The EOC Revolution

By Joshua Ozugbakun & Emerald Awa- Agwu

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

“‘’All the work that eHA does is not for ourselves but to make our partners’ work better’’”

— Atef Fawaz, Deputy Director, Program Operations, Nigeria

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

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

Step 1: Capacity Building Workshop

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

Photo of Capacity Building Training

Step 2: 60- day Transition Phase

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

• Creation of maps to support routine immunization and other micro-planning activities in the states

• Acting as frontline brand ambassadors to showcase eHA solutions such as Logistics Management Information System (LoMIS) Suite, Vaccine Direct Delivery (VDD) etc.

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

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

Behold the new faces of the EOCs!

Good Data Saves Lives: The eHA Meetup in Berlin

By Jennifer Bencivenga and Emerald Awa- Agwu

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

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

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

Johanna Roegele, the Managing Director of the Germany Office, welcomes global health and technology enthusiasts!

Our strategy: The virtuous cycle

Ever committed to our virtuous cycle strategy, the “Good Data Saves Lives” event brought participants from various fields within the global health and technology space to discuss the importance of data availability and accessibility to the transformation of health systems and delivery of health care

Big Data and E-medicine

Prof. Dr. Tim Conrad, from the Department of Mathematics and Computer Science at Freie Universität Berlin, spoke about how “big data” analysis, or analysis on extremely voluminous data sets, can be used by medical doctors to support disease diagnosis in E-medicine

The audience listened closely as Hila Azadzoy of Ada Health introduced an app that leverages data to help people diagnose illnesses and connect them with real doctors

Prof. Dr. Titus Kühne, the Director of the Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, discussed the processes of collecting, sharing, and analyzing medical data, the tools needed for these initiatives, and their function in low-resource contexts

Presenting: Aether

eHA's Shawn Sarwar introduced our new platform Aether, an open source application of software, services, procedures, and best practices developed to help organizations exchange live health information

The event was an opportunity to network and forge connections

Participants discussed various issues related to the talks during the networking session

eHA talks Disease Surveillance with Public Health Students at Emory University

By Hawa Kombian

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

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

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

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

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

Thanks to the students and staff at Emory University.

Improving Coverage Rates, One Track at a Time

By Emerald Awa- Agwu and Friday Daniel

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

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

Debriefing at a state- level review meeting in Sokoto State

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

Why is this Important?

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

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

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

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

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

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

STRIVE supplement published in The Journal of Infectious Diseases

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

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

• Lessons Learned in Clinical Trial Communication During an Ebola Outbreak:The Implementation of STRIVE

• Implementing a Multisite Clinical Trial in the Midst of an Ebola Outbreak: Lessons Learned From the Sierra Leone Trial to Introduce a Vaccine Against Ebola

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

Increasing Sierra Leone's efficiency in disease detection with eIDSR

By Sahr Ngaujah

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

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

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

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

“Before the introduction of eIDSR, most National health information from the Primary Health Care Unit were written hard copy. It took a lot of time for data staff to capture written hard copy data into the soft health management system. Data processing with the paper based system was time consuming and error prone. Transitioning to eIDSR would improve the quality and timeliness of health information.”

— Dr. Tom Sesay, District Medical Officer (DMO), Port Loko - Northern Sierra Leone

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

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

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

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

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

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

“eIDSR has built the capacities of our health workers most of whom had little experience in the use of smartphones. eIDSR has contributed to improving our interaction with our facility staff.”

— Albert Kamara, District Surveillance Officer, Port Loko

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

Getting Vaccinations on Time

By Hawa Kombian

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

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

One of the terrain challenges encountered by eHA's officers

• Leveraging eHA’s geographic and information systems (GIS) capabilities to optimize delivery routes (including rugged terrain as pictured), reduce cost and maximize efficiency.

• Collecting, analyzing and reporting data to provide custom delivery workflow support through a near real-time electronic data collection application - Logistics Management Information Systems (LoMIS) for stock level summaries via an integrated reporting dashboard.

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

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!