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Increasing Community Awareness on Covid-19 Prevention in Jakarta, Indonesia:

An Outreach Program for Urban Poor

Article  in  Asia-Pacific Journal of Public Health · March 2022

DOI: 10.1177/10105395221084931

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1084931
research-article2022
APHXXX10.1177/10105395221084931Asia Pacific Journal of Public HealthSiregar et al
Short Communication
Increasing Community Awareness on
Covid-19 Prevention in Jakarta, Indonesia:
An Outreach Program for Urban Poor
Kemal N. Siregar, PhD1, Narila Mutia Nasir, PhD2,3 ,
Baequni, MPH, PhD2,3, Deddy Darmawan, SKM3,
Rico Kurniawan, SKM, MKM1, Retnowati, SKM, MKM1,4,
Artha Prabawa, MSc1, Ede Surya Darmawan, Dr3,5,
Fajar Ariyanti, PhD2,3, Daniah, MKM3,6,
Ryza Jazid Bahar Nur, SKM, MKM1,
and Yolanda Handayani, SKM, MKM1
Introduction
COVID-19 has become a global threat. In Indonesia, within
3 months after the announcement of the first case on March
2, 2020, the cumulative cases of COVID-19 reached 27 549
positive cases on June 2, 2020, with 1663 deaths.1 This situ-
ation has placed Indonesia as one of the countries in the
Southeast Asian region with a high number of COVID-19
cases.2
At the beginning of the pandemic, the community tended
to follow the three prevention behaviors (wearing masks,
physical distancing, and handwashing). However, the com-
munity’s compliance has been decreasing, while the number
of cases increased. Refer to the two essential functions of
public health, which are to inform, educate, and empower the
community and to drive community participation to solve
their health issues,3 there is a need to provide evidence about
how community-based interventions might have a positive
impact on preventing more COVID-19 cases. Community-
based fighting initiative against COVID-19 or PARC-19 as
an outreach program is a method to reach out to the commu-
nity in implementing COVID-19 prevention behavior. Thus,
this study aimed to analyze the implementation of PARC-19
to increase awareness of COVID-19 in the urban poor com-
munity in Jakarta Province, the main epicenter of COVID-19
in Indonesia.
Methods
This was a repeat cross-sectional study with intervention to
a group of communities in Kalibata, an urban poor area in
Jakarta Province. Using a structured questionnaire, we con-
ducted face-to-face interviews from July 14 to July 17,
2020, with 476 respondents at their homes who were
recruited purposively as a baseline data of awareness using
Asia Pacific Journal of Public Health
1­–3
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four indicators: handwashing with soap, wearing masks,
physical distancing, and disinfection. We implemented the
concept of the Community-Based Fighting Initiative against
COVID-19 or Perang Akar Rumput COVID-19 (PARC-19)
in Indonesia as an outreach program. PARC-19 has five ele-
ments of activities to empower the community facing the
COVID-19 pandemic. These are (1) health promotion, (2)
specific protection, (3) early diagnosis and immediate treat-
ment, (4) disability limitation, and (5) rehabilitation, which
were developed from the concept of five levels of preven-
tion by Leavell and Clark.4 In this study, we focused on
health promotion and specific protection. At the conclusion
of the 20-minute session, we gave the respondents a mask
and soap. In the post-intervention (October 14 to October
26, 2020), we involved 148 respondents in interviews. To
measure the understanding of the community about the
health message, we asked the people to demonstrate hand-
washing and wearing mask correctly. We performed the
Mann-Whitney test to analyze the differences in awareness
1
Department of Biostatistics and Population Studies, Faculty of Public
Health, Universitas Indonesia, Depok, Indonesia
2
Public Health Study Program, Faculty of Health Sciences, Universitas
Islam Negeri Syarif Hidayatullah Jakarta, Tangerang Selatan, Indonesia
3
Indonesian Public Health Association for Jakarta Region, Jakarta,
Indonesia
4
Hospital of Universitas Indonesia, Depok, Indonesia
5
Department of Administration and Health Policy, Faculty of Public
Health, Universitas Indonesia, Depok, Indonesia
6
Sekolah Tinggi Ilmu Kesehatan Mitra Ria Husada, Jakarta, Indonesia
Corresponding Author:
Narila Mutia Nasir, Public Health Study Program, Faculty of Health
Sciences, Universitas Islam Negeri Syarif Hidayatullah Jakarta, Jl.
Kertamukti No. 5, Pisangan, Ciputat, Tangerang Selatan, Banten 15419,
Indonesia.
Email: narilamutia@uinjkt.ac.id
2 Asia Pacific Journal of Public Health 00(0)

Table 1.  Mean of Respondent’s Awareness at Baseline and Post-intervention (Non-Parametric Test).

