Understanding Health Information Systems Utilization Across Public Health Centers in Indonesia: Cross-Sectional Study

Area of Science:

• Digital Health
• Health Informatics
• Primary Health Care Systems

Background:

• Indonesia's primary healthcare relies on 10,260 public health centers (Puskesmas).
• Health Information Systems (HIS) are vital for community health monitoring and effective service delivery.
• Accurate health data recording and reporting are essential for managing public health.

Purpose of the Study:

• To map the national utilization of HIS in Indonesian Puskesmas.
• To identify the number of HIS platforms used and their origins.
• To evaluate challenges and contextual factors affecting HIS adoption and implementation.

Main Methods:

• A cross-sectional survey was conducted across 34 Indonesian provinces from January to February 2022.
• Data collection involved questionnaires on HIS usage, development, implementation challenges, and infrastructure.
• Descriptive and bivariate statistical analyses were applied to the collected data.

Main Results:

• 2606 Puskesmas participated, reporting an average of 30 different HIS platforms per center.
• While most HIS (72.94%) were developed by national ministries, significant operational barriers exist, including excessive data entry (49%), frequent downtime (33%), and lack of automated analysis (29%).
• Infrastructure and human resource challenges are prominent: 9.45% lack internet access, staff manage multiple HIS, and training is often limited to initial implementation.

Conclusions:

• Indonesia's HIS environment is fragmented, with disparities in infrastructure, usability, and workforce capacity.
• Context-specific recommendations are crucial: offline systems for rural areas and advanced tools for urban centers.
• Future research should focus on HIS interoperability, impact, cost-effectiveness, and user experience to guide digital health transformation.