Implementation Analysis of COVID-19 Vaccination Policy in Southwest Maluku Regency

The implementation of the COVID-19 vaccination policy can be influenced by several factors, including communication, available resources, task disposition


INTRODUCTION
One of the Government's efforts to tackle the surge of Covid-19

MATERIALS AND METHODS
This research is a qualitative study.The research conducted by the author is descriptive qualitative with data collection techniques using observation and interviews.This research is a descriptive qualitative study in which data collection techniques include observation and interviews.The research was conducted in Southwest Maluku Regency in October-November 2022, with a total of 5 informants consisting of key informants, namely the Regent of Southwest Maluku as the chairman and spokesperson of the Task Force, regular informants including the Head of the Regional Disaster Management Agency, the Head of Surveillance and Immunization of the Southwest Maluku District Health Office, and the Coordinator of the COVID-19 Task Force Expert Team, and regular informants including community leaders.

RESULTS
The Covid-19 vaccination policy implemented by the Indonesian government is a top-down approach, aimed at addressing the surge in Covid-19 cases in the country.The effectiveness of the vaccination program can be influenced by communication, resources, disposition, and bureaucratic structure.The study findings revealed the following: recipients.In communication, there are several indicators to determine effective communication in implementing government policies, namely transmission communication, clarity communication, and consistency communication. 1 The Coordinator of the COVID-19 Task Force of Southwest Maluku stated that: "The government of Southwest Maluku regency is actively conducting socialization regarding COVID-19 and the importance of implementing COVID-19 vaccination to prevent a resurgence of cases and create immunity within the community" (Coordinator of the COVID-19 Task Force).

"In the initial stages of implementation, we faced many challenges due to misinformation received by the public, such as false information about the dangers of the vaccine, which caused various issues" (Coordinator of the COVID-19 Task Force).
The challenges faced in implementing the COVID-19 vaccination policy are related to the demographic nature of Southwest Maluku, which consists of islands.This presents its own obstacles, such as inadequate access, communication barriers due to limited network coverage, and a time-consuming distribution process (Regent of Southwest Maluku).

"At the beginning of the implementation, people often heard inaccurate news about the vaccine. Therefore, religious leaders frequently encourage their congregations to participate in the program together, aiming to overcome the COVID-19 pandemic in Southwest Maluku" (Religious Leader).
Resources: Based on interviews conducted with the Regent of Maluku Barat Daya as the head of the COVID-19 handling team: "The budget for COVID-19 handling primarily comes from two sources, namely the state budget (APBN) and the regional budget (APBD).This allows the public to receive the vaccine free of charge at designated locations" (Regent of Southwest Maluku).
"Currently, the implementation of the COVID-19 vaccination policy receives funding from the Ministry, regional government, health department, and the National Disaster Management Agency (BNPB).The budget is considered sufficient and well-managed.In addition to covering consumables and medical equipment, it also includes provisions for the consumption and transportation needs of the vaccinators" (Spokesperson for the COVID-19 Handling Team of Southwest Maluku).
"The resources for handling COVID-19 and implementing the COVID-19 vaccination, including the first, second, and booster doses, come from two sources.The vaccine funding is obtained from the state budget (APBN) channeled through the provincial health department.Meanwhile, funds for implementation, such as socialization activities and vaccination events, are acquired from the regional budget (APBD) through the contingency fund, both in 2021 and 2022" (Chairperson of BNPB Southwest Maluku).
Disposition: Regarding the implementation of vaccination in the district, the Regent mentioned: "Currently, the number of vaccinators is considered sufficient.The vaccination teams are coordinated by health centers, hospitals, and elements of the Indonesian National Armed Forces and Police" (Regent of Southwest Maluku).
"The vaccination implementation involves multiple teams coordinated by the health department, including health centers and hospitals.The Indonesian National Armed Forces and Police also provide significant assistance in the implementation process" (Spokesperson for the COVID-19 Handling Team).
"The number of vaccinators in the district is adjusted based on the number of cases.Currently, the number of personnel is sufficient.However, due to the overwhelming response from the community, the task force sometimes faces challenges in fulfilling their duties.Therefore, the government ensures an equitable distribution of personnel, reaching all elements of the community on the islands" (Chairperson of the Surveillance Team for COVID-19 Handling).
Organizational Structure: Based on interviews conducted with the Head of the COVID-19 Handling Task Force in Southwest Maluku: "The handling of COVID-19 and the acceleration of COVID-19 vaccination in Southwest Maluku district are directly led by the Regent and involve several coordination teams.Each team has its own tasks and responsibilities, working synergistically" (Regent of Southwest Maluku).

"In terms of bureaucracy, the task force is currently led by the Regent, with guidance from superiors, and has eight team coordinators. Decision-making in the implementation of the COVID-19 vaccination is done through deliberation. The government often consolidates with relevant stakeholders to discuss current issues and their solutions, as well as conducting socialization activities" (Spokesperson for the COVID-19 Handling Team).
"Communication barriers arise due to the geographical nature of the islands, which affects cellular signal and Wi-Fi coverage.Additionally, the vaccine distribution system needs to consider expiration dates and distribution procedures" (Head of BNPB).

