In 2020, Indonesia reported the highest number of COVID-19 cases in Southeast Asia. As of 31 December 2020, the country had recorded 735 124 cases and 21 944 deaths.[1] The protracted nature of the COVID-19 pandemic in Indonesia necessitated an urgent review of the national response to identify areas within the public health response that require strengthening to improve the ongoing COVID-19 response.

To fulfil this need, WHO supported Indonesia to conduct an Intra-Action Review (IAR) of its COVID-19 response in August 2020. The IAR critically reviewed and reflected on progress in the COVID-19 response across the nine pillars of Indonesia’s COVID-19 strategic preparedness and response plan. The nine pillars included (1) Coordination, planning, and monitoring; (2) Risk communication and community engagement; (3) Surveillance, rapid response team, and case investigation; (4) Points of entry, international travel and transport, and large-scale social restrictions; (5) National laboratories; (6) Infection prevention and control; (7) Case management; (8) Operational support and logistics; and (9) Maintaining essential health services and systems. Furthermore, vaccination pillar was also discussed during three monthly regular monitoring of IAR recommendation implementation.

Following IAR recommendations, WHO immediately expanded and designated members of its Incident Management Team (IMT) to support and monitor the implementation along the nine pillars of the COVID-19 strategic preparedness and response plan.

Notable outputs from implementing IAR recommendations include the complete revision of Indonesia’s health sector COVID-19 Strategic Preparedness and Response Plan (SPRP), with recommended adjustments to the command and coordination structure to ensure that operational and strategic functions are clearly defined. Indicators of the COVID-19 strategic preparedness and response plan (SPRP) are now monitored through an information flow dashboard at the national and sub-national level by multisectoral coordination  comprising local and international stakeholders.

To improve risk communication and community engagement, WHO supported collaboration between the Ministry of Communications and Information and telecommunications companies for information sharing to the general public via WhatsApp, SMS and other information platforms. Furthermore, media coaching continued with ongoing coaching for the designated officials in the Ministry of Health to improve risk communication and community engagement for relevant government and community organisations.

WHO also supported interventions to improve surveillance and case management. Part of the support was to conduct a national seroepidemiological survey that covered samples in 17 provinces. WHO also supported piloting of a mobile technology application (SILACAK) for COVID-19 contact tracing and monitoring in 44 districts. Scale-up is ongoing in 98 districts. To further enhance contact tracing and monitoring at international travel entry points, provincial health officers can now access eHealth Alert Card data.

WHO has also supported developing an External Quality Assurance (EQA) dashboard to monitor the conduct of quality assurance of commercial and non-commercial laboratories providing COVID-19 testing. As of February 2021, more than 177 labs have had an EQA. Findings from the EQA have informed new policies, and technical guidance on COVID-19 testing, including the use of antigen detection Rapid Diagnostic Test (RDT) in COVID-19 testing, has been issued. WHO has also facilitated the development of technical guidelines and built the capacity of primary health workers to deliver optimal essential health services in Puskesmas as part of the COVID-19 response

Since the official announcement of the first COVID-19 cases on 2 March 2020, a sustained increase in new cases and deaths occurred up till January 2021. Following the implementation of IAR recommendations, Indonesia has for the first time experienced a sustained downward trend in COVID-19 cases and deaths. The WHO support to facilitate the IAR provided the learning and improvement necessary to turn the tide against the COVID-19 pandemic.