Akros featured in recent reports

`Andy Prinsen August 28, 2017
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We strive to be consistently on the cutting edge of the development and technology sector. And the cutting edge does not form without a stalwart commitment to research and a collecting of best practices. We are excited to have been mentioned in several recent pieces of independent research as having implemented technologies and systems that are furthering development work around the world.


Mobile Solutions for Malaria Elimination Surveillance Systems: A Roadmap

The first is in a report titled “Mobile Solutions for Malaria Elimination Surveillance Systems: A Roadmap” funded by the Gates Foundation and carried out by Vital Wave. The study was done to “develop key recommendations regarding appropriate, scalable strategies to promote further innovation and coordination among technology partners” and to “Develop specific recommendations for a coherent and effective Foundation strategy for strengthening data collection systems and associated platforms.” Our mSpray system was featured as a highlight of the geolocation category for the way it increases the efficiency and effectiveness of indoor residual spraying (IRS) campaigns (page 48 of the report).

In its conclusions and recommendations, the report points out that “many of the key elements needed to improve the development and implementation of robust mobile tools for malaria surveillance already exist.” It also says that coordination among malaria program implementers will be key to success and will help keep current the list of necessary features within these digital tools.

Read the full report here.


Improving Data Quality in Mobile Community-Based Health Information Systems–Guidelines for Design and Implementation

Another report, titled “Improving Data Quality in Mobile Community-Based Health Information Systems–Guidelines for Design and Implementation” carried out by Measure Evaluation focuses on the most localized levels of data collection, namely the areas where community-based health workers (CHWs) collect and submit data and often provide services as an extension of the health system at large. Akros is featured when the report speaks to performance-based incentives established for health workers and their supervisors (page 26). In our community-based surveillance of malaria program, CHWs were incentivized with mobile phone airtime, helping the program maintain strong reporting rates and therefore better data from which to make decisions.

Read the full report here.


DHIS2 Community Health Information System Guidelines

In a third report, titled “DHIS2 Community Health Information System Guidelines” by the Health Data Collaborative, Akros and the University of Oslo collaborated on a DHIS2-based information system for Water and sanitation that was featured for its focus on transition to the Zambian government, its unique moible-to-web application, and its use of automated feedback loops (page 164).

Read the full report here.

Akros in India: Perspectives on ICT4D

`Brian O'Donnell June 20, 2017
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What do you feel when the Star Wars end credits roll? If you’re like me, it’s an abrupt mental shift from awestruck fantasy back to real life, a reminder the movie only got made when thousands of real people collaborated towards a singular vision. If you’re nerdy enough to dive into “behind the scenes” extras, all the grunt work needed to make a blockbuster franchise looks… well… less exciting. Of course, once you discover how a film was made, you begin to appreciate its artistry on a whole other level.

I had the same feeling as I absorbed two weeks of conferencing in India with digital development and global health practitioners from around the world on behalf of Akros. At the Information and Communication Technology for Development (ICT4D) conference in Hyderabad, we joined global experts to share our practical experiences in applying new technologies across a wide spectrum of development and humanitarian programs. Akros also participated in the Health Data Collaborative’s community health experts’ consultation in Goa, The workshop convened academics, government officials, and implementers from eight countries to craft technical guidelines on digitizing mobile health data from community health workers, the volunteers who deliver critical services in the most remote regions of Africa and Asia.

From theorizing on the broad meaning of the “Data Revolution” down to nitty-gritty tech requirements of community information systems, the overarching theme of both events was mainstreaming technology into day-to-day operations of development programs. That means moving past the futuristic “gee wiz” stage of exploring what’s possible with ICT4D, towards setting practical expectations and realistic national strategies. This is very familiar territory for us at Akros, where we have a developed for applying practical informatics systems for a variety of complex development challenges, ranging from malaria prevention to education management.