DISCUSSION
George C. Edwards III, in Mustafa Lutfi-Kurniawan's article (2012:121-125), discusses four factors or variables that play a role in the success of policy implementation. 2The variables or factors that influence the success or failure of policy implementation are as follows: Communication: Communication is the process of conveying information from a communicator to a recipient.In the context of policy communication, it refers to the process of delivering policy information from policy-makers to policy implementer.The information needs to be conveyed to the implementer so that they understand the substance, purpose, direction, and targets of the policy.This enables the implements to prepare for the implementation of the program and ensures efficient and coordinated operations.Communication as a factor in policy implementation involves key aspects such as information transformation (transmission), information clarity, and information consistency.Transformation aims to ensure that information is not only transmitted to program implementers but also to relevant parties and target groups.Clarity ensures that information is easily understood and avoids misinterpretation by policy implementers, target audiences, or related stakeholders.On the other hand, consistency expects that the information conveyed maintains consistency to avoid concerns among policy implementers, target audiences, or related parties. 3cording to Edward III's theory of Policy Implementation (1980), in terms of communication, it can be considered appropriate as the government has made efforts to disseminate information about the vaccination policy implementation in West Southeast Maluku Regency.In addition to dissemination, the government has made persuasive approaches to religious leaders in an effort to educate the community, as religious leaders have significant influence in community education. 4sources: According to Van Meter and Van Horn, as cited in Utami (2022), 5 besides policy standards and goals, the implementation of a policy requires support from both human resources and nonhuman resources. 6Human resources are the most important resource in determining the success of an implementation.Each stage of implementation requires qualified human resources appropriate to the tasks indicated by the policy.Additionally, financial resources are also crucial alongside human resources.In the context of COVID-19 mitigation, human resources include healthcare professionals directly involved in controlling the spread of the virus, such as doctors and healthcare workers, as well as those who are part of the overall COVID-19 mitigation efforts, such as government officials in the Health Department.Doctors and healthcare workers play a crucial role in COVID-19 mitigation as they administer COVID-19 vaccinations to the public. 5search findings reveal that resources in the implementation of COVID-19 include human resources (vaccinators), the competence or abilities of implementers, budgetary resources, and equipment resources.
Disposition: One of the factors influencing the effectiveness of policy implementation is the disposition of implementers.It refers to how the implementing party, in this case the government, responds to emerging issues with a sense of responsibility, honesty, and commitment in policy implementation.In this regard, based on Edward III's theory of policy implementation (1980), it can be considered reasonably successful in terms of disposition, as the number of implementing personnel has been fulfilled and they have been able to distribute personnel effectively throughout the archipelago's demographics.

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Organizational structure: Bureaucratic structure plays a role in the systematic and efficient implementation of the COVID-19 vaccination program.The purpose of the bureaucratic structure is to facilitate task distribution and responsibility allocation to individuals involved in the COVID-19 vaccination program based on their potential and competence in respective fields.The bureaucratic structure has two aspects: Standard Operating Procedures (SOP) and the fragmentation or distribution of responsibilities. 7SOP functions as a guideline for the implementation of the COVID-19 vaccination program.It serves as the legal basis for the implementation, ensures communication among the vaccination team, and serves as a measure of the team's discipline in carrying out the program.Hence, SOP is crucial in the implementation of the COVID-19 vaccination program.The SOP implemented in the vaccination program in Kabupaten Maluku Barat Daya is in accordance with the Decree of the Minister of Health of the Republic of Indonesia Number HK.01.07/MENKES/4638/2021 concerning Technical Guidelines for COVID-19 Vaccination Implementation.Therefore, the COVID-19 vaccination implementation in Kabupaten Maluku Barat Daya adheres to the SOP outlined in the Minister of Health's decree.The implementation of the COVID-19 vaccination program is conducted by the central government in collaboration with provincial and district/city governments, as well as legal entities/businesses.The District/City Health Office conducts data collection through vaccinations, which serves as the basis for determining vaccine allocation, distribution, and logistical needs.Additionally, the Health Office collects data on healthcare facilities that will be designated for COVID-19 vaccination services. 5Cite this article: Rap JR, Balqis, Palutturi S, Indar, Masni, Wahyu A, et al.Implementation Analysis of COVID-19 Vaccination Policy in Southwest Maluku Regency.Pharmacogn J. 2023;15(5): 843-845.
cases in the country is through the Covid-19 vaccination policy.The Covid-19 vaccination policy is a top-down government policy, as stated in the Republic of Indonesia Ministry of Health Regulation Number 18 of 2021 regarding Amendments to the Ministry of Health Regulation Number 10 of 2021 on the Implementation of Vaccination in the Framework of Combating Coronavirus Disease 2019 (COVID-19).The coverage rate of the Covid-19 vaccination program in the Maluku Province is not yet evenly distributed.Based on data obtained from the Republic of Indonesia Ministry of Health, the coverage of the first dose of vaccination in Maluku Province as of March 2022 has reached 70.68%.This figure is equivalent to 1 million vaccine recipients out of a target of 1.42 million people.Based on Covid-19 vaccination data in the Maluku Province, the top three lowest first dose vaccinations are in West Seram Regency with 79,373 individuals (43.18% of the target), followed by East Seram Regency with 63,793 individuals (53.82% of the provincial target), and South Buru Regency with 38,309 individuals (59.54% of the provincial target).This indicates that Covid-19 vaccination is not yet fully distributed evenly in the Maluku Province.