Tag: Digital Tools

Revolutionizing Malaria Interventions in Nigeria: 5 Digital Tools Leading the Fight

Posted on by Moshood Isah

By Judith Owoicho

Several factors may account for why malaria is so common in Nigeria which bears up to 25% of the malaria burden in sub-Saharan Africa. It remains a significant health concern. In 2021,  the country accounted for 31% of global deaths from the disease. Control of malaria is often hinged on global strategies,  including prompt and effective case management, intermittent preventive treatment (IPT) of malaria in pregnancy, and integrated vector management (IVM): use of insecticide-treated nets (ITN), indoor residual spraying (IRS), and environmental management (EM), all of which have been employed at varying degrees to combat the disease.

Efforts made over the years were further stalled in the first year of the pandemic which saw a rise in malaria cases and deaths. With at least half of the world’s population at risk of contracting malaria, it is critical to continually explore new interventions to prevent and treat the disease.

 So far, insecticidal-treated nets have proven to be the most effective way of preventing malaria and reducing death rates in Nigeria. However, their distribution to the last mile is often a challenge. To overcome this challenge, several organizations have turned to technology and digital tools to enhance the efficiency of malaria intervention programs. Here are five innovative tools that have been predominantly used:

LoMIS

Lomis is an offline logistic management tool custom-built by eHealth Africa for the Seasonal Malaria Campaign (SMC)  in Borno, Nigeria. The platform was used to support the distribution of malaria commodities, including insecticidal treated nets (ITNs), malaria diagnostic kits, and antimalarial drugs. Through the  platform,  government and development partners were able to track the distribution of malaria commodities from the national level down to the health facility level. The tracking system ensures that malaria commodities are delivered to the right places at the right time, and that stock-outs are minimized. It also ensures  that malaria commodities are not lost or stolen during transportation and that they are stored properly at health facilities. It has improved data management and reporting in the malaria sector in Nigeria.

Planfeld

Plainfield is eHealth Africa’s digital solution- a mobile and web-based application that helps you plan field logistics for public health interventions. It is deployed for malaria campaigns to ensure better planning, tracking of teams, data collection, and coverage with geospatial tools. Micro planning is done based on the geospatial listing of settlements from the Nigeria data portal: mapping information and can be auto-generated to estimate the appropriate number and distribution of teams to effectively implement activities within specified days across selected settlements or locations. The planning is carried out at the local government administrative level for each ward/district to be covered. GIS-enabled mobile devices are deployed to every ward/district where malaria activities are to be implemented. GPS tracks and location data are collected, via passive and active monitoring respectively. These geospatial datasets are analyzed via automated systems to determine which settlements are reached and the proportion of settlement areas that have been covered. With the use of the Planfeld during the seasonal malaria chemoprevention campaign in  2020, coverage of all 27 LGAs in Born was achieved, reaching over 2 million children.

CommCare

CommCare is a digital platform that has been used to support the distribution of insecticidal-treated nets (ITNs) to hard-to-reach areas. Through the platform, community health workers (CHWs) can register households and distribute ITNs, recording data on the location, number of nets distributed, and the size of the household. This information is then sent to a centralized server, where it can be monitored and evaluated for effectiveness. CommCare has also been utilized to support the treatment of malaria. CHWs can use the platform to diagnose and treat malaria in the community, recording data on the diagnosis, treatment, and follow-up visits. In addition to ITN distribution, CommCare has also been used to support behavior change communication (BCC) campaigns to educate communities on the prevention of malaria, delivering educational messages to individuals and communities, providing them with the information they need to protect themselves from the disease. Commcare has been used in 130 countries for several interventions including malaria.

Reveal

Reveal is a global good and an open-source platform that uses spatial intelligence to drive the delivery of life-saving interventions. Reveal has played a critical role in improving the efficiency and effectiveness of malaria interventions, particularly in the areas of data collection, analysis, and reporting. It has been used to collect data on the distribution of insecticidal treated nets (ITNs), malaria diagnosis and treatment, and other malaria interventions. Community health workers (CHWs)  use the platform to record data on the number of ITNs distributed, the number of people tested and treated for malaria, and other key indicators. It also generates automated reports on the status of malaria interventions, including ITN distribution, malaria diagnosis and treatment, and other key indicators. The platform can also generate alerts and notifications, highlighting areas where interventions may be falling short. It has also been integrated with national health information systems, allowing for data to be shared across different levels of the health system. This integration enables program managers and policymakers to monitor the effectiveness of malaria interventions at a national level.

RedRose

RedRose is a mobile-based platform that provides real-time monitoring and evaluation of malaria programs, allowing for tracking progress and identifying areas for improvement. It enables health workers to collect data in real-time using mobile devices including information on the number of ITNs distributed, the number of malaria cases diagnosed and treated, and the number of pregnant women who received intermittent preventive treatment for malaria. This real-time data collection helps to quickly identify challenges and respond to them before they escalate. Its digital mapping capabilities allow for the identification of areas with high malaria burden and prioritizes interventions accordingly. The platform can also be used to map the distribution of ITNs, ensuring that they reach the last mile. It includes an SMS reminder feature, which sends reminders to health workers and patients on important tasks and appointments. This feature helps to ensure that patients receive timely care and that health workers stay on top of their tasks. 

