Implementasi Penanggulangan TB Paru: Sinergi Peran Tenaga Kesehatan, Promosi Kesehatan, dan Kader TB – Analisis Model SEM PLS

Raudatul Rizkiyah, Rindu Rindu, Nining Arini

Abstract


Background: The cure rate ofuberculosis T (TB) patients has increased. However, TB cases are still on an upward trend. Indications of the implementation of TB control and prevention are still far from the End TB target or TB elimination. Purpose: The focus of research is to evaluate the influence of the role of health workers, the role of health promotion, and the role of TB cadres on the implementation of tuberculosis control at the Cibinong Public Health Center, Indonesia in 2022. Methods: Cross sectional study was chosen as the design of this study with PLS model analysis. Involving pulmonary tuberculosis patients who received outpatient treatment as many as 90 respondents who met the inclusion and expansion criteria as a research sample. The data collection instrument uses questionnaires, in the form of positive questions with closed ended questions with multiple choices to obtain data on the role of health workers, health promotion and cadres. Data analysis was performed in a multivariate manner using SEM models with Smart PLS. Results: The evaluation of TB control was influenced by the role of health workers, the role of health promotion and the role of cadres by 94.5%, 11.4%, and 67.3% respectively. The model was able to explain the variability of the data by 97.3%, while 2.7% was explained by other variables that were not studied in this study. Conclusion: Increasing the role of health workers, the role of health programs, and the role of TB cadres affect TB control. Therefore, cross-sectoral synergy, cooperation between health workers and TB cadres as well as the general public to achieve the WHO target, namely End TB in 2035 or and the Ministry of Health's program to accelerate the elimination of TB programs in 2030 need to be increased by seeking effective innovations.

Latar Belakang: Tingkat kesembuhan pasien Tuberkulosis (TB) mengalami peningkatan. Namun, kasus TB masih mengalami tren peningkatan. Indikasi implementasi penanggulangan dan pencegahan TB masih jauh dari target End TB atau eliminasi TB. Tujuan: Fokus penelitian untuk menganalisis pengaruh peran tenaga kesehatan, peran promosi kesehatan, dan peran kader TB terhadap implementasi penanggulangan TB di Pusat Kesehatan Masyarakat Cibinong, Indonesia tahun 2022. Metode: Studi cross sectional dipilih sebagai desain penelitian ini dengan analisis model PLS. Melibatkan pasien TB paru yang berobat rawat jalan sebanyak 90 responden yang memenuhi kriteria inklusi dan eksluasi sebagai sampel penelitian. Instrumen pengumpulan data menggunakan kuesioner dalam bentuk pertanyaan positif dengan pertanyaan tertutup (close ended) dengan multiple choice untuk memperoleh data peran tenaga kesehatan, promosi kesehatan dan kader. Analisis data dilakukan secara multivariat menggunakan SEM dengan Smart PLS. Hasil: Implementasi penanggulangan TB dipengaruhi oleh peran tenaga kesehatan, peran promosi kesehatan dan peran kader TB. Besar pengaruh peran kesehatan 94,5%, peran promosi kesehatan 11,4%, dan peran kader TB 67,3%. Model mampu menjelaskan variabilitas data sebesar 97,3%, sedangkan 2,7% dijelaskan oleh variabel lain yang tidak dikaji dalam penelitian ini. Simpulan: Peningkatan peran tenaga kesehatan, peran promkes, dan peran kader TB berpengaruh pada penanggulangan TB. Oleh karena itu, sinergi lintas sektor, kerja sama tenaga kesehatan dan kader TB maupun masyarakat umum untuk mencapai target WHO, yaitu End TB tahun 2035 atau dan program Kementrian Kesehatan percepatan eliminasi program TB tahun 2030 perlu ditingkatkan dengan mencari Inovasi yang efektif.

Keywords


Kader TB; peran tenaga kesehatan; promosi kesehatan; penggulangan TB; eliminasi program TB.

