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Challenges in implementing Indonesia's community-based chronic disease management program (Prolanis): A scoping review

  • Published: 11 September 2025
  • Non-communicable diseases (NCDs) pose a major public health challenge worldwide, particularly in low- and middle-income countries (LMICs) like Indonesia, driven by urbanization, lifestyle changes, and environmental risks. Challenges such as constrained healthcare resources and socio-economic disparities hinder the effectiveness of NCD prevention and management. In response, Indonesia has implemented the Community-Based Chronic Disease Management Program (Prolanis), designed to promote regular monitoring, medication adherence, lifestyle modifications, and health education through primary health centers. This scoping review aimed to identify and map the barriers to Prolanis implementation across different regions and communities in Indonesia. A comprehensive literature search was performed in Scopus, ScienceDirect, and PubMed for peer-reviewed publications between 2014 and 2024. After the screening process, 38 peer-reviewed works met the inclusion criteria and were analyzed thematically. Thematic analysis indicated five major categories of barriers, including infrastructure and staffing constraints, low coverage, participation and adherence, socioeconomic and cost barriers, cultural and health literacy barriers, and pandemic-related disruptions. Key issues included inadequate human resources, inconsistent medical supplies, geographic barriers, patient time conflicts, and a lack of perceived benefit. Additionally, socio-economic challenges such as out-of-pocket expenses and transportation costs further restricted participation. Addressing these identified barriers is critical for improving the effectiveness of Prolanis and enhancing chronic disease management in Indonesia. These findings also contribute valuable insights for the implementation of community-based NCD programs in other LMIC settings.

    Citation: Raden M. Febriyanti, Aalbrecht Alby Irawan, Nursanti Anggriani, Yudhie Andriyana, Rizky Abdulah. Challenges in implementing Indonesia's community-based chronic disease management program (Prolanis): A scoping review[J]. AIMS Public Health, 2025, 12(3): 890-915. doi: 10.3934/publichealth.2025045

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  • Non-communicable diseases (NCDs) pose a major public health challenge worldwide, particularly in low- and middle-income countries (LMICs) like Indonesia, driven by urbanization, lifestyle changes, and environmental risks. Challenges such as constrained healthcare resources and socio-economic disparities hinder the effectiveness of NCD prevention and management. In response, Indonesia has implemented the Community-Based Chronic Disease Management Program (Prolanis), designed to promote regular monitoring, medication adherence, lifestyle modifications, and health education through primary health centers. This scoping review aimed to identify and map the barriers to Prolanis implementation across different regions and communities in Indonesia. A comprehensive literature search was performed in Scopus, ScienceDirect, and PubMed for peer-reviewed publications between 2014 and 2024. After the screening process, 38 peer-reviewed works met the inclusion criteria and were analyzed thematically. Thematic analysis indicated five major categories of barriers, including infrastructure and staffing constraints, low coverage, participation and adherence, socioeconomic and cost barriers, cultural and health literacy barriers, and pandemic-related disruptions. Key issues included inadequate human resources, inconsistent medical supplies, geographic barriers, patient time conflicts, and a lack of perceived benefit. Additionally, socio-economic challenges such as out-of-pocket expenses and transportation costs further restricted participation. Addressing these identified barriers is critical for improving the effectiveness of Prolanis and enhancing chronic disease management in Indonesia. These findings also contribute valuable insights for the implementation of community-based NCD programs in other LMIC settings.



    加载中

    Acknowledgments



    This study is funded by Universitas Padjadjaran Research Grant 2024 awarded to RMF. Authors thank the Rector of Universitas Padjadjaran for funding APC via the Directorate of Research and Community Engagement.

    Authors' contributions



    RMF and AAI contributed to the conceptualization, methodology, data curation, formal analysis and writing the original draft. NA, YA, and RA provided supervision and contributed to review and editing the final draft. All authors have read and approved the final published version of the manuscript.

    Conflict of interest



    The authors declare no potential conflicts of interest regarding the research, authorship, or publication of this manuscript.

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