Building on health security capacities in Indonesia: Lessons learned from the COVID-19 pandemic responses and challenges.

As an active member country of the WHO's International Health Regulation and Global Health Security Agenda, Indonesia, the world's fourth-most populous and largest archipelagic country has recorded the second-highest COVID-19 cases in Asia with over 1.8 million cases in early June 2021. This geographically and socially diverse country has a dynamic national and sub-national government coordination with decentralized authorities that can complicate a pandemic response which often requires nationally harmonized policies, adaptability to sub-national contexts and global interconnectedness. This paper analyses and reviews COVID-19 public data, regulations, guidance documents, statements and other related official documents to present a narrative that summarizes the government's COVID-19 response strategies. It further analyses the challenges and achievements of the country's zoonotic diseases preparedness and responses and lastly provides relevant recommendations. Findings are presented in four sections according to the Global Health Security Agenda capacities, namely epidemiological surveillance (detect capacity); laboratory diagnostic testing (respond capacity); data management and analysis (enable capacity); and the role of sub-national governments. The COVID-19 pandemic has been a catalyst for the rapid transformation of existing surveillance systems, inter-related stakeholder coordination and agile development from the pre-pandemic health security capacities. This paper offers several recommendations on surveillance, laboratory capacity and data management, which might be useful for Indonesia and other countries with similar characteristics beyond the COVID-19 response, such as achieving long-term health security, zoonoses and pandemic prevention, as well as a digital transformation of their governmental capacities.

The evaluation of effect Gammarana intervention to reducing stunting during the Covid-19 pandemic: Protocol evaluation of stunting intervention in Enrekang District.

BACKGROUND: Evaluation of large-scale stunting interventions in Indonesia has never been carried out, because it found limited sensitive and specific interventions that were carried out massively at the village level. The provincial government of South Sulawesi Indonesia in 2020 has implemented a stunting intervention model called Gammarana. The purpose of this evaluation is to analyze the impact of Gammarana on changes in stunting at the project site. Location project as many as 30 villages with a population estimated 60,000.  Design and methods: Evaluation in this study using a retrospective method and internal and external audit to document potential, then validated after the field visit Gammarana first phase in 2020. Basic Logic Model evaluation model with 22 indicators (input, process, secondary output and primary output). Proving the effect of Gammarana on changes in stunting by comparing the phenomena in the comparison village. RESULTS: The comparison villages were set as equal and comparable in 13 indicators that could disturb the study conclusions. The result of the initial condition is that the conditions of the two villages of Gammarana and Villages Comparison are seen as the same in various characteristics, so that whatever the results of this evaluation study are believed to be the impact of Gammarana Project. CONCLUSIONS: this protocol eligible to evaluation of Gammarana Project Intervention in Enrekang District, South Sulawesi Indonesia.

The Capacity of the Indonesian Healthcare System to Respond to COVID-19.

The Indonesian Government has issued various policies to fight Coronavirus Disease (COVID-19). However, cases have continued to fluctuate over a year into the pandemic. There is a need to assess the country's healthcare system's capacity to absorb and accommodate the varying healthcare demands. We reviewed the current capacity of Indonesia's healthcare system to respond to COVID-19 based on the four essential elements of surge capacity: staff, stuff, structure, and system. Currently available medical staffs are insufficient to deal with potentially increasing demands as the pandemic highlighted the human resources challenges the healthcare system has been struggling with. The pandemic has exposed the fragility of medical supply chains. Surges in the number of patients requiring hospitalization have led to depleted medical supplies. The existing healthcare infrastructure is still inadequate to deal with the rise of COVID-19 cases, which has also exposed the limited capacity of the healthcare infrastructure to manage medical waste. The COVID-19 pandemic has further exposed the weakness of the patient referral system and the limited capacity of the healthcare system to deliver essential health services under prolonged emergencies. The Indonesian Government needs to ramp up the country's healthcare capacity. A wide range of strategies has been proposed to address those mounting challenges. Notwithstanding, the challenges of increasing healthcare capacity highlight that such efforts could represent only one part of the pandemic response equation. Effective pandemic response ultimately requires governments' commitment to increase healthcare capacity and flatten the curve concurrently.