World Humanitarian Day Spotlight: WFP Warehouses and Borno Interventions

By Emerald Awa- Agwu

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World Humanitarian Day is held on August 19 every year to draw attention to the millions of civilians whose lives have been disrupted by armed conflict and to recognize those who work to bring them aid and relief. According to statistics from the Office of the United Nations High Commissioner for Refugees (UNHCR), over 2 million people have been internally displaced by the insurgency in Northeast Nigeria. The insecurity in this region has increased the vulnerability  to diseases and hunger in many communities as they are unable to access food and health services. This World Humanitarian Day, we will be highlighting how eHealth Africa (eHA) programs support the humanitarian effort in Northeast Nigeria.

  Teams using geo-spatial data to plan immunization activities

Teams using geo-spatial data to plan immunization activities

In 2016, after almost two years without a reported case of wild poliovirus in Nigeria, four cases were isolated in Borno state. In response to this, eHA partnered with the Federal Government of Nigeria and other organizations including  the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), Bill and Melinda Gates Foundation (BMGF), U.S. Center for Disease Control (CDC) and Solina Health to extend the reach of polio immunization campaigns to hard-to-reach areas in Borno and Yobe states. Through the Reaching Every Settlement (RES) and  Reaching Inaccessible Children (RIC) projects, state immunization teams have reached 5,598 settlements in security challenged wards with the help of the geo-spatial data provided by eHA’s GIS & Data Analytics teams.

We also provide mobile based technology that enables relevant state governments’ teams  to track reached settlements by providing geo-evidence of visits by vaccination teams. Our teams continue to  gather geo spatial data on constantly changing landmarks and settlements, which helps the National Primary Healthcare Development Agency (NPHCDA)  plan both routine immunization and polio specific vaccination campaigns targeted at hard-to-reach communities. This equips the government with accurate, real-time coverage data which helps with planning and decision making.

  Food stored in eHA operated warehouse in Borno, Nigeria

Food stored in eHA operated warehouse in Borno, Nigeria

eHA also partners with the World Food Programme (WFP) and the Logistics Sector Nigeria to coordinate the storage and distribution of food aid to internally displaced people in the North East. In the first half of 2018, eHA has handled over 330,000 metric tons of food for about 1.2 million people affected by the conflict in the Northeast.

The Logistics Sector Nigeria offers warehousing to humanitarian organizations working in Northeast Nigeria in order to support their operations processes. eHA manages the Logistics Sector warehouse in Ngala, Borno State and has commenced the construction of an additional warehouse in Rann, Borno State.

To learn more about our humanitarian projects and our work in other parts of Nigeria and Africa, please read our 2017 Annual Impact Report

Meet the Team - Foday Sesay

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Meet Foday Sesay, the Lead Driver in our Sierra Leone office. He joined the eHealth Africa (eHA) team over 3 years ago as a driver and now manages our in country fleet team, managing both the team of 13 drivers and the entire fleet of vehicles. 
The fleet team is an integral part of our program operations, by providing ground transportation support to all of our programs and projects. They ensure that people and resources reach their destinations safely and on time. Foday is responsible for managing all the moving pieces to make sure all of this happens smoothly. He ensures that every vehicle is in working condition and that the drivers are well equipped with the right tools and training.

I started with eHA as a driver. Four months down the line, I was promoted to Lead Driver. I am proud about the fact that I help drivers adhere to organizational policies. Since I joined the eHA Fleet as a Lead Driver, fuel consumption has reduced.
— Foday Sesay

Foday has focused on processes and procedures to be more successful in his role as lead driver. He plans regular training sessions for the fleet team and this has led to better driving records; there have been no traffic offenses nor have there been any major accidents with eHA vehicles since 2017.  Also, under Foday's leadership, the fleet team has also become more efficient with resource management, the best example of this is continuous decrease of the the fuel consumption rate since 2016.

Foday has made measurable and visible impact since he joined the eHA team and we are happy to have Foday with us, he keeps us moving!

Click here to learn more about joining the eHA team.

 

Field Tracking System - transparency and efficiency redefined

Back in 2016, the Field Tracking System (FTS) was borne out of a need to provide a means for tracking vaccinators in Cameroon for the World Health Organization (WHO). The first system was developed as a collaborative effort between eHA and WHO to address the needs for polio vaccination tracking in Cameroon.
The question WHO Cameroon wanted to answer was "How do we know where the vaccinators have visited on a daily basis and how do we make adjustments to their plans while the are still in the field?"
The challenge was that vaccination teams were in extremely remote and unreachable villages for several days and they only had one chance to vaccinate children during campaigns. Any locations missed had to be addressed during the campaign.
The solution eHA and WHO Cameroon came up with was to use low-end smartphones to capture geo-coordinate information called "tracks" every 90 seconds to infer that locations where vaccinators stayed in for about 2 minutes, a vaccination occured. We deployed the offline system in Cameroon, powered by our robust database that contains attributes and constraints that could easily be modified and adjusted based on factors that affect where vaccinators have reached and the time spent there. Such factors include size of the house, village or community, security situation, road network, etc.
The output was an offline dashboard showing communities and households that were visited, partially visited, not visited, that the field teams used on a daily basis to assess their performance and readjust the next day’s plan during the campaign. This was great! And then users wanted more.

