Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Yogyakarta Province, Indonesia.
Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Yogyakarta Province, Indonesia.
PLoS One. 2022 Sep 29;17(9):e0275153. doi: 10.1371/journal.pone.0275153. eCollection 2022.
The Indonesian government has issued various policies to control COVID-19. However, COVID-19 new cases continued to increase, and there remain uncertainties as to the future trajectory. We aimed to investigate how medical and health academics view the Indonesian government's handling of COVID-19 and which areas of health systems need to be prioritized to improve the government's response to COVID-19. We conducted a modified Delphi study adapting the COVID-19 assessment scorecard (COVID-SCORE) as the measurement criteria. We invited medical and health academics from ten universities across Indonesia to take part in the two-round Delphi study. In the first round, participants were presented with 20 statements of COVID-SCORE and asked to rate their agreement with each statement using a five-point Likert scale. All participants who completed the first cycle were invited to participate in the second cycle. They had the opportunity to revise their answers based on the previous cycle's results and ranked a list of actions to improve government response. We achieved a moderate consensus level for five statements, a low consensus level for 13 statements and no consensus for two statements. The prioritization suggested that top priorities for improving the government's response to COVID-19 in Indonesia encompass: (1) strengthening capacity to ensure consistent, credible and targeted communication while adopting a more inclusive and empathic communication style to address public concerns; (2) ensuring universal access to reliable COVID-19 testing by expanding lab infrastructure, facilitating operational readiness, and scaling up implementation of proven alternative/complementary tests to RT-PCR; and (3) boosting contact tracing implementation capacity and facilitating contact tracing for all positive cases, involving key stakeholders in further development of the existing contact tracing system (i.e. PeduliLindungi) as well as its evaluation and quality assurance. Ultimately, our study highlights the importance of strengthening health system functions during the pandemic and improving health system resilience for dealing with future public health emergencies.
印度尼西亚政府已发布多项政策以控制 COVID-19。然而，COVID-19 新发病例持续增加，未来疫情轨迹仍存在不确定性。我们旨在调查医学和卫生学术界如何看待印度尼西亚政府对 COVID-19 的处理，以及需要优先考虑卫生系统的哪些领域，以改善政府对 COVID-19 的应对。我们采用修改后的德尔菲法，使用 COVID-19 评估记分卡（COVID-SCORE）作为测量标准。我们邀请了来自印度尼西亚十所大学的医学和卫生学术界人士参加两轮德尔菲法研究。在第一轮中，参与者被提供了 20 项 COVID-SCORE 陈述，并要求他们使用五点 Likert 量表对每项陈述的同意程度进行评分。所有完成第一轮的参与者都被邀请参加第二轮。他们有机会根据前一轮的结果修改答案，并对一系列改善政府应对措施的行动进行排名。我们在五项陈述上达成了中等共识水平，在十三项陈述上达成了低共识水平，在两项陈述上没有达成共识。建议的优先事项包括：（1）加强能力，确保一致、可信和有针对性的沟通，同时采用更具包容性和同理心的沟通方式来解决公众关切；（2）通过扩大实验室基础设施、促进运营准备和扩大实施经过验证的替代/补充 RT-PCR 测试，确保可靠的 COVID-19 测试的普遍获取；（3）增强接触者追踪实施能力，并为所有阳性病例提供接触者追踪，让关键利益攸关方参与到现有接触者追踪系统（即 PeduliLindungi）的进一步开发及其评估和质量保证中。最终，我们的研究强调了在大流行期间加强卫生系统功能和提高卫生系统弹性以应对未来突发公共卫生事件的重要性。
