IMPLEMENTASI KEBIJAKAN PENANGGULANGAN TUBERKULOSIS DENGAN STRATEGI DIRECTLY OBSERVED TREATMENT SHORT-COURSE (DOTS) DI PUSKESMAS KECAMATAN BANGSAL KABUPATEN MOJOKERTO

Publika ◽  
2021 ◽  
pp. 201-214
Author(s):  
Febry Mega Kumalasari ◽  
Indah Prabawati
Keyword(s):  
Health Workers ◽  
Public Awareness ◽  
Monitoring And Evaluation ◽  
Government Support ◽  
Political Commitment ◽  
Literature Study ◽  
District Health ◽  
Short Course ◽  
Analysis Technique ◽  
Directly Observed Treatment

Data Dinas kesehatan Kabupaten Mojokerto, jumlah penderita TBC positif sepanjang tahun 2018 mencapai 1.436 orang, dari jumlah itu 177 penderita dinyatakan sembuh dan 4 orang meninggal dunia. Puskesmas Bangsal melaksanakan kebijakan Directly Observed Treatment Short-course (DOTS) untuk penanggulangan penyakit TB berdasarkan Peraturan Menteri Kesehatan No. 67 Tahun 2016 tentang penanggulangan tuberkulosis. Penelitian ini bertujuan untuk menganalisis implementasi kebijakan penanggulangan tuberkulosis dengan strategi DOTS di Puskesmas Bangsal. Metode penelitian yang digunakan adalah kualitatif deskriptif menggunakan studi kepustakaan dan wawancara menggunakan teknik analisis Miles dan Huberman. Hasil penelitian pada implementasi kebijakan DOTS pada puskesmas Bangsal dalam lima ketepatan yaitu. Ketepatan Kebijakan sudah tepat, namun dalam pemecahan masalah masih kurang optimal pada kesadaran masyarakat dalam penghentian pengobatan sepihak jika sudah merasa sembuh oleh masyarakat dan ketakutan masyarakat terhadap ancaman virus COVID-19. Ketepatan pelaksanaan, pencapaian target strategi DOTS yang belum mencapai target karena dukungan pemerintah pada pendanaan untuk sosialisasi, penyuluhan dan promosi kesehatan terbatas. Ketepatan target belum optimal karena pada tahun 2020 Puskesmas Bangsal mendapatkan 43 kasus dan 250 orang yang diperiksa atausekitar 53% dari target yang telah ditetapkan. Ketepatan Lingkungan, komunikasi dengan Dinas Kesehatan belum optimal dalam monitoring dan evaluasi, pelaporan STIB. Ketepatan Proses, Puskesmas Bangsal mulai dari penemuan kasus, pengobatan hingga ke pelaporan sudah sesuai dengan SOP pelaksanaan kebijakan DOTS. Permasalahan yang terjadi adalah tenaga kesehatan kesulitan dalam melakukan pelaporan online (STIB). Saran yang dapat diberikan yaitu melakukan sosialisasi secara intensif. Dukungan pemerintah dalam menambah pendanaan untuk sosialisasi, penyuluhan dan promosi kesehatan. Meningkatkan koordinasi lintas sektoral dan memberikan pelatihan tentang tata cara pengisian SITB. Kata Kunci: Implementasi, Tuberculosis, Directly Observed Treatment Short-course (DOTS).   Mojokerto District Health Office data, the number of positive TBC patients throughout 2018 reached 1,436 people, of which 177 patients were declared cured and 4 people died. Puskesmas Bangsal implements a Policy of Directly Observed Treatment Short-course (DOTS) for TB disease management based on Regulation of the Minister of Health No. 67 of 2016 on tuberculosis prevention. This study aims to analyze the implementation of tuberculosis control policies with the DOTS strategy at Puskesmas Bangsal, Mojokerto Regency. The research method used  descriptive qualitative using literature study and interview with the analysis technique of Miles and Huberman. The results of research on the implementation of the DOTS policy at the Bangsal puskesmas were in five accuracy.The accuracy of the policy is right, but in managing the problemis not optimal in public awareness of treatment and the community's fear of the COVID-19. Accuracy of implementation, the DOTS target strategy has not yet reached the target due to the limited political commitment to budget funds for cadres, outreach, health education and promotion. The accuracy of the target is not optimal in 2020 the Puskesmas Bangsal received 43 cases and250 people were checked or about 53% of the target. Environmental accuracy, communication with the Dinas Kesehatan is not optimal in monitoring and evaluation, STIB reporting. Accuracy of Process, Puskesmas Bangsal starting from case finding, treatment to reporting are in accordance with the DOTS Policy. The problem is health workers have difficulty in conducting online reporting (STIB). The advice that can be given is to conduct intensive socialization. Government support in increasing funding for socialization, counseling, and health promotion. Improve cross-sectoral coordination and provide training on procedures for filling SITB application. Keywords: Implementation, Tuberculosis, Directly Observed Treatment Short-course (DOTS).

