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

Area of Science:

• Public Health
• Health Systems Research
• Global Health

Background:

• Non-communicable diseases (NCDs) are a growing global health challenge, particularly in low- and middle-income countries (LMICs).
• Indonesia faces significant hurdles in NCD prevention and management due to limited healthcare resources and socio-economic disparities.
• The Community-Based Chronic Disease Management Program (Prolanis) was established to enhance NCD care through primary health centers.

Purpose of the Study:

• To identify and map the barriers encountered during the implementation of the Prolanis program across diverse Indonesian regions.
• To provide insights for optimizing community-based NCD management strategies in Indonesia and similar LMIC contexts.

Main Methods:

• A scoping review methodology was employed to systematically identify relevant literature.
• A comprehensive search of Scopus, ScienceDirect, and PubMed databases was conducted for publications from 2014 to 2024.
• Thematic analysis was performed on 38 selected peer-reviewed articles to categorize implementation barriers.

Main Results:

• Five primary categories of barriers were identified: infrastructure/staffing, coverage/participation/adherence, socio-economic/cost, cultural/health literacy, and pandemic-related disruptions.
• Specific challenges include inadequate human resources, inconsistent supplies, geographical access issues, patient time constraints, and perceived lack of program benefits.
• Socio-economic factors like out-of-pocket expenses and transportation costs significantly limited patient engagement.

Conclusions:

• Overcoming identified barriers is essential for enhancing the effectiveness of Prolanis and improving chronic disease management outcomes in Indonesia.
• The findings offer valuable lessons for implementing and refining community-based NCD programs in other LMICs facing similar challenges.