Funded by Duke-NUS Global Health Institute, Dr. Qian Long led Duke Kunshan Health Policy and System team collaborated with researchers of University of Indonesia to investigate a model of integrated care for co-management of tuberculosis (TB) and diabetes mellitus (DM) in the primary healthcare setting in Jakarta, Indonesia.

The study found improvement of DM screening and case detection among TB patients after the introduction of TB-DM co-management program. However, the program implementation remains sub-optimal, especially in the coordinated efforts of TB and DM control. The research team engaged the decision-makers for TB control at the regional and national level in Indonesia and discussed the key findings with them. Researchers proposed to strengthen policy dialogue and multi-sector cooperation for improving the performance of TB and DM co-management in Indonesia.

Through a combination of quantitative and qualitative methods, the research team preliminarily identified the four main forces influencing COEN, including two external dimensions of governmental policies and social services and two internal dimensions of physical resources and public services. The COEN scale includes five dimensions of community efficacy that influence residents’ health and NCD management, including community physical environment, NCD behavioral risk factors, mental health and social relationships, community health management, and community organization and activities. This study innovatively established the quantifiable concept of community efficacy by introducing the theory of community empowerment, and designed and validated its evaluation system. The research team will continue to promote the adoption of the COEN evaluation system in more communities and evaluate the pathways through which community factors influence NCD management. This study is expected to provide theoretical support and new tools for strengthening NCD control at the community level.