Blog — eHealth Africa - Building stronger health systems in Africa

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!

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.

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

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 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

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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:

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

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.