Maya Masita, Farizah Mohd Hairi, Adang Bachtiar, Nana Mulyana, Helen Andriani
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引用次数: 0
Abstract
Background: Central Java, Indonesia, struggles with low drug-resistant tuberculosis (DR-TB) case detection (33%) and treatment rates (25%), far below the 60% target. Despite policies, including Minister of Health Regulation No. 67/2016 and Presidential Regulation No. 67/2021, along with the National TB Strategy for Tuberculosis Control 2020-2024 have been implemented, targets remain unmet due to weak community involvement. This study analyzed TB policy implementation in high-prevalence Banyumas Regency, focusing on cadres and community organizations.
Design and methods: This qualitative study employed the Van Meter and Van Horn framework to assess policy implementation. Key stakeholders involved informants from Puskesmas (community health centers), TB cadres, TB program holders at the Regency Health Office, and the Mentari Sehat Indonesia Foundation. Data collection involved in-depth interviews with these informants, as well as policy documents, guidelines, and reports from agencies or institutions. Triangulation methods were used to enhance the validity of the findings.
Results: Implementers understood policy standards, supported by consistent communication among Health Offices, community health workers, local organizations, and village leaders. Positive attitudes were reflected in joint commitments and Regional Action Plans. Cadres and communities actively supported case-finding, treatment, education, socioeconomic aid, and stigma reduction.
Conclusions: Policies lack sufficient local budget allocation. Weak motivation of TB cadres, lack of commitment among regional organizations, and persistent stigma in the community are evident. The Global Fund aids DR-TB control through grants and patient support to ensure treatment adherence. However, sustained impact requires government attention to policy, human resources, infrastructure, and complementary resources to achieve synergy.
期刊介绍：
The Journal of Public Health Research (JPHR) is an online Open Access, peer-reviewed journal in the field of public health science. The aim of the journal is to stimulate debate and dissemination of knowledge in the public health field in order to improve efficacy, effectiveness and efficiency of public health interventions to improve health outcomes of populations. This aim can only be achieved by adopting a global and multidisciplinary approach. The Journal of Public Health Research publishes contributions from both the “traditional'' disciplines of public health, including hygiene, epidemiology, health education, environmental health, occupational health, health policy, hospital management, health economics, law and ethics as well as from the area of new health care fields including social science, communication science, eHealth and mHealth philosophy, health technology assessment, genetics research implications, population-mental health, gender and disparity issues, global and migration-related themes. In support of this approach, JPHR strongly encourages the use of real multidisciplinary approaches and analyses in the manuscripts submitted to the journal. In addition to Original research, Systematic Review, Meta-analysis, Meta-synthesis and Perspectives and Debate articles, JPHR publishes newsworthy Brief Reports, Letters and Study Protocols related to public health and public health management activities.
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