Abstrak: Pelayanan kesehatan orang terduga TB merupakan salah satu standar pelayanan minimal (SPM) bidang Kesehatan yang harus dipenuhi oleh pemerintah Kab/Kota. Puskesmas merupakan unit terdepan dalam pencapaian target kinerja SPM bidang Kesehatan. Capaian SPM TB di kota Depok tahun 2021 baru mencapai 36,17 % dan menjadi capaian terendah kedua dari 12 SPM bidang Kesehatan Kota Depok. Tujuan dari penelitian ini adalah untuk menganalisis secara mendalam aspek struktur, aspek proses peningkatan mutu dan kinerja dengan pendekatan PDSA (Plan-do-study-act) serta output dalam upaya peningkatan capaian pelayanan kesehatan orang terduga TB di Puskesmas Kota Depok Tahun 2022. Penelitian ini menggunakan pendekatan kualitatif dengan menggunakan desain studi kasus melalui wawancara mendalam kepada 31 informan, observasi lapangan dan telusur dokumen. Hasil penelitian, belum semua Puskesmas menetapkan Tim TB Dots, kurangnya tenaga yang terlatih,sarana-prasarana belum semua sesuai standar, bahan-obat belum memadai, penggunaan teknologi informasi belum optimal, komitmen pimpinan dan staf masih kurang. Pada faktor proses, kegiatan upaya peningkatan capaian SPM TB pada tahapan study belum semua Puskesmas melakukan monitoring dan evaluasi terhadap capaian SPM TB.Pada output; terjadi peningkatan capaian pelayanan orang terduga TB pada tahun 2022 dibandingkan tahun 2021, namun belum semua Puskesmas dapat mencapai target SPM TB yang ditetapkan. Kesimpulan: faktor struktur dan proses peningkatan mutu dan kinerja yang dilakukan berpengaruh terhadap keberhasilan dalam pencapaian SPM TB di Puskesmas

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The health service for people suspected of having TB is one of the minimum service standards (MSS) in the health sector that must be met by the district/city government. The Public Health Center is the leading unit in achieving the MSS performance targets in the health sector. TB MSS achievement in Depok city in 2021 only reached 36.17% and became the second lowest achievement of the 12 MSS in Depok City Health. The aim of this study was to analyze in depth aspects of the structure, aspects of the quality and performance improvement process using the PDSA (Plan-do-study-act) approach as well as outputs in an effort to increase the achievement of health services for people suspected of having TB at the Depok City Health Center in 2022. This research used a qualitative approach using a case study design through in-depth interviews with 31 informants, field observations and document searches. The results of the study, not all Public Health Centers have established TB Dots Teams, lack of trained personnel, not all facilities are up to standard, medicinal materials are not adequate, use of information technology is not optimal, leadership and staff commitment is still lacking. In terms of process factors, not all Public Health Centers have conducted monitoring and evaluation of TB MSS achievements at the study stage. On output; there has been an increase in the achievement of services for people suspected of having TB in 2022 compared to 2021, but not all Public Health Centers have reached the set TB MSS target. Conclusion: structural factors and quality and performance improvement processes carried out influence success in achieving TB MSS at the Public Health Centers

Abstrak: ABSTRAKRendahnya cakupan penemuan kasus TB di Indonesia berdampak padaberlanjutnya proses transmisi infeksi Mycobacterium Tuberculosis M.tb dimasyarakat. Pondok pesantren merupakan populasi rentan dan berisiko dengankarakteristik hunian relatif padat, sanitasi lingkungan kurang sehat. Beberapakasus TB terjadi di pondok pesantren, akibat rendahnya kesadaran santri terhadapgejala TB sehingga berdampak pada akses layanan kesehatan. Perlu upayapengendalian TB dengan melibatkan masyarakat sebagai solusi ketika pemerintahkurang memiliki kapasitas menyediakan layanan dan menjangkau penderita TB.Permasalahan yang sama terjadi di Kabupaten Garut, yaitu terbatasnya sumberdaya kesehatan untuk menjaring dan mengawasi penderita TB. Kegiatanpemberdayaan santri sebagai kader TB di pondok pesantren merupakan inovasidalam upaya menjembatani suspek dan penderita TB untuk mendapatkan akses kefasilitas kesehatan atau active case finding TB. Penelitian ini bertujuan untukmengetahui dampak positif pemberdayaan santri kader TB terhadap aksesibilitaslayanan TB di fasilitas kesehatan. Metode yang digunakan adalah metodekuantitatif dengan menggunakan desain quasi eksperimen rancangan ldquo;nonequivalent control group design rdquo;, dan metode kualitatif menggunakan wawancaramendalam. Studi ini dilakukan di enam pondok pesantren dengan jumlah sampel493 orang, masing-masing tiga pondok pesantren intervensi sampel 232 orang dantiga pondok pesantren non-intervensi jumlah sampel 236 orang.Penelitian ini membuktikan bahwa pemberdayaan santri kader TB padapondok pesantren di Kabupaten Garut memberikan pengaruh yang signifikanyaitu peningkatan proporsi aksesibilitas layanan TB di fasilitas kesehatan sebesar41.4 pada kelompok intervensi. Santri yang tinggal di pondok pesantrenintervensi berpeluang 3.9 kali lebih besar untuk mengakses layanan TB di fasilitaskesehatan dibandingkan yang tinggal di non-intervensi. Intervensi ini jugaberhasil menemukan 14 kasus TB positif di pondok pesantren dengan tingkatkeberhasilan convertion rate dan cure rate masing-masing sebesar 100 .Program ini perlu direplikasi di wilayah lain mengingat di Indonesia terdapatpondok pesantren dengan kondisi tidak jauh berbeda dengan lokasi dan kondisipenelitian ini.Kata kunci : Santri, Kader TB, akses layanan TB, pondok pesantren

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ABSTRACTThe low coverage of cases of TB in Indonesia has an impact on thecontinuation of the process of transmission of infection with Mycobacteriumtuberculosis M.tb in the community. Students in Islamic Boarding Schools arevulnerable and are at risk populations with relatively dense residentialcharacteristics and poor environmental sanitation. Some cases of TB occurred inthe boarding school due to the low knowledge TB symptoms among students.This problem, in turn, leads to low access to health care. There is a need forinvolving the community when the government lacks the capacity to provideservices and reach out to people with TB. The same problems occur in Garut,namely the limited health resources and workforce to recruit and supervise TBpatients. The empowerment of students as a cadre of TB in a boarding school is aneffort to bridge suspected TB patients to gain access to a health facility or activeTB case finding. This study aims to determine the positive impact of empoweringstudents as TB Cadre on the accessibility of TB health services. The method usedis quantitative by using a quasi experimental design non equivalent controlgroup design, and qualitative method in the form of interviews. The study wasconducted in six boarding schools with a sample size of 493 people, Theintervention group consists of three boarding schools with 232 students, while therest of the boarding schools with 236 students was chosen as the non interventiongroup.This study proves that the empowerment of students cadre of TB in theboarding school in Garut has a significant and positive impact. It is observed thatthere was an increased in the proportion of service accessibility TB in healthfacilities as much as 41.4 in the intervention group. Students who live in theintervention group were 3.9 times more likely to access TB services in healthfacilities compared to those living in non intervention. This intervention alsomanaged to find 14 positive TB cases in the boarding school with a conversionrate and cure rate of 100 . This program needs to be replicated in other regions inIndonesia, considering that there are many boarding schools with similarconditions across Indonesia.Keywords Students, TB Cadre, Access to TB service, Islamic Boarding School