Status of Indonesia Multi-sectoral Response Plan

Partners’ Response Overview

The Multi Sectoral Response Plan aims at complementing the efforts of the Government of Indonesia in addressing the direct and indirect impact of the COVID-19 crisis.

Working through the Ministry of Health, UNICEF has designed a platform for tracking COVID-19 related capacity gaps across all public and private hospitals in the country. Technical protocols for this platform have been disseminated to 834 hospitals across all 34 provinces.

IOM continues to deliver essential medical equipment and supplies to the COVID-19 task force and health providers across Indonesia. The medical equipment and supplies include ventilators, PPE for health care workers, x-ray viewers, defibrillators, and hospital beds, among other essential items

IOM cooperates with various local health departments to enhance the management and referral mechanism for COVID-19 within the refugee communities, including on the use of isolation facilities, epidemiological surveys, and contact tracing

WHO, the Directorate of Surveillance and Health Quarantine, MoH, the National Institute of Health Research and Development (NIHRD), and the COVID-19 Task Force are in discussions to optimize testing capacity in line with WHO recommendations, and to strengthen subnational surveillance and contact tracing

UNFPA continues to support the provision of Personal Protection Equipment in 400 Midwifery clinics in DKI Jakarta, Banten and West Java and will expand the support to East Java Province

UNFPA supports the development of related guidelines on Sexual Reproductive Health, Family Planning and Elderly care in Crisis situations including the COVID-19 pandemic

WHO and MoH jointly announced through a media release in English and Indonesian, Indonesia's involvement in a global serological study for COVID-19. The Study will involve more than 10 000 participants from 17 provinces and aims to estimate the national seroprevalence of antibodies to COVID-19

UNFPA supports the continuation of the Sexual Reproductive Health and Family Planning services under the coordination of the Ministry of Health, BKKBN and with the Indonesia Midwives Association.

WHO handed over 253800 viral transport media and swabs amounting to $532,980 to the government to enhance case finding in all 34 provinces.

Partners’ COVID-19 response

Vulnerabilities

At least 70 doctors and 50 nurses have died from COVID-19 in Indonesia, with hundreds more contracting the disease while fighting the pandemic. The Indonesian Medical Association (IDI) estimated that between 200 and 300 doctors have been infected by the virus, while the National Nurses Association (PPNI) stated that at least 300 nurses have contracted the disease.

Health resources have significantly increased. From the initial 132 referral hospitals, there are now 668 referral hospitals, with 166,233 beds and 2,338 isolation rooms. However, these remain low when considered against the total number of people in Indonesia.

Prior to COVID-19, 5.4 million pregnant women per year required Ante Natal Care, Intra Natal Care, and Post Natal Care services, as well as 30 million couples of childbearing age needed family planning services. Interrupted reproductive health services are causing immediate and long-term issues.

An assessment of immunization services among over 5,000 health facilities identified service disruptions in 84 per cent of facilities.

28 percent of Puskesmas (community health centers) are not fully functioning as per operational hours and 84 percent of Puskesmas experienced a reduction in the number of visits which is likely to impact the provision of Reproductive Health including Family Planning services.

A 40 percent reduction of new Family Planning users in March compared to February 2020 means that unmet needs for Family Planning have likely increased.

Reproductive Health services are needed for 5.4 million pregnant mothers and 30 million eligible couples.

At least 900 private practicing midwives closed their services due to lack of PPEs.

In family planning services, there is an estimated 30-40% reduction of new users of contraceptive methods.

An estimated 370,000 to 500,000 additional unintended pregnancies were announced by BKKBN.

Partners’ COVID-19 response

Activities

WHO and UNICEF published a joint press release to commemorate World Breastfeeding Week. The statement calls on the government and stakeholders to safeguard and promote access to services that support mothers to continue breastfeeding practices during the COVID-19 pandemic.

