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Kabamba Nzaji M, Kapit AM, Stolka KB, Fezeu Meyou S, Kasendue CK, Dahlke M, Perry RT, Doshi RH, Aksnes BN, Luce RR, Bateyi Mustafa SH, Mwina-Ngoie CK, Aimé CMWB, MacDonald PDM, Standley CJ. Provincial Intra-Action Review of the COVID-19 Vaccination Programme: Opportunities to Improve Vaccine Response in North Kivu, Democratic Republic of Congo. J Multidiscip Healthc 2024; 17:2147-2156. [PMID: 38736542 PMCID: PMC11088377 DOI: 10.2147/jmdh.s450699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/22/2024] [Indexed: 05/14/2024] Open
Abstract
Background Low levels of COVID-19 vaccination coverage in many countries prompted the use of rapid assessments to characterize barriers to vaccination and identify corrective measures. The World Health Organization recommended the use of intra-action reviews (IARs) to identify best practices, gaps, and lessons learned to make real-time improvements to the COVID-19 vaccination response. Objective The Democratic Republic of the Congo (DRC) implemented a national IAR in July 2021 that was poorly attended by the provincial health level, where vaccination activities are planned and implemented. To bridge this gap, we proposed sub-national IARs focused on COVID-19 vaccine program implementation at the provincial level. Methods Using the WHO methodology, we organized a four-day provincial IAR workshop and invited national, provincial and health zone Ministry of Health (MoH) representatives and private and non-governmental organizations involved in the provincial COVID-19 vaccination response. Participants were divided into six groups based on their expertise, affiliation, and role within the health system to assess and identify lessons learned, challenges and the solutions within each of the six technical areas: (1) coordination, planning and monitoring; (2) service delivery; (3) risk communication and community engagement; (4) adverse effects following immunization (AEFI); (5) logistics; (6) and data management, monitoring and evaluation. Results The first provincial COVID-19 IAR was conducted in Goma, North Kivu, from January 19-22, 2022. A total of 56 participants came from provincial and health zone offices, and non-governmental organizations. Through work group discussions, they identified best practices, challenges, and lessons learned, and made recommendations to improve implementation of vaccination activities and reach coverage targets. Activities were proposed to operationalize recommendations and address challenges to improve the provincial response. Conclusion This provincial IAR was a useful tool for reviewing progress and areas of improvement, while evaluating aspects of the COVID-19 vaccine rollout. It provided a means to share information with vaccination partners on areas of intervention, tailored to the local context.
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Affiliation(s)
- Michel Kabamba Nzaji
- Social, Statistical, & Environmental Sciences, RTI International, Kinshasa, Democratic Republic of the Congo
| | - Anselme Manyong Kapit
- Social, Statistical, & Environmental Sciences, RTI International, Kinshasa, Democratic Republic of the Congo
| | - Kristen B Stolka
- Social, Statistical, & Environmental Sciences, RTI International, Research Triangle Park, NC, United States America
| | - Shanice Fezeu Meyou
- Social, Statistical, & Environmental Sciences, RTI International, Research Triangle Park, NC, United States America
| | - Charlie K Kasendue
- Division of Global Health Protection (DGHP), U.S. Centers for Disease Control and Prevention (CDC), Kinshasa, Democratic Republic of the Congo
| | - Melissa Dahlke
- Global Immunization Division (GID), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States America
| | - Robert T Perry
- Global Immunization Division (GID), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States America
| | - Reena H Doshi
- Global Immunization Division (GID), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States America
| | - Brooke Noel Aksnes
- Global Immunization Division (GID), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States America
| | - Richard R Luce
- Division of Global Health Protection (DGHP), U.S. Centers for Disease Control and Prevention (CDC), Kinshasa, Democratic Republic of the Congo
| | - Stephane Hans Bateyi Mustafa
- Expanded Programme on Immunization (EPI), Ministry of Public Health & Hygiene, Kinshasa, Democratic Republic of the Congo
| | - Crispin Kazadi Mwina-Ngoie
- Expanded Programme on Immunization (EPI), Ministry of Public Health & Hygiene, Kinshasa, Democratic Republic of the Congo
| | - Cikomola Mwana Wa Bene Aimé
- Expanded Programme on Immunization (EPI), Ministry of Public Health & Hygiene, Kinshasa, Democratic Republic of the Congo
| | - Pia D M MacDonald
- Social, Statistical, & Environmental Sciences, RTI International, Kinshasa, Democratic Republic of the Congo
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States America
| | - Claire J Standley
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States America
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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Harapan BN, Harapan T, Theodora L, Anantama NA. From Archipelago to Pandemic Battleground: Unveiling Indonesia's COVID-19 Crisis. J Epidemiol Glob Health 2023; 13:591-603. [PMID: 37707715 PMCID: PMC10686963 DOI: 10.1007/s44197-023-00148-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to countries worldwide, including Indonesia. With its unique archipelagic geography consisting of more than 17,000 thousand islands, Indonesia faces unique complexities in managing the spread of the virus. Based on existing literature, this review article elaborates on key issues that have shaped Indonesia's COVID-19 response. The article begins by examining the early stages of the COVID-19 pandemic in Indonesia, along with the implementation of various preventive measures and the impact of the virus on public health. This article examines how Indonesia's socio-economic factors have generally influenced its healthcare system and further delves into the COVID-19 response strategies implemented by the Indonesian government and public health authorities as well as overall crisis preparedness. It discusses the actions taken to control the spread of the virus, including testing strategies and vaccination efforts. The difficulties encountered in implementing these measures are presented. In conclusion, this review article provides a comprehensive understanding of the COVID-19 crisis in Indonesia, covering facts on multiple dimensions ranging from the timeline of the pandemic to vaccination efforts, epidemiology, socio-economic implications, testing strategies, mobility patterns, public holidays, the impact of working from home, and the utilization of complementary and alternative medicine in addition to the standard of care for COVID-19. The insights gained from this article can complement future strategies for pandemic management and response in Indonesia and other countries facing similar challenges.
