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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.

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