The SMILE Malaria App Testing and Piloting in Southwest Sumba district of East Nusa Tenggara province.
Photo: UNDP

It is well established that digital tools can have a significant impact on improving health and well-being. The SMILE Malaria application, a newly developed addition to the Sistem Monitoring Imunisasi dan Logistik secara Elektronik (SMILE) or Electronic Immunization and Logistics Monitoring System, is one such tool that assists health workers to better control and monitor the spread of malaria, benefiting the lives of vulnerable populations in Indonesia. 

Developed by the United Nations Development Programme (UNDP) and the Indonesian Ministry of Health (MoH) in 2018, SMILE is a cloud-based digital solution which strengthens the immunization supply chain by providing a real-time and customized end-to-end tracking of the vaccine inventory. Notably, the SMILE app has successfully helped to monitor the distribution of around 454 million doses of COVID-19 vaccines at over 12,000 health facilities across Indonesia. This success has led UNDP and MoH to leverage SMILE’s robust system for malaria control.   

The WHO’s World Malaria Report 2022 estimated there were 247 million malaria cases with 619,000 deaths globally. The African region accounted for around 95 percent of the global cases and deaths, and around 2 percent of cases were in the South and Southeast Asia region. Malaria is endemic in nine countries in South and Southeast Asia, with the top three being India, Indonesia and Myanmar. 

According the MoH’s latest data, Indonesia recorded 399,666 cases in 2022. As of December 2022, 372 out of the country’s 514 districts (72.4 percent) were certified as malaria-free. Yet, malaria elimination challenges remain in its highly endemic and terrestrial eastern provinces of Papua, West Papua and East Nusa Tenggara where over 90 percent of cases in the country are found.

Indonesia's objective to eradicate malaria by 2030 has faced several challenges, compounded by the impact of the COVID-19 pandemic. In addition to complex geography, the lack of appropriate digital tools and risky behaviour have impeded progress towards reducing disparities in malaria control logistics. 

To help address this, UNDP Indonesia with support from the Access and Delivery Partnership (ADP) has been working with the Ministry of Health to identify cost-effective interventions and easily accessible digital solutions. Together they have developed the SMILE Malaria app, which digitizes the recording, monitoring and reporting of malaria logistics, thereby improving the supply chain management system and preventing stockouts of malaria drugs and diagnostic tools. 

Effective adoption of this new digital solution into the health system will require greater investment in the health care workforce capacity, and across health programmes. UNDP and MoH have piloted the SMILE Malaria app to help combat malaria in the Southwest Sumba district of East Nusa Tenggara province. A training workshop was organized in March 2023 for 47 health staff (52 percent of whom are women) of the Pharmacy and Malaria programme from 16 local community health centers, the District Health Office of Southwest Sumba and the Provincial Health, Population and Civil Registry Office of East Nusa Tenggara. 

Speaking at the recent training, the Head of the Malaria Programme at the Provincial Health, Population and Civil Registry Office of East Nusa Tenggara, Alfred Duka explained, “The East Nusa Tenggara province is Indonesia’s third highest malaria endemic province with 15,825 cases and nine deaths in 2022. About 5,370 positive cases of malaria were found in Southwest Sumba district. Three high endemic districts are all located on the island of Sumba, which contributes about 80 percent of cases in the province. We hope that by utilizing a digital solution such as offered by the SMILE Malaria app it will speed up our effort to eradicate malaria.” 

“The SMILE Malaria app reduces delays in reporting, as it is quicker than using the traditional paper forms. It ensures effective distribution of malaria drugs and logistics, despite the long distances and mountainous areas we have here. Now, I can easily monitor the malaria drugs and logistics via my phone. It really saves time,” said Chendriani Dominika Fernandez, the Malaria Programme Officer at the District Health Office of Southwest Sumba.

Through the SMILE Malaria app, health workers now can monitor, report and notify providers of their current malaria drugs and logistics situation in real-time. This digital innovation strengthens the ability to identify stockouts, enables timely reporting of logistics distribution, and allows quick decision-making to optimize malaria supply chain management. 

Currently, 7 out of 16 community health centers in Southwest Sumba have completed record-keeping for malaria drugs and logistics, and have begun placing orders via the SMILE Malaria app to the District Health Office. 

As part of the piloting of the SMILE Malaria app, UNDP Indonesia is also working closely with the national and local governments to promote women’s involvement in leadership and decision-making positions in health care, including in issues related to malaria response such as health worker training, vector control and engagement with grassroots and civil society organizations.  

Leaving no one behind in the malaria response in Indonesia and adopting people-centered approaches and gender responsive programming will be critical to achieving success. Central to this is the active engagement of women health care workers with communities and stakeholders to identify local needs and develop evidence-based malaria control strategies that address equality and inclusion.

As part of next steps, UNDP and the MoH are entering into a partnership with the Global Fund to expand the use of the SMILE Malaria app through an additional pilot programme in the provinces of Papua and West Papua.

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