#DigitALL: 4 Compelling Reasons to Bridge the Digital Gender Gap in Health

By Judith Owoicho

The theme for international women’s day 2023 has a clear and loud message for all. It says DigitALL: it is a call for inclusion, a call for a world where innovation and technology can be used by more women and for the needs of more women and girls.

Technology has certainly improved the quality of lives and opened doors to opportunities for many around the world. In healthcare, the rapid transformation of healthcare delivery has offered a range of solutions to improve access to healthcare, reduce costs, and improve health outcomes, but not without ushering in a fresh stream of inequality, especially across gender lines. 

Despite the potential and adoption of digital health technologies, it is often limited by gender-based disparities in access, use, and benefits. The effects of this inequality are far-reaching, but primarily it has led to a limited understanding of the healthcare needs of women and other marginalized groups. Achieving gender equity in digital health practice has never been this urgent. Here are 4 reasons we must achieve gender equity in digital health.

1. Innovations tailored to the needs of women

It is not uncommon to see digital health tools and innovations developed with no single woman in the room. This can often leave gaps either out of ignorance or just simply failing to see the priority. Research reveals that most digital tools were typically designed for the universal user: a middle-class male. This shows itself in devices that do not fit well on female bodies or that targeted options like menstrual tracking options not initially included in the smartwatch design.

Women have unique health needs and often experience a range of health issues that are specific to their gender, including menstrual health, reproductive health, and menopause. With more women in these rooms, we can ensure that the needs of women are taken into consideration.

2. Economic growth and productivity

Building digital skills in women and girls can create a path to the labor market through internships, apprenticeships, and job placement programs. The eHA academy has added the all-female cohort to their software development and network engineering training academy so that more young women at the early stages of their career can adopt software development/ design skills. The academy sends them off to internships after the training, creating pathways to economic prosperity.  Ensuring that women and girls have equal access to and use of digital technologies — mobile phones, computers, and the internet — is central to their economic and social empowerment and inclusive economic recovery.

3. Reduced disparities in access to healthcare for women

Gender bias is a pervasive problem in healthcare, including in the digital health sector. Without addressing this bias, we risk further driving existing disparities in healthcare access and outcomes. Studies have shown that women use more online health and medical information than men. This could suggest If more women have digital skills, it could reduce disparities in access to healthcare for women. Acquiring digital skills will enable them to access information and resources related to healthcare through the internet and they can be better informed and able to take more control of their own health and make informed decisions.

4. Increasing workforce diversity

 Achieving gender equity in digital health practice can promote fairness and equal opportunities in the workplace. This will also help increase diversity in the workforce. Promoting the participation of women in digital health will introduce new perspectives and ideas to the field, ultimately leading to better outcomes for patients. By improving health outcomes and increasing workforce diversity, we can create a more productive and inclusive healthcare sector.

We realize that many factors, including social norms, poverty, access to electricity, illiteracy, and even more, are at the intersection of this unevenness in digital skills distribution. But as we move farther into the digital future, we must all collaborate and start from where we are to leave no woman or girl behind. 

On this International Women's Day, we call on collaboration from the government, private sector, and civil society organizations to DigitALL. Let's move from imagining a gender-equal world free of bias, stereotypes, and discrimination to living in it.

Strengthening Blood Management Systems with Digital Tools

By Emmanuel Uko

Every month, eHealth Africa (eHA) convenes stakeholders and subject-matter experts on a fresh episode of the Insights Webinar for topical discussions, solutions and recommendations that improve public health and contribute to the attainment of SDG goal 3: good health and wellbeing for all. The aim is to share lessons learned across different areas of project implementation and to offer recommendations.

The 8th edition of the Insights webinar was focused on how digital tools can strengthen blood management systems. Alluding to the topic, one of the panelists, Dr. Mohammed Farouk (MD, MBA), Managing Director of the Africa Society for Blood Transfusion (AfSBT), said “Incorporation of technology and data-driven solutions makes the blood management value chain more seamless. Recruitment of donors is done with online questionnaires, after which the donor institution determines eligibility of the donor, then invites them to the donation center.” This process saves time and resources as donors are only invited on appointment, based on schedule.

Still on eligibility, Michelle Vermeulen, Head of Marketing & Public Relations at Western Cape Blood Services in South Africa outlines the criteria: “In order to be an eligible donor, criteria differ from country to country. However, generally, one must be between the ages of 16 and 75, weigh more than 50 kg, be healthy on the day of donation, without flu or symptoms of cold, and be leading a healthy sexual lifestyle.”

In addition, Emmanuel Nene Dei, Head of Planning, Monitoring and Evaluation at the National Blood Service, Ghana, further stated that “An eligibility quiz for prospective donors helps to shorten the recruitment process. Those not eligible are, with their consent, linked up with other healthcare facilities for quality healthcare, as necessary.” Francis Ayo, Technical Project Manager in the Informatics Department at eHealth Africa, added that “Integration of data-driven technology creates visibility, accountability and transparency, leading to appropriate decisions about quantity and types of blood products required at specific health facilities, while third-party logistics systems carry out the distribution and ensure supplies where needed.”

The webinar had 160 online participants from Canada, Ethiopia, Germany, Ghana, Guinea, Nigeria, Rwanda and Sierra Leone; and eHA’s live LinkedIn audience (eHealth Africa), had 1,441 viewers at the time of the webinar. eHA’s Strategic Engagement Lead / Senior Manager, in Berlin, Germany, Johanna Roegele, who has worked on the management of the blood supply chain observed that eHA and partners have modelled a system to ensure continual availability of blood products. She recommended that such models be replicated especially in other African countries.

From their vast experience, the panelists shared other lessons for effective blood supply chain management: donors prefer to be contacted with personalized messages (SMS, Whatsapp and emails) rather than general messages sent to everyone. Personalized messages enhance the likelihood of recurrent donations, especially for first-time donors. More so, social media and traditional media help create visibility for institutions and to attract donors. Digital interoperability between digital blood management information systems and testing machines reduces human error, speeds up testing time, increases accuracy, eliminates waste and averts silo functioning. In addition, drone-based delivery to hard-to-reach areas, saves more lives especially in emergencies.

Human-centered project design approach should be applied, taking into consideration inputs and needs of stakeholders and potential beneficiaries. In the data management process, privacy of clients is paramount while keeping appropriate databases updated for tracking and monitoring of trends in blood services.

eHA’s monthly Insights webinar is an opportunity to learn more about how experts are resolving public health issues with the use of digital technology and data-driven solutions, sharing both the solutions and the lessons in creating them for replication.

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

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.

Working as a Recorder is Easier with the Optimized EMID Application

By Farid Suleiman

Opening interface of the EMID Mobile Application

The Electronic Management of Immunization Data (EMID) is Nigeria's homegrown digital platform for the collection, storing, and analysis of covid-19 immunization data. It is domiciled at the National Primary Health Care Development Agency (NPHCDA).

The first version of the app was rolled out by the Nigerian Minister of Health in 2021, as a platform to ensure a smooth COVID-19 vaccination process across the country.

With the rise in the number of unvaccinated adults and unimmunized children in Nigeria, NPHCDA saw the need to scale up the EMID application beyond its regular use for COVID-19 vaccination data to capture and store information on other immunization activities. However, the capacity of the application was below its intended use, with multiple functionality errors, hence the need for an optimized version of the app.

eHealth Africa (eHA), partnered with NPHCDA, to optimize the app for newly defined and broadened functions. They further piloted its use in selected states towards its deployment for use. 
The mobile application provides a gateway for inputting immunization data. This enables the end-user-recorders to work hand in hand with vaccinators across the country to upload data in real-time to the platform. This data enables stakeholders to analyze and monitor the progress of vaccination teams on the field, and where necessary, come up with better strategies to enhance the effectiveness of the immunization program.

Tasiu shehu Jigawa State EMID focal person

Photo Credit: eHA

Abdullahi Muhammad, like other recorders, was quick to spot the changes the new app had come with. He observed: “a lot of features have been simplified on the new EMID application. The data input process and its submission to the server have all been simplified, this will make the work easier.”

