Standard 4.3 Increase coverage and quality of immunization.

Standard 4.3 Increase coverage and quality of immunization.

Increasing the coverage and quality of immunization is carried out in an effort to improve health services towards universal health coverage, especially strengthening primary health services, by encouraging promotive and preventive efforts.

Puskesmas implements immunization programs in accordance with statutory provisions.

a. Criterion 4.3.1

Immunization programs are planned, implemented, monitored and evaluated in an effort to increase immunization coverage and quality.

1) Main Thoughts:

a) As an effort to protect the public from infectious diseases that can be prevented through immunization, Community Health Centers are required to carry out immunization activities as part of the national priority program.

b) Determining immunization performance indicators is integrated with determining Puskesmas performance indicators.

c) The implementation of the immunization program at the Community Health Center needs to be planned, implemented, monitored and evaluated in order to achieve optimal immunization coverage.

d) Detailed planning (micro planning) includes area mapping, identifying and determining the number of targets, human resource requirements, determining needs, immunization implementation schedules, as well as logistics distribution schedules and mechanisms, and operational costs are prepared to ensure the implementation of the immunization program runs well. Detailed planning is prepared involving cross-related programs.

e) Follow-up actions to improve the immunization program based on the results of monitoring and evaluation are carried out including promotive and preventive efforts in the context of reaching targets and increasing immunization coverage through:

(1) sweeping activities, drop out follow up (DOFU), SOS (sustainable outreach services) activities for difficult geographic areas, defaulter tracking, backlog fighting, crash programs, and catch up campaigns;

(2) efforts to improve the quality of immunization through administering vaccines in accordance with procedures, administering immunizations safely and in accordance with procedures, target data validation activities, self-assessment of data quality (data quality self-assessment/DQS), and rapid comfort assessment (rapid convenience assessment/RCA) to validate the results of immunization coverage and periodic supervision; as well as

(3) efforts to mobilize the community with outreach activities through various communication media, increasing involvement across programs and related sectors, and establishing a community communication forum that cares about immunization.

f) Puskesmas carries out cold chain vaccine management in accordance with established procedures.

g) The Community Health Center measures the performance indicators that have been determined and is accompanied by an analysis of achievements. Analysis of indicator achievements is carried out using analytical methods in accordance with applicable guidelines/guidelines, for example by referring to the situation analysis method contained in the Community Health Center Management Guidebook.

h) Recording and reporting of immunization services, both manually and electronically, is carried out completely, accurately, on time, and in accordance with procedures with a predetermined report format which includes coverage of immunization performance indicators, stock and use of vaccines and other logistics, as well as conditions vaccine chain equipment and AEFI. Reporting to the head of the community health center and district/city regional health service and/or other parties refers to the provisions of statutory regulations. Reporting to the head of the community health center can be done in writing or delivered directly through meetings such as monthly mini workshops, management review meetings, and other forums.

i) Monitoring and evaluation is carried out periodically, continuously and in stages, then analysis is carried out and follow-up plans are made to improve the immunization program.

j) Plans for programs to increase and cover the quality of immunization are prepared by prioritizing promotive and preventive efforts based on the results of analysis of immunization problems in the Puskesmas work area with cross-program involvement that is integrated with the RUK and RPK for UKM services as well as UKP, laboratory and pharmacy.

2) Assessment Elements:

a) Determine performance indicators and targets for the immunization program accompanied by achievements and analysis (R, D, W).

b) Establish an immunization program (R,W).

c) Vaccines and logistics are available according to the needs of the immunization program (R,D,O,W).

d) Vaccine management is carried out to ensure that the vaccine chain is managed in accordance with procedures (R,D,O,W).

e) Activities to increase immunization coverage and quality are coordinated and implemented in accordance with plans and procedures that have been jointly established across programs and across sectors in accordance with established policies, guidelines, procedures and terms of reference (R,D,W).

f) Monitoring and evaluation are carried out as well as follow-up efforts to improve the immunization program (D,W).

g) Recording is carried out and reporting is carried out to the head of the community health center and the district/city regional health service in accordance with established procedures (R, D, W).