"Connecting the Dots - Geodata in Healthcare"- The eHA Meetup in Berlin

By Benedetta Ludovisi

Geographic data and accurate maps are essential for improving public health outcomes. Up-to-date information on where people live, the best way to reach them, and the location of nearby medical facilities is fundamental to enhancing healthcare systems. When settlements and points of interest are surveyed and mapped, frontline healthcare workers and medical supplies can reach even the most remote communities. The proliferation of geographic information systems (GIS) technology and spatially enabled data collection tools have helped governments and NGOs connect the dots in public health and improve effectiveness of health interventions.

 Connecting the dots - Geodata in Healthcare” audience ready for the Q&A  session

Connecting the dots - Geodata in Healthcare” audience ready for the Q&A  session

  Johanna Roegele, the Managing Director of eHA German office, welcomes attendees and introduces the speakers for the evening

Johanna Roegele, the Managing Director of eHA German office, welcomes attendees and introduces the speakers for the evening

In order to take a closer look at this topic, our Germany-based office partnered with Viderum to host "Connecting the dots - Geodata in Healthcare" on September 19 at the co.up coworking space in Berlin, the second in a series of technology and global health meetups in Germany.

Johanna Roegele (Managing Director, Germany Office, eHealth Africa) welcomed attendees and introduced eHA’s and Viderum's speakers for the evening. She also shared her vision for these meetups—a forum to share the work eHA does with Berlin’s tech and global health communities, and to create opportunities for innovative organizations to partner and learn from each other.

 Sebastian Moleski, Viderum's CEO, introduces their mission to the audience

Sebastian Moleski, Viderum's CEO, introduces their mission to the audience

The second speaker was Sebastian Moleski (CEO, Viderum) who introduced Viderum as an expert in Open Data working with high-profile partners in the field of data and health. He explained that their mission is to make the world's public data discoverable and accessible to everyone by providing data management solutions and tools that not only allow the strategic use of data, but also play a crucial role in analyzing, tracking and predicting public health trends.

Dave Henry, eHA’s Director of Global Health Informatics, gave a presentation on eHA's use of GIS technology for the VTS project, aimed at polio eradication, a disease for which immunization requires at least three vaccine doses within a child’s first year of life. GIS technology has enabled vaccination campaigns to locate, reach, and vaccinate children in hard-to-find settlements.

 Adam Butler, eHA Technical team lead in Berlin, gives a demonstration of eHA's data collection tool Gather

Adam Butler, eHA Technical team lead in Berlin, gives a demonstration of eHA's data collection tool Gather

After Dave’s overview of the effort to eradicate polio, its challenges, and the role of GIS technology in the initiative, Adam Butler (Technical Team Manager, Germany office, eHealth Africa) and Marko Bocevski (CTO, Viderum) got ready to demonstrate how geodata can be collected, shared and visualized using eHA’s and Viderum's tools.

Adam demonstrated eHA’s latest data collection tool Gather, built for secure, real-time, spatially-enabled data collection and map-plotting, to show how GPS-enabled devices can easily capture coordinates of health facilities, settlements, and roads.

 Marko Bocevski, Viderum's CTO, shows the functionalities of Viderum's visualization tool for CKAN

Marko Bocevski, Viderum's CTO, shows the functionalities of Viderum's visualization tool for CKAN

Following Adam’s demo, Marko demonstrated the technology Viderum developed to enable the visualization and analysis of collected data. The tool, which can be connected to Gather, facilitates data-driven decision making, project planning, and implementation.  

Following the demos, we had time to engage with the audience and answer few of their questions that animated discussions around topics related to data privacy and local community engagement.

We would like to extend a special thanks to the speakers and audience members whose participation and collaboration were essential for the success of the event.




International Translation Day Spotlight: AVADAR

By Adaeze Obiako

If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart.
— Nelson Mandela

This year, the United Nations is celebrating “International Translation Day” for the first time. The celebration is an opportunity to pay tribute to language professionals, whose work plays an important role in bringing nations together, facilitating dialogue, fostering understanding and cooperation, and contributing to the development and strengthening of world peace and security.

For eHealth Africa (eHA), translation has been instrumental to the success of several projects, particularly the Auto-Visual AFP Detection and Reporting (AVADAR) project.

When AVADAR commenced in 2016, we knew it was a worthwhile intervention towards the eradication of polio in Nigeria; however, we could not have anticipated just how much of a positive impact it would end up having on the Acute Flaccid Paralysis (AFP) surveillance system across Africa. Between 2016 and 2018, AVADAR grew from a small pilot in two states in Nigeria to a full-fledged project across 8 West and Central African nations. Several factors contributed to the success and scale of the project, one of which was the educational AFP video embedded in the AVADAR mobile app used to train community informants on proper detection (and subsequent reporting to health authorities) of AFP cases within their communities.

