Peningkatan Kompetensi Petugas Dalam Penanggulangan Tuberkulosis di Rumah Susun Sewa (Rusunawa) Jakarta: Hasil Penelitian Sebagai Rekomendasi Kebijakan Menuju Eliminasi TBC 2030
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Abstract
Tuberkulosis (TBC) masih menjadi masalah kesehatan masyarakat di DKI Jakarta, terutama pada populasi rentan di Rumah Susun Sewa (Rusunawa). Kepadatan hunian, mobilitas penghuni, keterbatasan akses, stigma, serta belum optimalnya skrining aktif dan investigasi kontak menjadi hambatan penemuan kasus. Penelitian ini bertujuan menganalisis pelaksanaan penemuan kasus TBC, mengidentifikasi hambatan penanggulangan, menganalisis kebutuhan dan strategi penguatan kompetensi petugas kesehatan dan kader, mengevaluasi implementasi skrining terpadu berbasis komunitas dan investigasi kontak, serta merumuskan implikasi kebijakan menuju eliminasi TBC 2030. Penelitian menggunakan pendekatan kualitatif dengan desain studi kasus eksploratif melalui wawancara mendalam, Focus Group Discussion (FGD), observasi, studi dokumentasi, dan advokasi multipihak. Informan meliputi pembuat kebijakan, petugas kesehatan, pengelola rusunawa, kader, masyarakat, dan organisasi mitra. Data dianalisis secara tematik melalui triangulasi sumber dan metode. Hasil menunjukkan penemuan kasus TBC belum optimal akibat keterbatasan sumber daya dan kompetensi, beban kerja, lemahnya investigasi kontak, karakteristik lingkungan hunian, stigma, keterbatasan akses, dan koordinasi lintas sektor. Penguatan kompetensi mencakup aspek teknis TBC, komunikasi, sosial kultural, advokasi, community outreach, dan koordinasi melalui strategi pembelajaran terintegrasi 70:20:10. Skrining terpadu berbasis komunitas di lima rusunawa memperkuat penemuan kasus dan investigasi kontak. Pemanfaatan portable X-ray berbasis artificial intelligence (AI) meningkatkan efisiensi penapisan dan pemanfaatan Tes Cepat Molekuler (TCM), dengan potensi efisiensi biaya 27-37%. Penelitian merekomendasikan penguatan penemuan kasus berbasis risiko dan lokasi, pengembangan kompetensi berkelanjutan, pemanfaatan teknologi diagnostik, dan kemitraan lintas sektor menuju eliminasi TBC di DKI Jakarta tahun 2030.
Tuberculosis (TB) remains a major public health challenge in Jakarta, particularly among vulnerable populations residing in public rental housing (Rumah Susun Sewa [Rusunawa]). High residential density, population mobility, limited access to healthcare services, stigma, and suboptimal active case finding and contact investigation continue to hinder timely TB case detection. This study aimed to analyze the implementation of TB case finding, identify barriers to TB control, assess the needs and strategies for strengthening the competencies of healthcare workers and community health cadres, evaluate the implementation of integrated community-based screening and contact investigation, and formulate policy implications toward TB elimination by 2030. A qualitative approach with an exploratory case study design was employed, incorporating in-depth interviews, Focus Group Discussions (FGDs), observations, document analysis, and multi-stakeholder advocacy. Informants included policymakers, healthcare workers, Rusunawa managers, community health cadres, residents, and partner organizations. Data were analyzed thematically through source and methodological triangulation. The findings indicate that TB case finding remains suboptimal due to limited human resources and competencies, high workloads, weak contact investigation practices, residential environmental characteristics, stigma, restricted access to healthcare, and inadequate cross-sectoral coordination. Competency strengthening should encompass technical TB knowledge, communication skills, sociocultural competence, advocacy, community outreach, and intersectoral coordination through an integrated 70:20:10 learning strategy. Integrated community-based screening implemented across five Rusunawa sites strengthened TB case finding and contact investigation. The use of artificial intelligence (AI)-enabled portable X-ray technology improved screening efficiency and the appropriate utilization of rapid molecular testing (Tes Cepat Molekuler [TCM]), with an estimated potential for cost savings of 27-37%. This study recommends strengthening risk- and location-based TB case finding, establishing continuous competency development for healthcare workers and community cadres, expanding the use of technology-enabled diagnostic approaches, and institutionalizing cross-sectoral partnerships. These strategies are critical for addressing persistent structural and operational barriers to TB detection and accelerating progress toward TB elimination in Jakarta by 2030.
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