Community Diagnosis of Hypertension and Knowledge After Single-Session Health Education in a Peri-Urban Indonesian Primary Care Catchment: A Mixed-Methods Study

Abstract

Background: Hypertension is the leading diagnosis at many Indonesian primary health centers (Puskesmas), yet community diagnoses that guide local action rarely standardize site selection or state what their evaluations can establish.

Objective: To report a community diagnosis of hypertension in the Puskesmas Teluknaga catchment (Tangerang Regency, Banten) and the knowledge outcome of the education session that followed.

Methods: Routine Puskesmas records were combined with village population estimates to compute standardized visit ratios. A mini-survey of 30 Puskesmas visitors identified determinants, which were prioritized by non-scoring Delphi and traced by fishbone analysis. Thirty-two adult residents received one lecture with a leaflet and then a knowledge post-test. Pre-test scores were unavailable, so all paired pre/post tables consistent with the post-test were enumerated (exact McNemar tests).

Results: Desa Teluknaga contributed 124 of 491 hypertension visits (25.3%) from 14.6% of the catchment population (rate ratio versus the other six villages 1.98; 95% CI 1.60 to 2.44; p<0.001). Low community knowledge was designated the root cause. Afterwards, 26 of 32 participants scored ≥90 (81.3%; 95% CI 64.7 to 91.1). Improvement was significant under every admissible pairing only if 15 or fewer participants had scored ≥90 beforehand, and under none if 21 or more had, so knowledge change could not be identified.

Conclusion: Population standardization supported the choice of intervention village. Knowledge after the session was high, but demonstrating an educational effect, and converting knowledge into blood-pressure control, requires retained paired scores, follow-up and repeated interventions supported by community health volunteers (kader).