Craig Adam T, Japri Andrew Prasettya, Heryanto Bambang
The University of Queensland, Centre for Clinical Research, Brisbane, Australia.
Australia-Indonesia Health Security Partnership, Jakarta, Indonesia.
J Glob Health. 2025 Jun 20;15:04118. doi: 10.7189/jogh.15.04118.
Community-based surveillance (CBS) refers to a structured process whereby community members systematically detect and report events of public health significance occurring within their communities. In response to the COVID-19 pandemic, the Government of Indonesia has taken steps to enhance national preparedness for future health threats, focussing on expanding the use of CBS. Given the novelty of CBS's use in Indonesia, we undertook this research to provide evidence-based advice to guide its implementation across the country's diverse communities and operational contexts.
We employed three strategies to gather data: a content analysis of policy documents related to CBS implementation in Indonesia, site visits, and interviews with purposefully selected key informants from the animal, wildlife and human health sectors, planning agencies, village leadership, and inter-government coordination bodies. We conducted additional interviews with staff from the United Nations and donor development assistance agencies involved in CBS implementation in Indonesia. A semi-structured tool guided the interviews, and we analysed the data using an inductive approach.
We identified eight policy documents, visited six CBS project sites, and interviewed 120 key stakeholders. Key themes that emerged included the need for greater clarity on the scope, purpose, and function of CBS and how data collected intersect with and is used within Indonesia's broader early warning disease surveillance architecture, a need to harmonisation CBS legislation and implementation guidance across and within ministries, and that ongoing investment in essential health system building blocks - workforce, data systems, and analytical capacity - is required to ensure the scalability and sustainability of CBS across the country.
Although CBS holds promise for strengthening public health security in Indonesia, key challenges related to common understanding, workforce capacity, data flow, and system governance must be addressed if the strategy is to make a meaningful contribution. Effective collaboration among government ministries, administrative levels, and community stakeholders is crucial for adapting CBS to balance local and national health security priorities, while ensuring stability, sustainability, and scalability across Indonesia's diverse contexts.
基于社区的监测（CBS）是指一个结构化的过程，通过该过程社区成员系统地发现并报告在其社区内发生的具有公共卫生意义的事件。为应对新冠疫情，印度尼西亚政府已采取措施加强国家对未来健康威胁的防范，重点是扩大CBS的使用。鉴于CBS在印度尼西亚使用的新颖性，我们开展了这项研究，以提供基于证据的建议，指导其在该国不同社区和业务环境中的实施。
我们采用了三种策略来收集数据：对印度尼西亚CBS实施相关政策文件进行内容分析、实地考察，以及对从动物、野生动物和人类健康部门、规划机构、村庄领导和政府间协调机构中特意挑选的关键信息提供者进行访谈。我们还对参与印度尼西亚CBS实施的联合国和捐助方发展援助机构的工作人员进行了额外访谈。一个半结构化工具指导访谈，我们使用归纳法分析数据。
我们确定了八份政策文件，走访了六个CBS项目地点，并采访了120名关键利益相关者。出现的关键主题包括需要更明确CBS的范围、目的和功能，以及所收集的数据如何与印度尼西亚更广泛的早期预警疾病监测架构相交并在其中使用，需要在各部委之间以及部委内部协调CBS立法和实施指南，并且需要对基本卫生系统要素——劳动力、数据系统和分析能力——进行持续投资，以确保CBS在全国的可扩展性和可持续性。
尽管CBS有望加强印度尼西亚的公共卫生安全，但如果该战略要做出有意义的贡献，就必须应对与共同理解、劳动力能力、数据流和系统治理相关的关键挑战。政府各部委、行政层面和社区利益相关者之间的有效合作对于调整CBS以平衡地方和国家卫生安全优先事项至关重要，同时要确保在印度尼西亚不同环境中的稳定性、可持续性和可扩展性。
