These assessments and recommendations provide a strong basis for carefully tailoring national TB responses to the country's epidemic – the starting point for ending discriminatory practices and improving respect for basic human rights for all to access high-quality TB prevention, treatment, care and support services quality. While another study found that "10% of marriages ended in divorce due to the female spouse diagnosed with TB (common among younger spouses); 25% of. And in both selected districts, those who do not have the subsidized health insurance or local ID, still able to access TB services due to the national TB program when they reached the health services.
Capacity building in terms of gender sensitization of various stakeholders is one of the priorities, as is awareness of gender issues, i.e. Tuberculosis is one of the ten leading causes of death and the leading cause of infection worldwide. An enabling environment is one of the strategies set out in the Strategy to End Tuberculosis (WHO, 2015)13, which calls on different institutions to take responsibility for the implementation of the TB programme.
Selection of the villages is based on the calculation of scores on various variables related to density and poverty. The study of the legal environment related to TB is carried out through an analysis of the national legal framework and policies of TB in Indonesia through a hierarchical approach to Indonesian legislation and international instruments ratified in state legislation related to TB.
Know your Epidemics
Figure 3 above indicates that in terms of absolute number of TB cases, Java and Bali, West Nusa Tenggara and Sumatera, Kalimantan and Sulawesi have the highest TB burden consecutively. While treatment success rates based on gender, as seen in Figure 5 below, there is a tendency for women to have a slightly higher rate of success in TB treatment than men, but statistically it may not be significantly different. To see the situation of TB treatment in HIV-positive patients compared to HIV-negative patients, Figure 6 below suggests that TB treatment success among HIV-positive patients is consistently lower than HIV-negative patients, the difference reaching 24% at the national level, and even higher in North Jakarta, reaching 31%.
This condition suggests a greater susceptibility to successful TB treatment among HIV-positive patients compared to HIV-negative patients. A total of 2,244 people or 29% of patients with TB and HIV co-infection are receiving antirheumatic drug treatment nationally, and the graphs show a slightly higher proportion among the female than the male group. However, at the provincial and district level, men appear to have a slightly higher proportion than the female group in this observation, indicating no significant difference in receiving ART between TB and HIV co-infected patients.
Disaggregated analysis by age can be seen in figures 9, 10 and 11 respectively on TB treatment success rate, TB patients who know their HIV status and TB-HIV patients receiving ARV treatment. Children, or patients younger than 15 years, tend to be more successful in TB treatment than adult patients (15 years and older), but smaller proportion of TB patients in children who know their HIV status, and tend to to be smaller in relation to ARV treatment (See Figures 9, 10 and 11 below).
Know Your Response
Circular of the Minister of Internal Affairs No Bangde on support to accelerate the control of tuberculosis;. Data and information are managed in an integrated monitoring and evaluation system, which consists of information systems for routine program implementation, control and further analysis of routine data and control in order to obtain an overview of the state of the country in terms of the implementation of tuberculosis status and effectiveness. programs in Indonesia. One of the recommendations from the results of the 2014 Tuberculosis Prevalence Survey is to conduct an inventory study.
The National Strategic Plan for TB Control NSP TB) is structured with reference to the National Medium Term Development Plan (RPJMN and Strategic Plan of the Ministry of Health 2015-2019 where TB control has become an integral part of the broader strategy on disease control and environmental control) health .The NSP TB will become a reference in the implementation of TB control across all sectors of government, private and public, and can also. Even in one of the statements about the increase of community involvement in TB control, putting patients' rights and responsibility as individuals as the center of TB control, there are unfortunately no acknowledgments that the challenges and strategies on human rights issues and legal barriers for people with TB do not address
TB control in Indonesia is carried out in accordance with the principle of decentralization within the framework of autonomy with districts/municipalities as the focus of program management, which includes: planning, implementation, monitoring and evaluation and ensuring the availability of resources (funds, personnel, facilities and infrastructure). TB control is implemented using the DOTS strategy as a basic framework and taking into account the Global Stop TB Strategy. Strengthening TB control and development aimed at improving the quality of services, easy access to case finding and treatment in order to be able to break the chain of transmission and prevent the emergence of drug-resistant TB.
