Midwife service coverage, quality of work, and client health improved after deployment of an OpenSRP-driven client management application in Indonesia

摘要

The quality of maternal and child health services remains suboptimal in most low and middle-income countries (LMIC). Data are routinely collected with paper-based systems but are incomplete, underutilized, and reported as poorly-usable aggregated indicators. Therefore, we developed the Open Smart Register Platform (OpenSRP) application for midwives in Indonesia wherein routine paper registers were transformed into a smart real-time data-driven client management system. The app running on Android tablets was deployed as a matched-pair study in Central Lombok District in 2015-2018 to 30 frontline workers (midwives, nutritionists, and vaccinators) in 10 villages, and compared to workers in 10 matched villages using the routine paper-based system. Preliminary results indicate complete antenatal care (ANC) for pregnant women increased from 55% in the control area to 73% in the OpenSRP area (p<0.05). Moreover, postnatal care (PNC) visits for mothers and neonates increased from 1% in the control area to over 45% (p<0.05) in the OpenSRP area. Maternal and neonatal morbidity and mortality tended to be lower at 27% compared to 8% in the control area. Using the OpenSRP system, health workers can take rapid action to provide better quality service based on data, which resulted in a higher impact on maternal and neonatal health.