In Jakarta, Indonesia’s bustling capital city, Dr. Ani Ruspitawati’s office oversees more than 5,500 health facilities — known locally as puskesmas — which serve a population of 10 million people.
When COVID-19 struck, with Jakarta as the nation’s hotspot, the Provincial Health Office needed well-organized, up-to-date data on this massive health system in order to mount an effective response.
“Data is needed for decision-making,” explained Dr. Ani, head of the Health Resources Division. “If the data is inaccurate, then the decisions will be wrong.”
Nine years ago, when Dr. Ani first started working at the Provincial Health Office, data about health workers and facilities was “pretty much nonexistent,” she said. But by the time the pandemic arrived, her office was better prepared.
Creating systems that work
In 2019, USAID began investing in innovative digital tools to help Indonesia improve its Human Resource Information System (HRIS), which collects, monitors, and stores health workforce data. USAID helped transform the fragmented HRIS by linking together massive amounts of data from 25 siloed systems into actionable information.
Using the improved HRIS during the pandemic, Dr. Ani was able to set evidence-based targets for vaccinating health workers, and the Provincial Health Office was able to make data-driven decisions about where to best place COVID-19 response volunteers, including doctors and nurses.
Serving providers, serving patients
Dr. Astrid Sri Kusumawati manages the mental health service unit at the Pancoran Sub-District Puskesmas in Jakarta. Before the pandemic, many of her patients needed at-home treatment because their health issues precluded clinic visits. COVID-19 restrictions made it harder than ever before to treat these patients, so Dr. Astrid turned to the data now available at her fingertips.
“The system greatly helps us to get information about health workers or clinics in a given area,” she said. She was able to coordinate with other providers who lived closer to her patients and could provide services.
Dr. Astrid’s puskesmas also used HRIS to plan for an efficient vaccine rollout for health workers. “When we administered the first doses, the system greatly helped us — in mapping; gathering data on providers who needed to be vaccinated; and planning for procurement, scheduling, and implementation,” she said.
On top of bolstering the COVID-19 response, HRIS supports other critical aspects of Dr. Astrid’s job, like maintaining records for her licensure. “Without a license, I would not dare to practice. That would endanger me and certainly the patients I’m serving,” she said. “The HRIS system helps in the process of licensing and planning continued training.”
Dr. Ani added that licensing data also helps the Provincial Health Office alert health care facilities about unlicensed practitioners who might pose a danger to clients.
No time to lose
During the COVID-19 response, the Provincial Health Office was able to use the HRIS data to quickly deploy more than 1,400 COVID-19 response volunteers, based on expertise and staffing gaps at the puskesmas.
Nur Aulia, a recent college graduate with a degree in public health, decided to volunteer. “I saw the recruitment announcement on Instagram,” she said. “I registered, submitted my application, and went for an interview. When we were notified of acceptance, we immediately got our assignments.”
“The volunteers were a huge help to us,” said Dr. Astrid. “Early on in 2020, we struggled getting information out to the public, but the volunteers helped. They also did contact tracing and monitored patients in self-quarantine.”
Aulia helped her assigned puskesmas communicate with the community about COVID-19, vaccine stigma, and misinformation. “There were volunteer radiographers, data analysts, surveillance staff, and health support staff, too,” she says.
Toward a data-driven future
In addition to supporting the COVID-19 vaccine rollout for frontline healthcare professionals and easing burdensome licensure processes, the streamlined HRIS system has helped reassign over 115 qualified healthcare professionals to more appropriate locations based on community needs.
Dr. Ani’s creed is simple: “Data can’t just sit there in a document. It has to be continually used — including the HRIS data.” In the future, she hopes, “we can find out if 100 percent of our health care providers are licensed and then track their abilities relative to the standard.”
As for the ongoing pandemic, systematic use of data to make decisions will help Indonesia move more quickly into a post-COVID-19 recovery period.
“Every individual, everyone, has the right to good health — and this has to be provided through optimal service,” Dr. Astrid said.
With the streamlined HRIS system in place, Indonesia has taken a big step forward toward an optimized health system that can maximize the potential of its health workforce.
USAID’s 2020 Digital Development Awards (the Digis) recognize USAID projects that harness the power of digital tools and data-driven decision making. The Human Resources for Health in 2030 (HRH2030) Program in Indonesia, implemented by a consortium led by Chemonics International, was recognized for strengthening the country’s information system for human resources for health.
About the Authors
Samantha Martin is the Development Outreach and Information Editor at USAID’s Mission in Indonesia, and Elizabeth Walsh is the Director of Communications & Knowledge Management of HRH2030 (with support from Anastasia Susanto, the Health System Strengthening Team Lead at USAID’s Mission in Indonesia).