Full Text:

PDF

References


Abraham R. (2019). Implementasi Kebijakan Penanggulangan Penyakit Tuberkulosis di Puskesmas Kamonji Kota Palu. ISSN: 2302-2019. 6(5), 118–123. http://jurnal.untad.ac.id/jurnal/index.php/Katalogis/article/view/11422

Ahdiyat, A. (2022). Ini Provinsi dengan Kasus TBC Terbanyak pada 2021. https://databoks.katadata.co.id/datapublish/2022/08/23/ini-provinsi-dengan-kasus-tbc-terbanyak-pada-2021.

Arfan, I., Rizky, A., & Alkadri, S. R. (2020). Optimalisasi Kemampuan Kader TB dalam Pengendalian Tuberkulosis. Dharma Raflesia: Jurnal Ilmiah Pengembangan Dan Penerapan IPTEKS, 18(2), 209–217. https://doi.org/10.33369/dr.v18i2.13927

Bagcchi, S. (2023). WHO’s global tuberculosis report 2022. The Lancet Microbe, 4(1), e20. https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(22)00359-7/fulltext

Broto. (2003). Sumber Daya Manusia dan Kondisi Kesehatan Penduduk Masa Depan di Indonesia. Warta Demografi Tahun 33 No. 1, Jakarta.

Chakaya, J., Khan, M., Ntoumi, F., Aklillu, E., Fatima, R., Mwaba, P., Kapata, N., Mfinanga, S., Hasnain, S. E., Katoto, P. D. M. C., Bulabula, A. N. H., Sam-Agudu, N. A., Nachega, J. B., Tiberi, S., McHugh, T. D.,

Abubakar, I., & Zumla, A. (2021). Global Tuberculosis Report 2020 – Reflections on the Global TB burden, treatment and prevention efforts. International Journal of Infectious Diseases, 113, S7–S12. https://doi.org/https://doi.org/10.1016/j.ijid.2021.02.107

Chakaya, J., Petersen, E., Nantanda, R., Mungai, B. N., Migliori, G. B., Amanullah, F., Lungu, P., Ntoumi, F., Kumarasamy, N., & Maeurer, M. (2021). The WHO Global Tuberculosis 2021 Report–not so good news and turning the tide back to End TB. International Journal of Infectious Diseases, 124, S26–S29. https://doi.org/10.1016/j.ijid.2022.03.01

Puskesmas Cibinong. (2022). Laporan Tahunan 2019-2021. Puskesmas Cibinong Kabupaten Bogor, Jawa Barat.

Daroji M, Prabandari YS, P. I. (2011). Peran Petugas Puskesmas dalam Promosi Kesehatan Berhenti Merokok pada Pasien dan Masyarakat. Berita Kedokteran Masyarakat, 27(2), 83–93. https://etd.repository.ugm.ac.id/penelitian/detail/47281

Dey, A., Thekkur, P., Ghosh, A., Dasgupta, T., Bandopadhyay, S., Lahiri, A., Sanju SV, C., Dinda, M. K., Sharma, V., & Dimari, N. (2019). Active case finding for tuberculosis through TOUCH agents in selected high TB burden wards of Kolkata, India: a mixed methods study on outcomes and implementation challenges. Tropical Medicine and Infectious Disease, 4(4), 134. https://doi.org/10.3390/tropicalmed4040134

Fitriana, F., Anis, W., & Ferdinandus, E. D. (2022). Optimalisasi Peran Kader Kesehatan dalam Upaya Promotif dan Preventif Tuberkulosis Paru pada Kehamilan. Aksiologiya: Jurnal Pengabdian Kepada Masyarakat, 6(3), 488–500. http://dx.doi.org/10.30651/aks.v6i3.12201

