Responding to Impending Public Health Emergencies in War-torn Region - Atef Fawaz

Atef Fawaz - Executive Director of eHealth Africa

In the last two decades, more than 1.3 million people and nearly two trillion dollars have been lost to disasters caused by natural hazards, a United Nations Development Program (UNDP) data reveals. These disasters tend to come with varying degrees of devastation and impacts while in many other cases, affected locations tend to battle with especially public health emergencies during and after such disasters. 

While these disasters are largely natural, the escalation of wars in different parts of the world causes both humanitarian and environmental depredation with potential public health exigency. For instance, since its commencement in February 2022, the World Health Organisation revealed that about  7 million individuals have been displaced within Ukraine and another 7.5 million refugees have been displaced across Europe with over 6000 deaths. Meanwhile in the first 2 weeks, the Palestine-Israeli war has registered over 3000 deaths with many more wounded and displaced. 

Thus there are major concerns that the ongoing crisis in the region is not just an international relations crisis but also a public health crisis that can result in long-term consequences. With the few available hospitals overcrowded, overwhelmed and reaching breaking point while corpses litter the streets, medical experts are concerned about the potential outbreak of infectious diseases especially in Gaza.  Beyond little or no access to good food and water, victims of the ongoing crises risk mental health disorders like depression, anxiety amongst others. Even in the cause of seeking succor, displaced persons are largely exposed to health risks which could degenerate into pandemic both now and in the future. 

For instance, Dr. Jack Tsai, a professor and regional dean at UTHealth Houston School of Public Health in San Antonio is worried that people who are forcibly displaced are at greater risk of communicable diseases such as COVID-19 and measles, which could lead to an outbreak. Also, the impact of deadly weapons like rockets, gravity bombs, amongst others could escalate the potential of future disasters from floods, and earthquakes to public health crises like pandemics and other  outbreaks. 

At the moment, immediate medical attention for the victims of war remains a priority, these nations could be preparing for an impending public health emergency in the near future. With hospitals vulnerable to attacks and healthcare workers losing their lives in the process, the diminishing healthcare facilities and personnel will no doubt contribute to an impending health emergency both during and aftermath of the conflict.  It's more worrisome that these crises have the potential to spillover to neighboring countries and allies to affected nations as a result of mass migration.

This no doubt underscores the importance of developing robust Digital health intervention strategies to complement existing structures for a more improved response to a potential public health emergency and response. One important global best practice is the operationalization  of Emergency Operation Centers (EOC) that provides a platform for response teams to collect, analyze, prioritize, monitor, and disseminate information about health crises or disasters. This goes  a long way in providing access to information to stakeholders to ensure timely and effective decisions to ensure effective response to health emergencies. Just last year, the WHO inaugurated its first EOC in Gaza as part of efforts to improve emergency response amidst incessant conflict and health emergencies like the COVID-19 pandemic. 

Thus this is an opportunity to identify digital innovations and creative strategies to respond to impending health emergencies in the region.  Experts have suggested that Digital Health solutions can facilitate the integration of health data to monitor impacts, and potentially predict impacts on health, and also serve as decision support tools to provide alerts for potential related disasters. For instance, the Center for Strategic and International studies in one of its briefs on Disaster Risk Reduction through Digital Transformation revealed that, using data from Twitter feeds or even from satellite imagery has helped map the spread of disasters, especially with pandemics. Similarly, it was said that social media platforms played an important role in identifying and discussing symptoms of COVID-19 even before it became a pandemic. The online conversations no doubt helped medical experts to determine the origin of the virus and its eventual spread.

Also, applications like Geographic Information System; an important analytical mapping technology, helps build early warning systems in a bid to understand where potential hazards are located, how many people are affected and what response is needed. With this deep modeling capabilities of GIS, public health leaders and governments in developing nations or vulnerable locations  have a huge opportunity to build a predictive and estimation data repertoire, which can lead to more efficiently targeted emergency preparedness and recovery strategies.

There is also a need to develop emergency communications applications in a bid to reach out to a large public about emergency response efforts. Through this kind of mobile applications, users can receive weather reports, locate emergency shelters and even register for disaster aid. The app offers tips for handling over 20 types of emergency situations and disasters.  An example is the First Aid Disaster Readiness App developed by the  American Red Cross which provides health instructions in situations where victims cannot access hospital immediately. The app has consistently helped in to control bleeding, treat a broken bone, perform Cardiopulmonary resuscitation amongst others. Aside from providing support on first aid for allergies, asthma attacks, burns, choking, distress, heat strokes, stings and bites, the multiple section application also provides detailed information on preparing for situations like  an earthquake, drought, flooding, landslides, tsunamis, volcanoes, and more.

