Strengthening Tuberculosis Preventive Treatment Through Management Functions in Primary Health Centers; Evidence From Jambi, Indonesia

Abstract

Tuberculosis (TB) remains a major primary health concern in Indonesia. Preventive treatment (TPT) is a key strategy to reduce the risk of TB disease among high risk populations. Effective program management at Primary Health Centers (Puskesmas) is essential to ensure optimal implementation of TPT. However, limited evidence is available on how management functions are applied at the frontline level in supporting TPT delivery. Objective: To assess the implementation of management functions such as planning, organizing, actuating, and controlling in TPT programs at Primary Health Centers in Jambi, Indonesia. Methods: A quantitative cross sectional study was conducted involving 60 TB program officers across 20 Primary Health Centers in Jambi. Data were collected using a structured questionnaire covering four management functions. Descriptive and bivariate analyses were performed to identify strengths and weaknesses in management implementation. Results: The study revealed that planning and organizing functions were relatively strong across most health centers, particularly in the identification of eligible TPT targets and allocation of resources. In contrast, actuating and controlling functions were less consistently implemented, leading to challenges in ensuring adherence, follow up, and monitoring of TPT completion. Key obstacles included limited human resources, insufficient supervision, and workload distribution issues. Conclusion: Management functions play a crucial role in strengthening TPT implementation at the primary care level. Interventions to improve actuating and controlling functions, including enhanced supervision, monitoring, and capacity building, are needed to optimize TPT program performance in Jambi and potentially in other similar high burden settings.