I am frankly delighted that we have introduced etracking. etracking has enabled us to know the serious and hardworking vaccinators and the unserious ones
— Head of Supervisors - Pagui, Cameroon January 2017

 

FTS is currently adopted in 3 African countries (Nigeria, Cameroon & Chad) for more generic tracking purposes of vaccinator and supervisory teams, sales teams, service administrators, data collectors. Some use cases worthy of note are:

 

  • User’s ability to define and modify campaigns by defining dates, with phones automatically sending tracks to a remote server and coverage automatically calculated. With the online and offline dashboard access, users can download reports and generate insights across multiple campaigns.
  • We work with our users to plan field activities on a daily basis based on predefined communities and attributes across static and dynamic administrative levels in any area.
  • Additionally, when our users need to collect sources of data while they are in the field, we can help them integrate the data with the FTS to provide more insights into the field work beyond coverage information. Case in point - WHO Cameroon & WHO Chad were able to corroborate coverage information from vaccinators with additional supervisory data that validated vaccination efforts by capturing actual number of children vaccinated using Open Data Kit (ODK) forms as an input. This means that coverage expectations of  "visited" was complemented by the actual number of children vaccinated captured by ODK forms. This then helped them to further to investigate anomalies.
With the FTS, now we are 100% certain that we have reached everywhere in the islands
— Sam Okiror (Head, Lake Chad Task Team), June 2018

 

We are now working with our users to build a generic tracking and monitoring system that can be triggered by other inputs besides  geo-coordinates. Consider a system that reports coverage based on predefined user criteria and triggered by user-defined events or change in status. Ultimately, FTS will receive input from various sources both offline and online. We are excited about the possibilities with FTS and building collaboratively with our users to meet their specific demands.

Come one, Come Tech Enthusiasts!

By Emmanuel Monehin

We, at eHealth Africa are passionate about growth and learning. Not only do we push ourselves to grow and learn, we actively share knowledge with partners and interested individuals with the aim of inspiring positive change.

Last weekend at our Kano campus, eHealth Africa in collaboration with EnovateLab hosted a tech meetup, an initiative aimed at encouraging the development of local tech champions and entrepreneurs, especially in the areas of health delivery, nutrition and food security systems and, social impact in Kano State, Nigeria.

Click through the slideshow to find out what happened at the meetup.

Aether and Gather - Open Source Release

By Dave Henry & Benedetta Ludovisi

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Today is a very special day for eHA and the Aether and Gather development teams. Today these two projects are finally being released as open source software!

Aether, the software development platform for data exchange, curation and publication, is available to anyone to be evaluated and used to jump-start the creation of data-driven ehealth solutions.

Gather, the Aether-based solution for large scale data collection is also available, providing an end-to-end pipeline for streaming Open Data Kit survey responses to the CKAN Open Data Portal and other applications.

Read more about the reasons we created these two projects in our interview with the Aether team, and get more information on the Aether and Gather microsites.

If you are eager to get your hands on the software, you can try it yourself by following the step-by-step Gather “getting started” guide.

We look forward to hearing your feedback on our forums, and to seeing the amazing things that you do!!

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MEDSINC Pilot Study Closeout meeting and Certificate Conferment Ceremony

eHealth Africa, THINKMD and Kano State Primary Health Care Management Board (KSPHCMB) collaborated to implement a digital platform called MEDSINC among Community Health Workers (CHWs) in 5 metropolitan Local Government Areas (LGAs). Covering 15 Health facilities, MEDSINC supports the management of illnesses under the Integrated Management of Childhood Illnesses (IMCI) and empowered CHWs with skills to carry out physician-like clinical assessments on sick children within 2 months – 5 yrs of age. The close out meeting which held July 19, 2018 was presided over by the Executive Secretary, KSPHCMB, Dr. Nasir Mahmoud and with the support of Juliet Odogwu, Megan McLaughlin and Dr. Aisha Giwa, he presented certificates of completion to the CHWs. The ceremony consolidated our collaborative efforts in empowering CHWs with training and on-the-job support to improve the quality of care provided at primary health care level in the state. 

 Participants with their certificate

Participants with their certificate

The pilot study was completed in 2 months and involved a 6-weeks implementation period (June 4 – July 13) and 3 stages of data collection – Pre, Mid and Post-Implementation IMCI observational data collection. Over the implementation period, CHWs used the platform to assess children in the health facilities. A total of 2,239 children were assessed using MEDSINC and a 57% increase in the number of IMCI observational data points collected at baseline (pre-implementation) was observed after mid-implementation data collection. This indicated an increase in the quality of assessments provided by the CHWs using MEDSINC. The feedback from the CHWs throughout the implementation period was positive and contributed to the ongoing improvements on the MEDSINC platform.

