Fidelity Implementasi Program Public Private Mix TB pada Rumah Sakit dan Klinik Swasta di Kabupaten Pringsewu Provinsi Lampung

Suzi Hermawati Romauli S., dr. Riris Andono Ahmad, MPH, Ph.D; Prof. dr. Ari Natalia Probandari, MPH, Ph.D

2024 | Tesis | S2 Ilmu Kedokteran Tropis

LatarBelakang: Indonesia berada di peringkat kedua dengan kasus tuberkulosis (TB) terbanyak di dunia setelah India, dengan 969.000 kasus per tahun, meningkat 17% sejak 2020. Insiden TB mencapai 354 kasus per 100.000 penduduk, dan kematian akibat TB naik 60%, dari 93.000 menjadi 150.000. Laporan WHO 2022 menunjukkan kesenjangan pelaporan sebesar 54,3%, menandakan banyak kasus TB tidak teridentifikasi. Walaupun program penanggulangan TB nasional berhasil dalam pengobatan, penemuan kasus masih menjadi tantangan, terutama di sektor swasta. Penelitian menunjukkan bahwa 74% masyarakat memilih fasilitas kesehatan swasta, tetapi pelaporan dari sektor ini masih rendah, dengan notifikasi di bawah 10%. Strategi Public-Private Mix (PPM) belum optimal di beberapa wilayah, termasuk Kabupaten Pringsewu, Lampung. Tujuan: Penelitian ini bertujuan menilai fidelity implementasi PPM TB dan faktor-faktor yang mempengaruhinya di RS dan klinik swasta di Kabupaten Pringsewu. Metode: Penelitian dilaksanakan dari April hingga Juni 2024 dengan desain mix method dan pendekatan sequential explanatory. Tahap pertama kuantitatif menggunakan survei terhadap 79 responden dari RS dan klinik swasta. Analisis deskriptif dan inferensial digunakan untuk mengukur fidelity dan faktor-faktor yang mempengaruhinya. Tahap kedua melibatkan wawancara mendalam dengan tiga responden dari Dinas Kesehatan, dianalisis dengan teknik tematik. Hasil: Penelitian kuantitatif menunjukkan tingkat fidelity implementasi PPM TB di RS dan klinik swasta tergolong tinggi, dengan rata-rata 2,798 (skala 1,00-3,00). Faktor signifikan yang mempengaruhi adalah kualitas penyampaian (p<0>

Background: Indonesia ranks second with the highest number of tuberculosis (TB) cases in the world after India, with 969,000 cases per year, an increase of 17% since 2020. The incidence of TB reached 354 cases per 100,000 population, and deaths from TB increased by 60%, from 93,000 to 150,000. The 2022 WHO report showed a reporting gap of 54.3%, indicating that many TB cases are not identified. Although the national TB control program has been successful in treatment, case finding remains a challenge, especially in the private sector. Research shows that 74% of the community chooses private health facilities, but reporting from this sector is still low, with notifications below 10%. The public-private mix (PPM) strategy has not been optimal in several areas, including Pringsewu Regency, Lampung. Objectives: This study aims to assess the fidelity of TB PPM implementation and the factors that influence it in hospitals and private clinics in Pringsewu Regency. Methods: The study was conducted from April to June 2024 with a mixed-methods design and a sequential explanatory approach. The first quantitative stage used a survey of 79 respondents from hospitals and private clinics. Descriptive and inferential analysis were used to measure fidelity and the factors that influence it. The second stage involved in-depth interviews with three respondents from the health office, analyzed using thematic techniques. Results: Quantitative research shows that the level of fidelity of TB PPM implementation in hospitals and private clinics is relatively high, with an average of 2.798 (scale 1.00–3.00). Significant influencing factors are the quality of delivery (p<0>

Kata Kunci : Public Private Mix, TB, Mix Method, Fidelity, Implementasi / Public Private Mix, TB, Mix Method, Fidelity, Implementation