Developing nations must also learn from the current situation by strongly investing in digital structures, building partnerships across all critical stakeholders and developing a legal framework that meets global standards in a bid to internalize effective digital health strategy.  

Atef Fawaz is the Executive Director of eHealth Africa. He is a Complex operations Management and ICT expert with experience in Humanitarian Response and Digital Health

ehealth Africa Commits to promoting early detection of Vaccine Derived Polio Virus through Lab Support

by Moshood Isah

Nigeria may have been declared a polio free nation but the Variant Poliovirus Type 2 strain transmission still lingers. Nigeria reported 168 cases in 2022. This  has made further interventions crucial particularly  around early detection. The growing cases in a  number of African countries require a focused effort to strengthen polio laboratories that can effectively help the affected countries to quickly confirm cVDPV2 cases and launch outbreak responses, including the introduction of novel OPV2.  

In 2018, the World Health Organisation (WHO) introduced a Global Polio Surveillance Action Plan (GPSAP 2018-2020) to support endemic, outbreak, and high-risk countries in evaluating and increasing the sensitivity of their surveillance systems against Polio. The plan also initiated supplemental strategies that may help in closing gaps in detecting polioviruses, including strategies for immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) while also strengthening coordination across surveillance field teams to foster a more effective programme and document zero cases worldwide. 

The new Global Polio Surveillance Action Plan (GPSAP) for 2022-2024. also focuses on increasing the speed of poliovirus detection, improving surveillance quality at the subnational level, fostering the integration of polio surveillance with surveillance for other epidemic-prone vaccine preventable diseases (VPDs), and mainstreaming gender equality in surveillance activities and programming as a key enabling factor.

To achieve parts of the Global Polio Surveillance Action Plan (GPSAP) 2022-2024, ehealth Africa worked with World Health Organisation (WHO)  supported by the Bill and Melinda Gates Foundation (BMGF) to  renovate and upgrade the   Sequencing Laboratory in the Virology department, University College Hospital (UCH) Ibadan, Oyo State. The laboratory was commissioned by Kazadi Walter, Country Representative and Head of Mission; World Health Organisation to Nigeria. This is part of the effort to improve surveillance, rapid detection and response against the spread of Vaccine Derived Polio Virus and other vaccine preventable diseases.  

Speaking during the official commissioning of the Laboratory, Dr. Kazadi Walter reiterated the commitment of WHO towards eradicating polio virus through the provision of facilities and rendering of technical support to Nigeria’s health care. He stated that WHO in collaboration with the government established the Global Polio Laboratory Network of which 16 are currently in Africa, with two located in Nigeria; Ibadan and Maiduguri. According to Walter, the primary objective is to work with WHO in the African Region (AFRO) to equip the global polio laboratory network labs for robust and rapid sample analysis for polio and to provide support in equipping these labs with sequencing capabilities.

Prof. Kayode Adebowale, the university vice chancellor, commended the initiative saying “this laboratory will not only provide vital information for the eradication of polio but also contribute to our university infrastructure, helping us to fulfill our vision and mission in addressing social needs.” The VC said: “The department has played a crucial role in Nigeria’s polio eradication programmes by contributing significantly to the country’s achievements of being declared wild polio-free in 2021.

Speaking on the role of eHealth Africa in the support for Laboratory Supplies across selected countries in Africa, the Project Manager, Tolulope Oginni said, to ensure optimum utility of the laboratory supplies, eHealth Africa leverages previous and current experience in setting up and managing Emergency Operation Centers to strengthen the staff capacity at the Laboratories in operating the installed equipment.

“These interventions  for  the support for laboratory supply and installation with consumables currently ongoing in at least 12 African countries are expected to improve the labs functionality for faster outbreak detection”, he said. With the support of other stakeholders in the region, this intervention will support labs in the African region that are targeted for expansion of sequencing capacity, support to improve existing sequencing capacity, or labs that require support for virus isolation and identification. This intervention has a huge opportunity to explore collaboration with WHO and other global stakeholders to transform the laboratory infrastructure in Africa into world class facilities which in turn will significantly strengthen their capacity and preparedness for disease outbreaks.

