By Les de Wit and Emerald Awa-Agwu
In 2018, there were approximately 258 million cases of Malaria worldwide and 93% of these cases occurred in Africa. Pregnant women and children have been the focus of most Malaria eradication projects and this has led to a remarkable decrease in the prevalence and incidence of the disease in this population1. However, among young people and non-pregnant adults, the number of new cases is on the rise.1 and very little is known about the attitudes and health-seeking behavior of this group around Malaria.2
Patients at Nuhu Bamalli Maternity Hospital
To answer the questions about the knowledge, attitude and behavior patterns of young people and to inform Malaria strategy and program development to eliminate the disease, data was needed.
With our expertise in data collection, eHealth Africa teamed up with Restless Development, a youth-led development organization, whose mission is to place young people at the forefront of change and development and CUAMM, an Italian non-governmental organization. This key goal of the project was to support the implementation of the Fighting Malaria Improving Health Project, funded by Comic Relief and GSK.
How did we do this?
eHA developed the digital survey tool, set up mobile devices for data collection and provided data visualization and analysis, as well as related training. The survey was created using an open-source tool often utilized in low resource settings, Open Data Kit (ODK).
Following the creation of the electronic survey, tablets were installed with an ODK app and configured to download the survey form. Data was collected from 5,000 individuals between the ages of 15 - 24 in three chiefdoms within the Port Loko district of Sierra Leone. Chiefdoms are the third and lowest administrative levels of governance in Sierra Leone. eHA trained a team of young people to conduct the survey and send reports electronically. Data collection could take place in the absence of an internet connection because of ODK’s ability to store data offline and then, synchronize to the server periodically when an internet connection became available.
eHA has developed an ODK companion tool, Gather, which allows for secure turnkey integration with various data sharing solutions. Using Gather, the collected data was able to be viewed online in an open-source visualization service, Kibana. The Gather and Kibana connection allowed representation of data in near real-time - as soon as the survey responses were synced from the mobile tablets the survey results would appear live in Kibana which had been configured with a number of data monitoring dashboards to provide aggregated views of response data.
At the conclusion of the two data collection periods, the results were automatically compared within Kibana and workshops were held in Lunsar in conjunction with all stakeholders to review and discuss survey findings.
A refresher training on ODK for researchers in Lunsar, Sierra Leone
Overall, the insights gained from these projects supported learning around how action research can help young people to take a leadership role in identifying the underlying causes of public health issues in communities.
eHealth Africa in the Fight against Malaria
Malaria is a public health issue that eHealth Africa is extremely passionate about. We have collaborated with several partners to identify challenges within the continuum of care and to provide the decision-makers and program planners with solutions that are appropriate for their contexts and with data that paints a true picture of the situation so that they can make informed decisions.
A data collector in Kaduna State, Nigeria
Recently, we supported Malaria Consortium to map nine hard-to-reach local government areas of Kaduna State and eleven hard-to-reach local government areas of Kano State. We leveraged our expertise in Geographic Information Systems to collect geospatial data relating to settlement names and locations, and the nearest functional primary and secondary health facilities to the settlements over a period of two weeks.
Also, last year, eHealth Africa partnered with Case Western Reserve University, Hemex Health and the University of Nebraska Medical Center (UNMC) to design the Sickle and Malaria Accurate Remote Testing (SMART), an integrated point of care platform that diagnoses, tracks and monitors sickle cell disease and malaria in low-resource settings. The solution won the Vodafone Wireless Initiative Project Prize.
eHA also worked with THINKMD and the Kano State Primary Health Care Management Board (KSPHCMB) to implement a 2-month study among community health workers (CHWs) in five LGAs to determine if the MEDSINC, a digital clinical assessment platform could improve adherence to the Integrated Management of Childhood Illnesses (IMCI) clinical guidelines.
As always, our goal is to support our partners with technological solutions that can improve health delivery and increase access to quality health services for underserved populations.