World Immunization Week: VaxTrac - helping health workers provide vaccines in Sierra Leone

By Musa Bernard Komeh and Uche Ajene

Through routine immunization programs, health workers bring life-saving vaccines to people around the world. At eHealth Africa, we work  with our partners to increase vaccination rates in the countries we work in. In Sierra Leone, one of the ways we do this is via VaxTrac.

VaxTrac at work in the Macauley Street Government Hospital, Freetown

VaxTrac, is a clinic-based vaccination registry system which health workers can use in the field to enroll children and track their immunization records. It eliminates the need for paper-based cohort books, tally sheets, and monthly reporting forms and improves health workers accuracy and efficiency.

With the introduction of VaxTrac technology into the routine immunizations activity of  Sierra Leone’s Western Area Urban, significant contribution has been made with a view to improving on quality, timely, and useful  immunization data. eHA VaxTrac currently covers 50 health facilities including the biggest and only children’s referral hospital in Sierra Leone.

One of the key features of  VaxTrac is that health workers can easily access information on defaulters which can be used for defaulter tracing activity during their outreach programs within  the communities they serve. Priority areas within the Western Urban Area have been identified which will further strengthen processes and contribute to the success of the project. This was based on lessons learned and data collected from 2016-2017.

eHA further commits to:

• Working closely with the District Health Management Team of Western Area Urban to ensure regular and more structured outreach programs that will target defaulters

• Sharing of facility performance to in-charges so they know where improvement should be made to achieve higher coverage

• Training of more health workers on the use of VaxTrac

• Modifying of the VaxTrac software to increase user friendliness and usefulness.

“In 2017, a total of  39,101 children were registered on VaxTrac. We have plans for more efficient and impactful work in 2018.”

— Musa Bernard Komeh, Project Supervisor, VaxTrac

At eHA, we know #VaccinesWork and we look forward to successful outcomes with increased immunization coverage and a reduction in defaulter numbers.

eHealth Africa helping #VaccinesWork with Vaccination Tracking Systems

By Uche Ajene and Abdul Yakubu

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.

Setting out

Final check in before leaving eHA Kano campus

Arrival in Mubi!

eHA team with our partners from the World Health Organization (WHO), Adamawa State and LGA health workers.

Everything we need

Offloading the equipment we need for the next few days

Powered Up

These power charging stations are essential to our success. We ensure that each vaccinator has a fully charged device every day to capture all the data from the field.

Briefing session

Frequent meetings with our partners to agree on daily plans, set goals and work out any issues that may arise

Analysis

We have one on one meetings with out state partners. Here I meet with the state technical facilitator to discuss the coverage percentage of the day and plan for the next dau

Heading back

After another successful IPD campaign, we’re now ready to head to Yola then back to Kano.

Post-Ebola Liberia: eHealth Africa strengthens laboratories in readiness for future infectious disease outbreak

Prior to the Ebola Virus Disease (EVD) outbreak in 2014, the Liberia public health laboratory system had weak capacity to detect, report and respond to public health emergencies. In order to fulfill our mission to build stronger health systems, eHealth Africa (eHA) supported Liberia’s laboratory system from 2014 - 2018. eHA’s lab support program has improved effectiveness of the laboratory system by providing human capacity support for four years, as well as improved electronic submission of lab reports by providing internet connectivity at priority labs (ELWA, Redemption, LIBR & Bong) since 2014.

Test samples in an eHA supported priority lab in Liberia

The Bong lab is situated at the Phebe Hospital Compound, Bong County. In October 2014, it was one of the regional laboratories selected by Liberia’s Ministry of Health (MOH), the United States Navy (US Navy) and other partners for testing suspected Ebola samples as part of the fight against the 2014 West Africa EVD outbreak. The Bong lab and other identified priority labs faced a few similar capacity challenges, including the lack of skilled staff, lack of adequate equipment and poor internet connectivity. eHA provided lab support by developing technology for capturing of lab data, provided internet connectivity to enable the labs submit the data electronically and also provided human capacity support, including recruitment and training of lab desk officers.

Roberto Koimenee is one of the four lab desk officers that eHA worked with via the laboratory support program. He is deployed at Bong Lab to enter Ebola virus disease (EVD) data and report daily samples test results to the Liberia’s Ministry of Health and eHealth Africa.

From Roberto
‘’I got involved with eHealth Africa-Liberia through an application and CV submission during the Ebola outbreak in September, 2014 in Liberia. I was called by eHA for an interview which was followed by training as a Lab Desk Officer. I was assigned to Bong EVD Lab. I was motivated to work in the lab because I wanted to help in the fight against Ebola in Liberia. Since eHealth is a technology driven company, with my knowledge in data management, I decided to help in this fight against Ebola by entering data from samples tested and submit report for decision making at the National level.

I have more than eight years of experience as an Administrative staff and four years of experience as a data officer at eHealth Africa-Liberia, where I have won some performance awards. I love managing database and solving data issues. I am a person who thrives to work out things when it’s difficult to do and work independently to solve complicated problems”, he explains.  

I participated in a three-day training conducted by eHA and this training impacted my life and work by increasing my knowledge in the following topics: Sample handling storage, and processing; Confidentiality/Document control, Data entry and analysis. Today, I know how to control and secure patient information and report accurate and reliable results to requisite and identified individuals responsible to receive said information or results.

The part of the training I like the most was the off-line tracker although it has not been fully utilized by Bong Lab. The off-line tracker is so unique in that it tracks all data or information in all the four (4) regional labs in the country (Liberia). Each lab can see and access information including reports/results of specimen tested. This system can be used without internet. However, that training especially the off-line tracker needs to be fully utilized for the safety, reliable and secure of lab information/data.

Although I worked with other institutions before eHealth Africa came to Liberia, but life was not too good for me and my family. My salary was too small to cover all my expenses including undertaking house construction project. But after I was employed by eHA, my salary was encouraging that enable me and my family to live better life.’’

