Many of our neglected tropical disease programmes use mass drug administration (MDA), in which entire populations are treated with medication. These MDAs take place within local communities, making it historically difficult to monitor treatment and distribution.
Our new MDA monitoring process and platform, which uses mobile phones to collect data throughout the MDA, is now being used in Cameroon, Nigeria and Zimbabwe. This offers much greater visibility: if an area is behind target, for example, we can investigate any issues and attempt to solve them as soon as possible, while the campaign is still under way. This has significantly improved the quality and timeliness of our data, as well as our ability to supervise the activities, and means far fewer drugs are wasted.
Operations for advanced trachoma (known as trachomatous trichiasis, or TT) are often carried out in remote settings that lack resources, which means caring for patients continuously and reporting the results of surgery can be challenging. The TT tracker helps surgeons, assistants and supervisors to collect and analyse information about surgery and performance, and to determine when and where follow-up appointments are needed. Data is collected using smartphones, with supervisors given reports online and via email.
Under the Accelerate programme, TT Tracker is being rolled out in Nigeria, Guinea and Benin, with Senegal and Zimbabwe set to be added later in the year. In 2019, we will also configure the TT Tracker for use in our child cataract programmes, with plans to pilot this approach in Nigeria.
Sightsavers has adopted one centralised system to manage mobile survey data collection and data visualisation across our programmes. This cross-cutting approach includes surveys undertaken in our eye health, NTD and research activities. We have more than 50 surveys planned over the next 18 months.
Our most successful mHealth project to date has been the Global Trachoma Mapping Project (GTMP), the largest infectious disease survey ever undertaken. Partnering with 53 organisations, Sightsavers led a coalition to collect and transmit data on 2.6 million people in 29 countries using smartphones. That project came to an end in early 2016,
Created with partners including the World Health Organization, Tropical Data is a mobile-based data-collection initiative that uses the same approach and technology as the Global Trachoma Mapping Project. Tropical Data helps countries carry out surveys as they work towards eliminating trachoma. In total, 300 surveys in 23 countries have already taken place, and soon the platform will be set up for other neglected tropical diseases.
Using the many lessons learned from GTMP and Tropical Data, we’re working with partners in Ghana and Nigeria to devise new ways to collect valuable data about river blindness (also known as onchocerciasis). The OEM project will focus on carrying out the project in certain districts in Mozambique in 2019, in close coordination with WHO and WHO/ESPEN, the Task Force for Global Health, The Bill & Melinda Gates Foundation and many other partners.
As an example of how we’re using mHealth for areas other than data collection, in Kenya we’ve incorporated TT case finder and trachoma SAFE strategy training into our partner AMREF’s LEAP mHealth platform, a mobile learning package that helps community health volunteers learn at home. The platform provides continuous training and support, with content, quizzes, chat rooms and interaction with trainers all delivered via SMS, with no smartphones needed.
In Zambia, Sightsavers is working with Akros, which already uses mobile phones to collect data about water and sanitation. We are now gathering data linked to trachoma elimination, and Akros is feeding information back to the communities: chiefs have tablets showing their area’s water cleanliness, and community volunteers are sent SMS updates about medication distribution and other activities.
Since 2014, surgeons have been using simple mobile phones to collect data about operations for advanced trachoma. This not only helps us to get accurate data more quickly, but saves time and petrol costs: it ensures we don’t have to collect paperwork from each location where surgery takes place. The platform is built by the Mali Ministry of Health, which takes ownership of the data. We’re working with the ministry to expand it to other eye health services, such as cataract operations.
We define inclusive eye health as services that are sustainable, accessible and planned with gender and disability considerations in mind. In 2018 we began collecting patient data for eye health programmes in Mozambique, Pakistan and Bangladesh using mobile devices. Each patient surveyed will have an eye health assessment, and their disability status determined using the Washington Group short set of questions. This will be used as comparative data to measure the success of the project.
Sightsavers’ mobile surgeon Boubacar Fomba travels by motorbike to the most remote regions in Mali to perform trichiasis surgery in the field and collect data about trachoma via mobile phone.Read his story