scholarly journals Implementation of Management of Pulmonary Tuberculosis with the Directly Observed Treatment Short course Strategy

2022 ◽  
Vol 2 (4) ◽  
pp. 130-142
Author(s):  
Nursalim Nursalim ◽  
Mappeaty Nyorong ◽  
Asriwati Amirah
Keyword(s):  
Health Center ◽  
Health Workers ◽  
Health Sector ◽  
Case Finding ◽  
District Health Office ◽  
District Health ◽  
Pulmonary Tb ◽  
Remote Areas ◽  
Short Course ◽  
Directly Observed Treatment

The purpose of this study was to describe the implementation of pulmonary TB disease management with the DOTS strategy at the Jagong Health Center, Central Aceh Regency.The implementation of Pulmonary TB Management with the DOTS (Directly Observed Treatment Shortcourse) strategy in the working area of the Jagong Health Center, Central Aceh Regency has been maximized. by facilitating and providing motivation so that patients want treatment in a complete and integrated manner, case detection can be carried out by health workers or cadres who have been given training to recognize the symptoms of pulmonary TB. The distribution of drugs is distributed to each puskesmas in Central Aceh Regency, from the Puskesmas the drugs are arranged directly by P2TB officers then given directly to the PMO or the patient himself. PMO performance has never been given special training about treatment, PMO only received direction from P2TB Pulmonary officers. Recording and reporting carried out at the Jagong Health Center includes case finding, treatment, and recovery. Suspected pulmonary TB will be recorded and then monitored until the results of the examination have been obtained. Recording and reporting will be reported every month in a meeting at the Central Aceh District Health Office. For the Central Aceh Regency government to further enhance the development and improvement of infrastructure in the health sector so that health services are more easily accessible to people in remote areas.

scholarly journals Analisis pelaksanaan program indonesia sehat dengan pendekatan keluarga (PIS-PK) pada Puskesmas di Kabupaten Nagan Raya

2022 ◽  
Vol 3 (1) ◽  
pp. 85
Author(s):  
Darmansyah Darmansyah
Keyword(s):  
Program Implementation ◽  
Health Workers ◽  
Human Resources For Health ◽  
Community Support ◽  
Monitoring And Evaluation ◽  
Government Support ◽  
District Health ◽  
Cross Sectional ◽  
Significance Level ◽  
Family Approach

Background: The achievement indicators of the healthy Indonesia program with a family approach (PIS-PK) at the Nagan Raya District Health Center was still low. The implementation of the PIS-PK program was only training, preparation, analysis of the initial healthy family index. In contrast, further intervention and analysis have not run optimally, so the existing data has not been used appropriately.Objective: The purpose of the study, to analyze the implementation of the healthy Indonesia program with a family approach at the Public Health Centers (PHC) in Nagan Raya Regency.Method: This research design is a cross sectional study conducted in Nagan Raya Regency in 2021. The data were collected using a questionnaire with a sample size of 70 officers. The measurement of the variables of government support, infrastructure, community support, human resources for health workers, monitoring and evaluation, was measured using a questionnaire sheet. Data analysis used Chi-Square statistical test and Binary Logistic Regression with a significance level of 95%.Results: The results was showed that there was a relationship between community support (p= 0.010, OR = 3.72), facilities and infrastructure (p= 0.019, OR= 3.2),, government support (p= 0.00, OR= 6.15), health personnel resources (p=0.008, OR= 4.8), monitoring evaluation (p= 0.007, OR= 4.52) with the implementation of the PIS-PK program. Based on the multivariate test, the dominant variable associated with the PIS-PK program was government support.Conclusion: The good government support is 6.15 times related to the success of the PIS-PK program implementation program compared to less government support.

