Reveal, an open-source Digital Global Good, claims Southern Africa (specifically Zambia) as the region which nurtured its development throughout its formative years and many phases of expansion. After six years of optimizing the delivery of household-level interventions in Southern and Eastern Africa, 2020 marked the first year that Reveal made its way to the western edge of the continent to augment malaria prevention programming in Senegal. Building on the success of their partnership in Zambia, PATH’s Malaria Control and Elimination Partnership in Africa (MACEPA) alongside Senegal’s Ministry of Health and Social Action collaborated with Akros to conduct enumeration and mapping in 7 districts, 4 of which used these maps to support indoor residual spraying (IRS) microplanning and delivery in 2020. With a better understanding of how granular geospatial data can support IRS planning in the second phase of this collaboration, these 4 districts used the Reveal mobile application to enhance their ability to deliver an effective IRS campaign and to more accurately understand spatial gaps in achieving campaign effectiveness. Notably, this was also the first opportunity for Reveal’s user interface to be made available in French so that francophone teams in Senegal could effortlessly make use of its features.
The first Reveal Forum of the year was held virtually on Wednesday, 23 June 2021. The Reveal Forum is a community event that takes place several times a year, which includes government partners, implementers and developers from ~ 28 organizations who are currently implementing Reveal, or are tracking the roadmap and are interested in using Reveal to improve the impact of health campaigns.
The objectives of the Reveal Forum are to provide community members with the opportunity to:
give an update on any new features that have been developed, or are in the process of being developed, and what we as community members can expect as a result;
share valuable lessons learnt through new or ongoing implementations, and why these are important in the context of operationalizing and scaling Reveal; and
based on implementation experiences, provide a view on what is most needed, technically or otherwise, to better operationalize and scale Reveal in the future.
The goal of the Reveal Forum is to bring community members together so that all have a common understanding of the current and possible future state of Reveal; to understand who is doing what, where and how; and ultimately, to learn from and support each other in a collective ambition to scale and sustain the Reveal platform to help health and other campaigns achieve their intended impact.
The recent Reveal Forum was attended by approximately 35 community members. Kyle Hutchinson, Reveal Coordinator, opened the Reveal Forum by providing participants with an overview of the goal and objectives of the Reveal Forum, along with an update on some additional community building efforts, including the establishment of both Steering and Technical Committees.
Accurate quantification of a population, and the ability to locate this population with precision, are fundamental requirements for reporting the true coverage and effectiveness of public health interventions—such as childhood immunizations, indoor residual spraying (IRS) for malaria, or mass drug administration (MDA) for neglected tropical diseases.
Public health interventions, however, often rely on field teams to locate rural villages or even homes on the ground. In areas where there are no street address systems, or where homes are not mapped, manual searches often result in groups of households being missed; thus preventing the delivery of services to those in need. When service coverage is subsequently reported as a function of the population found, the impact and effectiveness of an intervention may be overstated.
Spatial Intelligence and the Reveal Solution
The transformative field of spatial intelligence is revolutionizing digital health and public health more broadly. Artificial intelligence (AI), digital maps, and spatial modeling are powerful, burgeoning toolsets; but until more recently, they have not benefited field workers and large-scale, labor-intensive campaigns. Now, the power of these digital tools is being accessed by field workers in rural, underserved communities.
Reveal, an open-source platform and global good, uses spatial intelligence to help field workers effectively navigate and deliver life-saving interventions to people who previously would have been missed, increasing the true coverage of interventions and improving health outcomes for vulnerable populations.
Supporting an IRS Campaign in Zambia
Satellite imagery was enumerated to establish a baseline understanding of structure count and spatial distribution in several districts. These were layered with risk maps to target high-risk regions, which enabled users to identify eligible households and assign teams to priority areas.
Using Reveal’s mobile and map-based interface, field workers were able to navigate through communities, identify targeted households, and collect intervention data against eligible households in a coordinated manner within and across teams. The near real-time feedback of data, as a result of the mobile application’s offline and peer-to-peer (P2P) syncing functionality, inspired increased teamwork and cohesion as the campaign progressed and teams worked toward a common goal.
Through dashboards, map-based visualizations, and built-in feedback loops, intervention managers were able to actively monitor campaign progress toward targets, in a given spray area and as a whole, thus facilitating data-driven course correction to optimize performance and maximize impact.
With the support of Reveal, Siavonga District increased its absolute coverage of IRS from 51.5% to 75.5%, while Sinazongwe increased from 31.5% to 61.9%. These changes in coverage were possible due to a better understanding of resource needs. In other words, the use of Reveal allowed districts to better understand the size and distribution of the target population, thus impacting planning and implementation.
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.
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.