[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100657778":3},{"organization":4,"outcomesModule":7,"designInfo":147,"detailedDescription":154,"studyPopulation":146,"armGroups":155,"interventions":166,"overallOfficials":173,"centralContacts":178,"locations":184,"responsibleParty":199,"collaborators":202,"id":205,"slug":206,"hasResults":207,"nctId":208,"briefTitle":209,"officialTitle":210,"acronym":211,"eligibilityCriteria":212,"healthyVolunteers":213,"sex":214,"minAge":146,"maxAge":146,"enrollmentInfo":215,"targetDuration":146,"studyType":218,"phases":219,"briefSummary":221,"conditions":222,"keywords":228,"overallStatus":233,"whyStopped":146,"lastUpdateSubmitDate":234,"lastUpdatePostDateStruct":235,"startDateStruct":238,"completionDateStruct":240,"leadSponsor":242,"locationsCount":243},{"fullName":5,"class":6},"Summit Institute for Development, Indonesia","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":13,"otherOutcomes":146},[9],{"measure":10,"description":11,"timeFrame":12},"Completeness of Antenatal Care (ANC) Services within the Gestational-Age Window","Completeness of ANC services within the gestational-age window, in accordance with the recommended schedule and standard:\n\nTrimester 1 (1 visit, 1 ultrasound, 1 physician examination); Trimester 2 (2 visits); Trimester 3 (3 visits, 1 ultrasound, 1 physician examination).\n\nBinary, individual-level: 1 = received all scheduled ANC contacts within the nationally recommended gestational-age windows; 0 = otherwise. Denominator = all eligible pregnant women registered at the cluster in that cluster-period. Analysed via generalised linear mixed model with a cluster random effect and categorical calendar period as a fixed effect (Hussey \\& Hughes, 2007). This is the study's single registered primary outcome; ANC \"12T\" completeness, PNC completeness, and PNC standard-assessment completeness are secondary outcomes.","From first ANC contact up to 40 weeks gestation, assessed up to 9 months",[14,18,22,25,29,32,35,38,42,46,49,53,56,60,63,66,69,72,75,79,83,87,91,95,98,101,104,107,110,113,117,121,125,128,131,135,138,142],{"measure":15,"description":16,"timeFrame":17},"Proportion of Participants with Timely ANC Contacts","Proportion of pregnant women for whom mandated ANC visits are documented within the correct gestational-age window (per trimester schedule) in routine facility records (KuApps and Legacy Apps). Coded 1 = Timely; 0 = Not timely","Assessed at each gestational-age window, up to 40 weeks gestation",{"measure":19,"description":20,"timeFrame":21},"Proportion of Participants with Complete Postnatal Care (PNC)","Proportion of postpartum women for whom all four scheduled PNC contacts are documented by a health worker in routine facility records (KuApps and Legacy Apps):\n\nPNC1 (6 hours-2 days), PNC2 (3-7 days), PNC3 (8-28 days), PNC4 (29-42 days). Coded 0 = Incomplete, 1 = Complete.","From delivery through 42 days postpartum",{"measure":23,"description":24,"timeFrame":21},"Proportion of Participants with a Complete Standard PNC Assessment","Proportion of postpartum women with all 14 mandated components of the Book of KIA standard PNC assessment, documented in routine facility records (KuApps and Legacy Apps). Components include breast examination (assessment of lactation\u002Fbreastfeeding), bleeding assessment, examination of the birth canal\u002Fperineum, Vitamin A administration, postpartum family planning, mental health screening, counselling, and case management. Documented in routine facility records (KuApps and Legacy Apps)",{"measure":26,"description":27,"timeFrame":28},"Proportion of Neonates with Complete Neonatal Visits","Proportion of neonates for whom all three neonatal visits (KN1, KN2, and KN3) fully documented in routine facility records (KuApps and Legacy Apps). Classified as incomplete if one or more visits are not documented.\n\nCoded 0 = Incomplete, 1 = Complete.","From birth through 28 days of age",{"measure":30,"description":31,"timeFrame":28},"Proportion of Neonates Receiving Complete Essential Neonatal Care","Proportion of neonates for whom all required essential neonatal care components are documented in routine facility records (KuApps and Legacy Apps). Assessing the completeness of all required essential neonatal care components documented, comprising eye antibiotic ointment, Vitamin K administration, umbilical cord care, early initiation of breastfeeding, and exclusive breastfeeding.