Ghozali, I. L. H. (2015). Konsep, Tehnik, dan Aplikasi Menggunakan Program SmartPLS 3.0 Untuk Penelitian Empiris. (2 Ed.). Badan Penerbit UNDIP. https://scholar.google.com/scholar?hl=id&as_sdt=0%2C5&q=Ghozali%2C+I.+L.+H.+%282015%29.+Konsep%2C+Tehnik%2C+dan+Aplikasi+Menggunakan+Program+SmartPLS+3.0

Green, L. W., & Kreuter, M. (2005). Health Promotion Planning; An Educational and Environmental Approach. London: Mayfield Publishing Company. Health Program Planning An Educational And Ecological Approach: Fourth Edition: ISBN 00725. https://cir.nii.ac.jp/crid/1130282268755190016

Hoang, T. T. T., Nguyen, N. V., Dinh, S. N., Nguyen, H. B., Cobelens, F., Thwaites, G., Nguyen, H. T., Nguyen, A. T., Wright, P., & Wertheim, H. F. L. (2015). Challenges in detection and treatment of multidrug resistant tuberculosis patients in Vietnam. BMC Public Health, 15, 1–10. https://doi.org/10.1371/journal.pmed.1002119

Kemenkes RI. (2022). Laporan Program Penanggulangan Tuberkulosis 2021. https://tbindonesia.or.id/wp-content/uploads/2023/02/Laporan-Tahunan-Program-TBC-2021_Final-20230207.pdf

Kemenkes RI. (2017). Buku Saku Kader TB. https://Www.Kemkes.Go.Id/Resources/Download/Pusdatin/ Profil-Kesehatan-Indonesia/Profil-Kesehatan-Indonesia-Tahun-2017.Pdf.

Khan, A. H. (2017). Tuberculosis control in Sindh, Pakistan: Critical analysis of its implementation. Journal of Infection and Public Health, 10(1), 1–7. https://doi.org/10.1016/j.jiph.2016.02.007

Lestari, I. P., & Tarmali, A. (2019). Faktor-Faktor yang Berhubungan dengan Peran Kader dalam Penemuan Kasus Tuberkulosis BTA Positif di Kabupaten Magelang. Journal of Healthcare Technology and Medicine, 5(1), 1–12. DOI: https://doi.org/10.33143/jhtm.v5i1.314

Long, Q., Guo, L., Jiang, W., Huan, S., & Tang, S. (2021). Ending tuberculosis in China: health system challenges. The Lancet Public Health, 6(12), e948–e953. https://doi.org/10.1016/S2468-2667(21)00203-6

Lönnroth, K., Jaramillo, E., Williams, B. G., Dye, C., & Raviglione, M. (2009). Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Social Science & Medicine, 68(12), 2240–2246. https://doi.org/10.1016/j.socscimed.2009.03.041

Main, S., Dwihardiani, B., Hidayat, A., Khodijah, S., Greig, J., Chan, G.,

Parry, A. E., Nababan, B., Billy, I., & du Cros, P. (2022). Knowledge and attitudes towards TB among healthcare workers in Yogyakarta, Indonesia. Public Health Action, 12(3), 133–140. https://doi.org/10.5588/pha.22.0017

Maisyarah, A. (2022). Evaluasi Pelaksanaan Penanggulangan Penyakit TB Paru di Kota Bukittinggi. Jurnal Endurance: Kajian Ilmiah Problema Kesehatan, 7(2), 236–388. DOI: https://doi.org/10.22216/jen.v7i2.1057ss.

Moosazadeh, M., & Amiresmaili, M. (2018). Challenges in case finding of tuberculosis control program in Iran: A qualitative study. Bangladesh Journal of Medical Science, 17(3), 462. https://www.proquest.com/openview/193c02c7de5aa56c26c73d9eedb4d672/1?pq-origsite=gscholar

Nasution, N., Sri Andayani, L., & Rochadi, K. (2020). The Role Of Tuberculosis Cadres In The Tuberculosis Control Program In Medan City. International Journal of Public Health & Clinical Sciences (IJPHCS), 7(5). https://doi.org/10.22146/bkm.55207