scholarly journals SUPLEMENTASI VITAMIN A PADA ANAK DIARE USIA 12– 59 BULAN

2020 ◽  
Vol 7 (1) ◽  
pp. 46-53
Author(s):  
Latifah Susilowati ◽  
Masta Hutasoit
Keyword(s):  
Vitamin A ◽  
Health Workers ◽  
Public Awareness ◽  
World Health ◽  
Morbidity Rate ◽  
Case Group ◽  
District Health ◽  
Vitamin A Supplementation ◽  
History Of ◽  
Health Organization

Diarrhea is the leading cause of infant mortality in Indonesia. Data from the Bantul District Health Office showed that the diarrhea morbidity rate in 2015 was 4.57 per 1000 population. World Health Organization launched program to reduce morbidity and mortality due to pneumonia and diarrhea by recommending supplementation of vitamin A as an effort to maintain health since baby was born. The purpose of this study was to determine the correlation of vitamin A supplementation with the incidence of diarrhea in children aged 12 - 59 months in Kasihan 1 Public Health Center. This study was used case control design with a retrospective approach. The number of control and case group were 44 children of each. Researcher collected data of children aged 12 - 59 months who suffered diarrhea last 6 months then conducted a home visit to ask about the history of vitamin A supplementation in children. There was no statistically significant correlation between vitamin A supplementation and the incidence of diarrhea in children aged 12 - 59 months. Health workers especially nurses need to increase public awareness of vitamin A supplementation to children under five years old as a form of support for government program to prevent diarrhea.

scholarly journals Inovasi Pemberdayaan Masyarakat Melalui Program Aceh Kreatif Untuk Mengurangi Kemiskinan di Aceh

2021 ◽  
Vol 7 (1) ◽  
pp. 75
Author(s):  
Agatha Debby Reiza Macella ◽  
Najamudin Najamudin ◽  
Sri Wahyu Handayani ◽  
Irma Juraida
Keyword(s):  
Local Governments ◽  
Qualitative Method ◽  
Central Government ◽  
Monitoring And Evaluation ◽  
Community Empowerment ◽  
Government Support ◽  
Regional Government ◽  
Literature Study ◽  
Group Discussions ◽  
The Village

Aceh as one of the special autonomous regions which has a large enough budget compared to other regions makes the Aceh regional government have more useful programs to help alleviate poverty with a variety of superior programs, many regional potentials from various sectors that can be developed. The purpose of this study is to analyze the implementation of community empowerment programs through the Aceh Kreatif program so far and how the conditions of opportunities and challenges can be utilized by local governments in developing products and services from community empowerment through the Aceh Kreatif program. The research method used is a qualitative method. descriptive with the literature study technique The Aceh Creative Program is one of the 15 flagship programs of the Aceh government which indeed aims to improve the community's economy by emphasizing innovation creativity and utilizing local potential that is spread throughout the region from cities to villages in Aceh, contained in Aceh Qanun No.1 of 2019 concerning the Aceh Medium Term Development Plan (RPJM) for 2017-2022. The performance of the implementation of community empowerment through the Aceh program can be said to be good. 115 Bumdes are developing and getting turnover and obtaining PAG, several businesses were born in the village from community empowerment through the Aceh Kreatif program. Communication of the implementing agency is carried out through Focus Group discussions (FGD) then coordination meetings which are held regularly at the beginning of the year. In addition, the PMG Aceh Office conducts monitoring and evaluation of several gampongs in Aceh. Opportunities and challenges faced include central government support, competition, advances in science and technology, limited advice and infrastructure, as well as the quality and quantity of human resources.

scholarly journals Beyond DOTS (Directly Observed Treatment Short-Course) in tuberculosis' control: interfacing and sharing needs

2009 ◽  
Vol 17 (5) ◽  
pp. 689-694 ◽  
Author(s):  
Alba Idaly Muñoz Sanchez ◽  
Maria Rita Bertolozzi
Keyword(s):  
Treatment Adherence ◽  
Health Workers ◽  
Disease Process ◽  
Structured Interview ◽  
Ethics Committee ◽  
Health Needs ◽  
Tuberculosis Control ◽  
Short Course ◽  
Directly Observed Treatment ◽  
The City