Some of the tips shared at the ICT4D Conference might seem obvious in theory, but can be surprisingly rare in practice, especially in public health. For example, before you start an new system to collect community level health data, you ought to know what kind of data already exist, and ask real people how these data are used. This tactic was exemplified by Cooper/Smith, which presented a robust landscape analysis of HIV data in Malawi under the Kuunika – Data for Action! project. Their focus groups with stakeholders found over 3,527 unique data elements across five systems, informing 335 unique decisions. Detailed assessments like these will not only increase the use of routine health data for decision-making, but might catalyze new innovations to send data where its most needed. Ona presented on the tablet-based mSpray tool, deployed by Akros in Zambia, which gives managers of Indoor Residual Spray teams the localized geographic information they need to manage local spray operations. Mangologic and e-Registries also presented on two adaptive tools for health professionals to bridge individual-level patient records with population-level health management systems— two solutions which only arose from assessing what tools already exist, and finding their design inappropriate for the complex user needs.
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Akros entries selected in photo competitions

`Akros Media May 31, 2017

Over the past few months, two photos by Akros Communications Lead Andy Prinsen have been selected as winner and honorable mention in their respective photography competitions. The first was the “Picturing inclusive CLTS photo competition” sponsored by the CLTS Knowledge Hub, and Prinsen’s photo titled “School Sanitation: Equal and Proud” was selected as one of three winners.

Female students from Maunga School in Zambia’s Southern Province stand in front of one of the school’s new improved latrines. When the girls were menstruating, they would often stay home for lack of sanitation facilities at school. Now, with funds from UNICEF, the girls’ latrines are built with a privacy enclosure and a specially built water-channeling floor so they can wash properly before returning to class. Through sanitation tracking done by Akros, the school has seen a significant decrease in the young women missing school for days at a time.

The CLTS Knowledge Hub is a collection of news and information on the Community-Led Total Sanitation Movement and is a great resource for professionals working in the field or those interested in learning about CLTS.

Another of Prinsen’s photos was selected as the honorable mention for the category of mHealth and Communications Technology in the 12th annual Photoshare contest.

An Akros surveillance officer sits with Community Champions from Nyimba, Zambia, to map the villages they serve. In this innovative mapping process, the surveillance officer uses Google Earth’s satellite imagery to navigate these community members’ villages “like a bird in the sky.” Most community champions have never seen satellite imagery before, but they know their communities so well that the mapping process works amazingly well. This is the first time decision makers at the national level will have detailed location data on these villages, allowing them to make more informed decisions and reach villages in times of emergency.

Photoshare is a service of the Knowledge for Health (K4Health) project, based at Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP). Photographers submit images to Photoshare for free, public use by nonprofits and for educational purposes. Photoshare is a leading source for public health and development communication, focused on demonstrating the value and impact of photography in global health efforts to improve health and save lives.

The Elimination 8 Regional Surveillance Database (ERSD)

`Annie Martin May 8, 2017
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To achieve malaria elimination, an understanding of neighboring country malaria situations is critical for the prevention of introduction of parasites. Malaria parasites don’t stop at country borders, so effective elimination strategies shouldn’t either. That is why the Elimination 8 (E8), in its strategy on cross-border collaboration, identified Akros to support the development of the E8 Regional Surveillance Database System (ERSD) for the eight member states constituting the E8: Botswana, Namibia, South Africa, Swaziland, Angola, Mozambique, Zambia, and Zimbabwe. This innovative approach is a means to level the playing field and conduct malaria surveillance at a regional scale.

Figure 1. Cross-border incidence* in districts in Zambia, Mozambique, and Zimbabwe: Having access to several countries in one database allows these kinds of visualizations, which may highlight transmission patterns that occur between countries, which in turn supports decisions to invest in control methods in border areas.
*All data shown is used purely for illustrative purposes and do not reflect current or historic epidemiological status of countries. Current data can be accessed in the database itself by those granted authority.

Malaria is hardly an emerging disease, and though the interventions of preventing, treating, and monitoring malaria are somewhat standardized, each country has slight permutations of their approach to doing so. Indicators may differ slightly, investment in one prevention method versus another likely differs too, and policies surrounding implementation certainly are not identical.
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Mobile Platform Enables Unprecedented Sanitation Uptake in Zambia

`Andy Prinsen February 15, 2017
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CLTS has been shown to be an effective method to combat malnutrition and stunting in children under five. In this study, a mobile-to-web platform increased the uptake of CLTS even further, allowing for greater community feedback, a reduced cost per new user of sanitation, and increased data transparency.

Akros, in partnership with Zambia’s Ministry of Local Government and Housing (MLGH) and UNICEF, layered a unique mobile-to-web application over traditional CLTS delivery methods, resulting in an innovative service delivery and monitoring system dubbed “CLTS M2W.”