The MoH, supported by WHO, is conducting a comprehensive field assessment to identify best practices, gaps and challenges and develop contextualized recommendations for provinces to strengthen the COVID-19 response. The assessment tool was piloted in nine provinces: Banten, East Java, North Maluku, North Sulawesi, Papua, South Sulawesi, West Java, West Papua and Yogyakarta. WHO assisted the MoH in a country-level Intra-Action Review (IAR) during the second week of August. The global IAR guidelines and facilitators’ packages were translated to Indonesian and adapted to the country context and around 100 participants were trained from multiple sectors to conduct the IAR. The results of the field assessment and the IAR will be used to guide the development of national and province-specific recommendations when updating the provincial and national COVID-19 response plans

WHO, the Indonesia Global Compact Network (IGCN), ILO and UNDP conducted an Executive Roundtable Dialogue on 6 August, to be followed by a series of webinars on ‘Business Unusual in the New Normal’. The webinars aimed to facilitate the dialogue between UN agencies, governments, business associations, the private sector and workers regarding the needs, concerns and challenges for health and safety standards for businesses in the private sector during the COVID-19 pandemic.

WHO is supporting IDI to develop supplementary comprehensive protocols for doctors, focusing on their personal protection during COVID-19 service delivery, and the establishment of an information system to collect data on the number of COVID-19 infections, hospitalizations, recoveries and deaths in doctors. Similarly, WHO also supports preventive measures for nurses, particularly in developing educational materials on IPC and to assess nurses’ exposure to the virus.

WHO supported the MoH with the finalization and dissemination of the fifth revision of the national Guidelines on COVID-19 Prevention and Control. The latest guidelines have revised some case definitions and discharge criteria, in line with WHO guidance.

Partners’ COVID-19 response

Cont. Activities

UNFPA, with the MoH’s Family Health Directorate as Coordinator of Reproductive Health Sub Cluster, is developing awareness and educational videos for health providers and pregnant mothers for the continuation of Sexual Reproductive Health and Family Planning services.

Under the leadership of Bappenas and the MoH, a rapid situational assessment on the immediate impact of COVID-19 on reproductive health services has been conducted and the results were shared on 18-19 August by Bappenas. The next one will be conducted in September 2020 – February 2021.

UNFPA supported the Family Planning National Agency with the development and sensitization of the Operational guidelines on contraceptive availability in crisis situations; natural disaster and pandemic situations.

The Indonesia Midwives Association, supported by UNFPA is facilitating capacity building/support for midwifery centres of excellence to implement distance learning mechanisms and disseminating guidelines for the provision of maternal and newborn health services during the pandemic.

Coordinated with the MoH, UNFPA facilitated a capacity building seminar for health workers and programme managers by disseminating guidelines through virtual, video, and face to face, for the provision of maternal, newborn health and contraceptive services.

UNFPA has provided Personal Protection Equipment (PPE) to 412 midwifery clinics in 3 COVID-19 epicentral areas in Jakarta, West Java and Banten Provinces, to help the continuation of their services from April to September. The expansion of services to East Java Province (Surabaya and Siodarjo Cities) is underway.

The North Luwu District Health Cluster and its Reproductive Health (RH) Sub-cluster have been activated in mid-July, following flashfloods in the area. UNFPA has been supporting coordination and linking the regular RH Sub cluster coordination at the district level to the National RH Sub Cluster. Supported by DFAT, UNFPA distributed 120 dignity kits to the district.

As of 10 July, Muhammadiyah has treated 656 confirmed cases, and 6,359 suspected cases in its 79 hospitals.

Partners’ COVID-19 response

Cont. Activities

UNODC, the Ministry of Social Affairs (MoSA) and the National Narcotics Agency (BNN) launched guidelines on mitigating and preventing the impact of COVID-19 on drug treatment facilities. The two Government institutions run drug treatment facilities in the country. The Guidelines will help prevent COVID-19 among drug treatment patients and users and to protect doctors.

UNOPS is procuring oxygen respirator, PCR test machines, mobile labs for COVID-19 testing, respirator/ventilators, and ambulance without sound pressure function, as well as thermal imaging cameras for Jakarta LRT station funds, with support from KOICA ($3.4 M). It also procures PCR test machines, ambulances, ventilators, reaction kits, packaging boxes, and medicine with funds from the Japan Ministry of Foreign Affairs ($4 M). The medical equipment will be handed over through BNPB / MoH.