This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of São Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the health-disease process including the treatment and life projects of patients with tuberculosis.

scholarly journals The Role of Governments in the Implementation of Patient Safety and Patient Safety Incident Reporting in Indonesia: A Qualitative Study

Healthcare ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 64 ◽  
Author(s):  
Dhamanti ◽  
Leggat ◽  
Barraclough
Keyword(s):  
Patient Safety ◽  
Monitoring And Evaluation ◽  
Incident Reporting ◽  
Government Support ◽  
National Guidelines ◽  
District Health ◽  
Safety Incident ◽  
Patient Safety Incident ◽  
The Government ◽  
Safety Incident Reporting

(1) Background: A patient safety incident reporting system was introduced in Indonesian hospitals in 2006; however, under-reporting of patient safety incidents is evident. The government plays a vital role in the implementation of a national system. Therefore, this study focuses on how the Indonesian government has been undertaking its role in patient safety at provincial and city/district levels, including incident reporting according to the National Guideline for Hospital Patient Safety. (2) Methods: This study employed a qualitative approach with interviews of 16 participants from seven organizations. The data were managed using NVivo and thematically analyzed. (3) Results: The findings revealed several problems at the macro-, meso-, and micro-level as the government was weak in monitoring and evaluation. The District Health Office (DHO) and Provincial Health Office (PHO) were not involved in incident reporting, and there was a lack of government support for the hospitals. (4) Conclusions: The DHO and PHO have not carried out their roles related to patient safety as mentioned in the national guidelines. Lack of commitment to and priority of patient safety, the complexity of the bureaucratic structure, and a lack of systematic partnership and collaboration are problems that need to be addressed by systematic improvement. To ensure effective and efficient national outcomes, the three levels of government need to work more closely.

scholarly journals Tuberculosis: limitations and strengths of Directly Observed Treatment Short-Course

2012 ◽  
Vol 20 (2) ◽  
pp. 369-377 ◽  
Author(s):  
Elisangela Martins de Queiroz ◽  
Mónica Cecilia De-La-Torre-Ugarte-Guanilo ◽  
Kuitéria Ribeiro Ferreira ◽  
Maria Rita Bertolozzi
Keyword(s):  
Treatment Adherence ◽  
Healthcare Providers ◽  
Disease Process ◽  
Working Hours ◽  
Short Course ◽  
Analysis Technique ◽  
The Social ◽  
Directly Observed Treatment ◽  
The City

This study analyzed the limitations and strengths of the Directly Observed Treatment Short-Course (DOTS) for tuberculosis from the perspective of patients and healthcare providers in a Technical Health Supervision unit in the city of São Paulo, SP, Brazil. Four patients and 17 healthcare providers from nine Primary Care Units were interviewed from April to June 2006, after signing free and informed consent forms. The reports were decoded according to the speech analysis technique. The Theory of the Social Determination of the Health-Disease Process was adopted as the theoretical framework. The strengths were: establishment of bonds between healthcare providers and patients and the introduction of incentives, which promotes treatment adherence. Limitations included: restricted involvement of DOTS' healthcare providers and reconciling patients' working hours with supervision. Treatment adherence goes beyond the biological sphere and healthcare providers should acknowledge patients' needs that go beyond the supervision of medication taken.

scholarly journals Implementasi Program Posyandu Tfc (Theurapetic Feeding Center) Sebagai Strategis Penuntasan Dan Pemulihan Gizi Buruk Bagi Balita Di Puskesmas Bumijawa Kabupaten Tegal.

2019 ◽  
Vol 10 (2) ◽  
pp. 773-782
Author(s):  
Nora Rahmanindar ◽  
Juhrotun Nisa ◽  
Nilatul Izah
Keyword(s):  
Data Collection ◽  
Health Center ◽  
Health Workers ◽  
Monitoring And Evaluation ◽  
World Health ◽  
District Health ◽  
Planning Stage ◽  
The World ◽  
Feeding Center ◽  
Health Organization

