Strengthening government's response to COVID-19 in Indonesia: a modified Delphi study of medical and health academics

The Indonesian government has issued various policies to control COVID-19. However, COVID-19 new cases continued to increase and there remains uncertainties as to the future trajectory. We aimed to investigate how do medical and health academics view the Indonesian government9s handling of the COVID-19 and which area of health systems that need to be prioritized to improve government9s response to COVID-19. We conducted a modified Delphi study adapting the COVID-19 assessment score card (COVID-SCORE) as the measurement criteria. We invited medical and health academics from ten universities across Indonesia to take part in the Delphi study. In the first round, participants were presented with 20 statements of COVID-SCORE and asked to rate their agreement with each statement using five-point Likert scale. All participants who have completed the first cycle were invited to participate in the second cycle in which they had the opportunity to revise their answer based on results of previous cycle and to rank a priority of actions to improve government response. We achieved consensus for 5 statements, majority agreements for 13 statements and no consensus for 2 statements. The prioritization suggested that top priorities for improving government9s response to COVID-19 in Indonesia, according to medical and health academics, encompass: (1) The authorities communicate clearly and consistently about COVID-19 and provide public health grounds for their decisions; (2) Everyone can get a free, reliable COVID-19 test quickly and receive the results promptly; (3) Contact tracing is implemented for positive cases; (4) Public health experts, government officials, and academic researchers agree on COVID-19 nomenclature and clearly explain the reasons for public health measures; and (5) Government communications target the entire diverse population. Ultimately, our study highlights the importance of strengthening health system functions during the pandemic and to improve health system resilience for dealing with future public health emergencies.