Nhari, L. G., Dzobo, M., Chitungo, I., Denhere, K., Musuka, G., &

Dzinamarira, T. (2020). Implementing effective TB prevention and treatment programmes in the COVID-19 era in Zimbabwe. A call for innovative differentiated service delivery models. Public Health in Practice, 1, 100058. https://doi.org/10.1016/j.puhip.2020.100058

Nisa, S. M., & Santik, Y. D. P. (2017). Hubungan antara karakteristik kader kesehatan dengan praktik penemuan tersangka kasus Tuberkulosis Paru. Journal of Health Education, 2(1), 93–100. https://doi.org/https://doi.org/10.15294/jhe.v2i1.19117

Noé, A., Ribeiro, R. M., Anselmo, R., Maixenchs, M., Sitole, L.,

Munguambe, K., Blanco, S., le Souef, P., & García-Basteiro, A. L. (2017). Knowledge, attitudes and practices regarding tuberculosis care among health workers in Southern Mozambique. BMC Pulmonary Medicine, 17, 1–7. https://doi.org/https://doi.org/10.1186/s12913-018-3815-1

Notoatmodjo, S. (2014). Kesehatan Masyarakat Ilmu dan Seni. Rineka Cipta. https://scholar.google.com/scholar?hl=id&as_sdt=0%2C5&q=Notoatmodjo%2C+S.+%282014%29.+Kesehatan+Masyarakat+Ilmu+dan+Seni.+Rineka+Cipta.&btnG=

Nur, A., Hasnidar, H., & Swarjana, I. K. D. (2021). Efektivitas Dukungan Keluarga Terhadap Tingkat Kepatuhan Berobat Pasien Tuberculosis Paru. SENRIABDI, 1–10. https://jurnal.usahidsolo.ac.id/index.php/SENRIABDI/article/view/834

Pratama, M. Y., Gurning, F. P., & Suharto, S. (2019). Implementasi Penanggulangan TB di Puskesmas Glugur Darat Kota Medan. Jurnal Kesmas Asclepius., 1(2), 196-205. DOI: https://doi.org/10.31539/jka.v1i2.961

Pratama, M. Y., Gurning, F. P., & Suharto, S. (2019). Implementasi Penanggulangan Tuberkulosis di Puskesmas Glugur Darat Kota Medan. Jurnal Kesmas Asclepius, 1(2), 196-205.

Puspitha, A., Erika, K. A., & Saleh, U. (2020). Pemberdayaan Keluarga dalam Perawatan Tuberkulosis. Media Karya Kesehatan, 3(1). https://doi.org/10.24198/mkk.v3i1.24040.g12827

Ratnasari, N. Y., Marni, M., & Husna, P. H. (2019). Knowledge, Behavior, and Role of Health Cadres in The Early Detection of New Tuberculosis Case in Wonogiri. KEMAS: Jurnal Kesehatan Masyarakat, 15(2), 235–240. https://doi.org/10.15294/kemas.v15i2.20647

Rejeki, D. S. S., Nurlaela, S., & Anandari, D. (2019). Pemberdayaan Kader Pendeteksi Tuberkulosis Paru Menuju Desa Linggasari Yang Sehat Dan Produktif. Dinamika Journal: Pengabdian Masyarakat, 1(4). http://jurnal.lppm.unsoed.ac.id/ojs/index.php/dinamika/article/viewFile/910/823

Republik Indonesia. (2014). Undang-Undang Republik Indonesia Nomor 36 Tahun 2014 Tentang Tenaga Kesehatan. Menteri Hukum Dan Hak Asasi Manusia Republik Indonesia. https://scholar.google.com/scholar?hl=id&as_sdt=0%2C5&q=Republik+Indonesia.+%282014%29.+Undang-Undang+Republik+Indonesia+Nomor+36+Tahun+2014

Risal, M., & Akbar, M. (2020). The influence of TB care community cadre’s roles on the treatment adherence of tuberculosis (TB) sufferers. Enfermería Clínica, 30, 244–248. http://digilib.stiem.ac.id:8080/jspui/handle/123456789/706