Roberto’s wife, Christiana Hne Koimenee, believes her husband made a good decision working for eHA in the fight against Ebola in Liberia, even though she expressed fear over her husband doing one of the riskiest jobs, and comes to the conclusion it was worth it.

“‘’It was sad and worrisome for individuals like my husband to be at the frontline to test Ebola specimen. But it was also historical for him and those who stood firm to help in the process of fighting Ebola in Liberia.”
”

— Christiana Hne Koimenee

Roberto Koimenee and family

Did You Know?

Our GIS & Data Analytics team has mapped over 20,000 points of interest across 19 districts within the Lake Chad region (in Chad, Cameroun and Niger)?

This GIS data is crucial in ensuring that polio vaccination campaigns reach the total populations of at-risk individuals. In the past, vaccination campaigns relied on old maps and data, which left thousands of people unaccounted for, and left them out of the campaign plans. However with more robust maps like these,  planning and executing vaccination campaigns has become easier. Now teams can identify missed settlements, map accurate routes for vaccine and other vital health commodities delivery.

Our executive Director, Evelyn Castle, spoke recently at the Global Digital Health Network forum, sharing how using mapping data can help us end infectious disease outbreaks, and shared how eHealth Africa has used GIS mapping to fight polio and ebola. Click here to watch her presentation.

To learn more about our GIS & Data Analytics services, please click here

Spotlight: eHA Internships

By Olufunke Femi-Ojo

I am Olufunke Femi-Ojo, a graduate of Public Health from Babcock University Ilishan-Remo, Ogun State. I have a passion for studying human diseases and conducting clinical studies on how to improve the health of the public by collection and interpretation of public health information, data analysis, studying trends and making forecasts. In the near future, I intend to get a masters degree in Public Health with a focus on Biostatistics and Epidemiology as I would like to to work within the public health field, perhaps with a hospital, government agency or an international health organization. My passion for public health, led to my search for an organization suitable for jump starting my career. Then I found eHealth Africa.

I joined eHealth Africa (eHA) in September 2017 as an Intern with the Monitoring Evaluation & Research (MER) Department. The MER Department is responsible for assisting in monitoring and evaluation of eHA’s programmatic and project areas. Currently, the department assists with the development of outcome and output indicators in alignment with project’s outcomes. In addition, the MER department is responsible for monitoring and analyzing data that comes in from some of the projects, to ensure that activities and interventions done are contributing to the overall outcome and objective of the project. The department also provides support in generating and developing reports that are shared with stakeholders and donors.

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Walking into the building I was a bundle of nerves with a blend of emotions: scared, anxious and also so expectant. Scared because I wasn't sure of what lay ahead of me, I thought I might have to struggle to fit in, anxious and expectant of the things I would learn and could add to the organization.

It did not take long for all my fears and anxiety to be laid to rest. The environment and people are not just welcoming but they are supportive in every way. eHA has a relaxed environment and just by sitting and observing I have learned the importance of teamwork as here there are different departments with varied roles but they all have to come together for a common good.

At eHA, I have gained a better understanding of my skill set and where my career may take me. Being a part of MER department has broadened my knowledge and expertise as I have learned to work with the programs department to collate and analyze data which are then used as internal quality assurance mechanism for project delivery. This is especially useful to me as I have acquired deep rooted knowledge about the methods and techniques of data collection and analysis which has taken me a step up my career ladder.

“... this hands-on approach is definitely priceless.
”

— Olufunke Femi-Ojo

Most of these experiences are knowledge I had gained in classroom but this hands-on approach is definitely priceless. It has served as a beneficial ending to my formal education. I have thoroughly enjoyed my internship thus far as the experience has been insightful and I now have very valuable experience under my belt.

We are hiring, come join us! We have several open position for interns in our offices. If you’d like to apply, or join the eHA team in any other capacity, head over to our Careers page to learn more about us.

Meet the Team - Mariam Diop

Mariam joined the eHealth Africa team over 2 years as a project manager in our Sierra Leone office. She managed the 117 Call Center project during the Ebola Virus disease (EVD) epidemic. After the EVD epidemic, she was instrumental in transitioning the call center to a sustainable public health mechanism for Sierra Leone. She has worked closely with partners involved in strategic emergency response and surveillance initiatives at national and district level in ensuring the 117 hotline system was a successful tool that aided their decision making processes.

Working with the U.S. Centers for Disease Control and Prevention and a team of data managers, she helped develop a comprehensive data warehouse of all EVD related data. The Sierra Leone Ebola Database (SLED) will help support Sierra Leonean researchers on the effects and trends of Ebola epidemic in Sierra Leone and how lessons learned can help prevent and inform another outbreak.

Mariam embodies the values of eHA, her work as a project manager has made a transformational difference for health care in Sierra Leone. She acts as a planner, troubleshooter, risk manager, mentor and support for her team, and has grown professionally while working  with us at eHealth Africa. We are happy to have Mariam on board the eHealth Africa team.

“I dare to say I have become a well rounded public health professional with the growth and experience gained from my position as a Project Manager with eHA.
”

— Mariam Diop

Are you interested in joining our team? Click here to find out more

Lessons Learned from Implementing A Multi-Country Project - Part II

By Olajumoke Arinola & Nwanyibuife Obiako

In Part II of the lessons learned series, the AVADAR project team share additional lessons from project expansion in 2017. For the first three lessons mentioned, please refer to Part I.

Cross-country projects come with unique challenges, however, with proper planning, monitoring, and consideration of all project aspects, success is attainable. While there are many success ingredients for multi-country projects, high-quality planning, early consultation with local experts, community inclusion, and consideration of local socio-political contexts are most vital.

Below are three additional lessons learned from implementing the AVADAR project:

Integrate Project Processes within Applicable Local Context

Hiring local facilitators to support kick-off training for community informants was cost-effective and efficient, with the AVADAR project benefitting from their wealth of experience. Our training facilitators were locally recruited in every country the project was expanded to; this directly improved the engagement rates, understanding, and comfort level of participants in each location. For each country, the coordination team had to adapt to country-specific health administrative structures to customize the mobile application and also understand roles and responsibilities of key healthcare personnel on the project.

