Indonesia faces a myriad of challenges posed by geography, urban migration and a large population spread over more than 17,000 islands, many of which are hard to reach.
Nearly five million children are born every year and, notwithstanding ongoing government efforts to improve the programme, over one million children residing in remote islands and growing urban slums miss out on basic vaccines every year. As a result children in Indonesia still die of vaccine preventable diseases and measles outbreaks continue to occur, causing unnecessary suffering and death, as well as social and economic costs for families, communities and the country.
This measles-rubella campaign provides a rare opportunity to identify missed children and disease hotspots, and even to develop strategies to reach these populations more regularly in future with the full range of vaccines. But fulfilling this potential will require serious commitment and efforts to prioritise unreached children as a key measure of campaign success. In provinces such as Papua, where immunisation coverage has been historically low, achieving a campaign coverage rate of 95% is a daunting task and yet an imperative.
Why do I say this?
First, look at the sheer numbers – 35 million children are expected to receive the measles-rubella vaccine during the campaign’s first phase held in the Java region from August to September 2017, spanning 3,569 public health centres in 119 districts and six provinces. The second phase, which will be conducted in August-September 2018, will cover another 35 million children and all other regions outside Java. Due to Indonesia’s geographical complexity, these areas will be much more difficult to reach and the campaign coverage climb will become much steeper. Success will demand massive mobilisation of not just financial, human resources and logistics, but also social mobilisation and seamless coordination among several government ministries, in particular health, education and religious affairs.