Globally, digital tools such as EMID help keep track of information about people vaccinated, types of vaccines they received, doses, location, and other relevant data key to the success of vaccination campaigns. As of January 2023, three years after the commencement of covid-19 vaccination, over 60 million eligible Nigerians have received the vaccine. It is safe to say that Nigeria's immunization strategy, of which EMID is a part, has been successful. The optimization of the EMID app adds value to the overall success, especially on the EMID application’s ease of use, optimized process flow, help desk setup, and renewable power supply.

The optimized EMID application has integrated a client validation tool used to take pictures of the client to validate their presence at the vaccination site. Other validation features such as the geofencing feature ensure that data is only collected by fixed teams when they are within the geographical location assigned for their data entry to be registered on the app, eliminating the possibility of procuring services and the new liveness detection feature which ensures that beyond the still photos of clients, facial feature movements such as blinking are required for verification of client vaccination. This eliminates the possibility of utilizing pictures/static images for data entry. The national team can now have a higher level of confidence in the vaccination data generated using the tool.

The new application also allows recorders to capture data in environments where network connectivity is at its lowest. The specific additional feature is a draft page that prevents the loss of incomplete data. Recorders no longer need to resort to manual synchronization of data when there is internet connectivity as the new application allows automatic data synchronization once internet connectivity is restored. The sort and filter functionality has also been included to allow for ease in identifying previous records via the new native EMID mobile application. Rilwanu Dahiru, another EMID Recorder, describes the use of QR codes for client search as making their work even easier. He says, “if I have the QR code of a client, I search directly for the record without inputting the vaccination number or name.”

Overall, the level of flexibility on the optimized app now allows vaccinators to record and validate client details themselves without having a different validator assigned to them while on duty.

The troubleshooting feature-the FAQs and Help center provides easy access to support questions or challenges that arise while using the application. The help center also has links to the various channels that allow for direct communication with the EMID helpdesk support office.

Optimizing the National Electronic Management of Immunization (EMID) Data Tool for Improved Efficiency

By Emmanuel Uko

The Electronic Management of Immunization Data (EMID) system was designed to facilitate the overall management of immunization data and other programs at Primary Healthcare Centers (PHCs) including vaccination scheduling, real-time entry of clients’ data, and collation, analysis, and validation of such data.

The health sector depends heavily on data for planning. To ascertain how well a country’s immunization plans and implementation are going, adequate information is necessary. The World Health Organization states that immunization data helps to monitor improvements in vaccination trends and identify gaps for its surveillance processes. More so, there is a consensus among vaccination stakeholders that real-time data reporting has allowed decision-makers to follow-up on the unvaccinated and forecast needs for supplies.

Coordinator, Business Application Support at eHA, Diligence Saviour-Albert (left) is confident that users of the native EMID app will use it optimally as she trains them on its different components.
Photo credit: eHA

Since March 2022, eHealth Africa (eHA), has supported the National Primary Healthcare Development Agency (NPHCDA) in Nigeria to optimize the functionality of the Electronic Management of Immunization Data (EMID) System. This optimization is funded by Global Alliance for Vaccines and Immunization (GAVI). They identified the need to fill up the vaccination data gap, after seeing  lapses in the primary data capture tool - the EMID application. Users of the unoptimized app expected more than it was offering. Dr Oyetunde Olasunboye, the Osun State EMID Focal Person said, “the functionality of the system declined noticeably and would sometimes become difficult to input client’s information, search for, or confirm clients’ details. More so, it became increasingly difficult to scan a client’s quick response (QR) code, although this was mostly dependent on the device at the user’s disposal.” These errors adversely affected the application’s functionality.

These inadequacies gave rise to the need for optimization of the EMID application to enable it function at its best for end users at health facilities. “We developed a roadmap for an optimized application that would be scalable country-wide. We built and deployed the optimized application, we conducted training and capacity-building activities for NPHCDA EMID team at national and state levels, and recorders at the PHCs, in preparation to hand over the optimized system to the agency”. Said Stephanie Okpere, eHA’s EMID Project Manager.

Similarly, Kasim Sani, a Network support staff at NPHCDA ICT Unit, said this about the optimized helpdesk: “The new setup has made our work more responsive to clients’ needs. We are able to detect and resolve issues more promptly and applications can now be deployed on the server seamlessly.”

In preparation for the deployment of the optimized app, eHA trained 351 users including recorders, EMID focal persons at State and Local Government levels, and piloted its use across selected states within the six geopolitical zones of Nigeria. From each of the states, eHA selected one rural Local Govermment Area (LGA), one urban LGA and one LGA with poor internet connectivity.

Health Information Recorder, Ife South LGA in Osun State, Tope Oluwatoyin (right), displays a native (optimized) EMID application from his tablet, hopeful that the application would resolve challenges he used to encounter with the old EMID app. 
Photo Credit: eHA

In collaboration with the ICT Unit at NPHCDA, eHA also trained users on help desk use and structure for issue resolution, support process flow, roles and responsibilities of the support tiers, and the use of support channels like email, Whatsapp and phone lines.  Specifically, the training focused on how to download and log into the application, how to conduct online and offline mode check, searching, filtering and updating of records, manual syncing, import and export of records. Participants were also shown how to navigate to the help section and the frequently asked questions (FAQs) on the native application. The optimized application ensures seamless management of vaccination data at national and subnational levels.

In Nigeria, eHealth Africa Optimizes Systems for Seamless Vaccination Data Collection and Retrieval

By Emmanuel Uko

Building and optimizing software applications to improve public health outcomes is at the core of  eHealth Africa’s work. With the Electronic Management of Immunization Data (EMID) application, the organization went beyond optimizing the app to redesigning a new process flow for vaccination data capture. The redesign of an optimized process flow was necessary as research shows that inadequate health data is a challenge in Nigeria due to unintentional duplication, lack of synchronization and dearth of data storage systems.

The quality of data collection tools and the uncoordinated nature of the collection process compounded the data challenges, thus the need for a redesigned data collection process flow. eHA’s Technical Project Manager, Software Engineering, Dayo Akinleye said, “The redesigned process flow was necessary because the new process eliminates the possibility of duplicate records for offline users; utilizes the current quick response (QR) code for easy identification and seamless operation; and eliminates redundant information generated on the Public Registration portal (PubReg). The old process flow used the KoboCollect platform, so it did not have these capabilities. It was also unable to synchronize with the District Health Information Software (DHIS2).”

Former process flow with the old EMID application
Image: eHA

New process flow with the native (optimized) EMID application
Image: eHA

Both process flows allow users to register via the PubReg portal and receive registration ID before visiting the vaccination center to receive the vaccine. At the vaccination site, both processes allow for manual registration of clients into the EMID physical register, and receive a vaccination card with QR code.

eHA’s EMID Project Manager, Stephanie Okpere (right), during a Strategy Group meeting at NPHCDA Headquarters, Abuja.
Photo Credit: eHA

Tope Falodun,  eHA’s Associate Project Manager on the EMID project, affirmed that “the new process departs from the old as it allows for instant validation of clients once registered. Upon successful validation, the optimized EMID system generates a vaccination ID for clients that register at the physical site. For those who register via PubReg, their registration ID is replaced with the vaccination ID, eliminating duplicates, unlike the old system. The new vaccination ID is generated from the QR code for both online and offline clients to avoid duplicate registration. If the registration on the optimized (native) app is unsuccessful, the error message redirects the user to the specific item that needs to be updated or corrected. After correcting the error message the recorder saves the information to complete the registration and validation process.”

EMID Recorder for Isale-Agbara PHC, Egunsola Ayobami (middle), at the pre-deployment training of the native (optimized) EMID application in Osogbo, Osun State
Photo Credit: eHA

End users have found the new process flow more responsive than the old one, and better fit for purpose. As the EMID Recorder at Isale-Agbara Primary Healthcare Centre in Osogbo, Osun State, Egunsola Ayobami, confirmed, “one of the important variations from the old system is the ability to validate a client instantly, making the work easier and faster. It is also easier to use. When in doubt, I now know how to contact helpdesk, and their responses are instant,” he concluded.

