Analisis Pelaksanaan Kebijakan dalam Upaya Memerangi Tuberkulosis (TB) di Kabupaten Lampung Tengah

ABSTRACT Tuberculosis (TB) remains a public health problem requiring effective and sustainable policy implementation. Central Lampung Regency has established Regent Regulation Number 27 of 2023 concerning Tuberculosis Control; however, its implementation needs to be assessed at the policy, healthcare service, and community levels. Objective to analyze policy implementation in efforts to combat TB and identify supporting and inhibiting factors in the implementation of Regent Regulation Number 27 of 2023 in Central Lampung Regency. This study employed an exploratory design with a descriptive qualitative approach. Informants were selected purposively based on their involvement, authority, experience, and knowledge of policy implementation. Data were collected through Focus Group Discussions (FGDs), in-depth interviews, and source triangulation involving policy stakeholders, Health Office program implementers, Primary Health Centers, TB cadres, and three TB patients who had recovered. Data were analyzed thematically based on George C. Edwards III's policy implementation model. Policy communication had been conducted across levels and sectors, but community communication was not yet continuous and still faced stigma and limited communication media. Resources were available, but the number, competency, and distribution of human resources, as well as cadre support, funding, and facilities, were uneven. Implementers demonstrated strong commitment, although sustainability was affected by workload and limited institutional support. The bureaucratic structure had been established and SOPs were available, but technical guidelines were not yet standardized, while monitoring and follow-up were not fully integrated. The implementation of Regent Regulation Number 27 of 2023 has been carried out but remains suboptimal. Strengthening communication, resources, institutional support, technical guidelines, coordination, and monitoring is needed. Keywords: Tuberculosis, Policy Implementation, Communication, Resources, Disposition, Bureaucratic Structure. ABSTRAK Tuberkulosis (TB) masih menjadi masalah kesehatan masyarakat yang memerlukan implementasi kebijakan secara efektif dan berkelanjutan. Kabupaten Lampung Tengah telah memiliki Peraturan Bupati Nomor 27 Tahun 2023 tentang Penanggulangan Tuberkulosis, namun pelaksanaannya perlu dikaji pada tingkat kebijakan, pelayanan kesehatan, dan masyarakat. Tujuan menganalisis pelaksanaan kebijakan dalam upaya memerangi TB serta mengidentifikasi faktor pendukung dan hambatan implementasi Peraturan Bupati Nomor 27 Tahun 2023 di Kabupaten Lampung Tengah. Penelitian menggunakan desain eksploratif dengan pendekatan deskriptif kualitatif. Informan dipilih secara purposiveberdasarkan keterlibatan, kewenangan, pengalaman, dan pengetahuan terhadap implementasi kebijakan. Data dikumpulkan melalui Focus Group Discussion (FGD), wawancara mendalam, dan triangulasi sumber pada stakeholder kebijakan, pelaksana Dinas Kesehatan, Puskesmas, kader TB, serta tiga pasien TB yang telah sembuh. Analisis data dilakukan secara tematik berdasarkan model George C. Edwards III. Komunikasi kebijakan telah berlangsung lintas jenjang dan sektor, tetapi komunikasi di masyarakat belum berkelanjutan dan masih menghadapi stigma serta keterbatasan media. Sumber daya tersedia, namun jumlah, kompetensi, distribusi SDM, dukungan kader, pembiayaan, dan sarana belum merata. Pelaksana menunjukkan komitmen kuat, tetapi keberlanjutannya dipengaruhi beban kerja dan keterbatasan dukungan. Struktur birokrasi telah terbentuk dan SOP tersedia, tetapi juknis belum seragam serta monitoring dan tindak lanjut belum terintegrasi. Implementasi Peraturan Bupati Nomor 27 Tahun 2023 telah berjalan, tetapi belum optimal sehingga diperlukan penguatan komunikasi, sumber daya, dukungan kelembagaan, juknis, koordinasi, serta monitoring. Kata Kunci: Tuberkulosis, Implementasi Kebijakan, Komunikasi, Sumber Daya, Disposisi, Struktur Birokrasi.