Digital reporting in a decentralized public health system: lessons from Indonesia's micro PPKM experience.

BACKGROUND: During the COVID-19 pandemic, Indonesia implemented Micro PPKM (Community Activity Restrictions) as a decentralized public health response, coordinated through village-level command posts. To support nationwide implementation across diverse administrative levels, a digital reporting system was developed to capture operational activities from local command posts in near real-time. As COVID-19 has transitioned from an acute emergency to longer-term disease management, this experience offers an opportunity to examine what large-scale digital reporting systems can contribute to future pandemic preparedness in decentralized low- and middle-income country (LMIC) settings. In particular, empirical evidence remains limited on how such systems can support data visibility, organizational coordination, and policy implementation across fragmented administrative structures.

METHODS: This study analyzed secondary data generated by Indonesia's Micro PPKM digital reporting system between June 2021 and February 2022. Reports were submitted by authorized command post personnel-primarily public order forces and registered community volunteers-across all provinces of the country. Descriptive analyses were conducted to examine the volume, geographic coverage, actor composition, activity types, and temporal trends of reported Micro PPKM activities at national and subnational levels.

RESULTS: A total of 151,558,372 activity reports were recorded from 44,770 villages, 5,502 sub-districts, 474 districts/cities, and 34 provinces. Reporting activities spanned multiple operational domains, including public health communication, mobility restrictions, enforcement actions, and support for vaccination programs. Participation involved a combination of formal state actors and community-based contributors, reflecting a hybrid governance structure. Temporal analyses showed substantial variation in reporting intensity across activity types and policy phases, while population-adjusted comparisons revealed marked subnational heterogeneity.

CONCLUSION: The findings demonstrate the feasibility of deploying a large-scale, digitally mediated reporting infrastructure embedded within local implementation structures to support decentralized public health reporting and operation coordination during emergencies. Beyond pandemic response, such systems offer insights into how digital tools can support data visibility and standardized reporting across decentralized public health systems. Considerations related to data quality, equity, and ethical governance remain critical for sustaining and institutionalizing similar digital public health infrastructures.