The findings and treatment in the context of TB control are implemented by all Primary Health Care Facilities (PHCF) and Referral Health Facilities (FKRTL), including: Puskesmas (Subdistrict Level Public Health Center), State and Private Hospital, Lung Hospitals ( RSP), Community Lung Health Center (B / BKPM ), Medical Clinic and Private Practitioners (DPM). Among people affected by TB in 2016, only 8% of the estimated 32,000 MDR people affected by TB were diagnosed. One of the challenges in TB response in Indonesia is that most people affected by TB go to the private sector for providers seeking initial care, of which 78,597 are registered as medical doctors) and only 495 private practitioners, 63 private hospitals and 225 private clinics are in the process of notifying. people in 2016.
13/2013 on Guidelines for comprehensive management of TB-MDR control, (3) CDC Director General Decree no.
Identify Determinant Factors
Those of the TB MDR patients mostly have a long history of TB diagnosis and treatment, as below. I don't really make time to go to nurseries because I'm busy taking care of the children. Finally, delayed diagnosis and treatment of TB can have a detrimental effect in the form of material loss on the part of the patient because they have to spend transportation costs every time they visit a health service.
In addition to losing patients due to the uncertainty of test results, it can increase the rate of TB transmission; and even death due to delayed tuberculosis patients being treated. The development of effective communication strategies at all levels should be carried out to ensure implementation in every aspect of the program and to make people correctly understand the problems of TB, especially those that are affecting the perceptions of TB in the community. A particular population that is also susceptible to TB transmission is among workers (factory workers) and residents in densely populated settlements, which is closely related to the characteristics of Sidoarjo regency which is an industrial area.
The characteristics of the study area (Sukodono District) are industrial areas and densely populated areas based on the health profile of the district. People with TB have the right to actively participate in the planning, development, monitoring and evaluation of both policy and implementation of the TB programme. The right to participate is guaranteed by the Minister of Health's constitution and regulation of 1945 no.
Government support, financial commitments, support of health workers and local communities are very important in efforts to meaningfully involve OCDs and CBOs in contributing to the implementation of the TB control program. The Constitution of 1945 regulates the protection of the citizens' right to health in general terminology. Importantly, health insurance now covers 82.64% of the population and provides free health services to the poorest in society.
Based on the findings of the FGD, it would be important for TB workplace policies to be comprehensive, as recommended by the ILO, UNAIDS and WHO, and in particular address issues related to continued employment and provision of reasonable accommodation for people with TB. Most of the people interviewed do not answer the questions about tuberculosis correctly, especially those who live in slums and are not tuberculosis patients, but live at home with tuberculosis patients.65. None of the IDI respondents were aware of their rights in accessing TB treatment services.
Summary Table of Indonesian 2018 Global TB Report
Supporting Data on Key Population Assessment
This TB KP is also one of the national priorities and part of the main program. We exclude this in the study due to budgetary constraints. especially for a follow-up after diagnosed persons with diabetes. Need to build stronger coordination with health professionals and health facilities around the jail/prison.
Need to ensure that the National Minimum Standard for Health Services (SPM) includes services for prisoners and detainees. Build a transit mechanism for people on TB treatment, including those to be mobilized from one prison to another. Relatively far even from the nearest PHC, for those who are very poor (do not have sufficient transport costs).
Strongly stigmatized Even if the national or subnational insurance is available, the administrative process can be completed. Late diagnosis (due to self-medication) Delayed treatment Dropout Standard Lack of preventive measures among family members.
Supporting Data on Gender Analysis
Supporting Data on Drivers of TB in Indonesia
