Campak dan Rubela merupakan penyakit menular berpotensi wabah yang dapat menimbulkan komplikasi serius bahkan kematian, terutama pada anak-anak. Namun keduanya dapat dicegah melalui pemberian imunisasi. Trend cakupan imunisasi yang menurun, terutama paska pandemi COVID-19, telah menyebabkan peningkatan Kejadian Luar Biasa (KLB) salah satunya Campak-Rubela, sehingga diperlukan respon cepat melalui pemberian imunisasi tambahan berupa Outbreak Response Immunization (ORI). Pelaksanaan ORI di sebagian besar wilayah terdampak KLB masih belum optimal, terutama dari sisi ketepatan waktu respon. Kementerian Kesehatan telah menyediakan alat bantu untuk mendukung proses pra-pelaksanaan ORI, namun penginputan masih bersifat manual dan sistem ini belum terintegrasi dengan sistem informasi lain, serta belum memiliki mekanisme verifikasi dan monitoring oleh tingkat administrasi yang lebih tinggi. Oleh karena itu, dibutuhkan suatu inovasi yang dapat memperbaiki sistem yang ada saat ini. Penelitian ini bertujuan untuk mengembangkan prototipe sistem informasi terintegrasi guna meningkatkan ketepatan waktu pelaksanaan ORI di tingkat puskesmas dalam rangka penanggulangan KLB Campak-Rubela.
Metode yang digunakan adalah Pendekatan Rapid Evolutionary Prototyping yang memungkinkan pengembangan dilakukan bertahap berdasarkan masukan yang diperoleh selama proses implementasi dengan cakupan terbatas. Sistem dikembangkan melalui tahapan analisis kebutuhan, identifikasi masalah, desain (logis serta fisik) dan implementasi. Penelitian ini menghasilkan prototipe yang terintegrasi dengan sistem SKDR dan SMILE dilengkapi beberapa menu utama yaitu notifikasi status, penginputan data kajian epidemiologi, perhitungan kebutuhan vaksin dan pelaporan ORI secara real time. Hasil pengujian yang melibatkan informan dari Dinas Kesehatan Kota Depok, Puskesmas Pengasinan dan Depok Jaya menunjukkan bahwa prototipe Sistem Informasi Outbreak Response Immunization (SIORI) efektif dan efisien dalam mendukung penyelenggaraan ORI. Kesimpulannya, prototipe SIORI memiliki potensi memperbaiki sistem yang ada saat ini dalam meningkatkan ketepatan waktu penyelenggaraan ORI KLB Campak-Rubela.

Measles and Rubella are highly contagious infectious diseases that can lead to serious complications and even death, especially in children. These diseases could cause outbreaks, however, can be prevented through immunization. The declining trend in immunization coverage, particularly after the COVID-19 pandemic, has led to an increase in outbreaks, including Measles-Rubella, thus requiring a prompt response through supplementary immunization activities known as Outbreak Response Immunization (ORI). The implementation of ORI in most outbreak-affected areas remains suboptimal, particularly in terms of response timeliness. Although the Ministry of Health has provided supporting excel based tools to support the pre-implementation process of ORI, data entry is still manual, the system is not yet integrated with other relevant information systems and is not complemented with verification and monitoring mechanisms from higher administrative levels. Therefore, an innovation is needed to improve the current system. This study aims to improve the timeliness of ORI implementation at the primary health care level in response to Measles-Rubella outbreaks through development of an integrated information system prototype. The Rapid Evolutionary Prototyping approach was used as the system development model, which allows for incremental development based on feedback collected during implementation assessment. The system was developed through the stages of needs analysis, problem identification, logical and physical design, and implementation. This study resulted in the development of a prototype information system named SIORI, designed to improve the timeliness of ORI implementation. The system includes several key features including outbreak status notification that is integrated with the Early Warning Alert and Response System (SKDR), input for epidemiological assessment data, vaccine stock data obtained from the Electronic Immunization and Logistics Monitoring System (SMILE), vaccine needs calculation, and reporting functions covering response timeliness and immunization service data input. Implementation test involving informants from Depok City Health Office and selected health centers (Puskesmas Pengasinan and Depok Jaya) showed that SIORI is more effective and efficient in supporting ORI implementation. The conclusion is that prototype SIORI has potentials to improve the current system in to accelerating ORI implementation timeliness.

