Family-Based Tuberculosis Prevention Through Self-Management Education (SME) for Community Health Workers in Rural East Indonesia

Pulmonary Tuberculosis (TB) remains a significant public health concern in Indonesia, especially in East Nusa Tenggara Province. This community service program aimed to strengthen the knowledge and skills of community health workers (cadres) in delivering family-based TB prevention through a Self-Management Education (SME) approach. A pre–post descriptive design was implemented involving 35 active Integrated Service Post (ISP) health cadres in Manusak Village, Kupang Regency. The intervention included cadres training, developing and distributing educational materials (modules, posters, and leaflets), conducting structured home visits, and implementing monitoring tools. Cadres’ knowledge and skills were measured using a structured 15-item questionnaire and a skills observational checklist before and after the intervention. The results showed an increase in average knowledge scores from 57% before the intervention to 94% after the intervention. Cadres’ skills also improved markedly, with the proportion of cadres categorized as having good skills increasing from 6% at baseline to 94% after the intervention. This program demonstrates that SME is a feasible and effective approach to empowering community health cadres to deliver family-based TB prevention in rural settings. Each family affected by TB received four home visits over an eight-week period. Post-intervention observations indicated that 80% of families practiced proper cough etiquette, 72% maintained adequate household ventilation and 64% consistently wore masks when interacting with TB patients. These results reflect an improvement in household-level TB preventive behaviors. Longitudinal follow-up is recommended to assess whether cadres continue to apply SME principles consistently, and whether preventive behaviors among families are maintained over time.