Moderator: Hallie Goertz
Implementing DHIS 2 as the national disease surveillance system in Guinea: Results and Lessons Learned
Through the U.S. Centers for Disease Control and Prevention (CDC)-funded Global Health Security project in Guinea (2015-Present) RTI International provides technical assistance to the Ministry of Health (MoH) to strengthen the disease surveillance system to better prevent, detect and respond to outbreaks. Guinea lacks a national database shared across the different stakeholders, that enables tracking of weekly aggregate disease surveillance reports and individual cases and their laboratory results. Instead, each stakeholder maintains their own databases in parallel, leading to duplication of effort, difficulties in harmonizing data, and lack of information sharing. RTI is working with the MoH and key partners, including the CDC and the World Health Organization (WHO), to implement DHIS 2 as the national disease surveillance database. This poster presentation will review results from the pilot phase in 2017 and key lessons learned.
Presenter: Eileen Reynolds (RTI International)
Improving HIV-control program effectiveness by replacing bicycle rides with an e-health system in Uganda
The applications seeks to address challenges of turnaround time, data quality and accessibility by replacing bicycle specimen riders with a fully-fledged mobile e-service system structured to enable automatically transmitting viral load count results from the testing laboratory to rural health facilities; compare data transmission timelines of results by courier/motorcycle and by the electronic system, and ; assess the electronic systems’ ability to increase patient involvement and adherence, by increasing the numbers of patients tested and initiated on HIV/TB treatment, and by improving the ability of tracking patients’ records. The envisaged system will open up a more efficient and modern way to deliver laboratory results to rural clinics that can be used for and beyond HIV programs; allow for fast contact with patients, further enhancing chances they will be retained in the healthcare system; allow for decent electronic tracking of patient records, even making it possible to track health data of patients that are very mobile.
Presenter: Jostas Mwebembezi (Rwenzori Centre for Research and Advocacy)
Use of Mobile Health by Community Health Workers in the Integrated Community Case Management Program in Malawi
In 2008, Malawi introduced integrated community case management (iCCM), a strategy for delivering treatment of malaria, diarrhoea, and pneumonia among children under five years of age by community health workers called health surveillance assistants (HSAs). In 2014, D-tree International developed a decision-support mobile application to help improve the quality of care provided by HSAs. The application was piloted as part of the WHO Rapid Access Expansion (RAcE) Programme. In 2016, a study was conducted to assess the value of using the mobile application in the iCCM program in delivering better quality of care to children under five years of age and in improving the quality of data reported by HSAs. No difference was found in treatment of children with the three illnesses nor in data quality measures. However, results lend some support to the use of the mobile application as a tool to facilitate shifting tasks to less-trained HSAs. Although the mobile application has potential, it is unclear whether necessary resources are available to expand and sustain its implementation in the iCCM program.
Presenter: Joy Kamunyori (ICF)
Introduction to the Master Facility List Resource Package
The Master Facility List (MFL) Resource Package was developed to guide countries through the process of establishing or strengthening their MFL. The MFL Resource Package describes the various elements that need to be in place to have a functional MFL including a governance structure, a comprehensive and up-to-date facility list, and a software platform to house and share the MFL. It discusses key decisions that need to be made during the planning and implementation phases; describes best practices for establishing, maintaining and sharing an MFL; and discusses resource needs. Additionally, the MFL Resource Package includes case studies from various countries, and links to tools and practical resources that implementation teams may find helpful.
Presenter: Olivia Velez (ICF)
eHypertension Tracker Vietnam: From community longitudinal care to national registry
Noncommunicable diseases (NCDs) are a growing challenge in low and middle income countries (LMICs); hypertension alone affects more than 1 billion people in LMICs. People with NCDs need to be tracked over time to ensure they get the care they need over the long term—but this is harder in low resource settings. Digital tools offer a way to rapidly and cost-effectively transform health systems, creating structures which support longitudinal care of individuals with NCDs and facilitate greater access to data for planning and decision making. Dr. Truong Bui from PATH’s Community for Healthy Hearts project in Vietnam will present the eHTN.Tracker, the first digital NCD case management tracking tool in the country. Developed with local health authorities, the eHTN.Tracker demonstrates the potential of digital health to improve chronic and noncommunicable disease management. It has the potential to be integrated into a national registry and be applied across other health areas. There are currently 18.2876 individuals registered in the system, 54,011 of which have been screened and 14,157 diagnosed with hypertension and are being followed by community health workers.
