Effectiveness of Tuberculosis Surveillance System in Remote Areas Through A Mixed-Methods Approach: A Case Study in Kabawo District, Muna Regency
DOI:
https://doi.org/10.51601/ijhp.v6i1.506Abstract
Tuberculosis (TB) remains a public health problem, especially in remote areas with limited resources and access to health services. The effectiveness of the TB surveillance system is crucial for successful disease control. This study aimed to assess the effectiveness of the TB surveillance system in Kabawo District, Muna Regency, using a mixed-methods approach. This study employed a mixed-methods design with a concurrent triangulation strategy. Quantitative data were analyzed univariately using SPSS to assess the components of the surveillance system, while qualitative data were obtained through in-depth interviews and analyzed descriptively. The quantitative analysis showed that the availability and capacity of human resources had an average score of 3.28, the TB case reporting system 3.83, the TB treatment success process 3.52, and the availability of facilities and infrastructure 2.89. The TB case detection process had an average score of 0.87. The overall effectiveness of the TB surveillance system was categorized as effective with an average score of 0.85. Qualitative findings revealed barriers such as social stigma, trust in traditional medicine, and limited geographic access that impacted the implementation of TB surveillance. The TB surveillance system in Kabawo District is considered effective, but still requires strengthening in the aspects of active case detection, utilization of facilities and infrastructure, as well as socio-cultural and geographic access-based interventions to increase effectiveness in a sustainable manner.
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[1] Adrian, MM, Purnomo, EP, & Agustiyara. (2020). The Implementation of Government Policy: Minister of Health Regulation No. 67 of 2016 for Tuberculosis Prevention in Yogyakarta City. Indonesian Journal of Health Policy, 09(02), 83–88. https://jurnal.ugm.ac.id/jkki/article/view/55965
[2] Al kalali, FSA, Mahyoub, E., Al-Hammadi, A., Anam, L., & Khader, Y. (2021). Evaluation of the national tuberculosis surveillance system in sana'a, yemen, 2018: Observational study. JMIR Public Health and Surveillance, 7(11), 1–8. https://doi.org/10.2196/27626
[3] Alsdurf, H., Benedetti, A., Buu, T.N., Adjobimey, M., Cook, V.J., Fisher, D., Fox, G., Fregonese, F., Hadisoemarto, P., Johnston, J., Long, R., Obeng, J., Oxlade, O., Ruslami, R., Schwartzman, K., Strumpf, E., & Menzies, D. (2024). Human resource implications of expanding latent tuberculosis patient care activities. Frontiers in Medicine, 10:1265476, 1–10. https://doi.org/10.3389/fmed.2023.1265476
[4] Statistics Indonesia (BPS). (2022). Statistics Indonesia Statistical Yearbook Of Indonesia. In Badan Pusat Statistik Infdoensia. https://www.bps.go.id/publication/2020/04/29/e9011b3155d45d70823c141f/statistik-indonesia-2020.html
[5] Statistics Indonesia (BPS). (2023). Statistical Yearbook of Indonesia. In Statistics Indonesia. https://www.bps.go.id/publication/2020/04/29/e9011b3155d45d70823c141f/statistik-indonesia-2020.html
[6] Statistics Indonesia (BPS). (2025). Statistics Indonesia Statistical Yearbook Of Indonesia. Statistics Indonesia, 53, 780. https://www.bps.go.id/publication/2020/04/29/e9011b3155d45d70823c141f/statistik-indonesia-2020.html
[7] Benu, FF, Isfandiari, MA, & Pramono, E. (2024). Evaluation of the Tuberculosis Surveillance System in Blitar Regency: A Study of Systems and Attribute Approaches. Periodical Journal of Epidemiology, 12(1), 88–97. https://doi.org/10.20473/jbe.v12i12024.88
[8] Ersanti, AM, Nugroho, A., & Hidajah, AC (2016). Overview of the quality of the TB surveillance system at the Gresik District Health Office based on a systems approach and attribute assessment. Journal of Information Systems for Public Health, 1(3), 9–15. https://doi.org/10.22146/jisph.9871
[9] Faryabi, R., Raesi, R., Taghdisi Heydarian, S.M., Daneshi, S., Kermani, B., Hushmandi, K., & Barfar, E. (2024). Evaluation of the Tuberculosis Surveillance System in the Southern Region of Iran. The Open Public Health Journal, 17(1), 1–7. https://doi.org/10.2174/0118749445275993240104084831
[10] Febriani, ER, Putri, ASE, Markolinda, Y., & Masnarivan, Y. (2024). Analysis of the Recording and Reporting System of the Tuberculosis Control Program at the Padang City Community Health Center. Jurnal Kesehatan Medika Saintika, 15(2), 417–424. https://doi.org/http://dx.doi.org/10.30633/jkms.v15i2.2744
[11] Hasnanisa, N., Prasetyo, S., & Burhanudin, A. (2022). Evaluation of the Tuberculosis Surveillance System at the Banyumas Regency Health Office Based on a Systems Approach. Journal of Biostatistics, Population, and Health Informatics, 2(3). https://doi.org/10.7454/bikfokes.v2i3.1033
[12] Judijanto, L., Wibowo, GA, Karimuddin, Samsuddin, H., Patahuddin, A., Anggraeni, AF, Raharjo, & Simorangkir, FMA (2023). Research Design Qualitative and Quantitative Approaches. PT. Sonpedia Publishing Indonesia.
