DETERMINANTS OF COMMUNITY HEALTH CENTRE BASIC IMMUNIZATION PROGRAM ACHIEVEMENT DURING THE COVID-19 PANDEMIC: A MIXED METHODS STUDY FROM TABANAN REGENCY
Main Article Content
Abstract
Imunisasi adalah salah satu strategi pencegahan kesehatan masyarakat yang paling hemat biaya di semua tingkat sosioekonomi. Pada tahun 2020, pada saat pandemic COVID-19, capaian imunisasi di wilayah Kabupaten Tabanan, Bali, mengalami penurunan, bahkan pada tahun 2021 terdapat 3 puskesmas di wilayah Kabupaten Tabanan yang capaian imunisasinya di bawah 50 %. Tujuan penelitian ini untuk mengidentifikasi faktor-faktor yang mempengaruhi pencapaian program imunisasi dasar Puskesmas di Kabupaten Tabanan, Provinsi Bali selama pandemi COVID-19. Penelitian ini menggunakan rancangan metode campuran (mixed method), studi kuantitatif dan kualitatif, untuk mengidentifikasi faktor-faktor yang mempengaruhi Capaian Program Imunisasi Dasar Puskesmas pada Masa pandemi COVID-19 di Kabupaten Tabanan. Survei kuantitatif dan wawancara semi-terstruktur menilai perspektif 100 ibu yang memiliki anak di bawah 12 bulan dan 5 penyedia layanan kesehatan. Hasil penelitian menunjukkan bahwa sikap ibu dan dukungan keluarga merupakan faktor yang paling mempengaruhi status imunisasi dasar lengkap di Puskesmas Kabupaten Tabanan. Masih terdapat kesalahan informasi mengenai dampak negatif imunisasi terhadap masyarakat di salah satu Puskesmas di Kabupaten Tabanan. Pengawasan pada saat pemberian imunisasi perlu ditingkatkan sehingga dapat meminimalisir tindakan anti vaksin, dan juga memberikan edukasi kepada masyarakat mengenai pentingnya imunisasi. Perencanaan pelaksanaan imunisasi dasar dengan menggunakan sistem clustering dan sistem monitoring dan evaluasi dengan pendekatan teknologi informasi dapat diterapkan pada situasi pandemi COVID-19.
Article Details
References
S. Y. Sim, E. Watts, D. Constenla, L. Brenzel, and B. N. Patenaud, “Return on investment from immunization against 10 pathogens in 94 low-and middle-income countries, 2011–30,” Health Aff, vol. 39, no. 8, pp. 1343–1353, Aug. 2020, doi: 10.1377/hlthaff.2020.00103.
World Health Organization, “Immunization Agenda 2030: A Global Strategy to Leave No One Behind,” World Health Organization, Apr. 2020.
J. M. Okwo-Bele and T. Cherian, “The expanded programme on immunization: A lasting legacy of smallpox eradication,” Vaccine, vol. 29, no. SUPPL. 4, Dec. 2011, doi: 10.1016/j.vaccine.2012.01.080.
Ministry of Health of the Republic of Indonesia, Textbook of immunization. Center for education and training of health workers, 2014.
A. Lindstrand, T. Cherian, D. Chang-Blanc, D. Feikin, and K. L. O’brien, “The World of Immunization: Achievements, Challenges, and Strategic Vision for the Next Decade,” J. Infect. Dis., vol. 224, no. Suppl 4, pp. S452–S467, 2021, doi: 10.1093/infdis/jiab284.
Child Health Task Force, “United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME) Report 2022,” 2023.
World Health Organization, “Childhood immunization begins recovery after COVID-19 backslide,” 2023. [Online]. Available: https://www.who.int/news/item/18-07-2023-childhood-immunization-begins-recovery-after-covid-19-backslide
S. Bechini et al., “Paediatric activities and adherence to vaccinations during the COVID-19 epidemic period in Tuscany, Italy: A survey of paediatricians,” J Prev Med Hyg, vol. 61, no. 2, pp. E125–E129, Jul. 2020, doi: 10.15167/2421-4248/jpmh2020.61.2.1626.
D. Buonsenso, B. Cinicola, M. N. Kallon, and F. Iodice, “Child Healthcare and Immunizations in Sub-Saharan Africa During the COVID-19 Pandemic,” Front Pediatr, vol. 8, Aug. 2020, doi: 10.3389/fped.2020.00517.
F. A. Moraga-Llop, M. Fernández-Prada, A. M. Grande-Tejada, L. I. Martínez-Alcorta, D. Moreno-Pérez, and J. J. Pérez-Martín, “Recovering lost vaccine coverage due to COVID-19 pandemic,” Vacunas, vol. 21, no. 2, pp. 129–135, Jul. 2020, doi: 10.1016/j.vacun.2020.07.001.
