Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

Community-based COVID-19 vaccination services improve user satisfaction: findings from a large household survey in Bali Province, Indonesia

I. Made Dwi Ariawan A , Anak Agung Sagung Sawitri A , Putu Cintya Denny Yuliyatni A , Desak Nyoman Widyanthini A and I. Nyoman Sutarsa A B *
+ Author Affiliations
- Author Affiliations

A Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia.

B School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.

* Correspondence to: sutarsa.nyoman@anu.edu.au

Australian Journal of Primary Health 30, PY24014 https://doi.org/10.1071/PY24014
Submitted: 5 March 2024  Accepted: 12 August 2024  Published: 30 August 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Understanding community preferences for vaccination services is crucial for improving coverage and satisfaction. There are three main approaches for COVID-19 vaccination in Indonesia: health facility-based, community-based, and outreach approaches. This study aims to assess how the vaccination approaches impact user satisfaction levels.

Methods

This study was part of a large household survey involving 12,120 respondents across nine districts in Bali Province. The study population comprised all residents aged ≥12 years who had received at least one dose of COVID-19 vaccination. Samples were selected through three stages of systematic random sampling. Data were collected through interviews using structured questionnaires, which included socio-demographic characteristics, vaccination services, and satisfaction levels. Analysis was performed using Chi Square test and logistic regression, with the entire process incorporating weighting factors.

Results

A total of 12,120 respondents reported receiving their first dose of COVID-19 vaccination. The satisfaction level among vaccine recipients (partial, complete, and booster doses) was high (84.31%). Satisfaction within each SERVQUAL dimension was highest in tangibles (96.10%), followed by responsiveness (93.25%), empathy (92.48%), assurance (92.35%), and reliability (92.32%). There was no significant difference in the overall SERVQUAL score between the health facility and community-based approaches. However, the latter slightly improved user satisfaction across three dimensions: tangibles (adjusted odds ratio, AOR = 1.52, 95% confidence interval (CI) = 1.21–1.90), reliability (AOR = 1.67, 95%CI = 1.42–1.96), and assurance (AOR = 1.26, 95%CI = 1.07–1.48).

Conclusion

During the pandemic, both health facility and community-based approaches resulted in a high satisfaction level. It is recommended that the government prioritise and optimise community-based programs and health facility-based delivery in future vaccination initiatives, especially during public health emergencies.

Keywords: community-based, COVID-19 vaccination, household survey, Indonesia, satisfaction, service delivery, service quality, SERVQUAL.

References

Are EB, Song Y, Stockdale JE, Tupper P, Colijn C (2023) COVID-19 endgame: from pandemic to endemic? Vaccination, reopening and evolution in low- and high-vaccinated populations. Journal of Theoretical Biology 559, 111368.
| Crossref | Google Scholar |

Ati NWJ, Suyasa IGPD, Mastryagung GAD (2022) Level of community satisfaction with COVID-19 vaccine services in Belantih Village, Kintamani District. Jurnal Medika Usada 5(2), 34-41 Available at https://ejournal.stikesadvaitamedika.ac.id/index.php/MedikaUsada/article/view/134.
| Google Scholar |

Bali Province Central Bureau of Statistics (2021) Official statistics news: results of the 2020 population census for Bali Province. Available at https://bali.bps.go.id/pressrelease/2021/01/21/717592/hasil-sensus-penduduk-2020-provinsi-bali.html

Biancolella M, Colona VL, Mehrian-Shai R, Watt JL, Luzzatto L, Novelli G, Reichardt JKV (2022) COVID-19 2022 update: transition of the pandemic to the endemic phase. Human Genomics 16, 19.
| Crossref | Google Scholar |

DeRoo SS, Pudalov NJ, Fu LY (2020) Planning for a COVID-19 vaccination program. JAMA 323(24), 2458-2459.
| Crossref | Google Scholar |

Fadhilah MU, Fauziyah U, Cahyani AA, Arif L (2021) Evaluation of COVID-19 vaccination services (case study of Mojo Public Health Center, Surabaya City). Journal Publicuho 4(2), 536-552.
| Crossref | Google Scholar |

