Developing community-based surveillance systems for vaccine-preventable diseases: lessons learned from Indonesia

Area of Science:

• Public Health
• Epidemiology
• Health Systems Strengthening

Background:

• Routine immunization programs in Indonesia faced significant disruptions during the COVID-19 pandemic.
• This disruption led to an increase in vaccine-preventable diseases (VPDs).
• Community-based surveillance (CBS), effective for COVID-19, has limited application for VPD monitoring.

Purpose of the Study:

• To investigate current practices and challenges in developing a CBS for VPDs.
• To identify opportunities for enhancing VPD surveillance through community involvement.
• To explore the potential of community health volunteers (CHVs) in VPD monitoring.

Main Methods:

• A convergent mixed-method study was conducted in Sleman regency, Indonesia.
• Qualitative data were gathered through interviews with 41 stakeholders (health staff, CHVs, community leaders).
• Quantitative data were collected via surveys from 70 caregivers of under-5 children.

Main Results:

• Community involvement in disease surveillance exists but is inconsistent for VPDs.
• Key challenges include limited CHV knowledge, high workloads, lack of digital literacy, and resource shortages.
• Existing reporting systems are often unintegrated, hindering effective monitoring.

Conclusions:

• Formalized guidelines for community-to-health facility reporting are essential for strengthening CBS for VPDs.
• Integration of digital and conventional reporting systems, alongside improved coordination, is needed.
• Certified CHV training and sustainable policy/financing frameworks are critical for long-term success.