Ishikawa Diagram is Used to Map and Overcome Factors that Contribute to a Problem

Tuberculosis (TB) is an infectious disease that ranks second as the second highest cause of death. Despite ongoing control efforts, contact investigation coverage in various regions is still relatively low, including in Pekanbaru City, which only reaches 8% of the national target. Contact investigation is a key step in breaking the chain of TB transmission, but its implementation faces various obstacles. This study aims to identify the root causes of the low TB contact investigation coverage in Pekanbaru using the Ishikawa Diagram. Through in-depth interviews and qualitative analysis, five main categories of causes were found, namely: (1) environment, in the form of a lack of cross-program advocacy; (2) machines, namely network constraints in online reporting; (3) costs, in the form of minimal budget allocation; (4) methods, including unsustainable supervision and suboptimal recording; and (5) people, namely limited human resources. The results of this study indicate that the Ishikawa Diagram approach is effective in systematically mapping and analyzing problems. These findings can be the basis for formulating more appropriate strategies to increase the scope of TB contact investigations to reduce transmission rates in the community.