Journal of Health Research · Published 2025-08-04 · DOI 10.56808/2586-940x.1148
<p><strong>Background</strong>: The Multidrug-Resistant-Tuberculosis (MDR-TB) Cascade of Care includes MDR-TB treatments from suspicion to completion. Implementation gaps can lower treatment success. This study aimed to identify gap causes and opportunities to improve MDR-TB treatment in North Maluku, Indonesia</p> <p><strong>Methods: </strong>To identify gaps, we conducted in-depth interviews and focus group discussions with health workers at <em>Puskesmas</em> (Indonesian government's primary healthcare centers) and hospitals, MDR-TB patients, and patients’ families. Thematic analysis was conducted using the Consolidated Framework for Implementation Research (CFIR) for health workersand the health belief model (HBM) approach for patients and their families.</p> <p><strong>Result</strong><strong>s</strong><strong>: </strong>Significant gaps were found in all MDR-TB services in North Maluku, especially in health facility services. The gaps occurred due to the absence of Standard Operating Procedures (SOPs) and technical guidelines, discrepancy between these guidelines with MDR-TB services at <em>Puskesmas</em>, limited operational funds, and management teams. Other barriers included a lack of TB knowledge among health workers, errors in filling out the TB information system, stigma towards MDR-TB patients, limited health workers for home services, and assignment of officers without training. Patients and their families faced barriers, including lack of knowledge about MDR-TB, use of traditional medicine, belief in magic, delay in seeking health services, and complaints about hospital service times.</p> <p><strong>Conclusions:</strong> Improvements should focus on increasing MDR-TB knowledge among health workers and community members, improving management of MDR-TB services, and stregnthening communication and coordination between <em>Puskesma</em>s and hospitals to manage MDR-TB effectively.</p> <p><strong>Keywords</strong>: Cascade of Care, MDR-TB, Health barrier, Healthcare gaps, Patients perception</p>
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