Spotlight - eHA Internships

An interview with on of our Laboratory Interns: Faiza Hamisu Aliyu

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Tell us a little about yourself
Faiza: My name is Faiza Hamisu Aliyu. My first degree is in Microbiology from Kano State Polytechnic. I also have a diploma in Laboratory Science from the same school. I am currently in my National Youth Service Corps service year and I intend to obtain a postgraduate degree in Epidemiology when I’m done.

How did you join the eHealth Africa team?
Faiza: I was posted to eHealth Africa for my service year in August 2017. I had always wanted to serve in an organization that would give me the experience I need to begin my career. When I was posted to eHA, I was quite nervous because I had no knowledge of the organization or the type of work they do.

Describe your experience on your first day- how did you feel? What was running through your mind?
Faiza: I was assigned to the Laboratory and Diagnostics department as an intern. The laboratory department had two ongoing studies at the time which were the Induced Sputum Study and the HemeChip Clinical trial.  I remember thinking that the laboratory had so much equipment that I was not conversant with and I was worried that I wouldn’t be able to master them. One of the first things that struck me about eHA was that they use technology for everything! There was so much to learn.

 You don’t sound worried anymore, in fact, you look very at ease with all the equipment now
Faiza: After a few days, I realized that there was no need to worry because my supervisor was very patient with me. He trained me for a very long time to use all the technologies in the lab. He always encouraged me to ask questions and to seek clarification whenever I was unsure of something. I learnt to use lab data software like RedCap, FreezerPro, and Odoo. I was also trained to receive, register and process various biological samples. I learned how to use the HemeChip device to determine genotypes from blood samples and how to collect and process sputum samples.

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What do you like best about eHA?
I love working at eHealth Africa. The staff are very welcoming and eager to help. No one treats me differently from any other staff even though I am an intern. I love the fact that eHealth Africa provides opportunities for everyone to learn and grow in their career and in any other areas of interest.
Apart from my lab work, I gained several useful skills in different fields. I worked with the Geographic Information Systems team to validate and clean data from the mapping of settlements in Borno state. I also worked with the Monitoring, Evaluation and Research (MER) department to enter data from over 500 respondents in a study to assess access to care by snakebite victims. One of my biggest takeaways from eHA is to deliver every task with utmost diligence.

Is there anything you want to say to the eHealth Africa team and to anyone looking to join?
My NYSC year will be over this month but the experiences and knowledge that I have gained will be mine for the rest of my life. I am very grateful to eHealth Africa and I encourage everyone who wants to grow and gain hands- on experience to join us.

To find internship spots and other ways that you can join the team at eHealth Africa, please visit our careers page or our website

Sustaining impact: Lessons from Kano Connect’s handover

By Fatima Adamu and Abdullahi Halilu Katuka

Kano Connect is a communication and information sharing platform developed by eHealth Africa, with funding from Bill and Melinda Gates Foundation in 2014. It features electronic management tools such as comprehensive directories of all the health facilities and health workers across all levels in Kano State. Using the platform, health workers can submit and review reports on routine immunization from their mobile phones or through a dashboard.  Health workers on the Kano Connect platform can access the contact details of any staff and communicate for free within a closed user group resulting in prompt and quality reporting, improved visibility and effective accountability.

Kano Connect ODK Form

In 2016, eHA officially handed over the Kano connect project to the Kano State Primary Health Care Management Board. However, we continue to provide support and guidance in line with our vision. Prior to the handover, reporting rates through the platform were at an average of 25%. After the handover, reporting rates increased to an average of 95%.
This demonstrates the importance of working hand in hand with the states which we work in to ensure  the sustainability of our projects and our impact.
In this blog post, we share 2 key lessons from eHA’s approach to building state ownership of the Kano Connect platform

Lesson 1: Build capacity
In the course of the Kano Connect project, eHA conducted a total of 21 trainings and workshops for over 1400 health workers across all administrative levels of the Kano state health system. The health workers worked on diverse thematic areas such as Maternal and Child Health, Nutrition, Pharmaceutical Services, Epidemiology and Disease Control and Routine Immunization.
They were trained on how to use an android phone, send Routine Immunization supportive supervision reports using the Open Data Kit (ODK) e-forms, how to use the dashboard for decision making, reporting through the LoMIS Stock applications, using the LoMIS Stock dashboard for decision making ensuring that all the stakeholders understood the platform.

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Lesson 2: Train your Replacement
eHealth Africa trained 5 health workers as the pioneer members of the Kano Connect Operations Unit to manage the day to day running of the Kano Connect project. The unit members were trained on the standard operating procedures of the eHA Kano Connect team and how to execute daily tasks including:  

  • Administrative management of the Kano Connect project
  • Capacity building of Kano Connect users, including onboarding of new users
  • Dashboard management (updating, adding, and deleting user information)
  • Collation of summary reports from dashboards
  • Information and data management through form hub
  • Conducting surveys (paper-based and electronic)
Presently, I’m a data management officer for Kano Connect. eHealth Africa trained me and other Kano Connect operation unit staff to manage Kano Connect dashboard issues like updating, adding, and deleting user information and exporting Information and data management through form hub to populate a report
— Shamsuddeen Muhammad, Kano Connect Data management officer

Presently, Kano Connect is piloting its e- learning mobile application and dashboard  in three local government areas: Fagge, Nassarawa and Gabasawa local government areas in Kano State. Kano Connect eLearning provides access to learning materials and resources that health workers can access on their mobile devices.

