Background
Female workers in Indonesia are vulnerable, because they must work to earn a living while still being responsible for domestic problems. This study analyzes the barriers to the use of modern contraceptives by female workers in Indonesia’s urban areas.
Methods
This cross-sectional survey looked at 21,696 female workers. We used modern contraceptive use as a dependent variable, and age, education, wealth, known modern contraceptives, number of live births, ideal number of children, and insurance ownership as independent variables. In the final test, we employed binary logistic regression.
Results
The results showed that women at all age categories were more likely than those aged 15–19 years not to use modern contraceptives, except those aged 35–39 years, who showed no difference. All other marital types were more likely to use modern contraceptives than married individuals. Rich female workers were 1.139 times more likely than poor workers not to use modern contraceptives (adjusted odds ratio [AOR], 1.139; 95% confidence interval [CI], 1.026–1.264). Female workers who did not know about modern contraceptives were 4.549 times more likely than those who did not to use modern contraceptives (AOR, 4.549; 95% CI, 1.037–19.953). Female workers with more than two children were 9.996 times more likely than those with two or fewer children not to use modern contraceptives (AOR, 9.996; 95% CI, 9.1890–10.875).
Conclusion
This study identified five factors associated with the non-use of modern contraceptives by female workers in Indonesia’s urban areas: young, unmarried, rich, did not know about modern contraceptives, and had more than two children.

Background
: CRC is an ideal target for population screening because it is a prevalent disease with an identifiable precursor lesion. This study was performed for the purpose of comparing cost-effectiveness of CRC screening strategies.

Methods : The natural history of a simulated cohort of 50- year-old Koreans in the general population was modeled with and without CRC screening until age 80 years. We evaluated 16 different screening strategies with Markov model. Cases of positive screening test results were worked up with a colonoscopy. After polypectomy, colonoscopy was repeated every 3 years. Our main outcome measurements were discounted lifetime costs, life expectancy and incremental cost-effectiveness (CE) ratio, comparing 16 different CRC screening strategies.

Results : In base-case analysis, compliance was assumed to be 60% with the initial screen and 80% with follow-up or surveillance colonoscopy. The non-dominated strategies were colonoscopy every 10 years (COL10), colonoscopy every 5 years (COL5) and colonoscopy every 3 years (COL3). Strategies that only included sigmoidoscopy were generally not regarded as non-dominated strategies, but sigmoidoscopy every 5 years (SIG5) showed similar cost and effects as COL10 while sigmoidoscopy every 3 years (SIG3) had similar results as COL5. Other strategies recommended by the expert panel, such as sigmoidocopy plus colon study every 5 years were less cost-effective than the alternatives.

Conclusion : Colonoscopy is the most cost-effective strategy in Korea for colorectal cancer screening. Unfortunately, the number of physicians skilled enough to perform colonoscopy is not enough to meet the demands of screening for colorectal cancer in average-risk adults. Therefore, we consider alternative strategies such as SIG5 or SIG3.

Background
: Upper respiratory infection account for many of the visits in primary care. As most URIs are caused by viruses, antibiotic therapy is not desirable. However, for URI treatment antibiotic therapy is commonly used, which causes many public health proplems such as drug-resistant becteria and high medical cost. This paper examines patient knowledge of the normal presentation of a URI, beliefs in the effectiveness of antibiotics and health care utilzation.

Methods : A survey of 200 outpatients or their families was conducted in one university hospital from March to April, 1998. Two URI conditions were given for the survey:(1) a condition of 5 days' duration with cough, sore throat, and clear nasal discharge (question 1), (2) a condition of the same symptom as (1) except discolored nasal discharge (question 2). For various questions in each of these conditions they were to answer in 5 point Likert-type scale. Statistical softwares of SAS 8.0 and GAUSS 3.21 were used for analyzing the survey data.

Results : For question 1, 61% of the sample reported that they would seek care from a physician while for question 2, 75% of the sample reported that they would do so (p<0.1). the health service suppliers, in the order of visiting frequencies, were pharmacy (58%), hospital (38%), no visit (2.5%), public health center (0.5%), and Chinese medicine clinic (0.5%) for question 1 and pharmacy (54%), hospital (42%), no visit(2%), Chinese medicine clinic(0.5%) and public health center (0.0%) for question 2. For question 1, 54% of the sample and for question 2, 63% reported that they believe antibiotics were effective (p=.068). For question 1, 79.5% and for question 2, 89.5% of the subjects reported that they had complied to prescriptions of doctors or pharmacists (p<0.05). Out of those subjects, only 19.5% for question 1 and 21.2% for question 2 reported that they checked the presence of antibiotics in the prescriptions. A multivariate analysis shows that older people, normally used antibiotics and current smokers had higher tendency of seeking care and stronger beliefs in the effectiveness of antibiotics.

Conclusion : There is a lack in patient understanding of normal presentation of a URI and the effectiveness of antibiotics as a treatment. A confusion about the meaning of discolored nasal discharge is particularly evident. The patients visited pharmacies more often than hospitals, and majority of them (80%) did not know the details of their prescriptions.