mHealth in Indonesia with UNICEF
We began working with UNICEF on an mHealth project in Indonesia mid-2017. The aim of the program for UNICEF was to support the Government to transform and modernize community health and nutrition services by introducing innovative mhealth applications to improve health, nutrition, sanitation and hygiene.
At the start of the program the expected outcomes were to strengthen community capacity to take appropriate actions to safeguard the nutritional and health status of children under five years old.
The program specifically targeted children under 5 years old, pregnant and breastfeeding women particularly in urban slums as well as children 9 months to 15 years old, through the national measles and rubella campaign
The potential of mobile health applications
Timely and accurate information is critical for improving system performance. Mobile health (mHealth) innovations have the potential to improve both access and quality of health services. While Indonesia has a high degree of Internet and wireless connectivity, the application of these tools in the health sector has thus far been limited.
To strengthen community capacity to safeguard the health of children, UNICEF has been working to adapt and deploy an SMS-based platform called RapidPro to expand access to immunization services for children living in urban slum areas. The intervention combines mobile-phone based caregiver– newborn pair registration; SMS reminders aligned to the immunization schedule; vaccine stock monitoring, and mini household surveys, called rapid card checks (RCC).
The platform was deployed in 23 new urban slum communities (sub-villages) in mid-2018. Early results suggest increases in vaccine coverage from a baseline of 38 per cent to 87 per cent over just nine months. The program runs until June 2019.
Measles and rubella: a real-time RapidPro dashboard system was also deployed to monitor the national measles and rubella (MR) vaccine campaign—the world’s largest MR campaign which targets 70 million children aged 9 months to 15 years. In 2018 alone, over 2.5 million SMS have been sent between the RapidPro system with 6,500 health facilities reporting daily through the system across 395 districts. By the end of 2018, MR campaign coverage reached 73% of the target population, with over 23 million children vaccinated in 2018.
Malaria: In 2018, UNICEF developed a separate RapidPro dashboard system to support the Malaria Sub-directorate of the Ministry of Health (MoH) to monitor a national bed net distribution campaign, which spans 20 provinces and 20,000 villages and has been ongoing since 2018.
HIV: UNICEF supported the HIV sub-directorate of the MoH to link their Health Management Information System (HMIS) to RapidPro with an interactive dashboard to facilitate better monitoring of HIV services and infection rates. The integrated dashboard system was launched in 3 pilot districts in July 2018.
Mapping of vulnerable children: In mid-2018, the Ministry of Social Aﬀairs approached UNICEF to assist with the mapping and visualization of these children, leveraging the data collection technologies and platforms developed above. The focus was on 27 urban centers and the initial purpose of this exercise was to ensure that vulnerable children are connected with the nearest public health facilities and reached as part of the MR campaign. Since September 2018, 1,132 institutions and street communities and over 51,000 children have been identified and linked to nearby health facilities through this initiative.
UNICEF will continue as planned until the end of Nokia’s funding, including to refine and expand the use of mHealth tools to enhance community and government capacity in the areas mentioned above (e.g. immunization, HIV, malaria, integrated national data) and to ensure the long-term sustainability and scalability of this program as it is gradually handed over to the government. Additional use cases are underway, alongside eﬀorts to move pilot models to scale.