Analyzing Barriers and Strategies to Improve Health Screening Implementation for Adults and Elderly
DOI:
https://doi.org/10.37287/ijghr.v8i1.344Keywords:
adults, elderly, health screening, non-communicable diseases, primary health careAbstract
Non-communicable diseases (NCDs) such as hypertension, diabetes, and cardiovascular disease are major health problems in Indonesia, particularly among adults and the elderly. Health screening is essential for early detection, yet its implementation in primary health centers faces various challenges. This study aims to analyze barriers, supporting factors, and strategies to optimize health screening. This qualitative case study was conducted in five Puskesmas in Cilegon City, selected through purposive sampling. A total of 42 informants were involved, including Puskesmas heads, program managers, health workers, cadres, community members, and health office representatives. Data were collected using in-depth interviews, focus group discussions (FGDs), participatory observations, and document reviews. Data were analyzed thematically using Braun and Clarke’s framework, guided by the theories of Policy Implementation and the Theory of Planned Behavior (TPB). The main barriers included limited human resources, inadequate facilities, fragmented reporting systems, and low community awareness. Supporting factors were leadership commitment, active cadres, outreach innovations, integration with other services, and cross-sectoral collaboration. Optimizing health screening requires strengthening reporting systems, improving human resource capacity, cross-sectoral advocacy, and community-based approaches. Policy support, application integration, training, and local-level.
References
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211.
Baker, R., & Johnson, L. (2023). Strengthening primary health care for chronic disease prevention: Lessons from community screening programs. Global Health Action, 16(1), 219–230.
Bloom, D. E., Chen, S., & Kuhn, M. (2022). The global economic burden of noncommunicable diseases. The Lancet Public Health, 7(6), e458–e469.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
Burns, K., & Caldwell, L. (2020). Barriers to preventive health service uptake among older adults: A systematic review. Preventive Medicine Reports, 19, 101–118.
Cohen, J., & Sharma, S. (2023). Multi-sectoral partnerships in health promotion: Lessons for sustainable primary health care. International Journal of Health Policy and Management, 12(5), 550–562.
Dinas Kesehatan Kota Cilegon. (2024). Laporan capaian skrining kesehatan usia dewasa dan lanjut usia. Cilegon: Dinkes Kota Cilegon.
Fitzgerald, H., & Abbott, P. (2023). Human resource constraints and quality of care in primary health screening programs. BMC Health Services Research, 23(1), 455.
Kementerian Kesehatan RI. (2019). Laporan Riskesdas 2018. Jakarta: Badan Litbangkes.
Kementerian Kesehatan RI. (2023). Keputusan Menteri Kesehatan Republik Indonesia Nomor 2015 Tahun 2023 tentang Pedoman pelaksanaan integrasi layanan primer. Jakarta: Kemenkes RI.
Kementerian Kesehatan RI. (2024). Peraturan Menteri Kesehatan Republik Indonesia Nomor 19 Tahun 2024 tentang Pusat Kesehatan Masyarakat. Jakarta: Kemenkes RI.
Mansur, H., & Sihombing, R. (2022). Community-based strategies for non-communicable disease screening: Evidence from Indonesian primary care. Indonesian Journal of Public Health, 17(2), 101–110.
Mazmanian, D., & Sabatier, P. (1983). Implementation and public policy. Glenview, IL: Scott Foresman.
Ng, W., & Kong, A. (2024). Digital health integration for early detection of non-communicable diseases: A primary care perspective. Journal of Medical Internet Research, 26, e47562.
Nguyen, T., Pham, H., & Tran, Q. (2021). Effectiveness of community-based screening for non-communicable diseases in Southeast Asia: A systematic review. BMC Public Health, 21(1), 1825.
Perwita, D., & Rahayu, N. (2020). Utilization of e-health systems in Indonesian primary care: Challenges and opportunities. Jurnal Administrasi Kesehatan Indonesia, 8(1), 11–20.
Pramita, R., & Purnama, S. (2023). Barriers and enablers of health screening programs in Indonesia: A qualitative synthesis. Kesmas: Jurnal Kesehatan Masyarakat Nasional, 18(3), 112–121.
Sari, M., Lestari, T., & Widodo, A. (2022). Community satisfaction with Posbindu PTM services in Indonesia: A national survey. Jurnal Kesehatan Masyarakat, 18(2), 210–219.
Setiawan, I., Putri, A., & Kusuma, D. (2022). Predictors of health screening participation in Indonesian communities: Application of the theory of planned behavior. BMC Public Health, 22(1), 1458.
Sun, Y., & Zhao, L. (2021). Monitoring and evaluation in primary health care: A review of global best practices. Health Policy and Planning, 36(8), 1298–1307.
Taufiq, M., Sari, Y., & Nugroho, B. (2021). Mobile health applications for non-communicable disease screening: Opportunities and challenges in Indonesia. JMIR mHealth and uHealth, 9(12), e31522.
Wulandari, S., & Hasan, A. (2021). Cross-sectoral collaboration in health promotion: Evidence from elderly care programs. Jurnal Promosi Kesehatan Indonesia, 16(1), 1–12.
Yuliana, N., & Sutrisno, A. (2020). Barriers to hypertension screening in Indonesian primary care: A qualitative study. BMC Family Practice, 21(1), 287.
Yuliana, N., & Sutrisno, A. (2024). Evaluation of hypertension screening in primary health centers: Missed opportunities and lessons learned. International Journal of Hypertension, 2024, 1–8.
World Health Organization. (2023). Noncommunicable diseases: Key facts. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