Acquire Business Management Knowledge per Country

When coordinating implementation of multi-country projects, adequate knowledge, and awareness of country-specific regulations and policies that may impact project implementation are critical to success. Knowledge of import/export policies for equipment procurement, local labor laws, and management of business relationships (internally and externally) should be researched and factored into the overall project process and strategy. One vital lesson we have learned as a team is the need to understand country-specific policies and regulations around the procurement of equipment, timely shipping and clearing of goods, staff recruitment, and local currency fund transfers.

Risk Management

Research on country-specific laws and current affairs, as well as consulting with local indigenes help to anticipate challenges and risks likely to occur that can negatively impact the project success. The political atmosphere, climate change, and high insecurity locations within a country (e.g. areas with frequent insurgent attacks) need to be closely monitored and project plans adjusted accordingly. Our team leverages on local hires and authorities, our security team, and project partners in-country to remain up-to-date on relevant activities that have an effect on project plans and ensure the safety of all field teams.

Implementing AVADAR has been a remarkable personal and professional growth experience for the team. As we look forward to the continuation and further expansion of the project into priority districts in 2018, we continue to draw from our experiences to improve the quality of our services. eHA is leveraging on lessons learned from projects like AVADAR to execute other multi-country efforts that support our mission to strengthen health systems through data-driven solutions and improve the quality of healthcare provided in underserved communities. Learn more about our programmatic expertise and scope of projects from eHA’s 2016 Impact Report!

Lessons Learned from Implementing A Multi-Country Project - Part I

By Olajumoke Arinola & Nwanyibuife Obiako

Managing a multi-country project requires substantial time, strategic planning, and team effort. The very nature and scope of multi-national projects already pose a challenge, especially when the implementing organization does not have a previously established presence in the implementing countries.

eHA's Technical Officer with community informants in N'Guigmi, Niger using the AVADAR mobile application to send in their weekly AFP case report.

One must consider several factors including staff recruitment, efficient management of multicultural teams, managing changes in project requirements, mitigating risks, ensuring adherence to best practices, and knowledge acquisition of country-specific regulations & policies. These factors inform the strategies employed in executing the project.

Under the disease surveillance program, eHealth Africa (eHA) collaborated with the Bill and Melinda Gates Foundation (BMGF), the World Health Organization (WHO), and Novel-T to implement the Auto-Visual AFP Detection and Reporting (AVADAR) surveillance project. AVADAR is a multi-country project which aims to increase the sensitivity and quality of Acute Flaccid Paralysis (AFP) detection and reporting. The project combines the use of an SMS-based mobile technology for real-time reporting with a community participatory surveillance approach. Building on the pilot’s success in Nigeria in 2016, the project was expanded within a period of seven months to six additional countries (Chad, Sierra Leone, Liberia, Cameroon, Niger and Democratic Republic of Congo) in 2017.

eHA has country offices in only two of the six countries (Sierra Leone and Liberia). Over 150 team members were required to support kickoff and field activities in about 30 districts across countries where expansion was planned. Below are lessons learned from the AVADAR implementation that will be helpful for health-related project managers as well as those working across other sectors and industries in multiple project environments:

Standardize Communications

Every project needs a communication plan and strategy. Standardizing internal and external communication channels helps avoid confusion and unify processes across all countries. Confusion easily arises when team members have overlapping responsibilities, multiple reporting lines or when information is not adequately documented.

Multi-country projects usually involve multi-cultural teams separated by distance.The AVADAR team conducts routine remote meetings for cross-country team members to provide project updates, discuss challenges, and collectively develop resolution strategies. Mentoring sessions for country teams are also held on best practices, routine reporting expectations, and proper documentation procedures. In addition, routine progress reports are shared with global and country-level partners to keep them updated on project activities, change requests, challenges, and action items for collective follow up and resolution.

Look Inward for Resources

To save time and improve the efficiency of the work, it’s important to look inward for resources. There may be potential human resources within your organization; across different programs and departments, that may have relevant skill sets required for your project. We engaged francophone staff across eHA’s country offices as part of the AVADAR cross-country training team, resulting in cost and time savings related to recruitment and onboarding of new staff.

“During 2017 scale up planning, I was tasked with recruitment of the expansion training team. I liaised with eHA department managers to engage their team members with the required skill sets; including multilingual capabilities and prior experience implementing mobile-based application projects.”

— Wilson Inalegwu (AVADAR Technical Lead)

Leverage on Existing Relationships with Partners

Implementing AVADAR has been a multi-organizational effort that required each partner to rely on shared resources and existing infrastructure for optimization and efficiency. One must anticipate the areas where partner assistance is required during project planning and make prompt requests through the appropriate communication channels. Although eHA did not have established offices in four of the countries, our team benefitted from partner relationships and the engagement of 3rd party recruitment and logistics vendors in establishing contractual agreements with local vendors, clearing shipped equipment at each country’s Customs office, facilitating in-country travel, and securing storage space for project equipment/materials.

In Part II of the series, we’ll share key lessons learned directly related to implementation in the countries without a previously established eHA office. Sign-up for our newsletter today and get all the latest information on what's happening at eHA.

Extending the Digital Agenda in Underserved Communities

By Elizabeth Okunlola

The ongoing digital revolution has given birth to innumerable changes in communication, collaboration, knowledge sharing, and innovation. Technology is now a way of life,  and certainly the United Nations’ Sustainable Development Goals cannot be achieved without technology.