\n\nCoded 0 = Incomplete, 1 = Complete.",{"measure":33,"description":34,"timeFrame":28},"Proportion of Neonates Receiving Complete Standard Neonatal Examination","Completeness of the standard neonatal examination, comprising: KN1: weight measurement, length measurement, head circumference measurement, breastfeeding assessment, umbilical cord care, Vitamin K1 administration\\*, eye ointment\u002Fdrops\\*, Hepatitis B immunisation, congenital hypothyroidism screening (after 24 hours), congenital heart disease screening, triple elimination screening. KN2: breastfeeding assessment, umbilical cord examination\u002Fcare, danger-sign assessment, jaundice identification, Hepatitis B immunisation\\*, congenital hypothyroidism screening (if not yet given), triple elimination screening. KN3: breastfeeding assessment, umbilical cord examination\u002Fcare, danger-sign assessment, jaundice identification, congenital hypothyroidism screening (if not yet given), triple elimination screening.\n\nCoded 0 = Incomplete, 1 = Complete.",{"measure":36,"description":37,"timeFrame":28},"Proportion of neonates with timely neonatal visits","Proportion of neonates for whom each neonatal visit is documented within the appropriate age window in routine facility records (KuApps and Legacy Apps): KN1 (6-48 hours), KN2 (3-7 days), KN3 (8-28 days). Coded 1 = Timely; 0 = Not timely.",{"measure":39,"description":40,"timeFrame":41},"Proportion of Pregnancy Outcomes","Proportion of recorded pregnancies resulting in a live birth and non-live birth (such as stillbirth or miscarriage\u002Fabortion), ascertained at delivery from routine facility records (KuApps and Legacy Apps). Coded 0 = Death\u002Fstillbirth, 1 = Miscarriage\u002Fabortion, 2 = Live birth","At delivery, (up to 9 months from Puskesmas enrolment)",{"measure":43,"description":44,"timeFrame":45},"Proportion of Neonates with Birth Weight ≥ 2,500 g","Proportion of live-born neonates with birth weight ≥ 2,500 g, measured in grams using a calibrated infant scale and recorded in routine facility records (KuApps and Legacy Apps). Coded 1 = ≥ 2,500 g; 0 = \\\u003C 2,500 g (low birth weight)","At delivery (up to 9 months from Puskesmas enrolment)",{"measure":47,"description":48,"timeFrame":45},"Proportion of Facility-Based Deliveries","Proportion of deliveries occurring at a health facility, ascertained from routine facility records (KuApps and Legacy Apps). Coded 1 = Facility-based delivery; 0 = Delivery outside a health facility",{"measure":50,"description":51,"timeFrame":52},"Proportion of Deliveries Attended by a Skilled Birth Attendant","Personnel who assisted the delivery process, ascertained from routine facility records Coded 0 = Non-health-worker, 1 = Health worker","During pregnancy (from the first ANC contact, up to 40 weeks gestation), at delivery, and up to 42 days postpartum",{"measure":54,"description":55,"timeFrame":52},"Proportion of Documented Complications with Documented Management","Proportion of participants with a documented obstetric complication for whom a documented set of clinical actions and care is recorded in routine facility records (KuApps and Legacy Apps). Coded 1 = Documented management; 0 = Not documented.",{"measure":57,"description":58,"timeFrame":59},"Mean Arterial Pressure (MAP)","A person's average blood pressure in the arteries during one complete cardiac cycle recorded as a continuous variable in mmHg. An additional ordinal variable derived from MAP, categorising the continuous value into clinical groups:\n\n0 = Normal (\\\u003C90 mmHg)\n\n1. = Elevated (≥90-\\\u003C92)\n2. = Stage 1 hypertension (≥92-\\\u003C96)\n3. = Stage 2 hypertension (≥96)","Assessed at each ANC contact, up to 40 weeks gestation",{"measure":61,"description":62,"timeFrame":59},"Blood Pressure (Systolic)","The pressure inside the artery when the heart contracts and pumps blood through the body. the \"top number\" of a blood pressure reading. Recorded as a continuous variable in mmHg in routine facility records (KuApps and LegacyApps). An additional ordinal variable derived from systolic blood pressure for systolic status:\n\n0 = Normal (\\\u003C130 mmHg)\n\n1. = Stage 1 hypertension (≥130-\\\u003C140 mmHg)\n2. = Stage 2 hypertension (≥140 mmHg)",{"measure":64,"description":65,"timeFrame":59},"Blood Pressure (Diastolic)","The pressure inside the artery when the heart is at rest. Recorded as a continuous variable in mmHg. the \"bottom number\" of a blood