June 19, 2024

WHO is partnering with the Government of Indonesia in transforming its primary health care (PHC) services. A key pillar of its health transformation agenda, it underscores Indonesia’s commitment to ensure that all people in Indonesia can enjoy the best possible health throughout their lives. Taking lessons learned from the COVID-19 pandemic, the Ministry of Health is accelerating efforts to address gaps in the health system, including puskesmas and public health laboratories (labkesmas). A lack and an unequal distribution of adequately trained laboratory staff, including environmental health experts, or sanitarians, affect the quality of health services at the community level. This challenge is compounded by limited supervision, mentorship and guidance to improve the skills of laboratory staff, including in environmental health surveillance, and to maintain standards of quality laboratory services.

As part of the government’s efforts to transform primary health care services, the Ministry of Health launched a programme with support from WHO aimed at strengthening environmental health surveillance at the primary care level. Under WHO’s guidance, the University of Indonesia (UI) helped develop a training curriculum and resources for sanitarians at puskesmas across Indonesia. These sanitarians are environmental health experts who play a critical role in ensuring the quality of environmental health in the communities. They perform laboratory and field tests to monitor the environment, investigate sources of pollution and food-borne diseases, and they also conduct vector surveillance to monitor mosquito populations and disease prevalence.

Inspection of a sanitarian kit at Puskesmas Beji. (Photo credit: PKKLI UI)

The programme started with an assessment to understand the training needs and site visits to inspect the availability of sanitarian kits at puskesmas level. Based on the needs assessment and consultations, the team developed a training curriculum and five modules which covered topics and exercises related to basics of environmental health, air quality measurements, food testing, water quality measurements, and vector and animal reservoir. Subsequently, the team conducted the three-day training for 36 sanitarians from 35 provinces from 14-16 November 2023 in Depok, West Java. The training programme combined theoretical presentations with practical exercises in each module. Participants were also stimulated to discuss and work together to provide a solution on a given case study related to environmental health. Training participants demonstrated an average 25% increase in knowledge and skills in environmental surveillance. Moreover, these sanitarians will have the capacity to provide supervision and mentorship to their peers in their respective provinces.

36 sanitarians from across Indonesia participated in the training (Photo credit: PKKLI UI)

Following the successful programme, the Ministry is taking steps to formalize the curriculum and the modules to be registered on the official training accreditation information system (SIAKPEL). The registered curriculum and modules will serve as the foundation for extending standardized and accredited training for sanitarians at the puskesmas level. With over 10 000 public health laboratories at the community level, the developed training curriculum and modules have the potential to significantly enhance Indonesia’s capacity for environmental health surveillance in the years to come. WHO remains committed to collaborating with the Ministry of Health to fortify Indonesia’s public health laboratories, recognizing their vital role in safeguarding the health and well-being of the Indonesian population.”


The activity is funded by the European Union
Written by Tina Kusumaningrum, National Professional Officer for Laboratories, WHO Indonesia

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