The Quality System of Early Warning, Alert, and Response System (EWARS) in The South Kalimantan Province, Indonesia

Abstract

EWARS is a system to monitor the trend of potential disease outbreaks each week and provide a warning signal (alert). South Kalimantan is one of the provinces in Indonesia that implements EWARS. Evaluation of system performance and weakness was needed to improve EWARS quality in the South Kalimantan Province. It was an evaluation study with input, process and output approaches to EWARS that were implemented at a provincial level from the 1 st until the 39 th week in 2017. Data was collected through interviews, document studies, and observations in two Public Health Centers (PHC), the District and Provincial Health Offices. There was no problem in input components such as the availability of facilities and funds in all the districts, but there were still some untrained PHC officers. Evaluation of process components showed that only 94% of PHC submitted the reports and only 79% submitted timely reports. Evaluation of output components found that only 40% of alerts have been verified, weekly analyses were not created, monitoring of reporting and alert responses have not been done intensively. The weaknesses on the input, process, and output components were expected to contribute to the low quality of the EWARS implementation.