WHO, in collaboration with University of Hasanuddin and National Board for Disaster Management (BNPB), supported the Ministry of Health (MoH) to conduct field assessments in 211 locations across Indonesia from 4 September to 9 October 2020. The activities aimed to assess COVID-19 preparedness in fifteen provinces, based on the status of their pandemic risk: Bali, Bangka Belitung Island, Central Java, Central Kalimantan, Central Sulawesi, DKI Jakarta, East Java, East Nusa Tenggara, Maluku, North Sumatera, Papua, Riau, Riau Island, South Sulawesi, and West Kalimantan.

A field enumerator (volunteer) assigned by BNPB conducts an interview using the field assessment  tool in Tanjung Pinang District Health Office, Riau Island. Photo credit: xx

About ten participants from WHO, MoH and University of Hasanudin Makasar developed assessment questionnaires which were then tested in nine provinces. Field enumerators assigned by the BNPB underwent a training followed by field assessment, data collection and analysis.

The assessment covered provincial command centres, provincial health offices, port health offices, hospitals, laboratories, district health offices, public health centres, and community health centres.

Results and conclusions

All assessed provinces had a functioning command and control structure for pandemic management; however, not all of them established Emergency Operations Centres (EOC). Contingency plans for pandemic response were in place in several locations, but there remains a need for joint Contingency Plans with neighbouring countries.  

Key areas of improvements were case reporting and analysis for pandemic severity, budget allocation for response in points of entry, personal protective equipment stockpiling and exit screening of passengers. The assessment further identified health systems gaps in provinces, such as availability of ICU and other facilities in the event of rising COVID-19 cases. Health systems need to be strengthened, especially for district-level hospitals.

Laboratories for COVID-19 testing are facing challenges, such as backlog of specimens tested and low level of testing referral among laboratories. One of the solutions is to develop a laboratory referral system to avoid specimen accumulations. Meanwhile, the biggest gaps in the surveillance system in all provinces were the low level of isolation of suspected cases and the challenge to confirm COVID-19 status within 48 hours. Contact tracing, contact quarantine and case isolation need to be strengthened.

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