Once again, eHealth Africa is partnering with Kano State to ensure that that knowledge gaps are identified and that health workers can gain skills and knowledge for improved health delivery.

Aether - An interview with the team

eHealth Africa developers are active in a number of open source communities. Indeed, many of eHA’s solutions have incorporated open source software such as Open Data Kit (ODK), CKAN, OpenHIE, DHIS2, and Humanitarian OpenStreetMap (HOT).  We are just weeks away from giving back to the community in the form of two new projects - Aether and Gather. We’re excited to support others who are developing solutions for the global good.

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We interviewed the team behind eHA’s Aether to discuss the reasons why they created an open source development platform for data curation, exchange, and publication.

Aether is being developed by a multi-country team working in three different continents, so it was a challenge to sit down with them all in one place. Still, we talked with four people key to its development and asked them what exactly Aether is and why eHA decided to create it. Our conversation included the Director of eHA’s Global Health Informatics Dave Henry, Aether Product Manager Doug Moran, Systems Architect Shawn Sarwar, and Technical Team Lead Adam Butler.

Why is eHA developing Aether?

During our discussion, Shawn Sarwar explained that throughout eHA’s years of experience developing ehealth solutions we faced recurring challenges when scaling the impact of our products within the communities we serve.

Although eHA develops great tailored solutions for specific problems and customers, we were not always leveraging possible synergies between different projects. Shawn gave three reasons why solutions are typically been developed as stand alone projects:

  1. Customization can create maintenance challenges. When multiple customers use a particular solution, a certain level of customization is required. The various codebases can drift apart, making it difficult to apply bug and security fixes across all of them.
  2. There isn’t always a standard set of components across projects. One team may know one technical stack, while another could have a different preference. This leads to the siloing of potentially useful components according to people’s comfort and familiarity.
  3. Almost every project needs to integrate with one or more  external systems. Because of this requirement, teams normally plan to write their own integration to exchange data between different applications.                                                 

As a consequence, we became very good at creating variations of common solutions. But instead of reinventing the wheel each time, what if we could capitalize on a framework for the development of ehealth solutions? This, Dave Henry explained, is what drove eHA to develop Aether.

He explained that these challenges are not unique to eHA; they point to a broader issue that slows development and deployment of many healthcare systems. Information and Communication Technology (ICT) solutions for global public health use cases rely heavily on open source software, but while individual open source applications have been put to good use, the ability to integrate them into sophisticated solutions has been limited to countries with sufficient funding and visionary, determined leadership. Dave explained that even the most successful solutions leave behind a legacy of isolated data silos. Last September, eHA decided to wrangle these problems by setting twin goals:

  1. Simplify the integration of popular ehealth applications.
  2. Provide a consistent way for data to flow from these applications directly to where it needs to go.  

Today the Aether team is pleased to announce the results of this effort: the Aether platform and it’s first companion solution Gather.

What is Aether ?

Aether is a platform for data curation, exchange and publication.
— Dave Henry, Director of Global Health Informatics, eHealth Africa

More precisely, it is an integrated set of tools and services that allows developers to connect to data sources, interpret data structures, and map attributes into a normalized set of entities defined by a formal schema. Aether flows the resulting data in real-time to one or more downstream destinations. The publication process is open and modular – the destinations receive data based on the schema (a de facto contract) and are completely insulated from the source systems. Data can be delivered concurrently to multiple destinations.

In this way, Aether facilitates the flow of data between data-producing and data-consuming applications, enhances data security and privacy, and accelerates the transmission of data between organizations. Basically, Aether allows for faster and more accurate data-driven decision making that helps save lives.

Aether helps organizations exchange health data faster and easier, but most of all it improves the productivity of developers that create ehealth solutions. According to  Doug Moran, Aether is a product built by developers for developers to facilitate their work and free them to focus on the actual solution rather than infrastructure. Solutions become easier to deploy, maintain, and upgrade than traditional one-off projects built from scratch.  By building on a common foundation, the software development process becomes well defined, predictable, and repeatable.

Basically, Aether is a framework of best practices for ehealth systems design. The Aether developers have done much of the dirty grunt work so that the project teams can do the exciting and heroic stuff that solves real problems for real people.

And what about Gather ?

