Challenges in implementing Indonesia's community-based chronic disease management program (Prolanis): A scoping...

Non-communicable diseases (NCDs) pose a major public health challenge worldwide, particularly in low- and middle-income countries (LMICs) like Indonesia, driven by urbanization, lifestyle changes, and environmental risks. Challenges such as constrained healthcare resources and socio-economic disparities hinder the effectiveness of NCD prevention and management. In response, Indonesia has implemented the Community-Based Chronic Disease Management Program (Prolanis), designed to promote regular monitoring, medication adherence, lifestyle modifications, and health education through primary health centers. This scoping review aimed to identify and map the barriers to Prolanis implementation across different regions and communities in Indonesia. A comprehensive literature search was performed in Scopus, ScienceDirect, and PubMed for peer-reviewed publications between 2014 and 2024. After the screening process, 38 peer-reviewed works met the inclusion criteria and were analyzed thematically. Thematic analysis indicated five major categories of barriers, including infrastructure and staffing constraints, low coverage, participation and adherence, socioeconomic and cost barriers, cultural and health literacy barriers, and pandemic-related disruptions. Key issues included inadequate human resources, inconsistent medical supplies, geographic barriers, patient time conflicts, and a lack of perceived benefit. Additionally, socio-economic challenges such as out-of-pocket expenses and transportation costs further restricted participation. Addressing these identified barriers is critical for improving the effectiveness of Prolanis and enhancing chronic disease management in Indonesia. These findings also contribute valuable insights for the implementation of community-based NCD programs in other LMIC settings.