Judul: Health communication in the treatment of disease among the poor
Abstrak: World Health Organization (WHO) data shows that the condition of Indonesian public health is still poor. Indonesia sits in the fourth among countries in the world with related TB cases after India, China, and South Africa (WHO 2012). Prevalence of all TB cases are estimated of 680,000 and 450,000 new cases per year. The number of death caused by TB is estimated 65,000 per year (WHO 2012). To overcome this problem, since 1995 Indonesia has implemented Directly Observed Treatment Short course (DOTS) as a method of TB treatment recommended by the WHO and various agencies involved in a movement known as "STOP TB Partnership" (Kemenkes 2011). DOTS method is not only implemented through clinical approach (self medication or in the hospital), but also community-based approaches, especially among the poor with high prevalence of TB. The role of communication intervention becomes very important in TB treatment, so the demands on the development of health communication theory are also higher. Previously, health communication approach emphasized the importance of delivering information to the notion that people's reluctance to seek treatment was caused by lacking of knowledge about TB disease problem is known as transfer information approach or biomedical approach. Later, multi-level approach is needed to cope with the complexity of such vigorous movement of "Stop TB Partnership". This study used the theory of ACMS (McKee 1992), a multitrack model (Tufte and Mefalopulos 2009) to analyze structural and social issues and Health Believe Model (Rosenstock et al. 1988) to explain the behavior of the patient-level health . According to McKee (1999), the ACMS concept consists of three communication interventions namely advocacy, social mobilization, and program communication. Each of intervention works in different level but is related one another. Advocacy and social mobilization interventions are aimed to address the problems and obstacles in the development of social and structural level communication while at the level of individual programs Advocacy is intended to mobilize political commitment while social mobilization is intended to foster Partnerships in order to mobilize resources and services. Furthermore, social barriers can be overcome by executing structural and communication programs aimed at changing behavior. Research was conducted in May to December 2012. The research used qualitative approach with case by case study method of communication programs Communication and Social Mobilization Advocacy (AKMS) TB Control Program in the poor region by Community TB Care 'Aisyiyah KPT West Jakarta in Kelurahan Kalianyar, Tambora, West Jakarta. A total of 18 informants as a source of data, was obtained by the snowball technique. They knew and had experiences the activities of the Community TB Care Program 'Aisyiyah KPT West Jakarta. They represented people from different backgrounds namely diverse communities, community leaders, religious leaders, community volunteers, health workers, Drug Drinking Companion (PMO) and TB patients who were subjected to the Community TB Care 'Aisyiyah. Six of the informants represented patients based on their severity level, marital status, occupation, education level and age. Researcher collected data, especially with in-depth interviews and observations on the informants who were involved in the cases studied. Triangulation was implemented by checking the data that obtained
Keyword: health communication, participatory communication, ACMS, community-based interventions, tubercolusis