The impact of health system responsiveness on tuberculosis treatment adherence in public primary healthcare facilities in Indonesia

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-06-17 DOI:10.1016/j.cegh.2025.102107

Fajar Ariyanti , Mochamad Iqbal Nurmansyah , Riastuti Kusuma Wardani , Zilhadia , Bulent Kilic

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引用次数: 0

Abstract

Background

Tuberculosis (TB) has reemerged as the leading cause of mortality from a single infectious agent globally. Adherence to treatment is essential for patient recovery, controlling infection transmission, and reducing the emergence of drug resistance. This research aimed to investigate the influence of health system responsiveness on tuberculosis treatment adherence among patients in public primary care in Indonesia.

Methods

This is a cross-sectional quantitative research conducted in 25 government-operated primary healthcare facilities. In addition, 491 people with TB receiving treatment at public primary care facilities were selected as respondents. Independent variables included health system responsiveness consisting of eight domains such as attention, dignity, communication, autonomy, confidentiality, quality of basic amenities, social support, and access to healthcare. Medication adherence was measured as a dependent variable in this study. The data was analyzed using SPSS version 27.0, and an ordinall logistic regression was used to examine the responsiveness of healthcare to tuberculosis medication adherence.

Results

Over 95 % of respondents reported that the health system exhibits strong responsiveness in the domains of attention, dignity, and communication. The autonomy and quality of basic amenities received the lowest responsiveness score. The results showed that patients who reported having experienced good prompt attention and autonomy were approximately two times as likely to have higher medication adherence (AOR: 2.7 and 2.1, respectively).

Conclusion

Non-medical dimensions, particularly those related to attention, autonomy, and physical quality, should be considered and improved in order to increase medication adherence among people with TB.

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卫生系统反应性对印度尼西亚公共初级卫生保健设施结核病治疗依从性的影响

背景结核病（TB）已重新成为全球单一传染性病原体导致死亡的主要原因。坚持治疗对于患者康复、控制感染传播和减少耐药性的出现至关重要。本研究旨在调查卫生系统反应性对印度尼西亚公共初级保健患者结核病治疗依从性的影响。方法采用横断面定量研究方法，对25家政府经营的初级卫生保健机构进行调查。此外，在公共初级保健机构接受治疗的491名结核病患者被选为调查对象。独立变量包括卫生系统响应性，包括八个领域，如关注、尊严、沟通、自主性、保密性、基本设施质量、社会支持和获得医疗保健。在本研究中，药物依从性作为一个因变量进行测量。使用SPSS 27.0版本对数据进行分析，并使用普通逻辑回归来检验医疗保健对结核病药物依从性的反应性。结果超过95%的受访者报告说，卫生系统在关注、尊严和沟通方面表现出很强的响应能力。基本设施的自主性和质量得分最低。结果显示，报告经历了良好的及时关注和自主性的患者，其药物依从性的可能性大约是其两倍（AOR分别为2.7和2.1）。结论为提高结核病患者的药物依从性，应考虑并改善非医学因素，特别是与注意力、自主性和身体素质有关的因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.