Analysis Of Management Of Lung TB Management Program With DOTS Strategy At Belawan Puskesmas Medan Belawan District In 2017

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Analysis of Management of Lung TB Management Program with DOTS Strategy at Belawan Puskesmas, Medan Belawan District in 2017

Introduction

Tuberculosis (TB) is a serious public health problem that continues to cause a lot of pain, death, and disability worldwide. To overcome this problem, effective and efficient TB prevention and control management is necessary. Since 1995, Indonesia has implemented a TB control program through treatment with DOTS (Directly Observed Treatment, Short-Course) strategies. However, despite the implementation of this program, the incidence of TB remains high in many areas, including the Belawan Health Center in Medan Belawan District.

Background

In 2016, the Belawan Health Center recorded a high number of TB cases, with 144 patients diagnosed with positive BTA and a healing rate of only 54 people. This figure indicates the existence of various obstacles in the implementation of the Lung TB Management Program at the Belawan Health Center. The purpose of this research is to analyze the management of the TB program with DOTS strategies at the Belawan Health Center and to identify the obstacles that hinder the implementation of the program.

Methodology

This research is qualitative and aims to deeply understand the management of the TB program with DOTS strategies at the Belawan Health Center. The data collection method was carried out through in-depth interviews and observations of six informants, including the Medan City Health Office staff, the Head of Belawan Health Center, TB officers, a TB patient, and a PMO (Supervisor of Drugs for Drugs). Data analysis was carried out with the Miles and Huberman approaches.

Results

The results of this research showed that the TB program management with DOTS strategies at Belawan Health Center had not been running optimally. One indicator is the quality of TB officers who are still low in the discovery of the case. Many TB cases were found only through patients who came for treatment, instead of making active efforts in finding new cases. In addition, there is still a lack of training for TB patients on how to collect sputum resulting in a low understanding of the patient about the appropriate sputum collection technique, so that errors often occur in the diagnosis during the sputum examination microscopically.

Discussion

The results of this research indicate that the implementation of the TB program with DOTS strategies at Belawan Health Center is hindered by several obstacles, including the low quality of TB officers, lack of training for TB patients, and inadequate resources. These obstacles can be overcome by providing training to TB officers, increasing cross-sectoral cooperation, and improving the quality of DOTS officers. It is also important for TB officers to be more proactive in finding TB cases, providing counseling to patients about TB disease and their treatment, as well as strengthening the role of PMOs in supporting patient treatment.

Conclusion

In conclusion, the management of the TB program with DOTS strategies at Belawan Health Center has not been running optimally. The low quality of TB officers, lack of training for TB patients, and inadequate resources are some of the obstacles that hinder the implementation of the program. To overcome these obstacles, it is necessary to provide training to TB officers, increase cross-sectoral cooperation, and improve the quality of DOTS officers. With good support and cooperation, the TB prevention program at the Belawan Health Center is expected to provide better results in the future.

Recommendations

Based on the findings of this research, the following recommendations are submitted to the Medan City Health Office:

  1. Provide training to TB officers: The Medan City Health Office should provide training to TB officers to improve their quality and increase their ability to discover new cases.
  2. Increase cross-sectoral cooperation: The Belawan Health Center should increase cross-sectoral cooperation with other health facilities and organizations to improve the quality of TB care.
  3. Improve the quality of DOTS officers: The Belawan Health Center should improve the quality of DOTS officers by providing them with adequate training and resources.
  4. Strengthen the role of PMOs: The Belawan Health Center should strengthen the role of PMOs in supporting patient treatment and improving the quality of TB care.

Future Research Directions

Future research should focus on evaluating the effectiveness of the TB program with DOTS strategies at Belawan Health Center after the implementation of the recommendations. Additionally, research should be conducted to identify the factors that contribute to the low quality of TB officers and to develop strategies to improve their quality.

Limitations of the Study

This study has several limitations, including the small sample size and the limited scope of the research. Future research should aim to increase the sample size and scope of the research to provide more comprehensive findings.

Implications for Practice

The findings of this research have several implications for practice, including the need to improve the quality of TB officers, increase cross-sectoral cooperation, and improve the quality of DOTS officers. Additionally, the study highlights the importance of providing training to TB patients on how to collect sputum and the need to strengthen the role of PMOs in supporting patient treatment.

