Posyandu Cadres and AFP: The Frontline in Preventing Polio's Return

Indonesia has recorded various successes in controlling infectious diseases through immunisation programmes. However, this success does not mean the threat of disease has completely disappeared. One challenge that must still be guarded against is the emergence of Acute Flaccid Paralysis (AFP) cases, a condition that serves as an important indicator in the early warning system for the possible presence of the polio virus or other causes that attack the nervous system. For some communities, the term AFP may still sound unfamiliar. Many people only realise the importance of this disease when a child suddenly experiences weakness or paralysis in the hands or feet without prior injury. In fact, in the world of public health, every case of sudden paralysis in children must be immediately recognised, reported, and followed up. The speed of finding cases is key to preventing wider disease spread. This is where the role of Posyandu cadres becomes very important. For decades, Posyandu cadres have been the spearhead of health services at the community level. They not only assist with toddler weighing activities or nutritional counselling but also act as a link between the community and health facilities. Their closeness to families gives cadres a strategic position in detecting various health problems early. Unfortunately, public understanding of AFP remains limited. Many parents assume that limb weakness in children is merely due to fatigue or a sprain. As a result, they are late in bringing the child to a health facility, reducing the opportunity for epidemiological investigation. In public health surveillance, every AFP case in children under 15 is a signal that must be responded to immediately. The case may not necessarily be polio, but it still requires further examination to determine the cause. The sooner a report is received, the greater the chance of preventing transmission if the cause is related to a contagious virus. Therefore, educating Posyandu cadres is not just about adding knowledge but strengthening the community health alert system. Cadres need to understand the signs of AFP, the importance of rapid reporting, and referral mechanisms to health facilities. They also need good communication skills to explain the situation to parents without causing panic. In an era of high population mobility, the threat of infectious diseases no longer recognises territorial boundaries. Viruses can move from one area to another in a short time. Consequently, the early detection system must be able to work down to the community level. Posyandu cadres are a vital part of that system. Moreover, education on AFP is also a momentum to strengthen public trust in immunisation programmes. The re-emergence of polio cases in several regions in recent years serves as a reminder that high immunisation coverage must be maintained. Any decline in coverage, no matter how small, can open a gap for the return of diseases that were previously successfully controlled. The role of cadres does not stop at case reporting. They also serve as education agents who help families understand the importance of complete immunisation, maintaining environmental hygiene, and seeking immediate medical help if a child shows suspicious symptoms. The approach taken by cadres is often more easily accepted because they come from the same environment and have close social relationships with the community. The government and health workers need to provide adequate support to Posyandu cadres through continuous training. Educational materials must be delivered in simple language, accompanied by case examples, reporting simulations, and the use of easy-to-understand communication media. This ensures that cadres are not only aware of the theory but are also ready to act when they encounter suspected cases in the field. Higher education institutions also have an important role in assisting this process. Through community service activities, lecturers and students can help improve the capacity of cadres in recognising various health problems, including AFP. Collaboration between academics, health workers, local governments, and the community will strengthen the community-based surveillance system. Ultimately, the success of disease control depends not only on sophisticated health technology or the number of available hospitals. Success begins with the community’s ability to recognise symptoms early and report them quickly. Posyandu cadres are the eyes and ears of the health system at the grassroots level. They are closer to the community than anyone else. When they are equipped with adequate knowledge about AFP, Indonesia has a greater chance of maintaining its success in controlling polio while protecting future generations from the threat of preventable paralysis. Building a healthy society means building shared vigilance. In public health, one timely report can be the first step to saving many children from the risk of greater disease.