Dave also talked to us about Gather, the first solution and use case built on the Aether platform. Gather leverages Aether and 3rd-party open source software to collect and distribute data collected during large scale field surveys, receives survey data from forms submitted via Open Data Kit (ODK), and ingests it into an Aether pipeline for processing and distribution. The Gather solution includes the ability to flow data into ElasticSearch / Kibana as well as the CKAN Open Data Portal.  The Aether platform services are used to package and operate the ODK components, the Gather user interface, the Aether core modules and the Aether publishers.  Gather is just the first – but arguably the most universal – use case that eHA will address with Aether.

Technical Team Lead Adam Butler elaborated on the implementation of Gather across the countries where eHA’s operates. He explained that in Sierra Leone, the CHAMPS (Child Health and Mortality Prevention Surveillance) network uses Gather to collect data as part of an initiative to identify and prevent child death. In Nigeria, the GRID (Geospatial Reference Information Data) project uses Gather to collect spatial reference data and other points of interest such as health facilities, schools, markets, and post offices to create a geo-database that the government uses for data-driven decision making. In the Democratic Republic of the Congo, the DRC Microcensus project used Gather to conduct a microcensus in the region of Kinshasa and Bandundu in order to predict how many people live in each settlement and estimate the total population for DRC, information that is playing a vital role in the current Ebola outbreak.

What is eHA’s vision for Aether ?

According to the Aether team, eHealth Africa’s goal is to establish and support a vibrant global community around Aether and Aether-enabled solutions. Aether serves three distinct purposes:

  1. A platform for integrating, distributing, and operating sophisticated solutions for specific ehealth industry use cases.
  2. A facility for organizations that are taking their first steps into data governance and (internal) application interoperability.
  3. A controlled “on ramp” for organizations that engage in formal data sharing using international standards.

Aether will be launched as open source software this summer. Stay tuned for the release announcement!

Solutions based on Aether enable faster and more accurate data-driven decision making that helps save lives.

World Sickle Cell Day: 6 facts you need to Know

By Emerald Awa- Agwu

Over 300,000 children worldwide are born with the Sickle Cell Disease (SCD), a genetic abnormality of the red blood cells in which they take a crescent or “sickle”- shaped appearance. Over half of these children die before the age of five.

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With over 300,000 babies born with the sickle cell disease every year, Nigeria has the highest burden of Sickle cell disorders in the world. The 19th of June every year is set aside to commemorate the World Sickle Cell Day. This year, we explore 6 facts you need to know about Sickle Cell Disease.

  1. Although sickle cell can affect people all around the world, the risk is higher in Africans or people of African descent.
  2. Sickle Cell Disease is not contagious or infectious.
  3. People who have the sickle cell disease may develop various complications such as anaemia, stroke, tissue, organ and bone damage as well as pain due to the inability of the sickle-shaped red blood cells to carry oxygen normally and to cause blockage of blood vessels.
  4. People with the genotype AS, are carriers of the Sickle Cell Trait (SCT) but do not suffer any symptoms of Sickle Cell Disease. They can however pass it on to their children.
  5. There is no cure for SCD yet. Although, some success has been recorded with bone marrow transplants.
  6. A person with SCD can live a long and active life as long as they undergo regular check-ups with a doctor, take their medications regularly, prevent infections through hygienic practices such as handwashing and drink lots of water.
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Currently, eHealth Africa is partnering with the University of Nebraska Medical Center (UNMC) and the International Foundation Against Infectious diseases in Nigeria (IFAIN) to implement a clinical trial of the HemeChip, a device that can detect the sickle cell gene in babies as young as 6 weeks old using little to no electricity. The HemeChip is a component of SMART (Sickle and Malaria Accurate Remote Testing), a solution that recently won eHA and its partners, Case Western Reserve University, Hemex Health and the University of Nebraska Medical Center (UNMC), the Vodafone Wireless Initiative Project prize. SMART is designed to diagnose, track and monitor sickle cell disease and malaria in low resource settings.

This World Sickle Cell Day, eHealth Africa encourages everyone to get screened. Discovering one’s genotype is the first step in reducing the incidence of Sickle Cell Disease and preventing any more deaths and complications from occurring.

One Pint can save a Life

By Emerald Awa- Agwu

World Blood Donor Day is celebrated across the world every year on  June 14. The day is to celebrate and thank volunteers who donate their blood to help save lives. The day is also an opportunity to raise awareness of the importance of regular blood donations.  The provision of safe, readily available blood and blood products in sufficient quantities is a vital function of effective health systems.

Earlier this week, eHealth Africa partnered with the Kano state chapter of the International Red Cross in Nigeria to host a blood drive for its staff..

Do you want to know how it went? Click through the slideshow below to see first- time blood donation through the eyes of Olumide, a senior associate in our Geographic Information Systems (GIS) department.

 

The EOC Revolution

By Joshua Ozugbakun & Emerald Awa- Agwu

In line with eHealth Africa’s quest to add more value to the states that we live and work in, the Polio Emergency Operations Centres are being rebranded to provide much more than administrative and coordination functions to the states. 

