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Hospital DOTS and Linkage Project (HDL), Indonesia

In Asia, a significant proportion of TB cases are diagnosed and treated (often inappropriately) by private providers and in hospitals. This project brought together the National TB Program and the Indonesian Hospital Association to create a model of Public-Private Mix for DOTS Implementation in Yogyakarta province.

The model developed optimal methods of linking public health centers with private and public hospitals to increase TB case finding and diagnosis and improve case management. Six additional hospitals were trained and integrated in the DOTS system during the second half of 2005, bringing the total to 29 hospitals and chest clinics (out of a total of 34) in Yogyakarta since the beginning of the project.

At the same time, intensified training, supervision, and introduction of internal coordination meetings at the local level for community health facilities and hospitals helped to improve performance, including referrals for TB treatment. A solid Provincial DOTS Team and formation of DOTS teams in health facilities has proven to be a crucial step in hospital integration and networking.

Principal Investigator: 

Michael E. Kimerling, MD, MPH (University of Alabama, Birmingham/UAB)


Final Report (PDF format)


Irawati SR, Basri C, Arias MS, Prihatini S, Rintiswati N, Voskens J, Kimerling ME. Hospital DOTS linkage in Indonesia: a model for DOTS expansion into government and private hospitals. Inter J Tuberc Lung Dis. 2007 Jan;11(1):33-9.

Irawati SR, Arias MS, Voskens J, Kimerling ME. Establishing a hospital–health center referral network for TB patients in Yogyakarta Province, Indonesia: A model for private-public mix (PPM). Inter J Tuberc Lung Dis. 2004;8(11):S99.

Rintiswati N, Kristi I, Kimerling ME, Voskens J. Laboratory quality control system improvement in a public-private partnership in Yogyakarta Province. Inter J Tuberc Lung Dis. 2004; 8(11):S98.