The Technologies for Health Registers, Information, and Vital Events (THRIVE) Indonesia
A local adaption and pilot of ‘Open Smart Register Platform’, an integrated electronic health information system to enhance maternal and neonatal health outcomes. A multi-site research trial conducted in Indonesia, Pakistan and Bangladesh.
Frontline health workers (FLHWs) are the first and often the only point of contact for health care access for millions of people. Especially in resource-constrained environments which have a shortage of trained physicians and nurses, FLHWs form the backbone of the health system. However, FLHWs are often inadequately trained, and have poor access to health information, tools and guidance. The isolation and rudimentary training of this cadre of workers has often limited their capacity to provide little more than the most basic care, with little continuity of care for the clients being served. To this end, mHealth strategies have been developed for data collection, to provide continued skills development and training for FLHWs, increase the range of task-shifted health activities, and improving communication between different levels of the health care system, improve emergency health referrals, and overall motivation of the FLHW. The Indonesian health care system employs thousands of women frontline health workers, relying on paper-based health registers which present strategic challenges for communication, coordination, and resource sharing across all levels of this decentralized health system. There is a clear and urgent need for an integrated health information system to generate quality data, reduce the workload of frontline health workers, and provide data in real time for program managers and policy makers to guide strategy and improve health outcomes.
This project aims to adapt and trail an electronic information system, Open Smart Register Platform (OpenSRP), to provide an integrated health platform to improve frontline workforce efficiencies, data quality, and timeliness of RMNCH interventions to enhance maternal and neonatal health outcomes. The OpenSRP is an electronic register-based mHealth platform that covers the entire RMNCH continuum of care and related core interventions, such as antenatal care, birth planning, and vaccination. It combines data collection, client management, and reporting workflows into one linked mobile interface. OpenSRP is currently being implemented in India among one cadre of frontline health workers in a form that is localized to the Karnataka State ANMs: with content specific to their roles, responsibilities, intervention types and schedules. OpenSRP has not yet been made into a generic tool for adapted use among different cadres of health workers across countries.
The study hypothesizes that the OpenSRP improves frontline workforce efficiencies, data quality, and timeliness of RMNCH interventions, compared to use of current paper-based information-system approaches. ‘THRIVE Phase 1’ is a multisite study to be conducted in Bangladesh, Indonesia, and Pakistan. It consists of qualitative formative research to adapt the OpenSRP, followed by a quasi-experimental field-testing to assess the deployment and will be conducted over a 24-month period. This research study comprises three stages and four interlinked objectives with the overall goal being to determine the adaptation requirements, implementation components, and effect of an electronic information system as an intervention on the performance of health workers delivering RMNCH interventions. The findings of this research will be used to inform a second phase of research, entitled “THRIVE Phase 2”, which will include a robust multi-site randomized controlled trial which will aims to measure coverage, quality of implementation, cost-effectiveness of health system gains, and resulting impact on clients employing the Open Smart Register Platform (OpenSRP) across different cadres focused on delivering RMNCH interventions.