TBC masih merupakan masalah kesehatan dunia, bahkan Indonesia. Pemerintah telah menerapkan program DOTS untuk menurunkan angka kesakitan dan kematian akibat TBC, namun angka tersebut masih belum mencapai target. Selama pandemi Covid-19, program DOTS tetap diselenggarakan dengan adanya penyesuaian pengelolaan input dan process. Tujuan dari penelitian ini yakni mengetahui gambaran pelaksanaan program DOTS selama pandemi Covid-19 di wilayah kerja Puskesmas Depok Jaya. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Teknik pengumpulan data wawancara mendalam kepada informan utama, yakni Penanggung Jawab Program DOTS, Dokter Penanggung Jawab Program DOTS, Ketua Kader dan PMO, sedangkan informan pendukung, yakni Pasien TBC. Peneliti mengambil data secara daring melalui Zoom Meeting. Hasil penelitian bahwa pelaksanaan program DOTS di tengah pandemi Covid-19 dilaksanakan dengan menerapkan protokol kesehatan, diantaranya wajib memakai masker dua rangkap dan mencuci tangan pakai sabun. Sumber daya PMO dan petugas puskesmas yang berdedikasi memiliki peran penting dalam upaya penyembuhan pasien TBC. Selain itu, ketersediaan anggaran, sarana, dan prasarana yang cukup dapat menunjang keberlangsungan program agar efektif. Kegiatan utama yang masih rutin diadakan yakni pengobatan TBC melalui pemberian Obat Anti Tuberkulosis yang tidak pernah kurang. Terdapat beberapa kendala dalam program DOTS, antara lain jumlah sumber daya kader kesehatan yang sedikit, kurang tersedianya Tes Cepat Molekuler, dan kurang mendukungnya ruangan pasien TBC. Beberapa kegiatan utama di Puskesmas selama pandemi mengalami penurunan jumlah kegiatan, diantaranya investigasi kontak, skrining, penyuluhan, serta pelatihan. Selain itu terdapat beberapa masalah di pelaksanaan program DOTS yang terjadi selama pandemi Covid-19, yaitu masyarakat yang cenderung individualis, kurang terbuka, dan memiliki mobilitas yang tinggi, sehingga petugas puskesmas dan kader kesehatan seringkali kesulitan dalam melakukan pemantauan terkait dengan investigasi kontak dan pengobatan pasien TBC. Dampaknya, cakupan pengobatan TBC tidak mencapai target, yakni sebesar 71,87% berdasarkan Renstra Puskesmas Depok Jaya Tahun 2021—2026. Hasil penelitian menyarankan untuk Puskesmas dapat memberikan pelatihan kepada kader kesehatan terkait dengan penyikapan investigasi kontak dan edukasi penyakit TBC yang baik kepada masyarakat disesuaikan dengan kondisi pandemi Covid-19, memberikan pelatihan kepada PMO terkait memotivasi pasien TBC dalam minum obat secara teratur dan pemeriksaan cek dahak secara rutin, serta perlu melengkapi sarana dan prasarana yang mendukung terkait kebutuhan program DOTS.
TB is still a global health problem, even in Indonesia. The government has implemented the DOTS program to reduce morbidity and mortality due to tuberculosis, but this figure has not yet reached the target. During the Covid-19 pandemic, the DOTS program will continue to be held with adjustments to input and process management. The purpose of this study is to describe the implementation of the DOTS program during the Covid-19 pandemic in the Depok Jaya Health Center work area. This research uses a qualitative approach with a case study design. Data collection technique is in-depth interview with the main informants are the person in charge of the DOTS Program, the doctor in charge of the DOTS Program, the head of the cadre, and the medical supervisors, while the supporting informants are the TB patients. Researchers took data online through Zoom Meeting. The results showed that the DOTS program in the mindst of the Covid-19 pandemic was carried out by implementing health protocols, including the obligation to wear two masks and wash hands with soap. Medication supervisor and health center officer resources have an important role in efforts to cure TB patients. In addition, the availability of sufficient budget, facilities, and infrastructure can support the sustainability of the program to be effective. The main activity that is still routinely held is TB treatment through the provision of Anti Tuberculosis Drugs which is never lacking. There are several obstacles in the DOTS program, including the small number of health cadre resources, the lack of availability of Molecular Rapid Tests, and the lack of support for TBC patient rooms. Several main activities at the Health Center during the pandemic experienced a decrease in the number of activities, including contact investigation, screening, counselling, and training. In addition, there are several problems in the implementation of the DOTS program that occurred during the Covid-19 pandemic. People who tend to be individualistic, less open, and have high mobility, so that health center officers and health cadres often find it difficult to carry out monitoring related to contact investigations and patient treatment. As a result, TB treatment coverage did not reach the target, which is 71,87% based on the Depok Jaya Health Center Strategic Plan 2021—2026. The results of the study suggest that the Puskesmas can provide training to health cadres related to the attitude of contact investigations and TB education to the communities adapted to the Covid-19 pandemic conditions, provide training to medication supervisors related to motivating TB patients to take medication regularly and check sputum regularly, and complete supporting facilities and infrastructure related to the needs of the DOTS program. |
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