N. Chanchlani, F. Buchanan, and P. J. Gill, “Addressing the indirect effects of COVID-19 on the health of children and young people,” CMAJ, vol. 192, no. 32, pp. E921–E927, Aug. 2020, doi: 10.1503/cmaj.201008.
S. Saxena, H. Skirrow, and H. Bedford, “Routine vaccination during covid-19 pandemic response,” The BMJ, vol. 369. BMJ Publishing Group, Jun. 16, 2020. doi: 10.1136/bmj.m2392.
S. Chandir, D. A. Siddiqi, H. Setayesh, and A. J. Khan, “Impact of COVID-19 lockdown on routine immunisation in Karachi, Pakistan,” The Lancet Global Health, vol. 8, no. 9. Elsevier Ltd, pp. e1118–e1120, Sep. 01, 2020. doi: 10.1016/S2214-109X(20)30290-4.
A. Haqqi et al., “COVID-19 in Pakistan: Impact on global polio eradication initiative,” Journal of Medical Virology, vol. 93, no. 1. John Wiley and Sons Inc, pp. 141–143, Jan. 01, 2021. doi: 10.1002/jmv.26240.
H. I. McDonald et al., “Early impact of the coronavirus disease (COVID-19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020,” Eurosurveillance, vol. 25, no. 19, May 2020, doi: 10.2807/1560-7917.ES.2020.25.19.2000848.
The Lancet Child & Adolescent Health, “Pandemic school closures: risks and opportunities,” The Lancet Child and Adolescent Health, vol. 4, no. 5. Elsevier B.V., p. 341, May 01, 2020. doi: 10.1016/S2352-4642(20)30105-X.
K. Proudfoot, “Inductive/Deductive Hybrid Thematic Analysis in Mixed Methods Research,” J Mix Methods Res, vol. 17, no. 3, pp. 308–326, Jul. 2023, doi: 10.1177/15586898221126816.
J. Fereday and E. Muir-Cochrane, “Demonstrating Rigor Using Thematic Analysis: A Hibryd Approach of Inductive and Deductive Coding and Theme Development,” Int J Qual Methods, vol. 5, no. 1, 2006, [Online]. Available: http://www.ualberta.ca/~iiqm/backissues/5_1/pdf/fereday.pdf
M. D. Fetters, L. A. Curry, and J. W. Creswell, “Achieving integration in mixed methods designs - Principles and practices,” Health Serv Res, vol. 48, no. 6 PART2, pp. 2134–2156, 2013, doi: 10.1111/1475-6773.12117.
T. C. Guetterman, M. D. Fetters, and J. W. Creswell, “Integrating quantitative and qualitative results in health science mixed methods research through joint displays,” Ann Fam Med, vol. 13, no. 6, pp. 554–561, 2015, doi: 10.1370/afm.1865.
S. Chandir et al., “Impact of COVID-19 pandemic response on uptake of routine immunizations in Sindh, Pakistan: An analysis of provincial electronic immunization registry data,” Vaccine, vol. 38, no. 45, pp. 7146–7155, Oct. 2020, doi: 10.1016/j.vaccine.2020.08.019.
L. R. Baghdadi, A. Younis, H. I. Al Suwaidan, M. M. Hassounah, and R. Al Khalifah, “Impact of the COVID-19 Pandemic Lockdown on Routine Childhood Immunization: A Saudi Nationwide Cross-Sectional Study,” Front Pediatr, vol. 9, Jun. 2021, doi: 10.3389/fped.2021.692877.
N. Muammar, A. Ajeebi, A. Aladwany, A. Yousif, N. Alharthy, and W. Phillip, “Factors associated with delayed child vaccine during coronavirus disease-2019 pandemic,” Saudi Journal of Emergency Medicine, pp. 18–25, 2021, doi: 10.24911/sjemed/72-1603445943.
A. Dong et al., “Routine childhood vaccination rates in an academic family health team before and during the first wave of the COVID-19 pandemic: a pre-post analysis of a retrospective chart review,” CMAJ Open, vol. 10, no. 1, pp. E43–E49, Jan. 2022, doi: 10.9778/cmajo.20210084.
É. M. Garcia, C. Nery Teixeira Palombo, E. A. Waldman, and A. P. S. Sato, “Factors Associated with the Completeness of the Vaccination Schedule of Children at 12 and 24 Months of Age in a Brazilian Medium-Size Municipality,” J Pediatr Nurs, vol. 60, pp. e46–e53, Sep. 2021, doi: 10.1016/j.pedn.2021.02.028.
Soekidjo Notoatmodjo, Education and Health Behavior. Jakarta: Rineka Cipta, 2003.
R. of I. Ministry of Health, Technical Guidelines for Immunization Services During The Covid-19 Pandemic. Jakarta: Ministry of Health, Republic of Indonesia, 2020.