ArticleFrontiers in health services2025
Perceived barriers to management of patients with diabetes mellitus and hypertension in primary care centers in Indonesia.
Article in Frontiers in health services, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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4 authors.
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Abstract
Objectives: This study aimed to explore provider knowledge, barriers, and opportunities for improving chronic disease management in Indonesian primary health care. Methods: A descriptive cross-sectional mixed methods study was conducted from December 1, 2022 to March 31, 2023 across 14 primary care centers in Jakarta. Multidisciplinary healthcare providers responsible in hypertension and diabetes mellitus (DM) care were involved. Data were collected using a semi-structured, interviewer-administered questionnaire consisting of both closed- and open-ended questions, structured across five domains: referral system knowledge, referral pathway implementation, hypertension management knowledge, DM management knowledge, and delivery of chronic disease care. Quantitative data were complemented with qualitative responses to provide contextual insight. Results: A total of 59 healthcare providers participated in the study, the majority of whom were female (89.8%). Participants included physicians (42.4%), nurses (35.6%), and midwives (10.2%). Most participants (71.4%) had over three years of practice. Notable knowledge gaps were identified in referral practices, diagnostic criteria, and monitoring protocols. Referrals were often delayed until complications occurred. Implementation of the national chronic disease (PROLANIS) program was suboptimal, particularly in patient selection and defining outcome targets. Screening for kidney complications was limited and medication availability was restricted. Poor adherence to national guidelines, short consultation times, and staffing shortages further hindered care and education efforts. Three major barriers-patient-related, provider-related, and structural-were identified. Conclusions: Improving chronic disease care in primary settings requires addressing provider knowledge gaps, strengthening referral systems, and enhancing PROLANIS implementation through targeted training and resource allocation.
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