1. TB eHealth System for Improved Service Delivery
2019 ENGINEERS CONFERENCE
Maurice Rhema Fundani

2. Contents eHealth project introduction Project summary
Problem definition
Current Community TB cases management and reporting approach
Current TB sample transportation interaction between health facilities
Methodology
Solution
Overall solution architecture
Mobile App
eHealth Web portal
Power and security issues
Solar based back up system

3. iMoSyS was contracted by the National TB Programme to develop an eHealth system for TB data collection and monitoring. Project implementation period: 2017 to 2019
The Government of Malawi is among four countries (Lesotho, Malawi, Mozambique and Zambia) participating in the Southern Africa Tuberculosis and Health System Support Project (SATHSSP) funded by the World Bank (IDA).
Introduction

4. Aim and Objectives of Project
To provide improved community TB care interventions that shall seek to minimize diagnostic and treatment delays
To provide strategic guidance and technical support to facilitate the introduction and use of eHealth strategies to strengthen health systems for the improvement of TB diagnosis and treatment outcomes especially for the SATHSSP target population namely miners, ex-miners and their communities.
Contribute to the regional perspective on developing and using eHealth solutions to address HIS challenges including late reporting and poor patient follow up
Outcome
Timely information sharing and feedback for improved patient care and management at community level

5. Targeted facilities
Northern Region KARONGA 1) Karonga District Hospital 2) Iponga HC 3) Nyungwe HC 4) Chilumba Rural H
Southern Region
BALAKA
1) Balaka Hospital
2) Mbera HC
3) Phalula HC
4) ChiendaUsiku HC
BLANTYRE
1) Lirangwe HC
2) Makata HC
3) Zingwangwa HC
4) Chileka HC
Central Region
LILONGWE
1) Bwaila Hospital
2) Kabudula HC
3) Nathenje HC
4) Area 25 HC
KASUNGU
1) Kasungu Hospital
2) Kaluluma Rural Hospital
3) Santhe HC
4) Chamama HC

6. Problem definition No accountability/ transparency
If you can’t monitor it; you can’t manage it
More time to reach out to the patient
HSA requires airtime for communication
Problem definition

7. Problem definition
Current TB sample transportation interaction between health facilities
- No accountability/ transparency
- If you can’t monitor it; you can’t manage it
- More time to reach out to the patient

8. Scope of Work
Develop use of ICT to enable community engagement with TB community outreach programmes
Develop use of mobile technologies to facilitate
Record of TB outreach services
Referral of samples and linkage with diagnosing health facilities
Treatment initiation, follow up and defaulter tracing
Produce reports and guidance
Regular reports and feedback

9. Solution

10. Methodology Baseline Assessment – understanding the current TB system
Use ICT solutions to solve challenges
Inception Report
System deployment in all the 20 Health facilities
Trainings and orientation meetings with health facilities staff from the 20 facilities
Deployment of equipment
On Job trainings of system users in the facilities

11. Overall solution architecture

12. SOLUTION Tracking samples and facilitating reporting Built on top of cellular platform Android APP and SMS Module

13. SOLUTION SMS MODULE For results reporting For next Appointment reminders

14. Power Backup Solution for Health Facilities

15. Project Achievements

16. Fully functional e-health system developed and it is currently in use in the twenty facilities in five districts.
More than 13, 000 cases have been processed through the system.
All facilities are equipped with equipment to enable them to do their jobs
Trainings of health facility staff was conducted
Follow-up visits were undertaken in all the facilities to ensure users manage cases using the system.
Review meetings took place where stakeholders provided feedback on the system itself.
WhatsApp groups were created to enable system users to provide any challenges and updates to iMoSys and NTP from time to time
Project Achievements

17. Web based dashboard for managing cases

18. Mobile App for managing TB cases

19. Some of mobile app functionalities

21. Benefits of the e-health system
Improved decision making by management since information is available in real-time.
Elimination on duplicate entries, patients are tracked using unique barcodes
Improved reporting. Reports are generated automatically.
Improved patient management, SMS's automatically sent to patients reminding them of their medication.
Improved sample collection as reported by several Health Facilities at different review meetings
Real-time tracking of sample status
Timely feedback of information to the patient
Benefits of the e-health system

22. THANK YOU