Technology has become a major driver for growth and development. It allows one individual to execute a task meant for 10 in an efficient and cost-effective manner. However, it comes with its own challenges, especially in the areas of access, adoption, and application. eHealth Africa (eHA) is committed to bridging the digital divide by promoting digital inclusion through her health intervention programs for vulnerable communities across Africa.

eHA implements interventions that not only improve the work performance of health workers but also their digital skills with new trends and technology that prepare them for today and the future. While creating solutions, workers are educated on new and emerging technologies that create opportunities and make them more efficient in their jobs. Several technology-driven projects like AVADAR, eIDSR, Kano Connect, et al., provide digital opportunities for health workers even at the last-mile to be relevant in this digital age. These projects address issues surrounding free access to technologies as eHA, through donors and support from implementing partners, provides hardware, software, high-speed internet connectivity, and access to a range of relevant work content.

Our programs and projects provide digital literacy services that assist health workers to navigate, understand, and evaluate their work through consistent training. They also promote collaboration and communication by leveraging new media tools and encouraging self-exploration; making it possible for workers to explore digital resources on their own.

The Kano Connect project, for instance, has promoted digital inclusion by creating access to, adoption, and application of technology for work. To engender access, the Kano Connect project provided 1,416 phones and 100 free SMS within a Closed User Group (CUG). It also provided a zero-rated data access (250mb) for job related data-driven applications on the Kano Connect infrastructure. In the area of adoption, the project provided digital literacy services for health workers - 1,416 health workers were trained across all levels (State, Zone, and LGA) in the Kano State Primary Health Care Management Board (KSPHCMB).

At eHA, we work on solving big problems. We believe in the power of technology to make a transformational difference in health systems, and we know that when we do high-quality work, we have the opportunity to change lives in the communities we impact. Sign-up for our newsletter today and get all the latest information on what's happening at eHA.

eHealth Africa Encourages Local Software Development in Sierra Leone

By Jasper Timm & Hawa Kombian

To pursue and promote continuous learning, eHealth Africa (eHA) supports the innovative technology solutions in Sierra Leone by encouraging local software development. Software development remains strategic for Africa's development and continues to widen opportunities in areas including health, education, and governance.

eHA’s Information Systems (IS) department runs a community outreach program in an effort to promote software development as a vocation and build relationships with the software development community in Freetown, Sierra Leone. eHA currently holds software talks and workshops for the general public at Freetown’s Sensi Tech Hub. An extension of this program involves a workshop held at our office with students enrolled in software development related courses from local universities.

Top Left: Ibrahim Bayoh from the IS team shares developer tips and tricks with the students (Photo: Les De Wit)

In September, eHA hosted students from BlueCrest College, a high-tech tertiary institution in Freetown, Sierra Leone. The team covered eHA software development tools, developer tips and tricks, and gave a comparison of life at university vs. work in the software industry - with personal accounts of what got the current IS team members so passionate about software development. In addition,  we got hands-on with the students to tackle a mock software problem. Almost like a mini Hackathon, the students split up into groups and with assistance from an IS team member, they wrote code to implement a couple of features in a simple web application. At the end, each group presented their solution.

The day was a great success and the students provided enthusiastic feedback on the overall event and how it met their expectations (It was amazing!). Many students commented that they valued the exposure to new programming tools and languages in the software world.

“I learned that I should never sleep regretting a day I spent coding”

— Participant

It was an absolute pleasure to host the students from BlueCrest College - they were all extremely attentive throughout the session. Thanks to Madhusudan Mukerjee and Shailesh Kanani from BlueCrest College for supporting our initiative. At eHA, we believe in the power of technology to make a transformational difference in health systems, and we know that when we do high-quality work, we have the opportunity to change lives in the communities we impact.

We are hiring, come join us! We have an open position for an Intern Software Developer with the IS department in Sierra Leone. If you’d like to apply, or join the eHA team in any other capacity, head over to our Careers page.

Reflections: eHealth Africa’s 360-Degree Approach to Sierra Leone's Mudslide Disaster

By Hawa Kombian

On August 14, communities in Freetown, Sierra Leone were shocked by devastating mudslides following continuous heavy rain. eHealth Africa’s (eHA) presence and impact in the country since the 2014 Ebola Virus Disease outbreak and response positioned it well to sprint into public health emergency management action for the benefit of the many vulnerable communities.

Western Freetown community members receiving and counting goods for the area distribution. Photo courtesy of Hawa Kombian.

From activating the Emergency Operations Center to repurposing original software solutions and visiting communities to deliver aid, eHA truly took a 360-degree approach to meet the needs of at-risk populations.

Community Visits

Freetown is home to eHA’s Sierra Leone’s office and as such, the team banded together to show its support for the communities affected by the mudslide. Employees donated funds to purchase necessary items including mattresses, oil, water, sanitary pads, diapers, powdered milk and baby goods, sanitizers and used clothing. Distributions were made to communities in Western and Eastern Freetown.

Emergency Operations Center (EOC)

eHA set up the infrastructure for the EOC during the Ebola response and continues to support and strengthen its maintenance. Following the recent mudslides in Sierra Leone, the Ministry of Health and Sanitation (MoHS) was able to seamlessly assemble and activate key emergency support pillars to manage the ensuing and necessary activities. eHA and several public health partners (U.S. Centers for Disease Control and Prevention, (CDC) World Health Organization (WHO), and Public Health England) were also able to craft and validate an emergency response document with clear roles, responsibilities, and steps for action from the perspective of a natural disaster with health implications.

Software Solutions

Key eHA software tools have facilitated the MoHS and partners’ ability to gather data, generate evidence-based insights to understand the information trends and determine solid execution strategies to improve health outcomes. Such measures improve the use of resources towards effective public health emergency management.

