Community Nurses Empowerment in Addressing Stagnation of Tuberculosis (TB) Elimination Programs in Indonesia: A Systematic Review Sukatemin Sukatemin (a)*, Ester Ester (a), Ardiansa Ardiansa (a), Mulyanti Mulyanti (b), Ramadhan Tribahari Sugiharno (a), Wibowo Hanafi Arisusanto (a)
(a) Department of Nursing, Polytechnic of Health of Jayapura, Papua, Indonesia
(b) Department of Nutrition, Polytechnic of Health of Jayapura, Papua, Indonesia
Abstract
Background: Community nurses play a pivotal role in TB care, but their empowerment^s impact on overcoming these barriers remains understudied.
Objective: This systematic review examines the influence of community nurses^ empowerment on addressing stagnation in Indonesia^s TB eradication programs, aiming to identify gaps and opportunities for intervention.
Methods: A systematic review was used with PRISMA guidelines to analyze studies (2019-2024) on community nurses^ empowerment and TB program stagnation in Indonesia, using PICOT framework (Population: Indonesian community nurses/TB programs- Intervention: empowerment strategies- Outcome: program stagnation metrics). Searches across Scopus, Google Scholar, ResearchGate, and PubMed utilized keywords: ^community nurse empowerment,^ ^tuberculosis program stagnation,^ and ^Indonesia.^ Included studies were peer-reviewed empirical works in English/Indonesian, assessed for bias using Cochrane and Newcastle-Ottawa tools. Data synthesis combined quantitative analysis with GRADE-CERQual and NVivo-assisted thematic coding of qualitative findings.
Results: The PRISMA analysis of 15 studies demonstrated that empowered community nurses improve TB detection by 27-40% and treatment success by 1.8x in LMICs (PICOT), with moderate-to-high confidence evidence (CERQual) despite some performance bias (ROB). Thematic analysis (NVivo) identified three effective empowerment mechanisms: structural support, psychological ownership, and community engagement, though implementation barriers persist in high-burden settings.
Conclusion: The structured empowerment of community nurses significantly enhances TB program outcomes in high-burden settings, and the integrating nurse-focused training, resource allocation, and policy reforms into national TB elimination strategies are recommended to address implementation gaps.
Keywords: community nurse empowerment, Indonesia, TB program stagnation, TB eradication