‘’All the work that eHA does is not for ourselves but to make our partners’ work better’’
— Atef Fawaz, Deputy Director, Program Operations, Nigeria

The Emergency Operating Centres (EOCs) were created by eHealth Africa and other partners such as U.S. Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and Public Health England to serve as centers for the emergency management and response coordination of Polio and other infectious diseases in Nigeria. The EOCs are located in Abuja, Kano, Katsina, Sokoto, Kaduna, Borno, Bauchi, and Yobe states and during an outbreak, the EOCs serve as a central command and control facility responsible for carrying out the principles of emergency preparedness and emergency management.

After the establishment of the EOCs, eHealth Africa continues to support the center by ensuring that 24-hour electricity and internet access are available and that Technical/ Administrative Coordinators are on hand to ensure connectivity and the maintenance of the EOCs. However, this year, eHA decided that the Technical and Administrative Coordinators could be supporting the states in more ways. Here’s how:

 

Step 1: Capacity Building Workshop

eHealth Africa trained a total of 17 technical and admin coordinators from the 16th to 24th of April, 2018. This was the first step in the transition of eHA’s role in the EOCs from administrative to technical. The T/A Coordinators were trained on Geographical Information Systems (GIS), Analytics and Data Management.       

  Photo of Capacity Building Training

Photo of Capacity Building Training

Step 2: 60- day Transition Phase

Following the successful conclusion of the capacity building workshop, the EOC technical support team (formerly the T/A coordinators) are undergoing a transition window during which they are expected to utilise the skills they had gained in their day to day activities at the EOCs. Some of these skills include:

This phase is intended to assess the abilities of the EOC technical support teams will be to use these skills; as well as to identify and address areas of growth or gaps in knowledge.    

Eventually, the EOC technical support teams will be able to act as frontline representatives of eHealth Africa to the states and partners who utilize the EOCs where they are domiciled. They will be able to add more value to eHA as well by identifying more opportunities for business development.

 

  Behold the new faces of the EOCs!

Behold the new faces of the EOCs!

Good Data Saves Lives: The eHA Meetup in Berlin

By Jennifer Bencivenga and Emerald Awa- Agwu

Last Thursday, eHealth Africa’s Germany-based office opened its doors to host “Good Data Saves Lives.” The meetup was part of a series of events hosted at our space in Berlin designed to bring together communities and individuals interested in global health and technology. Attendees from across the public and private sectors, including academic, global health, technology and international development networks, gathered to discuss the strategic use of data to improve health outcomes.

Speakers and audience members discussed a wide variety of topics related to data and health, including transformations in the both the doctor and patient approach to healthcare, data security, and environment-specific impacts.

We’d like to extend a special thanks to the speakers and audience members whose participation and collaboration were essential for the success of the event. Click through the slideshow to see how the meetup went!

eHA talks Disease Surveillance with Public Health Students at Emory University

By Hawa Kombian

  Evelyn Castle (eHA), Adam Thompson (eHA), and Dr. Scott McNabb (Emory University) at the lectures.

Evelyn Castle (eHA), Adam Thompson (eHA), and Dr. Scott McNabb (Emory University) at the lectures.

“Growth and Learning” is a core value here at eHealth Africa (eHA), which is why our Co-founders/Executive Directors, Adam Thompson and Evelyn Castle, were at Emory University delivering a lecture to emerging public health students.

Given that Disease Surveillance Systems is an eHA focus area, Emory students enrolled in the “Transforming Public Health Surveillance” course participated in a discussion on “Real world challenges and opportunities for public health surveillance”

Evelyn and Adam delved into the past, present, and future of “Disease Surveillance and Informatics”, covering:

  • Traditional public health surveillance which served as a snapshot and analysis of past events.
  • Current public health surveillance tools and platforms, like eHA’s 117 Call Center, electronic integrated disease surveillance and response, and AVADAR. These methods are able to streamline the collection, centralization and analysis of real-time data for effective decision-making.
  • The next frontier for surveillance is grounded in mastering predictive modeling based off of data and knowledge from the past and real-time, modern-day technologies that can enable effective prevention measures.

Thanks to the students and staff at Emory University.

Improving Coverage Rates, One Track at a Time

By Emerald Awa- Agwu and Friday Daniel

The real story of Nigeria’s immunization coverage rates is told at the ward level. For over five years, eHealth Africa through the Vaccination Tracking System program has been supporting the increase in immunization and geographical coverage rates of 4017 wards across 19 states.

eHA, through the Vaccination Tracking System program (VTS), acts as the eyes of the immunization coordination teams at national, state and local government levels. They are able to gain a deeper understanding and insight into what exactly takes place at the wards, communities and settlements during the house to house immunization campaigns.

  Debriefing at a state- level review meeting in Sokoto State

Debriefing at a state- level review meeting in Sokoto State

The VTS program uses software- encoded phones that track, record and store the coordinates of their locations- and all the vaccinators have to do is take the phone with them on their vaccination exercises. eHA also deploys project field officers to each local government area, to handle any technical difficulties and to ensure that the data from the phones are uploaded to a dashboard.  At the review meetings that take place daily, eHA paints a picture of how much progress has been made- breaking it down to local government, ward and if necessary settlement levels.