pressure reading, recorded in routine facility records (KuApps and Legacy Apps). Reported as a continuous variable. An additional ordinal variable derived from diastolic blood pressure for diastolic status:\n\n0 = Normal \\\u003C 80 mmHg\n\n1. = Stage 1 hypertension (80-89 mmHg)\n2. = Stage 2 hypertension (\\>90 mmHg)",{"measure":67,"description":68,"timeFrame":59},"Maternal Body Height","Vertical distance from the soles of the feet to the top of the head of a person standing upright",{"measure":70,"description":71,"timeFrame":59},"Maternal Body Weight","Maternal's total amount of fluid, fat, muscle, and bone mineral in the human body, as measured using a scale, expressed in kilograms (kg)",{"measure":73,"description":74,"timeFrame":59},"Body Mass Index (BMI)","Maternal BMI which considered as an index used to determine ideal body weight based on the ratio of weight to height. Reported as a continuous variable. Descriptive categorisation:\n\nunderweight \\\u003C18.5 normal 18,5-22,9 overweight 23-24.9 obesity type 1: 25-29.9 obesity type 2: \\>30",{"measure":76,"description":77,"timeFrame":78},"Maternal Mid-Upper Arm Circumference (MUAC)","Maternal upper arm circumference measured in centimetres using a standard non-elastic MUAC measuring tape at the first ANC contact, recorded in routine facility records (KuApps and Legacy Apps). Reported as a continuous variable.","At each ANC contact, up to 40 weeks gestation",{"measure":80,"description":81,"timeFrame":82},"Proportion of participants with Chronic Energy Deficiency (CED)","Proportion of pregnant women are classified as having Chronic Energy Deficiency (CED) if their Mid-Upper Arm Circumference (MUAC) is \\\u003C 23.5 cm, measured at the first Antenatal Care (ANC) visit","At each ANC contact, from first ANC contact up to 40 weeks gestation",{"measure":84,"description":85,"timeFrame":86},"Occurrence of Stock Out of Essential ANC Medications and Supplements per Month","Occurrence of at least one day of unavailability (recorded stock = 0) during the observation month for essential ANC medications and supplements, such as Iron-Folic Acid (IFA) tablets, calcium, and folic acid, ascertained from monthly Puskesmas pharmacy and logistics records. Coded 1 = At least one stock-out day during the month; 0 = No stock out","From study initiation through study completion, assessed up to 9 months",{"measure":88,"description":89,"timeFrame":90},"Puskesmas Performance Score (PKP)","Aggregate score of Puskesmas (Community Health Centre) service performance, ascertained from the Ministry of Health's Puskesmas Performance Assessment (Penilaian Kinerja Puskesmas, called PKP) monthly tabulations. Reported as a continuous score per Puskesmas per observation month","Every 3 months, from study initiation through study completion, assessed up to 9 months",{"measure":92,"description":93,"timeFrame":94},"Workload Distribution per Health Worker","Number of pregnant women served per health worker (midwife or cadre) per Puskesmas per observation month, computed from routine service records (KuApps and Legacy Apps) divided by the roster of active ANC providers per Puskesmas. Reported as a continuous count","from study initiation through study completion, assessed up to 9 months",{"measure":96,"description":97,"timeFrame":86},"Proportion of ANC contacts recorded by cadres (Task Shifting)","Proportion of documented ANC contacts recorded by cadres compared with the total number of ANC contacts documented during the period, ascertained from KuApps and Legacy Apps entry logs. Reported as a continuous proportion (0-100%).",{"measure":99,"description":100,"timeFrame":86},"Proportion of Health Workers Actively Using the KuApps per Observation Month","Proportion of registered health workers and cadres per Puskesmas who actively used the KuApps application at least once during the observation month, ascertained from KuApps user activity logs (log-in timestamps and data entry events). Reported as a continuous proportion (0-100%) per Puskesmas per month.",{"measure":102,"description":103,"timeFrame":86},"Availability of digital infrastructure","Availability of supporting devices and connectivity (computers\u002Ftablets, internet connection) at health facilities. This is ascertained by facility inventory checklist adapted from the Digital Readiness Assessment (DRA). Coded 1 = Fully available (device + connectivity); 0 = Not fully available",{"measure":105,"description":106,"timeFrame":86},"Electronic