JMIR Publications

ABSTRACT

Background:

Electronic immunization registries (EIR) are increasingly used in low- and middle-income countries. In 2022, Indonesia's Ministry of Health introduced its first electronic immunization registry, named Aplikasi Sehat Indonesiaku (ASIK), as part of a comprehensive nationwide immunization program. This marked a conversion of traditional paper-based immunization reports into digital routine records encompassing a network of 10,000 primary health centres (Puskesmas).

Objective:

This paper provides an overview of the utilization of ASIK as the first electronic immunization system registry in Indonesia. It describes the coverage of the nationwide immunization program (BIAN) using ASIK data, and assesses the implementation challenges associated with the adoption of the electronic immunization registry in the context of Indonesia.

Methods:

Data was collected from primary care health workers’ submitted reports using ASIK. The data was reported in real-time, analyzed and presented using a structured dashboard. Data on ASIK utilization was collected from the ASIK website. A qualitative assessment was conducted by a cross-sectional survey between September and October 2022. A set of questionnaires was used to obtain data from participants to collect feedback from ASIK users.

Results:

A total of 9,708 Puskesmas (93.5%), 6,478 subdistricts (93.5%), and 501 District/Cities (97.4%) in 34 provinces reported immunization data using ASIK. With over 21 million data recorded, the national coverage for immunization campaigns for measles rubella, oral polio vaccine, inactivated polio vaccine, and Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib vaccine were 50.17%, 36.17%, 30.70%, and 40.23% respectively. The qualitative assessment showed generally users have a good understanding of ASIK as the EIR (80.35%), 61.66% users suggested the UI/UX was overall good but still can be improved, 54.03% of users suggested that the ASIK variable fit with their needs yet can be improved further, while 59.06% users observed sporadic system interference. Challenges faced during implementation of ASIK include heavy workload burden of health workers, inadequate access to internet at some places, system integration and readiness, and existence of dual reporting using paper-based format.

Conclusions:

The electronic immunization registry is beneficial and helpful to monitoring vaccination coverage. Implementation and adoption of ASIK as Indonesia’s first electronic immunization registry still faces challenges related to human resource and digital infrastructure as the country transitions from paper-based report to electronic/digital immunization report. Continuous improvement, collaboration, and monitoring efforts are crucial to encourage the use of the electronic immunization registry in Indonesia.