LocationsSouth-South Cooperation for a Better Tomorrow: The SMILE Initiative
November 7, 2024
South-South cooperation offers a valuable platform for developing countries to collaboratively address global challenges. Through concerted efforts, these nations can overcome shared obstacles, such as those encountered in the healthcare sector. Indonesia, a prominent example, has demonstrated its commitment to enhancing healthcare services by prioritizing equitable vaccine distribution. In 2008, immunization coverage for children in Indonesia’s outlying regions was notably low at 73%, falling significantly short of the international benchmark of 90%. This disparity underscored the imperative need for comprehensive reforms and substantial investments in the nation’s healthcare infrastructure.
Indonesia's unwavering commitment to addressing healthcare logistical challenges, particularly in ensuring equitable vaccine distribution, is evident in its efforts to improve immunization coverage. In 2008, immunization coverage for children in Indonesia's outer islands stood at only 73%, significantly below the global target of 90%. This underscored the urgent need for reform and investment in the nation's health infrastructure.
These challenges have led to the development of the Electronic Immunization and Logistics Monitoring System (SMILE). Inspired by India's successful eVIN system, SMILE was designed to streamline and enhance the efficiency of the healthcare supply chain. Launched in 2018, SMILE has rapidly expanded its role and scope, particularly in addressing the unique challenges posed by Indonesia's vast archipelago, which requires more accurate vaccine distribution records. Beyond expectations, SMILE has undergone a rapid transformation and become a valuable tool in Indonesia's recovery from the pandemic. By ensuring that 185 million people received 450 million vaccine doses within a year, SMILE has demonstrated its ability to meet the urgent needs of the nation and contribute to a more equitable and resilient healthcare system.
SMILE has emerged as a pivotal component of Indonesia's healthcare information recording system. The system has successfully managed over 450 million COVID-19 vaccines, 350 million routine immunization doses, and 100 million AIDS, TB and Malaria drug doses across 10,000 community health centers in 38 provinces. Its scope has expanded to encompass a wide range of health commodities, including COVID-19 vaccines, routine immunizations, tuberculosis, malaria, HIV, rabies, and medical waste management. Moreover, this success is further supported by an economic analysis that has validated SMILE's role in immunization programs. The analysis demonstrates that SMILE generates threefold financial returns for health services delivery, highlighting the significant economic benefits of digitalization in various sectors.
This achievement highlights Indonesia's role in advancing digital health. Through a collaborative effort with the Indonesian Ministry of Health and UNDP Indonesia with the support of the UNDP Digital Health for Development Hub and the UNDP Asia Pacific Regional Hub is looking to share it’s knowledge on digitzing medical logistics systems in other countries as part of a South-South collaboration effort. In addition, UNDP Indonesia together with the Hub, also offers the open-source code of SMILE and its local customization and adaptation.
In August 2024 UNDP Indonesia hosted an eight member high-ranking delegation, from the Ministry of Health (MoH) Malawi. This visit aimed to demonstrate the SMILE implementation and the scope of adapting the software in Malawi. The delegation made a field trip for a first-hand demonstration of SMILE smartphone application in a health facility and had an opportunity to interact and get insights from the health workers. The visiting MoH Malawi members professed their appreciation of the SMILE system and appreciated MoH Indonesia for their unwavering commitment to supporting the SMILE adoption process and they look forward to strengthening bilateral collaboration in digital transformation.
“We are deeply grateful for the invaluable knowledge shared through the SMILE project and eagerly anticipate future collaboration,” stated James Manyetera, Principal Secretary of Administration at the Ministry of Health of Malawi.
At the same time, Manish Pant, Policy Specialist, Digital Health of UNDP highlighted the key factors contributing to SMILE's success. "The success of this system stems from the country's accumulated lessons learned, encompassing technology advancement, interoperability, capacity building, and strategic management. SMILE is not merely an application but a foundational component of a digital ecosystem. Malawi, as it seeks to accelerate its digital transformation in the health sector through the Malawi’s E-HIN system, can draw valuable lessons from Indonesia's experience."
The Indonesian government's leadership and support have been instrumental in SMILE's success. The Ministry of Health's commitment to the system is evident in the development of a Ministerial Decree have drafted a Ministerial Decree on the Implementation of an Electronic Health Logistics Inventory Monitoring System on the SatuSehat Platform. This regulation aims to govern the implementation, inter-agency coordination, and financing of SMILE to support the health commodities supply chain.
The generosity of the Indonesian government facilitated a courtesy meeting with high-ranking officials from the MoH, WHO, and UNICEF, followed by consultations with technical units. Malawi's delegation visited Yogyakarta, where SMILE has been successfully implemented with a 100% active user rate.
Beyond Malawi, SMILE's impact has resonated with other nations interested in exploring knowledge exchange opportunities, including Vietnam, Maldives, Bangladesh, Kazakhtan and Haiti with the potential of technology and expertise transfer. The project's success serves as a testament to the potential of South-South cooperation in driving digital health innovation and improving healthcare outcomes.