Relasi Agen Dan Struktur Dalam Mendukung Upaya Eliminasi Tuberkulosis Tahun 2030 (Studi Kasus pada Yayasan Mentari Meraki Asa di Kota Medan)

Abstract

This study examines the relationship between agency and structure in supporting the tuberculosis (TB) elimination process by 2030, with a case study on Yayasan Mentari Meraki Asa (YMMA) in Medan. TB remains a major public health issue in Indonesia, marked by high case burdens and structural challenges such as stigma, limited resources, and the complexity of the health system. YMMA Medan City, acting as a Sub-Sub Recipient (SSR) under YMMA North Sumatra, serves as a community-based organization that connects patients, survivors, volunteers, health facilities, and government institutions.This research employs a qualitative method with a case study approach. Data were collected through semi-structured interviews, observations, and documentation, and analyzed using Anthony Giddens’ structuration theory, focusing on the dimensions of signification, domination, and legitimation.The findings reveal that community agents play significant roles in patient assistance, health education, and policy advocacy, while structures provide rules, resources, and legitimacy. The relationship is reciprocal, where structures act as both opportunities and constraints for agency. The study concludes that synergy between community agents and structural institutions is crucial to achieving the national target of TB elimination by 2030.