Hopkins KL, Underwood T, Iddrisu I, Woldemeskel H, Bon HB, Brouwers S, Almedia SD, Fol N, Malhotra A, Prasad S, Bharadwaj S, Bhatnagar A, Knobler S, Lihemo G (2023) Community-based approaches to increase COVID-19 vaccine uptake and demand: lessons learned from four UNICEF-supported interventions. Vaccines 11, 1180.
| Crossref | Google Scholar |

Indonesia Central Bureau of Statistics (2021) Health statistic profile 2021. Available at https://www.bps.go.id/id/publication/2021/12/22/0f207323902633342a1f6b01/profil-statistik-kesehatan-2021.html

Indonesia COVID-19 Countermeasures Task Force (2022) COVID-19 situation by province: Bali. Available at https://covid19.go.id/situasi/

Indonesia Ministry of Health (2020) Decree of the Minister of Health of the Republic of Indonesia Number HK0107/MENKES/382/2020 concerning Health Protocols for Communities in Public Places and Facilities in the Framework of Prevention and Control of Corona Virus Disease 2019 (COVID-19). Available at http://hukor.kemkes.go.id/uploads/produk_hukum/KMK_No__HK_01_07-MENKES-382-2020_ttg_Protokol_Kesehatan_Bagi_Masyarakat_di_Tempat_dan_Fasilitas_Umum_Dalam_Rangka_Pencegahan_COVID-19.pdf

Indonesia Ministry of Health (2021) Decree of the Minister of Health of the Republic of Indonesia Number HK0107/MENKES/4638/2021 concerning Technical Instructions for Implementing Vaccination in the Context of Overcoming the Corona Virus Disease 2019 (COVID-19) Pandemic. Available at https://farmalkes.kemkes.go.id/?wpdmpro=kmk-no-hk-01-07-menkes-4638-2021-ttg-juknis-pelaksanaan-vaksinasi-dalam-rangka-penanggulangan-pandemi-covid-19

Indonesia Ministry of Health (2023) Indonesia health profile 2022. Available at https://p2p.kemkes.go.id/profil-kesehatan-2022/

Indonesia Ministry of Health (2024) National COVID-19 vaccination. Available at https://vaksin.kemkes.go.id/#/vaccines

Kunno J, Supawattanabodee B, Sumanasrethakul C, Kaewchandee C, Wanichnopparat W, Prasittichok K (2022) The relationship between attitudes and satisfaction concerning the COVID-19 vaccine and vaccine boosters in Urban Bangkok, Thailand: a cross-sectional study. International Journal of Environmental Research and Public Health 19(9), 5086.
| Crossref | Google Scholar |

Lailasari A (2022) Analysis of satisfaction with services providing COVID-19 vaccination to the community at the Swasti Saba Public Health Center, Lubuklinggau City in 2022. Master thesis, STIKES Bina Husada Palembang. STIKES Bina Husada Repository. Available at http://rama.binahusada.ac.id:81/id/eprint/860/1/Ayu%20Lailasari.pdf

Lestari DA, Priyatno AD, Harokan A (2022) Analysis of Satisfaction COVID-19 vaccination services in the community in Jakabaring Palembang City OPI Health Center in 2022. Health Care: Jurnal Kesehatan 11(2), 246-257.
| Crossref | Google Scholar |

Muhtarom I (2021) Covid-19 vaccination reaches 70 percent, Is Bali ready to welcome tourists? Tempo. Available at https://travel.tempo.co/read/1476050/vaksinasi-covid-19-capai-70-persen-bali-siap-sambut-wisatawan/

Naidu A (2009) Factors affecting patient satisfaction and healthcare quality. International Journal of Health Care Quality Assurance 22(4), 366-381.
| Crossref | Google Scholar |

Nilsen P (2006) The theory of community based health and safety programs: a critical examination. Injury Prevention 12, 140-145.
| Crossref | Google Scholar | PubMed |

Parasuraman AP, Zeithaml VA, Berry LL (1985) A conceptual model of service quality and its implications for future research. Journal of Marketing 49(4), 41-50.
| Crossref | Google Scholar |

