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

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.