Facilitating collaboration for rapid response in public health crises

Situational awareness for more effective decision making through health service, resource and facilities mapping

Real-time, data driven decision-making through communication, collaboration and coordination tools

Greater access to critical health services for people in LMIC countries and those on the move

trellyz, Shelley Taylor CEO - Solution and Consortium Lead

There are more than 400 million people living in West Africa. Compared to other regions on the continent, West Africa has the greatest number of countries with more than 30% of the population living on less than $1.90 a day. 

The region contains 11.5 million on the move: including 7.5 million internally displaced (IDPs) and 4 million others (asylum seekers, refugees, stateless, returning IDPs, refugees) who face similar problems. 

People leave home for a reason. The challenges they face are present throughout their journey. Lack of economic security, hygiene and sanitation and extreme poverty and malnutrition lead to poor health conditions. Exposure to violence, physical injuries and psychological trauma (gender-based violence) increase health risks. 

Disease and pandemics pose a significant danger to both people on the move, living in crowded camps, and to those living in poverty with only basic health systems and insufficient sanitation. 

Location has a significant impact on the physical and psychological health of a population and access to health resources. Location can make people more vulnerable to diseases and health emergencies. People in need of medical care often find it very difficult to access health services which has a knock-on effect in health emergencies.

The project will focus on countries along the West African migration route 1) origin countries - assisting people before they feel forced to attempt migration, 2) transit countries - helping people on the move and  3) destination countries - helping newly arrived and communities in diaspora who both need help and offer help to those recently arriving or in route.

Our focus countries are based on where consortium partners have a strong base and include: Spain, Morocco, Senegal, Guinee (Phase 1), Côte d’Ivoire, Mali, Liberia, Tunisia, Algeria (Phase 2). Spain is a destination country in Europe where the RefAid app has already been successfully rolled out. The other countries are a combination of destination and transit countries.

In addition to those on the move, the groups we will focus on include: vulnerable and impoverished people in target countries and service organizations, volunteers, health care facilities, and governments. We will leverage communities in diaspora as an important part of the solution as well as village chiefs, councilors, association and brotherhood leaders who are all guarantors of community stability and contribute significantly to educating members of the community about health emergencies. These groups will help in communicating with hard to reach populations.

Our solution provides many ‘public goods’:

For the public:

• Free access to information about available health care services, facilities and resources in times of a pandemic, and in between, for reduction of vulnerability to health crises

• Free access to information about available potable water and sanitation and other preventative necessities

• Free access to time-sensitive information about current/future pandemics, e.g. vaccination centers, places to avoid - through push notifications and text messaging

• Anonymous use of app 

For healthcare institutions:

• Free for all service providers, facilities, healthcare professionals and stakeholders

• Interoperability of aggregated and anonymous data sets, by integrating data from multiple sources, across systems, to provide service provides and agencies access to better quality data, across regions

• Standardized data formats create opportunities for all institutional users to enter, map and manage their own resources and export it for use 

• Highest level of data protection, and roles/permissions based access to information in the platform

By helping people on the move, and in origin countries, we would be contributing to improving the health and well-being of the entire population. Our free app enables information to be widely accessible, and greater access to resources will build self-sufficiency and personal agency in vulnerable populations. 

Early warning

We are proposing an early warning system that will help identify the most vulnerable populations to an outbreak, through data collection, coordination and collaboration among service providers and healthcare professionals. “Infectious diseases like Ebola, HIV, usually spread easily and widely from poor communities in emerging cities and through health workers who serve such communities.”

Targeted intervention

We are making it possible to determine the most effective responses to a pandemic by bringing together disparate data sources about vulnerable populations, infection rates by location, and available services, in order to reduce delays in response due to lack of information. “A strong health system is critical in effectively combating Emerging Infectious Diseases through the establishment of strong infection prevention and control programmes.” (source: ibid)

Equitable response

In the wake of the social and economic impact of a pandemic, we provide situational awareness and decision-making tools that enable an equitable and proportionate resource allocation to communities in LMIC countries, to support recovery that promotes an equitable response. Providing information about health services and facilities will help to mitigate health emergencies, while available social services will create greater resilience and reduce risk factors in these emergencies.