Deployment of the native EMID application across Nigeria, with its optimized process flow, guarantees seamless data capture, storage and real-time retrieval. 

eHA’s areas of  expertise are data management, project logistics, infrastructure and ICT services, working in the following focus areas: health delivery, public health emergency management, disease surveillance, laboratory and diagnostics, and nutrition and food security.

Health Checks; No More Sick Projects

By Juliana Jacob

Case Study

Mark was proud to be doing well on his project, so it surprised him when a meeting with stakeholders revealed that his team did not meet quality and project standards. Although Mark and his team were a brilliant team, they were not implementing the project as expected. 

Project Manager,  Mark is working on a three-year project in Jigawa State. Through the completion of the various activities highlighted at the beginning of this project, Mark and his team thought the project was on track. They had organized capacity-building workshops for immunization officers in select health facilities, but it was insufficient.

Mark organized a pause and reflect session with his team to analyze the project implementation phases and activities they had conducted. This was to enable them to identify loopholes. It was during the session that they concluded that they should have conducted regular health checks as a part of the project improvement plan. 

After working closely with the Project Quality Assurance (PQA) specialist, they created a robust improvement plan which included quarterly health checks as a key component. The project met quality standards in a short period after they began the implementation of the quality plan.

Just like Mark resolved with his team, Project teams and Project Managers at eHealth Africa employ the health check tool to checkmate projects’ health.

Mohammed Bello.Project Manager at eHealth Africa

What is a project health check?

A project health check is a review of all projects to validate that projects are delivering on defined scope, processes, and agreed objectives. A project health check helps you assess the current state of any project and identify problems that could cause issues during the entire endeavor if left unattended. As a project manager, knowing the health of your team is crucial. Project Health Checks are a valuable means of assessing the likelihood of success  (or the risk of failure) of in-progress projects. They can provide a safety net and early warning system for senior management and for individual project managers by revealing environmental, structural, or intrinsic flaws in projects that, for those absorbed in managing them, are often difficult to recognize.

Our previous health check tool wasn't able to give us all the information \when it was time to access a project as there weren’t many insight categories, with projects scoring 100% but defaulting on key quality areas. So we upgraded to a more improved version of the health check tool that could assess projects based on eight core project parameters with sub-parameters including external parameters and stakeholders’ feedback.

Introducing Health Check V2

This newly introduced eHealth Africa’s health check self-assessment tool caters to the need for a project improvement plan, providing the next steps to improve project quality. Rather than a situation where the Project Support team receives documents from project managers and conducts the assessment, this tool allows project managers and project teams to self-assess their projects.

Project Managers at eHA have widely welcomed the tool because of its improved categories and wider reach.

Mohammed Bello, a Project Manager, explained that he is excited because the tool will improve his work. “I am very excited to have this new tool to help improve my work.” He added that the tool is an upgrade from the previous one, “The new self-assessment tool is an improvement, and I particularly like it because it encompasses everything a project needs to do well.”

For Tahir Buhari, another Project Manager with eHealth Africa, the scoring metrics are what appeal to him. “It is more practical than the previous tool we used. The scoring metrics are a lot clearer and easier to self-assess.”

eHealth Africa’s goal of ensuring that all projects implemented meet standards resulted in an improved version of the Health Check assessment tool. Project Managers use this tool to identify when a project needs improvement and make changes when necessary. We have made this tool as simple as possible to use, while still maintaining quality. At eHealth Africa, we constantly design new tools that will improve our processes. 

Collaboration is at the core of eHA’s culture

By Juliana Jacob

Collaboration across all stakeholders is key to the success of projects. It guarantees that stakeholder inputs can be taken into account early on, risks managed and that project objectives can be agreed upon, which benefits stakeholders and teams. 

We believe that building a culture where employees feel comfortable supporting one another is one of the best ways to maximize effectiveness across different aspects of their work. We have several activities in place where cross-functional teams at eHealth Africa collaborate. With teams working on multiple projects, the need for collaboration is more important than ever.

Here are 3 ways teams collaborate at eHA:

Programs & Impact Meeting
At the program team’s monthly time-out, participants share project highlights, challenges and lessons learnt. Team members celebrate their achievements at this meeting, share experiences, and learn from each other. It is also an excellent opportunity for new team members to learn about what everyone else has been working on throughout the month, and for existing team members to expand on their previous presentations.

In May, the Global Health Facility Database (GHFD) project team shared that the team successfully finalized desk research for all countries to better understand the existing health facility list. Data collection was from open-source platforms hosted by a variety of agencies. From these highlights, other team members have a better understanding of projects' progress.

Quarterly Review Meeting (QRM)

Every quarter, the review meeting is a chance for us to really dig into projects' performance as program managers share more than just project highlights. During this quarterly 3-day meeting, the executive team and other internal stakeholders get more structured updates on all the ongoing projects. Program Managers describe the project goals, resources, management and milestones, budget status, delivery dates, plans, etc. At eHA we aim for overall project success, and we believe structured meetings like this one are an important part of that process.

Program & Impact Retreat

Our annual Program and Impact directorate goal-setting retreat and knowledge-sharing forum provide an opportunity for teams to brainstorm and identify new focus areas and discuss challenges, and lessons learnt from previous projects. The 2022 P & I retreat which was held in February this year ended with a town hall meeting. It was an engaging session. We divided participants into smaller groups to maximize the opportunity.

Employees at the Abuja office

The more we can collaborate, the better we perform. Our team at eHealth Africa is constantly working towards providing quality solutions by working together collaboratively. Not only do we collaborate, but these opportunities also allow us to foster good relationships among our team members. We work together, share information and support each other to improve our performance. As a collective, we will continue to strengthen Health Systems across Africa.

Equipping Laboratories for Stronger health systems

By Emmanuel Uko

The journey of supporting and augmenting laboratories in Africa has only started, and evidently, the gap is huge. At the WHO Polio lab in Maiduguri, Borno State, eHA identified cases of damaged, obsolete and inadequate equipment and swung in to supply the needs with support from the World Health Organization (WHO).

As we walked into the office of Professor Marycelin Baba, the Director of the Laboratory, Professor of Medical Virology and lecturer with the University of Maiduguri, we could tell how busy the facility had become on a daily basis. Samples from patients were brought in  on a queue for processing. “Our work here is becoming satisfying”, Prof told us expressively, “especially with partnership from the World Health Organization (WHO) and eHealth Africa (eHA). They have provided various major equipment that enable the center to remain functional”, she said, her passion unwavering for 32 years in the profession.

The lab in Maiduguri, was set up by  Global Polio Laboratory Network (GPLN), to distinguish poliovirus as a cause of acute flaccid paralysis (AFP) from AFP caused by other diseases. It serves the northern part of Nigeria while the one earlier established in Ibadan, Oyo State, serves the southern part of the country. 

Prof. Marycelin Mandu Baba, Director, WHO Polio Laboratory in Maiduguri, is happy to have participated in the polio eradication process in Nigeria.

Photo Credit: eHA

The WHO Polio Laboratory in Maiduguri, like many other labs in developing countries, often  grapples with acute shortage of equipment, reagents, machines, power supply and human resource, which affect its productivity. Research has shown that the number of optimally functional laboratories accredited to international standards were 380, as of 2014; 91% of these were in South Africa. This means that 12 out of 49 countries in the region had one or more laboratories accredited to international quality standards; 37 had none. However, the Global Polio Laboratory Network consists of 146 WHO-accredited polio laboratories, in 92 countries, across the six WHO regions of the world.

Nigeria has 2 of those 146 WHO-accredited polio laboratories. eHA currently provides support to 7 laboratories: 2 in Nigeria, one each in Uganda, Kenya, Ethiopia, Egypt and the Democratic Republic of Congo. The organization is strategizing to commence support to laboratories in Cameroon, Côte d'Ivoire, Ghana, South Africa, Senegal and Central African Republic. This support will improve laboratory and diagnostic services for Africa’s teeming population. “We continue to carry out needs audits and take steps to offer solutions where we identify gaps,”  said eHealth Africa’s Project Manager, Tolulope Oginni. eHA has supported the lab with digitized biosafety cabinets for tissue culture, a Polymerase Chain Reaction (PCR) Workstation, a PCR thermomixer, multi-channel and single-channel pipettes of varied volumes for serology.

