Health delivery systems program
eHA has brought new approaches to the development of people centric and data driven technology solutions that connect and deliver better public health delivery systems for vulnerable communities. We have brought fresh ideas to routine immunization with integrated research, communications, design, and delivery which has improved the quality and availability of information, supplies and services to the last mile. Our Effective Vaccine Management Assessment and cold chain resource mapping has improved access to basic health care across Nigeria’s challenging northeastern zone.
In northern Nigeria there is limited access to medical care, due to the high cost and accessibility challenges for people living in rural areas. eHA started Health Camps (HC) to increase the visibility of the formal health sector and build trust among local communities for health interventions. eHA works with government partners to supplement monthly vaccination campaigns with medicines and medical supplies through HC boxes.
Each HC is supplied with a minimum of one portable box of essential drugs, distributed by trained community health workers. Trust increases compliance for vaccinations and encourages health-seeking behaviors. eHA and our partners work with traditional community leaders, who provide support and credibility to broader health systems strengthening efforts. One HC box treats on average 100 patients, and there have been 2,278,246 patient visits since March, in areas where it is their primary health care source.
Kano Connect (KC) is funded by the Gates Foundation and Dangote Foundation, in partnership with the Kano State government, to build a primary health care communications platform. It strengthens health systems, and has improved communication and information flows across Kano State.
eHA procures, sets up, and supports Android-enabled smartphones, manages a user group cellular network, and provides training and technical support for over 1200+ routine immunization health workers. eHA has developed a unified data architecture to expand the state’s capacity to manage routine immunization programs through our mHealth platform.
KC’s innovative system-wide connectivity improves responsiveness, rapid message dissemination, and can collect, track, and act on crucial health performance indicators.
KC has already distributed 884 devices to Primary Health Care Management Board health workers, focusing on key players involved in routine immunization. KC has trained health workers on smartphones and electronic data collection methods, including SMS surveys and Open Data Kit. It has enabled the state to improve responsiveness and operations, while getting the data needed to shape longer-term health system strengthening investments.
Sense: Last-mile Information Management
Handwritten paper records still exist which challenge the data analytics needed for quality health service delivery. eHA’s Software and Health Delivery Systems teams developed the last-mile information management platform Sense. It helps with the technical and practical hurdles of collecting and using data, and delivering high quality information direct to users.
Sense’s applications manage routine immunization supplies. LoMIS allows people to reorder vaccines and dry goods by tracking stock levels and reporting on service, performance monitoring at each transport network level, and supply forecasting and coverage. Sense reports cold chain failures; with just two taps system administrators are told of repair needs. eHa’s LoMIS started with 80 health workers, and there is potential in predicting vaccine stockouts and accelerating responsiveness to ensure greater availability for all health users.
Forward Cold Chain Evaluation
Nigeria’s ten fold increase in the procurement of routine immunization and several new vaccines has increased the cold chain capacity needed to meet people’s health needs. eHA has worked with Nigeria’s National Primary Health Care Development Agency and UNICEF to implement a pioneering study monitoring temperature, and looking at each aspect of the delivery system to see why cold-chain failures were occurring.
eHA conducted trainings, implemented electronic data collection in 40 local governments across Nigeria’s states, and provided data management and analytics to the study team. The three month study took 900 surveys and generated over 200,000 hours of temperature data.
Vaccine Direct Deliveries
The availability of effective vaccines is fundamental to primary health care and disease control systems. In the past, Kano State relied on a “pull” delivery system to get vaccines to the field which resulted in stocked-out facilities, scaled-back outreach, and poor supply forecasting.
eHA, in partnership with the Governor of Kano, the Bill & Melinda Gates Foundation, and the Dangote Foundation, piloted, scaled, and manages an informed “push” transport logistics operation. Supplies now go directly from the State cold store to local health facilities. This serves 328 facilities in 300 wards across 30 local governments -- effectively already managing vaccine supply for 68% of Kano’s wards in the first year.
eHA’s system ensures a twice-a-month delivery of fifteen immunization stock items to each solar-refrigerator-equipped facility. We have conducted facility mapping, route optimization, vaccine handling training and driver certification, temperature monitoring, data and stock management, and allocation forecasting.
Already over 10,000 km has been covered delivering 1.1 million doses of vaccines in 2400 deliveries, representing nearly $2 million of vaccines in management, and has dramatically reduced the frequency of stock-outs in Kano’s health facilities by over 60%.