Presenter: Bui Truong (PATH)
Influences on engagement in digital health interventions for behavior change: A review of the literature
Improving engagement is the holy grail for program managers of digital health programs, particularly programs designed to change health behaviors. Rapid drop-off and limited use constrain the ability of digital health interventions to positively affect health behaviors and ultimately health outcomes. In order to lengthen a user’s engagement, we ask: what influences the use of digital interventions? This poster answers that question by mapping out the literature on digital engagement and summarizing published engagement frameworks. In addition, through the incorporation of recommendations from the mobile health Evidence Reporting and Assessment (mERA) checklist, the poster proposes a comprehensive model of the influences on engagement with digital health interventions for behavior change. From this model, digital health researchers can develop many questions on the correlation of engagement with numerous individual, social and contextual factors that influence sustained use, propelling digital health research further.
Presenter: Radha Rajan (Johns Hopkins Bloomberg School of Public Health)
Experience in the implementation of electronic medical records in patient management of people living with HIV in Nigeria
The aim of this presentation is to discuss the programmatic use of an electronic medical record system (EMR) in Nigeria to improve decision making in HIV program implementation. It will focus on use of EMR for: patient information aggregation and analysis, efficient retrieval and management of client information, and facilitating quick responses to client information system and data needs. Readers will learn about the process by which the EMR is used for decision-making and the experiences and potential benefit from EMR utilization, including its use in decision making by healthcare workers during and after client consultation through the following ways: immediate access to key information - such as new and past patients' complains, lab test results, and medications; efficient, secure, and readily accessible patient information among providers; easy scheduling of patient appointments; good patient-provider interaction; and standardized reporting. This also aids in data management that can facilitate good data analysis for presentation to decision makers.
Presenter: Oluwatosin Ogungbade (MSH)
A Proposed Framework For a Systematic Development of a National eHealth Policy
Whereas many countries have eHealth Strategies in place, only 11 countries worldwide have an eHealth Policy according to WHO’s Global Observatory for eHealth website! This statistic is shocking given the role the health IT has in improving health outcomes in most of the countries. Almost all the countries around the world have some form of eHealth interventions in place. The absence of a policy exposes countries to privacy and confidentiality violations, non-standardized approaches and cross-border movement of patient information without government and individual consent among other challenges. Lack of a unifying toolkit for developing a National eHealth Policy such as the WHO’s National eHealth Strategy Toolkit may be a contributing factor to the low number of countries most countries with an eHealth Strategy. We seek to share a systematic approach for the development of a National eHealth Policy that was used to develop the Kenya eHealth Policy.
Presenter: Shem Mbandu Angolo (South Eastern Kenya University) presented by Onesmus Kamau (MoH Kenya)
mHealth for Non-Communicable Diseases: Experiences and Lessons from Deploying Digital Tools for Cancer Care Coordination in Asia and Africa
Non-communicable diseases (NCDs) pose one of the greatest health challenges of the 21st century, and disproportionately affect low and middle-income countries (LMICs). Mobile technology can play a crucial role in supporting care coordination for NCDs, strengthening health systems and improving outcomes in the last mile. In this poster, Medic Mobile, a non-profit organization that builds world-class software for community health systems, shares experiences from mHealth deployments for NCD care coordination, particularly cancer care in Asia (India, Nepal) and Africa (Kenya, Tanzania). We reveal key learnings from these deployments including the importance of human-centered design, a skilled health workforce, well-defined pathways to NCD care, and integration with existing systems of primary care. As the global NCD burden continues to grow, we also share opportunities for mHealth to improve NCD prevention, screening, early diagnosis, treatment and palliative care in the last mile, strengthen LMIC health systems, and transform the lives of those who are suffering from or at risk of NCDs.