UNDP provides advisory support services to the Government to strengthen data systems to ensure an informed, data-driven response strategy to the COVID-19 crisis.

UNDP and WHO are working to strengthen COVID-19 related medical waste management and procuring 4 incinerators and 4 autoclaves to support the Ministry of Health in increasing the capacity for medical waste handling.

With the financial support of the Asian Development Bank (ADB) and other partners, UNICEF has procured a total of 177,667 units of critical health supplies and handed these over to the MoH. Additionally, key equipment such as syringe pumps and biomedical deep freezers have been procured.

To improve the responsiveness of the health system, UNICEF has supported the update of technical protocols on hospital data, with socialization to 834 hospitals across all 34 provinces. Furthermore, UNICEF supported the MoH in the development of the ‘new normal’ guidance for health care facilities, for which field testing and piloting were completed. UNICEF has also supported the updating of the dashboard that visualizes COVID-19 related data for all private and public sector hospitals across the country, to reflect the adoption of new case definitions, as well as improved analyses of pediatric COVID-19 cases.

Partners’ COVID-19 response

Cont. Activities

UNDP provides advisory support services to the Government to strengthen data systems to ensure an informed, data-driven response strategy to the COVID-19 crisis.

UNDP donated 500,000 medical masks to the Ministry of Foreign Affairs (MoFA) and BNPB.

UNICEF and partners continue supporting a series of capacity-building exercises for immunization, HIV, MNCH, malaria, which have reached additional 11,432 health care workers across 34 provinces. To further highlight the importance of continuing HIV/AIDS services, UNICEF has been providing close technical support to MoH in the development of IEC materials.

On 22 July, IOM delivered essential medical equipment and supplies to the COVID19 task force and health providers across Indonesia. The medical equipment and supplies included ventilators, PPE for health care workers, x-ray viewers, defibrillators, and hospital beds, among other essential items.

UNICEF continues to enhance sub-national capacity through its network of 7 regional offices across Indonesia, where embedded staff have been supporting the provincial COVID-19 Task Forces in reviewing and implementing protocols and guidelines; surveillance and epidemiologic investigation; supporting improved data and information flows; supporting the establishment and monitoring of isolation centers and capacity building of health care workers; designing and disseminating risk communication and community engagement content; and locally adapting IEC materials. UNICEF has also been providing support around access to local government budget allocations as well as understanding the overall fiscal space in the health sector.

Following the MoH letter on the inclusion of refugees to access COVID-19 mitigation measures, IOM held virtual coordination meetings with health departments and local community clinics to enhance the management and referral mechanism for COVID-19 within the refugee communities, including on the use of isolation facilities, epidemiological surveys, and contact tracing.

Save the Children provided PPE to over 34,000 people through 62 community health centers and its networks.

Partners’ COVID-19 response

Cont. Activities

On 5 August, medical equipment and supplies were delivered by IOM to some places in Tangerang such as Tangerang hospital, BPBD office and several community health central. The distributed items were 1 mobile X ray, 12 hospital beds, 1,300 N95 masks and more.

o On 18 August, medical equipment and supplies by IOM were delivered to Bekasi Municipality and directly received by Mayor of Bekasi. The distribution took place in three different locations. The distributed items included 1.000 surgical masks, 400 N95 masks, 1.050 gloves pairs, 50 lt. hand sanitizers, and 1 mobile X ray.

On surveillance efforts, IOM collaborated with the city health office in Makassar on epidemiologic surveys and contact tracing within refugee communities in four community accommodations. In addition, the online self e-health assessment tool has been continuously utilized by refugees following its launch in May 2020.

Wahana Visi Indonesia has distributed around 250,000 masks, provided over 4,700 PPE packages for medical personnel, assisted 180 medical facilities including hospitals and clinics with COVID-19 preventative or response support, and reached 2,000 children with Mental Health and Psychosocial Support services (MHPSS).

Partners’ Response Overview

Gaps and Constraints

The COVID-19 pandemic has impacted the health systems in Indonesia, which require immediate and long-term support.