To form coordinated data-driven maternal and newborn care and nutrition by FHW teams through active use of routine client data on OpenSRP mobile information systems to ensure complete coverage and continuity of care in 6 districts across Indonesia covering a population of 5 million persons, within 3 years.
Description
The ANCS address the context in Indonesia with 262 million inhabitants, undergoing rapid transitions with urbanization&health governance decentralization to 514 districts. Current health gains across the country are uneven with major gaps such as stagnant maternal mortality, minimal change in neonatal mortality. The innovation is to create district level systems that optimize synergy between existing resources&policies by creating a dynamic network that links practice and data to adapt to the needs of each client, region, and time period. A core resource is frontline health workers in each primary health center (PUSKESMAS) that includes midwives, vaccinators, nutritionists, and community health workers (CHW). Their client data is recorded on paper form registers that precludes data-driven supervision and prevents assessment of FHW task completeness and quality for individual clients, hampers use of data on a frequent basis&limits data-driven action. A second resource is the universal health care system called Jaminan Kesehatan National (JKN)-BPJS, introduced in 2014&covering 203 million people. The system has improved health equity&service access, but with gaps for enrolled wealth Q2-Q3, and in overall low coverage for maternal and newborn care. It has created a pathway for insurance payments to midwives for ANC&PNC. But challenges in claim processing&lack of needed service authentication limits its impact.
- Our goal is for governments at all levels to show improved use of integrated digital health information systems, for example OpenSRP, and active use of data for monitoring&action to enhance the health of pregnant women&newborns
- Coordinated teams of frontline health workers (FHWs) will be established&supported with OpenSRP to have better coordination to jointly complete care plans for ANC, delivery, PNC, nutrition counseling, immunization, micronutrient supplementation, COVID-19 screening and vaccination, and for newborn and infant tracking for Covid-19, and breastfeeding, according to the new government schedule, as part of a digital health service ecosystem
- January 2022 in OpenSRP active districts, FHWs and program implementers will be provided with continuous training with digital and other job aides to provide better integrated services to improve training&performance.
- January 2023 in OpenSRP active districts, FHW and support teams are formed who can provide ANCS networked care delivery
- The innovation is available to provide performance-based assessment&to facilitate data-driven recognition&compensation of health workers
- Continuously approach and engage Government, at least twice a year, and involve the Government in the ANCS program so they have the commitment&capacity to use the innovations for care enhancement and decision making
Overarching commitment (for commitments submitted pre-2025)
Title
Adaptive Networks for Care at Scale/ANCS
Description
SID commits to overcome bottlenecks for maternal and neonatal care and nutrition utilizing 5 core components that include: (1) coordinated data-driven maternal and newborn care and nutrition by FHW teams through active use of routine client data on the Open Smart Register Platform (OpenSRP) mobile information system to ensure complete coverage and continuity of care. OpenSRP is currently deployed with the aim to enhance maternal care including COVID-19 screening, vaccination, and multiple micronutrient supplementation during pregnancy, blood pressure and diabetes monitoring and management, and for maternal, newborn and infant tracking for COVID-19 according to government schedules, and promotion of breastfeeding; (2) enhanced Frontline Health Workers (FHWs) knowledge/skills and accountability through the proctored Knowledge Ggateway (KG), online proctored assessment platform for targeted training i.e interprofessional collaboration, for workers to attain professional society certification and public sector human resource performance requirements, and provide coaching for the continuous improvement; (3) Universal Health Coverage provider incentivization by real- time verification of service completeness and quality by OpenSRP, and linked with accelerated provider claim payments; (4) client demand-side incentives that promote improved quality of care as clients’ feedback on care completeness and quality; (5) completion of app migration to the Fast Healthcare Interoperability Resources (FHIR) standard for a ‘One Data’ system according to the Presidential Regulation No. 39 Year 2019.
Components #1 to #4 are together to be achieved through deployment of OpenSRP, Knowledge Gateway, and coaching activities. Meanwhile, and component #5 is an effort to create a highly interoperable system for a unified data system across FHWs. Therefore, all components are integrated, to improve the quality to improve the quality of human resources in health and improve quality of maternal and child health and nutrition by improving the quality of human resources and the use of digital tools for health.
GNR assessment
| Verification status |
Verified
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| SMARTness index |
High
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Details
| Global nutrition target(s) |
Anaemia
Low birth weight
Exclusive breastfeeding
Childhood stunting
Childhood wasting
Adult diabetes
Raised blood pressure
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| Nutrition Action Classification(s) |
Enabling >
Research, monitoring and data
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| Linked event(s) |
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| N4G Summit theme(s) |
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Measurement
| Key indicator | Number of districts in Indonesia using OpenSRP mobile information system |
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| Value | Measurement date | |
|---|---|---|
| Baseline | 2 districts | 2021 |
| Target | 6 districts |
