Referring to Global Tuberculosis Report data (WHO 2023), Indonesia is the second largest contributor to the burden of Tuberculosis (TB) in the world after India. In 2022, it is estimated that around 144.000 deaths due to TB and as many as 969.000 new TB cases in Indonesia, 25 percent of which are undetected and unreported. Meanwhile, of the 75 percent of cases found, 24 percent did not complete treatment.
In an effort to overcome this, the government initiated an innovation through a TB program financing scheme that aims to change the behavior of Primary Health Facilities (FKTP) in finding, reporting, and treating TB until it is resolved.
The Center for Health Financing and Decentralization Policy, Directorate General of Infectious Disease Prevention with support from BPJS Kesehatan and development partners (USAID and World Bank) conducted a trial of Tuberculosis Program Financing Innovation at FKTP in 6 cities including: Medan City, North Jakarta City, Bogor City, Semarang City, Surabaya City, and Denpasar City. The official trial began in July 2023 and will end in June 2024.
The results of the Tuberculosis (TB) financing innovation trial showed positive results. This was revealed by Tiffany Tiara Pakasi, Head of the Tuberculosis Working Team, Directorate General of Prevention and Control of Infectious Diseases, Ministry of Health, at the Coordination Meeting and Dissemination of the Results of the Tuberculosis Program Financing Innovation Trial at Primary Health Facilities (FKTP) held at the JS Luwansa Hotel (4/11).
"There was an increase in notification (discovery and reporting) of TB patients in the trial FKTP, namely by 5 percent in the Government FKTP and 95 percent in the private FKTP when compared to the intervention period in the previous year. There was also an increase in the trial FKTP that carried out notifications by 15 percent," said the woman who is usually called Tiara.
"Another positive result, in the city of Bogor, the city of Semarang and the city of Surabaya, referrals for SO (Drug Sensitive) TB without complications have decreased. In addition, easy access to chest x-rays to confirm the diagnosis of suspected TB with negative Molecular Rapid Test (TCM) results at FKTP," Tiara continued.
Meanwhile, at the same time in the panel session, Ratu Martiningsih, Head of the JKN Policy Working Team at FKTP, Center for Health Financing and Decentralization Policy, Health Development Policy Agency (BKPK)
provide recommendations from the challenges faced at the trial stage.
"There needs to be regulatory certainty in the provision of TB program services to ensure access to quality and sustainable service financing. We also see that X-ray examinations will be more optimal if there is a separate financing scheme," said Marti.
"In addition, there needs to be incentives to encourage FKTP to complete treatment for TB patients comprehensively and also no less important is simultaneous assistance for private FKTP to increase the treatment success rate for TB treatment," he continued.
The new government in the era of President Prabowo Subianto through the 100-day work program (Quick Wins Program) is committed to continuing the acceleration of the completion of TB disease through innovative efforts in financing tuberculosis. Tiara said that the results of this trial will not stop and will be continued on a national scale.
"Our efforts are not finished, especially since TB is included in the best results program or Quick win from President Prabowo for 2025, and one of the things that will be used as a quick win is financial support to implement or expand TB financing innovations that have been implemented in 6 cities. The short-term program is quick win TB and the long-term elimination of TB for a healthier Indonesia," he concluded. (Ahdiyat Firmana)