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Affiliation(s)
| | - Triswan Harapan
- Complementary Cardiovascular Clinic (CCV Clinic), Tangerang Selatan, Indonesia
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Hardhantyo M, Djasri H, Nursetyo AA, Donna B, Ariani M, Pangaribuan H, Yogadhita GY, Yulianti A, Adipradipta BR. Evidence-Based Policy Recommendations for Public Health Emergency Operation Centers in Regional Settings: A Case Study in Indonesia. Public Health Rev 2023; 44:1604899. [PMID: 37601901 PMCID: PMC10435730 DOI: 10.3389/phrs.2023.1604899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background: Public health emergencies require integration between multiple stakeholders in different sectors to monitor the situation and carry out an appropriate response. As a country with a large land area consisting of thousands of islands, Indonesia's centralized Public Health Emergency Operation Center (PHEOC) system is currently unable to effectively contain diseases. A PHEOC system reform is required to accommodate Indonesia's circumstances, particularly at the regional level. We have outlined potential models at the sub-national level for PHEOC based on existing evidence. Policy Options and Recommendations: Based on existing evidence of PHEOC models internationally, we have formulated three policy models for regional-level PHEOC. These models (the ad hoc agency model, the independent agency model, and the Province Health Office (PHO)-based model) entail different chains of command, and each has its own benefits. Conclusion: We recommend that the Ministry of Health in Indonesia adopt the third PHEOC policy model, in which the chain of command lies under the PHO. This is the most practical approach, as the PHO has the authority to mobilize units and access resources in response to imminent public health emergencies. Further training and capacity-building are required to support the PHO as the commander of the regional PHEOC.
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Affiliation(s)
- Muhammad Hardhantyo
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Health Science, Universitas Respati Yogyakarta, Yogyakarta, Indonesia
| | - Hanevi Djasri
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Aldilas Achmad Nursetyo
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bella Donna
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Madelina Ariani
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Happy Pangaribuan
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gde Yulian Yogadhita
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Andriani Yulianti
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bernadeta Rachela Adipradipta
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Sane J, Schmidt T, Isla N, Ibrahim R, Boshevska G, Mayigane LN, Perriat D, Stauke J, Esquevin S, Fehr A, Brajovic M, Bajić B, Galic I, Humolli I, Bunjaku DG, Gheorghita S, Kuli A, Manevska S, Stavridis K, Demiscan D, Capmari D, Mengistu AA. Key lessons learnt from COVID-19 intra-action reviews in the Republic of Moldova, Montenegro, Kosovo and North Macedonia 2020-2021: a qualitative study. BMJ Open 2023; 13:e066279. [PMID: 36868592 PMCID: PMC9990164 DOI: 10.1136/bmjopen-2022-066279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES Our study described how the WHO intra-action review (IAR) methodology was operationalised and customised in three Western Balkan countries and territories and the Republic of Moldova and analysed the common key findings to inform analyses of the lessons learnt from the pandemic response. DESIGN We extracted data from the respective IAR reports and performed a qualitative thematic content analysis to identify common (between countries and territories) and cross-cutting (across the response pillars) themes on best practices, challenges and priority actions. The analysis involved three stages, namely: extraction of data, initial identification of emerging themes and review and definition of the themes. SETTING IARs were conducted in the Republic of Moldova, Montenegro, Kosovo and the Republic of North Macedonia between December 2020 and November 2021. The IARs were conducted at different time points relative to the respective pandemic trajectories (14-day incidence rate ranging from 23 to 495 per 100 000). RESULTS Case management was reviewed in all the IARs, while the infection prevention and control, surveillance and country-level coordination pillars were reviewed in three countries. The thematic content analysis identified four common and cross-cutting best practices, seven challenges and six priority recommendations. Recommendations included investing in sustainable human resources and technical capacities developed during the pandemic, providing continuous capacity-building and training (with regular simulation exercises), updating legislation, improving communication between healthcare providers at all levels of healthcare and enhancing digitalisation of health information systems. CONCLUSIONS The IARs provided an opportunity for continuous collective reflection and learning with multisectoral engagement. They also offered an opportunity to review public health emergency preparedness and response functions in general, thereby contributing to generic health systems strengthening and resilience beyond COVID-19. However, success in strengthening the response and preparedness requires leadership and resource allocation, prioritisation and commitment by the countries and territories themselves.
