eHealth Africa Transforms Disease Surveillance and Response in Sierra Leone

Electronic Integrated Disease Surveillance and Response (eIDSR)

By Daniel Ojabo & Hawa Kombian

Sierra Leone’s Ministry of Health and Sanitation (MoHS) is collaborating with eHealth Africa (eHA), the Center for Disease Control and Prevention (CDC), World Health Organization (WHO), and additional partners to strengthen surveillance for all priority reportable diseases and improve preparedness for potential public health emergencies.

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 developed a mobile electronic Integrated Disease Surveillance and Response (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.

Sierra Leone’s disease surveillance and reporting has improved drastically as a result of this new process. According to a recent CDC article, weekly disease reporting improved from occurring in 35% of health facilities, to occurring in 96% of all Sierra Leonean health facilities. This new disease reporting system has also cut the number of data entry errors in half, and verifies data 60% faster than the previous paper-based reporting system.

At the recent eIDSR National Rollout Review event in the Port Loko district (a district in the Northern Province of Sierra Leone), health facility workers and representatives from eHA, CDC, and WHO convened to assess the extent to which the rollout objectives had been achieved thus far. While speaking at the event, eHA’s Executive Director Evelyn Castle expressed her delight and emphasized that the system would be closely linked to Sierra Leone’s Front Line Field Epidemiology Training Program (FETP).

“We have been working with the Ministry of Health and WHO for the last few months on implementing a new electronic way to submit disease surveillance information. Instead of only submitting information from the district level, we are looking at collecting information from the health facility level ”

— Evelyn Castle, Executive Director and Co-Founder of eHealth Africa.

Collecting data at the health facility level would ensure that community-level health issues are captured. It also increases the accuracy of population wide health information. Thus, this approach better supports the district's’ ability to understand the needs of the multiple communities located within their district. When the information is ultimately provided to the national level, this allows for a more accurate, detailed, and timely assessment of disease prevalence nationwide. This information can then be used to make near real-time decisions about any potential disease outbreak.

Healthcare workers can now use the eIDSR app to submit weekly case reports of the standard 44 WHO priority diseases, conditions, and public health threats - including cases of diseases such as malaria and cholera. The eIDSR app is operational at all District Health Management Teams (DHMTs) across the country. It is currently being piloted in six (6) community health facilities within the Port Loko district to ensure that granular area level data is as accurate as possible before being consolidated at the DHMT level, through to the national level.

For the pilot, data was entered into mobile devices (i.e. tablets and smartphones) at the community health facility and sent to the DHMT before final transmission to the national level at the MoHS. This data is stored within DHIS2 (District Health Information System 2), a web-based open-source information system. DHIS2 is housed in the MoHS server and is managed by the MoHS Directorate of Policy, Planning Information. The DHIS2 is a tool for collection, validation, analysis, and presentation of aggregate statistical data, tailored to integrate health information management activities. The DHIS2 analytics and reporting functions utilize a dashboard interface to develop graphic and comprehensive insights into the state of public health across 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 here.

GIS Open Source versioning tool for a multi-user Distributed Environment (part 2)

This article is the 2nd part of GIS Open Source versioning tool for a multi-user Distributed Environment and originally appeared on GOGEOMATICS Canada. 

An Interview with Dami Sonoiki, GIS Department Manager and Samuel Aiyeoribe, Lead GIS Architect at eHealth Africa in Kano Nigeria.

1- What projects and workflow in eHealth Africa is this FOSS4G tool being used for within your GIS Team?

One of our largest data management platforms is the Geospatial Database dedicated for our National Polio program support. The data is used to support Polio Vaccination Campaigns in Northern Nigeria to ensure maximum vaccination coverage during every round of campaign.

Thus, the database must be kept up to date with the latest available geospatial data. This always requires having multiple staff processing geospatial data from multiple locations. Hence this is a good use case for the plugin. The plugin is also currently being used to manage geospatial data among multiple countries where eHA operates. This has helped simplify workflow, improved efficiency and increased data integrity.

Furthermore, we use the QGIS Versioning plugin to manage our Health Facility Database.

2- What did you see as the next development of such QGIS versioning plugin?

