Strengthening Indonesia’s Immunization Workforce and Strategy

Indonesia is intensifying its efforts to close critical gaps in its immunization infrastructure to protect its population from vaccine-preventable diseases (VPDs). With a focus on workforce training and strategic oversight, the country is working to ensure that healthcare delivery is equitable and high-quality across all provinces.

Key Takeaways

• Workforce Gaps: A 2025 assessment revealed that up to 37% of primary healthcare centres (puskesmas) lacked trained immunization officers.
• Training Overhaul: The World Health Organization (WHO) helped develop shorter, blended learning programs for immunization managers and vaccinators to reduce costs and increase accessibility.
• Zero-Dose Challenges: Indonesia ranks sixth globally for “zero-dose” children, with approximately 1.3 million children missing their first DPT vaccine dose between 2019 and 2023.
• Strategic Goals: Efforts are currently aligned with pursuing WHO-Listed Authorities status for vaccines.

Addressing the Immunization Workforce Crisis

High and equitable vaccine coverage depends on a skilled workforce. Though, Indonesia has faced significant hurdles in maintaining a trained staff. Beyond the lack of trained officers at 37% of puskesmas, more than half of the 10,000+ immunization officers reported a lack of accredited training. These gaps are driven by staff turnover, distance barriers and policies that previously reserved certified training only for civil-servant officers.

To solve these challenges, the World Health Organization (WHO) provided strategic assistance to the Ministry of Health in 2025. Key improvements include:

• Modernized Training: A previous unsustainable two-week program for managers was replaced with a week-long course focused on implementation needs. A latest three-day training was also created for vaccinators.
• Blended Learning: The introduction of online components has reduced costs and expanded the reach of training.
• Real-World Evaluation: A new training-evaluation tool was developed to move beyond simple pre- and post-tests, allowing the health system to assess how learning is applied in actual clinical settings.
• Practical Aids: Short, straightforward-to-use video job aids were deployed to maintain the quality of vaccine delivery.

The Urgency of “Zero-Dose” Children

The stakes for these improvements are high. During the World Immunization Week commemoration in April 2025, the Indonesian Ministry of Health highlighted a concerning trend regarding “zero-dose” children—those who have not received any vaccines.

According to data cited by MoH Director of Immunization dr. Prima Yosephine, Indonesia ranks sixth globally in this category. Between 2019 and 2023, approximately 1.3 million children in Indonesia did not receive their first dose of the DPT vaccine. The Ministry emphasizes that achieving quality coverage is a long-term investment and a necessity to prevent disability and death from VPDs.

Expanding Surveillance and Technical Support

Improving the workforce isn’t just about administering shots. it’s about monitoring outcomes. To strengthen post-immunization processes, training sessions on adverse events following immunization (AEFI) surveillance were conducted for both provincial and national officers. This is a critical step in Indonesia’s pursuit of the WHO-Listed Authorities status for vaccines.

Direct field support remains a priority. In 2025, WHO vaccination technical officers provided on-the-ground training to staff from hospitals, health offices, and more than 1,000 puskesmas across five provinces.

Frequently Asked Questions

What is a “zero-dose” child?

A zero-dose child is one who has not received any vaccines, specifically referring to those who have not received their first dose of the DPT vaccine.

How is Indonesia changing its training for health workers?

Indonesia is shifting toward blended learning (combining online and in-person training) and shorter, more focused courses to make accreditation more accessible and sustainable for healthcare workers.

Why is AEFI surveillance important?

Surveillance of adverse events following immunization (AEFI) ensures that the safety of vaccines is monitored and that any negative reactions are properly tracked and managed.