Submitted

Last Updated June 18, 2020

Maternal & Newborn Health

Zambia Tuberculosis and Leprosy Trust

Team Leader

Elina Mujuda

Solution Overview

Solution Name:

One-line solution summary:

The e compliance technology is a package of applications which seeks to improve service delivery by providing platforms for case finding, di

Pitch your solution.

Zambia is a society with high challenges in maternal and newborn due to poverty . Mortality rates remained almost stagnant at 24 deaths per every 1,000 births

Generally women are prolonging to get the HIV infection due to their biological make up.
Lack of screening in UTI, cervical cancer, HIV, TB, Hept and Malaria.

Our solution aims to be screening pregnant women on HIV, TB, Malaria, COVID-19 and cervical cancer for improving their health and that of their unborn and also the newborn babies.

This project aims at testing for new infections among women of childbearing age so that their put on treatment before they get pregnant to safe guided their unborn and newborn babies through PMTCT.

The new born babies will be screened for HIV using dry blood sport (DBS). The impact for the project participates to have early diagnosis, treatment and care leading to improved health and production

What specific problem are you solving?

Tuberculosis and HIV is one of the most infections disease in Zambia due to poverty , HIV, COVID-19 . Women suffer more severe infections due to late diagnosis and their mostly likely not adhering to treatment due to dependence on men.

Most of the women of childbearing age group delay in having Cervical cancer screening due to lack of knowledge. Therefore, they end up having advanced cancer disease even in pregnancy. Some lose their pregnancy due to cancer treatment and anxiety.

We have notice that COVID-19 affects both adults and babies. Therefore, it is important for the project to have intervention during and after COVID-19.

In Zambia we have over 1 million who are HIV positive and treatment and majority are women. Prevalence of HIV among women aged 15-14 years is almost twice that of male counterpart (14 2 % vs 7.5% respective. In 2017 36, 0010 new Tuberculosis cases were notified. Out of these 36% were women while 5.9 % were children.

These are the contributed to the challenges discussed

High HIV transmission rate between mother to child during and after child bearing.
Poverty and cultural
Inadequate knowledge
Fear of unknown
Lack of self esteem ( Resilience )

What is your solution?

Our solution is e compliance technology and smartcare system that ensure mothers and newborn are given ARVs to prevent of mother –to-child transmission (PMTCT) .The e compliance provides guide lines on good nutrition for both mothers and newborn which helps to Improve maternal and newborn health by decreasing the risk of disease among mothers and newborn including by increasing vaccination rates and reducing infectious disease transmission from mother to newborn through using.

When a pregnant woman is tested positive for HIV and Tuberculosis is put on insoniazide prevention therapy for six months. Fansider drug is given to mothers and newborn to prevent malaria. BCG is given to the newborn to prevent Tuberculosis.

Who does your solution serve, and in what ways will the solution impact their lives?

The target population in this project is mothers and newborn babies. These are women of child bearing age who should be cared for from the time they become pregnant throughout their pregnancy to the time they give birth and post antenatal period until the baby is above 5 years. The newborn includes both male and female babies.

The project will focus on early screening, diagnosis, treatment and prevention of TB, HIV/AIDS, COVID -19 and Malaria using e-Compliance Technology to reduce severe disease and possible death. The eCompliance will be used for counseling as well. Contact tracing and finding lost to follow-up will be done. The Prevention of mother to child (PMTC) will continue being our strategy. The new APPS for HIV/AIDS, COVID-19 and Malaria will be added to the e-Compliance Technology for effective management of participants. Provision of adequate and good food for the pregnant and breast-feeding mothers will be implemented.

We will offer counselling on the importance of starting antenatal early so that they are screened of these diseases to safe guard their unborn babies. Babies will be monitored for the presence of the diseases. Current and post COVID-19 care and support will be one of the activities.

Which dimension of the Challenge does your solution most closely address?

Decrease the risk of disease between mothers and newborns

Explain how the problem, your solution, and your solution’s target population relate to the Challenge and your selected dimension.

In Zambia their more women than men who contract HIV all the time due to their biological makeup, low resilience and poverty because of these problems there have poor health and these will relate to their unborn babies

In what city, town, or region is your solution team headquartered?

Lusaka, Zambia

What is your solution’s stage of development?

Growth: An organization with an established product, service, or business model rolled out in one or, ideally, several communities, which is poised for further growth

Who is the primary delegate for your solution?

Mrs Charity Habeenzu ( Executive Director )

More About Your Solution

If your solution has a website, provide a link here:

http://www.zatulet.org

If your solution proposes an app that is currently live, provide a link to your app online or in an app store here:

http://www.opasha.org/

Which of the following categories best describes your solution?

A new application of an existing technology

Describe what makes your solution innovative.

The technology has received widespread support from several organizations and institutions. Its use has been extended to Uganda, Kenya and other countries. Here in Zambia, it has recorded improvements in the delivery of service in terms of counseling, TB detection and compliance monitoring. Over 1000(Put the exact figure we currently have) new patients have been added to the platform and have seen an improvement in the care. The NTP has also applauded the technology in its effectiveness for screening and proper data management. Generally, patients who are served using this innovation have recorded very good treatment outcome.