Presenter: Shreya Bhatt (Medic Mobile)
Mixed-Method Impact Evaluation of mNutrition application in Indonesia
Growth monitoring (GM) aims to detect children at risk of malnutrition, provide resources for children with growth faltering, track nutrition trends, determine eligibility for counselling/other services, and to increase visibility of malnutrition. GM’s impact is limited by poor data quality, long delays in data collection and dissemination that prevent timely response, and weak interpretation and use of data. The Institute of Development Studies and World Vision (WV) evaluated the use of a mHealth application (app) for community-based GM created and deployed by WV and delivered through health posts (posyandu) over a 12 month period in rural and urban sites in Indonesia. Objectives were to assess impact on: data accuracy, accuracy of GM status classification, timeliness of data submission, real-time responsiveness and feedback to mothers. This poster presentation will highlight the results of this quantitative and qualitative analysis.
Presenter: Annettee Ghee (World Vision)
Cost-effectiveness and budget impact analyses of mCARE program provided through the public sector at scale during 2015-2020 in rural Bangladesh.
While economic evaluations may assist the prioritization of interventions, they are not sufficient to predict whether an intervention is affordable in light of finite resource constraints. This study examined cost-effectiveness, affordability and budget impact of implementing the mCARE program through the public sector to improve pregnancy surveillance and care-seeking of antenatal care in Gaibandha district over a six-year time horizon (2015~2020). We assess scenarios for implementing the comprehensive mCARE program (mobile phone-based surveillance and reminders based on SMS and home visit), and basic mCARE program (mobile phone-based surveillance) and a status quo comparator as a traditional paper-based system over a six-year analytic time horizon 2015-2020. The financial impact estimated over 2015-2020 ($47 million) for the mCARE intervention in the entire country makes up 0.9% of total annual health expenditure ($5.4 billion) and 2.5% of public health expenditure ($1.9 billion), which is favorable to the current financial arrangement in the country.
Presenter: Youngji Jo (JHU)
Supportive Supervision & Community Health Workers: Connecting the last mile Digitally: smarter management of delivering health services to a million and more using Smartphone Technology
The National Health Mission in the state of Uttar Pradesh (UP), India deployed ASHA Facilitators (AF) as supervisors to Accredited Social Health Activists (ASHAs), Community Health Workers responsible for providing key may maternal and child health services in the community. To strengthen supervisors’ support of ASHAs, boost accountability, and improve use of data, the Government of UP and CRS have jointly employed custom-built mobile phone based applications for AFs. This unique ICT tool has reduced paperwork, increased substantive supervisory visits, improved the quality and speed of reporting, promoted transparency, and enabled data to be used for decision-making. We will be demonstrating how smartphone technology helps aid supportive supervision of community health workers to deliver key health services efficiently and effectively while improving their own knowledge and performance. The presentation will share the main features of the application and how it improves health worker performance, management decisions, and accountability. We will be sharing our experience, learnings and results from the pilot phase while also sharing how we are now supporting the Government who have adopted and have taken this m-health initiative to scale working with 523 ASHA Facilitators and 10,385 ASHAs covering a population of 17.7 Million across 5 districts of the state.
Presenter: Satish Srivastava (CRS)
citiesRISE: A global multi-stakeholder initiative harnessing the digital health revolution for improved mental health and well-being
citiesRISE is a global platform tackling the urgent need to improve mental health through collective action in major cities to catalyze systemic change. It is the first effort of its kind where leading practitioners in the field of mental health are uniting to address mental health. We are scaling up proven methodologies and tools, and harnessing the skills and energy of experts and communities to achieve significant, measurable improvements in mental health, especially among young people. To make multi-disciplinary connections among topics seldom taken together, including digital health, mental health, social resilience, child development, and scaling-proven innovations, gender, and education. The citiesRISE poster provides a diverse overview of innovative digital health solutions in mental health and well-being that are ready to be scaled, discusses historical and contemporary challenges related to harnessing digital health for improving the mental health and well-being of young people, and communicates learnings and findings from innovations on the citiesRISE program that are amplifying digitally informed strategies in the field of mental health.
