Improve the layout of the IVA examination room

Oct 13, 2025 by wbrum.org 12 views

Introduction

Cervical cancer is one of the most serious health problems in Indonesia, with a high incidence rate of 23.4% in Asia. As a step to mitigate this issue, the Indonesian government has developed a visual acetic acid (IVA) inspection method to detect cervical cancer early. Puskesmas Bromo Medan is one of the public health centers that has implemented the IVA program since 2014. However, the Bromo Health Center recorded the lowest IVA examination coverage of all Medan City, which is only 2.84% of the set targets. This study aims to analyze the implementation of the early detection program of cervical cancer with the IVA method at the Bromo Health Center in Medan in 2019.

Background

Cervical cancer is a significant health problem in Indonesia, with a high incidence rate of 23.4% in Asia. The Indonesian government has developed a visual acetic acid (IVA) inspection method to detect cervical cancer early. Puskesmas Bromo Medan is one of the public health centers that has implemented the IVA program since 2014. However, the Bromo Health Center recorded the lowest IVA examination coverage of all Medan City, which is only 2.84% of the set targets.

Methodology

This study used a descriptive qualitative method with in-depth interviews with nine informants, consisting of officials of the Medan City Health Office, Head of Puskesmas, IVA officers, as well as IVA and non-Pasien patients. Data were analyzed using the Miles and Huberman methods.

Results

The results of the analysis show that human resources, facilities, and funding are in good condition and adequate to support the implementation of the IVA program. However, there are some significant deficiencies. One of them is the layout of the IVA examination room which is considered inadequate and not in accordance with the patient's privacy zone. This can cause discomfort for patients, which ultimately has the potential to reduce their interest in conducting examinations.

In addition, the IVA program at the Bromo Health Center emphasizes the passive method than the active method in reaching patients. The passive method only relies on patient arrival, while active methods, such as campaigns and counseling in the community, are proven to be more effective in increasing public awareness of the importance of early detection of cervical cancer. Counseling activities to patients are also still considered not optimal, so that their contribution to the increase in IVA examination coverage is less significant.

Discussion

The results of this study show that the implementation of the IVA program at the Bromo Health Center has several limitations. The layout of the IVA examination room is inadequate and not in accordance with the patient's privacy zone, which can cause discomfort for patients. The IVA program at the Bromo Health Center also emphasizes the passive method than the active method in reaching patients, which can reduce the effectiveness of the program.

Conclusion

Based on the findings of this study, there are several recommendations to improve the implementation of the IVA program at the Bromo Health Center. First, it is recommended to improve the layout of the IVA examination room to pay more attention to patient privacy. Second, the IVA program needs to be done with a balance between active and passive methods, including an increase in adequate counseling activities to educate patients about the importance of early examination. Finally, the Medan City Health Office is expected to conduct regular field supervision and review, to ensure the implementation of the IVA program runs as expected.

Recommendations

Improve the layout of the IVA examination room: The layout of the IVA examination room is inadequate and not in accordance with the patient's privacy zone. It is recommended to improve the layout of the IVA examination room to pay more attention to patient privacy.
Balance between active and passive methods: The IVA program at the Bromo Health Center emphasizes the passive method than the active method in reaching patients. It is recommended to balance between active and passive methods, including an increase in adequate counseling activities to educate patients about the importance of early examination.
Regular field supervision and review: The Medan City Health Office is expected to conduct regular field supervision and review, to ensure the implementation of the IVA program runs as expected.

Future Research Directions

This study provides several future research directions. First, it is recommended to conduct a study on the effectiveness of the IVA program in detecting cervical cancer early. Second, it is recommended to conduct a study on the impact of the IVA program on public health. Finally, it is recommended to conduct a study on the implementation of the IVA program in other public health centers in Indonesia.

Limitations of the Study

This study has several limitations. First, the study only focused on the implementation of the IVA program at the Bromo Health Center in Medan. Second, the study only used a descriptive qualitative method. Finally, the study only analyzed the data using the Miles and Huberman methods.

Conclusion

In conclusion, this study provides several recommendations to improve the implementation of the IVA program at the Bromo Health Center. The study also provides several future research directions. The study has several limitations, but it provides valuable insights into the implementation of the IVA program in Indonesia.

References

[1] World Health Organization. (2019). Cervical Cancer.
[2] Indonesian Ministry of Health. (2019). Visual Acetic Acid (IVA) Inspection Method.
[3] Puskesmas Bromo Medan. (2019). IVA Program Report.
[4] Miles, M. B., & Huberman, A. M. (1994). Qualitative Data Analysis: An Expanded Sourcebook. Sage Publications.

Appendix

[1] Interview Schedule
[2] Data Analysis Table
[3] Conclusion Table

Q: What is the IVA method?

A: The IVA method, also known as the visual acetic acid inspection method, is a screening test used to detect cervical cancer early. It involves applying a solution of acetic acid to the cervix, which causes abnormal cells to turn white, making them easier to detect.

Q: Why is the IVA method important?

A: The IVA method is important because it can detect cervical cancer early, when it is still treatable. Cervical cancer is a leading cause of cancer deaths in women worldwide, and early detection is key to preventing these deaths.

Q: What are the limitations of the IVA method?

A: The IVA method has several limitations, including the need for a skilled healthcare provider to perform the test, the potential for false negatives, and the need for follow-up testing to confirm the results.

Q: What is the purpose of the study?

A: The purpose of the study is to analyze the implementation of the IVA program at the Bromo Health Center in Medan, Indonesia, and to identify areas for improvement.

Q: What were the findings of the study?

A: The study found that the implementation of the IVA program at the Bromo Health Center had several limitations, including inadequate facilities, insufficient funding, and a lack of awareness among patients about the importance of early detection.

Q: What are the recommendations of the study?

A: The study recommends improving the facilities and funding for the IVA program, increasing awareness among patients about the importance of early detection, and implementing a more active approach to reaching patients.

Q: What are the implications of the study?

A: The study has implications for the implementation of the IVA program in other public health centers in Indonesia, and highlights the need for a more comprehensive approach to cervical cancer screening.

Q: What are the future research directions?

A: The study suggests several future research directions, including a study on the effectiveness of the IVA program in detecting cervical cancer early, a study on the impact of the IVA program on public health, and a study on the implementation of the IVA program in other public health centers in Indonesia.

Q: What are the limitations of the study?

A: The study has several limitations, including the use of a descriptive qualitative method, the limited sample size, and the reliance on secondary data.

Q: What are the implications of the study for public health?

A: The study has implications for public health, highlighting the need for a more comprehensive approach to cervical cancer screening, and the importance of increasing awareness among patients about the importance of early detection.

Q: What are the recommendations for healthcare providers?

A: The study recommends that healthcare providers improve their facilities and funding for the IVA program, increase awareness among patients about the importance of early detection, and implement a more active approach to reaching patients.

Q: What are the recommendations for policymakers?

A: The study recommends that policymakers increase funding for the IVA program, improve the facilities and infrastructure for the program, and implement policies to increase awareness among patients about the importance of early detection.

Q: What are the recommendations for researchers?

A: The study recommends that researchers conduct further studies on the effectiveness of the IVA program in detecting cervical cancer early, the impact of the IVA program on public health, and the implementation of the IVA program in other public health centers in Indonesia.