Use of USG Methods and Ishikawa Diagrams in Analysis of Clinical Problems

Human Immunodeficiency Virus (HIV) remains a serious global public health issue, with more than 40 million deaths from HIV-related illnesses since the beginning of the AIDS pandemic. Although entiretroviral therapy has been proven to reduce morbidity, mortality, and transmission rates, HIV treatment outcomes in various regions, including Indonesia, are still suboptimal. This study aims to evaluate HIV treatment outcomes in Karimun Regency and identify the root causes that affect program success using USG and Ishikawa diagrams. Through qualitative analysis using in-depth interviews, observations, and Focus Group Discussions (FGDs) with stakeholders related to HIV/AIDS programs, five main categories of causes were found, namely (1) people, in the form of lack of updated knowledge and information as well as limited resources; (2) costs in the form of lack of budget support from local governments and high initial treatment costs; (3) methods in the form of lack of continuous supervision, less than optimal recording and reporting, and weak policies at the regional level; (4) machines in the form of network constraints and operators inputting and reporting SIHA; and (5) the environment, in the form of lack of advocacy and cooperation across programs, across sectors and NGOs and limited access to services. This study demonstrates that the use of ultrasound and the Ishikawa Diagram can map and analyze problems in a structured and comprehensive manner. These results can be used as a reference in developing more targeted strategies to optimize HIV treatment outcomes and reduce transmission rates, morbidity, and mortality in the community.