Rita, E., Widakdo, G., & Supriyatna, N. (2019). Pemberdayaan masyarakat dalam peningkatan penjaringan suspek kesembuhan penderita tuberkulosis. Prosiding Seminar Nasional Pengabdian Masyarakat LPPM UMJ. https://jurnal.umj.ac.id/index.php/semnaskat/article/view/5479

Sari, M. T., Putri, M. E., Daryanto, D., Al Fajri, J., Apriyali, A., Vigri, S., & Misyina, M. (2022). Pemberdayaan Keluarga dengan Pendekatan Health Coaching pada Keluarga Sadar dan Siaga Tuberculosis Paru di Wilayah Kerja Puskesmas Payo Selincah. Jurnal Abdimas Kesehatan (JAK), 4(2), 267–273. http://dx.doi.org/10.36565/jak.v4i2.323

Sima, B. T., Belachew, T., & Abebe, F. (2019). Health care providers’ knowledge, attitude and perceived stigma regarding tuberculosis in a pastoralist community in Ethiopia: a cross-sectional study. BMC Health Services Research, 19, 1–11. https://doi.org/10.1186/s12913-018-3815-1

Solikhah, M. M., Nursasi, A. Y., & Wiarsih, W. (2019). The relationship between family’s informational support and self-efficacy of pulmonary tuberculosis client. Enfermería Clínica, 29, 424–427. https://doi.org/10.1016/j.enfcli.2019.04.062

Sumartini, N. P. (2018). Penguatan peran kader kesehatan dalam penemuan kasus tuberkulosis (TB) BTA positif melalui edukasi dengan pendekatan Theory of Planned Behaviour (TPB). Jurnal Kesehatan Prima, 8(1), 1246–1263. DOI : 10.32807/jkp.v8i1.47

Supriyana, D. S., & Prasetyawati, A. E. (2020). Pendekatan Home Care untuk Meningkatkan Dukungan Keluarga dalam Manajemen Tuberkulosis Paru pada Pasien Lanjut Usia: Laporan Kasus. Jurnal Stethoscope, 1(1). DOI : 10.54877/stethoscope.v1i1.778

Teo, A. K. J., Singh, S. R., Prem, K., Hsu, L. Y., & Yi, S. (2021). Duration and determinants of delayed tuberculosis diagnosis and treatment in high-burden countries: a mixed-methods systematic review and meta-analysis. Respiratory Research, 22(1), 1–28. https://doi.org/https://doi.org/10.1186/s12931-021-01841-6

Thirarattanasunthon, P., Wongrith, P., Dadras, O., & Kabmuangpak, S. (2023). The Determinants of Treatment Delay and Quality of Life among the Newly Diagnosed Pulmonary Tuberculosis Patients in Northeastern Thailand: A Cross-Sectional Study. Infectious Disorders-Drug Targets (Formerly Current Drug Targets-Infectious Disorders), 23(2), 81–88. https://doi.org/10.2174/1871526522666220818142651

Trajman, A., Wakoff-Pereira, M. F., Ramos-Silva, J., Cordeiro-Santos, M.,

Militão de Albuquerque, M. de F., Hill, P. C., & Menzies, D. (2019). Knowledge, attitudes and practices on tuberculosis transmission and prevention among auxiliary healthcare professionals in three Brazilian high-burden cities: a cross-sectional survey. BMC Health Services Research, 19(1), 1–8. https://doi.org/10.1186/s12913-019-4231-x

Ulfa, Z. D., Kuswardinah, A., & Mukkarromah, S. B. (2017). Faktor-Faktor Yang Mempengaruhi Pemanfaatan Pelayanan Kesehatan Maternal Secara Berkelanjutan. Public Health Perspective Journal, 2(2), 184–190. https://journal.unnes.ac.id/nju/index.php/phpj/article/view/13589