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Affiliation(s)
- Jussi Sane
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Tanja Schmidt
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Nicolas Isla
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Rawi Ibrahim
- World Health Organization Regional Office for Europe, Balkan Hub, Belgrade, Serbia
| | - Golubinka Boshevska
- World Health Organization Regional Office for Europe, Balkan Hub, Belgrade, Serbia
| | | | | | | | | | | | | | - Borko Bajić
- Institute for Public Health, Podgorica, Montenegro
| | - Igor Galic
- Institute for Public Health, Podgorica, Montenegro
| | - Isme Humolli
- World Health Organization Regional Office for Europe, Pristina Office, Pristina, Kosovo
| | - Dafina Gexha Bunjaku
- Ministry of Health, Kosovo (in accordance with UNSCR 1244 (1999))*, Pristina, Kosovo
| | - Stela Gheorghita
- World Health Organization Regional Office for Europe, Republic of Moldova Country Office, Chisinau, Republic of Moldova
| | - Arta Kuli
- World Health Organization Regional Office for Europe, North Macedonia Country Offic, Skopje, North Macedonia
| | | | | | | | - Dumitru Capmari
- National Agency for Public Health, Chisinau, Republic of Moldova
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Anagnostopoulos L, Kourentis L, Papadakis A, Mouchtouri VA. Re-Starting the Cruise Sector during the COVID-19 Pandemic in Greece: Assessing Effectiveness of Port Contingency Planning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13262. [PMID: 36293840 PMCID: PMC9603745 DOI: 10.3390/ijerph192013262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/01/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Coronavirus disease (COVID-19) outbreaks on board cruise ships early in the pandemic highlighted gaps worldwide in public health emergency contingency plans (PHECPs) for responding to unknown threats. To restart cruise operations in 2021 and respond to potential COVID-19 outbreaks, a major tourist-based Greek island port (Port A) developed a COVID-19 PHECP. We assessed plan effectiveness by reviewing epidemiological data and monitoring outcomes, followed by an intra-action review (IAR) analyzing three event responses. From May to December 2021, 118 calls from 23 cruise ships with 119,930 passengers were recorded, with 29 COVID-19 cases in 11 cruises on board 7 ships. No outbreak was recorded during the study period. Strengths of the introduced PHECP included commitment of senior management; a core multi-disciplinary team of local authorities/ship agents involved in design and execution; interoperability agreements for port and ships' PHECPs; cruise industry commitment to compliance; and pre-existing scenarios considering capacity needs. Central government coordination for preparedness planning at local ports is essential for successful responses. Monitoring local and country level response capacities is critical to inform planning, risk assessment, and decision-making. Immediately recording ports' response actions provides the basis to capture lessons and improve contingency plans. To facilitate communication and common response protocols between European and non-European ports, IARs should be conducted between countries.
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Affiliation(s)
- Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larisa, Greece
- EU Joint Action HEALTHY GATEWAYS, 22 Papakyriazi Street, 41222 Larisa, Greece
| | - Leonidas Kourentis
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larisa, Greece
- EU Joint Action HEALTHY GATEWAYS, 22 Papakyriazi Street, 41222 Larisa, Greece
| | - Antonios Papadakis
- Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes–Staurakia, 71110 Heraklion, Greece
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larisa, Greece
- EU Joint Action HEALTHY GATEWAYS, 22 Papakyriazi Street, 41222 Larisa, Greece
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Sudari F, Priskilla I, Febiola M, Sinuraya RK. Strategies to improve the vaccine distribution and community awareness of taking COVID-19 vaccine in rural areas in Indonesia. PHARMACIA 2022. [DOI: 10.3897/pharmacia.69.e81525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
COVID-19 has spread worldwide, and several governments, including Indonesia, are actively vaccinating. However, numerous factors may contribute to decreased vaccination administration, including hesitation, a lack of information, and demographic considerations. Therefore, this review provides insights on maximizing vaccine distribution and raising community awareness about COVID-19 vaccination in rural regions with difficulty in transportation access, a lack of health care workers, and limited vaccine storage facilities. It was discovered that numerous potential methods, such as the Internet of Things (IoT), bio-tracking and bio-detect, P-median, and Vehicle Routing Problem (VRP), can monitor vaccination delivery in rural parts of Indonesia. The correct vaccine distribution system can monitor situations during distribution by combining IoT technology with bio-tracking and bio-detect in airborne transportation. Besides enhancing vaccine distribution technologies, healthcare professionals play a critical role in maintaining vaccine quality and improving community awareness of diseases. In particular, as a healthcare professional, a pharmacist has an essential role in ensuring the quality of the vaccine until it is administered to the patient and improving patients’ awareness of COVID-19 and the vaccinations. Pharmacists can collaborate with other healthcare professionals to educate the community to identify important information related to wrong perceptions about COVID-19 and vaccinations.
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