• 117 Call Centre (117): 117 was initiated as public health emergency response line during the Ebola response to track and manage suspicious deaths and illnesses for follow-up by the MoHS. In the early moments of the mudslide, the MoHS was alerted to the severity and casualties via calls made to the 117. The mechanism was utilized to track locations and coordinate burials. In addition, the lead natural disaster management office has agreed to integrate their emergency line with 117 for enhanced effectiveness of emergency tracking and response. (1)
• Electronic Integrated Disease Surveillance and Response (eIDSR): eIDSR is designed to support disease surveillance through digital collection and sharing of the prevalence of priority diseases. eIDSR data is currently collected and shared by health facilities weekly for a clear depiction of disease prevalence across the country. Following the mudslide, eHA’s Information Systems team created a mini-eIDSR tool to capture the daily disease prevalence of cholera, dysentery, typhoid, and diarrhea cases from the Freetown, Western Area ahead of decisions of where and how to intervene for optimum public health. (1, 2)
• Health Facility Registry (HFR): The HFR data collection tool enables health facilities to track the level of medical and facility supplies and equipment in store to ensure that there are sufficient stock and materials to enable proper health delivery to patients. As a health prevention measure after the mudslide, the MoHS planned a cholera vaccination campaign and utilized the HFR data collection tool to support decisions about the location and quantity of vaccine distribution.

Learn more about our programmatic expertise and scope of projects from eHA’s 2016 Impact Report!

Project GRID: Mapping Communities in Nigeria to Aid Humanitarian Efforts

By Daniel Ojabo

A vast number of the most vulnerable human settlements in Africa have remained unmapped. In the case of a public health emergency, knowing where people live, the best ways to get in and out, and the locations of basic necessities such as hospitals are of paramount importance.

The paucity of accurate geospatial data, including population settlement data, presents a major obstacle to adequate decision-making across Nigeria and remains a barrier to development. The Nigeria GRID (Geospatial Reference Information Database) project is part of a bigger global initiative; a multi-country, multi-donor initiative that aims to collect and store geospatial data across several African countries.

Through the Global Polio Eradication Initiative (GPEI) in Nigeria, the Bill and Melinda Gates Foundation (BMGF) via eHealth Africa (eHA) has mapped 11 out of 36 states and the Federal Capital Territory (FCT) of Nigeria. Through the GPEI, eHA deployed a combination of remote sensing satellite imagery, primary data collection, and geographic information systems to map over 140,000 settlements and other relevant points of Interests (POIs). The GRID project is now scaling up to the whole country and will complete the mapping of the remaining 25 states plus the FCT, collecting settlement names, geographic coordinates, and POIs such as health facilities, schools, and markets across the country.

Several attempts have been made to provide reliable geospatial data to the country. But despite this, there still exist significant gaps to be addressed regarding the quality, completeness, and sustainability of geospatial data available across Nigeria. In addition, there is a lack of capacity within the state and the federal government to leverage existing infrastructure to develop robust systems which can collate, manage, and enhance existing geospatial data. The capacity to develop innovative tools to effectively exploit geospatial data which can support improved decisions, policies and socio-economic resilience is also limited.

The GRID project aims to bridge this gap, by supporting state and federal government agencies to strengthen geospatial data availability across Nigeria. To do this, the project will adopt the same methodology used during the GPEI to map and provide geospatial data for the rest of the country. Over a period of 9 months, the GRID project will develop a geodatabase of settlements with GIS coordinates, population estimates, and other relevant POIs across 25 states and the FCT. The project will also build the capacity of the Nigerian government to utilize the data effectively.

eHA remains committed to the development of people-centric and data-driven technology solutions that connect and deliver better public health services for vulnerable communities in Africa. See more stories and articles about eHA's innovative work by signing up for our monthly newsletter.

The DHIS2 Experts Academy 2017 - Pushing the Frontiers of Dynamic Health Information Systems

By Hawa Kombian

DHIS2 Experts Academy participants. Photograph courtesy Kjerstin Andreasen

eHealth Africa (eHA) participated in the DHIS2 Experts Academy Conference in Oslo, Norway in August of 2017. eHA’s Les de Wit (Software Project Manager) and Jasper Timm (Lead Software Developer) supported the conference’s focus on sharing the most exciting innovations and uses of DHIS2.

District Health Information Software 2 (DHIS2) is an open source health information platform used in 60 countries. eHA and its partners use DHIS2 in key public health projects to enable Ministries of Health to maximize the health of their citizens. DHIS2 enables users to store and track health data, analyze it to understand trends and patterns and develop evidence-based execution strategies that will deliver impact for communities.

Pictured top left and right: Les de Wit and Jasper Timm. Photograph courtesy of Kjerstin Andreasen

The DHIS2 Experts Academy Conference was a gathering of 170 DHIS2 users, implementers, and developers from government, academia, and non-government organizations (NGOs). Jasper Timm and Les de Wit delivered a presentation entitled “Offline apps for disease surveillance from eHealth Africa in Sierra Leone [1, 2] and Liberia” which highlights eHA’s work in electronic integrated disease surveillance (eIDSR). To reduce the frequency of the errors, which are prevalent in paper-based reporting and during the process of transferring data from one platform to another, eHA in collaboration with the Center for Disease Control and Prevention (CDC), World Health Organization (WHO), and additional partners developed a mobile eIDSR application. This eIDSR app enables the entire health system to accurately record and share community-level health information from the district level to the national level.

During the event, the DHIS2 roadmap was discussed as well as workshops on new and upcoming platform features. There were also sessions on the software’s best practices and demos highlighting use cases of DHIS2 implementation from around the world. The opportunity to connect with colleagues integrating information and technology in health aligns directly with eHA’s respective vision and mission; to establish new standards in technology and provide underserved communities with tools to lead healthier lives. Join our team today and work on innovative tools and platforms that impact public health!

Strengthening Liberian Human Capacity for Health Services

By Elizabeth Shelley

Since the height of the West African Ebola virus outbreak, eHealth Africa (eHA) has been working with the Liberian Ministry of Health (MOH) to rigorously improve nationwide electronic disease reporting systems, laboratory and diagnostic systems, and emergency management operations.

eHA established Emergency Operations Centers (EOCs) in each of Liberia’s 15 counties and supported specimen sampling and storage at 5 priority laboratories. Today, eHA is poised to launch our new electronic Integrated Disease Surveillance and Response (eIDSR) app on a national level. With each of these advancements, eHA recognizes the need to ensure the development of a local workforce to maintain these systems beyond the end of eHA’s involvement. As our teams continue to create innovative technological solutions to some of Liberia’s most pressing public health challenges, we are simultaneously providing experts to deliver training workshops for the continued management of these systems, and on ways to modify them to respond to a changing environment.