Latar Belakang: Masalah gizi merupakan salah satu masalah kesehtan masyarakat yang belum pernah tuntas di tanggulangi dunia. Organisasi Kesehatan Dunia memperkirakan bahwa sekitar 60 % dari semua kematian, yang terjadi antara anak-anak yang berusia kurang dari lima tahun dinegara berkembang, bisa dihubungkan dengan mal nutrisi. Therapeutic Feeding Center (TFC) atau Pusat Pemulihan Gizi (PPG) adalah pemuliha gizi kurang dengan perawatan serta pemberian makanan secara intensif dan adekuat sesuai usia dan kondisinya dengan melibatkan peran serta orang tua (ibu) agar mandiri ketika sudah kembali ke rumah.Tujuan: Penelitian ini bertujuan untuk menganalisa pelaksanaan program Posyandu TFC di Puskesmas Kabupaten Tegal.Metode: Penelitian ini bersifat kualitatif dengan menggunakan metode deskriptif. Pengumpulan data dilakukan dengan teknik wawancara mendalam sesuai dengan pedoman wawancara. Responden yang diteliti ada 8 orang yaitu 2 petugas sebagai informan kunci yaitu dokter penanggungjawab dan koordinator gizi di Puskesmas Bumijawa, 4 petugas sebagai informan utama yaitu 2 petugas kesehatan bidan dan petugas gizi serta 2 petugas kader posyandu dan 2 ibu yang mempunyai anak gizi kurang sebagai informan Triangulasi.Hasil: Penelitian menunjukan bahwa sumber-sumber program, tenaga, dana dan sarana prasarana sudah memadai, proses pelaksanaan program tersebut pada tahap perencanaan sudah didukung dan di analisa permasalahan serta sudah melibatkan lintas program dan lintas sektoral, tahap pengorganisasian sudah di bentuk, ada standar prosedur yang jelas, pembagian tugas sudah baik, pelaksanaan monitoring dan evaluasi program sudah memadai ada pengawasan dari pihak kepala puskesmas bumijawa dan dari Dinas Kesehatan kabupaten Tegal.Simpulan: Balita yang gizi kurang sudah ada pendataan dan di tangani dengan baik di posyandu TFC baik rawat inap atau rawat jalan, balita tersebut 100 persen mengalami kenaikan BB 0,5 kg per minggu, kecuali balita yang gizi kurang dengan kelainan penyerta seperti jantung, TBC dll perlu penanganan intensif.Sehingga program posyandu TFC sudah berjalan dengan baik sebagai penuntasan dan pemulihan gizi kurang bagi balita di Puskesmas Bumijawa Kabupaten Tegal.Kata Kunci : Implementasi kebijakan, program posyandu TFC Background: The problem of nutrition is one of the people's health problems that has never been solved in the world tackling. The World Health Organization estimates that around 60% of all deaths, which occur among children aged less than five years in developing countries, can be attributed to malnutrition. Therapeutic Feeding Center (TFC) or Nutrition Recovery Center (PPG) is recovery of malnutrition by intensive and adequate care and feeding according to age and condition by involving the participation of parents (mothers) to be independent when they return home.Objective: This study aims to analyze the implementation of the TFC Posyandu program at the Tegal District Health Center.Method: This research is qualitative by using descriptive methods. Data collection was carried out using in-depth interview techniques in accordance with interview guidelines. There were 8 respondents surveyed, namely 2 officers as key informants, namely the physician in charge and nutrition coordinator at Bumijawa Public Health Center, 4 officers as the main informants namely 2 midwife health workers and nutritionists as well as 2 posyandu cadre officers and 2 mothers who have undernourished children as informants Triangulation Results: Research results show that program resources, personnel, funds and infrastructure are adequate, the process of implementing the program at the planning stage has been supported and analyzed for problems and has involved cross-program and cross-sectoral, the organizing stage has been established, there are standard procedures clearly, the division of tasks is good, the implementation of program monitoring and evaluation is adequate, there is supervision from the head of the bumijawa puskesmas and from the Tegal district health office.Conclusion: Toddlers who lack nutrition already have data collection and are handled well in TFC posyandu both inpatient or outpatient, the toddler is 100 percent increasing in weight of 0.5 kg per week, except toddlers who are malnourished with comorbid disorders such as heart disease, tuberculosis etc. need intensive handling. So that the TFC posyandu program has been running well as the completion and recovery of malnutrition for children under five in the Bumijawa Health Center in Tegal Regency.Keywords: Policy implementation, TFC posyandu program

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