Indonesia is a high-burden tuberculosis (TB) country with a wide case detection gap, exacerbated by the COVID-19 pandemic. We aimed to review the epidemiology of TB in a high-endemic setting of Indonesia before and during the implementation of health system strengthening activities for TB, including during the first two years of the COVID-19 pandemic. We analysed TB program data from Mimika District, Papua, Indonesia from 2014 to 2021. Health system strengthening activities to improve the programmatic management of TB were implemented from 2017 onwards. Activities included decentralization of TB services, training and mentoring of healthcare workers, improved screening for co-morbidities, and introduction and optimisation of Xpert testing in 2018. A total of 11,803 TB cases were notified to the Mimika District Health Office over eight years (2014–21). Between 2015 and 2019, there was a 67% increase in annual case notifications, an 89% increase in bacteriologically confirmed cases and the proportion of TB cases detected in primary care increased from 26% to 46%. In 2020, coinciding with the COVID-19 pandemic, investigation of people with presumptive TB fell by 38%, but the proportion of those tested with Xpert increased. TB case notifications decreased by 19% from 1,796 in 2019 to 1,461 in 2020, but then increased by 17% to 1,716 in 2021. Routine screening for co-morbidities (HIV, diabetes) among TB patients improved over time and was not affected by the pandemic. Treatment success overall was 71% and remained relatively unchanged. Loss to follow-up and death were 18% and 3.7% respectively. Improvements in TB case finding were observed over a period in which a range of health system strengthening activities were implemented. While COVID-19 had a negative impact on the TB program in Mimika District, there are encouraging signs of recovery. Further work is needed to improve TB treatment outcomes.
The research aims to acquire a hypothesis on the implementation of academic supervision guidance in the improvement of learning integrated with primary schools. This research uses qualitative research methods. The focus of the research in this study is to analyze gaps that occur to look for the root of the problem in implementing the guidance of academic supervision in integrated learning improvement. The results of this research are the hypothesis that the motivation of supervisors in conducting learning improvement guidance for teachers affected the quality of learning improvement conducted by the teachers and the implementation of the guidance of academic supervision through a collaborative approach in elementary school can be more effective by integrating guidance through formal guidance and informal guidance by emphasizing the commitment of improvement through ongoing informal guidance.
Principals play an important role in the development and improvement of the performance of teachers and educational staff at the individual level and organizational levels. Principal leadership must be structurally integrated within the organization. This is to ensure the achievement of the vision and mission set by the school. In the current era of digitalization, school principals not only play a role in inclusive, distributive leadership, and encourage leadership capacity building within schools but also play a role as opinion leaders. This study uses a qualitative approach with exploratory research. The main focus of research is the principal of public elementary schools as opinion leaders in the disruptive era. Principals of 15 public primary schools with at least five years of experience were the subject of this study. This research was conducted between May and August 2022. The research location is in Brebes Regency, Central Java. The results of the study show that the principal as an opinion leader is tasked with introducing innovations and through persuasive or coercive actions taking policies to accelerate the use of innovations in education.
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