IT NEEDED MORE THAN JUST A SINGLE PRIMARY HEALTH CARE PREVENTION PROGRAM TO GET HYPERTENSION UNDER CONTROL IN JAMBI PROVINCE, INDONESIA

Abstract

Background: In February 2018, the Indonesian Ministry of Health’s preventative and promotional programs called Healthy Indonesia through Family Approach reported that 73.7% of people with hypertension in Jambi province were not on regular medication to control it. In support of the government’s effort to raise the number of controlled hypertensive patients (receiving and taking treatment), the national health insurance (Jaminan Kesehatan Nasional or JKN) with its Prolanis Clubs mandated club members to attend a monthly prevention program activity in which members got their blood pressure checked, informed about the use of the blood pressure charts, and prescribed their medication. This study appraised the prevention program and associated factors with the failure to control hypertension in the first half of 2019. 

Materials and Methods: This is a cross-sectional study with one hundred and eighty-five consenting JKN members aged 15-59 years, a representative sample randomly drawn from the total members of eighty-three JKN prolanis clubs in the Jambi province.  JKN’s prolanis club is a popular JKN’s prevention program to control chronic diseases, including hypertension. The data were collected by means of a structured questionnaire to collect data on members’ sociodemographic characteristics. Blood pressure measurements were taken six times in six months following the World Health Organization (WHO) guidelines. Results that conform to an average systolic blood pressure of < 140 mmHg and diastolic blood pressure of < 90 mmHg in those taking anti-hypertensive medication mean controlled hypertension.

Result: The prevalence of hypertension under control showed as low as 18% after six months of observation in six monthly prolanis gatherings.  Controlled hypertension was associated with older age groups (45-59 years) (Adjusted Odds Ratio 27.3; 95% CI 3.63 - 205.05), taking medicine regularly (Adjusted Odds Ratio 12.9; 95% CI 5.43-30.63), and being employed (Adjusted Odds Ratio 2.4; 95% CI 1.13-5.38). Gender, educational level, poverty status, knowledge about hypertension and practices of healthy behaviour did not show significant statistical correlations with controlled hypertension.

Conclusion: The findings recommend that JKN should employ more than just one intervention (prolanis) to control hypertension among members aged 15-59 years. 

Keywords: hypertension, prolanis, prevention, chronic diseases, Indonesia.