosis, asthma, and mental emotional disorders. Geographical mapping of the distribution of District/City with Smoking-Free Areas was made using QGIS 3·16. Results: Around 72% of districts/cities in Indonesia already had local regulations of SFA after more than ten years implementation of the regulation of the health law. There was a significant relationship between the high percentage of smokers and the high prevalence of diabetes (p value: 0·000, PR: 1·342, 95%CI 1·135 to 1·587), hypertension (p value: 0·000, PR 1·631, 95%CI 1·252 to 2·124), and lung tuberculosis (p value: 0·008, PR 1·219, 95%CI 1·049 to 1·417) at the District/City level. However, there was no significant association between URTI, pneumonia, asthma, and mental emotional disorders. Conclusion: The percentage of smokers in an area was associated with diabetes, hypertension, and lung tuberculosis. The implementation of Smoke Free Area should be evaluated.

Introduction: Sexual and reproductive health (SRH) among adolescents is a critical aspect of global health. Rural adolescents often encounter significant barriers to reproductive health awareness, elevating their risks for unintended pregnancies, sexually transmitted infections (STIs), and other reproductive health issues. This systematic review seeks to identify and analyze the barriers hindering reproductive health awareness among rural adolescents.Methods: This review followed PRISMA guidelines. Literature searches were conducted in PubMed, ScienceDirect, Google Scholar, and Taylor & Francis, focusing on studies published from 2019 to 2024. Keywords included “Adolescent,” “Rural,” “Reproductive Health,” “Awareness,” and “Barriers.” Studies were screened based on eligibility criteria, and data were extracted and analyzed to identify key barriers at the individual, interpersonal, social/community, and health services levels.Results: Out of 669 records, 20 studies met the inclusion criteria. Identified barriers at the individual level included lack of knowledge, myths, misconceptions, and feelings of shame and fear. Interpersonal barriers were related to poor communication between parents and adolescents and misinformation from peers. Social and community barriers encompassed rigid social norms, stigma, and discrimination. Health services barriers included limited access and negative experiences with reproductive health services.Discussion: Rural adolescents face complex barriers to reproductive health awareness driven by factors at the individual, interpersonal, social, and health services levels. Comprehensive interventions, such as educational campaigns, training for healthcare providers, and improved access via mobile or online platforms, are essential to enhance reproductive health awareness and outcomes.Systematic Review Registration: https://www.crd.york.ac.uk/, PROSPERO (CRD42024554439).

Child marriage often involves adolescents aged 10–19 years and poses significant health risks and challenges to gender equality. The aim of this systematic review was to examine the involvement of adolescent girls in decision-making processes regarding child marriage and identify influencing factors. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this review covered studies published between January 2014 and July 2024. The databases searched included ScienceDirect, Springer Link, PubMed, and Taylor & Francis, using terms related to adolescent girls, decision-making, and child marriage. Inclusion criteria targeted studies involving girls aged 10–19, with methods including qualitative, quantitative, longitudinal, and mixed-method, published in English. Data extraction and quality assessment followed the standards of the Joanna Briggs Institute. Of 6,967 articles, 29 met the inclusion criteria, spanning 26 countries across three continents, with 51.7% being qualitative studies. Economic pressure was identified as the primary driver of child marriage, with significant parental and community influences restricting the girls' decision-making autonomy. Parents, especially fathers, often force girls into marriage to reduce economic burdens and enhance family honor. Some adolescent girls initiate marriage to escape adverse home conditions or societal stigma. Education and strong family support emerged as protective factors, while entrenched social norms perpetuated early marriages. Comprehensive approaches including educational improvement, economic support, and social norm transformation are essential. Addressing child marriage requires multidimensional strategies, encompassing enhanced educational opportunities, economic support, and changing entrenched social norms. Future research should focus on interventions that boost adolescent girls' life skills and decision-making autonomy to delay marriage and enable informed choices.

Background: The Public Health Center (Puskesmas) is a primary care center in Indonesia that focuses on promotive and preventive efforts, as opposed to exclusively curative approaches. However, a major challenge has been identified in relation to the limited number of health personnel available to provide education to patients. The objective of this study, therefore, was to determine the impact of personal factors, severity of health problems, environmental situation, and patient activities on the level of attention payed to the audiovisual media. Design and methods: The study involved the screening of 12 kinds of health education video, which ran in the LCD panel in the waiting room. The population consisted of visitors/patients that were 15 years old or older, and a sample size of 124 was selected randomly during the study period. Results: Based on the statistical analysis, it was established that age, severity of health problems, environment situation, and visitor activity influence patient awareness to audiovisual media in the waiting room of the Public health center. Conclusions: It is recommended that public health centers improve their environment to encourage the patients to pay attention to health media.

Background: The negative impact of tobacco, especially second-hand smokers, requires imperative actions. Introducing tobacco control measures helps protect the public health. Data suggest that there were approximately 44 million daily smokers in Indonesia comprising 49.8 million males and 3.9 million females over ten years of age. East Java Province had the biggest number of smokers in Indonesia. To reduce trends in smoking behavior, we need to advocate local government to release and implement smoke-free regulations. Aims: The study aims to do action research through advocacy and communication for the regulation of smoke-free areas in East Java Province. Methods: The action research involved 12 districts of East Java Province, Indonesia. The method used in this study was Focus Group Discussion (FGD), one-on-one meeting, in-depth interviews, public speaking, press conference, and press release. Results: Intensive advocacy and communication worked successfully. Eight districts of East Java Province implemented local regulations of smoke-free areas. The advocacy and communication of the regulations made it possible to be implemented. Conclusion: Intensive advocacy and communication improve the awareness of executive and legislative government about the importance of smoke-free area regulations. It will be successful if regular meetings, discussions, press conferences, public speaking, and team work are conducted with many stakeholders.