Vigenschow, A., Edoa, J. R., Adegbite, B. R., Agbo, P. A., Adegnika, A. A.,

Alabi, A., Massinga-Loembe, M., & Grobusch, M. P. (2021). Knowledge, attitudes and practices regarding tuberculosis amongst healthcare workers in Moyen-Ogooué Province, Gabon. BMC Infectious Diseases, 21(1), 1–7. https://doi.org/https://doi.org/10.1186/s12879-021-06225-1

Volmink, J., & Matchaba, P. & Garner, P. (2000). Directly Observed Therapy and Treatment Adherence. The Lancet. 355(9212), 1345-1350. https://doi.org/10.1016/S0140-6736(00)02124-3

Vukugah, T. A., Akoku, D. A., Tchoupa, M. M., & Lambert, E. (2022). Knowledge, Attitude, and Practice on Pediatric Tuberculosis Management among Healthcare Workers in the Centre Region of Cameroon: A Cross-Sectional Study. Journal of Tropical Medicine, 2022. https://doi.org/10.1155/2022/4482131

Waryana. (2016). Promosi Kesehatan, Penyuluhan dan Pemberdayaan Masyarakat. Cetakan Pertama. Nuha Medika.

WHO. (2016). Global tuberculosis report 2016. World Health Organization. https://apps.who.int/iris/handle/10665/250441

WHO. (2019). Global tuberculosis report 2019. Geneva: World Health Organization. Licence: CC BY-NC-SA 3.0 IGO. https://www.who.int/publications/i/item/9789241565714

WHO. (2021a). Global tuberculosis report 2020. Geneva: WHO; 2020. Google Scholar There Is No Corresponding Record for This Reference. https://scholar.google.com/scholar?hl=id&as_sdt=0%2C5&q=WHO.+%282021a%29.+Global+tuberculosis+report+2020.+Geneva%

WHO. (2021b). Global tuberculosis report 2021. Geneva: World Health Organization. Licence: CC BY-NC-SA 3.0 IGO. 2020. https://www.who.int/publications/i/item/9789240037021

Widiastutik, G. K., Makhfudli, W. S. (2020). Hubungan Dukungan Keluarga, Kader dan Petugas Kesehatan Dengan Kepatuhan Berobat Penderita TB Paru. Indonesian Journal of Community Health Nursing, 5(1), 41–47. https://doi.org/10.20473/ijchn.v5i1.18654

Yanti, B. (2022). Optimalisasi Peran Kader Tuberkulosis Melalui “Program Ketuk Pintu” Di Pesisir Ujong Batee Aceh. ISSN: 2598-1218. Jurnal Pengabdian Kepada Masyarakat, 5(4). http://dx.doi.org/10.31604/jpm.v5i4.1463-1470

Yanti, N. L. P. E. (2016). Pengendalian Kasus Tuberkulosis melalui Kelompok Kader Peduli TB (KKP-TB). Jurnal Keperawatan Community of Publishing in Nursing (COPING), ISSN: 2303-1298. 75–80. https://simdos.unud.ac.id/uploads/file_penelitian_1_dir/28840629af063a42a1dacf27ec18ac05.pdf

Zulfadilah, R., Irianto, S. E., Djamil, A., & Putri, D. U. P. (2020). Analysis of Factors Related to the Performance of Officers in Discovery of Lung TB Case. Indonesian Journal of Global Health Research, 2(2), 153–164. https://orcid.org/0000-0003-1945-5630




DOI: https://doi.org/10.26630/jkmsaw.v16i1.3867

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


     


Published by Departement of Midwifery, Politeknik Kesehatan Kemenkes Tanjungkarang, Indonesia

Alamat: Jl. Brigjend. Soetiyoso No. 1 Kota Metro, Lampung, Indonesia

Phone: 0725-41819,E-mail: jkm@poltekkes-tjk.ac.id


Jurnal Kesehatan Metro Sai Wawai is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.