This is where language came in.

The project management team, made up of the World Health Organization (WHO), country Ministries of Health, the Bill and Melinda Gates Foundation, Novel-T, and eHA, knew early on that the key to ensuring accurate AFP detection and proper use of the AVADAR app for case reporting lay with developing a sense of connectedness and trust between all stakeholders (from project implementers to health workers to community informants) through the breakdown of language barriers.

Part of the pre-implementation phase in each country included research into what languages were spoken by indigenes using the AVADAR app and the AFP video, and the entire app was translated into each applicable language. Below is an example of the AFP video translated into Hausa, a local language commonly spoken in northern Nigeria, Niger, Chad, Cameroon and the Central African Republic.

In addition to the AFP video and app being translated into multiple languages, the training facilitators (who train informants on how to use the app) and field officers (who provide weekly phone troubleshooting support to informants) were all indigenes of the implementing regions and fluent in the local languages to ensure ease of communication and understanding for the AVADAR informants.

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As AVADAR continues operation across Africa, it is clear that we have the power of translation to thank for bridging the gap and allowing thousands of community members and health workers across different African nations to support the fight against polio. At this rate, it won't be too long before polio, like smallpox, is considered a public health issue of the "past".






Meet the Team - Adanna Alex

Meet Adanna Alex, Senior Coordinator with our Geographic Information Systems (GIS) team at our Kano Campus in Nigeria. She manages the Nigeria master geodatabase by ensuring that all updates and new data such as boundaries, settlement features, hamlets and other points of interest are integrated into the database and that all the microplan settlements in our database are validated.

This is very key for projects like the Vaccinator Tracking System, Polio Immunization Plus Days (IPD) tracking and the Geo-Referenced Infrastructure and Demographic Data for Development (GRID3) which rely heavily on geospatial data for their implementation.

Adanna has been with eHealth Africa for almost five years and has focused on building on her skills and knowledge everyday and helping to develop others. She trained the pilot team to manage the integration of Borno State data into the master geodatabase. In addition, she is currently responsible for supervising all interns with the GIS department.

Describing her work experience with eHA as fulfilling, Ada believes in doing every little task  diligently because it amounts to something big.

I joined eHA as a GIS analyst, editing and moving boundary points. Now, I manage the core geodatabase and support the VTS project by ensuring that the dashboard is up to date. I have grown over the years because eHealth Africa encourages personal development. In all this, I am most proud of my contribution to the eradication of the Poliovirus in Nigeria

Are you inspired by Adanna’s story? Click here to join our team!




eHealth Africa supports cholera Simulation as part of its Emergency Preparedness

By Umu McCarthy and Sahr Ngaujah

Sierra Leone is known for persistent heavy rains that sometimes lead to public health emergencies including the August 2017 mudslides and cholera outbreaks. As of June 2012, a total of 25,000 people were affected by cholera in Sierra Leone & Guinea, with 399 deaths in Sierra Leone. It was the country's largest outbreak of cholera since the disease was first reported in 1970 and the deadliest since the 1994–1995 cholera outbreak. This has been the largest outbreak in the West Africa region.

eHealth Africa (eHA) partnered with U.S. Centers for Disease Control (CDC), Sierra Leone’s Ministry of Health and Sanitation and the World Health Organization (WHO), in a Cholera Simulation Exercise conducted in the Kambia District, in Northern Sierra Leone. A total of 36 healthcare workers and Health Management Teams  across the country, represented their various Districts in the simulation exercise. The key objectives of the simulation exercise were to:

  • promote awareness of cholera to emergency response staff

  • assess the effectiveness of the surveillance, laboratory and logistics capabilities of the selected districts to respond during outbreaks

  • discuss the roles and responsibilities of Public Health National Emergency Operations Center (PHNEOC) personnel during a potential outbreak activation in accordance with the district and national plans

  • test existing communication and coordination structures  implementation of emergency preparedness and response operations

Usually during the rainy season there is an increase in the trend of diarrhea cases. This puts the country on red alert to heighten its surveillance and preparedness plans. This simulation exercise was a deliberate and proactive step to addressing cholera crisis, should they come up
— Alusine Kamara

Alusine Kamara, the Public Health Operations Coordinator at the Sierra Leone National Emergency Operations Center, was key facilitator of the simulation exercise alongside  Dr. Claudette Amuzu, National Professional Officer, Emergency Preparedness Response, WHO.

