Category: News

When good leadership meets smart technology

By Parysa Oskouipour on November 14, 2019 in Health Data Systems, Malaria, News, Uncategorized

On a sweltering summer day in Siavonga, a lakeside jewel of Zambia’s Southern Province, I sat down with Mr. Bisael Phiri, the District Surveillance Officer for Siavonga District, to get his perspective on the malaria situation in his region and at large in Zambia. A breeze lazily floating through an open window and a small desktop fan provided the only reprieve from the oppressive heat as we got down to brass tacks about the progress made in the last few seasons of malaria interventions and how Reveal has impacted that progress.

Team members using Reveal-enabled tablets during an IRS campaign.

Mr. Phiri has been working in public health for several years, and is a big picture thinker when it comes to tackling malaria in Zambia. His motivations to work in this field are straightforward, “I know the kind of impact that good health can have on people’s lives. I wanted to do this work to help change the environment so it doesn’t constitute a danger to the public.” His work is based in one of the select districts of Southern Province that utilizes Reveal for their indoor residual spraying (IRS), mass drug administration (MDA), and reactive IRS malaria interventions through a PATH MACEPA and Akros-implemented program. Reveal is a powerful, open-source platform that aids in household-level intervention management and data authenticity by using spatial intelligence and smart planning tools. Mr. Phiri stresses that learning how to use this technology is self-explanatory and that the dashboards, which are tailored to his administrative level, greatly assist his day-to-day responsibilities. In his own words, “the dashboard is important to view on a daily basis because it identifies the status of various teams and shows us where we need to go and where the problem areas are. When we have this information, we can change our strategy based on how well our teams are performing, and change targets midway if need be. For instance, if I didn’t receive updated data from a certain district, I would not know that there’s an issue there. Now because I have these data, I would be able to make a quick plan for how best to move forward with that district.”

Beyond program planning, Mr. Phiri’s work is strengthened by the hard proof the platform provides that work is being done where it is supposed to be done.

Reveal takes aim at malaria parasite through mass drug administration campaigns in Southern Province, Zambia

By Parysa Oskouipour on September 18, 2019 in Health Data Systems, Malaria, News

Deep in Zambia’s Southern Province, in a town a three-hour drive away from the district’s largest city and economic hub (Siavonga), lies Manchamvwa Health Facility. This clinic serves as the focal point for the health needs of hundreds of people who live in the surrounding villages, and as such, is often overwhelmed with the many health needs of its patients. Malaria season in particular tends to put a great strain on the facility, with peak periods in previous years seeing anywhere from 100 to 200 cases per month.

Over the last couple of years, the Government of the Republic of Zambia (GRZ), with the assistance of Akros and PATH’s Bill and Melinda Gates Foundation-funded Malaria Control and Elimination Partnership in Africa (MACEPA), have been working with the National Malaria Elimination Program district staff to overcome these numbers and improve the health of the local community by using geospatial technology to optimize indoor residual spraying (IRS) campaigns. Recently, the two organizations teamed up again to be the first to ever use Reveal’s spatial intelligence approach to maximize reach and ensure accountability in a mass drug administration (MDA) campaign that distributed antimalarials to the doorstep of each community member in three districts of Southern Province.

Lake Kariba’s still, glistening waters at sunset.

The recent history of malaria in Southern Province is one of resounding progress thus far. Due to its proximity to Lake Kariba’s glistening, still water, it is unfortunately a heavily malaria-burdened region by nature. But malaria in this region is highly seasonal, linked to the annual arrival of rainfall from December to April, leaving ample overgrowth and standing water—prime mosquito-breeding real estate. This seasonality provides an attractive window through which most interventions have taken aim. The result has been an impressive decrease in prevalence of malaria parasitaemia among children less than five years of age, from 15.5% in 2006, to 5.5% in 2010, and 0.0% in 2018.1,2 Trends like these make Southern Province appealing as a prime candidate for malaria elimination. However, despite overall improvement in the province’s malaria burden at large, districts directly adjacent to the lake are still at higher risk, as malaria cases have shown to be persistently high in some health facilities despite ongoing interventions.

