Setiaji  – Chief of Digital Transformation Office, Ministry of Health, Republic of Indonesia 

Norimasa Shimomura – Resident Representative, UNDP Indonesia 

This Opinion was published in the Jakarta Post on Monday, 25 November 2024

As Indonesia envisions a "Healthy Indonesia," digitalization has emerged as a driving force of transformation across various sectors, including healthcare. The pandemic demonstrated the critical role digital tools play in navigating challenges, and this momentum has only grown. The Government officially enacted the Health Law. At its core is SATUSEHAT (One Health) as National Health Information System, an ambitious initiative designed to integrate all health-related digital platforms into a unified system through standardization. This move, initially started within the comprehensive Digital Health Blueprint launched in 2021, signifies a pivotal moment in Indonesia’s journey towards a more cohesive and efficient healthcare ecosystem.

However, these advancements didn’t happen overnight. They are the result of overcoming significant hurdles—among them, the fragmentation of health data. With more than 400 health apps developed on health care service delivery by various government bodies, many operated in silos, potentially leading to inefficiencies.

As the SATUSEHAT Platform continues to evolve, its ecosystem—comprising SATUSEHAT Mobile, SATUSEHAT SDMK, SATUSEHAT Data, and the Aplikasi Sehat Indonesiaku—represents a significant step toward digital transformation in healthcare.  

Yet, one critical challenge remains: logistics. Ensuring the seamless distribution of pharmaceuticals and medical devices, from production and procurement to delivery at healthcare facilities across Indonesia, is a persistent struggle, particularly given the nation's vast and dispersed archipelago. Despite these challenges, logistics remains the backbone of an effective healthcare system, playing a pivotal role in enabling timely and life-saving interventions.

A 2020 report by the United Nations Inter-Agency Group for Child Mortality Estimation (UNIGME) revealed a startling reality: over 30,000 Indonesian children under the age of five die from preventable diseases each year. The report also noted an under-five mortality rate of 23 per 1,000 live births, totaling approximately 45,000 child deaths annually.

Many of these tragedies occur in underserved regions, where delayed or insufficient access to vaccines exacerbates the problem. At the heart of the issue lies a critical gap in the supply chain.

One of the earlier attempts to address the persistent health logistics challenges was in 2018, with the introduction of SMILE or the Electronic Health Logistics Inventory Monitoring System. Initially developed to improve vaccine logistics, SMILE has since become a game-changer in the country’s healthcare system, providing real-time data on vaccine availability and stock levels.

The impact of SMILE is best understood through the stories from those on the front lines.

In Bahu Village, North Sulawesi, immunization coordinators Jouke and Dora have spent over a decade working tirelessly to ensure children receive life-saving vaccines.

Before SMILE, their work was fraught with challenges. Vaccines had to be transported across treacherous mountain roads in unreliable vehicles, often resulting in spoilage due to inadequate storage or expired doses. Stock shortages were common, leaving healthcare workers frustrated and anxious, knowing that even one missed dose could endanger a child’s life.

Then, SMILE arrived. For Jouke and Dora, SMILE is more than just an application—it’s a lifeline.

"It’s like having a map to our vaccine stock," they explain, their relief evident. With SMILE, they can now track supplies, anticipate shortages, and ensure that every child in their care receives the vaccines they need.

What began in just two cities in 2018 has now expanded to over 12,000 health facilities across Indonesia. Today, SMILE not only manages routine vaccines but also tracks various health commodities, including treatments for tuberculosis, malaria, HIV, rabies, and medical waste management. This transformative system has reshaped healthcare logistics nationwide, bringing timely access to essential medicines and vaccines to even the most remote regions.