Evaluation of Tuberculosis Control Programs in Indonesian Community Health Centers Using Systemic Approach

Community health centers (CHCs) play an important role in Indonesian national tuberculosis (TB) control. Using the systemic approach, an approach for community health program evaluation developed by Department of Community Medicine, Faculty of Medicine, University of Indonesia, we evaluated two CHCs in East Jakarta by systematically identifying the problems, prioritizing problems, formulating alternative solutions, and prioritizing alternative solutions. For Jatinegara Kaum CHC, proportion of sputum examined suspects was 7.8%, proportion of smear-positive patients among suspects was 60.87%, proportion of smear-positive TB patients among all registered TB patients was 60.87%, conversion rate was 92.86%, cure rate was 91.60%, and case detection rate was 46.74%. For East Pisangan CHC, proportion of sputum examined suspects was 10.26%, proportion of smear-positive patients among suspects was 58.62%, proportion of smear-positive TB patients among all registered TB patients was 58.62%, conversion rate was 82.35%, cure rate was 100.00%, and case detection rate was 60.16%. Error rates were not available in both CHCs. Low case detection rate was considered prioritized problem for both CHCs. Prioritized solution for Jatinegara Kaum was new case finding training for cadres, while for East Pisangan periodic public health education events. Systemic approach was able to demonstrate its capabilities.