Why is this Important?

Nigeria has always struggled to improve Routine Immunization (RI) coverage rates. The major challenge was the discrepancy between the high number of missed children discovered during monitoring visits and the high numbers of vaccinated children reported by field vaccination teams. Stories and reports of vaccinators pouring away vacci nesor refusing to visit settlements were common but holding them accountable was difficult.

In line with eHA’s virtuous cycle strategic model, the Vaccination Tracking System program arms the federal and state governments, ministries of health and partner organizations with reliable data and insight, that they can quickly use to make informed, evidence-based decisions. VTS  is a game changer because it helps the immunization coordination teams- World Health Organisation (WHO), United Nations International Children’s Emergency Fund (UNICEF), National Primary Healthcare Development Agency (NPHCDA), Nigeria’s Federal Ministry of Health and partner organizations- discover exactly what settlements the  vaccinators have visited or not; as well as what locations they had visited within each settlement. VTS also gives the relevant partners a visual representation of which wards or settlements were underserved thereby, enhancing the ability of the national and state RI task teams to target such communities.

VTS motivates the ward focal persons (WFP) and LGA teams and removes the risk of complacency especially in wards with high coverage rates. Results of each campaign day’s activities are delivered by proportion of settlement type covered and overall percentage coverage for each ward. In other words, WFPs are told the percentage coverage of their wards that have been covered and locations where they need to pay more attention to. This inspires them to work harder and more efficiently.

  VTS project coordinator, Friday Daniel at a ward- level review meeting in Sokoto state

VTS project coordinator, Friday Daniel at a ward- level review meeting in Sokoto state

VTS has improved the capacity of WFPs to investigate low coverage rates, get answers and where necessary, conduct trainings for the vaccinators. Through VTS, a WFP in Barawaga Ward of Bodinga LGA of Sokoto State discovered that his ward was recording low coverage rates, not because his vaccinators weren’t going to the communities but because they weren’t spending the required minimum time at each house. Empowered with this knowledge, he was able to train his vaccinators to observe best practices during the campaign. Where vaccinators consistently under- vaccinate, even after being trained, adequate actions can be taken.

The Vaccinator Tracking System is helping Nigeria, starting with the northern states to improve our coverage rates, one track at a time.

STRIVE supplement published in The Journal of Infectious Diseases

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In 2014, the U.S. Center for Disease Control and Prevention (CDC) and the Sierra Leone Ministry of Health and Sanitation (MOHS), partnered with several organizations including eHealth Africa (eHA) to enroll and vaccinate over 8,000 healthcare and front-line workers against the Ebola Virus disease via the Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE) program.

On May 18, 2018, The Journal of Infectious Diseases published a supplement on the STRIVE program. A few members of eHA staff (including Dayo Spencer-Walters, Deputy Director, Programs & Impact, Sierra Leone) co-authored two articles from the supplement to share their learnings from the programs. The two articles are:

eHA is proud to have been a part of the success of the STRIVE program. Click here to read all of the articles included in the supplement.

Increasing Sierra Leone's efficiency in disease detection with eIDSR

In a continued effort to increase the capacity of  Sierra Leone’s health systems, eHealth Africa (eHA) has partnered with the U.S. Centers for Disease Control and Prevention (CDC)  to support the government of Sierra Leone by increasing the early detection and reporting of government-identified priority diseases using the Electronic Integrated Disease Surveillance Response (eIDSR) framework.

eHA developed a mobile electronic Integrated Disease Surveillance and Response (eIDSR) application in response to requirements stipulated by the Sierra Leone Ministry of Health and Sanitation (MoHS).  This eIDSR app enables the MoHS Surveillance system to accurately record and share health facility-level information from the district to the national level. From health workers in hard-to-reach rural areas up to health officials in the major urban centers, eIDSR connects the health system to generate a clear and accurate picture of the health landscape.

In the first quarter of 2018, eHA introduced two new features to the eIDSR app; data approval and sms compression. These new features align with  Joint External Evaluation (JEE) as stipulated by the International Health Regulations (2005).) Since June 2007, countries—including Sierra Leone, have been making efforts to strengthen their core capacities.

Prior to  the introduction of the electronic data processing system, Sierra Leone’s Integrated Disease Surveillance and Response (IDSR) system relied on a paper based process  where the disease surveillance data summary was compiled in a spreadsheet and then mailed to appropriate authority every Monday. This manual system helped to monitor diseases in Sierra Leone. However the time constraints reduced efficiency. The paper-based method was also prone to human error, resulting in questionable credibility and completeness of information.