IYD 2023: Achieving Green Tech Skills for Sustainable Health Sector - Atef Fawaz

The gospel of promoting environmental sustainability seems to have lasted as long as the human race, with the campaign taking different dimensions in different periods during the last decades. The apprehension about sudden change in temperatures in recent times has escalated precipitation leading to flood, amongst other negative impacts. It is more worrisome as the environmental situation is now being consistently aggravated by human activities, leading to a global concern that requires action from all .  Thus, this year’s International Youth Day with the theme; Green Skills for Youth: Towards a Sustainable World, rightly mainstreams  the need to shift towards an environmentally sustainable and climate-friendly world.  This is not just crucial in promoting the global climate crisis but also relevant in achieving the Sustainable Development Goals (SDGs) as it relates to health and other sectors; the role of young people in the entire process cannot be underestimated.

According to the United Nations Concept note for this year’s celebration, Green skills are “knowledge, abilities, values and attitudes needed to live in, develop and support a sustainable and resource-efficient society”. This holistically captures all technical knowledge and skills that enable the effective use of green technologies and processes in occupational settings, as well as transversal skills that draw on a range of knowledge, values and attitudes to facilitate environmentally sustainable decisions in work and in life. As confirmed by the  International Labour Organization (ILO), green skills transcends basic agriculture to any skill/job that contributes to the reduction  in the consumption of energy and raw materials, limit greenhouse gas emissions, minimize waste and pollution, protect and restore ecosystems and enable enterprises and communities to adapt to climate change.

It's even further interesting that, to a large extent, human jobs and survival largely depend on the sustainability of the natural environment. Thus there is a huge responsibility to take intentional steps that promote a sustainable environment. In this vein, stakeholders at all levels must galvanize the energy of young people towards achieving green skills to build a sustainable world across different sectors. 

Specifically, the health sector is taking notable leaps in developing and deploying digital innovations that have significantly reduced the use of paper in the health systems. This protects the trees, contributing to the SDGs of ensuring healthy lives and promoting well-being at all ages. Digital innovations like Logistics Management Information System (LoMIS),  a suite  of offline-capable mobile and web applications developed by eHealth Africa, addresses  challenges with the supply/distribution of health commodities to last-mile health facilities. The LoMIS Suite  applications provide critical solutions that ensure availability of health commodities, effective vaccine management, and enable broader health system policy decisions through the use of real data for insight and execution at the community, state and national level. Deployed in primary healthcare facilities in Kano, Sokoto and Bauchi, the solutions have  reduced the challenge of zero stock for vaccines due to effective automated documentation of vaccines and its consumables while also limiting the use of papers to promote sustainability in both environment and the health sector.   Progress recorded for  SDG Goal 3, reveals  global health has made some improvements in recent years. For example, 146 out of 200 countries or areas have already met or are on track to meet the SDG target on under-5 mortality.

Other environmental-friendly tools that have been used in the health sector in recent years include Geographic Information Systems (GIS);  particularly  in the area of vaccination and immunization programs. Geospatial tools that use environmental data however require stability of environmental conditions to ensure its optimal utility.

Thus there are a series of platforms that can be harnessed to achieve the objective of mainstreaming green skills amongst young people in line with the objective of this year’s commemorations. While healthcare stakeholders in concomitance with Information technology experts are increasingly scaling innovations to improve early detection and response to diseases, it is paramount to equip young healthcare providers especially at state and Local Government levels with the knowledge and information necessary to understand the importance of green skills to further promote sustainability in the sector.

This can be achieved through targeted training of budding experts in various sectors to build relevant skills that will enable them to contribute to achieving a sustainable world across sectors. A great example is the eHealth Africa Academy which has consistently built young people’s skills in website creation, software development and design that can be used to solve local problems across sectors to promote a sustainable world.

To complement existing efforts, governments at all levels have a huge responsibility to initiate and promote important policies that will encourage the learning and adoption of green skills especially by young people. Also, there is an urgent need to implement laws that encourage data protection and security during interphase between digital innovations and human beings.

Ultimately young people must understand that, as a critical demographic in the world right now, the success or failure of green transition will rely on them. As an intergenerational bridge between the younger and older generation, young people need to be well-equipped with green skills to successfully navigate this changing environment and leverage the opportunities that it presents for a more sustainable future.

Atef Fawaz is the Executive Director of eHealth Africa. He is a Complex operations Management and ICT expert with experience in Humanitarian Response and Digital Health

Nurturing Work-Life Synergy: eHealth Africa's 'Bring Your Kids to Work' Program

Kids in diverse outfits beam with excitement during eHealth Africa's 'Bring Your Kids to Work Day' at the Kano HQ office.

By Favour Oriaku

The aspiration to prevent work from consuming all our time is a shared one. The idea of a clear boundary between work and personal life can be somewhat blurry as modern life has intertwined the two, demanding a new approach to create a fine synergy between them. Achieving this synergy would enrich personal lives and also foster a sense of equilibrium that can elevate work performance and overall well-being.

