Opportunities for improvement of community-based non-communicable disease screening practices in Indonesia: a...

Non-communicable diseases (NCDs) remain a pressing public health problem globally, including in Indonesia. Despite the importance of NCD screening, screening uptake remains low. To improve screening capacity and linkage to care, the government of Indonesia launched Posbindu, a community-based intervention focused on screening and prevention of NCDs and their risk factors, which has also been integrated into the new Integrated Primary Health Care (IPC) policy. Effective implementation of Posbindu tailored to community needs is important to ensure utilization. This paper aims to measure the satisfaction of Posbindu participants and identify areas for improvement, including potential implementation in the new IPC policy of Indonesia.

A total of 1,263 participants were recruited from three provinces in Indonesia, i.e., Central Java, East Java, and North Sumatra. A validated Quality of Care as seen through the Eyes of the Patient (QUOTE) questionnaire was used to measure satisfaction in five dimensions: (1) service availability, (2) communication and information, (3) patient-staff interaction and counselling, (4) infrastructure, and (5) professional competence. A quality impact score (QIS) was calculated to measure the satisfaction level. Chi-square tests was conducted in STATA 16.0 to analyse QIS by different sociodemographic characteristics, highlighting specific needs among subpopulations.

Most respondents were women (86.4%), aged 45-59, high school graduates, not working, and living in rural areas. The participants were generally dissatisfied with the availability of services and Posbindu's infrastructure, particularly regarding the availability and sufficiency of health workers, health screening equipment, and health information posters, as well as easy access to Posbindu. The highest QIS (3.7) was observed in the health screening availability. The stratified analysis revealed that older urban participants emphasized the need for health screening availability and healthcare worker sufficiency, whereas rural participants with lower education reported inadequate health information materials.

Satisfaction with services availability and infrastructure of Posbindu is still lacking. To improve services availability, ensuring sufficiency of health workers or cadres as well as improving infrastructure by providing health screening equipment and health education materials are important. Improving access to NCDs screening can also be conducted by integrating Posbindu into existing community-based activities.