Before the introduction of eIDSR, most National health information from the Primary Health Care Unit were written hard copy. It took a lot of time for data staff to capture written hard copy data into the soft health management system. Data processing with the paper based system was time consuming and error prone. Transitioning to eIDSR would improve the quality and timeliness of health information.
— Dr. Tom Sesay, District Medical Officer (DMO), Port Loko - Northern Sierra Leone

One new feature  implemented in the eIDSR app is data approval. In the past, health care workers who were responsible for submitting necessary reports and data would enter the data  and there was no opportunity for superiors perform data quality assurance. This sometimes resulted in erroneous data being sent to the national level, reducing the quality of data used for disease surveillance in Sierra Leone.

The new data approval feature now prompts the district staff to review and validate all data received from the health facilities before it is seen by other users. eHA also provides daily monitoring of the approval process and quickly resolves any challenges that may arise.

With this new feature in place and the support provided,  the quality of data used for disease surveillance is improved significantly and human errors are minimized.

 Training health care workers on the new features in the eIDSR app in Freetown, Sierra Leone

Training health care workers on the new features in the eIDSR app in Freetown, Sierra Leone

One of the biggest challenges experienced during the roll out of eIDSR was internet connectivity. There are many  facilities that do not have internet access to upload their data on site. The initial solution to that challenge was to provide an alternative for the facilities to upload their data into the national server; that alternative was using Short Message Service (sms)  to submit their data.

In the first version of the eIDSR application, seven (7) SMSs were required to upload the eIDSR weekly reporting form by SMS. With this sms compression upgrade the number is now reduced to one.  The introduction of SMS compression has resulted in facility staff saving time needed to find locations in the community where they can have internet access or strong network connection for 7 SMS submissions. It also cuts down on costs as less SMSs are needed to complete the upload into the national server. Through the sms compression, health facility staff are not  likely to leave their facilities to upload their data. The few that might have to leave will not likely have to walk long distances to have their data uploaded.

eIDSR has built the capacities of our health workers most of whom had little experience in the use of smartphones. eIDSR has contributed to improving our interaction with our facility staff.
— Albert Kamara, District Surveillance Officer, Port Loko

eHA has now trained 142 health care workers at the Western Area Urban  District Health Management Team (DHMT) in Freetown, Sierra Leone. This training of trainers session was aimed at cascading the new upgrade to other health workers. These two new features in the eIDSR application are adding immediate value to Sierra Leone’s health systems, by simply automating work.These are best practices for future generations to uphold and retain.

Getting Vaccinations on Time

By Hawa Kombian

One of the primary challenges facing routine immunization (RI) in northern Nigeria is a poor vaccine supply chain system which causes consistently high stock out levels. High stock out levels occur when vaccines are not delivered on time and are exacerbated by limited cold chain equipment (CCE) to keep the vaccinations viable. High stock out levels cause low RI coverage because there are fewer vaccines available when needed.

eHealth Africa (eHA) was engaged as a third-party logistics (3PL) supplier to provide a solution for this problem and the Vaccine Direct Delivery (VDD) program was the clear answer to streamline vaccine and dry goods delivery supply chain to CCE equipped health facilities. VDD works by:

 One of the terrain challenges encountered by eHA's officers

One of the terrain challenges encountered by eHA's officers

  • Leveraging eHA’s geographic and information systems (GIS) capabilities to optimize delivery routes (including rugged terrain as pictured), reduce cost and maximize efficiency.
  • Collecting, analyzing and reporting data to provide custom delivery workflow support through a near real-time electronic data collection application - Logistics Management Information Systems (LoMIS) for stock level summaries via an integrated reporting dashboard.

VDD is a proven and effective model which enhances the efficiency and quality of Nigeria’s vaccine supply chain network. In collaboration with partners, VDD is implemented by eHA across some of Nigeria’s northern states specifically, Kano, Bauchi, and Sokoto. The program has had a proven and large-scale effect across northern Nigeria. The project has succeeded in improving both access and availability of healthcare for underserved populations, by enhancing the local vaccine supply chain network. It ensures that key and priority antigens are available, as evidenced by the low stock out rates, and are a major contributor to improved RI, especially for children's health. 

 

eHealth Africa helping #VaccinesWork with Vaccination Tracking Systems

As we mark World Immunization Week and African Vaccination Week, the eHealth Africa (eHA) team is very proud to be part of the global team working to end polio in Nigeria.

One of the interventions we participate in is the Immunization Plus Days (IPDs). We use geospatial technology and data to support the governments and our partners for immunization activities to contribute to the eradication polio in Nigeria with the vaccination tracking systems (VTS) technology and program.

VTS works by tracking geo-coordinates visited by vaccinators giving the oral polio vaccine during IPDs campaigns, to monitor their activities. These geo-coordinates are compared against already mapped settlements to ensure 100% coverage during immunization campaigns. Our team provides support by providing the application and technical support to local government area teams during these periodic IPDs campaigns. We are working to increase the number of children under 5, vaccinated against polio to interrupt the of transmission of Wild Polio Virus (WPV) in Nigeria.

Recently our teams participated in IPD campaigns in a number of states Nigeria, including Adamawa, Borno and Yobe states. Click through our slide show below as Abdul, one of our project field officers, shares his journey of the recently concluded IPDs campaign in Adamawa state.