Amid the digital transformation, we have come to an era where solutions are based on innovating technologies. In the healthcare industry, an efficient supply chain is critical to saving lives. This calls for a pivotal transition towards digitizing the healthcare supply chain to increase efficiency and strengthen the supply chain and inventory management to provide quality health care for all and eventually achieve targets to Universal Health Coverage (UHC) as part of the national health plan.
How has the pandemic affected vaccine care for children?
According to a UNICEF and Ministry of Health report, ever since the first case of Covid-19 was reported in March 2020, vaccine coverage for children has been declining. With an emphasis towards tackling Covid-19, the report showed that 84% of health facilities’ immunization services are disrupted by the Covid-19 outbreak, whereby they are interrupted partially or forced to shut down immunization services completely. Mothers are faced with challenges juggling with the current pandemic situation and the potential childhood diseases that they will face if their new-born child does not complete their immunization schedules. The lack of quality control for vaccines can lead to other outbreaks of diseases if not monitored properly. The latter can be problematic especially during post-pandemic, to heal the country’s wounds, preventive measures should be implemented for restoration, thus a cost-effective and efficient operation will be required as we know that the pandemic has caused a downturn to our economy.
The role of intergovernmental organizations is significant to address these equity challenges and bridge the gaps between the community and the government as they will remain key actors in addressing peace, security, health, and socio-economic challenges.
During the pandemic, limitations to receive access to medical resources are on the rise, but technology becomes a solution. United Nations Development Programme (UNDP) has introduced Sistem Monitoring Imunisasi Logistik secara Elektronik (SMILE), an innovative technological solution that aims to strengthen the immunization supply chain system in Indonesia – home to a birth cohort of nearly 5 million. It ensures that safe and effective vaccines are available to all children, at all times. SMILE enables real-time visibility of vaccine cold chain logistics by digitizing stock supplies and storage temperature across vaccine cold chain points.
Since 2020, SMILE has transitioned from a pilot project into scaling upstage, it has now become a part of the Ministry of Health’s 5 year plan for immunisation program with an aim that by 2024, SMILE will be implemented across all cold chain points (10, 000 facilities) in Indonesia. The mobile and web-based application are being implemented by the Ministry of Health and supported by UNDP. With SMILE, it can strengthen the public health system opening windows to achieve the health-related targets of the 2030 Agenda for Sustainable Development – namely those under Sustainable Development Goal 3: Good health and well-being for all of all ages.
How can this address equity and efficiency challenges in Indonesia’s healthcare system?
The digital innovation consists of a mobile app for the cold chain handlers, a web interface for data storage and a temperature logger that monitors storage temperature of vaccines to ensure that quality vaccines are delivered timely and as needed. Following its implementation in 2018, SMILE has focused on expansion to reach 600 Public Health Centers by 2021. Despite the pandemic, the role of technology protects its implementation in being hindered. Therefore, until now, SMILE has achieved the following results:
All vaccine inventories digitized at 58 cold chain points in West Java and Banten, linking to 2,723 Integrated Health Centers (Posyandu) and private practices and is currently on progress to be socialised through 6 provinces in Riau, Banten, DKI Jakarta, West and Central Java and Gorontalo, with a total of 11 districts and 560 cold chain points.
16,000 transactions per month on SMILE, showing high levels of usage and adoption by healthcare staff (Puskesmas). Data entry errors have also been reduced by 74%.
Vaccine stock-outs have been reduced by 70% and over-stocking by 47%. Vaccine stock wastage has been reduced by more than 90%.
Over 200 vaccine handlers and health care workers have been trained on SMILE.
75 temperature loggers installed for remote temperature monitoring of cold chain equipment.
Digitizing the core of the health chain can encourage operational efficiencies thus can offer cost-effective opportunities for healthcare providers to deliver quality products at the right time, this brings solutions to address inequities in health coverage. As SMILE is recognized by Indonesia’s Ministry of Health, they are supported and committed to providing the necessary resources from skilled training, knowledge management to implementation of the program to overcome constraints of infrastructure, monitoring, and management information systems, and human resources which often result in over-stocking of vaccines in storage centers. Setting preventive measures in the healthcare industry is important in a post-pandemic situation, with technology, we are provided with real-time data that will enable policy and decision makers to act upon empirical evidence and soon heal Indonesia’s wounds.
Technology enablers should come to the forefront in providing digitized supply chain tools and efficiency across the health chain from inventory management to medical supplies. These are one of the ways healthcare can be disrupted to provide access for all. With real-time data provision, the accuracy of information and data will be clear thus preventing inventory issues, which are critical to address Indonesia’s equity challenges due to its dispersed geographical nature.