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ID: HR23-834
Presenting author: CISDI Indonesia

Presenting author biography:

CISDI is a nonprofit that aims to advance the health sector development and strengthen the health system through impact-based policy, research, advocacy and inclusive-participative interventions

Tackling COVID-19 pandemic with community-led initiatives and primary health care strengthening

CISDI Indonesia
Strengthening primary health is currently seen as the key to tackle the pandemic. But when the COVID-19 virus hit Indonesia, the country's health system was not ready. The overlapping policies between central and regional governments has always hindered efforts in strengthening primary healthcare services. The budget for hospital development is six times bigger than for primary health care facilities (2017). This hospital-centric system makes primary health services responses fall short during the pandemic. As many as 45% of primary health services health workers were very poorly prepared for infection control and prevention. There were logistical shortages for N95 masks (66%), and medical dress (43%). Health workers also experienced a stigma in which they are disregarded by the community (33%), and labeled as spreaders of the virus (25%).

To bridge this gap, during the heights of the pandemic in 2021, the Center for Indonesia’s Strategic Development Initiatives (CISDI), trained 3,560 community health workers (CHW) affiliated with local health centers to perform community-based surveillance through active case finding and monitoring self-isolated patients. They could trace at least 15 close contacts of all COVID-19 patients in 72 hours, a feat never performed before in their community.

Expanding on this intervention, this year CISDI collaborated with more than a thousand CHW to provide COVID-19 vaccination for vulnerable groups. Since there has been no consensus to the definition of “vulnerable groups”, they were previously neglected. The CHWs also help to recover non-communicable diseases and nutrition services which were disrupted by the pandemic. Together, this joint effort has increased the community's habit of accessing healthcare facilities periodically and maintained their health status.

Through this presentation, we want to show that amplifying the collaboration of primary health care and community is the solution to ensure that the nation would be ready for future pandemic preparedness.