Center for Health Research, Universitas Indonesia, Depok, Indonesia
Reconstra, Jakarta, Indonesia.
BMJ Open. 2020 Dec 10;10(12):e038282. doi: 10.1136/bmjopen-2020-038282.
To assess the contribution of a digital health real-time monitoring platform towards the achievement of coverage targets during a national immunisation campaign in Indonesia.
A digital health platform was introduced to facilitate real-time reporting and data visualisation. Health workers submitted reports of children immunised each day by geolocation using mobile phones. Automated reports were generated for programme managers at all levels to enable early responses to coverage gaps.
Risk profiles were generated for each district to assess precampaign immunisation programme performance. Digital health platform use and progress towards targets were monitored continuously throughout the campaign. Study outcomes were total coverage and time to achieve full (100%) coverage. Kaplan-Meier, Cox and linear regression analyses were used to estimate the associations and outcomes after adjusting for district risk profiles. A complementary qualitative assessment explored user experiences and acceptance through interviews with vaccinators and programme managers in provinces and districts selected through multistage random sampling.
Between August and December 2018, 6462 health facilities registered to use the digital health platform across 28 provinces and 395 districts. After adjusting for precampaign district risk profile and intracampaign delays due to vaccine hesitancy, districts with greater platform utilisation demonstrated higher coverage overall (R=0.28, p<0.0001) and a shorter interval to achieving full coverage (>75% reporting compliance; Risk Ratio 15.4, 95% CI 5.8 to 40.6). Stronger effects were observed among districts experiencing implementation delays due to vaccine hesitancy. Results from 106 key informant interviews conducted in 6 provinces and 18 districts suggest high degrees of acceptability, ease of use and satisfaction.
A digital health platform introduced for real-time monitoring of a national immunisation campaign in Indonesia was feasible, well liked and associated with improved problem solving and programme performance, particularly among districts affected by vaccine hesitancy.
ISRCTN10850448.
评估印度尼西亚全国免疫运动中使用数字健康实时监测平台对实现覆盖目标的贡献。
引入数字健康平台以促进实时报告和数据可视化。卫生工作者每天通过手机进行地理位置定位来报告免疫儿童的情况。为各级方案管理人员生成自动报告，以便及时应对覆盖差距。
为每个地区生成风险概况，以评估免疫前方案执行情况。在整个运动期间，持续监测数字健康平台的使用情况和目标进展情况。研究结果是总覆盖率和达到完全（100%）覆盖率所需的时间。使用 Kaplan-Meier、Cox 和线性回归分析调整地区风险概况后，对关联和结果进行估计。通过对通过多阶段随机抽样选择的省份和地区的疫苗接种人员和方案管理人员进行访谈，进行了补充定性评估，以探索用户体验和接受程度。
2018 年 8 月至 12 月期间，共有 6462 个卫生机构在 28 个省份和 395 个地区注册使用数字健康平台。在调整免疫前地区风险概况和因疫苗犹豫而导致的运动期间延迟后，使用平台较多的地区总体上覆盖率更高（R=0.28，p<0.0001），达到完全覆盖所需的时间间隔更短（>75%报告合规性；风险比 15.4，95%CI 5.8 至 40.6）。在因疫苗犹豫而导致实施延迟的地区，观察到更强的效果。在 6 个省份和 18 个地区进行的 106 次关键知情者访谈结果表明，接受度、易用性和满意度都很高。
在印度尼西亚全国免疫运动中引入实时监测的数字健康平台是可行的，受到欢迎，与改进问题解决和方案执行情况相关联，尤其是在受疫苗犹豫影响的地区。
ISRCTN850448。
