Akros is a bit different than most development NGOs. Instead of a large corporate office in a distant setting, Akros bases its team in Southern Africa. If we are solving problems in rural developing contexts, shouldn’t we be near enough to the challenges so we understand them? We have chosen to be close to the beneficiaries of our work to receive feedback, learn from what works and what doesn’t, and provide simple yet innovative solutions to the everyday problems that are faced. Since our goal is to provide support to communities and their governments and to transition lessons learned into sustainable programs, shouldn’t we work very closely with our government partners both in the office and in the rural communities we serve?
We think yes. And that’s driven our design.
At Akros, we bring innovative ideas for gathering and using data to solve development challenges through a “boots on the ground” approach. We’ve built our organizational culture and nuanced approach to implementation by being where our work is: in Southern Africa. Akros has been supporting government and partner counterparts from our headquarters in Lusaka, Zambia for over ten years. This close partnership has helped to contextualize our work and to ensure that we are only scaling ideas and approaches that are proven to make impact and be sustained in under-resourced settings.
Being close to the challenges has meant the solutions that we’ve fostered gain ownership by community leaders. This type of accountability has created a huge impact. In Zambia, a chief’s wishes and commands hold a lot of weight. Getting these leaders data about their community, talking to them about health standards, and teaching them about health promotion and awareness can mean significant positive change for rural areas. For example, in some rural communities, open defecation was quite common. Our people went into communities, brought data and statistical evidence to the chiefs in formats they appreciated, and succeeded to get these community leaders on board with several water and sanitation interventions. Chiefs encouraged their communities to build latrines and use them. And then, the people did! The problem and effects of open defecation were therefore greatly reduced. The result was that some of the first open defecation free districts in all of Africa were named within Zambia.
If we had been based far from the situation, we may have missed the nuances of the problem by being outside of its context. We may have designed solutions that were too tech heavy for the environment. We may have created a “mobile tool” but not helped build an enabling environment for its success. We may not have understood how chiefdoms work and just gone into the situation blindly, wasting time and resources. We may have done “business as usual” and missed our mark. In short, we may have not made the impact on health that we strive to make.
There’s a joke in here somewhere about inside jobs. But for now, we’ll just say that at Akros, context is king.
About Anna Winters
Anna Winters founded and serves as the CEO of Akros. Winters holds a PhD and MS in epidemiology coupled with extensive field experience leading the development and implementation of community-wide surveillance systems in sub-saharan Africa aimed at targeting health interventions to maximize impact. Through Akros and previously with the Centers for Disease Control and Prevention, Dr. Winters works directly with host country governments to ensure viability and integration of health innovations. Contact her at firstname.lastname@example.org
How can the same sort of systems we use to collect and organize health data from rural areas be used to collect and organize land use? Why is land use important for development? Check out this recent article from “The Best of Africa” blog to learn some of those answers and more!
On November 16, current and former Akros GHC fellows shared their experiences and fielded questions from hopeful GHC candidates. Each year, GHC a diverse group of young leaders with a vested interest in health equity joins GHC to complete a 13-month fellowship with partner organizations in five countries: Malawi, Rwanda, Uganda, Zambia, and the U.S.
Below is a full recording of the webinar in case you missed it!
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.
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.
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.
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.
First and foremost, I wish to acknowledge the travel funds from Akros for providing me a great opportunity allowing me to attend the 2015 annual meeting American Society for Tropical Medicine and Hygiene (ASTMH). ASTMH is an interdisciplinary organization for the field of tropical medicine, and the annual meeting is for all scientists whose work is in tropical medicine around the world. The research topics ranged from basic science to clinical research. The conference program was divided into two blocks: oral presentations and poster presentations. Presentations of interest to the general audience were arranged for the morning and afternoon. The poster sessions were scheduled for lunch time.
The meeting began on Sunday evening with the keynote lecture given by an eminent scientist, Rajiv Shah MD who formerly opened the meetings. During this session we also had a moment of silence in honour of the former late president Dr Allan McGill who died suddenly.
The oral presentations were about 15 minutes each. The presenters were clinicians, researchers, PhD students, postdoctoral fellows and some MSc students. The presentations were of high quality cutting edge science research and a broad range of topics were covered. The topics were subdivided into Global health, Clinical, Virology, Molecular, Cellular, and Immunoparasitology research. Much emphasis was made on combating new infections during the global health discussions. This was with reference to the most recent outbreak of Ebola in West Africa. It was clear that the research field, and health systems around the world, need to be strengthened and prepared in the event of a major disease outbreak. Malaria research was a topic not to be missed. New cutting edge techniques on how to investigate ultra-low infections as malaria elimination is being implemented in several countries were presented. Such ideas work to our advantage as we can then interact personally with the researchers by asking questions in person at the meeting and after the meeting in the event that we decide to follow up on the idea for our research.
Akros recently hosted 14 undergraduate Montana State University (MSU) students in Zambia from May 14 to June 11, 2015. The students were enrolled in a course titled “Zambia: Community and Family Health,” taught by Professor Wendy Bianchini Morrison of the Health and Human Development department at MSU.
“I approached Akros management a year and a half ago with the idea for this course,” said Morrison. “I wanted to bring MSU students to Zambia to expose them to international community health work. Akros management was very open to the idea and expressed interest in collaborating on the course.” She reported that Akros was appealing because it is an established organization in Zambia that has strong relationships with the government, local ministries and communities across the country, and implements public health initiatives that use data and research to increase the efficacy of their interventions.
The three stories below were written by students from Montana State University during their time in Zambia.
The creators of DHIS2 at the University of Oslo highlighted Akros this month in their most recent newsletter. They shared a prezi that walks through how DHIS2 is used in Zambia, specifically the innovative new system The Government of the Republic of Zambia (GRZ) has created with technical assistance from Akros, to reach its goal of eliminating malaria country-wide by 2020. One of the components of this system centers around community-level malaria surveillance and leverages community health worker (CHW) networks in two main areas:
1. Finding, treating and reporting all malaria infections in the community
2. Reducing the burden of outpatient care and staff work load at the health facility through expanding access to malaria diagnosis and treatment by CHWs at community level.
Check out the prezi below, then click here to learn more about Akros’ work in community-level malaria surveillance.
[icon size=”22″]icon-file[/icon] Download a PDF about community-level surveillance.