Technology is playing an increasingly important role on the African continent, helping medical teams ensure children and vulnerable people are given essential vaccinations.
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Many developing countries still rely on paper-based health data systems. But a partnership comprising Vodafone Group Foundation (VGF), the World Health Organization (WHO), the national Ministries of Health and the United Nations Foundation (UNF) is supporting an initiative to develop efficient and effective health data systems, which are essential to improving global public health.
The partnership's Health Data Systems program is working to replace paper-based health systems with a powerful, portable electronic system based on open source technology developed by not-for-profit organisation DataDyne. The system provides the data that powers the fight against deadly diseases, and serves as an early-warning system for epidemics by flagging destructive trends before they transform into global health emergencies.
Mitul Shah, senior director of technology partnerships at the United Nations Foundation, said, The premise behind the work is to be able to provide health works with mobile technology to replace inefficient paper-based approaches."
Health workers need to run surveys and collect health data in order to run immunisation programmes such as the programme to provide immunisation against measles. "In rural areas, medical data did not exist." Shah and his team realised they needed a tool that would allow health workers to run surveys and questionnaires on mobile devices in order to collect medical data.
Joel Selanikio, a physician, epidemiologist formerly of the US Centers for Disease Control and Prevention, realised that the developing world needed an alternative. "My idea was to use computers for data collection, as most of the health surveys were being carried out using paper and clipboards." It could take health works in Africa two to three months to collect the data and anything between six months and a year to load data into a computer system.
Systems for collecting health data do exist, but they tend to be proprietary. "We tried using a questionnaire applications for handheld computers, but it required a programmer," Selanikio said. This would have made it costly to change and adapt the questionnaires.
Along with medical career, Selanikio had previously worked as a Wall Street computer consultant and decided that the only solution was to start building the software himself. "The software needed to be comparable to a word processor in terms of ease of use. I began programming it myself, and hired a programmer for the first stage of development."
The program, EpiSurveyor, is a free, open-source, standards-based software package for the collection and analysis of any type of information on mobile devices. In 2003, he co-founded DataDyne with computer consultant Rose Donna, who had previously worked for the American Red Cross, to help promote and develop EpiSurveyor.
By providing the free software, the two founders hope that participating countries will be able to collect and analyse data themselves, which should dramatically reduce their need for consultants. It could also increase their ability to identify and manage public health issues including HIV/Aids, malaria and measles.
"We are trying to create a tool for small non-government organisations that is low cost," Selanikio says. Data is moved from a Palm handheld device to a PC using a cheap data synchronisation cable. But he is keen to take advantage of the explosive growth of mobile phones in Africa. "In Kenya, almost 100% of health workers own a mobile phone, so we are working on a Jave 2.0 Mobile Edition application for mobile handsets that will allow us to transmit survey data via wireless."
Since 2006, regional/provincial health officers in every country of sub-Saharan Africa have been trained in the use of EpiSurveyor mobile electronic data collection software. Health officers in these countries have been given training on how to use EpiSurveyor for the collection of information to support clinic supervision, as well as any other data they need such as vaccination coverage and outbreak response.
Selanikio said he has seen promising results in Kenya, where EpiSurveyor is being adopted across health programmes. In particular he says it has been successfully used in the malaria department of Kenya's Ministry of Health. The Kenyan government has also taken the decision to allocate new funds to purchase additional PDAs. This will increase the use of EpiSurveyor in particular at the district level.
Along with Kenya, countries already trained and using EpiSurveyor include Zambia, Ghana, Uganda, Cameroon, Senegal and Sierra Leone. In November 2007 the Ethiopia Ministry of Health and the World Health Organization's African Regional Office gathered in Addis Ababa for training and field testing of DataDyne's EpiSurveyor open-source mobile data collection tool.
The use of EpiSurveyor in Africa is featured in a new report from the Vodafone Foundation and the United Nations Foundation, Wireless Technology for Social Change: Trends in Mobile Use by NGOs, which is being released on May 6. The report covers how advocacy groups active in the areas of global health, environmental conservation, and humanitarian relief are using wireless technology to effect social change.