Essential role of primary health care during COVID-19 pandemic: lessons learned from PUSPA (champion and integrated community health center) program in West Java, Indonesia

BACKGROUND: Primary health care plays a paramount role in responding to the pandemic. Aiming to strengthen the pandemic response in West Java, one of the hardest hit provinces by COVID-19 in Indonesia, the provincial government collaborating with a civil society organization (CISDI) initiated a primary health care strengthening program called PUSPA. This paper looks to assess the success and challenges faced throughout the PUSPA program. METHODS: This program was implemented in March to September 2021 by assigning a team of five interprofessional health care workers to assist 100 Community Health Center (Puskesmas) in West Java using The Whole-of-Society pandemic readiness approach. The implementation of the program included: strengthening of testing, tracing and treatment (3T), risk communication and community engagements (RCCE) as well as essential health care maintenance. RESULTS: Through the program, PUSPA has successfully contributed to the increased capacity of the interventional Puskesmas in responding to the pandemic. Testing capacity was strengthened during the implementation period, reaching the highest level at 4.5 testing per 1000 population during the peak of the delta wave of the pandemic in Indonesia. The trend of confirmed case and positivity rate declined from 1,937 daily cases and 19.6% to 534 daily cases and 6.14% respectively. Tracing performance was improved from 2.03 to 4.91 for each confirmed case. The PUSPA program maintained the coverage of isolation and quarantine monitoring above 97.5%. The adoption of RCCE has led the PUSPA team to reach 1000 sentinel places and 769,425 persons in total. Lastly, an increase in the use of essential health care services was recorded during the implementation of the program. CONCLUSION: Not only increasing pandemic response capacity, the PUSPA program also contributed to meaningful community empowerment. This program highlights the importance of close engagement between government and civil society in responding to health emergencies.