The Intra-Action Review (IAR) that was conducted virtually from 11 to 14 August 2020 by the Ministry of Health (MoH) with the support of WHO resulted in a series of recommendations covering the nine key pillars of COVID-19 response: 1) command and coordination; (2) risk communication and community empowerment; (3) surveillance, rapid response teams and case investigation; (4) points of entry, international travel, and transport; (5) laboratory; (6) infection control; (7) case management; (8) operational and logistics support and (9) maintaining essential health services and systems.

WHO facilitated a video conference to discuss the implementation of IAR recommendations. Photo credit: Endang Wulandari/WHO.

As a follow-up to the review, on 26 and 27 November 2020, WHO facilitated a virtual meeting between MoH and relevant stakeholders to discuss and monitor the implementation of IAR recommendations. A total of fifty participants attended the meeting, including the Presidential Office, Ministry of Home Affairs, Ministry of Transportation, Cabinet Secretary, point of entry officers, provincial health offices in DKI Jakarta and North Sulawesi, hospitals, Indonesian Red Cross Society (PMI), UNICEF, and development partners (including USAID and DFAT).

Bureau of public communication and health promotion, MoH presented the implementation of IAR recommendations on risk communication and community empowerment. Photo credit: Endang Wulandari/WHO

Officials in charge for each pillar from the MoH presented activities that have been implemented based on the recommendations and underlined challenges and limitations. The meeting also highlighted a set of achievements: a draft revision of the COVID-19 mitigation and response plan (currently in the process of signing by Secretary General of the MoH), improvements in areas such as trainings on contact tracing and infection control, logistics reporting system, standardization of laboratory reagents, claims for and financing of COVID-19 treatment, health care-associated infection surveillance (including COVID-19 transmission at healthcare facilities), and preparation of a vaccine deployment plan.

Risk communication efforts have also seen improvements. These include developments of a communications strategy; development of information, education and communications materials for COVID-19; daily media monitoring; efforts to counter hoaxes; designation of spokesperson; and media engagement.

Participants reported the use of COVID-19 Partners Platform to support the planning, implementation and resourcing of response activities. The COVID-19 Partners Platform now has included information on funding from donors and partners, as well as COVID-19 national and provincial response plans for Papua, West Papua, North Sulawesi, South Sulawesi, and North Maluku.

COVID-19 response at points of entry (PoE) has equally improved, particularly in terms of screening for travellers, implementation of the Health Alert Card, guidelines for arrival of international travellers at PoE, provision of health quarantine facilities, and resource mobilization to support response at PoE.

The meeting offered several new recommendations to further strengthen the national COVID-19 response:

• Coordination of different COVID-19 hotlines, such as Halo Kemenkes at MoH, COVID-19 hotlines 117 and 119, and analysis of hotline data.
• Continuous efforts for community engagement in collaboration with Ministry of Home Affairs, Ministry of Religious Affairs, and NGOs.
• Provision of Electronic Health Alert Card Access (e-HAC) for provincial health offices.
• Sharing information of e-HAC data from PoE to provincial health office.
• Monitoring tools that can be used in large-scale social restrictions and improve information on bed and ICU capacity for patient referrals and referral system.

The IAR monitoring meeting brought all stakeholders together again, this time to critically and systematically discuss and assess the implementation of IAR recommendations. At the end of the event, all participants agreed that regular coordination meetings are needed to closely monitor implementation, identify gaps, and create solutions to improve the COVID‑19 response in Indonesia.