Anticipating Continued COVID-19 Needs: Lessons from Yesterday

By Anabelle Nuelle on September 28, 2020 in Capacity Building, GIS, News, Water and Sanitation Health

At the time of writing, 33.7 million cases of COVID-19 have been reported worldwide. Regardless of socioeconomic standing, health systems around the world have shuddered beneath the weight of an international pandemic; leading to overflowing ICUs, overextended health care resources, and disrupted critical supply chains. 

 

Accordingly, international attention and funding has turned to global public health and preparedness. The World Health Organization (WHO) has estimated approximately US$1.7 billion total funding is needed to adequately respond to COVID-19 until December 2020. As of September 21, 2020 WHO reports receiving 79.5% of their goal, with an additional 4% expected from pledges—a combined US$1.51 billion raised in the span of a few months. Resources have been rightly and urgently mobilized to offer aid now, but as a responsible global health community, we must look toward the future and set in motion plans to meet anticipated gaps and needs. 

 

If we are to respond effectively and reach the most vulnerable populations, our future interventions to protect people from COVID-19 transmission will inevitably rely on community health structures to disseminate aid and vaccines. If the systems in place are not adequately equipped to respond, those interventions will fall short. Further, if we lack good data on the population and location of communities, getting resources to all those in need will be even more challenging. However, presently, population data are often inconsistent, outdated or quite coarse. Compromised by unclear boundaries or moving populations, the resulting data typically offers only a blurred picture of communities, making it challenging for public health teams to allocate resources effectively.

Reveal—spatial intelligence for planning, targeting, and real-time management of interventions in low-resource settings – A Case Study

By Kyle Hutchinson on June 28, 2020 in Capacity Building, GIS, Malaria, News

The Denominator Challenge

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

Reveal features a field-verified denominator, data collection points, and maps.

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.

Reveal uses electronic data collection forms that are smart and easy-to-use to ensure data quality, collect GPS data, and provide real time data feedback for decision making.

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.

The Inside of Context is King

By Anna Winters on January 31, 2019 in Capacity Building, Health Data Systems, News

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.

Akros GHC crew hosts webinar on what it’s like to be a GHC fellow at Akros

By Akros Media on November 21, 2017 in Capacity Building, News

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!

Akros featured in recent reports

By Akros Media on August 28, 2017 in Capacity Building, Health Data Systems, Malaria, News, Uncategorized, Water and Sanitation Health

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.

The Elimination 8 Regional Surveillance Database (ERSD)

By Annie Martin on May 8, 2017 in Capacity Building, Health Data Systems, Malaria, News

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.

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

By Laurie Markle on October 18, 2016 in Capacity Building, News

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.

Reflections on ASTMH Conference 2015

By Sandra Chishimba on January 21, 2016 in Capacity Building, Malaria, News

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.

Zambia Systems for Better Health consortium created

By Akros Media on November 9, 2015 in Capacity Building, Health Data Systems, News

USAID has awarded a new consortium a $54 million contract for a five year health systems strengthening project. Akros will be one member of the consortium led by Abt Associates that also includes the American College of Nurse-Midwives, the Broadreach Institute for Training and Education, Imperial Health Sciences, Initiatives, Inc., and Save the Children. Over the next five years, the consortium will collaborate with the Ministry of Health at all levels to strengthen the systems that underpin the delivery of high quality health services and increase the utilization of high impact health interventions at district and community levels.

The health systems strengthening strategies include an emphasis on five major program areas:

1. HIV – strengthening of systems that underpin the delivery of high impact HIV prevention, care and treatment services in high prevalence districts;

2. Family Planning – information and services to promote the delay, spacing and limiting births;

3. Nutrition –interventions at community level in Eastern Province aimed at reducing chronic malnutrition;

4. Maternal and Newborn Health – strengthening demand and services for safe delivery and newborn care; and

5. Child Survival – including Integrated Management of Childhood Illnesses (IMCI) and Expanded Program of Immunization (EPI).

This program builds on the success achieved by the Zambia Integrated Systems Strengthening Program (ZISSP) that was implemented from 2010 to 2014.