Parasuraman AP, Zeithaml VA, Berry LL (1988) SERVQUAL: a multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing 64(1), 12-40.
| Google Scholar |

Piraux A, Cavillon M, Ramond-Roquin A, Faure S (2022) Assessment of satisfaction with pharmacist-administered COVID-19 vaccinations in France: PharmaCoVax. Vaccines 10(3), 440.
| Crossref | Google Scholar |

Qassim SH, Chemaitelly H, Ayoub HH, Coyle P, Tang P, Yassine HM, Al Thani AA, Al-Khatib HA, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ (2023) Population immunity of natural infection, primary-series vaccination, and booster vaccination in Qatar during the COVID-19 pandemic: an observational study. eClinicalMedicine 62, 102102.
| Crossref | Google Scholar |

Rodrigues CMC, Plotkin SA (2020) Impact of vaccines; health, economic and social perspectives. Frontiers in Microbiology 11, 1526.
| Crossref | Google Scholar |

Sawitri AAS, Yuliyatni PCD, Ariawan IMD, Sutarsa IN, Widyanthini DN, Dewi AAIS, Cempaka PPAR, Pradnyadewi AAAD, Karya IKJD, Pramandani NLMS, Janadewi IGA, Dewi KRA (2022) Survey of COVID-19 vaccination coverage in Bali Province. Available at https://cdn.who.int/media/docs/default-source/searo/indonesia/non-who-publications/2022-bali-coverage-survey-covid-19-vaccination.pdf?sfvrsn=b269fbde_6&download=true

Shahzad MW, Al-Shabaan A, Mattar A, Salameh B, Alturaiki EM, AlQarni WA, AlHarbi KA, Alhumaidany TM (2022) Public satisfaction with COVID-19 vaccination program in Saudi Arabia. Patient Experience Journal 9(3), 154-163.
| Crossref | Google Scholar |

Stodolska A, Wojcik G, Baranska I, Kijowska V, Szczerbinska K (2023) Prevalence of burnout among healthcare professionals during the COVID-19 pandemic and associated factors – a scoping review. International Journal of Occupational Medicine and Environmental Health 36(1), 21-58.
| Crossref | Google Scholar | PubMed |

The Kobo Organization (2022) The KoboToolbox software. Available at https://www.kobotoolbox.org/about-us/software/

United Nations (2005) ‘Designing household survey samples: practical guidelines. Studies in Methods Series F No 98.’ (Department of Economics and Social Affairs, Statistic Division: New York) Available at https://unstats.un.org/unsd/demographic/sources/surveys/handbook23june05.pdf

Wijayanti SPM, Rejeki DSS, Rizqi YNK, Octaviana D, Nurlaela S (2023) Assessing the user satisfaction on COVID-19 vaccination service in Indonesia. Journal of Public Health Research 12(2), 1-10.
| Crossref | Google Scholar |

WHO (2018) World Health Organization vaccination coverage cluster surveys: reference manual. Geneva, Switzerland. Available at http://apps.who.int/bookorders

Xesfingi S, Vozikis A (2016) Patient satisfaction with the healthcare system: assessing the impact of socio-economic and healthcare provision factors. BMC Health Services Research 16, 94.
| Crossref | Google Scholar |

Yang Z-R, Jiang Y-W, Li F-X, Liu D, Lin T-F, Zhao Z-Y, Wei C, Jin Q-Y, Li X-M, Jia Y-X, Zhu F-C, Yang Z-Y, Sha F, Feng Z-J, Tang J-L (2023) Efficacy of SARS-CoV-2 vaccines and the dose–response relationship with three major antibodies: a systematic review and meta-analysis of randomised controlled trials. The Lancet Microbe 4(4), e236-e246.
| Crossref | Google Scholar | PubMed |

Zhang J-J, Dong X, Liu G-H, Gao Y-D (2023) Risk and protective factors for COVID-19 morbidity, severity, and mortality. Clinical Reviews in Allergy & Immunology 64, 90-107.
| Crossref | Google Scholar | PubMed |