UNICEF and Nokia boost healthcare access in Indonesia

Having worked in Indonesia for over 60 years, UNICEF is focused on protecting the rights of children in the country. When COVID-19 hit, continuity of care and development services became an even greater priority. Using funding from Nokia, UNICEF was able to leverage existing internet and mobile connectivity to access data that informed central decision-making and facilitated positive change.  

Nokia and UNICEF began collaborating in Indonesia in 2017, through a partnership with UNICEF Finland, to support the government in transforming and modernizing community health and nutrition services using innovative mHealth applications. Between 2017-2019 UNICEF made major strides using digital services, such as the SMS-based platform, RapidPro which was used in several initiatives, including providing an integrated approach to boosting child nutrition, tracking vaccinations and monitoring HIV testing and care across the country.

Extending support at a time of crisis

When Nokia renewed funding support in 2019, nobody could have foreseen how significant it would be. The arrival of COVID-19 in 2020 created huge disruptions to essential health and education services. Lockdowns and school closures highlighted inequalities and severely impacted the mental and physical health of children in the country.  

Marja-Riitta Ketola, Executive Director of UNICEF Finland said: “The outbreak of COVID-19 affected the lives of millions of children and their families, increasing the likelihood of more Indonesians descending into poverty. UNICEF was able to use Nokia funding to implement digital applications and assist the government in limiting the spread of the virus and providing continuity of community health services and development support across various provinces.” 

Coordinating activities to support the health and welfare of roughly 85 million children in a country consisting of thousands of inhabited islands where more than 300 native languages are spoken, is no small feat at any time. Complexity is added in Indonesia, with planning and budgetary decisions decentralized, meaning data about the country’s health and development is fragmented. Internet penetration, however, is high with access having risen from just over half of the population in 2017 to around 70 percent in 2021.  

Having already leveraged this connectivity to forge links and reach patients, caregivers and health workers, UNICEF knew that it could do that once again to understand community needs and continue to deliver much-needed assistance. Nokia funding had been instrumental in the establishment of a local data analytics team in 2019. With this team already focused on data innovations, UNICEF used its digital solutions to continue supporting the government in its efforts to improve child health and welfare in the country, even as the pandemic created barriers.

Maintaining continuity of vital nutrition and immunization services

UNICEF conducted a rapid health assessment survey using RapidPro to understand the concerns parents and caregivers of children under the age of two had around the safe resumption of immunization services.  Responses were used to formulate guidelines which were delivered, along with supplies, to health workers, to allow them to resume their work safely while reassuring communities.  

To ensure critical nutrition services and counselling support continued, UNICEF developed a RapidPro WhatsApp chatbot for mothers of children under the age of 5 with severe wasting. Help was given for example on how to record vital health signs for monitoring purposes and caregivers were connected to additional resources where needed. A successful pilot in Kupang City led the government to expand the service to 24 districts across 8 provinces.  

An SMS-based immunization outreach initiative was expanded to target approximately 10,000 pregnant women and 25,000 children under the age of two in the Aceh province. This was used to address crucial gaps during the first 1,000 days of life to improve health, nutrition, water and sanitization. This included SMS reminders on iron intake, immunization and antenatal care and text-based monitoring of child growth and development. Staff at local health posts provided key data via SMS and reports were delivered monthly to health managers. Using this data, teams could adjust the service to rapidly address issues in potential hotspots.

Optimizing distance learning  

With more than 500,000 schools closed, pupils began learning from home. To understand how this was impacting the most disadvantaged regions, UNICEF designed a mobile messaging survey, complementing those distributed by the Ministry of Education and Culture.

Responses revealed that while over 90 percent of students were learning from home, about half of those could study for only a few hours per weeks, the main reason being poor connectivity. Findings were used to develop recommendations around helping parents and equipping schools with learning management systems to help close the digital divide and optimize distance learning.  

Tracking the spread of COVID-19  

Over time as new variants and clusters of cases emerged, UNICEF devised a way to help monitor and track infection to help limit the spread of the virus. By developing a first-of-its-kind dashboard using data from all hospitals to assess transmission risk at district level and predict the impact on hospital capacity, UNICEF could support the Ministry of Health to better manage the pandemic. This information was also combined with other data sources and used by authorities to inform future decisions.

A new dashboard showing the availability of WASH services at health facilities and schools was mapped alongside COVID-19 risk at district level. The government used this to develop guidelines for reopening schools and community health services safely and to improve facilities. Volunteers and staff at schools, religious places, on public transport and at markets, informed people how they could stay safe and monitored hand washing, mask-wearing and physical distancing, recording their observations via RapidPro. Using geo-tagging, this information was presented in a dashboard view to decision-makers in the DKI Jakarta province so they could assess risk and implement policies.

Hanna-Leena Markus, Key Account Manager, Corporate Collaborations of UNICEF Finland said: “These digital solutions and the others we introduced in the past have been instrumental in promoting the health and development of children at a challenging time in Indonesia. It highlights the importance of connectivity and how quality data can be crucial in generating value and enhancing healthcare and child rights at large.”

From 2019 to 2021, at least seven UNICEF digital initiatives were adopted by the Indonesian government to enhance health and welfare in several communities and more than 2 million people were reached using mobile technology.

Nicole Robertson, VP Environmental, Social and Governance from Nokia said: “We are committed to leveraging digital technologies to enable positive change for communities. As such we have been pleased to work with UNICEF in Indonesia. It has shown how big data can inform important decision-making and enable the delivery of innovative services to meet the needs of people in the most challenging situations.” 

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