The use of digital tools for malaria control in Nigeria may face several challenges, including technical and implementation challenges, as well as limitations in reach. Addressing these challenges will be essential for the successful integration of digital tools into malaria control efforts. However, the use of digital tools for malaria control in Nigeria has great potential to improve the diagnosis, treatment, and prevention of malaria. Other areas needing a closer look may be to identify and address the challenges and limitations of digital tools and to maximize their potential for malaria control in Nigeria.

Help Desk – Optimizing Real-time Response Structure for Digital tools

Posted on by Moshood Isah

By Emmanuel Uko

In 2022, eHealth Africa conducted a gap analysis to identify support areas for the Electronic Management of Immunization Data (EMID) system IT infrastructure. The analysis  revealed the weaknesses and strengths of the current issue resolution approaches and the requirements for improving the current system. The help desk operations was identified  to ensure the smooth utilization of the EMID system and increased vaccination coverage data in Nigeria.

Physical and infrastructural constraints were identified: the help desk occupied an open space that was easily accessible, the server room was unrestricted and thus used for other purposes, too. Basic work tools for call agents, like  headsets, and  laptops were either not available or obsolete.

Helpdesk setup at NHPCDA, before and after the optimization.
Photo Credit: eHA

Similarly, operational challenges also existed: downtimes, issues and resolutions were communicated to the leads only through Whatsapp. In addition, a web-based system where users could access resources and information to resolve issues was lacking. More so, information history showing trend of cases and projections was non-existent. There was no existing standard operating procedure for the help desk to guide the team on how to handle issues, especially during off-peak hours. Finally, the support process flow was not fully defined/documented. Thus, the optimization of the help desk support was needed.

“I learnt how to use the native EMID application, as it is more user-friendly than the old one. Specifically, the ability to contact help desk and lodge complaints almost in realtime, whenever issues need to be resolved, is a real advantage that will speed up our work.”
– Ojetade Victoria Oyebimpe, EMID Focal Person, Ede South LGA, Osun State.

eHealth Africa (eHA) software development and help desk teams worked to develop a real-time response structure that caters to users’ needs within the optimized EMID application. As is the universal practice, the structure provides a centralized help to users of the application. The improved EMID help desk at the National Primary Health Care Development Agency (NPHCDA) ensures availability of personnel at every level of troubleshooting, to resolve issues down to zero for both the NPHCDA staff and end users of the EMID app.

Solomon Emmanuel, eHA’s Manager, Helpdesk, anchors training for NPHCDA helpdesk agents.
Photo Credit: eHA

With support from the Global Alliance for Vaccines and Immunization (GAVI), eHealth Africa procured the required IT equipment and facilities for renewable energy to ensure uninterrupted power supply to the IT server rooms, secured furniture and fittings; planned and implemented the setup in collaboration with the NPHCDA. In addition, eHA organized training sessions for the ICT unit at the agency on standard help desk processes and procedures based on the Information Technology Infrastructure Library (ITIL) methodology. They defined, developed and documented standard operating procedures for help desk, operational-level and service-level agreements to guide process flow, from issues escalated by recorders to their resolution stage.

“The native EMID app now helps us determine who, how and where to send complaints to, unlike the old one.”
– Akinyemi Yemi, EMID Focal Person

Jamil Galadanchi, eHA’S Senior Manager, Software Engineering, during a training for NPHCDA, on use of the EMID software.
Photo Credit: eHA

eHA also provided suitable work areas to prevent noise penetration and work tools such as desktops and laptops, display screens with a display/monitor to enable the helpdesk operator to manage multiple screens. This allows for a quick review of the several platforms that may be needed to resolve an issue, or for real time monitoring of the key equipment needed to ensure the EMID system works adequately with limited downtime. eHA also set up the Zendesk application to issue ticket IDs and track issue resolution, an access control system for the help desk main entrance, IT office door leading to the server room, and the server room itself to prevent unnecessary access. Lastly, a solar energy system was also set up at the NPHCDA to power the facilities and ensure a 24-hour electricity supply.

“In addition to its capacity to validate clients’ records in real time, it is now easy to ask questions and access the help desk for support.”
– Egunsola Ayobami Abiodun, EMID Focal Person, Isale-Agbara PHC, Osogbo, Osun State

As a result of the optimization, the help desk can respond to different levels of issues raised. The diagrams below portray mapped help desk support flows according to Tiers 1, 2 and 3 support required. They depict the help desk process flow, from the EMID users, the channels for registering queries, the different levels of helpdesk support system, and the process of resolving issues, the operational phases of response to queries from the end users and the processes involved in using the Interactive Voice Response flow in reporting and resolving EMID issues.

Helpdesk support for pilot training and user assessment test
Image: eHA
Helpdesk support for pilot training and user assessment test
Image: eHA

In addition, below is the Interactive Voice Response (IVR) support flow:

Interactive voice response support flow
Image: eHA

The process of developing the EMID application got all stakeholders working together, each one fulfilling relevant roles for the optimization of the application and realization of the help desk setup. eHA and partners learned important lessons in the course of executing the project. Buy-in and collaboration by relevant stakeholders from the beginning of the project proved necessary for its successful implementation. Setting out deliberate strategies that enable all partners to be carried along especially during important planning and decision making processes, budgeting and procurement, contributed to attaining success. More so, aligning the scope of work with appropriate timelines helped partners to manage the project for successful delivery.

“The new desktop for helpdesk now helps in resolving issues quicker, the monitors and screens help to give a clearer view of the issues presented and there is now a better working environment that enables us to resolve issues more promptly.”
– Nabil Nuhu Bamalli, System Administrator at NPHCDA.

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