As we all know that Covid-19 is a new respiratory disease caused by a virus, and it can be transmitted from person to person. However, a person who suffers from Covid can be more at risk when they have two lethal diseases; Tuberculosis (TB) and Diabetes Mellitus (DM). Moreover, the existence of Covid-19 has now diverted people's focuses to disease treatment. To date, some obstructions in the health concerns still exist, such as the medical personnel, patients, and the regulation of BPJS. These obstructions caused the delay in the two-way screening process in the average number of 16.5 percent and remained to increase. Additionally, the number of cases discovered for Tuberculosis and Diabetes mellitus is still low in the amount of 5.8 percent. Meanwhile, completing the proportion of TB treatment was 100 percent, and the completion of DM patients with controlled blood sugar was 85.7 percent.
According to WHO, Indonesia is the second country with the largest number of patients for TB in 2020. In 2019, the Health Profile of Indonesia recorded 543,874 cases found 2019. This number was quite high, and therefore, there should be more screening to discover more unexposed cases. Meanwhile, for Diabetes Mellitus, Indonesia is the seventh country with the largest DM patients in the age range between 20 to 79. Based on Basic Health Research (Riskersdas), there was an increase of ten percent during ten years, 5.9 percent in 2006 to 6.9 percent in 2016. Some DM patients unconsciously realized their illness, and it was discovered when they already have the complication. There were 2.1 percent of patients discovered; meanwhile, Yogyakarta has become the province with the highest cases of 2.6 percent.
"There should be a comprehensive approach so that we could conduct screening as soon as we can, one of which is a screening for individuals at high risk," said Dr. Merita Arini, MMR., at her open examinations of doctor promotion on Monday (10/5).
Based on her research to eighteen health clinics in Yogyakarta, dr. Merita concluded that Yogyakarta was not yet collaborative in handling these cases. It has had the socialization and policies, but seeing from the structure and the process still needs improvement on the multi sector collaboration conducted in the two-way technical method: education and implementation that is also at once covering the data record and report. She took the data model through patients' perspectives and experiences, medical workers, stakeholders, and experts to ensure the proper (quality, safe) and applicable components of integrated chronic disease services.
Three health clinics have implemented the collaboration for TB-DM. However, some obstructions may cause acceptability and feasibility. Those are the Covid-19 pandemic, medical workers, and the BPJS regulation. "There were only a few support factors for TB-DM collaboration. They are aspects of community and policies, health systems, as well as communication patterns and individual characteristics of officers," she said.
She concluded that improvements are necessary for the patient's service, such as the capacity building of officers, institutionalization of collaboration to the health facilities level, including the need for advocacy to relevant stakeholders, and intensive monitoring and evaluation.
"The involvement from parties including private health facilities, hospitals, cross-sectors is highly important to increase the service collaboration and control TB-DM cases in Yogyakarta," she said.
Author: Gusti Grehenson