Abstract:Since 2010, Indonesian government has initiated a chronic disease management program, Prolanis (Program Pengendalian Penyakit Kronis) targeted for diabetes and hypertension. The program is continued at the commencement of universal health coverage (UHC) in 2014. "This study aimed to report the utilization and cost of the implementation of Prolanis in Indonesia from 2014 to 2016, or two years since the commencement of Indonesian universal health coverage." Secondary data analysis was performed using publicly av… Show more
“…37 The impact of this program on population-level diabetes management and control is still unknown and coverage outside of Java is low; however, the success of a program like Prolanis will likely be dependent on the level of diabetes knowledge among Indonesia's primary care providers. 38 This analysis has several limitations that are important to consider when interpreting the findings. First, we measured provider knowledge using healthcare vignettes, which may not represent the actual quality of care that healthcare workers provide.…”
Section: Discussionmentioning
confidence: 99%
“…37 The impact of this program on population-level diabetes management and control is still unknown and coverage outside of Java is low; however, the success of a program like Prolanis will likely be dependent on the level of diabetes knowledge among Indonesia’s primary care providers. 38 …”
IntroductionIndonesia is experiencing a rapid rise in the number of people with diabetes. There is limited evidence on how well primary care providers are equipped to deal with this growing epidemic. This study aimed to determine the level of primary healthcare providers’ knowledge of diabetes, change in knowledge from 2007 to 2014/2015 and the extent to which changes in the diabetes workforce composition, geographical distribution of providers, and provider characteristics explained the change in diabetes knowledge.Research design and methodsIn 2007 and 2014/2015, a random sample of public and private primary healthcare providers who reported providing diabetes care across 13 provinces in Indonesia completed a diabetes clinical case vignette. A provider’s diabetes vignette score represents the percentage of all correct clinical actions for a hypothetical diabetes patient that were spontaneously mentioned by the provider. We used standardization and fixed-effects linear regression models to determine the extent to which changes in diabetes workforce composition, geographical distribution of providers, and provider characteristics explained any change in diabetes knowledge between survey rounds, and how knowledge varied among provinces.ResultsThe mean unadjusted vignette score decreased from 37.1% (95% CI 36.4% to 37.9%) in 2007 to 29.1% (95% CI 28.4% to 29.8%, p<0.001) in 2014/2015. Vignette scores were, on average, 6.9 (95% CI −8.2 to 5.6, p<0.001) percentage points lower in 2014/2015 than in 2007 after adjusting for provider cadre, geographical distribution, and provider experience and training. Physicians and providers with postgraduate diabetes training had the highest vignette scores.ConclusionsDiabetes knowledge among primary healthcare providers in Indonesia decreased, from an already low level, between 2007 and 2014/2015. Policies that improve preservice training, particularly at newer schools, and investment in on-the-job training in diabetes might halt and reverse the decline in diabetes knowledge among Indonesia’s primary healthcare workforce.