Recently, in partnership with the US Centers for Disease Control and Prevention (CDC), eHA delivered a workshop to MOH staff members in all counties, Surveillance Officers, and other National Public Health Institute of Liberia (NPHIL) staff on Threats and Hazard Identification and Risks Assessment (THIRA). In this workshop, participants learned to more effectively detect, investigate, and respond to potential public health emergencies.

eHA and the CDC recently delivered training workshops to MOH employees on risk communication and additional workshops technical skills required to manage software solutions and ICT infrastructure. Last year, eHA and the CDC brought representatives from the Linux Association to Liberia to conduct Africa’s first ever Linux Association Administrator Certification program. The workshop, conducted at eHA’s central office in Monrovia, resulted in ten professionals becoming  fully qualified Linux System Administrators.

As the development of our eIDSR Offline Tracker application progresses, eHA is simultaneously planning workshops to train MOH employees, District Surveillance Officers (DSOs), and additional Healthcare Workers (HCWs) on using the software. eHA recognizes the importance of developing local capacity to maintain the software and associated databases, to make modifications as required, and resolve bugs as they occur. This capacity strengthening will prove crucial for sustaining these projects.

Reaching the Hard-to-Reach

Solutions to the Healthcare and Nutrition Crisis in the Lake Chad Region

By Natalya Nepomnyashcha

Years of violent conflict and forced displacement have affected around 17 million people in the Lake Chad Basin, including the regions of North-eastern Nigeria, Northern Cameroon, Western Chad and South-east Niger. Due to food insecurity and the lack of basic healthcare services, the region is experiencing a widespread health crisis and high levels of malnutrition. Accessing the most remote, insecure, and hard-to-reach areas for emergency service provision and humanitarian assistance remains a pressing challenge.

eHealth Africa (eHA) is a health social enterprise focused on improving health systems in West Africa. eHA designs and implements data-driven solutions that respond to local needs and provides underserved communities with tools to lead healthier lives. The German-African Business Association (Afrika-Verein der Deutschen Wirtschaft) is the foreign trade association representing German companies and institutions with an interest in Africa.

Panelists L-R: Anna Sophia Rainer, Prof. Dr. Titus Kühne, Natalya Nepomnyashcha, Dr. Gabriele Poggensee, and Anu Parvatiyar.

Together, the two institutions hosted an event that provided insights into what is happening in the Lake Chad Basin and identify solutions. The speakers included:

• Dr. Gabriele Poggensee, Global Health and Biosecurity Unit, Robert Koch Institute
• Prof. Dr. Titus Kühne, Director, Institute for Computer-assisted Medicine, Charité
• Anu Parvatiyar, Associate Director, Programs, eHealth Africa

After an introduction by Anna Sophia Rainer, Project Manager, German–African Business Association, the panelists discussed the most pressing issues in the Lake Chad Basin. These included drought, terrorist insurgencies, insecurity, lack of equipment, poor infrastructure, dissatisfaction with the governments, and as a result, shaky political conditions.

Functioning disease surveillance systems are one necessary component to help detect and respond to other health problems. Dr. Poggensee believes that the Ebola outbreak of 2014 was a wake-up call for the whole world. Since then, developed countries have been more willing to invest not only in humanitarian aid but also into strengthening health systems and building capacities for potential outbreak responses in Africa. In this context, trained personnel are key to any successful response. Tools are great, but it’s more important that people know how to use them effectively.

eHA works on the outbreak response for polio and broader disease surveillance efforts in the Lake Chad Basin. Having supported polio eradication in Nigeria for several years, eHA helps track immunization campaigns across the region. With polio receiving substantial attention and funding, it also opens doors for related work, such as GIS mapping. For immunization and other aid purposes, it is important to know the location of settlements and points of interest, especially in regions where many roads or entire villages have been destroyed by active insurgents. eHA uses satellite imagery and field intelligence to provide invaluable data that enable aid to reach hard-to-reach populations.

Speaking on the use of digital tools, Prof. Dr. Kühne pointed out that we need a more coordinated approach so tools complement each other as opposed to several projects either targeting the same issue from different directions or missing the bigger picture completely. Rwanda, the Silicon Valley of Africa, is a positive example for a well-managed and interoperable system. To Prof. Dr. Kühne, ownership is the key factor in handling digital health tools.

Dr. Poggensee, Prof. Dr. Kühne, Natalya (Comms & Operations Coordinator, eHA) and Anu. 

According to Dr. Poggensee, another challenge is that many stakeholders develop new digital tools that are not compatible with the existing tools used by WHO. She stressed that this is vastly important since surveillance should not be done for the sake of collecting data, but for the sake of taking action. Anu Parvatiyar summarized it in a nutshell: Instead of collecting data to do reporting, it is essential to collect real-time data to be able to react promptly in case of an emergency. This is exactly where digital tools provide a huge advantage.

Integrating tech and health, eHA achieves its mission by establishing new standards in the delivery of healthcare to most vulnerable communities in West Africa. If you are interested in working with us, please have a look at our job board or contact our team at berlin@eHealthAfrica.org.

Women’s Empowerment At eHealth Africa

Women's empowerment remains a significant topic of discussion all over the world as women often face discrimination, especially when it comes to employment and work conditions.

According to UN Women, women are overall paid less than men. Women in most countries earn on average, only 60 to 75 per cent of men’s wages. In addition to this, a report by the World Bank implies that gender differences in official legislation impact women worldwide. In 90 percent of 143 economies that were studied, researchers found at least one law that restricts women’s economic opportunities. On the other hand, McKinsey & Company found that women’s economic equality is good for businesses. It increases organizational effectiveness and companies greatly benefit from increasing leadership opportunities for women. eHealth Africa (eHA) takes the topic of Women’s Empowerment very seriously and set it as a strategic goal for the year 2017. Amongst other HR initiatives, this led to the formation of eHA’s first Women’s Empowerment Group.

