The Use of a Health Compliance Monitoring System During the COVID-19 Pandemic in Indonesia: Evaluation Study.

BACKGROUND: COVID-19 cases are soaring in Asia. Indonesia, Southeast Asia's most populous country, is now ranked second in the number of cases and deaths in Asia, after India. The compliance toward mask wearing, social distancing, and hand washing needs to be monitored to assess public behavioral changes that can reduce transmission. OBJECTIVE: This study aimed to evaluate this compliance in Indonesia between October 2020 and May 2021 and demonstrate the use of the Bersatu Lawan COVID-19 (BLC) mobile app in monitoring this compliance. METHODS: Data were collected in real time by the BLC app from reports submitted by personnel of military services, police officers, and behavioral change ambassadors. Subsequently, the data were analyzed automatically by the system managed by the Indonesia National Task Force for the Acceleration of COVID-19 Mitigation. RESULTS: Between October 1, 2020, and May 2, 2021, the BLC app generated more than 165 million reports, with 469 million people monitored and 124,315,568 locations under observation in 514 districts/cities in 34 provinces in Indonesia. This paper grouped them into 4 colored zones, based on the degree of compliance, and analyzed variations among regions and locations. CONCLUSIONS: Compliance rates vary among the 34 provinces and among the districts and cities of those provinces. However, compliance to mask wearing seems slightly higher than social distancing. This finding suggests that policy makers need to promote higher compliance in other measures, including social distancing and hand washing, whose efficacies have been proven to break the chain of transmission when combined with masks wearing.

Health protocol compliance integrated monitoring system to inform public health actions during the COVID-19 pandemic in Indonesia

Background The Indonesia National Task Force for the Acceleration of COVID-19 Mitigation has developed an integrated monitoring system to measure community compliance with the health protocol Bersatu Lawan COVID-19. The current study aims to evaluate compliance with the health protocol in Indonesia through the Bersatu Lawan COVID-19 digital mobile application. Methods Data was collected from the National Task Force between Oct 1, 2020, and May 2, 2021. A total of 437 093 front-line public order forces (eg, police and the military) and Behavioural Change Ambassadors reported real-time community compliance on mask wearing and physical distance keeping at public places such as markets, malls, schools, offices, and worship places. Individuals who did not comply were reprimanded and educated. Findings As of May 2, 2021, more than 165 million reports were gathered, with 469 million people were monitored in 514 districts or cities across 34 provinces in Indonesia. The overall national figures show a compliance of 322 736 010 (85·9%) of 375 711 304 people in mask wearing, and of 315 973 207 (84·1%) of 375 711 304 people in keeping physical distance, as a cumulative estimate. The results showed the variation of compliance rates among districts and cities in provinces. An analysis of data gathered in the week of April 26 to May 2, 2021, showed that mask wearing compliance was low (defined as observed by less than 75% of people) in 103 (29·6%) of 348 districts and cities across Indonesia, and that physical distance compliance was low in 99 (28·4%) of 348 districts and cities. The temporal pattern analysis estimated that compliance decreased in November and December, 2020 (before the peak of the second wave of the pandemic), and that it increased between January and May, 2021 (during and after the second wave). 321 million people were reprimanded and educated on the importance of adherence to the health protocol. Interpretation This paper discusses an example of the use of the Bersatu Lawan COVID-19 application in Indonesia, the most populous country in southeast Asia. We report the first time that an application for digital health, introduced nationally, produced data that could be analysed on a real-time basis, thus enabling central and local government to strengthen enforcement of the health protocol to stop the potential transmission of COVID-19 in public places. Funding No funding to declare.