CDC is funding eHA’s Emergency Management and Preparedness Project in Sierra Leone. The goal of this project is to enhance the capacity of the Ministry of Health and Sanitation’s ability to prepare, prevent and adequately respond to current and future outbreak of diseases including Ebola Virus Disease.

eHA’s role is to build the capacity of Ministry of Health and Sanitation personnel on key emergency management concepts in line with the Global Health Security Agenda. Scenarios, plenary sessions and presentations were used to test participants’ knowledge on cholera response. After the exercise, participants now have knowledge on how to control the spread of cholera during an outbreak.

Emergency Operation is new to Sierra Leone’s Ministry of Health and Sanitation. Ebola crisis was our very first experience and we are still using the lessons learnt to inform future emergencies . The simulation exercise could not have come at a better time. Partners were able to identify relevant players at the District levels. This makes it easier for response teams during an emergency. If there is a cholera emergency now, I am better placed to mobilize both human and logistical resources to respond to it.
— Sahr Gbandeh, Emergency Operations Center Focal Person for Western Area Urban

The simulation exercise, if properly implemented, goes to also benefit thousands of Sierra Leoneans during an outbreak of cholera.






Celebrating the International Day of Charity

The UN International Day of Charity is celebrated every September 5, and this year is focused on the Sustainable Development Goals. While the projects that eHA implements provide data-driven approaches towards the goals of “Good Health & Well-Being” and “Zero Hunger”, we also recognize the central role of volunteering and philanthropy in creating global change.

This is a belief shared and supported by eHA and demonstrated by a team that frequently engages in various charitable outreach projects to support the communities that we live and work in.

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This year on the International Day of Charity, we would like to thank those who have contributed to our civic engagement and corporate social responsibility projects, including eHA staff and community members that participated in our donation drives. Your generous volunteering of time, as well as your donations of clothing and food items were vital to our charity projects at a retirement home in Freetown, Sierra Leone and a children’s home in Kano, Nigeria.

We also want to thank the almost 50 members of eHA staff, including our Executive Director Evelyn Castle, who participated in the blood drive organized at at our Kano campus on World Blood Donor day.

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At eHealth Africa, we are passionate about impacting lives and investing in the places that we call home. This International Day of Charity, we encourage everyone to do the same.

eHealth Africa supports training for Hepatitis B community-based Serosurvey

eHealth Africa (eHA) and Statistics Sierra Leone are implementing the Hep B Community-based Serosurvey project funded by U.S. Centers for Disease Prevention and Control (CDC). Technical leadership for the survey is being provided by CDC and Dr. Dennis Marke, Program Manager for the Government of Sierra Leone’s Child Health Program. The purpose of the survey is to

  • assess the impact of the current childhood Hepatitis B immunization program in Sierra Leone on the prevalence of chronic hepatitis B infections among children
  • evaluate the need for the Hepatitis B- birth dose in Sierra Leone by determining the burden of chronic hepatitis B virus among mother/child pairs.

In preparation for the survey eHA  supported the training of phlebotomists and surveyors for data and sample collection in the field.

  Practical session on processing and tracking of venous blood specimen

Practical session on processing and tracking of venous blood specimen

Strong human resource capacity is crucial to manage a household survey that consists of a detailed questionnaire and a rapid diagnostic test administered to the participant in their home. eHA and CDC trained a team of 50 people (13 surveyors, 13 team supervisors and 3 district coordinators and 20 phlebotomists) from Statistics Sierra Leone and the Ministry of Health and Sanitation. The training took place at Sierra Leone’s Public Health National  Emergency Operations Center (EOC) in Freetown, from 20th - 25th August 2018.

The 5-day training consisted of 3 full classroom days and a 2 days of field work. The following topics were covered:  

  • Overview and relevance of the Hepatitis B Serosurvey
  • Household identification procedure for enrollment
  • Counseling families about Hepatitis B results
  • Conducting Hepatitis B rapid diagnostic test
  • Processing and tracking of venous blood specimens
I have never worked in a survey field. However, this training did not only add to my knowledge about Hepatitis B, it also gave me the opportunity to go out in the field during the training and conduct a phlebotomy exercise on participants.
— Sahr Joseph, Phlebotomist


Key beneficiaries of the project are Sierra Leone’s Expanded Programme on Immunization (EPI), Sierra Leone’s Ministry of Health and Sanitation (MOHS), mothers and children in Sierra Leone and the wider public. Participants testified to the value of the training to facilitate learning valuable information needed for effectively administering the questionnaire and conducting rapid diagnostic tests in the field.

