Analisis advokasi kebijakan pencegahan dan penanggulangan tuberkulosis di Daerah Kota Malang

• Main Authors: Kartono, Rinikso Kartono, Salahudin, ,
• Format: Conference or Workshop Item
• Language: English
• Published: 2014
• Subjects: K Law (General); RA Public aspects of medicine
• Online Access: http://repo.uum.edu.my/13094/1/28.pdf; http://repo.uum.edu.my/13094/; http://www.uumicg2014.com/

Tuberculosis (TB) as an infectious disease has been widespread in many countries including Indonesia. TB is considered as a disease that can affect a person's low productivity (patients) that affect the economic growth and wellbeing of a country. The Indonesian government strive to prevent and control TB through any way and activities.Although the government has tried hard but the rate of TB in Indonesia is still quite high.In 2010, Indonesia is ranked as the state with the fifth highest TB burden in the world. Estimated prevalence of TB cases amounted to 660,000, and the estimated incidence amounted to 430,000 new cases a year.The number of TB deaths estimated 61,000 deaths a year (Minister of Health, 2010).Malang is still an obstacle in achieving the vision be malang healty city, or free of TB disease. In 2007, for TB disease, CDR which achieved only 57% and still achieve a cure rate of 54%.Malang became one of the cities with the most people with TB disease, as supported by the location of the landscapes are located in the highlands to the climatic conditions of air temperature (22.2 ° C - 24.5 ° C) (KPDE Malang Government, 2006).Results of the research team analyzes the TB Regional Malang shows: First, based on data from the Department of Health Malang, in 2013 the number of TB reached 1610 peoples (figure TB CNR), and with the discovery of pulmonary TB (AFB +) reached 615 peoples (rate of TB CDR), and or CDR reaches 68,% of the CNR in 1610. The rate of TB has increased from 2012 which only reached 1556 people (figure TB CNR), and with the discovery of pulmonary TB (AFB +) reached 573 people (rate of TB CDR), and or CDR reaches 65.3% of the CNR in 1556.Second, TB disease in Malang is caused by lack of public awareness for healthy living and clean, especially the lack of awareness to cough and sneeze properly.Third, communications through officer Poly RSSA of TB to TB patients is less well assessed so that TB patients, especially patients with MDR TB are reluctant to seek treatment completely.MDR TB patients and their families desperate for treatment, and they willingly accept it if one day die bacause of TB disease suffered.Clinic staff as a field companion also experiencing despair encourage MDR TB patients to be treated completely. Fourth, TB patient in Malang get free medicine from the clinic services. Free medicine is not available in the hospital. So that TB patients find it difficult to get access to services at the hospital.Fifth, TB patients have great hopes of the ministry health centers.Because the medicine is available for free at the health center of the neighborhood and close them.But unfortunate health care facilities, especially the provision of community health workers in health centers is very limited.Community health workers in health centers are not proportional to the number of health centers in Malang.Sixth, the health care program, especially related to the prevention and control of TB services in Malang is too far from Malang hopes to achieve as a Healthy City or unavoidable from TB disease. Health programs of Malang City Health Office assessed a technical nature (administrative), that’s not integrated between a program with the other programs to support prevention and control of TB disease in Malang. Seventh, Malang Government Budget Policy judged in favor of the health service.Of the total budget for Fiscal Year 2013 Malang, only 6.22% for the health sector.And according to the laws of health in Malang, local government must allocate 10% to the total budget of the health sector. Eighth, Budget 6.22% to health sector in Malang of the total budget for Fiscal Year 2013 are not allocated properly to the prevention and control of TB programs, but the budget actually leads to programs that are not directly related to the field of prevention and control TB in Malang. Ninth, the total loss suffered as a result of TB disease is at 1,415,050,875 (one billion four hundred and fifteen million fifty thousand eight hundred and seventy-five dollars. Tenth, The gap between budget policy, health development programs, and lack of health facilities to the prevention and prevention of TB disease in Malang is considered as the trigger is created and spread of TB disease in Malang.Based on the findings above, the editorial team of the TB situation Malang recommend to do the three forms of action, the main action, partnerships action,and strategic action program formulation prevention and control of tuberculosis in the city of Malang. In essence these three actions aimed at encouraging some important points, namely: (1) The Government of Malang and East Java provincial governments need to work together to create a policy for free treatment for TB patients at all levels of health services, especially in the General Hospital. (2) The Government of Malang need to increase health workers in health centers in an effort to optimize the public service, especially for TB people. (3) Integrating health development programs that are related to the prevention and control of TB in Malang.(4) The Government of Malang need to expand TB prevention and control programs are based on the active participation of the community. (5) Malang Government needs to encourage stakeholder participation broadly to the issue of TB is not only the responsibility of the government of Malang. (6) The government needs to devise Malang budget policies that favor the TB problem.Policies should support real budget reduction and prevention of TB in Malang. (7) Malang Government needs to publication of data on TB transparently, scalable, and accessible to anyone, especially for researchers who are steeped in the issue of TB in Malang. Three forms of action above also directed to encourage stakeholders, especially in Malang Aisyiyah Leaders to continue in building an intensive communication with the governments and parliaments of Malang, Malang City Health Department, Universities, Community Leaders, Religious Leaders, and Peer Support Groups (KDS) that formed a partnership in running the TB prevention and control programs are active, complete, and sustained.