Implementation of the “Semut Narsis” Educational Innovation for Reducing Tuberculosis Stigma and Improving the Community Social Productivity Index

Abstrak

Tuberculosis (TB) remains a major public health problem in Indonesia, and the stigma attached to the disease continues to be a key barrier to case finding and to the socio-economic recovery of survivors and their families. Elevated stigma tends to reduce social participation, work motivation, and the self-confidence of TB-affected families, thereby suppressing the Community Social Productivity Index (CSPI) in high-burden areas. This community engagement activity aimed to evaluate the effectiveness of the “Semut Narsis” innovation, delivered through two educational modules, “Don’t Be Afraid to Have Your Sputum Checked” and “TB Patients and Families Have the Right to Remain Productive.” A pre-experimental one-group pre-test post-test design without a control group was applied to 206 families. Stigma was measured using an Indonesian-language adaptation of the Community Perspectives on Tuberculosis scale, while social productivity was assessed with the Community Social Productivity Index (CSPI) questionnaire. At baseline, 50.85% of families (n = 104) exhibited high stigma, 41.74% (n = 86) moderate stigma, and only 9.70% (n = 16) low stigma; this pattern paralleled a low social-productivity proportion of 48.05% (n = 99). Following structured education, the proportion with high stigma fell sharply to 4.36% (n = 9), while low stigma rose to 57.28% (n = 118); concurrently, high social productivity increased from 7.28% to 42.23% (n = 87) and low social productivity declined to 11.16% (n = 23). Wilcoxon signed-rank tests confirmed statistically significant pre–post differences for both stigma (Z = −4.519, p < 0.001) and CSPI (Z = −3.109, p < 0.001). Structured education substantially reduced TB-related stigma and concurrently promoted the recovery of community social productivity, indicating that the intervention is a viable candidate for replication and integration into routine TB-control programs.