In an era where juggling professional commitments and family life has become increasingly complex, its significance cannot be overstated. The absence of work-life harmony negatively impacts employee performance, leading to reduced productivity and engagement. An example of an organization actively promoting work-life harmony was seen when eHealth Africa opened its doors for a unique event. "Bring Your Kids to Work Day"  showed eHealth Africa's commitment to being one of the best workplaces in Nigeria, prioritizing work-life harmony for its employees.

On the 4th of August, the eHealth Africa office came alive with excitement as little feet brought laughter and energy into the workspace. Parents and children embarked on a memorable journey together, participating in a meticulously planned day of activities. This initiative is a manifestation of eHealth Africa's belief that a happy workforce translates into a more productive one. Adesina Matti, the HR manager, expressed, "We want to create an experience that not only brings joy to the kids but also strengthens the bond between employees and their families. 'Bring Your Kids to Work Day' perfectly aligns with our commitment to a healthy work-life harmony and building stronger family connections within our workplace."

The event commenced with Fozia Malik, a member of the senior management team, warmly welcoming the children. She shared insights from her own life and career journey. Her motivational talk encouraged the kids to pursue their dreams with determination. The HR manager also addressed the young audience, introducing them to the organization's mission, vision, and work strategy.

The day was filled with activities designed to engage and inspire the young participants. Indoor games like 'concentration' and dancing chairs filled the air with excitement before transitioning to outdoor games, including a bouncing castle and a creative canvas painting competition. Face painting added an extra layer of fun, and the kids even had the opportunity to observe their parents at work, gaining insight into their daily routines and responsibilities.

The senior HR coordinator Regina Suowari, also stated: "Beyond providing children with a glimpse into their parents' work lives, today's event aimed to instill the value of education and empower them to envision and pursue their futures. The event also served as a bonding opportunity, allowing employees to connect on a more personal level as colleagues' children interacted and shared their aspirations."

The "Bring Your Kids to Work Day" initiative offered a unique opportunity for children to glimpse into the adult world of work. It demystified what their parents do during the day and provided a formative experience that could shape their own future career aspirations. The event served as an educational platform, teaching children the value of hard work, and teamwork, and perhaps sparked an early interest in fields they might not have been exposed to otherwise. It also allowed for a deeper emotional connection to be formed between parent and child, as they shared a special day together in a setting that is typically separate from family life.

In conclusion, eHealth Africa's "Bring Your Kids to Work Day" initiative achieved its vision of creating a remarkable experience for both employees and their families. The event re-echoes the possibility of harmonizing work and family life, cultivating a workplace culture that prioritizes employee well-being and engagement. As organizations worldwide seek ways to promote work-life harmony, eHealth Africa's example stands as an inspiring testament to the potential of such initiatives in nurturing a more harmonious and fulfilling work environment.

Watch the event highlight below:

eHealth Africa hosts the Insight Learning Forum 2023: Stakeholders Call for Interoperability and Institutionalization of Digital Health Innovations

By Moshood Isah

In recent years, there have been discussions to advance digital health innovations in a bid to tackle public health challenges especially in developing countries of the world. This has led to the proliferation of digital innovations in public health in a bid to achieve the Sustainable Development Goals (SDGs). This was the focus of discussion at the multi-stakeholder Insight Learning Forum organized by eHealth Africa on Wednesday, 26th July,  with the theme "Digital Innovations in Public Health Practice: Lessons and Impact. The forum officially launches an annual country digital health learning event, bringing together professionals and practitioners in the digital and public health sectors to share experiences, insights, and knowledge regarding the use of digital health innovations in public health implementation.  

The Executive Director of eHealth Africa, Atef Fawaz stated the relevance of the gathering saying, “it encourages the sharing of ideas and knowledge in a bid to explore solutions that will transform the way projects are being delivered to improve the health sector”.  This is in line with Report of the UN Secretary-General’s High-level Panel on Digital Cooperation that reveals that digital technologies have advanced more rapidly than any innovation in our history; reaching around 50 percent of the developing world’s population in only two decades and transforming societies. 

In his own remark, Deputy Director, Programs and Impact in Program Delivery at ehealth Africa David Akpan said “the maiden edition of the forum is to provide a platform for organizations to exhibit their solutions and subsequently, it will lead to potential interoperability, alignment and integration of these solutions.” This according to him will ensure that talks on digital innovations in Nigeria will be as entities rather than individual innovators.