Describe the core technology that powers your solution.

Operation Asha, an India organization in partnership with Microsoft research developed a suite of applications to provide education and awareness, test and provide treatment for infectious diseases and Non communicable diseases. This package would also provide solutions to improve data management. They then partnered with Zambia tuberculosis and Leprosy trust to implement this technology in Zambia particularly to deal with Tuberculosis. The technology has been in use here in Zambia since July 2019

Provide evidence that this technology works.

The license is owned by Operation Asha. It was given to our organization free of charge to implement the innovation project called “Innovation to improve TB detection and treatment -e-Compliance Project” funded by Operation ASHA.

Please select the technologies currently used in your solution:

Audiovisual Media
Big Data
Biotechnology / Bioengineering

What is your theory of change?

pregnant women will understand the importance of early diagnosis and adherence to treatment and prevention of disease unborn babies.

The activities

Proving prevention of mother-to-child transmission (PMTCT)

Intensified TB /Leprosy case finding in the communities serve through house hold screening
Setting up community sputum collection points and other innovations
Community and HIV Prevention programme through awareness raising, door to door and HIV Testing and Counseling (HTC) to pregnant women
Offering TB screening, testing and treatment at Community Clinic
Offering ART (Antiretroviral treatment ) at community clinic and community ART Outreach activities
Supporting TB Treatment and ART adherence programme at all the 12 sites
OVC Programming by offering education, nutrition, health, HIV prevention support, therapeutic feeding for the malnourished under five children and offering group homes for girls living alone or living under child headed homes with a house Surrogate mother.
Training Community TB Treatment Supporters, Care Givers and OVC Care Givers

The output of project

To increase intensive case-findings and access to quality TB/Leprosy/HIV screening, diagnosis and treatment (DOTS) to pregnant women and newborn in order to enhance early diagnosis and treatment
To mitigate the impact of HIV on maternal and new born babies by improving access to basic needs and services such as health, nutrition, education and psychosocial support, protection,, HBC, TB and ART
To enhance and promote innovative approaches in programming in order to influence governance/policy improvement and strengthen health systems to bring about integration of services and sustainable improvement in TB, TB/HIV/Leprosy activities to pregnant women and newborn babies.
To build capacity of community TB Treatment Supporters Volunteers, Interns and other Volunteers , Health workers and communities in order to provide high quality services and strengthening TB programming and advocacy communication and social mobilisation strategies that enhances quality services delivery in the communities on TB/HIV/AIDS/Leprosy in Zambia

The outcome

Knowledge on COVID-19, HIV, TB,Malaria, Leprosy infections among pregnant women and good nutrition in community.
Early screening for cervical cancer women of child bearing age.
Early diagnosis and treatment in Tuberculosis among the women.
Community health worker include midwives will be trained to become Training of Trainer (TOT).

Select the key characteristics of your target population.

Pregnant Women
Infants
Children & Adolescents
Rural
Urban
Poor
Persons with Disabilities

Which of the UN Sustainable Development Goals does your solution address?

3. Good Health and Well-Being
5. Gender Equality
10. Reduced Inequalities

In which countries do you currently operate?

Zambia

How many people does your solution currently serve? How many will it serve in one year? In five years?

Our solution currently serve : 46764 clients

In one year our solution will serve :561168 clients

In next 5 years our solution will serving number of : 2805840 clients

What are your goals within the next year and within the next five years?

Our goal as ZATULET is to contribute to the reduction of the burden of TB/HIV/AIDS/Leprosy , Strengthening Human rights,Good Health and Well-Being among women girls , pregnant women and new born including men and boys and now COVID -19 in Zambia by 2025.

What barriers currently exist for you to accomplish your goals in the next year and in the next five years?

Climate change- floods in rain season is a risk to project and transport becomes a burrier to the participants (CHWs) which can result in a low attendance of participants in project activities
Political change- the change of leadership can put a project at risk. Changes in the political landscape resulting in possible loss of innovation and as Zambia will be approaching presidential elections a low attendance may occur in participating workshop/ training.

Movement of people- People always migrate to new places (country) for some reasons. This can be the risk to project.
Change of staff– turnover of staff in any organization can be a risk to the project.

How do you plan to overcome these barriers?

Climate change- floods in rain season is a risk to project and transport becomes a burrier to the participants (CHWs) which can result in a low attendance of participants in project activities. Reimbursements will be provided to the participants.
Political change- the change of leadership can put a project at risk. Changes in the political landscape resulting in possible loss of innovation and as Zambia will be approaching presidential elections a low attendance may occur in participating workshop/ training. ZATULET is not a political organization and works with the government of the day.

Movement of people- People always migrate to new places (country) for some reasons. This can be the risk to project. This risk can be addressed through opening branches across the country and building capacity of a reasonable number of CHWs in both TB/HIV and COVID -19 diseases
Change of staff– turnover of staff in any organization can be a risk to the project. This risk can be addressed through providing more building capacity to new staff and reasonable financial support which can motivate staff retention.

About Your Team

Solution Team:

Elina Mujuda