References

  • World Health Organization. (2019). Tuberculosis.
  • Ministry of Health of Indonesia. (2016). National Tuberculosis Control Program.
  • Belawan Health Center. (2016). Annual Report.

Appendices

  • Appendix A: In-depth interview guide
  • Appendix B: Observation checklist
  • Appendix C: Data analysis table

Abstract

This study aims to analyze the management of the TB program with DOTS strategies at Belawan Health Center in Medan Belawan District. The results showed that the TB program management with DOTS strategies at Belawan Health Center had not been running optimally. The low quality of TB officers, lack of training for TB patients, and inadequate resources are some of the obstacles that hinder the implementation of the program. The study provides recommendations to improve the quality of TB officers, increase cross-sectoral cooperation, and improve the quality of DOTS officers.
Frequently Asked Questions (FAQs) about the Analysis of Management of Lung TB Management Program with DOTS Strategy at Belawan Puskesmas, Medan Belawan District in 2017

Q: What is the main objective of the study?

A: The main objective of the study is to analyze the management of the TB program with DOTS strategies at Belawan Health Center in Medan Belawan District and to identify the obstacles that hinder the implementation of the program.

Q: What are the key findings of the study?

A: The key findings of the study include:

  • The low quality of TB officers is a major obstacle to the implementation of the TB program with DOTS strategies at Belawan Health Center.
  • The lack of training for TB patients on how to collect sputum is a major obstacle to the implementation of the TB program with DOTS strategies at Belawan Health Center.
  • The inadequate resources are a major obstacle to the implementation of the TB program with DOTS strategies at Belawan Health Center.

Q: What are the recommendations of the study?

A: The recommendations of the study include:

  • Providing training to TB officers to improve their quality and increase their ability to discover new cases.
  • Increasing cross-sectoral cooperation with other health facilities and organizations to improve the quality of TB care.
  • Improving the quality of DOTS officers by providing them with adequate training and resources.
  • Strengthening the role of PMOs in supporting patient treatment and improving the quality of TB care.

Q: What are the implications of the study for practice?

A: The implications of the study for practice include:

  • The need to improve the quality of TB officers to increase their ability to discover new cases.
  • The need to increase cross-sectoral cooperation with other health facilities and organizations to improve the quality of TB care.
  • The need to improve the quality of DOTS officers by providing them with adequate training and resources.
  • The need to strengthen the role of PMOs in supporting patient treatment and improving the quality of TB care.

Q: What are the limitations of the study?

A: The limitations of the study include:

  • The small sample size.
  • The limited scope of the research.
  • The lack of data on the effectiveness of the TB program with DOTS strategies at Belawan Health Center.

Q: What are the future research directions?

A: The future research directions include:

  • Evaluating the effectiveness of the TB program with DOTS strategies at Belawan Health Center after the implementation of the recommendations.
  • Identifying the factors that contribute to the low quality of TB officers and developing strategies to improve their quality.
  • Conducting a comprehensive study on the TB program with DOTS strategies at Belawan Health Center to identify the strengths and weaknesses of the program.

Q: What are the implications of the study for policy?

A: The implications of the study for policy include:

  • The need to improve the quality of TB officers to increase their ability to discover new cases.
  • The need to increase cross-sectoral cooperation with other health facilities and organizations to improve the quality of TB care.
  • The need to improve the quality of DOTS officers by providing them with adequate training and resources.
  • The need to strengthen the role of PMOs in supporting patient treatment and improving the quality of TB care.

Q: What are the implications of the study for future research?

A: The implications of the study for future research include:

  • The need to conduct a comprehensive study on the TB program with DOTS strategies at Belawan Health Center to identify the strengths and weaknesses of the program.
  • The need to evaluate the effectiveness of the TB program with DOTS strategies at Belawan Health Center after the implementation of the recommendations.
  • The need to identify the factors that contribute to the low quality of TB officers and develop strategies to improve their quality.

Q: What are the implications of the study for public health?

A: The implications of the study for public health include:

  • The need to improve the quality of TB care to reduce the incidence and mortality rate of TB.
  • The need to increase cross-sectoral cooperation with other health facilities and organizations to improve the quality of TB care.
  • The need to improve the quality of DOTS officers by providing them with adequate training and resources.
  • The need to strengthen the role of PMOs in supporting patient treatment and improving the quality of TB care.