We expect 10 million vulnerable people to benefit from access to health services and resources in the app, both directly and indirectly through health care and social services providers. We aim to build a network of at least 5,000 institutions, organisations, community groups and service providers across 8 countries.

Network effect
As more organizations begin to use the platform they will be providing and accessing more relevant data that will improve responses in health emergencies. Through our partnership with DDM, we already have a strong foundation of networks to begin building the number of organizations across our target countries who will then map their health services and facilities. These networks will help expand the network to cover more of the population of West Africa. This enables us to scale up our reach to our target populations.

Decentralization and democratization of services
By allowing all stakeholders to upload and access information, overall situational awareness and access will improve. Forming strong connections with key health institutions and organizations, will help us to spread the word about our platform to other organizations in the area, and to beneficiaries supported by these institutions.

This consortium – trellyz and DDM – has been working together in Spain and Morocco. We’ve measured our progress in these countries using the following indicators:

• Number of institutions on-boarded: more than 300 in 6 months.

• Number of services mapped: more than 1400 in 6 months.

• Number of languages in which the information is displayed – 4 (English, French, Spanish and Arabic)

In order to measure impact and progress in this project, we plan to create and use some new Key Performance Indicators to evaluate our impact goals in terms of early warning opportunities, targeted interventions and equitable responses:

• Number of apps downloaded

• Number of facilities mapped

• Broad data and analytics

• Locations and populations serve  

Additionally, we can evaluate impact based on the level of cooperation and coordination within the service provider network:

• Custom data layers created (i.e. imported or pulled from APIs)

• Communication between entities using the collaboration tools

• Permitted data exported from the platform to other repositories

• Key service provider user activities 

Our goal is to see a 300% increase in these KPIs from year 1 to 2, 300% increase from year 2 to 3.

Our first challenge will be building the network of health service providers and facilities. DDM will help us to overcome these challenges, as their local presence in each country, and experience building networks, will ensure our success to overcome any cultural and language difficulties. 

Lack of WIFI or computers can limit some healthcare providers from inputting their own services directly, and many will not have the capacity for managing their services as their focus is delivering health emergency services in the field. Local offices of DDM and partner organizations will act as data collectors and help with updating in these situations.

Another challenge we will face is promoting the app to the public. We will rely on the network of service providers, and their expertise about appropriate marketing channels, to promote the app in their communities.

Obstacles to downloading the mobile app exist in some vulnerable communities for some of the target population, due to lack of access to the Internet or smart phones. Focal points will provide life-saving information from our central source of health service resources. Those who have low literacy will be able to access content through audio and video in the app.

All of RefAid's participating NGOs (5,000 including the largest) plus Diocesan Delegation of Migration (DDM), Morocco and their many partner organizations:

Cáritas
Médecins du Monde
OGLMI - Organisation Guinéenne pour la Lutte Contre la Migration Irrégulière
REDA - Réseau droit au Développement pour d’autres Alternatives
DIADEM - Diaspora Développement Education Migration

Challenges that Trinity Partners may help us overcome:

Network of health service providers and facilities In an effort to respond quickly to pandemics, stakeholders often reinvent the wheel, duplicate existing systems, spend money that could go to beneficiaries, or collect data that already exists. Warp-speed funding and deployment processes related to COVID have further clouded providers’ understanding of who is doing what where. Trinity Challenge partners will have insight into potential partners - health services, facilities, resources - and can offer this platform as a resource to its community.

Open data sets
When data about service availability, efficacy, or impact is collected, it often remains siloed within a single organization, limiting its utility for the wider community. Publicly released data may remain stuck in formats that limit interaction rather than in actionable formats like CSVs, Excels, or interactive data visualization platforms. Trinity Challenge partners can help us identify data that is useful and available for importing into this data visualization and registry tool.

Funding
With funding from Trinity we can make the platform available for free to all stakeholders, and then migrate to funding our innovative pricing model (low cost, unlimited users) at the end of the 3 year project.

We would like to partner with the Bill and Melinda Gates Foundation because of the health related networks they have, and because they are already working within the region.

We would like to partner with the Bay Area Global Health alliance because of their many members, their networks, and their access to cutting edge knowledge that may help us continue to develop our networks and platform.

We would like to partner with LSE to have access to their brain power in their repository, the potential of their network’s ability to add to our data analytics capabilities.