Evaluation of measles-rubella control and prevention program implementation: System and community review

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Clinical Epidemiology and Global Health Pub Date : 2024-08-13 DOI:10.1016/j.cegh.2024.101758
Sylvia Gusrina , Mei Neni Sitaresmi , Samsu Aryanto , Bayu Satria Wiratama
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Abstract

Introduction

The WHO targets Southeast Asia to eliminate measles and rubella by 2023. Measles-Contain Vaccination (MCV) coverage in Indonesia has dropped 6 %, and vaccine-preventable disease (VPD) reporting has fallen 30 % due to the pandemic. Bantul's MR positive rate rose 16 % in 2022. Measles outbreak with 71 cases in March 2023. We evaluated the system to identify program implementation gaps.

Methods

Following system surveillance evaluation guidelines 2006, we conducted a descriptive cross-sectional study. We evaluate the structure and attribute components. We chose eighteen public health facilities for sub-districts, with 52 health workers as representatives of all areas in the Bantul district. We interviewed with a semi-structured questionnaire. We calculated the frequencies and proportions of each component, categorized as good, fair, and weak.

Results

The average service time was almost ten years. No Public Health Center (PHC) used the system to make decisions. Since the private health facilities and community involvement was minimal, the surveillance system contains structural weaknesses in networks and partnerships. Timeliness completeness coupled with the weak evidence for variables of accessibility and flexibility is also vulnerable.

Conclusions

The Bantul measles-rubella disease surveillance system lacked networking, partnerships, and community involvement. The health office is expected to boost private health facility participation, monitoring and assessment, and vaccine coverage by at least 95 %, especially in vulnerable areas.

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麻疹风疹防控计划实施评估:系统和社区审查
导言世界卫生组织的目标是到 2023 年在东南亚消除麻疹和风疹。由于麻疹和风疹大流行,印度尼西亚的麻疹疫苗接种(MCV)覆盖率下降了6%,疫苗可预防疾病(VPD)报告率下降了30%。2022 年,班图尔的麻疹病毒阳性率上升了 16%。2023 年 3 月爆发了 71 例麻疹疫情。我们对该系统进行了评估,以确定计划实施的差距。方法根据 2006 年系统监测评估指南,我们进行了一项描述性横断面研究。我们对系统的结构和属性进行了评估。我们选择了 18 家公共卫生机构作为分区,52 名卫生工作者作为班图尔区所有地区的代表。我们使用半结构化问卷进行了访谈。我们计算了各组成部分的频率和比例,并将其分为良好、一般和较弱三类。没有一家公共卫生中心(PHC)利用该系统做出决策。由于私营医疗机构和社区的参与程度极低,监测系统在网络和合作关系方面存在结构性缺陷。结论班图尔麻疹风疹疾病监测系统缺乏网络、伙伴关系和社区参与。预计卫生局将促进私人医疗机构的参与、监测和评估,并将疫苗覆盖率至少提高 95%,尤其是在脆弱地区。
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来源期刊
Clinical Epidemiology and Global Health
Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.60
自引率
7.70%
发文量
218
审稿时长
66 days
期刊介绍: Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.
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