The Global Digital Health Strategy (2022-2025) designed by the World Health Organisation stresses the standard practice that players in the health sector are supposed to help countries achieve. Further emphasizing the role of stakeholders and importance of collaborations like the Insight Forum Pharmacist Murtala Bello, Director,  Sokoto State Primary Health Care Development Agency (SPHCDA)  said the meeting would present stakeholders with additional digital health solutions from other people so as to pick their interest to effectively utilize it to solve healthcare delivery service challenges.

The Insight Learning Forum presented an opportunity for organizations to showcase digital innovations which have been instrumental in disease surveillance, vaccine delivery in different parts of Nigeria and some parts of Africa. Some of the innovations demonstrated include the Logistics Management System (LoMIS), Vaccine Direct Delivery, enhancing HIV patients care, Laboratory Management Information System (LAMIS), IMMAP, among others.

The forum also featured a panel session where it dissects interoperability of Digital Health Innovations in Public Health across the African Region. The panelists featuring the Deputy Director, Global Health Informatics in ICT Services, Abdulhamid Yahaya from eHA, Evans Ondura, Deputy  Country Director DataFi and Emeka Chukwu, Senior Digital Advisor at Health Enabled emphasized the need to ensure a responsible African context sensitive digital solution and the need to develop solutions that distinctly provide solutions or enhance existing innovations.

From Novice to Software Engineer: Muflihat's Transformative Experience with eHA Academy

By Favour Oriaku

Introduction:

In today's digital era, technology plays a pivotal role in addressing local challenges and improving communities' well-being. Recognizing this, eHealth Africa (eHA) has taken on the mission to share knowledge and empower the next generation of tech enthusiasts in Africa. With over a decade of experience in developing and deploying digital solutions across the continent, eHA established the eHA Academy, a training arm that has been at the forefront of equipping aspiring individuals with software development skills for over four years now. In this blog post, we'll delve into the transformative journey of Muflihat Abdulmajid, a graduate of the eHA Academy, and how the program paved the way for a promising career in software engineering.

Unveiling the eHA Academy:

eHA Academy is a renowned program that offers free training to individuals throughout Africa, irrespective of their technical background. The program's primary focus is to equip participants with the necessary skills to create digital solutions that contribute to healthier communities. Spanning nine months, the program consists of two phases: three months of intensive in-class live sessions followed by a six-month internship. By combining engaging live sessions, videos, challenging assignments, and practical projects, students acquire both theoretical knowledge and real-world experience, setting them on the path to success.

Muflihat's Transformational Journey:

Muflihat Abdulmajid's story exemplifies the transformative impact of the eHA Academy. Initially skeptical due to a lack of computer science or engineering background, Muflihat hesitated to apply for the program. However, after realizing that a technical background was not a prerequisite, Muflihat took the leap of faith and applied, securing a spot in the cohort.

Reflecting on the training experience, Muflihat shared, "At first, it was quite fierce and challenging because I didn't have a computer background. However, the small wins of completing a challenging task and the support from fellow students kept me motivated." The rigorous curriculum, comprising live sessions, videos, and assignments, pushed Muflihat beyond her comfort zone, helping her develop a strong foundation in HTML, CSS, and Javascript.

Internship and Career Opportunities:

The journey didn't end with the completion of the eHA Academy program. Muflihat's dedication and newfound skills led to an internship offer from eHealth Africa's software department. This internship proved to be an invaluable opportunity to apply the knowledge gained during the program and work alongside experienced software developers. Muflihat recalls, "The internship sharpened my skills further and opened the door to a full-time role as an associate software engineer within the software department at eHealth Africa."

The Impact and Gratitude:

Muflihat's testimonial is a testament to eHA Academy's transformative impact on aspiring tech enthusiasts. "The eHA Academy course was the birth of my career as a software engineer," Muflihat shares. "The joy and fulfillment I now have, being part of a team building software solutions for public health interventions here at eHealth Africa, is compared to none."

Muflihat expresses gratitude to the eHA Academy team, mentors, and tutors for their dedicated efforts in shaping her professional journey. "I will forever be grateful to the eHA Academy team, the mentors and tutors who have put in effort in shaping me into who I have now become and for grooming young Africans in the tech ecosystem."

Conclusion:

eHA Academy's commitment to empowering the next generation of tech enthusiasts in Africa has led to remarkable success stories like that of Muflihat Abdulmajid. By providing free training, bridging the gap between theoretical knowledge and practical experience, and fostering career opportunities, the program serves as a vital stepping stone for aspiring tech enthusiasts. Through eHA Academy, eHealth Africa continues to nurture young African talent, enabling them to make significant contributions to their communities and beyond.