[13] Ministry of Health of the Republic of Indonesia. (2024). Tuberculosis Control Program Report. In Ministry of Health of the Republic of Indonesia. https://www.tbindonesia.or.id/pustaka-tbc/data-syarat-tbc/
[14] Khader, Y., Al-Rahamneh, M.J., Abu Khudair, S., Abaza, H., Al Shatnawi, A., Abuhmed, I., Saleh Abu Rumman, A., Okkah, K., Mohammed Alghoul, S., Falah Maia, I., & Satyanarayana, S. (2024). Evaluation of the National Tuberculosis Program and Tuberculosis Surveillance System, Jordan 2021. SAGE Open Medicine, 12, 1–11. https://doi.org/10.1177/20503121241241970
[15] Muamalah, Masitoh; Sa'adah, Lilis; Putri, Elsa Cornelia; Labibah, Hasna Aqila; & Maulana, J. (2025). Literature Review Study of the Implementation of Public Health Surveillance in Community Health Centers in the Java Region. Galen: Journal of Pharmaceutical and Health Sciences, 1(1), 1–22. https://doi.org/https://doi.org/10.71417
[16] Nasution, Johani Dewita; Elfira, Eqlima; and Faswita, NW (2023). Prevention of Pulmonary Tuberculosis Transmission. In Eureka Media Aksara: Purbalingga (Vol. 3, Issue 1). https://medium.com/@arifwicaksanaa/pengertian-use-case-a7e576e1b6bf
[17] Rachmad, YE, Rahman, Judijanto, L., Pudjiaarti, ES, Runtunuwu, PCH, Lestari, NE, Wulandari, D., Suhirman, L., Rahmawati, FA, Mukhlis, IR, Fatmah, Saktisyahputra, Purba, AE, NNopiah, R., Winarni, AT, Fanani, AF, & Mintarsih. (2024). Integration of Quantitative and Qualitative Methods: A Guide to Mixed Research Practices. PT. Green Pustaka Indonesia.
[18] Rahma, NA, Indira, ZN, Fauzi, H., & Lestari, UB (2024). Analysis of Pulmonary Tuberculosis Diagnosis in Inpatients in November 2023 at Banyumas Regional Hospital. Journal of Medical Records and Health Information, 5(3), 234–242. https://doi.org/10.25047/j-remi.v5i3.4718
[19] Rahmi, W., & Mitra. (2025). Implementation of Pulmonary TB Surveillance Program at Sungai Pakning Community Health Center, Bengkalis Regency in 2024. Journal of Research and Scientific Studies, 19(2), 726–735.
[20] Satav, A., Raje, D., Dani, V., Munje, R., Kumbhare, S., Zodpey, S., Shelgaonkar, M., Fernandes, G., Pinnock, H., Stagg, H.R., & Nair, H. (2025). Systematic review of barriers to and enablers of tuberculosis diagnosis, notification, and intervention for designing customized intervention packages to minimize 'missing millions' in tribal communities of India. Journal of Global Health, 15:04303. https://doi.org/10.7189/jogh.15.04303
[21] Silva, T., Aguiar, A., Gomes, A., Marques, M., Pereira, C., Rodrigues, R., Pinto, M., & Duarte, R. (2024). Delays have dangerous ends: Tuberculosis diagnosis delay in Portugal, a qualitative study. Pulmonology, 2(6), 653–658. https://doi.org/10.1016/j.pulmoe.2024.02.006
[22] Sudarmanto, E., Larasaty, ND, Rowiyani, Rahmawati, M., Sujatmiko, W., Yuniarti, R., Silvia, A., Farhan, FS, Hendrawati, TY, Wahidin, Khikmah, SN, Lusida, N., Rambe, MS, Novita, P., & Noer, KU (2025). Smart Research Design: An Integrated Approach for Researchers in the Digital Era. In Smart research design: An integrated approach for researchers in the digital era (pp. 197–209). MINHAJ PUSTAKA. https://www.researchgate.net/publication/394417940
[23] Sutriyawan, A., Jayanti, KD, Handayani, D., Arfan, I., Adnyana, IMDM, Muna, KUN El, Purnama, R. Me. I., Setiawan, DI, Handayani, D., Nuraeni, T., Fauziah, DA, Susanti, A., & Rachman, I. (2020). Public Health Surveillance. Indonesian Science Media.
[24] Uddin, L., Wahyuni, CU, & Setiawan, AY (2021). Evaluation of the Tuberculosis (TB) Surveillance System in Jember Regency Based on Surveillance System Attributes. Journal of Global Health, 4(1), 41–53. https://doi.org/10.33085/jkg.v4i1.4725
[25] WHO. (2022). Implementing the end TB Strategy: The Essentials 2022 Update. In World Health Organization. http://apps.who.int/iris
[26] World Health Organization. (2021). WHO consolidated guidelines on tuberculosis Module 2: Screening Systematic screening for tuberculosis disease. In WHO Press (p. 98).
[27] World Health Organization (WHO). (2023a). Global Tuberculosis Report. In GENEVA: World Health Organization (Issue License: CC BY-NC-SA 3.0 IGO.).
[28] World Health Organization (WHO). (2023b). Strategic Framework for Action for Strengthening Surveillance, Risk Assessment and Field Epidemiology for Health Security Threats in the WHO South-East Asia Region. http://apps.who.int/iris.%0D
[29] World Health Organization (WHO). (2024). World Health Organization Global Tuberculosis Report 2024. In GENEVA: World Health Organization.
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