Presenter: Lian Zeitz (Global Development Incubator)
OpenLMIS: Data Visibility for Improved Supply Chains
OpenLMIS is a state-of-the-art, open source, web-enabled electronic logistics management information system (LMIS) purpose-built to manage and strengthen data collection and visibility in health commodity supply chains. This poster provides details about OpenLMIS functionality and use as well as providing an overview of version 3, which provides better support for customization and extensions than previous versions through its new service-based, API-driven, modular architecture. OpenLMIS is also developing vaccine-specific functionality to complement the existing system and improve data reporting and analytics throughout the supply chain. By strengthening front-end data collection and building a flexible system to accommodate various immunization supply chains, OpenLMIS addresses critical needs identified by EPI managers across countries.
Presenter: Tenly Snow (Village Reach)
Health-e-Link - providing health information exchange solutions
In this poster session, JSI will demonstrate the complexities associated with data exchange in today’s healthcare world and the differences between standards-based data exchange and non-standard data exchange. JSI and its partner Bowlink Technologies have been developing and deploying a Health Information Mediator and Data Warehouse suite of tools called Health-e-Link for the past twelve years. Health-e-Link connects clinical and administrative information technology systems and also provides communications, data analytics and reporting capabilities in support of collaborating healthcare organizations. Health-e-Link is now in its third generation of deployment. The poster will illustrate how data sharing across collaborating organizations provides opportunities for using data in creative ways; how collaborating healthcare providers require tools for communicating among people and not just technology-based systems; how interoperability networks require a strong service orientation within the technologies they employ and by the operational and technical staffs that support those networks; and finally, an understanding of the various parts of a health information exchange network and data warehouse and how they work together.
Presenter: Jonathan Metzger (JSI)
Promoting Digital Health Data Governance and Resilience Capacity Approaches in Africa
Effective digital health data and information governance model integration is a critical in ensuring well-established standards and requirements compliance process in digital penetration and expansion in Africa. However, there is also insufficient indication on health data governance adoption and implementation studies aiming at understanding the interaction of health data collection and analysis, data sharing and quality access to vulnerability and impact of infectious and chronic diseases prevention and management in Africa. This poster will highlight the usefulness of local and contextual gaps and challenges in shaping digital health data governance and implementation across Africa.
Presenter: Ernes Tambo (Africa Intelligence and Surveillance, Communication and Response (AfriDISCoR))
A Conceptual Data Framework for Analyzing the Essential Domains of an Effective Data System
Building an effective data system must be informed by a consideration of a number of domains that contribute to a system's usefulness. During this poster session, RTI will present a conceptual framework that can be used as a tool for identifying and analyzing these domains. Informed by field assessments conducted in Bangladesh, Ethiopia, and Nigeria, the framework serves as an effective lens for understanding and organizing the health data environment, combining components of existing analytical frameworks used in health with tools typically used for business analysis and technology development. The framework also serves as a tool for determining the role ICT can play.
Presenter: Bill Philbrick (RTI)
mHealth: an opportunity for public health education and demand creation; lessons learned from Zambia's mHealth for Cervical cancer ( mCervicalcancer) program
Ms. Muliokela presents an overview and description of the mHealth for Cervical cancer program being implemented in Zambia in collaboration with World Health Organization, International Telecommunications Union and African Development Bank. The initial phase of the program mCervical cancer program is to increase awareness around cervical cancer prevention and treatment through use of a simple messaging system; SMS target women within the screening age group in Lusaka province. Eight messages that include a call to action to access screening services were sent to 250,000 women for a period of eight weeks. The session will look at some preliminary results, challenges faced during implementations and general lessons learned for both program and technical platform development. It will target both program managers and implementors in mHealth in low resource settings.
Presenter: Rosemary K Muliokela (mCervical Cancer)