Campak adalah penyakit dengan tingkat penularan dan fatalitas tinggi terutama di negara dengan sistem kesehatan yang lemah. Campak merupakan penyakit yang dapat dicegah dengan imunisasi sebagai bagian integral dari sistem kesehatan. Program imunisasi dasar merupakan bagian dari transformasi layanan kesehatan primer. Penelitian ini bertujuan untuk mendapatkan model ketahanan imunisasi campak rubela kabupaten/kota di Indonesia berdasarkan variabel-variabel yang berpengaruh terhadap imunisasi campak rubela.
Jenis penelitian ini adalah penelitian kuantitatif desain cross sectional, tapi pada level kabupaten kota menggunakan studi ekologi atau korelasi populasi, dimana unit penelitian terdiri dari 2 level, yaitu level individu dan level kabupaten/kota yang memiliki setidaknya 1 kasus positif IgM kasus campak rubela di 257 kabupaten kota tahun 2022-2023. Analisis menggunakan multilevel modelling, pada level individu dilakukan analisis variabel umur, jenis kelamin, dan riwayat imunisasi, sedangkan level kabupaten kota meliputi cakupan imunisasi, anggaran pelayanan imunisasi, pendanaan stabil, pemerintah kinerja program campak, SDM imunisasi dan surveilans terlatih, respon alert, kelengkapan dan ketepatan laporan.
Kasus campak rubela terbesar pada kelompok umur 0-5 tahun (60,7%), perempuan (51,3%) dengan riwayat imunisasi MR2 tidak lengkap (67%). Hasil analisis multivariat didapatkan variabel kasus campak rubela (OR=2,014), cakupan imunisasi campak rubela (OR=1,916), anggaran imunisasi (OR=1,856), pendanaan stabil(KLB) (OR=1,823), pemerintah kinerja program campak (OR=2,05), SDM imunisasi terlatih (OR=1,968) dan SDM surveilans terlatih (OR=1,841) menunjukkan pengaruh signifikan terhadap ketahanan imunisasi campak rubela kabupaten kota di Indonesia. Pada hasil analisis multilevel nilai MOR pada level individu 1.00159 dan level kabupaten kota 1.00081 sehingga dapat disimpulkan efek individu lebih besar dari efek level. Kontribusi variabel independen terbesar untuk level kabupaten kota adalah cakupan imunisasi sebesar 624,14% terhadap ketahanan imunisasi campak rubela kabupaten kota. Model prediksi ketahanan imunisasi campak rubela didapatkan dengan formula = -2,314 + 0,787 kasus campak rubela +0,685 cakupan imunisasi campak rubela + 0,586 anggaran imunisasi +0,568 pendanaan KLB + 0,712 pemerintah kinerja program campak baik + 0,627 SDM Imunisasi + 0,596 SDM surveilans.
Kesimpulan : Model ketahanan imunisasi campak rubela pada studi ini menemukan variasi ketahanan imunisasi campak rubela hampir sama/tidak beragam antar kabupaten kota dibandingkan antar individu, namun kontribusi/peran dari cakupan imunisasi kabupaten kota sangat besar terhadap ketahanan imunisasi campak rubela kabupaten kota. Saran : Peran program imunisasi penting dalam mencapai cakupan imunisasi campak rubela kabupaten/kota tinggi dan merata dalam memperkuat ketahanan imunisasi campak rubela, Kabupaten kota dapat melakukan evaluasi program imunisasi dengan menganalisis data ketahanan imunisasi untuk mewujudkan eliminasi campak rubela tahun 2026.

Measles is a highly contagious disease with a significant mortality rate, particularly in countries with underdeveloped healthcare systems. However, it is a vaccine-preventable illness. Immunization plays a vital role within the healthcare system, and basic immunization programs are a fundamental component of the ongoing transformation of primary healthcare services. This study seeks to assess the resilience of measles-rubella immunization at the district/city level. To achieve this, a model capable of evaluating the measles-rubella immunization resilience index is required, incorporating variables that influence immunization outcomes.
An observational study design employing an ecological or population-level correlation approach with multilevel analysis was used. The unit of analysis consisted of districts/cities that reported confirmed measles-rubella IgM-positive cases, resulting in a sample of 257 districts/cities. The analysis was conducted at two levels: the individual level (including variables such as age, sex, and immunization history), and the district/city level (including indicators such as immunization coverage, budget allocation for immunization services, funding stability, governance quality, availability of trained immunization and surveillance personnel, responsiveness to health threats, and the completeness and accuracy of reporting).
Results of the study with the largest cases of measles rubella were in the age group of 0-5 years (60.7%), women (51.3%) with a history of incomplete MR2 immunization (67%). The results of the multivariate analysis obtained the variables of measles rubella cases (OR = 2.014), measles rubella immunization coverage (OR = 1.916), immunization budget (OR = 1.856), stable funding (KLB) (OR = 1.823), government measles program performance (OR = 2.05), trained immunization human resources (OR = 1.968) and trained surveillance human resources (OR = 1.841) showed a significant influence on the resilience of measles rubella immunization in cities and districts in Indonesia. In the results of the multilevel analysis, the MOR value at the individual level was 1.00159 and the city district level was 1.00081 so it can be concluded that the individual effect is greater than the level effect. The largest independent variable contribution for the city district level is immunization coverage of 624.14% to the resilience of measles rubella immunization in cities and districts The measles rubella immunization resilience prediction model with the formula = -2.314 + 0.787 measles rubella cases +0.685 measles rubella immunization coverage + 0.586 immunization budget +0.568 KLB funding + 0.712 Good governance + 0.627 Immunization HR + Surveillance HR + 0.596. The largest independent variable contribution for the district/city level is immunization coverage of 624.14% to the resilience of measles rubella immunization in the district/city.
Conclusion: The results of the study show that the measles rubella immunization resilience model in this study proves that the variation in measles rubella immunization resilience is almost the same/does not vary between districts/cities compared to individuals, but the contribution/role of district/city immunization coverage is very large to the resilience of measles rubella immunization in the district/city. The variables of measles rubella cases, measles rubella immunization coverage, immunization budget, funding during the outbreak, government performance of the measles program is good, immunization and surveillance human resources show significant and positive effects on measles rubella immunization resilience. This model can be an important tool in data-based policy making. Recommendations/Suggestions: Districts and cities can evaluate immunization programs by analyzing immunization resilience data and need to study and make policies to realize measles and rubella elimination in 2026.