The group started in April 2017 and is based at the Nigeria office in Kano. The aim of the group is to give women a safe space to reflect on personal development and gain greater self-confidence.  So what makes this program so special and effective? The concept for the group was developed in collaboration with Tanja Schomann from Philia. Philia is an organization that teaches peer coaching as an alternative method to traditional mentoring schemes and counseling.

The basic idea is to use peer coaching as a tool to enhance communication skills that promote dialogue and mutual understanding. Participating women support each other in reaching their individual goals as well as enabling spillover effects on entire communities. The Philia Peer Coaching concept focusses not just on topics immediately related to work, but on all areas of life. The idea is that empowerment is a mindset that encompasses the entire personality. A woman that is unable to cope with problems at home will not be able to perform well at work. This is why eHA and Philia chose a more holistic approach to women’s empowerment.

“Philia taught me to be a better listener. It also taught me that most women tend to have the same problems regardless of their culture and backgrounds”

— Layal Srour (Participant)

The group meeting is conducted on a weekly basis. Each session consists of 30 minutes of peer coaching and 30 minutes of teachings on personal development and communication skills. With eleven women participating in the pilot phase, the group has reached a great level of openness, sharing, and mutual support - which is not always easy to reach in a professional context.

Strengthening Programmatic Excellence And Empowering Our Staff

By Natalya Nepomnyashcha

eHealth Africa (eHA) held its first ever Global Programs Conference in our Kano office. 50 participants from 6 offices and three continents represented 5 programmatic pillars as well as over 30 different projects in 10 countries.

The main conference goals were:

• To promote knowledge sharing among various program teams and offices

• To provide in-person training on people and process management

• To promote a common understanding of eHA's mission, values, and resources

• To spend time together growing, and collaborating better as a team

Together as a team, we looked back at our first project in Nigeria, a Maternal Health project in Kaduna, to our first entry into combating Polio, to our regional impact during the Ebola outbreak. We went further to discuss our current endeavors such as expanding the team in the Lake Chad region and the GIS GRID project that will map all states in Nigeria.

This conference was a great opportunity to highlight our integrated approach of connecting data, insight, and execution. As a team, we discussed the previously identified guiding principles in determining the eHA best project fit, which are:

1. Can we do it better than anyone else in the space?

2. Is it driven primarily by our beneficiaries?

3. Is it transformational?

The conference was held from May 17-21, 2017. Day one of the conference was focused on knowledge sharing. The teams had the opportunity to share and present various  projects, results, and impact to one another, be it Health Camp, electronic Integrated Disease Surveillance, and Response (eIDSR), or Vaccine Direct Delivery.

“My personal highlight was seeing the Health Camps boxes, a project in Nigeria. I didn’t know that eHA was testing the items. We also collected data to determine what needs to be in the boxes. It’s such an integrated model” - Dayo Spencer-Walters, Deputy Country Director, Sierra Leone

Day two was focused on people development. We showcased our interest and love for investing in and developing our greatest asset, our people. The conference participants attended a professional management training, where they learned about the importance of delegation and effective communication amongst other topics discussed.

No eHA conference would be complete without learning about the proper use of data and maps. On the final day, participants received very insightful in-house session on how data and maps can be used practically to allow for an evidence-based and timely decision-making.

At eHA, we understand and emphasize the importance of balancing work and life, hence we allocated some of the conference time to attending fun dinners with the team and participating in a slew of games such as trivia night.

The evaluation showed that the conference helped eHA staff to grow professionally, personally, and as a team:

• Almost 90% said the conference made them more excited to work for eHA

• 94% thought the conference provided content for personal and professional growth

As a result, participants not only received input on how to grow as managers, and gained insight into various projects - the group grew much closer as a team and will be able to represent our core values at a new level.

Impact & Quality // Innovative Problem-Solving // Passion // Honesty // Growth & Learning // Ownership

Are you interested in joining eHA? Have a look at our current job openings. We look forward to your applications!

Spotlight: eHA Internships

Yaya Jaiteh was eHA’s dynamic Product Marketing Intern in the Spring of 2017.

When deciding to apply for this internship, Yaya hoped to learn more about public health. “I always saw strengthening of the health sector as one of the most effective approaches in development work, Yaya explains. “I was also starting to develop an interest in software development and health tech solutions during a project I was working on prior to the internship. At eHA, I had all that in one internship while working with a truly international team”.

Yaya had the pleasure of being based in eHA’s German office and traveling to eHA’s Sierra Leone office. He also played a significant role in marketing two major eHA projects - Electronic Integrated Disease Surveillance and Response (eIDSR) and Service Availability and Readiness Assessment (SARA) during the course of his internship. While in Sierra Leone, Yaya was supervised by Hawa Kombian, Executive Projects Manager. 

“I really learned a lot during this internship. This makes it hard to sum up the lessons I learned during a period as short as just two months. To mention some key aspects, I would say that working within a team that is international and diverse was an exciting experience”.

Yaya has been an amazing intern with eHA. We wish him the absolute best in his future endeavors! Check out our job board and join our team today. 

Sierra Leone’s 117 Call Center Transitions Into A Sustainable Public Health Mechanism

By Hawa Kombian

June 22nd, 2017 marked the official celebration of the 117 Call Center’s transition into a sustainable public health mechanism for Sierra Leone. This successful transfer of ownership has been highlighted as an instrumental step towards strengthening the ability of Sierra Leone’s Ministry of Health & Sanitation (MoHS) to efficiently identify and respond to public health emergencies and other challenges.

Officials from the MoHS, UK Aid, eHealth Africa (eHA), and the United State’s Center for Disease Control and Prevention (CDC) gathered to mark this momentous occasion. The event was held at the Public Health National Emergency Operations Centre (PHNEOC) in Freetown, Sierra Leone.