Tackling Nigeria's Zero Dose Challenge: The Final Push with Geospatial Tracking

By Nnenna Ohiaeri

Introduction

In 2020, Nigeria was declared wild polio-free after meeting the requirements to attain the status, which includes 3 years without any new cases of wild poliovirus in the country1. Prior to achieving this milestone, Nigeria was one of only three countries in the wild with endemic wild polio. GIS (Geographic Information System) tracking was first implemented in Nigeria’s Polio program in 2012 with eHA’s Vaccination Tracking project (VTS). VTS was decommissioned in 2020, just after Nigeria was declared Polio free. 

Our Intervention

Since 2022, eHA has been providing GIS tracking support to the polio outbreak campaigns in security-compromised locations with the Polio Special Intervention project, which is part of a key focus area of eHA - Public Health Emergency Response Systems. The purpose of this project is to support the efforts to improve the Polio outbreak response in Nigeria, with a focus on circulating variant poliovirus type 2, cVPV2, using the new Geospatial Tracking System (GTS) application to track vaccination teams. 

“Special Intervention”, in this context, refers to the security-compromised nature of the implementing states. Due to banditry, kidnapping, and terrorism, several settlements in these states are either inaccessible or partially accessible. Vaccine-eligible children residing in these areas are denied access to their necessary vaccinations such as the Polio vaccine due to the insecurity posed by these activities. Accessing these communities means reaching the missed children and protecting the communities from disease outbreaks and securing a truly polio-free Nigeria. The project is being implemented in 57 local government areas (LGAs) with security-compromised settlements, in 7 priority states- Kaduna, Katsina, Kebbi, Niger, Sokoto, Yobe, and Zamfara. 

Geospatial Tracking System (GTS) was introduced by Novel-T after the decommissioning of the VTS application. The GTS application is a “lightweight” version of the VTS and was first piloted in Borno State in 2020 and is currently being used on this Polio Special Intervention project.

The GTS application is used to monitor vaccination teams and report daily missed settlements based on the DIPs (daily implementation plans) of a campaign. The process flow is displayed below:

Results

Since the inception of the project, the eHA-led activity has had a significant impact on the polio campaign implementation. Between September 2022 to May 2023, eHA has supported 66 LGAs with GIS tracking across the 7 implementing states. 3,953 settlements with vaccine-eligible children have been verified to have been visited by the vaccination teams during 2 rounds of polio campaign implementation in the states, using GTS trackers, and 1,664 vaccination teams were tracked during the campaigns. 

Field technical teams were deployed to each implementing LGA to support the campaign. 66 LGA consultants were trained on the administration and operation of the GTS application.  The consultants built the capacity of the LGA team on GIS tracking with trainings on GTS and the handling of the trackers. This was necessary to make sure that the vaccination teams are fully equipped and knowledgeable enough to successfully implement GIS tracking during the campaigns. Data collection activities were also conducted during the campaigns to obtain the geo-coordinates of settlements that are not on the Polio geodatabase (GDB). 69 data collectors were trained on the use of the KoboCollect application to collect geo-coordinate data in the field. This data collection ensured that the visitation of the planned settlements by the vaccination teams could be verified.

Conclusion

GIS tracking has helped increase vaccination coverage throughout the 7 priority states where it was implemented. In addition to increased coverage, GIS tracking also provided data-driven insights for decision-making. It increases the quality of campaign implementation and improves accountability, by validating the tally sheet reports generated by the vaccination teams. GIS tracking can be utilized beyond polio programming to support other vaccination initiatives by improving vaccination coverage and in turn, boosting Nigeria’s immunization indices.

Training of LGA team in Rijau LGA of Niger state on the GTS application and handling of the trackers

Engagement meeting with the Niger State Primary Health Care Development Agency team 

L-R : Basheerdeen Abdullahi (eHA State Coordinator), Mohammed Alhaji Usman (State Health Educator), Abubakar Shehu (Program Manager, eHA), Kpantus Abubakar (State Immunization Officer), and Nnenna Ohiaeri (Project Manager, eHA)

Digital Health Innovations Will Revolutionize Anti-malaria Fight - Expert

Dr Dennis H. Marke speaks on how digital health innovations will revolutionize anti-malaria fight

By Moshood Isah

As part of effort and advocacy to achieve Zero Malaria by 2030, experts have continued to call stakeholders in the health sector to intensify the adoption and deployment of digital health innovations for the fight against malaria especially in the African region. This is in line with the 2023 Malaria Day theme; time to deliver Zero Malaria: invest, innovate, implement. 

To commemorate World Malaria Day 2023, the World Health Organisation (WHO) had urged countries affected by malaria globally to accelerate the reach of high-impact tools and strategies to prevent, detect and treat malaria, with a focus on reaching the most vulnerable, ensuring that no one is left behind. 

