Experience in COVID-19 vaccine logistics and workforce management: Insights for strengthening health system preparedness in Indonesia

Abstract

The COVID-19 pandemic demonstrated that resilient vaccine logistics and an adequately prepared health workforce are fundamental components of health system preparedness, particularly in geographically diverse countries. This study examined Indonesia’s vaccine logistics and workforce implementation during the 2021 vaccination program to derive lessons for future crises. A cross-sectional design with a mixed-method triangulation approach was applied across 12 provinces, 24 districts/cities, and 517 public health centers. Data were gathered between February and October 2021 through questionnaires, interviews, and focus group discussions. Analysis combined descriptive statistics with thematic synthesis framed by health system preparedness perspectives. Result showed that vaccine distribution relied mainly on self-pickup mechanisms. While supply was generally sufficient, delays and allocation mismatches were common outside Java. Cold chain facilities existed but storage capacity remained inadequate. Vaccine management was largely overseen by pharmaceutical staff, though training for vaccinators and logistics managers was uneven. Financing depended primarily on local government budgets. Indonesia demonstrated quite strong operational capacity in rolling out COVID-19 vaccination. However, reinforcing cold chain infrastructure, integrating logistics systems, expanding workforce training, and ensuring sustainable local financing are critical to strengthen pandemic preparedness for future.