Tuberculosis Control Based on Integrated Primary Healthcare at Mulyorejo Community Health Center in Surabaya

Tuberculosis (TB) remains an important public health problem requiring strengthened control at the primary health care level. This study aimed to analyze TB control problems and formulate alternative solutions based on Integrated Primary Care (ILP) principles at the Mulyorejo Community Health Center, Surabaya. A descriptive analytical design with a case study approach was used. Data were obtained from the 2024 Community Health Center Performance Assessment (PKP), TB program reports, health profiles of Surabaya City and East Java Province, discussions with the TB program officer and relevant health workers, and observations of TB control activities. Priority problems were identified using the Urgency, Seriousness, and Growth (USG) method, followed by root-cause analysis using a fishbone diagram. The coverage of TB case detection and treatment reached 50% against a program target of 90%, resulting in a 40-percentage-point gap. USG analysis identified low TB case detection and treatment coverage as the highest-priority problem, with a score of 15. Fishbone analysis identified interconnected factors, including limited human resources and workload, predominantly passive case finding, limitations in screening activities, limited community and cadre involvement, and challenges in recording and reporting. Alternative solutions included community-based TB education, the use of educational media, and strengthening community health cadre involvement in TB case finding and prevention. TB control at the Mulyorejo Community Health Center has not yet achieved the program target. An integrated approach involving active case finding, community and cadre engagement, health education, treatment adherence support, and improved use of TB program data is needed within the ILP framework.