It will be great to develop and enable spatial filtering when using the PostGIS checkout. This is currently possible with SpatiaLite checkout, but it will be great if this can be the next phase for PostGIS checkout.

In addition to the above, the possibility to implement a PostGIS checkout (offline form the source DB) to another PostgreSQL/PostGIS instance will be a good plugin upgrade.

To learn more, click here for full article.

Coding for Good: Finding Tech Jobs in the Social Sector

eHealth Africa (eHA) hosted 'Coding for Good – Finding Tech Jobs in the Social Sector' to bring together the non-profit, development aid, and social enterprise sectors with tech professionals searching for jobs. The event was held at the Co.up, a co-working space in Kreuzberg, Berlin.

Although finding employees with technical expertise is often a priority for social organizations, and finding a socially responsible career is important to many tech professionals, these groups often struggle to reach one another. Amongst the panelists were:

• Naomi Ryland, Co-founder of The Changer
• Julius Murke, Sector Initiative Social Protection, German Society for International Cooperation (GIZ)
• Matthias Hellmund, Head of Product and Technology at ShareTheMeal
• Adam Butler, Technical Team Lead at eHealth Africa (eHA)

Key learning points for attendees covered the topics of: finding job positions, compensation for work in the social sector and the intersection of tech and health NGOs. Panelists highlighted how channels that social organizations, especially non-profits, typically use to recruit differ from the ways tech professionals normally navigate the job market. Many nonprofit organizations lack the resources to hire recruiting agencies or head-hunters, so they rely on community job boards (job websites that do not charge a fee for posts) and the personal networks of their employees.

Remuneration in the social sector was also discussed by the panelists. A common misconception among attendees was that working in the social sector could mean a pay-cut. However, the expert panel shared information on the many nonprofits and for-profit social businesses which do pay the industry standard in the tech field.

Additionally, not every nonprofit is behind on technology and trends - there are many that are run like successful for-profit businesses by thought leaders who are paving the way for a massive new generation of tech professionals. At eHA, we are committed to using tech to improve and expand availability of health care for underserved populations in Africa.

eHA was pleased to host an event that provided tech professionals with valuable insights into the environment and daily work occurring in the social sector. Additionally, social businesses and NGOs gained first-hand perspective from tech professionals regarding what they are looking for in their careers and how they maneuver through their job search processes. Having provided thought leadership and a great exchange platform to attendees, eHA is looking forward to hosting similar events in the future.

Integrating tech and health, eHA achieves its mission by establishing new standards in the delivery of healthcare to most vulnerable communities in West Africa. Our outstanding technical personnel is an essential part of our success. If you are interested in joining us, please have a look at our job board here. You can also check out our Elastic Stack Volunteer program here or contact our team at berlin@eHealthAfrica.org.

GIS Open Source versioning tool for a multi-user Distributed Environment

This article originally appeared on GOGEOMATICS Canada and was jointly written by Nicolas Gignac, Dami Sonoiki (eHealth Africa) and Samuel Aiyeoribe (eHealth Africa). 

In today’s digital world, organizations are effectively working to publish clean and up-to-date dynamic geospatial data. This data needs to be time-based in order to track changes in multiple versions within short periods. Finding the best tool that adapt seamlessly to one’s own organization’s workflow and capability has been a challenge faced by many organizations.

Managing geospatial data processing within a large team of editors in a distributed work environment can be complex especially with regard to conflicting modifications related to geometries or attributes. When managing a centralized database or an open crowd-sourcing environments, editors may like to track changes and edit data while disconnected from the centralized master database, using source code versioning like tools.

A number of tools already exist in the market to tackle versioning, for instance ArcGIS versioning database in the ESRI world. Unfortunately, this option requires buying multiple Desktop and Server licenses.

In the OpenStreetMap platform, Overpass queries can reveal modification history. However the tool cannot be used for an in-house database. There is also GeoGig and PGversion as Free and Open Source Software for Geospatial (FOSS4G) tools, but both lack functionality to fulfill the above described purposes. The setup involves using PostGIS as the main repository by having the ability to edit specific geographic sections of a data layer and to work offline without having to write any lines of code from the editor.

To learn more, click here for full article.