CLTS M2W uses mobile phones, automated data feedback loops, and engagement of traditional leaders to provide communities with the ability to clearly see their progress towards sanitation goals. CLTS M2W paved the way for unprecedented CLTS uptake in Zambia, facilitating the creation of over 1,500,000 new users of sanitation in 18 months. In short, CLTS creates the demand, and CLTS M2W creates the critical transparency necessary to drive sustained behavior change.

Read the full study in PLoS Neglected Tropical Diseases.

Read this and more CLTS-related news on the CLTS Knowledge Hub.

Gavi Pacesetter organizations

`Andy Prinsen February 8, 2017
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GAVI is an international organization – a global Vaccine Alliance – bringing together public and private sectors with the shared goal of creating equal access to new and underused vaccines for children living in the world’s poorest countries. It is backed in part by the Bill and Melinda Gates Foundation.

GAVI held its first INFUSE workshop (Innovation for Uptake, Scale and Equity in immunization) in Geneva. Around 60 organizations and companies applied to the program, and 18 of these projects were selected for a final round of vetting in front of a panel with representatives from the organizations and companies like the World Health Organization (WHO) and UNICEF. At the end of the workshop, the panel selected seven “pacesetter” organizations who will work with GAVI to scale up their ideas and projects and bring them to new countries.

We are excited to announce that Akros has been selected as one of these seven pacesetter organizations for a concept that follows in-line with our approach of gathering village level information to inform decision making. The approach takes existing monitoring tools in the country, like stock monitoring and commodities tracking, and merges them into a single vaccine-tracking database using a platform called DHIS2. In the database, Rural Health Clinics (RHCs) log immunizations delivered using simple feature phones. Parents of children due for their next immunization receive SMS appointment reminders along with a list of clinics that have the vaccine in stock. The RHC also receives a list of patients in the area who are due for follow-up vaccination appointments.

“Vaccine coverage has made big leaps, but until we reach the last mile of care, we won’t see disease elimination,” said Akros Portfolio Lead, Laurie Markle. “We are excited what this partnership could mean for reaching the ‘fifth child,’ not just in Zambia but around the globe.”

Akros shares its designation as a 2016 Gavi Pacesetter with six other organizations: Shifo, IRD, KhushiBaby, Energize the Chain, Broadreach, and Nexleaf Analytics.

As part of the partnership, Akros and GAVI will work closely over the coming year to identify resources and partnerships that will enable both implementation of the program and maximum impact.

Chipo’s Story

`Andy Prinsen February 3, 2017
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Akros is proud to be working with Sightsavers, an organization working in more than 30 countries to eliminate avoidable blindness and support people with visual impairments to live independently. Recently, we spent a day with Chipo, a young girl living in rural Zambia. Both Chipo’s great grandmother and great-great-grandmother are blind as the result of an infection called trachoma. Their disability would make life more difficult anywhere in the world, but especially so in the setting where their family lives. Chipo must work extra hard every day to care for her elders, often times at the expense of her studies.

Sightsavers has featured Chipo’s story, created in partnership with Akros, at their Exposure site. Click here to read the story, and stay a while to browse the other powerful pieces demonstrating the difference that can be made for those with blindness – and in the prevention of blindness – around the world.

For a longer version of Chipo’s story, click below to download the PDF.

Download Chipo’s story in PDF format


About Andy Prinsen

Andy Prinsen is Communications Lead for Akros. He has a masters degree in public affairs and a bachelors in journalism, both from Indiana University. He specializes in visual communication and photography.

Piloting Zambia’s first mobile-to-web education monitoring system

`Laurie Markle October 18, 2016
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About two years ago, Zambia’s Ministry of General Education (MoGE) approached us with an idea: let’s build a more routine, faster method for capturing key school indicators. At that point, the Ministry was collecting a 27-page annual census and using the data to make nearly every key decision like procurement of school supplies, investments in infrastructure, and distribution of teachers. The data was outdated by the time it was received and the Ministry needed a method of responding to student needs more than once per year. Shortages in teachers, textbooks and toilets require a more timely response than an annual survey allows.

