Rolling out Reveal 3.0—Advancing the Maturity of this Digital Global Good

By Parysa Oskouipour on April 8, 2023 in News

Since its first inception supporting house to house malaria campaigns in southern Africa, Reveal has been through numerous phases of growth. Originally named “mSpray,” the tool debuted in 2015 and was used exclusively to support indoor residual spraying (IRS) campaigns by using geospatial data and a suite of tools to improve coverage rates. In some cases, coverage rates improved by as much as 20-30 percent. (1)

In 2019, Akros received development funding to expand the tool and rebranded mSpray as “Reveal”—a platform to assist in the micro-planning, delivery, and management of a wide variety of health campaigns. Reveal is an open-source digital global good that uses smart maps and technology appropriate for resource-constrained settings to monitor coverage of interventions in real-time and optimize available resources. 

Reveal’s mobile application spatially guides field teams to planned areas and households for service delivery. This mobile application allows offline data collection and captures indicators to inform critical field decisions. Reveal also includes a web user interface with real-time dashboards to provide program managers with helpful coverage data that informs current activities and guides teams to achieve true coverage targets. 

Reveal was initially built on the OpenSRP trunk, but in late 2021 was shifted to a more appropriate backend solution. Through this monumental phase of growth, now called Reveal 3.0, the efficiency, stability, adaptability, and sustainability has improved significantly.

All in all, Reveal has impacted 3.6 million people across the 10 countries where Reveal has been deployed. (2)

Here is a snapshot of what has been improved, updated, modified, and rebuilt:

1. Quicker upload of geographic data. Reveal relies on large amounts of geographic information — locations of individual households, settlements, communities — Reveal allows health workers to visualize all these elements down to an extremely granular level. That level of geographic data is ‘heavy’. Given the often rural, low network environments where Reveal is used to allow health workers to navigate to last mile communities, it is crucial that these data can be made as ‘lightweight’ as possible. In 2020, importing geographic data to the Reveal system took as much as 3 to 7 days. By 2021, time required was reduced to 5-12 hours. Now, with the system wide improvements of Reveal 3.0, this same upload can be completed in as little as 1.5 hours, a huge performance and efficiency improvement.
2. Efficient assignment and tasking of areas to each health worker. In 2020, the map views were quite static and the user interface required assigning teams one by one to health facility catchments. This was a tedious process during the microplanning stage. Now, through Reveal 3.0, a gridded tabular view and improved, agile map view can both be used to guide microplanning. Managers are able to quickly assign teams through either the grid view or by clicking through the map. Further, the map view has made significant improvements — users can change the angle of elevation and switch between pre-loaded map layers. Multiple polygons can be selected and deselected on the fly.
3. Reduction in configuration time  to support a new field implementation. One major input we consistently have heard from Reveal implementing partners is “we need the setup to run Reveal in a new implementation to be faster and easier”. Through work containerizing Reveal infrastructure and components, we now see a reduced deployment timeframe from roughly 1 month (all Reveal 2.0 implementations in 2020 required a month’s worth of effort)  to 1 week.
4. The Reveal Planning Module including Improved visualization allowing users to develop geospatially rigorous microplans including the commodities and staffing necessary to achieve target coverage levels in campaign areas.

Reveal 3.0 brings with it significant performance improvements, stability, and faster speed, while being FHIR compliant. And yet, with all these modifications already in progress, we are still keeping an eye to the future and asking the question: What comes next on the Reveal roadmap? Thanks to generous funding from our partners at Digital Square, The END Fund, the National Institutes of Health, and the Bill and Melinda Gates Foundation (BMGF, Grand Challenge Grant), a number of exciting items are in progress, including:

• Reveal being made available through the Google Play store in June 2023 – users will be able to download and access the application quickly and easily. As an open source, digital global good, we want Reveal to be as open and accessible to Ministries of Health and their partners as possible. This has taken some time, but Reveal has made tremendous progress in that direction in the last year. Reveal will be live on the Google Play Store in 2023.
• Upload and activation of spatial models to guide campaigns taking into account population movement, and high risk areas for disease transmission. For example, spatial models capturing seasonal migration or displacement due to conflict can be built through tracking cell phone data — ‘operationalizing’ these models through the Reveal platform will equip teams to deliver health services to all.
• API for integrations – For sustainable scale of the Reveal platform, as well as uptake by the government, Reveal must integrate with existing health information systems (HIS). Further, Multiple countries and implementing partners have requested a direct integration between Reveal and DHIS2.In the coming months, Reveal and DHIS2 (also known as the District Health Information System which currently  is used by ministries of health in 73 low and middle income countries as a central repository for health records) are being integrated. By integrating these systems, we envision (1) easier institutionalization of the Reveal systems, and long term sustainability — as well as offering Ministries of health the ability to automatically visualize data captured through Reveal in their DHIS2 instances.

Reveal 3 will be deployed everywhere Reveal is currently being used. This transition will be monitored and assisted, with adequate support and training provided by the Reveal community. With Reveal 3’s brand new back end, new web application, same (but more functional) Android client, and other exciting new features, this tool delivers better performance with lower costs. 

**If your government program is interested in deploying Reveal, or you are a local implementer interested in joining the community to support Reveal deployments, please contact info@akros.com

References:

1. Larsen et al (2020). Leveraging risk maps of malaria vector abundance to guide control efforts reduces malaria incidence in Eastern Province, Zambia. Nature Scientific Reports. 10: 10307 https://www.nature.com/articles/s41598-020-66968-w
2. WorldPop https://www.worldpop.org/, total population per geographical area in which Reveal is deployed.