Standard 4.4 Tuberculosis control program.

Standard 4.4 Tuberculosis control program.

The Tuberculosis (TBC) Control Program was held in an effort to improve health services towards universal health coverage, especially strengthening primary health services by encouraging promotive and preventive efforts.

Puskesmas provides services to TB service users starting from finding TB cases in people suspected of TB, establishing a diagnosis, determining the classification and type of TB service users, as well as case management consisting of treatment of service users along with monitoring and evaluation to break the chain of transmission in accordance with the provisions of the legislation.

a. Criterion 4.4.1

Community Health Centers provide services to TB patients starting from finding TB cases in people suspected of TB, establishing a diagnosis, determining the classification and type of TB service users, as well as case management consisting of patient treatment along with monitoring and evaluation.

1) Main Thoughts:

a) Tuberculosis control is all health efforts that prioritize promotive and preventive aspects without neglecting curative and rehabilitative aspects aimed at protecting public health, reducing morbidity, disability or death, ending transmission, preventing drug resistance, and reducing the negative impacts resulting from tuberculosis.

b) Tuberculosis is an infectious disease problem both globally and nationally. Efforts to control the transmission of tuberculosis are one of the national priority programs in the health sector

c) Tuberculosis control programs are planned, implemented, monitored and followed up in an effort to eliminate tuberculosis.

d) Determination of TB performance indicators is integrated with the determination of Puskesmas performance indicators

e) TB patient services are carried out through:

(1) services for Drug Sensitive TB (SO) cases which consist of

(a) active and passive TB case finding;

(b) diagnosis is carried out according to the Standards by rapid molecular, microscopic and culture tests;

(c) TB treatment according to standards; And

(d) monitoring of TB patients is carried out through microscopic examination at the end of the 2nd month, the end of the 5th month, and at the end of treatment.

(2) services for Drug Resistant TB (RO) cases are carried out by:

(a) active and passive TB case finding;

(b) the ability of the Community Health Center to screen TB RO cases and refer suspects for diagnosis if necessary

(c) the ability of the Community Health Center to continue treatment of RO TB patients; And

(d) the ability of the Community Health Center to carry out laboratory examination referrals and follow-up for TB RO service users.

(3) providing TB preventive treatment to children and PLWHA;

(4) providing education about transmission, prevention of TB disease, and cough etiquette to patients and families;

(5) provision of services by the Community Health Center in monitoring drug swallowing (PMO) for TB SO and TB RO patients;

(6) obligation to report TB cases to the management of the National TB Control Program;

(7) participation in strengthening the quality of the TB microscopic laboratory in accordance with the provisions of the TB program; And

(8) strengthening the role of cross-programs, cross-sectors and communities in implementing public private mix (PPM), involving professional organizations, health facility associations, BPJS, etc.

f) Promotive and preventive efforts are carried out in the context of TB control programs in accordance with established guidelines.

g) Tuberculosis control programs need to be prepared and coordinated, both in preventive and curative efforts at Community Health Centers, through strategies or strategies for direct supervision of short-term treatment or DOTS (directly observed treatment short course). To carry out this strategy, the Community Health Center formed a DOTS team.

h) To achieve the targets of the National TB Control Program, provincial and district/city governments must set regional level TB control performance indicator targets based on national targets and pay attention to national strategies which are then used as the basis for Puskesmas in setting targets and performance indicators that are monitored annually.

i) The Community Health Center measures the performance indicators that have been determined and is accompanied by an analysis of achievements. Analysis of indicator achievements is carried out using analytical methods in accordance with applicable guidelines/guidelines, for example by referring to the situation analysis method contained in the Community Health Center Management Guidebook.

j) The tuberculosis control program plan is prepared by prioritizing promotive and preventive efforts based on the results of analysis of tuberculosis control problems in the Puskesmas work area with cross-program involvement that is integrated with the RUK and RPK of UKM services as well as UKP, laboratory and pharmacy.

k) Recording and reporting of tuberculosis control services, both manually and electronically, is carried out completely, accurately, on time and in accordance with procedures. Reporting to the head of the community health center and district/city regional health service and/or other parties refers to the provisions of statutory regulations. Reporting to the head of the community health center can be done in writing or delivered directly through meetings such as monthly mini workshops, management review meetings, and other forums.

2) Assessment Elements:

a) Determine performance indicators and targets for tuberculosis control accompanied by achievements and analysis. (R, D, W).

b) Establish a tuberculosis control program plan (R).

c) A TB DOTS team is established at the Community Health Center consisting of doctors, nurses, laboratory analysts and trained reporting recording officers (R).

d) Logistics are available, both OAT and non-OAT, according to program needs and managed in accordance with procedures (R,D,O,W).

e) Management of tuberculosis cases is carried out starting from diagnosis, treatment, monitoring, evaluation and follow-up in accordance with established policies, guidelines and procedures (R, D, O, W).

f) Coordinate and implement the tuberculosis control program in accordance with plans prepared jointly across programs and across sectors (R, D, W).

g) Monitoring and evaluation are carried out as well as follow-up efforts to improve the tuberculosis control program (D,W).

h) Recording is carried out and reporting is carried out to the head of the community health center, district/city regional health service in accordance with established procedures (R, D, W).