And so began the work of setting up Zambia’s first mobile-to-web Education Management Information System (EMIS). Though education was a new sector for Akros, we knew what it takes to build out a national system and began applying those principles:

(1) Keep your eyes on sustainability

I remember walking out of our initial stakeholder meetings with a list of over 40 data elements in hand. We knew this was too many. Sending data, though inexpensive, adds up when you grow to scale and sending too much data creates reporter fatigue. It took us a few months of asking key questions, like “when are you making decisions?” and “What do you need to know in order to make them?” to get the list of data elements down to 11. With only 11 questions, we’re monitoring student and teacher attendance, school-feeding program activity, grant distributions, access to sanitation and menstrual hygiene management, and test scores in literacy and numeracy.

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Building one of the world’s largest data surveillance platforms

`Alexis Barnes September 19, 2016
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Chief Singani of Zambia’s southern province displays the tablet that he uses to check up on his chiefdom’s sanitation progress.

Leveraging a massive network of community volunteers, Akros works with the Zambian government and UNICEF to manage one of the world’s largest data surveillance platforms. The platform, designed and scaled for monitoring sanitation uptake in rural villages, relies on a network of over 3,600 community champions (CCs), environmental health technicians (EHTs), and other government representatives at the district level to report on sanitation uptake from ~ 21,000 villages across Zambia using mobile devices. The sanitation platform, which includes information on community and school led total sanitation and facial and environmental cleanliness for trachoma elimination is the largest surveillance platform in Zambia. However, Akros also supports similar community data collection systems in Zambia for malaria, education and land tenure. The systems, although different in content, all funnel data up from the community level into national level DHIS2 databases using similar technology. Many of the community volunteers use their mobile phone to collect data for more than one of the systems, reporting on multiple issues simultaneously such as latrine standards and mosquito net usage in their communities.

How does this work?

Across all sectors, it begins with a feature phone, a simple Nokia model mobile device. In their respective sectors, volunteers visit the households in their specific catchment area and survey specific indicators such as hand washing stations, proper number of mosquito nets per household member and latrine covers. They then input this information into the mobile phone DHIS2 platform for that month. With consistent data input, the software then allows anyone with a username, password and Internet access the ability to see up-to-date data on malaria, sanitation and trachoma statistics for different districts and provinces in Zambia. In community-led total sanitation (CLTS) alone, more than 1,300 village-level Community Champions (CCs) provide monthly reports to DHIS2 from over 13,500 villages.

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Akros-led consortium to develop Elimination 8 regional malaria database

`Andy Prinsen August 19, 2016
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We are excited to announce that an Akros-led consortium has been selected to develop a regional malaria surveillance platform for a coordinated, eight-country effort to achieve the historic goal of eliminating malaria in eight southern African countries. The Southern African Malaria Elimination 8 (E8) is a partnership between Botswana, Namibia, South Africa, Swaziland, Angola, Mozambique, Zambia, and Zimbabwe. The first four of these countries (frontline countries) have an elimination goal of 2020, and the later four (second line countries) hold a goal of elimination by 2030. Consortium members working with Akros include HISP-SA and Compre Health.

E8 countries reported a tremendous reduction of malaria cases of more than 50% since 2004. However, the closer we get to elimination, the better surveillance we must have. Malaria does not respect borders, meaning the four eliminating countries cannot eliminate as long as high transmission remains within the region, and human migratory patterns facilitate parasite movement from more highly endemic countries. Therefore, new regional strategies are needed to support the surveillance and control efforts by the second line countries in order to reduce the reservoir of malaria parasites which have a potential for cross border spread of infections that could re-establish infection in the frontline four countries. As frontline countries progress towards malaria elimination, second-line countries are intensifying their malaria control efforts in order to achieve pre-elimination status.

The knowledge of malaria trends between countries will be one of the main factors influencing the success of malaria elimination. To facilitate the ease of information sharing, the E8 working with the consortium have developed a regional database, which will sit within the District Health Information System (DHIS 2), a system already familiar to many of the 8 countries. The regional database will not be a parallel system — no new malaria data elements or indicators will be collected. Rather several malaria data indicators already captured in countries will be shared amongst countries via the regional database. This is in-line with E8 country-level commitments to malaria data sharing in efforts to eliminate the disease. The more data we have consistently and accurately, the better we can plan and target relevant interventions that will drive the malaria burden in southern Africa down to zero.