Presidential Vote Share and COVID-19 Vaccination Rate in Indonesia: A District-level Cross-Sectional Ecological Study

Political affiliation has been reported as a determinant of COVID-19 vaccine acceptance in some countries, although few studies have examined the Asian context. This study aims to fill this gap by employing an ecological study design using Indonesian regions as data points. Political affiliation was represented by incumbent President Jokowi’s vote share in the 2019 presidential election. Potential confounders included population density, human development index, availability of hospitals and primary health care, 2019–2020 economic growth, COVID-19 mortality rate, and proportion of Muslims in the population. The final analysis included 201 out of 501 districts and cities in Indonesia. Controlling for confounders, multivariate regression found that Jokowi’s vote share was an independent predictor of vaccination rate, with standardized β and R2 values of 0.350 and 0.734 for the first dose vaccination rates and 0.251 and 0.782 for the second dose, respectively. This association may be underpinned by differences in religiosity, public trust, and vulnerability to misinformation between Jokowi’s supporters and the opposition. Improving public trust in a politically polarizing society is crucial to improving future coverage of COVID-19 and other vaccines

Perspectives on voluntary assisted partner notification among providers, people with HIV and the general population in Indonesia: a formative qualitative study.

BACKGROUND: Voluntary assisted partner notification (aPN) services are effective in increasing access to and uptake of HIV testing among partners of people with HIV. Following recommendations by the World Health Organization in 2016, Indonesia evaluated various approaches to aPN. We present the lessons learned from formative operational research undertaken to understand provider and patient perspectives on aPN from three demonstration sites in cities with a high HIV burden. METHODS: We conducted a formative qualitative study in three cities: Jakarta, Semarang, and Denpasar between September and October 2019. We conducted six focus group discussions (FGDs) (n = 44 participants) among health-care providers, people living with HIV and the general population. We explored participant preferences and concerns about how aPN should be delivered, including the methods of and messaging for contacting partners. All FGDs were conducted in the Indonesian language. Qualitative data were analysed using thematic analysis. RESULTS: aPN was acceptable across different participant populations, although with caveats. Some differences were observed between the general population, providers and people living with HIV. People living with HIV were mainly concerned with confidentiality of the procedure and preferred the use of telecommunication and messages that avoid explicit mention of HIV exposure. Providers preferred similar approaches but for different reasons, being concerned mainly with self-efficacy and security. There was consensus regarding dual referral models. The use of phone calls and short messages were preferred as these are perceived to minimize negative reactions and stigma, protect client confidentiality and are suitable in the current legal situation. The general population was mainly concerned with effectiveness and prefer direct provider-led approaches, such as preferring in-person meeting with explicit notification of potential HIV exposure. CONCLUSIONS: We found consensus among stakeholders on acceptance of aPN, especially dual referral methods. Development and implementation of aPN protocols should also consider clients' individual situations and concerns regarding safeguarding of confidentiality, and offer a range of options to accommodate all stakeholders involved

Health Beliefs and Socioeconomic Determinants of COVID-19 Booster Vaccine Acceptance: An Indonesian Cross-Sectional Study

Introduction: The threat of new SARS-CoV-2 variants indicates the need to implement COVID-19 vaccine booster programs. The aim of this study was to identify the level of booster acceptance and its determinants. Methods: A cross-sectional online survey was conducted in Jakarta and Bali, Indonesia. Booster acceptance was divided into three categories: non-acceptor, planned acceptor, and actual acceptor. The primary independent variables were health beliefs, media influence, and trust in authoritative sources. Other covariates included demographics, socioeconomic status, and COVID-19 history. A primary analysis was conducted through multinomial logistic regression. The effects of the hypothetical situations on booster acceptance were tested using the Wilcoxon signed-rank test. Results: The final analysis included 2674 respondents with a booster acceptance rate of 56.3% (41.2% planned acceptors, 15.1% actual acceptors). Health beliefs, social media influence, and trust in authoritative information sources were identified as determinants for planned and actual booster acceptance. Socioeconomic status indicators were also identified as determinants for actual booster acceptance. Booster acceptance was increased in hypothetical scenarios involving booster requirements for work, travel, and accessing public places. Conclusions: Booster acceptance was found to be lower than the predicted primary vaccine acceptance prior to its launch. The acceleration of booster coverage requires strategies that leverage health beliefs and focus on people with a lower socioeconomic status

ECONOMIC INSECURITY AND STRESS AS DETERMINANTS OF COVID-19 PREVENTIVE BEHAVIOUR IN DENPASAR

Background: The COVID-19 pandemic has constituted concurrent public health and economic crises. An inter-correlation between economic and public health impacts due to the COVID-19 pandemic needs to be studied to improve mitigation measures.Aims: This study identified a correlation of the economic insecurity and perceived stress with adherence to recommended preventive behaviours Methods: This across-sectional analytic study was conducted to adults in the working areas of East Denpasar Primary Healthcare Center I. Respondents were selected using consecutive sampling and given a self-administered questionnaire. The research variables included demographic characteristics, economic insecurity indicators, perceived stress, and adherence to handwashing, mask-wearing, physical distancing, and limitation on the social gathering. Correlations, linear regressions, and path analyses were conducted using IBM SPSS 23.0.Results: As many as 161 respondents of which 34.2% males were involved had a mean age of 36.31 (± 7.16) years. Sex, job insecurity, income insecurity, and perceived stress were found as independent determinants in females. Female sex and job insecurity was associated with better preventive behaviours with an adjusted β value of 0.276 and 0.306, while income insecurity and perceived stress had the opposite association with a β value of -0.247 and -0.224.Conclusion: There are correlations between economic insecurity and preventive behavioural practices during COVID-19. It is suggested that public health policies against COVID-19 cover measures of economic safety nets to improve adherenceKeywords: behaviour, COVID-19, economic insecurity, perceived stress, prevention