Using Data and Digital for Health in Challenging Operating Environments – Global

Digital and data tools are revolutionizing healthcare systems in countries around the world. Their impact in Challenging Operating Environments (COE), in particular, has transformative potential – overcoming the challenges that have impeded consistent access to health services for millions of vulnerable people.

Although they are home to less than 14% of the world’s population, centers of excellence account for approximately one third of the global burden of disease related to HIV, tuberculosis (TB) and malaria. The intertwined crises facing the world today – the COVID-19 pandemic, hunger, conflict and the climate crisis – all have enormous health impacts. The World Health Organization reports that health systems in all regions and in countries at all income levels are severely affected, with little or no improvement since 2021. These worsening crises could continue to reverse gains. hard won in the fight against poverty, infectious diseases and inequalities, especially in the centers of excellence. But they also offer an opportunity to do things differently, using new tools and flexible approaches to deliver health services to the most vulnerable.

Digital Innovations for Centers of Excellence

The challenge

Timely and accurate data are the cornerstone of effective health systems. However, collecting data at centers of excellence – and delivering care – means facing barriers to accessing remote areas and hard-to-reach populations, limited institutional capacity, and a shortage of resources. already overworked health workers, among other factors.

When data is collected by hand, records must be transported to public health facilities in major cities for analysis. Long distances and difficult terrain can slow this process, delaying health services for vulnerable populations.

Additionally, managing supply chains for the distribution of diagnostics, medicines, and other health products can be time consuming when done by hand – and is more likely to be inaccurate. Ineffective supply management systems can lead to drug stock-outs, expiring tests on shelves, or shipments arriving too late for hard-to-reach people.

The solution

Access to quality data to make informed and timely decisions is essential to help frontline health workers improve service delivery to vulnerable people. People-centered digital tools, when implemented equitably, can enable reliable, real-time surveillance of outbreaks, support prevention and treatment efforts, and empower community health workers and others to do their jobs more effectively and provide health services to populations in need.

Digital tools have great potential to increase access, as seen with the use of telemedicine and other digital health technologies in response to COVID-19.

Feature Stories: Digital Technology and Data Solutions in Guinea-Bissau, Chad and Afghanistan

Supporting real-time health surveillance in Guinea-Bissau

Prior to digitization, health data in Guinea-Bissau was collected through a paper-based system and physically shipped to the National Institute of Public Health in the capital, miles away through flood-prone terrain.

“It took about two to three weeks between collecting and analyzing the local data,” says Herculano Bras da Silva, health worker. This has made it nearly impossible to monitor malaria outbreaks in real time and respond in a timely manner.

In 2018, UNDP began working with partners in Guinea-Bissau to adapt the country’s District Health Information Software (DHIS) to support malaria data collection. To put the software in the hands of community health workers, UNDP and the Global Fund, with support from the World Bank, distributed mobile devices to record and transmit data, and trained community health workers in their use. use.

This digitization of health data has strengthened the national government’s ability to map and track malaria outbreaks in real time, improving response times. Live surveillance of new malaria cases is now routine in nearly 150 health facilities across the country of 2 million people. Problems can be detected quickly: for example, if the data transmitted in real time shows that a woman visited a health facility during her pregnancy but did not receive a mosquito net or preventive treatment against malaria such as expected, it could mean that the health facility has temporarily run out of stock. This can be quickly investigated and corrected by reallocating stock from neighboring facilities. This work is ongoing – in the first six months of 2022 alone, almost half a million people were tested for malaria and 50,000 people received treatment.

Increasing Efficiency and Improving Supply Chain Management in Chad

Malaria is the leading cause of death among children under five in Chad. More than a million children are eligible to receive preventive treatment, but treatment distribution is often delayed by a health information system that requires workers to manually record data. This system made it difficult to assess the number of eligible children living in a community, track those who had received treatment, and determine which communities to prioritize in the event of an outbreak.

Starting in early 2022, UNDP supported the digitalization of the malaria prevention program in Chad, helping to train more than 1,300 community health workers in 13 health districts and 184 health facilities on digital data collection in the country. first phase of implementation.

“The main advantage of digitization… is that it allows us to control the data sent in real time at all levels,” explains Zachée Mbayam, malaria focal point for the health district of Kouloudia in the Lac province. When distributing scarce resources, every treat counts, so avoiding discrepancies in records is essential. With digitization, “everything is centralized, we detect errors very quickly and we can correct them in real time”.

During the first phase of the initiative, more than 200,000 children were reached. The pilot also provided important lessons that carried over into the second phase, such as creating instant messaging groups to help with troubleshooting and sharing tips.

Building on these lessons, UNDP will scale up the use of digital tools for malaria prevention and treatment in 2023 to improve inventory management and mass distribution of bed nets. This has the potential to reach nearly 19 million people.

Preparing healthcare workers for success in Afghanistan

Internet connectivity, electricity and other utilities can be scarce throughout Afghanistan. This presents additional challenges when using digital health tools.

UNDP, together with the Global Fund, supported the digitization of the National Malaria Control Program in Afghanistan. This required working with partners to design software that works offline and then pushes data to the central database when internet connectivity resumes. All provincial malaria focal points have been trained and equipped with mobile devices, and the new surveillance system has been rolled out nationwide. Another digital solution to meet the specific needs of the community is Afghanistan’s first mobile money system, HesabPay, which guarantees the timely payment of healthcare workers.

Digital technologies and tools are the future of centers of excellence

To end HIV, TB and malaria as public health threats, we must reach the most vulnerable people with prevention and treatment services, wherever they are. This is particularly important in centers of excellence, where innovative and flexible solutions are needed to address existing weaknesses and adapt to rapidly changing contexts. Digital and data solutions can play a critical role in improving the efficiency and effectiveness of health services and increasing access to health services for hard-to-reach populations.

Through its partnership with the Global Fund, governments, civil society and others, UNDP helps countries implement digital tools that address their unique challenges and improve the health of their citizens. In Afghanistan, UNDP is supporting the expansion of the digital monitoring and evaluation program to also track TB. In Guinea-Bissau, work is underway to increase the number of community health workers using digital devices.

The UNDP-Global Fund partnership helps countries build sustainable health systems that can withstand shocks and crises and make progress against the three diseases. The Global Fund’s Seventh Replenishment is an important opportunity to scale digital and data solutions for more resilient health systems.

In accordance with UNDP recommendations Strategic Plan 2022-2025 and his HIV, health and development strategy, UNDP partners with the Global Fund, governments and civil society to support and strengthen multi-sectoral national responses to malaria, providing integrated support for policy, program and capacity development. To date, 7.3 million lives have been saved, 1.5 million people are currently receiving HIV treatment; 96 million people treated for malaria; 1 million cases of tuberculosis detected and people put on treatment; greater than 1.1. million health workers trained to support COVID-19 responses.

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