'Africa Health' features eHA's Integrated Community Health Pilot (ICHP) in Guinea

A holistic approach to improving community health in Guinea

This article originally appeared on Africa Health and was written by Taylor M. Snyder, MPH, Senior Technical Advisor, eHealth Africa

eHealth Africa (eHA) is driven by the philosophy that focusing on improving the overall basic standard of healthcare, rather than using a disease-based model of healthcare, can lead to population-wide health improvements that achieve value for money.

eHA Guinea’s Integrated Community Health Pilot (ICHP) implemented connected reforms in order to improve community health at scale through sustainable platforms. ICHP was funded by The Paul G. Allen Family Foundation, and its project realisation phase was less than one year. The Guinean Ministry of Health (MOH) was critical to the project’s success, as they were engaged from ICHP’s onset and selected the subprefecture of Timbi Touni as the pilot’s site. Continuously engaging the Timbi Touni community to collaboratively implement evidence-based and locally-adapted solutions was key to achieving health infrastructure and medical supply improvements, connectivity and the digitisation of health data, and healthcare worker (HCW) capacity building.

To learn more, click here for full report.

Health Camps: Enhancing Access To Healthcare in Kano State

By Daniel Ojabo

Some areas of northern Nigeria still do not have consistent access to healthcare. This is mainly due to the lack of health facilities in remote areas, and the inability of local populations to access transportation to functioning primary healthcare centers.

Health Camps (HC), a demand-creation intervention, was birthed to fill this gap by working with government partners to supplement monthly polio vaccination campaigns (Immunization Plus Days) with essential medicines. It also serves as a means to address persistent cases of refusal of polio vaccines by heads of households.

Funded by the Bill & Melinda Gates Foundation, eHealth Africa (eHA) has supported the Kano State Ministry of Health as an implementing partner. We procure, package and distribute medications across the 44 Local Government Areas (LGA) in the State.

By the end of 2016, eHA had distributed 82,452 HC boxes across over 27,000 settlements in Kano; up from 34,188 HC boxes delivered in 2014. In September 2016, to ensure that the National Guidelines of Malaria testing before treatment were met, Rapid Diagnostics Test (RDT) Kits were introduced to the HC boxes. RDTs permit a rapid, accurate, and accessible detection of malaria parasites, particularly in remote areas with limited access to health facilities. This exercise has promoted a more rational use of increasingly costly drugs, through enabling health workers to distinguish between fevers caused by malaria parasites from those caused by other illnesses.

“Last year, we recorded increased cases of malaria in the state. So, the Kano State government provided some rapid diagnostic test kits for malaria. ”

— Dr. Kabir Ibrahim Getso, Commissioner For Health, Kano State.

Each HC box contains supplies for 100 people. These supplies include RDTs, and medicines to treat malaria, tapeworms, ulcers, diarrhea, scabies, and other diseases. Trained community health workers administer RDTs for malaria and prescribe corresponding medications. In cases where the diagnosis are advanced, the beneficiaries are referred to the nearest health center.

eHA procures and packages over 2,000 HC boxes for every Immunization Plus Day (IPD) campaign. Since 2014, over 5 million people have benefited from HCs; including 2.2 million children under the age of 5. This initiative has also seen 3.6 million cases of malaria diagnosed and treated, which is around 70 percent of total patients serviced since inception.  

“We found out that a lot of people were voluntarily bringing out their children to accept the vaccination, getting an opportunity to also treat minor ailments which the Health Camps were designed to basically address.”

— Dr. Ahmed Suleiman Haladu, State Lead Polio CDC-NSTOP

After more than two years without wild poliovirus in Nigeria, the Government reported in August 2016 that 2 children had been paralyzed by the disease in the northern Borno state. The cases highlighted the need to prioritize immunization of children particularly, in hard-to-reach areas in northern Nigeria. In the last quarter (Oct. Dec.) of 2016 alone, over 480 thousand children were Immunized with Oral Polio Vaccines (OPV) at HCs. The significant progress and achievements in the past couple of years, have been due to the high level of political commitment and leadership. Traditional community leaders have also provided credibility to the project by openly promoting and encouraging community members to attend HCs.

“We are making all efforts to ensure that the government reaches everywhere for people to understand the mission behind this program.”

— Alhaji Ja’afaru Ahmed Gwarzo, Sarkin Tsafta, Kano Emirate Council.