Dr Muhammad Talle of the WHO Polio Laboratory in Maiduguri showcases how the new PCR thermomixer donated by eHA works.

Photo Credit: eHA

Dr. Muhammad Talle remains hopeful that the lab will continue to deliver appropriate services according to approved standards.

Photo Credit: eHA

“eHA has brought us relief”, said the Assistant Director for Lab Technical Operations, Dr Bamidele Oderinde, who came in later to the conversation. “The new machines help to reduce technical problems and the functionality complaints we have. We have upgraded our operations, research capabilities and training standards for our students”.

Professor Baba remains keen on contributing her quota towards the eradication of viral diseases, through differential diagnosis of acute flaccid paralysis. According to her, the newly equipped lab benefits people beyond Borno State and extends to other parts of Nigeria. Supporting this lab and other laboratories is part of eHA’s service areas, to build and operate effective laboratories in-country across the globe, and develop the tools and technology needed for effective dissemination and use of public health-related information.

The Director, Prof. Marycelin Baba (3rd right), with eHA delegates and other staff of the laboratory, during eHA’s visit to the lab.

Photo Credit: eHA

Geolocation Intelligence and Clean Data for Mini-grid Setups

By Favour Oriaku

Sustainable Development Goal 7 is one of 17 Sustainable Development Goals established by the United Nations General Assembly in 2015

Overview:

Energy access is essential for proper healthcare service delivery. Healthcare facilities in Nigeria require electricity for lighting, emergency procedures, and storage of vaccines and drugs. Unfortunately, Nigeria’s grid electricity supply has stalled at around 4GW on average and covers only about 57 percent of the population. According to the World Bank, of the 16,900 public healthcare (PHC) facilities in Nigeria, 81 percent lack a reliable power supply. A recent study conducted in the Federal Capital Territory (FCT) shows that power supply to PHCs is intermittent, with an average of 4 hours or less daily. It is worse for facilities not connected to the grid as they rely solely on expensive fossil fuel generators to provide electricity. These generators contribute to both ambient noise and air pollution and are unsuitable for healthcare environments.

Globally, there is a growing interest in alternative power sources, including mini-grids and off-grid solar, which can be highly effective in helping to achieve Sustainable Development Goal 7 (SDG7) by 2030.

The government of Nigeria, other major corporate industry players, and the private sector have worked for years toward realizing the SDG 7. The aim is not just to achieve it but also because lack of or epileptic power supply in public healthcare centers can be life-threatening. Despite the large strides already made, the mini-grid market is yet to reach a tipping point at which it can expand without support. To achieve this, funding is required, but also, getting the right geolocation solution and clean data for informed decision-making remains a challenge. 

The Challenge:

Despite the great strides and enormous support made by the government and other stakeholders to ensure that renewable energy is an established, cost-effective alternative source of power in Africa, implementation is still lagging. For example, identifying the right site for a mini-grid may not be easy in Africa because not every region is mapped and assigned a geolocation coordinate. Demography data on residents within some remote and/or security-challenged regions are difficult to find.

A report by the African Development Bank on Green Mini-Grids in Sub-Saharan Africa has  identified the lack of up-to-date and reliable data as a  barrier to the growth of mini-grids in Africa. As businesses become more reliant on data, the importance of data quality has increased. Data analytics are used to help drive business decisions, therefore, it is important that data must be accurate, complete, reliable, relevant, and timely for it to be trusted. Getting a data set that meets these criteria requires an innovative approach that includes diligence, dedication, and quality assurance throughout the collection process.

The Solution:

Geospatial intelligence is achieved by visualizing and analyzing geographical data. Organizations can use intelligence tools to identify where an event has taken place, why it is happening, and what caused it by adding layers of geographical information, such as demographics, traffic, and weather data, to smart maps and dashboards. “It’s one of the hottest technologies out there,” said Professor Sunil Bhaskaran, founding director of the Geospatial Center of the CUNY CREST Institute (BGCCCI) at Bronx Community College.

A geospatial platform created by eHealth Africa is The Data Portal. A result of several years of geospatial data collection across Nigeria and some parts of Africa. It contains up-to-date data on points of interest, including schools, settlements, health facilities, and roads, including their population estimates. 

The goal of the data portal is to make existing geospatial data accessible and reusable. This will allow organizations to focus resources on programmatic data rather than base geospatial data for their planning and monitoring across Nigeria. A GIS expert with eHealth Africa, Fashoto Oluwatosin Busayo, spoke on the effectiveness of the data portal, “geospatial intelligence is proving to be a more effective way of allocating energy resources than traditional methods. Using this method, it is possible to identify areas that lack access to energy or are underserved. eHealth Africa has provided training on map production and micro-planning with geospatial data freely available on its data portal to various stakeholders” he said.

eHealth Africa’s recent project on Remote Assessment of Energy Gaps in Selected Health Facilities, used the remote survey method of data collection to get accurate, reliable data from 291 health facilities in Kano and Osun states, and 300 health facilities in Nasarawa State. “We deployed this method because it is reliable in security-challenged environments like Nigeria. It is also less expensive. Trained helpdesk agents conducted the remote surveys at eHealth Africa.” said the project manager Mohammed Bello.

eHealth Africa is committed to the design and implementation of innovative data-driven solutions for public health interventions across Africa.

In Nigeria, eHealth Africa uses GIS Tracking to Prevent Seasonal Malaria

By Mohammed Bello, Victoria Onyilokwu and Zakariyau Aliyu

In March 2012, the World Health Organization (WHO) issued a policy recommendation on Seasonal Malaria Chemoprevention (SMC), a new intervention against plasmodium falciparum malaria. This intervention has proved efficient, cost-effective, safe, and workable for prevention of malaria among children under 5 years of age in highly susceptible areas with intense seasonal malaria transmission.

The malaria parasite is still the leading cause of morbidity and mortality, causing an estimated 228 million cases of clinical malaria and at least 602,000 deaths in Africa, as of 2021 according to WHO. About 80% of these cases and deaths occur in children under five years old.

In Northeast Nigeria, malaria is endemic, with perennial transmission: the marked seasonal peak runs from July to November each year. This coincides with the onset of the rainy season (June through October) which limits humanitarian relief access and exacerbates the shelter, food, and health situation with direct risks related to sanitation, nutrition, and malaria.

SMC is designed to protect children by clearing existing infections and preventing malaria during the season of greatest risk. This is achieved through the monthly administration of antimalarial medicines, usually sulfadoxine-pyrimethamine plus amodiaquine (SP+AQ), for as long as the rainy season lasts. WHO recommends the SMC as a highly effective, community-based intervention among vulnerable populations.

Following the successful implementation of the pilot cycle of the SMC GIS Tracking Support in October 2021, eHealth Africa (eHA) worked with support from WHO in July 2022, for a state-wide administration of SMC. This time, the exercise covered all 21 Local Government Areas (LGAs) of Adamawa State, and 4 selected LGAs of Yobe State. During the campaign, eHA sought to improve the monitoring of the campaign using GIS Tracking of Community Drugs Distributors (CDD). In addition, they worked to improve accountability during commodity distribution and utilization across the campaign locations.

Training of field staff on the use of the MISTA Tool in Yola, Adamawa state.

Photo Credit: eHA

How did we do this?

eHA has in-depth knowledge of the Nigerian terrain, strong partnerships and extensive experience in collaboratively implementing projects across the country including in security-compromised locations. They use this experience in field operations, data management, project logistics, and project management to conduct GIS micro-planning activities, geospatial data analysis and visualization.

To access the hard-to-reach settlements and effectively monitor the campaign and coverage of commodities distributed and utilized, they deployed GIS Tracking throughout the SMC campaign in both states to aid effective and timely monitoring of the movement of over 2,000 teams of Community Drugs Distributors. This enabled real-time information on coverage of households and settlements. The tracking system identified omitted households and provided insight into the areas eligible for mop-up. This also enhanced accountability and transparency during the implementation.