Mean of Mean Mann-Whitney

Group N awareness rank test (P value)
Baseline 476 64.07 292.26 <.0001
Post-intervention 148 77.19 377.59

100.0 0.7
6.3
90.0 13.5 16.9
21.8
80.0 45.6
70.0 60.1
70.0
60.0
50.0 99.3
93.7
40.0 86.5 83.1
78.2
30.0 54.4
20.0 39.9
30.0
10.0
0.0
Baseline Post-int Baseline Post-int Baseline Post-int Baseline Post-int
Proper handwashing with Wearing mask Physical distancing Disinfecon
soap
Indicators

Yes No

Figure 1.  Practice at baseline and post-intervention.

before and after the intervention. The ethical approval was
obtained from the Ethical Committee of Faculty of Health
Sciences, UIN Syarif Hidayatullah Jakarta (Un.01/F.10/
KP.01.1/KE.SP/06.08.046/2020).
Results
The result showed that there was a significant difference of
awareness at baseline and post-intervention (P < .0001).
Statistical analysis confirmed that there was a difference of
mean of awareness among the respondents before and after
they received PARC-19 program (Table 1).
We observed a change of prevention practice against
COVID-19 in the study area, as shown in Figure 1. At the
beginning, we found that only 54.4% of respondents prac-
ticed proper handwashing with soap; the good practice
increased to 86.5% at post-intervention. More than 90%
respondents were wearing mask at baseline (93.7%) and
post-intervention (99.3%). An increasing practice was also
indicated for physical distancing. We observed that 78.2% of
respondents observed physical distancing at baseline, which
increased to 83.1% pos-tintervention. However, there was
little change in the practice of disinfection at baseline com-
pared with post-intervention (30% vs 39.9%).
Discussion
The results indicated that the respondent’s awareness of the
prevention behavior against COVID-19 increased signifi-
cantly after they engaged in the PARC-19 program. The
population density of the neighborhood in urban poor makes
it difficult for them to observe physical distancing, although
one of the key community mitigation strategies is reducing
direct and close contact between people in the community.5
Our study showed that 83.1% of respondents observed phys-
ical distancing at baseline, with only a 5.3% increase com-
pared with the situation post-intervention. Previous studies
have emphasized that physical distancing was impractical
and may not be effective among the urban poor.6-8
The Indonesian government has tried hard to promote
health awareness regarding prevention behavior of COVID-
19. Unfortunately, the health promotion activities have
been mainly online, which may not be fully accessed by
the urban poor community with a low-resource setting.
Therefore, an outreach program was one of the answers to
empower them. Community outreach program is designed
to make people care about their condition, and the method
can be varied, such as door-to-door strategies, posters, or
other media.9 Instead of promoting health messages only,
the community should be supported by tools that enable
them to properly observe prevention. We provided masks
and soap for the community to convince them that they had
the empowerment. The results of the present study showed
that providing those tools to the urban poor community
increased the practices of washing hands (54.2%-86.5%)
and wearing masks (93.4%-99.3%). The intervention did
not provide disinfection tools to the community, and the
results revealed that even after the intervention, the disin-
fection behavior remained low (30% at baseline and 39.9%
at the post-intervention).
 Siregar et al 3
To establish effective action for the empowerment of
urban poor community, the role of government and commu-
nity is not enough. A collaboration strategy called the penta-
helix, which involves the participation of health professionals,
academic institutions, non-government organizations, and
businesses, is suggested to be implemented.10 Furthermore,
the community should be aware that they are the subject and
driving force to stopping the transmission of COVID-19,
which is supported by an outreach program.
Conclusions
PARC-19 is a community-based intervention designed to fight
against COVID-19. In this study, we implemented the concept
as an outreach program for the urban poor community in
Jakarta Province. The assessment of the program showed that
this approach should be applied in other areas to improve
awareness and good health practices to prevent COVID-19
transmission. Further research is needed to explore the effec-
tiveness of PARC-19 in other communities in different areas.
Acknowledgments
The authors thank the Directorate of Research and Community
Service at Universitas Indonesia for funding this research. A special
thanks goes to the Dean of the Faculty of Public Health, Universitas
Indonesia, and the Indonesian Public Health Association (IAKMI)
Jakarta Region. They also thank the Islamic Relief and Tramp for
their role in data collection and to the community in the Kalibata
area for their contribution as respondents.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support
for the research, authorship, and/or publication of this article: This
research was conducted on assignment and funding from the
Directorate of Research and Community Service of the University
of Indonesia under the Q2 International Publication Assistance
View publication stats
(PPI Q2) Grant with Contract Number NKB-581/UN2.RST/
HKP.05.00/2021.
ORCID iD
Narila Mutia Nasir https://orcid.org/0000-0001-6116-5835
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