Indonesia is the fourth largest country in the world, with a population of 252 million people spread throughout thousands of islands. With at least one neglected tropical disease (NTD) in all 514 districts, it has one of the heaviest burdens of NTDs in the world.
Since 2009, the Indonesia NTD program has not had the resources to train laboratory personnel, even though new global guidance for lymphatic filariasis (LF), schistosomiasis (schisto) and soil-transmitted helminthiases (STH) assessments has been issued. Recently, the national NTD Program and the National Institute of Health Research and Development (NIHRD) have found issues when performing cross-checks on LF slides submitted by laboratory personnel from lower levels, including false positive slide readings when cotton fibers were mistaken for LF microfilaria. As a result, the Indonesia Ministry of Health reached out to USAID’s ENVISION project for assistance with building the necessary local cadre of laboratory personnel equipped with the critical microscopy skills needed to support impact assessments for the LF, schisto, and STH programs.
With many districts and provinces financing and implementing LF sentinel and spot-check site assessments, capacity building at all levels is needed to ensure quality is maintained throughout the country. The availability of trained laboratory personnel also helps to ensure the long-term sustainability and local-ownership of the program as they move towards elimination.
This year, ENVISION successfully trained over 50 lab personnel from laboratories and public health offices in Sumatra, Kalimantan, Sulawesi and Papua islands, including staff from Provincial Health Offices, District Health Offices, Balai Laboratorium Kesehatan Daerah (provincial laboratories), regional communicable disease laboratories, and national NTD program staff.
Training included both lecture and hands-on learning, which covered different NTD program strategies, M&E assessment preparation and implementation, and parasite identification. The newly trained cadre of lab personnel found the training to be very useful, not only in improving their microscopy skills but also in getting a better understanding of the national NTD program strategies. Ibu Chairyah, Indonesia national NTD Program recalls, “We have been wanting to hold such a training for a long time. The success of this training reinforced our conviction that it is necessary to build the capacity of our staff at all levels. We hope this will be the start of an annual standardized training for laboratory personnel that can be implemented regionally.”
In FY15, ENVISION will continue support to the Government of Indonesia, providing technical assistance for LF mapping in 34 districts, 4 LF sentinel site assessments and 6 LF transmission assessment surveys. Lab results will be tested for quality with cross-checking performed on all positive tests and 10% of negatives in all mapping districts.