Impact of COVID-19 Pandemic on Routine Childhood Immunization Programs in Indonesia: Taking Rural and Urban Area into Account

Abstract

Nur Rahayuningsih,1,2 Rano K Sinuraya,1,3,4 Yasmin Fatinah,1 Ajeng Diantini,1,4 Auliya A Suwantika1,4,5 1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia; 2Faculty of Pharmacy, Universitas Bakti Tunas Husada, Tasikmalaya, Indonesia; 3Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 4Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia; 5Center for Health Technology Assessment, Universitas Padjadjaran, Sumedang, IndonesiaCorrespondence: Rano K Sinuraya, Email [email protected]; [email protected]: To date, the primary global concern has revolved around addressing the COVID-19 pandemic. However, there is a growing awareness of the pandemic’s secondary impacts on critical aspects of healthcare, such as childhood immunization programs.Objective: This study aims to assess the impact of the COVID-19 pandemic on childhood immunization programs in Indonesia, with a specific focus on performance disparities between rural and urban areas. It considers factors like access, utilization, and program workload.Methods: Data were collected from primary health cares (PHCs) in two regions in West Java Province, Indonesia, representing rural and urban areas. A descriptive analysis was conducted to compare vaccination coverage, drop-out rates, and the ratio of vaccinators per dose from 2019 to 2021 in 40 and 22 PHCs for rural and urban areas, respectively. A general linear model was employed to evaluate the differences in these parameters over the three consecutive years.Results: The results indicate fluctuations in vaccine coverage over the three years, with the most significant impact observed in 2020, particularly in rural areas. Statistical analysis revealed a significant difference in routine immunization coverage, drop-out rates, and vaccinator ratios between rural and urban areas from 2019 to 2021 (p< 0.05). In 2021, both rural and urban areas displayed significant differences in performance parameters for routine immunization and COVID-19 vaccination (p< 0.05), except in terms of coverage for IPV and COVID-19 vaccination.Conclusion: The study highlights a reduction in routine immunization coverage during the pandemic, a concerning issue that increases the risk of vaccine-preventable diseases, particularly in rural areas.Keywords: immunization coverage, dropout rate, workload, primary healthcare centers

Keywords

• immunization coverage
• dropout rate
• workload
• primary healthcare centers