TY - JOUR
T1 - The readiness of public primary health care (PUSKESMAS) for cardiovascular services in Makasar city, Indonesia
AU - Arsyad, Dian Sidik
AU - Hamsyah, Esliana Fitrida
AU - Qalby, Nurul
AU - Qanitha, Andriany
AU - Westerink, Jan
AU - Cramer, Maarten J.
AU - Visseren, Frank L. J.
AU - Doevendans, Pieter A.
AU - Ansariadi, Ansariadi
N1 - Funding Information:
The authors are extremely grateful to the patients and their families. The authors would also like to acknowledge ChemAxon Ltd. ( www.chemaxon.com ) and The Cambridge Crystallographic Data Centre ( https://www.ccdc.cam.ac.uk ) for their respective licensing agreements. This study was supported by the Haya Linde Memorial Fund, Team Evan Schumacher, and the Phyllis Cohen Fund for Bile Duct Cancer Research. LY3410738 compound and funding for the in vitro studies were provided by Loxo at Lilly. The work was also supported by grants from the National Institutes of Health (P50 CA127003 and 5R01CA227640-03). J.M.C. is also supported by the Lustgarten Foundation, Stand Up To Cancer, and the Grateful Foundation. B.M.W. is also supported by the Hale Family Center for Pancreatic Cancer Research, Lustgarten Foundation Dedicated Laboratory program, NIH/NCI U01 CA210171, NIH/NCI P50 CA127003, Stand Up to Cancer, and Pancreatic Cancer Action Network.
Funding Information:
The authors would like to thank the City Health Office of Makassar for their permission to conduct the study and all informants involved in the data collection.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Backgrounds: The increasing burden of cardiovascular disease (CVD) has become a major challenge globally, including in Indonesia. Understanding the readiness of primary health care facilities is necessary to confront the challenge of providing access to quality CVD health care services. Our study aimed to provide information regarding readiness to deliver CVD health services in public primary health care namely Puskesmas. Methods: The study questionnaire was adapted from the World Health Organization (WHO) Service Availability and Readiness Assessment (SARA), modified based on the package of essentials for non-communicable disease (PEN) and the Indonesian Ministry of health regulation. Data were collected from all Puskesmas facilities (N = 47) located in Makassar city. We analysed relevant data following the WHO-SARA manual to assess the readiness of Puskesmas to deliver CVD services. Human resources, diagnostic capacity, supporting equipment, essential medication, infrastructure and guidelines, and ambulatory services domain were assessed based on the availability of each tracer item in a particular domain. The mean domain score was calculated based on the availability of tracer items within each domain. Furthermore, the means of all domains’ scores are expressed as an overall readiness index. Higher scores indicate greater readiness of Puskesmas to deliver CVD-related health care. Results: Puskesmas delivers health promotion, disease prevention, and prompt diagnosis for cardiovascular-related diseases, including hypertension, diabetes, coronary heart disease (CHD), and stroke. Meanwhile, basic treatments were observed in the majority of the Puskesmas. Long-term care for hypertension and diabetes patients and rehabilitation for CHD and stroke were only observed in a few Puskesmas. The readiness score of Puskesmas to deliver CVD health care ranged from 60 to 86 for. Furthermore, there were 11 Puskesmas (23.4%) with a score below 75, indicating a sub-optimal readiness for delivering CVD health services. A shortage of essential medicines and a low capacity for diagnostic testing were the most noticeable shortcomings leading to suboptimal readiness for high-quality CVD health services. Conclusion: Close cooperation with the government and other related stakeholders is required to tackle the identified shortcomings, especially the continuous monitoring of adequate supplies of medicines and diagnostic tools to achieve better CVD care for patients in Indonesia.
AB - Backgrounds: The increasing burden of cardiovascular disease (CVD) has become a major challenge globally, including in Indonesia. Understanding the readiness of primary health care facilities is necessary to confront the challenge of providing access to quality CVD health care services. Our study aimed to provide information regarding readiness to deliver CVD health services in public primary health care namely Puskesmas. Methods: The study questionnaire was adapted from the World Health Organization (WHO) Service Availability and Readiness Assessment (SARA), modified based on the package of essentials for non-communicable disease (PEN) and the Indonesian Ministry of health regulation. Data were collected from all Puskesmas facilities (N = 47) located in Makassar city. We analysed relevant data following the WHO-SARA manual to assess the readiness of Puskesmas to deliver CVD services. Human resources, diagnostic capacity, supporting equipment, essential medication, infrastructure and guidelines, and ambulatory services domain were assessed based on the availability of each tracer item in a particular domain. The mean domain score was calculated based on the availability of tracer items within each domain. Furthermore, the means of all domains’ scores are expressed as an overall readiness index. Higher scores indicate greater readiness of Puskesmas to deliver CVD-related health care. Results: Puskesmas delivers health promotion, disease prevention, and prompt diagnosis for cardiovascular-related diseases, including hypertension, diabetes, coronary heart disease (CHD), and stroke. Meanwhile, basic treatments were observed in the majority of the Puskesmas. Long-term care for hypertension and diabetes patients and rehabilitation for CHD and stroke were only observed in a few Puskesmas. The readiness score of Puskesmas to deliver CVD health care ranged from 60 to 86 for. Furthermore, there were 11 Puskesmas (23.4%) with a score below 75, indicating a sub-optimal readiness for delivering CVD health services. A shortage of essential medicines and a low capacity for diagnostic testing were the most noticeable shortcomings leading to suboptimal readiness for high-quality CVD health services. Conclusion: Close cooperation with the government and other related stakeholders is required to tackle the identified shortcomings, especially the continuous monitoring of adequate supplies of medicines and diagnostic tools to achieve better CVD care for patients in Indonesia.
KW - Cardiovascular Diseases/epidemiology
KW - Diabetes Mellitus/therapy
KW - Health Facilities
KW - Health Services Accessibility
KW - Humans
KW - Hypertension
KW - Indonesia/epidemiology
KW - Primary Health Care
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85137079487&partnerID=8YFLogxK
U2 - 10.1186/s12913-022-08499-w
DO - 10.1186/s12913-022-08499-w
M3 - Article
C2 - 36050732
SN - 1472-6963
VL - 22
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 1112
ER -