  Practical sessions with phlebotomists on the use of the mobile refrigerator to store blood samples

Practical sessions with phlebotomists on the use of the mobile refrigerator to store blood samples

The training was intense. However, I was able to master the purpose of the survey, became conversant with the questions and how to determine the eligibility of participants.
— Tamba Fatorma, Surveyor

eHA provided the phones and internet data for the survey and installed the open data kit (ODK) app (which is used for data collection in the field), the age= app for age calculation, and the  ODK dashboard. eHA’s provision of the android phones for the survey discourages potentials errors via paper-based methods by presenting an automated approach to health data collection. With ODK, data collection will be done easily and survey activities monitored in near real time.

 

Next Steps

The Western Area Urban, Bo and Bombali districts have been identified as target areas for the  survey. After this training, eHA, CDC, Statistics Sierra Leone and the MOHS (including those trained)  will Implement the serosurvey through June 2019, at 14, 200 households in the areas identified. The survey will include infants in the following age categories: 4–24 months; 5-9 year olds and their mothers to evaluate the risk of mother to child transmission (MTCT) of Hepatitis B. Evidence from the survey will be presented to the Sierra Leonean government to inform decision makers on whether to introduce administration of the Hepatitis B vaccine at birth.

Preventing childhood diseases through Vaccine Direct Delivery

By Adamu Lawan

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The Challenge
In Northern Nigeria, vaccines are often unavailable at health facilities due to irregular deliveries. There are no systems in place to track inventory and movement of commodities between facilities and state cold stores. This has led to substantial stock outs of vaccines at last- mile health facilities and consequently, the inability of children under the age of one to access routine immunization services.

eHealth Africa’s solution
In 2013, eHealth Africa developed a logistics platform, LoMIS, to transport vaccines and dry goods from the state cold store to health facilities at the ward level that are equipped with cold chain storage facilities. The project was launched in Kano in 2014 and in Bauchi and Sokoto in 2015.
Following its success in the pilot LGAs of Bauchi State this year, the implementation of Vaccine Direct Delivery was scaled up to include an additional 148 health facilities in the northern clusters of Bauchi State.

The Impact

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FIND Visits Kano State

During the month of August, eHealth Systems Africa in collaboration with THINKMD, FIND and Kano State Primary Health Care Management Board (KSPHCMB) implemented the second phase of the pilot study of the eHealth platform MEDSINC. In the first phase of the pilot, Community Health Workers (CHWs) in 15 health facilities across Kano state had been trained to use the platform and carry out physician like clinical assessments on ill children between the age of 2 months and 5 years of age. At the completion of their training the CHWs received a training certificate during a conferment ceremony. Taking from the success of the first phase, a new version of MEDSINC was developed and combined with malaria rapid diagnostic tests to guide CHWs through clinical assessment, malaria diagnosis and management. This phase of the pilot was implemented in 5 health facilities across five metropolitan Local Government Areas.

Last week, FIND representative, Dr. Karell Pellé, visited eHealth Systems Africa and met with the Executive Secretary of Kano State Primary Health Care Management Board (KSPHCMB), Dr. Nasir Mahmoud, to discuss ongoing plans for scaling up the use of mHealth tools to improve clinical diagnosis of childhood illnesses. She also visited some of the pilot health facilities in Kano State to interact with the CHWs and observe first-hand how quality of care and health delivery had been improved in those facilities.

Meet the Team - Friday Daniel

Friday Daniel

Friday Daniel is Project Field Operations Coordinator in our Nigeria office.  He joined eHealth Africa over four years ago as a Field Officer on the Vaccinator Tracking System (VTS) project. He helped to improve vaccination coverage as well as to reach frequently missed settlements in states with high risk of Polio and low immunization coverage rates.  VTS provides immunization coordination teams at national, state and local government levels with a deeper understanding and insight into what exactly takes place at the wards, communities and settlements during the house to house immunization campaigns.
Less than a year after he joined eHA, he became a field operations coordinator and worked across five projects including Auto-Visual AFP Detection and Reporting (AVADAR), Lake Chad Mapping, Field Tracking System and the Polio Vaccination Monitoring and Accountability System. One of his greatest achievements is his pivotal role in identifying unknown settlements under the Vaccinator Tracking System project. He researched and introduced an existing tool to the Field Operations Team which helped to increase the tracking coverage from 68% to 89%.

Friday works closely with partners and stakeholders to ensure that project objectives are met and that governments are provided with useful data that can aid decision- making and planning in line with eHA’s strategy. He also manages and supervises the activities of the field operations personnel to ensure that project activities are implemented efficiently.

I have gained so many new skills since joining eHealth Africa. I love working at eHA because it gives me the opportunity to solve problems and try new things. Being able to pilot several projects to completion and see able to its impact in the communities of operation, is an awesome experience!
— Friday Daniel

Would you like to be a part of our team? Click here to find out more

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 41% 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.