The tracker analyzed and produced daily settlement visitation status and settlement coverage (visited/not visited). In addition, a dashboard was created for both Adamawa and Yobe to monitor drug distribution and utilization during the campaign. 

GIS Tracking proved effective in monitoring SMC campaign activities. It helped to improve accountability during commodity distribution/utilization. eHA remains committed to harnessing technology-driven approaches to eradicate the burden of malaria and other diseases.

CDD Team supervisor, Buhari Bello marks a house after administering SMC in Kofar Arewa Yusufari LGA, Yobe state.

Photo Credit: eHA

eHA Field Officer, Aisha Hussaini (right), retrieving trackers from Ward Focal Persons after SMC field activities in Yola North, Adamawa State.

Photo Credit: eHA

The Program Partners

eHealth Africa: getting ahead of Breast Cancer through awareness

By Favour Oriaku

Kano, Nigeria

Staff who attended the training physically at the eHealth Africa's HQ office in Kano State.

18 years ago, Hauwa Garba, witnessed a family friend go through breast cancer and eventually lost her. She had never heard of cancer. It was a painful experience that stuck with her. It left her terrified.

Over the years, Hauwa has lost others - colleagues and friends to several forms of cancer. “It is never an easy experience to see a loved one dying gradually. Awareness of breast cancer and other cancers is very important. It is consoling to know that early detection can help save lives.” She said.

According to the World Health Organization (WHO), 2.3 million women were diagnosed with breast cancer in 2020. 685,000 deaths were recorded globally, and significant differences in breast cancer mortality rates have been evidenced among countries. As expected, low- and middle-income countries had increasing mortality rates. A study has revealed that a lack of awareness and early detection programs in developing countries is the reason for escalating mortality.

To commemorate Breast Cancer Day, eHealth Africa partnered with EHA Clinics to host a training session for the entire eHA workforce including Hauwa who is a procurement manager at the organization. The training addressed misconceptions about breast cancer, including those Hauwa had held for so long. It also reminded participants of the importance of early detection in fighting the disease. The session was anchored by Dr. Mujidat Babah, who has a verifiable track record of applying medical knowledge to the diagnosis, prevention, and management of diseases in both clinical and public health settings. She gave information on how mammogram works, new discoveries in treating breast cancer, as well as adopting the right lifestyle as a preventive measure for not contracting the disease.

Hauwa Abdulmutalib-Garba, Manager, Procurement and Asset, eHealth Africa

“I used to believe that mammograms were dangerous because of the radiation, but during the training, I learned that the radiation level used for a mammogram is insignificant.”

— Hauwa Abdulmutalib-Garba

Asked what other lessons she'd take away from this session for other women who share similar misconceptions about breast cancer, Hauwa committed to encouraging women to examine their breasts regularly for lumps and squeeze the nipple to see if any liquid comes out. She would also advise them to go for a medical examination if anything felt strange. 

The training brought together all staff of eHA Africa and staff of the eHA clinics in Kano, including their family and friends. Another Participant Aisha Bello, also commented “the training was an eye-opener for me. It was also quite revealing to me to learn that men could also get breast cancer. I always thought it was entirely a women’s issue"

eHealth Africa is intentional about staff health and well-being and continues to prioritize it at all times through insightful trainings and sebinars to optimize their performance and general well-being.

eHealth Africa: Making Mental Health a Priority

By Emmanuel Uko

Discussions about mental health are becoming popular. However, the gap between reliable information and positive action remains to be bridged. One of those who experienced this information gap is Farid Suleiman, an intern at eHealth Africa. He believed that mental health interventions could only take place in psychiatric units. For Farid, this is now changing.

“My perspective has improved. I now know that being overworked  and stressed, and the quality of my social interaction directly correlate to the state of our mental health”, he said.

All staff at eHealth Africa participated in the campaign, either virtually or physically.

For the 2022 World Mental Health Day, eHealth Africa created a forum where Farid and the rest of the eHealth workforce would learn, following the theme: “Make Mental Health and Wellbeing for All a Global Priority”. The learning session was anchored by a mental health expert and public speaker, Chidi Chukwudi-Madu. The session opened with a clarification that there is no physical health without mental health. It explored the relationship between pressure, stress and mental health. The learning forum presented facts, causes and red flags associated with the topic of the day and how they relate to the workplace.

Mental health issues are prevalent amongst young people especially in low income countries. According to WHO, one in four adults experience mental health issues annually and nearly 1 billion people live with a mental health disorder. More so, one out of ten young people experiences a mental health problem; three out of four of these have their onset by the age of twenty, and about 50% of mental health disorders start by the age of fourteen. 11% of 18 – 34-year-olds report having attempted suicide and 16% report self-harm at some stage in their lives. 

It is estimated that by the year 2032, depression will put more burden on countries than any other disease. There is, therefore, a need for more interventions around mental health management, especially in the workplace, which potentially has multiple stressors.

Anchoring the learning event on mental health, Ms Chukwudi-Madu emphasized three key points on prioritizing mental health at work:

Farid Suleiman’s perspective on mental health topics has changed.

1. At the workplace, three out of ten employees develop mild mental health issues annually, for varied reasons. Individuals must therefore, ensure work-life balance, talk with friends, keep active creatively and learn new productivity skills.

2. Red flags to watch out for include social withdrawal, decline in work performance, deteriorating physical appearance, frequent headaches, poor judgments and indecision. Other red flags include unexplained changes in eating and sleeping patterns, self-harming behaviors, emotional numbness, frequent tearfulness and poor memory.

3. Managers should hold regular check-ins with employees, enable people to connect, review workloads, encourage discussions and promote learning at the workplace.

Mohammed Bello, a Project Manager at eHealth described the session as, “An eye-opener and a wake-up call to be deliberate about mental health, especially in the workplace where employees spend most of their time”.

Adama Shallangwa, an Intern with eHealth Africa, added, “This session has opened me up to the responsibility of mutual support towards remaining mentally healthy and productive at work and at home, understanding that it is okay not to be okay.”

Asked what he would do differently after the campaign, Farid expressed, “Now that I know better, I will be deliberate about my state of mind, think positively, rest adequately, avoid stress and most importantly, treat people well and add value to the wellbeing of others.”

eHealth Africa, one of Nigeria’s #BestPlacesToWork, continues to use innovative ways to enable its workforce access relevant information that add value to their personal and professional productivity.

In Tanzania, eHealth Africa hands over state-of-the-art Polio Emergency Operations Center (PEOC) to support the fight against polio

By Juliana Okoro

On Thursday, 13th October 2022, the Ministry of Health Tanzania commissioned the polio emergency operations center (PEOC) set up by eHealth Africa in Dodoma, Tanzania.

With support from Bill and Melinda Gates Foundation (BMGF) and the Global Polio Eradication Initiative (GPEI), the PEOC supports the Ministry to facilitate collaboration and coordination of public health stakeholders within the country in the fight against the Vaccine-Derived Poliovirus 2 (cVDPV2) and vaccine-preventable diseases.

Over the years, Tanzania has made magnificent progress in eradicating polio, but with polio rising in neighboring countries, the need for further efforts to prevent cross-border epidemics has increased. The effect of the covid-19 pandemic has negatively affected the country’s vaccination program, including the coverage for polio vaccines. With the establishment of the Polio emergency operation centers, equipped with modern technology, coordination will be easier. The PEOC will serve as a central location for coordinating operations and providing tools and resources for the strategic management of public health emergencies. 

To ensure sustainability, e-health Africa handed over the center to the Ministry of Health, Tanzania to support their effort in the fight against polio and other vaccine-preventable diseases. The center will provide health data that will give the government information on any threats within their borders and those coming up in their neighboring borders. “The goal of the polio emergency operations center (PEOC) is to ensure you have the resources you need to fight and respond to outbreaks all in one place. Joint efforts of the government and partners will help to improve the quality of any response in Tanzania. It will function at this national level during emergencies and ensure proper response to other outbreaks beyond polio.” said Dr Delayo Zomahoun, GPEI Coordinator for Tanzania.