medical record integration","Connectivity status of the Puskesmas recording system with the national Electronic Medical Record system (SATUSEHAT), ascertained by facility inventory checklist and confirmed via SATUSEHAT integration logs. Coded 1 = Integrated; 0 = Not integrated",{"measure":108,"description":109,"timeFrame":86},"Proportion of routine reports submitted on time","Proportion of routine Puskesmas reports (monthly ANC, PNC, and neonatal reports) submitted by the established Dinas Kesehatan deadline during the observation month, ascertained from Dinas Kesehatan report intake logs. Reported as a continuous proportion (0-100%)",{"measure":111,"description":112,"timeFrame":86},"Training Costs","Total cost of training healthcare workers using the DED (trainer's fee, healthcare worker training time, materials, transportation), per Puskesmas. Reported in Indonesian Rupiah (IDR)",{"measure":114,"description":115,"timeFrame":116},"Infrastructure cost","Hardware and network costs (such as tablets\u002Fmobile phones, servers\u002Fcloud, internet) measured based on economic lifespan, attributable to the DED ecosystem, annualised over economic lifespan, ascertained from a prospective cost inventory. Reported in Indonesian Rupiah (IDR)","From procurement through study completion, assessed up to 9 months",{"measure":118,"description":119,"timeFrame":120},"Dashboard and Software Costs","Annualised development and licensing costs of the KuApps application and PWS dashboard attributable to the DED ecosystem, ascertained from a prospective cost inventory. Reported in Indonesian Rupiah (IDR)","From application deployment through study completion, assessed up to 9 months",{"measure":122,"description":123,"timeFrame":124},"Digital interoperability\u002Fintegration costs","Costs of RME and AI-OCR integration attributable to the DED ecosystem, ascertained from a prospective cost inventory. Reported in Indonesian Rupiah (IDR)","From integration initiation deployment through study completion, assessed up to 9 months",{"measure":126,"description":127,"timeFrame":86},"Technical support & maintenance costs","Ongoing operational costs of HealthComm, Tableau, PWS, and KuApps dashboard servers per period, ascertained from a prospective cost inventory. Reported in Indonesian Rupiah (IDR)",{"measure":129,"description":130,"timeFrame":86},"Healthcare service costs per unit","Cost of providing ANC, PNC, delivery, and referral services per service unit, ascertained from a prospective service costing exercise (facility-based micro-costing). Reported in Indonesian Rupiah (IDR) per service unit",{"measure":132,"description":133,"timeFrame":134},"Cost time horizon and period","The timeframe over which costs are calculated covering the identification of incurred costs and the duration (time horizon) of the study, as well as costs categorized by source and expenditure period. Reported as a structured cost inventory in Indonesian Rupiah (IDR), stratified by source and expenditure period","From initial expenditure through study completion, assessed up to 9 months",{"measure":136,"description":137,"timeFrame":86},"Number of additional services","Difference in the number of documented services and visits delivered between the intervention and control periods, ascertained from routine facility records (KuApps and Legacy Apps). Reported as a continuous count",{"measure":139,"description":140,"timeFrame":141},"Number of Participants completing the complete continuum of maternal care","Number of mothers documented as completing the full continuum: ANC (per standard), delivery, and PNC (all four contacts), ascertained from routine facility records (KuApps and Legacy Apps). Reported as a continuous count.","From ANC1 through 42 days postpartum",{"measure":143,"description":144,"timeFrame":145},"Incremental Cost per Disability-Adjusted Life Year (DALY) Averted","Incremental cost of the DED ecosystem per DALY averted, computed by linking observed improvements in maternal and neonatal care coverage to modelled reductions in mortality and morbidity risk using published transition-model parameters. Reported as IDR (Indonesian Rupiah) per DALY averted.","At trial end, through study completion (up to 9 months of rollout and follow-up)",null,{"allocation":148,"interventionModel":149,"interventionModelDescription":150,"primaryPurpose":151,"observationalModel":146,"timePerspective":146,"maskingInfo":152},"RANDOMIZED","SEQUENTIAL","The