Kinerja Pengelola Program Penanggulangan Tuberkulosis dalam Penemuan Kasus Tuberkulosis dengan Investigasi Kontak di Kota Medan

Abstract

The achievement of finding Tuberculosis (TB) cases in Medan City is still low: 43.77 percent in 2020 and 33.98 percent in 2021. Contact investigation implementation, which is one of the efforts to actively find TB cases, is also not optimal: 14.79 percent of the target of 80 percent in 2020 and 18.28 percent of the target of 85 percent in 2021. The performance of TB officers is a determining factor of contact investigation target achievement. This research aimed to explore the performance and factors contributing to the performance of TB officers in finding TB cases through contact investigation in Medan City. This was qualitative research. Data were collected using in-depth interviews and observed documentation. The results showed that the performance of TB officers had not been optimal. Factors that contributed to the performance were individual factor such as the inadequate ability of TB officers. Organizational factors such as the limited number of TB officers in health facilities, the limited funds for the contact investigation implementation, the slowness of SITB application during working hours, no specific suggestion from the heads of health facilities, no special rewards in implementing contact investigation, undetailed job descriptions, technical instruction for contact investigation that was not yet clearly known, and other duties officers had besides the TB program. Psychological factors such as perceptions and attitudes that were less positive related to the entry data of contact investigation conducted by cadres, as well as less enthusiasm due to the large number of reports and high workload. Other factors were suboptimal coordination between TB officers and cadres and obstacles that came from the contact investigation’s target community. It is suggested to implement a contracting-out mechanism for data entry, provide written feedback to the health facilities, improve cross-sectoral coordination, and empower and make cadres partners.