Services: Assessment, Monitoring, Evaluation, and Research, Program Development, Technical Assistance, Training, Capacity Development
Technical Expertise: Universal Health Coverage, Infectious Diseases, Health Supply Chain Management
Indonesia has health challenges similar to those in neighboring countries and many other developing countries, but has comparatively weaker health outcomes, especially maternal health outcomes. The total fertility rate is 2.6, with a modern methods contraceptive prevalence rate (for married women) of 58 percent. Unmet need for contraception is 11.5 percent and the under-five mortality rate is 40/1000. Furthermore, every year, there are about 500,000 new tuberculosis (TB) cases and approximately 65,000 TB-related deaths in Indonesia and cases of multi-drug resistant TB are on the rise. Indonesia is also experiencing a rapidly growing HIV epidemic, with an estimated 480,000 people living with HIV. The Indonesian drug supply chain also faces a number of challenges.
Although JSI’s work in Indonesia through DELIVER started out by making key contributions to reduce influenza-like illnesses, between 2013 and 2016, JSI focused on key technical assistance to elevate supply chain support. JSI also served in a leadership capacity for the People that Deliver (PtD) Global Initiative and Indonesian PtD Forum. The project worked across various levels of the health system to build capacity of supply chain human resources and improve coordination among partners to ensure that each group has the supply chain management knowledge, skills, and equipment needed to help combat health threats.
JSI also helped to draft a three-year MOH Nation Drug Management Strategy with key MOH stakeholders; facilitated the development of a supply logistics system for the 2013/14 National TB Prevalence Survey, which took place in 150 districts over the course of 14 months; and designed a TB MDR specimen transport and cold chain pilot for 16 districts in nine provinces among several other activities.
Through the program, JSI fostered partnerships not only with the local government but also with the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), the Global Fund (GF), the USAID-funded TB-Care, the Clinton Health Access Initiative (CHAI), and a number of other international and national agencies, to support disease-specific programs within the Ministry of Health (MOH) such as the National Tuberculosis Program (NTP) and the HIV/AIDS and malaria programs.
During 2015, the TB Cold Chain Pilot was developed to help address one of the main challenges found in the TB program: ensuring cold chain integrity during specimen transport from lab-to-lab. To prepare for the pilot, the standard operating procedures (SOP) from the Salatiga Reference Lab were used as a generic template for all other reference labs that followed. The WHO Laboratory Manual was also translated into Bahasa Indonesia.
The TB Cold Chain Pilot included training at the district and provincial labs on their lab-specific SOPs, outsourcing of transportation/courier services for specimens between labs, and return of cold chain boxes, procurement of cold chain supplies, and monitoring and supervision.