Introducing a Regulatory Sandbox Into the Indonesian Health System Using e-Malaria as a Use Case: Participatory Action Study.

BACKGROUND: Regulatory sandboxes offer an alternative solution to address regulatory challenges in adopting disruptive technologies. Although regulatory sandboxes have been widely implemented in the financial sector across more than 50 countries, their application to the health sector remains limited. OBJECTIVE: This study aims to explore stakeholders' perspectives on introducing a regulatory sandbox into the Indonesian health system using e-malaria as a use case. METHODS: Using a participatory action research approach, this study conducted qualitative research, including desk reviews, focus group discussions, and in-depth interviews with stakeholders. This study sought to understand stakeholders' concerns and interests regarding the regulatory sandbox and to collaboratively develop a regulatory sandbox model to support the malaria program. RESULTS: The study revealed that most stakeholders had limited awareness of the regulatory sandbox concept. Concerns have been raised regarding the time required to establish regulations, knowledge gaps among stakeholders, data protection issues, and limited digital infrastructure in malaria endemic areas. Existing regulations have been found to be inadequate to accommodate disruptive healthtech for malaria. Nevertheless, through a collaborative process, stakeholders successfully developed a regulatory sandbox model specifically for e-malaria, with the crucial support of the Ministry of Health. CONCLUSIONS: The regulatory sandbox holds the potential for adoption in the Indonesian health system to address the limited legal framework and to facilitate the rapid and safe adoption of disruptive healthtech in support of the malaria elimination program. Through stakeholder involvement, guidelines for implementing the regulatory sandbox were developed and innovators were successfully invited to participate in the first-ever trial of a health regulatory sandbox for e-malaria in Indonesia. Future studies should provide further insights into the challenges encountered during the e-malaria regulatory sandbox pilot study, offering a detailed account of the implementation process.

Health Belief Model of Persistent Dengue Transmission in Klaten, Indonesia.

Objectives: In this study, we aimed to assess health beliefs, barriers, and motivations of individuals that will be useful in formulating the appropriate social and behavior change communication (SBCC) campaigns regarding dengue vector control. Methods: We conducted this qualitative study among adult residents of Gergunung and Kajen villages in Klaten, Indonesia. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) using interview an interview guide. We had audio-recorded interviews transcribed and coded. The analysis focused on general perspectives and practices of behaviors in the attempt of vector control. Results: We recruited 188 participants from 2 villages for the study. Our study revealed knowledge deficits among the villagers. Barriers include incorrect perceptions on disease severity, perceived mosquito breeding places, improper practice on mosquito source reduction, and perceived toxicity of the insecticides. Households tend to weigh the benefits of performing vector control versus perceived benefits. Conclusions: By using the Health Belief Model, a future SBCC campaign should address changing beliefs that DHF is a serious disease, increasing knowledge about mos- quito source reduction and insecticide use, and promoting benefits of performing dengue vector control.