Factors Affecting the Implementation of the GERMAS Program: Analysis of Social Support and Community Empowerment in Langkat Regency

Abstract

Indonesia still faces the double burden of both noncommunicable and communicable diseases. The government has launched a movement for a healthy living program (Gerakan Masyarakat Hidup Sehat, or GERMAS) to reduce morbidity, mortality, and healthcare costs caused by these two types of diseases, but its implementation remains challenging. This could be due to various factors, both internal and external. The aim of this study is to analyze the effect of social support and community empowerment on the implementation of GERMAS. This cross-sectional study was conducted in Langkat Regency, one of the regencies in North Sumatra Province, Indonesia, where the burden of noncommunicable diseases has increased. The sample size was 96 respondents, selected using cluster random sampling from seven community health centers located in seven subdistricts in Langkat Regency. Data were collected using questionnaires and analyzed using multiple logistic regression. The findings showed that social support (Exp (B): 5.585 (2.080-14.997); p=<0.001) and community empowerment (Exp (B): 6.276 (2.342-16.819); p=<0.001) had an effect on the implementation of GERMAS. The most important factor affecting GERMAS implementation in Langkat Regency was community empowerment, in which poor community empowerment increased the tendency of the community to not properly implement GERMAS by 6.276 times. Local governments are expected to focus on strengthening community empowerment through health cadre training, continuous socialization, and the provision of health infrastructure support. Families must also actively support healthy living behaviors through strengthened communication and practicing healthy living together.