According to the World Health Organisation, there were an estimated 247 million cases of malaria worldwide in 2021 with over 600,000 malaria deaths yearly. Unfortunately, the  African Region is reportedly home to 95% of malaria cases and 96% of malaria deaths with  Children under 5 accounting for about 80% of all malaria deaths in the Region.

Despite continued effort to eradicate malaria, the parasite remains a challenge especially amongst children. This is largely due to rising resistance to insecticide-treated nets and to antimalarial drugs particularly in Africa according to the World Health Organisation. It is more than ever imperative to deploy innovative ways  to combat the parasite which is why stakeholders are now turning towards the use of digital tools. Adoption and deployment of innovative digital tools have helped in early detection, improved diagnosis and potentially better treatment of Malaria parasites in the predominantly affected locations.  

For instance, Lomis, an offline logistic management tool was custom-built by eHealth Africa for the Seasonal Malaria Campaign (SMC)  in Borno, Nigeria. The platform was used to support the distribution of malaria commodities, including insecticide treated nets (ITNs), malaria diagnostic kits, and antimalarial drugs. Through the  platform,  government and development partners were able to track the distribution of malaria commodities from the national level down to the health facility level.  Plainfield is another eHealth Africa's digital solution- a mobile and web-based application that helps you plan field logistics for public health interventions. It is deployed for malaria campaigns to ensure better planning, tracking of teams, data collection, and coverage with geospatial tools. Other tools proving to be important in fighting malaria especially in the area of logistics management and distributon, include CommCare, Redrose, Reveal  amongst others.

Speaking during Insights- a public health webinar hosted by eHealth Africa, medical expert, Dr Dennis Marke, a clinician and program manager, Systems strengthening  in the ministry of Health and Science and  National Malaria control program in  Sierra Leone reiterated the need to strengthen public private partnership to improve the fight against malaria through improved access to medical information, communication and health application in issues around malaria control. 

The webinar series tagged; insight titled “Time to Deliver Zero Malaria: Investing in Sustainable Digital Health Innovations," fosters conversations with professionals within the public health space. During the discussion, Dr Dennis said digital health tools have proven instrumental in the seemingly unending antimalaria fight in the region. 

According to him, mobile based innovations through SMS messages have between 70-80% penetration in Sierra Leone and have been effective in reaching out to the population about the symptoms of Malaria and need for testing. He gave an instance saying, "in the 2017 mass campaign, we used rocket pro mobile applications to track the supply of medical equipment and drugs at our peripheral health units".

Dr Dennis also mentioned other forms of digital tools like Solar Power Mosquito Trap; District Health Information System(DHIS) amongst others,  that have been instrumental in laboratory analysis, research, surveillance and  tracking of health interventions even in remote communities.

While admitting the existing challenge of Internet connectivity in some hard to reach communities he said, "you can have this technology sitting out there and if the cell phone penetration is the hardest to reach, the marginalized communities are not covered, that's a huge challenge". He called for proper coordination in delivering digital health interventions, through effective mapping of digital health partners to identify their areas of  strength. This according to him will ensure unity of purpose and to ensure all partners work towards achieving the overall goal of fighting against malaria.

Insights is a Public Health webinar series hosted by eHealth Africa. The webinar series enables conversation with public health professionals to establish eHealth Africa as a thought leader in the Public Health space, create visibility for the organization and create new opportunities for business opportunities for the organization within the public health space. 

Shaping the Future of Healthcare Access in Africa: Abigail Ayogu's Story

By Favour Oriaku

Abigail Ayogu’s story is one of passion, dedication, and commitment to making a positive impact in Africa's healthcare sector through technology. As a UI/UX designer at eHealth Africa, she plays a crucial role in building digital health solutions that improve healthcare access and outcomes for millions of people on the continent. 

Abigail's journey began when she discovered her passion for UI/UX design during her studies in Computer Science at Baze University, Abuja. She has since worked in various industries, honing her skills and experience in design and technology, including healthcare, where she found her true calling.

At eHealth Africa, Abigail's focus is on designing user interfaces and user experiences that are intuitive, user-friendly, and accessible to diverse users across the continent. Her human-centered approach involves understanding the needs and constraints of users and developing solutions that solve their problems effectively.

One of Abigail's notable achievements is her work on the Electronic Management of Immunization Data (EMID) platform. She designed and prototyped a robust mobile application for managing COVID-19 vaccination records in Nigeria within a short timeline.

The platform's publicly-accessible vaccination registration and verification system promotes transparency and timely vaccinations, making it a critical tool in the fight against the pandemic.