The growing cases of the Vaccine-Derived Poliovirus 2 (cVDPV2) in many African countries require focused efforts to establish Emergency Operating Centers to improve the coordination and coverage of vaccination efforts to tackle the spread of type 2 circulating vaccine-derived poliovirus (cVDPV2). eHealth Africa’s project manager Sodipe Oluwaseun said “In March, we came to Tanzania to support the setup of the EOC and outbreak response. 7 months later, we facilitated the setup of the polio EOC. We hope this EOC provides the platform to ensure no child is left behind in the fight against polio and other vaccine-preventable diseases. We thank the government of Tanzania for an enabling environment.”

Here are some pictures from the handover event in Dodoma, Tanzania. 

Abel Makubi, representing the Ministry of Health in Tanzania, opens the PEOC in the presence of partners

All stakeholders in the conference room, discussing with virtual participants

Permanent Secretary, Tanzanian Ministry of Health, Abel Makubi, giving a speech at the handover ceremony.

WHO Country Representative for Tanzania, Dr Zabulon Yoti giving a speech at the handover ceremony

eHealth Africa’s project manager, Oluwaseun sodipe presenting the worktools to the permanent secretary.

Presentation of worktools - 5 lenovo laptops and 4 smartphones.

Permanent Secretary, Tanzanian Ministry of Health, Abel Makubi (middle) and other dignitaries after the PEOC handover ceremony

BMGF Focal person for Tanzania, giving a speech at the handover ceremony

eHealth Africa’s project manager, Oluwaseun Sodipe giving his remark at the handover ceremony.

Renewable Energy for Improved Healthcare Delivery in Nigeria

By Juliana Okoro

Access to energy is a prerequisite for quality health care and it is fundamental to the achievement of universal health care coverage and the Sustainable Development Goals. Yet, about one in four health facilities in Sub-Saharan Africa lack access to electricity, and three in four facilities lack reliable power. The lack of sufficient and reliable power is jeopardizing the well-being of hundreds of millions of people, especially women and children, who often bear the brunt of inadequate primary healthcare services. According to Dr Julie Yemi-Jonathan. O, Country Manager, We Care Solar, “without a reliable source of electricity, nighttime deliveries are most of the time, attended in near darkness, cancelled or conducted by flashlight, and the outcomes are often tragic.”

Off-grid renewable energy solutions present a key opportunity to provide clean, reliable and cost-effective electricity to rural health centers, which can dramatically transform the quality of healthcare services provided to rural communities.

Harnessing the enormous potential of renewable energy to improve energy access for primary healthcare facilities requires combined action from the health and energy sectors. To this end, the Nigeria Energy Conference, which took place between 20 - 22 September 2022, brought together key energy and health sector stakeholders, including policy-makers, practitioners, financial institutions, development partners, and NGOs that can play a role in enhancing electricity access for primary healthcare facilities.

During a panel session at the conference, eHealth Africa facilitated a discussion about sustainable energy for improved healthcare delivery in Nigeria. The panelists discussed what needs to be done to ensure that Primary Health Centers (PHCs) have access to energy for better health outcomes. Acknowledging the challenges most PHCs face, the panelists elaborated more on how the lack of electricity in primary health centres has led to more medical emergencies and increased mortality rates.

The panel discussion sparked the much-needed, cross-sector thinking around how to deliver energy to health facilities, especially in resource-constrained environments. A resounding takeaway was that distributed solar power and energy-efficient devices hold great potential for creating stronger and more resilient health systems in Africa and beyond.

We Care Solar's deployment of solar suitcases to Primary healthcare centers has had a tremendous impact on reducing child mortality and maternal mortality rates. According to the company’s representative on the panel, “a lot of our health facilities do not have access to a reliable power supply. We have seen cases where surgeries are turned down because of a lack of power. Sometimes surgical operations are suddenly interrupted, leading to the death of the patient, due to power failure”. This she said, “prompted We Care Solar to develop the Solar Suitcase”. 

Another speaker, Mohammed Bello, a project manager at eHealth Africa, identified solar energy as the reliable solution to these challenges. He highlighted some projects implemented by eHealth Africa with support from partners and stakeholders to ensure health facilities across the country have access to a reliable power supply. According to him, eHealth Africa is working with the Nigerian Energy sector and Integration Consulting firm, which are critical players on issues concerning energy.

The panel speakers and moderator after the session hosted by eHealth Africa at the Nigeria Energy Conference 2022

Key lessons from the panel session hosted by eHealth Africa at the Nigeria Energy Conference 2022:

• There is a dire need to increase renewable energy access in primary health centres, especially those in remote areas.

• The use of solar panels as an alternative source of electricity in primary health centers will help mitigate the energy challenges faced by primary health centers.

• Health facilities should be a top priority in electrification plans for both national governments and development partners. Off-grid renewables offer rapidly deployable, reliable, cost-effective solutions.

• In order to address the energy access needs of healthcare facilities, the energy and health sectors must work together. This should happen at all levels, from strategy and planning to policies, budgeting, procurement and implementation.

• Innovation has to be encouraged and promoted, as in the case of the solar-powered suitcases by We Care Solar. Also, in the design of robust, low maintenance, efficient, user-friendly medical devices suited for remote off-grid areas.

• Energy-efficient medical devices, combined with off-grid renewable energy and telecommunications, can expand the services offered by primary health centres in under-served communities. This also reduces the need for patients to travel to larger, more distant facilities.

• There are funding opportunities from donors as long as the organization involved can provide evidence of work done in this field.

Women at Work - 3 Ways eHA supports women in the workplace

By Favour Oriaku

One of our focuses at eHealth Africa is to increase the number of women in our workforce. While we work on getting more women into eHA, we also focus on retaining the talented women who currently work at the organization. Here are three ways we support women at eHealth Africa. 

Early career programs

As an organization, we are committed to building a more diverse and fair workplace, and we have implemented strategies to increase the number of women in our workforce. We are actively building a pipeline of talent through early career programs to help young women jumpstart their careers. One of these programs is our just concluded all-female paid internship program that lasted for six months. The program exposed young women to an early career within the International NGO space. Juliana Okoro, who was a part of the 2021 all-female internship cohort and now works full time as an associate with the communications team, has this to say

Juliana Okoro

Coming as an intern helped build my confidence and my career path. Before the internship, I didn’t know what to make of my career or which direction to go, but the internship gave me the clarity and experience I needed. My internship exposed me to a lot of opportunities and I am forever grateful to eHA for the opportunity.

Open Door Policy

Past research and society advise women to stand out if they want to get ahead. But taking on visible roles in the workplace may expose women to risk, and we know this. And that is why we have policies in place that promote unconventional forms of leadership, fight implicit bias, and create an equitable working environment where everyone’s ideas are valued and respected. Our Human Resources department maintains an open-door policy that ensures that staff, especially female employees, do not suffer in silence when marginalized or ill-treated, either by their colleagues or bosses. 

We constantly encourage female employees to take on tasks and roles that put them in the spotlight, and this has ultimately reflected on the senior leadership team, as we have just as many women at the decision-making table as we have men. An offshoot of this is that we now have more senior female employees who the younger ones not only look up to but also get mentorship from.

A Work/family balanced life

One initiative we put in place to ensure employee wellbeing, fairness, and gender inclusivity is flexible work (remote) and work/life balance. 

We have constant check-ins between managers and the employees they manage. In these sessions, employees get to discuss issues relating to their overall well-being and how they may affect their productivity at work, and managers help them through it by providing feedback and guidance. We also have a remote working option in certain cases where your job does not require you to be physically present at the office. With this process in place, female employees who’ve completed their paid maternity leave can spend more time bonding with their families while working from home.

At eHealth Africa, we recognize that talent development is crucial to our success as an organization which is why we have invested in programs that continue to up-skill and re-skill employees at all levels. These programs are easily accessible and we constantly encourage employees to take advantage of them so they can stay current and relevant in their fields.  We don’t just pay lip service to gender inclusivity and to building an equitable working environment; we constantly live into those values. 

eHA Academy: The Journey So Far

By Favour Oriaku

If you are someone who’s interested in a tech program that builds the capacity of young people in software development, then you are probably familiar with the name eHA Academy, our brainchild academy that has successfully trained several aspiring tech enthusiasts in software and web development. Here is a walkthrough of our journey so far.

