Sitorukmi Galuh, Rusadi Cici Permata, Lazuardi Lutfan, Prasetyo Sabarinah, Putri Likke Prawidya
Center For Health Policy and Management Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Health Policy and Management Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia.
Glob Health Action. 2025 Dec;18(1):2548083. doi: 10.1080/16549716.2025.2548083. Epub 2025 Aug 28.
Routine immunization was severely disrupted during the COVID-19 pandemic, leading to a resurgence of vaccine-preventable diseases (VPDs) in Indonesia. While community-based surveillance (CBS) was instrumental in COVID-19 detection, its role in VPD monitoring remains limited.
This study explores practices, challenges, and future opportunities to develop a CBS for vaccine-preventable diseases (VPDs).
We applied a convergent mixed-method study in Sleman regency, Indonesia. We interviewed 41 stakeholders - health staff, community health volunteers (CHVs), and community leaders - and surveyed 70 caregivers of under-5. Interviews were analysed using content analysis according to the health systems combined with public health surveillance frameworks. The survey was examined descriptively.
Existing community involvement in communicable disease surveillance includes systematized reporting for TB, dengue, and COVID-19 using tools like mobile apps and formal guidelines, and non-systematized case reporting for leptospirosis and VPDs. While health facilities have established procedures for recording, reporting, and responding to VPDs, community roles remain undefined. Challenges include CHVs' limited surveillance knowledge, high workloads, lack of digital literacy, inconsistent incentives, absence of case definitions and reporting procedures, and resource shortages. Additionally, unintegrated reporting systems hinder health staff from utilizing and monitoring CBS reports effectively. Future CBS development should focus on neighbourhood committees and CHVs, with 61% of surveyed community members willing to participate.
Strengthening CBS for VPDs requires formalized guidelines on community-to-health facility reporting, integration of both conventional and digital reporting systems, improved coordination with facility-level systems, certified CHV training, and a supportive policy and financing framework to ensure long-term sustainability.
在新冠疫情期间，常规免疫接种受到严重干扰，导致印度尼西亚可通过疫苗预防的疾病（VPDs）再度流行。虽然基于社区的监测（CBS）在新冠病毒检测中发挥了作用，但其在VPD监测中的作用仍然有限。
本研究探讨了开发用于可通过疫苗预防疾病（VPDs）的CBS的实践、挑战和未来机遇。
我们在印度尼西亚斯莱曼县应用了一项收敛性混合方法研究。我们采访了41名利益相关者——卫生工作人员、社区卫生志愿者（CHV）和社区领袖——并对70名5岁以下儿童的看护人进行了调查。根据卫生系统结合公共卫生监测框架，采用内容分析法对访谈进行分析。对调查进行描述性分析。
社区目前在传染病监测方面的参与包括使用移动应用程序和正式指南等工具对结核病、登革热和新冠病毒进行系统化报告，以及对钩端螺旋体病和VPDs进行非系统化病例报告。虽然卫生设施已经建立了记录、报告和应对VPDs的程序，但社区的作用仍不明确。挑战包括CHV的监测知识有限、工作量大、缺乏数字素养、激励措施不一致、缺乏病例定义和报告程序以及资源短缺。此外，未整合的报告系统阻碍了卫生工作人员有效利用和监测CBS报告。未来CBS的发展应侧重于居委会和CHV，61%的受访社区成员愿意参与。
加强针对VPDs的CBS需要制定关于社区向卫生设施报告的正式指南，整合传统和数字报告系统，改善与设施层面系统的协调，对CHV进行认证培训，以及建立一个支持性的政策和融资框架，以确保持久的可持续性。
