Penguatan Kapasitas Kader Melalui Peer Group Sebagai Strategi mengurangi Stigma Pada Pasien TBC Paru Di Puskesmas Janti Kota Malang

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ABSTRAK

Permasalah kesehatan yang dihadapi Indonesia salah satunya adalah penyakit TBC, khususnya di Kota Malang. Stigma sosial yang melekat pada pasien TBC menghambat upaya pengendalian TBC Paru. Kader kesehatan di tingkat layanan primer sangat vital dan kapasitasnya sering kali terbatas, khususnya dalam menghadapi stigma sosial yang dialami pasien TBC. Kader lebih sering dibekali pelatihan medis dasar menemukan kasus baru dibandingkan keterampilan komunikasi dan strategi advokasi untuk mengurangi stigma sehingga pasien menjadi enggan melaporkan dan menunda pengobatan. Kegiatan pengabdian ini adalah untuk meningkatkan kapasitas kader kesehatan melalui pelatihan dan penguatan peer group SI Peduli TBC sebagai strategi untuk mengurangi stigma pada pasien TBC paru di wilayah kerja Puskesmas Janti Kota Malang. Persiapan dilakukan koordinasi dengan stakeholder, identifikasi kader aktif dan komunitas pendukung TBC, pembentukan tim pelaksana dan fasilitator peer group yaitu melalui Tim Si Peduli TBC Komunitas sebanyak 19 orang. Dilanjutkan mengumpulkan data kasus dan tingkat stigma. Pelaksanaan kegiatan berupa memberikan materi pelatihan meliputi pengenalan TBC dan Stigma, peran kader dalam mengurangi stigma dengan komunikasi efektif serta praktik dan perencanaan aksi Peer Group Si Peduli TBC Komunitas. Tahap terakhir evaluasi pengetahuan melalui Post-test untuk mengukur peningkatan pengetahuan kader terkait TBC dan stigma, evaluasi kualitas interaksi dalam peer group, Refleksi bersama kader terkait efektivitas strategi pengurangan stigma. Kegiatan pengabdian melibatkan 3 kelurahan yang ada di wilayah kerja puskesmas Janti Kota Malang yaitu Kelurahan Bandungrejosari, Sukun, dan Tanjungrejo. Tahap persiapan dengan koordinasi pada 15 Agustus 2025 dan 22 Agustus 2025. Pelaksanaan pelatihan pada 23-24 Agustus 2025 sekaligus sosialisasi dan pembentukan peer group Si Peduli TBC Komunitas. Luaran kegiatan berupa video edukasi dan diketahui pengukuran tingkat pengetahuan konsep TBC Paru, stigma TBC dan cara komunikasi efektif terjadi peningkatan masing-masing 63,2%, 68,4% dan 63,3%. Program Si Peduli Komunitas terbukti mampu meningkatkan pengetahuan kader, relawan, dan penyintas serta memperkuat peer group Si Peduli TBC omunitas sebagai strategi untuk mengurangi stigma pada pasien TBC paru di wilayah kerja Puskesmas Janti Kota Malang.

Kata Kunci: Tuberkulosis paru, Stigma, Kader Kesehatan, Peer Group, Si Peduli TBC Komunitas.

ABSTRACT

One of the health problems facing Indonesia is tuberculosis (TB), especially in Malang City. The social stigma attached to TB patients hampers efforts to control pulmonary TB. Health cadres at the primary care level are vital and often limited in their capacity, especially in dealing with the social stigma experienced by TB patients. Cadres are more often provided with basic medical training in identifying new cases rather than communication skills and advocacy strategies to reduce stigma, which makes patients reluctant to report and delay treatment. The purposeof this sudy is to increase the capacity of health cadres through training and strengthening the SI Peduli TBC peer group as a strategy to reduce stigma in pulmonary TB patients in the work area of the Janti Community Health Center in Malang City. Preparations were carried out in coordination with stakeholders, identification of active cadres and TB support communities, formation of an implementation team and peer group facilitator, namely the Si Peduli TBC Community Team of 19 people. This was followed by collecting data on cases and stigma levels. The implementation of the activity included providing training materials covering an introduction to TB and Stigma, the role of cadres in reducing stigma through effective communication, and practice and action planning for the Si Peduli TBC Community Peer Group. The final stage of knowledge evaluation was through a post-test to measure the increase in cadre knowledge regarding TB and stigma, evaluation of the quality of interaction in peer groups, and joint reflection with cadres regarding the effectiveness of stigma reduction strategies. The results of the community service activity involved three sub-districts within the Janti Community Health Center's work area, namely Bandungrejosari, Sukun, and Tanjungrejo. The preparation stage with coordination took place on August 15, 2025, and August 22, 2025. The training was implemented on August 23-24, 2025, along with the socialization and formation of the Si Peduli TB Community peer group. The activity outputs were educational videos and measurements of the level of knowledge of the concept of Pulmonary TB, TB stigma, and effective communication methods, which increased by 63.2%, 68.4%, and 63.3%, respectively. It can be concluded that the Si Peduli TB Community program has been proven to increase the knowledge of cadres, volunteers, and survivors and strengthen the Si Peduli TB Community peer group as a strategy to reduce stigma in pulmonary TB patients in the Janti Community Health Center's work area, Malang City. 

Keywords: Pulmonary Tuberculosis, Stigma, Health Cadres, Peer Group, Community TB Care