The Birth of eHA Academy in 2016

In 2015, eHealth Africa was one of several organizations working in the three main West African countries that were affected by the Ebola epidemic - Guinea, Sierra Leone, and Liberia. We primarily provided support for the EVD outbreak response by building and customizing software-based solutions for contact tracing and disease surveillance. By the end of 2016, the epidemic was declared over, and as we finalized the response effort in Guinea; we identified a need. Who would maintain and improve the solutions we introduced to Guinea? There were not that many software developers living in Guinea and we decided we needed to build human capacity in-country to maintain or upgrade the digital solutions we introduced in Guinea during the epidemic. This led to the eHealth Africa team designing a program to build the capacity of young people and equip them with the skills needed to do this.  

In-person class session at eHA Academy in Conakry, Guinea

In August 2016, we launched the inaugural eHA Academy in Conakry, Guinea. The software team at eHA designed an eight-week curriculum in software development and network engineering and staffed the course with expert instructors, bringing international software design and development expertise to Guinea. 

The Academy was offered free of charge to all participants who were successfully admitted into the program. By the end of the first cohort, 100% of the participants completed the entire 8-week program, 15 software developers took part in eHealth Academy and three of them were so skilled that we offered them full-time positions with eHealth Africa.

Pioneer graduates, tutors, and management of the eHA Academy in Conakry, Guinea

eHA Academy Re-designed In 2019

After the successful interventions in Guinea, Sierra Leone, and Liberia, we wrapped up operations in those countries. As we focused on our operations in Nigeria and on eradicating the wild poliovirus; we continued to build a larger physical presence in Kano state. Members of a small but growing tech ecosystem often contacted us to provide resources, including space for their meetings, expert speakers, and mentorship. By 2018, we were full members of this community, and our head office was an unofficial meeting space for the monthly tech meetups. Every month we had speakers come and give talks about different topics in tech and people came from neighboring states to attend the meeting in person and several joined online. Again, we noticed a need. 

The need we noticed was the large number of tech enthusiasts seeking additional training for software and web development skills.

Students of the 1st Nigeria cohort of eHA Academy.

In 2019, our management team reintroduced eHA Academy to address this need. We then redesigned a new version of eHA Academy. This time we focused primarily on building the top requested skill-set, web development. In the redesign version, we introduced self-directed learning. Each participant was required to focus on completing coursework on our eLearning platform, prior to in-person workshops and sessions. We also paired each participant with a mentor, and we matched the most successful participants to an internship opportunity.

The Switch to 100% Virtual Learning Sessions

When COVID-19 Pandemic forced the world to shut down, we were 3 weeks into the 2nd Nigeria cohort of eHA Academy. We quickly pivoted to all online learning sessions, mentoring, and even internships and have a few success stories. Watch Jamiu Musa’s success story here.

After successfully completing two eHA Academy cohorts in Nigeria, we took a pause to re-evaluate the number of students we’ve trained so far, and we realized that over 70% of the total number of students trained were male. As an organization, we recognize the importance of having diversity in all sectors, especially in the technology sector. To address this, we hosted an all-female cohort of the Academy. This attracted several female participants across Africa. We recently completed the all-female cohort and here are a few testimonials from some participants.

Juliet Odogwu, eHealth Africa's Executive Director, with mentors and some graduates of the all-female cohort who attended the graduation ceremony in person.

So what is next for eHA Academy? 

The academy’s primary goal is to create a platform for young people to gain first-hand experience and training in technology. We are also working with partners to expand our curriculum to train more people in more aspects of innovative technology, from data science to artificial intelligence to machine learning.

The schedule of the Academy is to implement two cohorts every year, and young people interested in web and software development are welcome to apply. To better prepare yourself and increase your chances of being selected to be part of the next cohort, here is a free course we recommend for you to take.

We invite you to get involved

We are constantly looking to increase the number of participants we take on for every cohort we implement. eHA Academy needs your donation to increase the number of software and web developers in Africa. We have an ongoing donation campaign on the GlobalGiving platform where you can either make a one-time donation or commit to a monthly or yearly donation. We are also accepting donations on academy.ehealthafrica.org as well.

Another way to get involved is by signing up to be a mentor. To find out more about becoming a mentor and to apply, click here.

How eHealth Africa is implementing the Geolocation Health Facilities Database Initiative (GHFDi) Project in the Republic of Togo

By Friday Daniel, Chinedu Anarado and Munachi Okoro

The public health space has relied on platforms from multilateral agencies and nonprofits to plan interventions. Platforms such as the Humanitarian OpenStreetMap, the WHO Integrated Supportive Supervision (ISS), and electronic surveillance (e-SURV) database, GRID3, and the Global Health mapping platforms were some of the only sources of information on health facility data. But these data sources can be inadequate, rarely reflect the realities on the ground and do not have the imprimatur of relevant government authorities. Equally, Ministries of Health in most WHO countries lack the capacity to curate and manage their health facility data, leaving a critical information gap in the health planning process. 

The WHO conceived the Geolocated Health Facility Data initiative (GHFDi) project as a public good to enhance access to information on the status, location and functionality of health facilities across participating WHO member countries. The overall idea is to deepen capacities in each country to manage this data, ensure its openness and availability in planning public health interventions. 

The GHFD project requires participating countries to grow their capacity to curate and manage their health facility data. But first, an assessment of the existing health facility list or registry is essential. This is expected to provide insight into the efforts required to achieve an ideal scenario which is a database of health facility information, with name, location, unique identifier, geographic coordinates and hosted in an open source platform. Countries may then choose to share this information with a global database managed by the WHO, and then invest in an ongoing process to grow their capacity to ensure the information is updated periodically. 

eHealth Africa is one of the implementing partners of the AFRO region responsible for implementing this project in the Republic of Togo. On the 9th of August 2022, an introductory meeting was held at the headquarters of the Ministry of Health in Togo. This meeting was organized by eHealth Africa in partnership with the Ministry of Health and the WHO country office. 

It brought together various stakeholders responsible for establishing and updating the health facilities database in Togo, including the Ministry of Health (MSPAUS), the National Institute of Statistics and Studies and Demographics (INSEED), as well as the delegate ministry in charge of Territorial Development.

Landscape assessment and data collection session during the workshop in Togo

With an introduction by Dr. Ouedraogo Romain Hilaire, health systems coordinator at the WHO country office, Mr. Compaore Fabris, eHealth Africa representative in Togo and Chinedu Anarado, program manager, eHealth Africa, discussed with the participants on how GHFD seeks to strengthen the capacities of the Ministry of Health to guarantee the availability, quality, accessibility and use of a health facilities master list (HFML) in countries. 

This capacity building should enable the Republic of Togo to have a standardized database open to the public. Participants discussed the seven strategic pathways through which the GHFD initiative will strengthen the Ministry of Health, including governance and policies, partnerships and collaboration, technical capacities, innovation, financial sustainability, communication and advocacy, interoperability, and data management.This introductory meeting led to the conclusion and agreement to hold a participatory landscape analysis workshop on August 30th and September 2nd.

At the end of this workshop, it was discovered that Togo has a unit in charge of the health services mapping, who oversees the health facilities master list (HFML). The Ministry of Health in Togo appreciates the initiative and sees it as an opportunity to strengthen the government's efforts to ensure universal access to care.

Group photograph of the workshop participants

eHealth Africa has since implemented a landscape assessment and is currently developing a report and cost work plan that will itemize the efforts required to bring Togo to the ideal scenario. 

To learn more about the GHFD initiative: https://www.who.int/data/GIS/GHFD 

Conducting successful Remote Energy Survey in security/network challenged environment

By Mohammed Bello, Tope Falodun and Busayo Fashoto

Remote Assessment of Energy Gaps in Selected Health Facilities: Identifying Potential for Alternative Energy Sources (Part 2)

Energy access is needed to maintain health, especially during pandemics. A prompt emergency response also depends on reliable energy access; health facilities have two main energy requirements: electricity for health services and medical equipment and thermal requirements related to sterilization, space and water heating, and incineration. However, lack of energy access poses additional challenges for the provision of emergency care services and the functioning of intensive care units.  When basic energy services are unavailable, essential components of emergency responses become compromised, including night-time care, refrigeration to keep samples, sterilization facilities, or electricity to power simple medical devices.

