Community-based COVID-19 vaccination services improve user satisfaction: findings from a large household survey in Bali Province, Indonesia

Background Understanding community preferences for vaccination services is crucial for improving coverage and satisfaction. There are three main approaches for COVID-19 vaccination in Indonesia: health facility-based, community-based, and outreach approaches. This study aims to assess how the vaccination approaches impact user satisfaction levels.Methods This study was part of a large household survey involving 12,120 respondents across nine districts in Bali Province. The study population comprised all residents aged >= 12 years who had received at least one dose of COVID-19 vaccination. Samples were selected through three stages of systematic random sampling. Data were collected through interviews using structured questionnaires, which included socio-demographic characteristics, vaccination services, and satisfaction levels. Analysis was performed using Chi Square test and logistic regression, with the entire process incorporating weighting factors.Results A total of 12,120 respondents reported receiving their first dose of COVID-19 vaccination. The satisfaction level among vaccine recipients (partial, complete, and booster doses) was high (84.31%). Satisfaction within each SERVQUAL dimension was highest in tangibles (96.10%), followed by responsiveness (93.25%), empathy (92.48%), assurance (92.35%), and reliability (92.32%). There was no significant difference in the overall SERVQUAL score between the health facility and community-based approaches. However, the latter slightly improved user satisfaction across three dimensions: tangibles (adjusted odds ratio, AOR = 1.52, 95% confidence interval (CI) = 1.21-1.90), reliability (AOR = 1.67, 95%CI = 1.42-1.96), and assurance (AOR = 1.26, 95%CI = 1.07-1.48).Conclusion During the pandemic, both health facility and community-based approaches resulted in a high satisfaction level. It is recommended that the government prioritise and optimise community-based programs and health facility-based delivery in future vaccination initiatives, especially during public health emergencies. Without effective treatments, with emerging variants and waning immunity, vaccination remains our primary defence against COVID-19. Maintaining high population immunity is crucial. Both health facility and community-based approaches to vaccination yielded high satisfaction during the pandemic. It is recommended that the government prioritise and optimise these programs for future vaccination initiatives, especially during public health emergencies.