BEBAN GANDA PENYAKIT DI PUSKESMAS PERKOTAAN: TINJAUAN NARATIF DAN PELUANG PROMOSI KESEHATAN TERPADU
DOI:
https://doi.org/10.51574/illea.v2i3.6031Keywords:
Beban Ganda Penyakit, Integrasi Pelayanan Primer, Penyakit Menular, Penyakit Tidak Menular, Promosi KesehatanAbstract
Puskesmas perkotaan kini menghadapi dua beban sekaligus, yaitu penyakit menular seperti diare dan demam berdarah dengue (DBD) yang belum tuntas, serta penyakit tidak menular (PTM) seperti hipertensi dan diabetes melitus (DM) yang terus bertambah. Kedua beban ini masih sering ditangani melalui program yang berjalan sendiri-sendiri. Tinjauan ini bertujuan merangkum bukti tentang besarnya beban ganda penyakit di Indonesia, keterkaitan antara kedua kelompok penyakit, tantangan layanan primer, serta peluang promosi kesehatan yang menyasar keduanya. Tinjauan naratif ini menelusuri artikel ilmiah dan dokumen resmi terbitan 2016–2026 melalui PubMed dan portal jurnal nasional, lalu menyintesisnya secara tematik. Sebagai ilustrasi, disajikan pula data sekunder lima program dari empat puskesmas di Kota Makassar. Hasil tinjauan menunjukkan bahwa Indonesia menghadapi beban ganda yang nyata: faktor risiko utama kehilangan tahun sehat kini didominasi tekanan darah tinggi, risiko pola makan, dan gula darah tinggi, sementara diare dan DBD tetap menjadi penyumbang beban. Data puskesmas memperlihatkan pola serupa, dengan ribuan penderita hipertensi dan DM lansia berdampingan dengan kasus diare dan DBD yang naik-turun. Kedua kelompok penyakit juga saling memperberat, misalnya DM meningkatkan peluang DBD berat. Program yang terpisah, pencatatan yang terfragmentasi, dan jangkauan Posbindu yang belum merata menjadi tantangan utama. Integrasi layanan primer berbasis klaster membuka peluang promosi kesehatan terpadu melalui rumah tangga sehat, pemberantasan sarang nyamuk yang dikemas sebagai aktivitas fisik, Posbindu lintas klaster, tatanan sekolah dan tempat kerja, serta penguatan kader.
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