research adopts a stepped-wedge cluster-randomized design. Puskesmas are randomized sequentially to receive the intervention. Following a one-month baseline (retrospective data of Aug-Sept, taken in October), an additional set of 15 clusters begins the intervention at the start of each three-month step: step one covers randomisation and digital-readiness training for that wave, and the remainder of the step is given over to monitoring utilisation of the digital platform. Three successive steps of three months each follow this pattern until the full sample is covered, within a 9-month rollout-and-monitoring window.","HEALTH_SERVICES_RESEARCH",{"masking":153,"maskingDescription":146,"whoMasked":146},"NONE","DED 2.0 (Digitally Enabled Districts) is designed to examine whether integrated digital health tools can strengthen the performance of Primary Health Care (PHC) in Indonesia. The package targets several interconnected areas: (1) strengthening district-level human resources in core components of knowledge and skills for digitalisation; (2) establishing adaptable and modifiable digital infrastructure (e.g., data pipelines, dashboards, and KuApps) that local personnel can configure to their own needs; (3) building sustainable implementation capacity in both workforce skills and financing; and (4) enabling high-fidelity scale-up of digitalisation across Puskesmas, resulting in improvements in primary healthcare delivery.\n\nWhile local health information systems face fragmentation, with multiple disconnected applications causing duplicate data entry, inconsistent indicators, and delayed decision-making, DED 2.0 addresses these issues by building an integrated digital system that enables seamless data integration across services, real-time monitoring of population health, improved coordination among health workers, and stronger data-driven planning and decision-making. This is expected to enhance the completeness, timeliness, visibility, and use of routine health data, allowing earlier identification of service gaps and high-risk cases, strengthening care coordination and follow-up, increasing timely referrals, and improving monitoring of maternal and neonatal services.\n\nBeyond technology adoption, DED 2.0 places equal emphasis on strengthening human resources: training health workers to use the digital systems, building local technical capacity, fostering coaching and peer learning through selected health-worker \"Champions,\" and accelerating digital adoption across facilities through a tiered \"train the trainer\" model. DED is hypothesised to increase the completeness and timeliness of antenatal, postnatal, and neonatal services; improve facility-based delivery and skilled birth attendance; and ultimately contribute to improved maternal and neonatal outcomes.\n\nThe trial uses a cluster-randomised stepped-wedge design, with Puskesmas as the unit of intervention, in a single district, Garut Regency, West Java, Indonesia. A one-month baseline (retrospective data of Aug-Sept, taken in October) is followed by three sequential steps of three months each, at each of which a new sequence of 15 clusters (one-third of the 45 eligible PHCs) crosses over from control to intervention status. All 45 sites have received the intervention by the start of the third step, reaching full coverage in April 2027; outcome monitoring for the final wave continues through the end of that step in May 2027, a 9-month rollout-and-monitoring window in total. Each cluster undergoes an initial preparatory stage, a phased pre-intervention digital-readiness phase, followed by a data-driven action phase, sequencing digital readiness first to improve managerial and behavioural accuracy and consistency.\n\nDED is expected to serve as a replicable framework for district-level digital health transformation across Indonesia, generating practical evidence on implementing and sustaining digital health systems in primary health care and informing national scale-up strategies.",[156,162],{"label":157,"type":158,"description":159,"interventionNames":160},"DED Intervention Group (Ecosystem of DED)","EXPERIMENTAL","Prescription for Action (DED Model), a system-level intervention consisting of: KuApps, a digital health application (BidanKu, KaderKu) for frontline health workers, built on OpenSRP\u002FFHIR standards for SATUSEHAT integration; supports electronic patient registration, centralised