Barriers to Covid-19 RT-PCR Testing in Indonesia: A Health Policy Perspective

Abstract

Abstract. Indonesia has been facing a hard time accelerating the number of laboratory capacity. This study provides an overview of the data on daily tests, confirmed cases, and the challenge of Covid-19 control associated with government policy. This study utilizes data reported from 2 March to 29 April 2020 by online official sources and regulations. Initially, the government only trusted one lab for the Covid-19 test. As the number of cases increased, referral labs were increased, until 29 April 2020, there were 89 officially appointed laboratories. The daily number of testing results fluctuated and unstable, although the number of reference labs increases. This reflects implementation challenges from different factors: readiness and capacity between labs; availability of swab collection officers; availability of reagents in the lab; rules for lab officers and swab collection officers; and transportation for a specimen from health facility to the referral lab. This study recommends to ensure the lab readiness in terms of human resources, tools, and reagents when appointed; ensure the adequacy and quality of qualified laboratory staff & swab collectors; ensure adequate reagents for RT-PCR, and rearrangement of shift rules for lab & swab collection officers, and improve handling procedures and transport specimen delivery mechanisms. Abstrak. Indonesia kesulitan melakukan percepatan jumlah kapasitas laboratorium (Lab). Tujuan studi mereview hasil testing harian, kasus terkonfirmasi, dan tantangan imlementasi penanganan Covid-19 dikaitkan dengan kebijakan pemerintah. Analisis studi memanfaatkan data sekunder, periode 2 Maret sampai 29 April 2020, yang dilaporkan berbagai website resmi dan kajian regulasi. Awalnya pemerintah hanya percaya satu lab untuk testing Covid-19. Seiring bertambahnya kasus, jumlah lab rujukan ditambah, sampai tanggal 29 April 2020 sudah 89 lab yang ditunjuk resmi. Hasil testing harian memperlihatkan angka yang berfluktuasi. Ini mencerminkan tantangan implementasi dari berbagai faktor: kesiapan dan kapasitas antar laboratorium; ketersediaan & kemampuan petugas pengumpul swab; ketersediaan reagen di laboratorium; aturan untuk petugas lab dan petugas pengumpul swab; dan transportasi untuk spesimen dari fasilitas kesehatan ke laboratorium rujukan. Studi ini merekomendasikan untuk memastikan kesiapan laboratorium dalam hal sumber daya manusia, alat, dan reagen ketika ditunjuk; memastikan kecukupan dan kualitas petugas lab & pengambil swab mumpuni; memastikan kecukupan logistik reagen untuk RT-PCR; dan penataan ulang aturan shift untuk petugas lab & pengumpul swab, dan meningkatkan prosedur penanganan dan mekanisme transportasi pengiriman specimen.