To propel Southern Province closer to elimination, in 2014 MACEPA supported the national program with a malaria MDA research study in the Southern Province districts lining Lake Kariba, an area with an estimated population of 300,000 people. The rapid malaria reduction in the study area resulted in Zambia adding MDA to its arsenal of interventions in 2017. The country’s experience of malaria MDA—two rounds with one month in between doses­—has shown it to be an effective intervention in areas with a strong foundation of vector control, case management, and surveillance. Recognizing that MDA campaigns are most effective when every household and individual in the targeted region are reached, MACEPA engaged Akros for its technical expertise in introducing Reveal as a novel approach to maximize the impact of MDA for malaria control and elimination in this area.

Finding a village never before visited by IRS

By Ernest Mulenga on April 16, 2019 in Malaria, News

Background

The Reveal tool is more than just a mobile data collection tool that improves data quality and timeliness. The tool provides spray teams with maps to navigate to areas that might otherwise be difficult to find. These maps are highly accurate and complete, made through our satellite enumeration process. The district mop-up teams are especially reliant on these maps. Mop-up teams are teams designated by the district with the specific task of revisiting areas that were not sprayed well during an initial visit or areas that were missed completely.

Unsurprisingly, mop-up teams help more areas reach the coverage goal of 90% sprayed and these teams visit some of the most remote villages, some of which have never been visited before. Ernest Mulenga, an Akros Surveillance Officer, documents the Chadiza’s mop-up team visit to a village; because the the team relies heavily on maps to navigate, they adopt vernacular of mapping and navigation, referring to the villages by the codes assigned to the “polygon” shapes appearing on the maps.

The search for polygon 01-455

It was the 9th of November 2017 when the mop-up team left Chadiza IRS base in search of Polygon 01-455 under Mtaya catchment area, which is located to eastern side of Chadiza district about 45 km from the district main post office.

Passing through Ngala area under Miti catchment, the team made a first stop at polygon 01-457 around 11:00 before proceeding to 01-455. The team used the GPS locator on the Reveal application, to navigate to a road that would lead to the village. Discovering the road to be impassable due to flooding from the heavy rain, the team was re-directed by locals to a path that went through the mountain and was said to be passable with a vehicle.

The Mtaya catchment area. The spray team was progressing through this area when they found polygon 01-455, which had never before been visited by a spray team.

The journey through the mountain started off well. After climbing some distance, however, the path became too filled with potholes for the Land Cruiser to continue. The team was left with no choice but to complete the journey on foot. At this point the team felt that they had covered a considerable distance with the Cruiser and that the polygon must not be far off. Thus, the team began to move with the aid of a GPS on the tablet. Once the direction of walking was set, the tablet was switched off for fear of using too much battery power.

It’s All About the Maps

By Anna Winters on January 15, 2019 in Health Data Systems, News

The Sustainable Development Goals (SDGs) set out big goals and targets—and countries are making real progress in some cases. Under five mortality has reduced by 58% in under 20 years. New drugs and vaccines are continuously coming to market. Some diseases, like polio and guinea worm, are nearing elimination.

Even still, large gaps remain. Every day, 3,000 children die from malaria. About 100,000 children die from HIV-related causes each year. These are diseases that are entirely preventable and treatable. Malaria is controlled with mosquito bed nets, antimalarial treatment courses, and insecticides. Antiretroviral treatments are making it possible for people living with HIV to live a long, healthy life.

If solutions exist, then why do we continue to see such levels of morbidity and mortality in the developing world? Too often it comes down to a lack of the right tools in the right place and at the right time. In seventeen malaria endemic countries in Africa, for example, indoor residual spraying (IRS) is used at a cost of hundreds of millions of dollars per year to kill mosquito vectors of malaria. In many cases, this tool is not achieving its full potential of reducing malaria, in part because it is not distributed to obtain a high enough true coverage. The World Health Organization tells us that IRS must be applied to at least 85% of a community in order to reach “true” coverage. Given the costs and the lack of enough resources to go around, the impact of this intervention sways further away from optimally saving lives from malaria.