The document describes a web-based malaria disease surveillance and mapping project in northern Botswana. The project aimed to address slow reporting times and inefficiencies in the existing paper-based system by developing (1) smartphone forms for health workers to enter and submit data in real-time, and (2) a web-based tool for aggregating, analyzing, and mapping reported cases on an interactive map. The project helped reduce reporting times from 3-4 weeks to near real-time, and allowed health officials to more immediately investigate and respond to reported outbreaks.
2. Web Based Malaria
Disease Surveillance & Mapping Project
Overview
Problem
Solution
Technical Details
Challenges
Feedback & Results
3. Overview
CURRENTLY PAPER BASED REPORTS ARE DATA CLERKS
MALARIA REPORTING COLLECTED ENTER DATA
AFFECTS SYSTEM AND SENT INTO SYSTEM
NORTHERN BACK TO TO BE
AREAS OF MOH AT THE AGGREGATED
BOTSWANA END OF THE & ANALYZED
MONTH
4.
5. Slow turnaround time
Problem
3 - 4 weeks
Paper based system
cumbersome
& inefficient
No immediate
notifications of
outbreaks
Data entry, analysis and
aggregation
timely & expensive
6. Solution
Forms developed for smartphone data entry
Health workers trained how to enter &
submit data using smartphone
Web based tool developed to view data real-time
DATA
SITE
MAPPING OF SMS
BREAKDOWN EXPORT TO CASES & SITES NOTIFICATIONS
REPORTING
AND EXCEL WITH CASE OF REPORTED
STATISTICS
AGGREGATION INFORMATION CASES
14. Feedback and Results
Increased dialogue Officials at MoH can
between users about
immediately escalate
how the reporting
process could work
& investigate
better reported cases
Dramatic increase
turnaround time for
data aggregation and
analysis
15.
16. Overlaying case map with net distribution and
chemically treated site maps to gauge effectiveness
- Ministry of Health wishes to to eliminate malaria completely by 2015- Ministry of Health has standard reporting forms that are filled out for weekly reports- When a positive case is reported another form is filled out with the individual case detailsDrivers come and collect forms every two weeks and deliver them to HQ in GaboroneData clerks constantly are entering data into spreadsheets which are then aggregated and analysis
Human error from data entry or data cleaning is an extra burden-Other issues such as illegible handwriting. Picking up and delivering forms to HQ is time consuming and expensiveCurrent protocol requires a positive case to be called in. Often the calls are missed or never made at all.Full time Data clerks are employed
- 3 forms were developed for the smartphones - weekly reporting - case investigation - immediate case followup- 90% of health workers in Chobe were trained on how to use the phones e.g nurses, doctors, lab technicians16 health facilities were issued with a smartphone-MoH officials can login to site to view data real time- web based system allows them to login from any location with a secure password
-Recently a large public servant strikes caused some disruption in reporting. Some health workers were replaced. -Normally health workers are rotated once a year some some rotations have occurred which mean nurses will have to be trained-A couple users were irresponsible and using the phone to surf sites and download a lot of data which depleted the allotted data package which meant data couldn’t be uploaded -Some users experienced some difficulties with upload data but are located in remote locations. We will be doing a joint site visit in late OCT to resolve these issues.
-Users feel more connected to the reporting process. They can also view data themselves from other sites as well-SMS notifications allow MoH officials to follow and call health workers about reported cases- Users have been providing feedback about how they would like the forms to be structured
Expansion to 20 new sites in eastern Botswana with higher incidences ratesSMS announcements to health workers, individual SMSing to specific site-Overlaying case map with net distribution and chemically treated site maps to gauge effectiveness-Other notifiable disease include: MDR TB, Polio, Rabies, Ebola, Cholera, etc…
HP have allowed us access to host the service on their secure cloud.