Strengthening Health Systems to Overcome Respiratory Infectious Diseases in Indonesia: A Comprehensive Review

Area of Science:

• Public Health
• Epidemiology
• Health Systems Strengthening

Background:

• Respiratory infectious diseases (RIDs) pose a significant public health burden in Indonesia.
• The COVID-19 pandemic exposed critical vulnerabilities in Indonesia's health system, particularly in surveillance, diagnostics, and outbreak response.
• There is an urgent need to shift from a reactive to a proactive, prevention-focused approach for managing RIDs and enhancing pandemic preparedness.

Purpose of the Study:

• To assess Indonesia's health system performance in managing RIDs.
• To identify evidence-based priorities for health system reform in RID management.
• To inform strategies for strengthening pandemic preparedness in Indonesia.

Main Methods:

• Systematic synthesis of existing literature, policy documents, and evaluation reports.
• Analysis structured around five key health system components: surveillance, diagnostics, workforce, infrastructure/primary care, and governance/financing.
• Assessment of strengths and persistent gaps in Indonesia's RID management capacity.

Main Results:

• Indonesia possesses strengths like a widespread Primary Health Center network and vaccination capacity.
• Significant gaps include declining surveillance reporting completeness (EWARS from 75% to 53%), inadequate diagnostics in rural areas, and inequitable health workforce distribution.
• Key reform priorities include scaling point-of-care diagnostics, integrating surveillance via SatuSehat, empowering community health workers, and securing sustainable financing.

Conclusions:

• Strengthening Indonesia's health system for RID management requires integrated surveillance, enhanced diagnostics, and a focus on primary care.
• Medium-term strategies involve workforce redistribution and regional health security centers.
• Long-term goals include predictive health intelligence, resilient supply chains, and facility upgrades, necessitating sustained commitment and collaboration.