‘Diabetes is a gift from god’ a qualitative study coping with diabetes distress by Indonesian outpatients

Quality of Life Research - More than two-thirds of patients diagnosed with type 2 diabetes mellitus (T2DM) in Indonesia encounter medical-related problems connected to routine self-management of...     

Improving knowledge,acceptance, and utilization of female condoms among sex workers through a peer education: a mixed methods study in Surakarta Municipality,Central Java Province,Indonesia

Abstract

Female sex workers (FSW) are high-risk for HIV infection. The authors conducted a quasi-experimental study by providing peer education on 110 FSWs, and routine HIV education on 120 controls, in Surakarta Indonesia. An additional qualitative study was performed to explain the contextual factors contributing to the effectiveness of peer education. The difference in difference approach showed that peer education improved knowledge, acceptance, and utilization of female condom. The improvements were related to the clients’ perceptions, access, and available interactive communication with the peer educator. The peer education program should be enhanced to support the prevention of HIV/AIDS.     

Life of a partnership: the process of collaboration between the National Tuberculosis Program and the hospitals in Yogyakarta, Indonesia

Public-private partnerships (PPP) for improving the health of populations are currently attracting attention in many countries with limited resources. The Public-Private Mix for Tuberculosis Control is an example of an internationally supported PPP that aims to engage all providers, including hospitals, to implement standardized diagnosis and treatment. This paper explores mainly the local actors' views and experiences of the process of PPP in delivering TB care in hospitals in Yogyakarta Province, Indonesia. The study used a qualitative research design. By maximum variation sampling, 33 informants were purposefully selected. The informants were involved in the Public-Private Mix for Tuberculosis Control in Yogyakarta Province. Data were collected during 2008-2009 by in-depth interview and analyzed using content analysis techniques. Triangulation, reference group checking and peer debriefing were conducted to improve the trustworthiness of the data. This analysis showed that the process of partnership was dynamic. In the early phase of partnership, the National Tuberculosis Program and hospital actors perceived barriers to interaction such as low enthusiasm, lack of confidence, mistrust and inequality of relationships. The existence of an intermediary actor was important for approaching the National Tuberculosis Program and hospitals. After intensive interactions, compromises and acceptance were reached among the actors and even enabled the growth of mutual respect and feelings of programme ownership. However, the partnership faced declining interactions when faced with scarce resources and weak governance. The strategies, power and interactions between actors are important aspects of the process of collaboration. We conclude that good partnership governance is needed for the partnership to be effective and sustainable.     

Missed opportunity for standardized diagnosis and treatment among adult Tuberculosis patients in hospitals involved in Public-Private Mix for Directly Observed Treatment Short-Course strategy in Indonesia: a cross-sectional study

Background  

The engagement of hospitals in Public-Private Mix (PPM) for Directly Observed Treatment Short-Course (DOTS) strategy has increased rapidly internationally - including in Indonesia. In view of the rapid global scaling-up of hospital engagement, we aimed to estimate the proportion of outpatient adult Tuberculosis patients who received standardized diagnosis and treatment at outpatients units of hospitals involved in the PPM-DOTS strategy.     

The Incremental Cost-Effectiveness of Engaging Private Practitioners to Refer Tuberculosis Suspects to DOTS Services in Jogjakarta,Indonesia

We aimed to evaluate the incremental cost-effectiveness of engaging private practitioners (PPs) to refer tuberculosis (TB) suspects to public health centers in Jogjakarta, Indonesia. Effectiveness was assessed for TB suspects notified between May 2004 and April 2005. Private practitioners referred 1,064 TB suspects, of which 57.5% failed to reach a health center. The smear-positive rate among patients reaching a health center was 61.8%. Two hundred eighty (280) out of a total of 1,306 (21.4%) new smear-positive cases were enrolled through the PPs strategy. The incremental cost-effectiveness ratio per smear-positive case successfully treated for the PPs strategy was US$351.66 (95% CI 322.84–601.33). On the basis of an acceptability curve using the National TB control program''s willingness-to-pay threshold (US$448.61), we estimate the probability that the PPs strategy is cost-effective at 66.8%. The strategy of engaging PPs was incrementally cost-effective, although under specific conditions, most importantly a well-functioning public directly observed treatment, short-course (DOTS) program.