For Abigail, the most rewarding aspect of her work is seeing the solutions she designs in the hands of the people they were intended for, solving their problems, and making their lives better. "For me, it’s an indescribable feeling seeing my solution in the hands of the people it was designed for as they use it seamlessly, and seeing how it fits well into their workflow, solving the problems it was designed to solve. That feeling of making a positive impact is something I truly cherish," says Abigail when asked what she finds most rewarding about her work at eHA.

She is committed to staying current with the latest trends and best practices in UI/UX design, taking online courses, reading design books, and keeping up with local and international design and product communities.

Abigail is also passionate about empowering young girls and women to pursue careers in STEM, specifically in UI/UX design. Abigail has this advice: "It is worth it, and it is fulfilling to pursue a career in design and tech. To be successful, you need to put in the work, stay curious and always be willing to learn. Make sure to network and build relationships within the industry, and find a mentor who can guide you."

As we celebrate International Day of Girls in ICT, Abigail Ayogu's story is a reminder of the critical role that women and girls play in shaping the future of healthcare access in Africa. Her dedication, passion, and commitment to making a positive impact in the world through technology serve as an inspiration to all.

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

By Judith Owoicho

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

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

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

LoMIS

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

Planfeld

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

CommCare

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

Reveal

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

RedRose

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

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

How Digital Tools Connect Rural Populations with Modern Diagnostics and Treatment for Tuberculosis (TB)

By Judith Owoicho

Tuberculosis is a big burden in Africa. The region accounts for more than half of the 30 high-burden TB countries worldwide. In 2020, at least half a million lives were sadly lost to this curable and preventable disease in Africa.  

Efforts have been made in funding and creating more testing and diagnostic options, however, in many rural villages in Africa,  access to modern diagnostics facilities is a significant challenge that results in delayed diagnosis, inadequate treatment, and poor health outcomes for tuberculosis. Lack of the necessary infrastructure and resources, such as electricity, water, and transportation, to set up and operate modern diagnostic facilities continue to impede the elimination of tuberculosis in the region. More effort is required to connect rural populations with central modern diagnostics facilities for TB/HIV diagnostics and care.

Digital technology has shown significant potential in advancing disease surveillance, monitoring, management, and care. It is being applied in innovative ways to help overcome barriers to prevention, detection, treatment, and management of infectious diseases including tuberculosis, to promote treatment adherence, support learning and knowledge dissemination progress in low and middle-income countries. One of such technologies is the Health Telematics Infrastructure (HTI).

Bridging the gap between rural population and urban diagnostic facilities

eHealth Africa worked with the Charité University of Medicine to design HTI, a digital solution to improve, analyze, and evaluate the diagnosis and treatment of TB and HIV. It was implemented in St. Francis Referral Hospital (SFRH), Ifakara Health Institute (IHI) in Ifakara, and Kilombero District, Central Tanzania. The system is a low-cost open-source software solution that captures data, tracks samples, and provides healthcare workers and patients with real-time feedback via SMS. With this digital platform, nurses can access a TB Diagnostics Dashboard on an android phone to view patients' information and make decisions based on their test results. Patients or disease suspects are registered using an OpenDataKit form template, while sputum/blood samples are labeled with pre-printed QR codes to track shipment status from collection to the central diagnostic facility. Laboratory staff enter the test results into the HTI database, and rural healthcare staff/patients are informed about the availability of test results via SMS messages.  So, Instead of patients traveling to facilities, samples and information are transported and managed by the HTI system, which works under low-bandwidth and unstable internet conditions, anywhere with at least 2G coverage. 

Overall, the system significantly shortened the previously long turnaround time from first symptom until treatment initiation, it eliminated the paper based workflow and delayed information transmission replacing it with a digital workflow. It shortened the long distance to the molecular test facility by providing mechanisms for village level tests and it eliminated the high financial burden by moving samples and data  instead of patients.

Community engagement and involvement

Digital tools such as the HTI offer viable solutions to the challenges faced by rural communities, enabling them to access high-quality healthcare regardless of their location. To ensure the success of digital solutions especially in rural communities, it is important to involve local communities in the planning and implementation process. Community engagement can help to identify the specific needs and challenges faced by rural populations, as well as the most effective ways to address them. In rural Tanzania, there was awareness creation for the communities and in addition, capacity building for community health workers. This ensured that more cases of TB were identified and the rapid spread of the disease curtailed. By involving local communities and organizations in the process, we can ensure the success of these initiatives and work towards a future where all populations have access to modern diagnostics facilities for effective management and control of infectious diseases.

#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.