Efforts by the Government of Indonesia in
expanding the health infrastructure were instrumental in helping the EPI
programs reach the UCI targets. The
health infrastructure features an extensive service delivery network down
to the village. At the sub-national
level, the structure is jointly managed by Ministry of Health (MOH) and
Ministry of Home Affairs (MOHA).
Primary health care in Indonesia
extends from static and mobile health centers to community-based health
services involving community workers at the village level called
cadres. The Integrated Village Posts
(posyandu) were first established in 1984 to
provide five basic preventive cares services including immunization. Routine immunization services are
provided by approximately 7,800 health centers, 22,000 sub-health centers
and 6,600 mobile clinics in addition to public and private hospitals. At the community level, over 50,000
village midwives supervised around 260,000 posyandu
in providing routine immunization.
All routine EPI
vaccines are manufactured locally by companies that have met WHO
prequalification standards and financed by the Indonesian government. An exception to this arrangement is GAVI
supported new vaccine introduction.
having a strong commitment to EPI programs, the government of Indonesia
has met with some recent challenges.
The change of government during the late 1990’s, the South East
Asian financial crisis, and global economic factors put considerable strain
on the primary health care infrastructure.
Nevertheless, in keeping with both national & global disease
reduction goals, the Government of Indonesia has emphasized its commitment
to immunization programs as a priority public health intervention.