SIZE GHSA Presentation ZDAP Final

Indonesia developed an integrated health surveillance system called SIZE that links human, animal, and wildlife health information systems for early detection and response to zoonotic diseases. SIZE has been piloted in several areas and evaluated positively for improved coordination and faster response times. Further expansion and improvements are planned.

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SIZE GHSA Presentation ZDAP Final

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irwantoko

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Integrated Health

Surveillance
with a One Health
Approach
in Indonesia
Presentation Outline

Background How SIZE Works Impact of SIZE

Lessons learned The way forward

Background
Indonesia initiated the development of an integrated/interoperable health
surveillance system using the One Health approach that links 3 information
systems for Zoonoses/EIDs called SIZE.

SKDR

Human Health Animal Health Wildlife Health

Early Warning Alert and Integrated National Wildlife Health
Response System Animal Health Information Information System
(EWARS / SKDR) System (iSIKHNAS) (SEHAT SATLI)

Objectives: early report, early detect, and early response

SIZE 2.0 currently focuses on Rabies Control and will be expanded to other priority
zoonotic diseases as well as risk mapping.
Stakeholders

Min of
The Coordinating Ministry Environment BPPT
for Human Empowerment Min of Health Min of
and Forestry Agency for the
and Culture public health Agriculture
wildlife health assessment and
legislation framework, animal health
application of
intersectoral coordination
technology, SIZE
mechanism & policy making
developers

Min of And many more….

Min of Home Affairs sub- BNPB Bappenas Communication (Including
national implementation, National and sub- National Planning and Information development
replication and monitoring of national Disaster Agency standardize, partners and
Provincial & District Agencies, joint risk interoperability and universities)
Government mapping one big data policy
How SIZE works
https://onehealth-size.id/
Two Way Data Flow System: Field ⇔ Central
Community

Human Health Sector Animal Health Sector Wildlife Health Sector

ALERT 0 ALERT 0 ALERT 0

Local

Field officers Field officers Field officers

ALERT 1-2-3 ALERT 1-2-3 ALERT 1-2-3

Decision Makers Decision Makers Decision Makers

ALERT 1-2-3 ALERT 1-2-3 ALERT 1-2-3

Central

SKDR

Decision Makers Decision Makers Decision Makers

Cross Sectoral

https://onehealth-size.id/
SIZE Blueprint and Current SIZE Development

SKDR
Evaluation of SIZE
Implementation at the Field Level
● After 6 months of trial in the field
● Get input from field users regarding features that
need to be improved in SIZE
● Activities carried out in January-February 2020
● 4 One Health pilot area locations
● Methods: Online survey, FGD and observation of
field activities
: evaluation results in pilot areas

73% 72% 80% 80%

Speeds up the Clear “Chain of
Easy to use for Simple case input Custody” on the
response coordination
resolving cases and reporting reported cases
with other sectors

Total Respondents 107 74

Benefits

83% 85%
Increased Speed up case
coordination with detection and
other sectors response

83% 84%
Improved prevention Faster decision
of bite victims / making process for
zoonosis cases case response
Challenges and Lessons Learned
Non - Technical Aspects Technical / System Aspects

● Improving data quality ● System

and standardization architecture that
allows continuous
● Different Priorities enhancements
between National and
Sub-Nat’l governments ● Time and budget
constraints for
● Requires further data further system
analysis & visualization to development and
support a faster decision- replication
making process
● Technology
● Replication to other Evolution
districts nationwide
Basic Requirements for developing an
Integrated Information Sharing System: SIZE

Non-Technical Aspects Technical / System Aspects

● Establish a national legal ● Select a simple but expandable

basis for One Data Policy platform that allows fast development
(Customizable / Reuse / Adapt)
● Obtain multi sectoral
agreement on notifiable ● Identify, use and improve existing
priority zoonotic information systems
disease/EIDs
● Implement a national
and centralized system
● Available data for easy management
connectivity coverage
nationwide
The Way Forward
● Continue strong collaboration across sectors and agencies,
including national and sub national government, universities,
and development partners to operationalize SIZE.
● Replicate nationwide with stronger roles of district and
provincial governments, disaster agencies, and other key
stakeholders, coordinated by the Coordinating Ministry.
● Include other diseases of concern (priority zoonoses/EIDs),
risk mapping and other non-biological risks across sectors,
and incorporate community-based surveillance (Next
Generation versions) into SIZE.
If you would like more information, please contact ZDAP
Indonesia:
Terima Kasih! Email: [email protected]