The 117 is a MoHS initiative set up in 2012 as part of a wider support system to improve maternal and child health. In 2014 it was scaled-up in response to the Ebola Virus Disease (EVD) outbreak - to serve as a tool to document, track and provide follow-up on suspected EVD cases and deaths. Funded through the Government of the United Kingdom’s  £13.7 million aid package to the Ebola Response Consortium, eHA provided technical and operational support to expand the 117 to every district in Sierra Leone. eHA developed a custom software to enable near real-time documentation of call details and the dispatching of the 117 calls to District Emergency Response Centers. This system also provided call-back services to deliver updates on the dispatching of health workers to original callers. 

Speakers (left to right): A CDC Representative, the Deputy Minister from the MoHS, the British High Commissioner to Sierra Leone, the Deputy Chief Medical Officer from the MoHS, the Head of PHNEOC, and eHA’s Deputy Country Director of Sierra Leone. Photo: Hawa Kombian, eHA

Speakers at the event included eHA’s Deputy Country Director in Sierra Leone, the Deputy Minister of Health from the MoHS, the Deputy Chief Medical Officer from the MoHS, the British High Commissioner to Sierra Leone, and several CDC representatives. 

“117 has been a real effort and success in partnership between the Ministry of Health [and Sanitation], the UK Government, eHA, and other partners on the ground. eHA will continue to be a willing and able partner with the Ministry to improve health outcomes in Sierra Leone” - Dayo Spencer-Walters, eHA's Deputy Country Director, Sierra Leone.

The event concluded with a ceremonious ribbon cutting performed by the British High Commissioner and the MoHS’s Deputy Minister of Health, followed by a tour of the new call center space in the PHNEOC facility.

The British High Commissioner to Sierra Leone and the Deputy Minister of Health from the MoHS complete the official ribbon-cutting ceremony. Photo: Hawa Kombian, eHA

At the height of the EVD crisis, the 117 received an average of 6,000 alerts of suspicious deaths and sickness per month. Over 300 dispatchers and operators were trained to utilize the eHA software solution and provide weekly updates to the MoHS and partners. This information was invaluable in the management of the outbreak, as it informed near real-time response efforts. With continued funding from UK Aid’s Resilient Zero program, the 117 call center currently receives around 2,000 alerts per month to its decentralized data managers who are deployed across all 13 districts in Sierra Leone. The 117 is a key element in strengthening the public health surveillance system, including tracking maternal deaths, child deaths, and suspicious infectious disease cases.

With a desire to maintain a strong disease surveillance system that can prevent and respond to public health threats, the MoHS will exercise renewed leadership over the technical and operational aspects of the 117. In light of this, the CDC Foundation has committed to short-term funding support for the project.

The public is encouraged to continue to place calls and send public health alerts to the 117 in order to report all deaths and suspicious illnesses in their respective communities. Social mobilization activities will continue in national efforts to enhance disease prevention, management, and the overall health sector development in Sierra Leone. eHA remains committed to achieving its mission by improving preparedness for potential public health emergencies across underserved communities in West Africa. To find out more about the work that eHA does, kindly subscribe to our monthly e-newsletter.

Electronic Immunization Registry and Tracking System in Sierra Leone

Written By Hawa Kombian

In November 2016 we announced the launch of a Child Immunization Initiative in Sierra Leone - an Electronic Vaccination Record and Tracking Project, also known as VaxTrac. The goal of this initiative was to implement an electronic registry for children’s immunizations in order to provide timely and quality data for decision making.

The Immunization Dashboard shows the client's immunization history and upcoming immunization dates. Photo credit: Bryan Gastonguay

Funded by the Centers for Disease Control and Prevention (CDC), eHealth Africa (eHA) implemented the project in collaboration with VaxTrac, Africell, and the Child Health Division at the Sierra Leonean Ministry of Health and Sanitation (MoHS). The pilot phase ran from November 2016 to June 2017.

The VaxTrac project has been a thriving success in the Western Area Urban District of Freetown. eHA has led the training of over 110 MoHS health officials and workers from 50 health facilities to conduct electronic registration for children receiving vaccinations via the VaxTrac app. The patient profiles are generated and linked using biometric indicators (i.e. fingerprint scans) from their caregivers or via a QR code sticker on their traditional vaccination cards. Each child’s demographic and vaccination details (i.e. type of vaccine and date of administration) are collected via the VaxTrac mobile app and synced to the VaxTrac monitor analysis system, which the MoHS can access.

“VaxTrac has helped us give accurate return dates [for immunization follow-up] to our patients. ”

— Trained, Freetown Health Care Worker (HCW)

In addition to storing immunization information in a secure and accessible platform, VaxTrac includes features which support the health system proactively addressing child immunizations. The system has a “call-back” feature which tracks follow-up vaccination timelines and calls caregivers with reminder messages encouraging them to bring children back in for their next round of immunization. This friendly and automated reminder helps ensure that vaccine coverage is as high as possible. It further provides a simple and reliable mechanism for healthcare workers to conduct routine follow-ups.

Ultimately, the MoHS will be able to utilize compiled VaxTrac data to make more strategic and informed vaccination decisions via the VaxTrac monitor dashboard which runs data analysis and produces reports.

Following the success of the pilot where over 20,000 patients were registered, the completed end-of-pilot evaluation will provide information on necessary software upgrades to ensure that the app remains user-friendly and is streamlined for data collection and analysis. The project partners plan to expand VaxTrac to the 20 remaining health facilities for 100% coverage within the Western Urban Area District. This activity will include greater engagement of MoHS staff in the process of training health care workers to use the VaxTrac app, monitoring its usage and effectiveness throughout health facilities, and analyzing the data collected for a clearer understanding of immunization trends across the district.

eHA establishes new standards in health delivery through the integration of information, technology, and operations. This supports our mission to improve the quality of healthcare for underserved populations across Africa. To join our team or find out more about the work we do, kindly visit our website.