Abstract
Tuberculosis (TB) is still a public health problem in Indonesia and ranks second in the world. Obstacles in implementation of public policies, the National the TB Control Program, the low number of new cases finding, will hinder TB Elimination 2030. The involvement of the private sector and the community in Pasuruan City has increased the case finding rate in the last three years but has not yet reached the target. The finding of TB patients in Diabetes Mellitus (DM) patients is three times higher than the general population, and the prevalence of TB in DM patients is ten times higher than in non-diabetic patients. The purpose of this study was to analyze the partnership model that was carried out and to develop a model for implementing partnerships: Public-Private Mix (PPM) in Pasuruan City. Methodology with a qualitative study goes through the exploration process understands and obstacles of the implementation model the collaboration of the TB control program. Results of the study that principles of partnership that are carried out are only in trust, equality, mutual benefit, and risk-sharing. Then a partnership the model was developed PPM TDC (TB-DM Collaboration), a strategy development to improve case finding and service quality involving primary, secondary and government-private health facilities by collaborating with TB and DM programs, and implementing the principle of Commitment, Cooperation, Trust, Communication, Quality of service, Dependancy, Adaptability, and Profit. As a conclusion of the partnership model: PPM TDC can be an effort to accelerate the achievement of TB elimination. Suggestions for District/Municipality Governments that have implemented PPM are to evaluate and develop the TDC PPM approach, which has not been able to carry directly out the TDC PPM approach. PPM TDC evaluation is carried out by an integrated monitoring team involving academics, professional organizations and periodically.
Highlights
In two decades, there has been a shift in the map of diseases that occurred in Indonesia
The Government of the Republic of Indonesia has made efforts to overcome it through the issuance of public policies that are set by policies that are tiered, comprehensive, and have sensitive indicators, namely: 1) Presidential Regulation Number 67 of 2021 concerning Tuberculosis Control, in which it has been determined that Indonesia will be heading to the Tuberculosis Elimination stage in 2030, where there is a decrease in the incidence of TB to 65 per 100,000 population and a decrease in mortality to 6 per 100,000 population
The results of this study provide new findings in implementing public policies in the health sector of the national TB control program by developing a partnership model, namely the public-private mix by collaborating with TB-Diabetes Mellitus (DM), to increase service access in the context of accelerating Indonesia's TB elimination in 2030
Summary
There has been a shift in the map of diseases that occurred in Indonesia. In 2010, Indonesia faced different challenges, namely infectious disease health problems experienced a decreasing trend in numbers, but non-communicable disease health problems (NCDs) experienced an increasing trend. This condition causes Indonesia to face a double issue in health. TB is an infectious disease and, in many cases, deadly caused by various strains of mycobacteria, generally Mycobacterium tuberculosis [27] Based on the measurement of DALYs loss, in 2020 compared to 1990, it can be seen that for 20 years, there has been a shift in non-communicable diseases, namely stroke. The Government of the Republic of Indonesia has made efforts to overcome it through the issuance of public policies that are set by policies that are tiered, comprehensive, and have sensitive indicators, namely: 1) Presidential Regulation Number 67 of 2021 concerning Tuberculosis Control, in which it has been determined that Indonesia will be heading to the Tuberculosis Elimination stage in 2030, where there is a decrease in the incidence of TB to 65 per 100,000 population and a decrease in mortality to 6 per 100,000 population. 2) Presidential Instruction Number 1 of 2017 concerning Community Movement for Healthy Living (GERMAS); 3) Regulation of the Minister of Health of the Republic of Indonesia Number 39 of 2016 concerning Guidelines for the Implementation of the Healthy Indonesia Program; 4) Regulation of the Minister of Health of the Republic of Indonesia Number 67 of 2016 concerning Tuberculosis Management; 5) Government Regulation Number 2 of 2018 concerning Minimum Service Standards (SPM) [22]
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