This expanded phase was implemented in Nasarawa states and is also part of the Nigerian Energy Support Programme (NESP), a technical assistance program co-funded by the European Union and the German Government and implemented by the Deutsche Gesellschaft fürInternationaleZusammenarbeit (GIZ) GmbH in collaboration with the Federal Ministry of Power (FMP), in partnership with eHealth Africa. It was conducted in close cooperation with geospatial data experts from INTEGRATION energy and environment. Still part of the effort of the NigeriaSE4ALL to bring you the most up-to-date, ground-truthed, electrification data available in Nigeria.

Following the successful first phase remote survey of 291 health facilities in Kano and Osun states in September 2020, INTegration contracted eHA to conduct a second phase of the remote survey in 300 Health facilities (HFs) of Nasarawa state.  This next project phase analyzes the energy status of communities in Nasarawa state.

In recent times Online surveys have been the most popular way of conducting survey research as opposed to the traditional face-to-face surveys widely used before now.  Although the face-to-face survey gives you more advantages in capturing additional emotional and behavioral clues, online surveys are cheaper.  The migration in recent times to remote surveys is a result of the migration of many organizations to digital solutions. This type of survey is less expensive and gives you some of the elements obtainable in the traditional face-to-face survey, such as the accuracy and efficiency of the data gathered.  It is also reliable in security-challenged environments. This result cannot be achieved without the expertise of agents trained to perform all the aforementioned.  At eHealth Africa (eHA), we have specially trained helpdesk agents specifically for these purposes.  In addition, our specially trained GIS and program delivery staff for the same purpose. They work collaboratively with stakeholders/beneficiaries to get accurate and efficient data based on planned activities.  The methodology and learnings from the first successful survey led to the successful planning of activities to conduct the grid supply quality in this second phase.

The following activities led to the success of the second phase survey in the 13 LGAs in Nassarawa State;

• Engagement with the state Team; Trained program staff to conduct a high-level stakeholder engagement with the state to introduce the project to the state team, get their buy-in, and discuss necessary data needed for the successful survey implementation.

•  Identification of Health Facility OICs Lead; following the high-level engagement is the identification of the health facilities officers in charge leads.  These are chairpersons of each LGAs OICs responsible for all OICs under their jurisdiction.  They assist in reaching out to the OICs to pre-inform the OICs of the implementation commencement and are relevant in following up with the OICs where the latter are unreachable.

• Health facility data gathering, verification/validation, communication with the LGA leads for HFs list sharing. HFs were then sorted, and some HFs not included on the list were verified following validation of all the selected HFs.

•  Training helpdesk agents for a successful survey;  The eHA helpdesk agents experts were trained on the survey tools and how to administer them. This includes what to look out for, understanding the tools, and further probing where necessary.

•  Conducting remote Survey; We completed the survey within three weeks of the project implementation with the helpdesk team working collaboratively with the GIS and program team to ensure the activity's success.

•  Continuous communication/collaboration with the state team;  The program team continued to communicate with the state team regularly to escalate issues encountered and collaboratively sought solutions to such problems.

Challenges:

There is no activity without its peculiar challenges; however, the excellent collaboration between the program team and the LGA/State team enabled the team to proffer solutions to address challenges such as unreachable OICs, wrong numbers of OICs, wrong OICs in actual HFs, non-network communities, etc.

Despite the challenges mentioned above, the lessons from the first phase of the project and other similar projects gave room for the team to be prepared for risks and challenges ahead of implementation.  This led to about 85% HFs data gathered at the end of the first two weeks, with only the unreachable HFs due to the earlier listed factors.  Communication platforms include Whatsapp chat, voice calls, SMS messages, etc. Intensive follow-up and the positive relationship between the team and the state team assisted greatly in successfully implementing the survey. At the end of the 3rd week, the group gathered the entire 300 HFs data, including geo-coordinate for HFs initially without geo-coordinates.  You are assured of the cost efficiency, especially considering Nigeria's current insecurity challenges.

The Program Partners

#BestPlacestoWork - How eHA builds a healthier work environment for its employees.

By Munachi Okoro

Four out of five employees worldwide are not flourishing at work, according to a survey of over 14,000 people from 37 countries by Great Place to Work® and Johns Hopkins Carey Business School. This fact bolsters the need for employers to create an enabling work environment for their employees to thrive and be productive. Conversations on #TerribleBosses and workplaces have seen a rapid global shift in organizational work cultures and policies. Organizations are evolving from embracing new policies like remote working during the COVID-19 pandemic to adopting a more inclusive workforce. 

This year,  eHealth Africa (eHA) got certified as one of Nigeria’s best places to work. eHA employees ranked the organization high on employee conditions, workplace culture, and policies recognizing the organization as one of the rewarding places to work where people can unlock their potential in a diverse and inclusive workplace. 

The certification is no surprise because of the policies eHA has in place to create an enabling environment for its employees. According to eHA’s Chief Financial Officer and Senior Director of Administration, Zahir Baloum, the eHA management team has prioritized 

employee satisfaction and growth for the past four years. We believe this significantly impacts employee attitudes about their jobs, coworkers, and organization, enhancing productivity and mental health.

What do our employees think about the work culture at eHA?

According to a business day article published in July 2022 on Mental Health and Employees’ Productivity in Today’s Workplace, A happy and healthy workforce will produce vibrant, and enthusiastic employees focused on delivering beyond business goals and expectations.  When asked how she feels about eHA’s work culture, Fatima Mohammed, a project coordinator, said that The eHA work environment has been friendly, and the organization has prioritized the work-life balance policy. It ensures that staff appropriately utilize their leave days and introduces activities that provide good work-life balance practices.

Fatima started her career at eHA as a phone logistician for the Vaccination Tracking Project over seven years ago and has since grown to the position of project coordinator, a testament to the growth opportunities within the organization. She says that the newly adopted people-focused culture has allowed for employee cohesion. They feel more comfortable and valued because the organization carries them along, is ready to listen to their voices, and uses that to gauge and improve.  There’s no doubt that employees feel happier and are more productive when their voices are heard. I appreciate the organization for employing this approach to creating a healthy work environment. 

For Juliana Jacob, a Senior Knowledge Management Associate at eHealth Africa, the work culture at eHA encourages teamwork and innovation, creating a healthy work-life balance. It promotes continuous learning and development as well as career growth. Juliana started her career at eHA as an intern with the Helpdesk team and has since transitioned to her current role.

Living the eHA values 

Aligning an individual’s role with the organization’s mission can foster a higher sense of purpose or fulfillment. That is why it is no surprise that eHealth Africa tries to foster an environment where its employees can lead to its core values of integrity, impact, quality, problem-solving, and innovation. In ensuring that the organization's influence is felt in its immediate environment, eHA embarks on community development initiatives with its staff on a mission to ensure that people in underserved communities can lead healthier lives. Early this year, one of the community development initiatives embarked on was the renovation of  22 boreholes across 10 LGAs in Kano, Borno, and the FCT. 

Another initiative within the organization that strives to create a healthier work environment at eHealth Africa is the Culture Club. According to Mohammed Bello, a project manager within the organization and the Culture Club head, eHA created the club to provide a more definitive and strategic pathway for culture stewardship and collaboration within the organization. It has been used as a mechanism to support the achievement of the organization’s result framework of ‘making eHA the best place to work through several Employee engagement activities such as Employee recognition, where eHA reward and recognizes the best employee of the month. The culture club organizes activities within the organization from time to time. One of those activities was the planting of 500 trees planted in Kano and Abuja during the  2022 Earth Day celebration. 

Undoubtedly, eHealth Africa is committed to building a healthy work environment for its employees through its policies, initiatives, and commitment to building the capacity of its staff as well as the communities impacted by its work across Africa.