Upgrading medical waste management information system (SIKELIM)

Fig. 1. Updated medical waste management system (Sistem Kelola Limbah Medis-SIKELIM) web page. Photo Credit: Indah Deviyanti/WHO Indonesia 

During the COVID-19 outbreak, healthcare services inevitably create more waste that may pose health risks. This has put further pressure on the capacity of the healthcare infrastructure to manage medical waste. 

WHO has been supporting the information system upgrade of medical waste management (known as “SIKELIM” – Sistem Informasi Kelola Limbah Medis), managed by MoH, since August 2021. The system accommodates data collection and analyses on the waste management process, such as waste segregation, storing, treatment and transportation, and disposal. The programme improvement also covers better data of puskesmas and hospitals (private and public), informs about COVID-19 waste generation, maps waste management capacity and resources. Environmental health officers can also utilise the system to identify the progress of national commitment in eliminating health devices containing mercury at health care facility level. More broadly, water sanitation and hygiene (WASH) questions are provided to assist environmental health officers in assessing the overall WASH conditions in their facilities. This tool is aligned with SDG 6 indicators on WASH in health care facilities.

Fig. 2. On 26 November 2021, participants from Sanitarian, PHO and DHO tested the SIKELIM application using their phone in Puskesmas Pagadungan, Pandeglang District, and gave feedback for improvement of the application. Photo Credit: Indah Deviyanti/WHO Indonesia

To develop the web-based application system, WHO has worked with PIAREA as the information and technology programmer. The Radiation Safety and Waste Management Subdit of the Directorate of Environmental Health and WHO environmental technical officers drafted and guided the development of tools, programme algorithms and system workflow through a series of virtual meetings (Fig. 2).

Fig.3. Directorate of Environmental Health facilitated regular technical meetings to discuss the programme design and tools for SIKELIM web-based application system. Photo Credit: Indah Deviyanti/WHO Indonesia

The MoH, WHO and IT programmer visited seven puskesmas and five hospitals in South Jakarta, Pandeglang and Bandung districts from 25^th to 30^th November 2021 (Picture 2). The visits to assess and monitor the existing resources in performing medical waste management and discussing the challenges in reporting medical waste. The Provincial Health Office (PHO), District Health Office (DHO) and sanitarian tested the mock-up application during the visits. Recommendations from the field were considered to improve the web application and waste management implementation, which includes interoperability between the hospital, puskesmas information system (SIRS – Sistem Informasi Rumah Sakit and SIMPUS – Sistem Informasi Puskesmas) and ASPAK (Aplikasi Sarana Prasarana dan Alat Kesehatan - Health facility and medical devices application system); strengthen the PHO’s roles to coordinate and assist the Puskesmas regarding joint MOU between puskesmas that are in the same region and waste treatment facility. 

Fig 4. MOH and WHO met Bandung District PHO and DHO on 26 November 2021 to discuss the challenges and opportunities to manage medical waste at the operational level. Photo Credit: Ryco/PIAREA

In 2022, MoH targeted 4,850 health care facilities to report COVID-19 waste and waste management status through SIKELIM. With WHO support, MOH will build capacity on medical waste and socialise SIKELIM in mid-2022. The medical waste information system is expected to assist the government in reviewing the implementation of the policy and regulations and as crucial information for targeted planning, budgeting, and design of waste and WASH program activities at the health facility levels.

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