STRATEGIC MANAGEMENT OF COMMUNITY EMPOWERMENT IN THE PREVENTION AND CONTROL OF TUBERCULOSIS (TB) IN PREGNANT WOMEN: POLICY REVIEW AND RECOMMENDATIONS FOR COMMUNITY-BASED PROGRAMS

Abstract

Tuberculosis (TB) remains a global health challenge, with Indonesia ranking second in the world in terms of the highest number of cases, with an estimated 969,000 cases in 2021. Despite national policies, such as Presidential Regulation No. 67/2021, targeting a 90% case detection rate, the national achievement in November 2022 was only 52%, indicating a serious gap in case detection. This study focuses on Metro City, Lampung, which presents unique challenges: although the TB cure rate is reported to be above 85%, its case detection rate was the lowest in the province during the 2011-2013 period, indicating many hidden cases. This study analyzes how strategic management can integrate community empowerment to address this detection problem, especially among pregnant women—a vulnerable group for which prevalence data in Metro City is still limited. Using literature review and policy analysis methods, this study synthesizes best practices from community empowerment models that have proven effective. The results identify the need for three strategic pillars: 1) integration of TB screening into antenatal care (ANC) services, 2) optimization of the role of cadres as the spearhead of active case finding and medication adherence monitoring (MAM), and 3) strengthening of cross-sector collaboration to address under-reporting from private facilities. These recommendations provide measurable guidance for designing effective and sustainable programs in the effort to achieve TB elimination by 2030 in Metro City.