ID management, and structured care-plan tracking. PWS Dashboard, central monitoring dashboard tracking primary healthcare services and operational data (staffing, drug procurement, vaccine logistics) across District (Dinas Kesehatan), PHC, and Village (Posyandu) levels. AI OCR, converts handwritten text from Maternal and Child Health (KIA) books into structured digital data for automated form-filling and reporting. Health communication: two-way maternal\u002Finfant\u002Fchild health communication via WhatsApp",[161],"Device: Digitally Enabled District (DED)",{"label":163,"type":164,"description":165,"interventionNames":146},"Control Group (non-DED)","NO_INTERVENTION","Legacy Apps: digital health application (SIGIZI, Electronic Medical Records, and ASIK) for frontline health workers. There will be no PWS Dashboard, AI OCR, and Health communication in the control group.",[167],{"type":168,"name":169,"description":150,"armGroupLabels":170,"otherNames":171},"DEVICE","Digitally Enabled District (DED)",[157],[172],"DED 2.0",[174],{"name":175,"affiliation":176,"role":177},"Yuni Dwi Setiyawati, B.Nutr, MHID, Dietitian","Summit Institute for Development","PRINCIPAL_INVESTIGATOR",[179],{"name":180,"role":181,"phone":182,"phoneExt":146,"email":183},"Yuni Dwi Setiyawati, B.Nutr, MHID, Dietitian, Master's degree","CONTACT","+6285337006810","yuni.setiyawati@sid-indonesia.org",[185],{"facility":176,"status":146,"city":186,"state":187,"zip":188,"country":189,"countryCode":190,"cosmosGeoPoint":191,"geoPoint":196,"contacts":197},"Mataram","West Nusa Tenggara","83238","Indonesia","ID",{"type":192,"coordinates":193},"Point",[194,195],116.11667,-8.58333,{"lat":195,"lon":194},[198],{"name":180,"role":181,"phone":182,"phoneExt":146,"email":183},{"type":177,"investigatorFullName":200,"investigatorTitle":201,"investigatorAffiliation":5,"oldNameTitle":146,"oldOrganization":146},"Yuni Dwi Setiyawati","B.Nutr, MHID, Dietitian",[203],{"name":204,"class":6},"Bill and Melinda Gates Foundation","100657778","the-effect-of-digitally-enabled-district-ded-20-ecosystem-on-the-completeness-and-timeliness-of-maternal-and-neonatal-services-in-primary-health-care-100657778",false,"NCT07842224","The Effect of Digitally Enabled District (DED 2.0) Ecosystem on the Completeness and Timeliness of Maternal and Neonatal Services in Primary Health Care","The Effect of Digitally Enabled District (DED 2.0) Ecosystem on the Completeness and Timeliness of Maternal and Neonatal Services in Primary Health Care: A Stepped-Wedge Cluster Randomised Trial in Garut Regency, Indonesia","DED","Inclusion Criteria (Pregnant Women):\n\n* Mothers residing within the catchment area of a participating Puskesmas in Garut Regency during their pregnancy\n* Pregnancy registered in the maternal health records of a participating Puskesmas within the study catchment area in Garut Regency\n* The pregnant woman provides informed consent to participate in the study.\n\nExclusion Criteria (Pregnant Women):\n\n\\- The participant relocates permanently outside the study area before the outcome-observation window begins.\n\nInclusion Criteria (Puskesmas Level):\n\n\\- Located in Garut Regency; at baseline, the DED ecosystem had not been integrated into daily service operations.\n\nExclusion Criteria (Puskesmas Level):\n\n* Puskesmas had fully implemented the DED ecosystem in daily practice before the study baseline period\n* Puskesmas lacks adequate routine service data for outcome measurement throughout the study period",true,"FEMALE",{"count":216,"type":217},10800,"ESTIMATED","INTERVENTIONAL",[220],"NA","DED 2.0 is a stepped-wedge cluster-randomized trial testing whether an integrated digital health ecosystem (KuApps, a service-monitoring dashboard, AI-assisted OCR for handwritten records, two-way WhatsApp-based health communication, and an automated worker-support tool) improves the completeness and timeliness of maternal and neonatal primary health care services, delivered through 45 Puskesmas in Garut Regency, West Java, Indonesia.",[223,224,225,226,227],"Digital Health","Maternal Health Services","Prenatal Care","Intensive Care, Neonatal","Postnatal Care",[229,223,230,231,232,189],"Randomised Controlled Trial","Maternal-Child Health Services","Telemedicine","Health information systems","NOT_YET_RECRUITING","2026-09-21",{"date":236,"type":237},"2026-09-25","ACTUAL",{"date":239,"type":217},"2026-10",{"date":241,"type":217},"2027-07",{"name":5,"class":6},1]