The Qualitative Study: Evaluation of Tuberculosis Control Program in Bandar Lampung City

Abstract

Introduction: Indonesia has committed to implementing a TB control programme that is directed at accelerating the achievement of TB elimination by 2030, including Lampung Province and Bandar Lampung city is an area with a high prevalence of TB. Implementation of the TB control programme has been carried out. However, the cause of the high prevalence of TB remains unknown. Purpose: This study aims to evaluate the implementation of the TB control programme in Bandar Lampung City. Thus, it can contribute to planning efforts to reduce TB prevalence. Methods: This study is a qualitative research with a system approach based on input, process and output components. Data were collected at the Health Office of Bandar Lampung City and at three Community Health Centres in Bandar Lampung City. Data were collected using in-depth interviews, observation, and document review. Informants included policy makers, managers, cadres and TB patients. Data were analysed by collaborating the research data using triangulation methods, both source triangulation, method triangulation and data triangulation to draw conclusions. Results: The findings of this study showed that the TB control program in Bandar Lampung City has been running well and is in line with the achievement of the TB elimination acceleration program target in the input, process and output components, but TB prevention health promotion efforts are still not optimally implemented and coverage figures that describe TB prevention behaviour are not yet available. Conclusion: In general, the TB control programme in Bandar Lampung City is good and in line with the targets of the TB elimination acceleration programme.  However, there is no evaluation of TB prevention health promotion efforts related to the attitudes and behaviour of TB prevention by vulnerable communities.

Latar Belakang: Indonesia telah berkomitmen melaksanakan program penanggulangan TB yang diarahkan untuk mempercepat pencapaian eliminasi TB tahun 2030, termasuk Provinsi Lampung dan kota Bandar Lampung yang merupakan wilayah dengan prevalensi TB yang tinggi. Implementasi program penanggulangan TB telah dilakukan. Namun belum diketahui penyebab prevalensi TB masih tinggi. Tujuan: Penelitian ini untuk mengevaluasi program pelaksanaan penanggulangan TB di Kota Bandar Lampung. Sehingga, dapat memberikan kontribusi untuk upaya perencaan penurunan prevalensi TB. Metode: Penelitian ini merupakan penelitian kualitatif dengan pendekatan sistem berdasarkan komponen input, proses dan output. Pengumpulan data dilakukan di Dinas Kesehatan Kota Bandar Lampung dan di tiga Pusat Kesehatan Masyarakat di kota Bandar Lampung. Data dikumpulkan dengan metode wawancara mendalam, observasi, dan telaah dokumen. Informan terdiri dari para pengambil kebijakan, pengelola, kader dan pasien TB. Analisis data dilakukan dengan mengkolaborasikan data hasil penelitian menggunakan metode triangulasi, baik triangulasi sumber, triangulasi metode maupun triangulasi data untuk diambil kesimpulan. Hasil: Temuan pada penelitian ini diketahui bahwa program penanggulangan TB di Kota Bandar Lampung sudah berjalan baik dan sejalan dengan pencapaian target program percepatan eliminasi TB baik pada komponen input, proses dan output, namun upaya promosi kesehatan pencegahan TB masih belum terlaksana secara optimal dan angka cakupan yang menggambarkan perilaku pencegahan TB belum tersedia. Simpulan: Secara umum program penanggulangan TB di Kota Bandar Lampung sudah baik dan sejalan dengan pencapaian target program percepatan eliminasi TB.  Namun, upaya promkes pencegahan TB tidak ada hasil evaluasi terkait sikap dan prilaku pencegahan TB oleh masyarakat yang rentan.