“…37 The impact of this program on population-level diabetes management and control is still unknown and coverage outside of Java is low; however, the success of a program like Prolanis will likely be dependent on the level of diabetes knowledge among Indonesia's primary care providers. 38 This analysis has several limitations that are important to consider when interpreting the findings. First, we measured provider knowledge using healthcare vignettes, which may not represent the actual quality of care that healthcare workers provide.…”
Section: Discussionmentioning
confidence: 99%
“…37 The impact of this program on population-level diabetes management and control is still unknown and coverage outside of Java is low; however, the success of a program like Prolanis will likely be dependent on the level of diabetes knowledge among Indonesia’s primary care providers. 38 …”
IntroductionIndonesia is experiencing a rapid rise in the number of people with diabetes. There is limited evidence on how well primary care providers are equipped to deal with this growing epidemic. This study aimed to determine the level of primary healthcare providers’ knowledge of diabetes, change in knowledge from 2007 to 2014/2015 and the extent to which changes in the diabetes workforce composition, geographical distribution of providers, and provider characteristics explained the change in diabetes knowledge.Research design and methodsIn 2007 and 2014/2015, a random sample of public and private primary healthcare providers who reported providing diabetes care across 13 provinces in Indonesia completed a diabetes clinical case vignette. A provider’s diabetes vignette score represents the percentage of all correct clinical actions for a hypothetical diabetes patient that were spontaneously mentioned by the provider. We used standardization and fixed-effects linear regression models to determine the extent to which changes in diabetes workforce composition, geographical distribution of providers, and provider characteristics explained any change in diabetes knowledge between survey rounds, and how knowledge varied among provinces.ResultsThe mean unadjusted vignette score decreased from 37.1% (95% CI 36.4% to 37.9%) in 2007 to 29.1% (95% CI 28.4% to 29.8%, p<0.001) in 2014/2015. Vignette scores were, on average, 6.9 (95% CI −8.2 to 5.6, p<0.001) percentage points lower in 2014/2015 than in 2007 after adjusting for provider cadre, geographical distribution, and provider experience and training. Physicians and providers with postgraduate diabetes training had the highest vignette scores.ConclusionsDiabetes knowledge among primary healthcare providers in Indonesia decreased, from an already low level, between 2007 and 2014/2015. Policies that improve preservice training, particularly at newer schools, and investment in on-the-job training in diabetes might halt and reverse the decline in diabetes knowledge among Indonesia’s primary healthcare workforce.
“…Therefore public awareness-raising and training for healthcare staff was instigated between 2005-2008 in two rural areas (Kediri City and Kediri Regency) to improve healthcare workers' ability to meet patients' needs. Social educators and health workers were trained and established diabetes awareness information posts in 26 districts (26,27).…”
Section: Discussionmentioning
confidence: 99%
“…The program included a variety of stakeholders involved in diabetes management and focused on prevention and increasing the capacity for diagnosis and management of diabetes. An extensive training program for doctors in the eld of diabetes was currently running as well (26,27).…”
Section: Discussionmentioning
confidence: 99%
“…To address the human resource capacity gap, awareness-raising, and educational activities for community members, the program comprised of training master level staff, nurses, educators, patients, and their relatives in diabetes management took place between 2011 and 2014. A community-based approach in the provinces of West Sumatra, Bengkulu, and Banten was developed to reduce the prevalence of NCDs and their risk factors with the main aims to provide early detection, counseling, and education for people with or at risk of developing NCDs (26,27) This analysis shows diabetes-related diagnoses patients with low education in rural areas have the highest risk for CMD which could hamper their adherence to diabetes treatment regimens. This result implies that tailoring mental health services in diabetes as well as other NCD treatment from the early stages should be a high priority, especially in the outer Jawa Bali region.…”
Background Depression is one of the major comorbid conditions associated with chronic diseases like diabetes. There are a several studies of diabetes and CMD including diabetes depression (DD) and diabetes-related distress (DRD) in Indonesia mostly performed in health facilities. To the authors’ knowledge, there are yet to be studies exploring the risk of diabetes comorbid on CMD. This analysis is the first to explore urban-rural and educational level differences of diabetes patients risk for also having comorbid CMD using the latest Indonesian community health survey.MethodsThis is secondary cross-sectional data analyzed using the latest 2018 Indonesian community health survey Riskesdas comprised of 240703 respondents aged 30 or higher. CMD data based on face to face interviews using the SRQ-20. Diabetic conditions and other chronic diseases based on doctor's diagnosis were reported by the respondents in the interview. Descriptive bivariate and multivariate logistic regression analyses were carried out for identify risk profiles on Common mental disorders (CMD) for diabetes patients by geographic and social factors.ResultsThree-point three percent of the sample had diabetes-related diagnoses, and almost 20% of diabetes patients had CMD. The analysis identifies different risk of CMD among diabetes patients according to place of residence and education. The highest risk of diabetes without complications diagnosed for developing a CMD is among poorer educated rural patients, while the lowest was among poorer educated urbanites. Being more highly educated in both rural and urban settings shared almost the same risk. Higher educational attainment in a rural setting is most protective – these diabetes patients have the lowest risk of developing a CMDConclusionsThe differing risk profiles of CMD among diabetic patients underpin the importance of tailoring mental health service delivery among diabetics in different geographic settings for patients of differing educational backgrounds.
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