Implementation the triple elimination program in Cilacap Regency, Indonesia: A sequential exploratory mixed- method study of supporting and hindering factors

Abstract

Background: Sexually transmitted infections, HIV, and viral hepatitis contribute substantially to global morbidity and mortality, causing approximately 2.3 million deaths annually. Integrated screening for HIV, syphilis, and hepatitis B is crucial because these infections share similar transmission routes and pose significant risks of mother- to-child transmission. In the absence of intervention, the transmission risk ranges from 20–45% for HIV, 69–80% for syphilis, and over 90% for hepatitis B. Indonesia introduced the Prevention of Mother-to-Child Transmission (PMTCT) program in 2007 and subsequently adopted the Triple Elimination strategy.The risk of transmission from mother to child for HIV/AIDS is 20%-45%, for Syphilis is 69-80%, and for Hepatitis B is more than 90%. The transmission of these three diseases occurs thru sexual contact and blood.

Objectives ; this study evaluated the implementation of the Triple Elimination program in Cilacap Regency, Indonesia, and identified factors supporting and hindering its implementation. To evaluate the implementation of the Triple Elimination program in Cilacap Regency.

Methods: Actually, the study closely resembles a sequential explanatory mixed- methods design because the quantitative phase is conducted first, followed by interviews that help explain the quantitative findings. Quantitative study as the initial phase, followed by qualitative study. Data analysis in the quantitative research is conducted through descriptive analysis, while qualitative research employs thematic analysis.

Results: The highest coverage of hepatitis screening was 88.05%, the lowest was 32.34%, with an average coverage of 61.85%, and an average of 0.59% reactive cases. For HIV screening, the coverage was 88.05%, 23,15%, 59.81%, and 0. For syphilis screening, the coverage was 88.05%, 23,07%, 59.81%, and 0.06%. Supporting factors for program implementation include government programs, innovative coverage improvement programs, and programs integrated with ANC.

Conclusions: The implementation of the triple elimination program in Cilacap district has been carried out, but it still needs to be improved.