BarEl For Improved PHC

Malawi has a population of about 17 million. About 84% of people in Malawi live in rural areas.Malawi is bombarded with poor primary health care performance measurement; especially in rural areas; resulting in unsatisfactory primary health care performance. This is so because of lack of comprehensive vision and purpose for data collection; Poor quality or impractical data; Measurement that primarily informs funders rather than practical performance improvements; Systems that fail to generate real-time data; Information or data systems that do not communicate with others; Burden of data collection being borne by frontline health workers; failure of systems to provide feedback mechanisms for data collectors themselves; omission of critical PHC indicators; and delays in analysing data because data has to be collected by someone, and then entered into the system by another for analysis. If primary health care performance measurement is improved; then health care will improve.

BarEl is like the port of entry in as far health care digital health record is concerned. Available eHealth solutions  do not sufficiently support the needs of rural health posts or health centers or health facilities, where most antenatal, childhood care and Primary Health Care is provided throughout Africa. Current digital health records were meant for national data reporting needs while BarEl engages frontline health workers and direct beneficiaries like parents or patients in the entire design process to ensure that BarEl maximizes their ability to interact and streamline national data reporting requirements. BarEl models on health personnel job description. It provides real-time individualized data trends to customise health education, and provides data requirements of governments. Health personnel can enter data and track health trends over time of conditions or cases or events, individuals, territories and health facilities.

BarEl is a cost effective and quality solution that support health facilities to improve Primary Health Care performance measurement through technology. It is designed for scale throughout the world.

BarEl helps diverse health care stakeholders, including patients, frontline health workers, policymakers, and everyone in between, the means to understand what’s working well and where further improvements are needed. It provides comprehensive vision and purpose for data collection; it improves quality of data; and manages practical data; it provides for measurement  that primarily informs all primary health care providers for practical performance improvements; It generates real-time digital data. It enhances communication among information or data systems; it eradicates or reduces burden of data collection being borne by frontline health workers; and it provides instant feedback mechanisms for data collectors themselves.

The planned solution implementation has the potential to impact the lives of people living in Malawi and other   low and middle income countries. It is the main vehicle for achieving universal health coverages and Sustainable development Goals like SDG 3:Good health and Well-being, SDG1:No poverty, SDG5:Gender Equality,SDG6: Clean Water and Sanitation.

I have  a realistic, practical plan for financial sustainability and implementing the solution, and the solution is feasible . The solution will be financially stable through revenue from the sale of the software, from training users of the software and funds from other donors. The solution is feasible, technically, economically, culturally and financially.

The solution includes a new application of technology called BarEl . It has additional PHC indicators, which include: 

• Percentage Of Deaths Due To Delays Because Of Policies,
• Percentage Of Deaths Due To Negligence By Health Workers In A Given Period.
• Percentage Of Meetings On PHC By Management.
• Number of workshops.
• Percentage Of Health Workers Aged 55 Years And Above.
• Density Of Unlicenced Health Products
• Density Of Herbalists Or Traditional Healers
• Percentage Of Languages In An Area Used In Disseminating Health Messages
• Percentage Of Health Messages Transmitted In A Particular Language
• Percentage Of Health Workers With Chronic Diseases
• Percentage Of Female PHC Providers
• Percentage Of Meals With Balanced Diet Given To Inpatients
• Percentage Of Frontline Staff Involved In Budgeting, Planning And Programming
• Number of collaborative meetings between health workers and herbalists. Number of outreach visits to older or disabled people.
• Number of Feedback from the community about the health services,
• Number of Suggestion Boxes at a health facility.
• No of attacks on Health workers by community.
• Number Of Human resource plans.
• Number of financial reports prepared and submitted

The solution is designed with and for people living in low and middle income countries, underserved communities.  TK Computers & Consultancy which developed the software operates in Malawi, a low middle income country. TK Computers & Consultancy embodies and addresses diversity, equity, and inclusion through their solution.

The solution can be scaled to affect the lives of more people living in low and middle income countries. Though BarEl software is based on Microsoft Access, it also has a version of Express Edition, which can contain voluminous information. It can also be upgraded to SQL Microsoft Azure, which can enable it reach many people worldwide through cloud services.

 With BarEl, we will immensely contribute to global health. Our vision is to serve Primary Health Care stakeholders globally through technology regardless of their backgrounds, their languages, and their culture.

BarEl employs unconventional or proxy data sources to inform primary health care performance improvement.

BarEl provides improved measurement methods that are low cost, fit-for-purpose, shareable across information systems, and streamlined for data collectors.

BarEl also  leverages existing systems, networks, and workflows to streamline the collection and interpretation of data to support meaningful use of primary health care data.

BarEl also provides actionable, accountable, and accessible insights for health care providers, administrators, and/or funders that can be used to optimize the performance of primary health care.

BarEl also balances the opportunity for frontline health workers to participate in performance improvement efforts with their primary responsibility as care providers.

With BarEl, we are able to calculate PHC indicators on real-time. BarEl can automatically  interpret results or make decisions on behalf of  Frontline PHC providers. 

The target population is the one that seek primary health care from providers of primary health care, which include women, children, pregnant mothers, rural people, urban people and many more. The solution will enable the PHC providers to quickly make interventions for the benefit of the target group.

Am right within the community I want to serve. I have been working with the Ministry of Health. And I know the challenges the communities face in Malawi. The content of my solution is developed in accordance with the communities’ input, ideas, and agendas.In addition, I have provided BarEl software, free of charge to the University of Livingstonia, free of charge. It has a module of PHC indicators. With it, the University will reach it's students who pursue health programs. As such, such graduates will be in a better position to use it when they get employed;thereby,  positively impacting the communities they serve.

I do not have adequate funds to reach out to health facilities and PHC providers. This challenge will assist me to overcome financial problems. With adequate funds, I will be able to overcome market barriers through promotion of BarEl software.

The following make my solution innovative:

• It has a long list of indicators than any other software.

(A) It can be used both online and offline.

(B) It is easy and user friendly. 

(C) It has additional PHC indicators, which are:

• Percentage Of Deaths Due To Delays Because Of Policies,
• Percentage Of Deaths Due To Negligence By Health Workers In A Given Period.
• Percentage Of Meetings On PHC By Management.
• Number of workshops.
• Percentage Of Health Workers Aged 55 Years And Above.
• Density Of Unlicenced Health Products
• Density Of Herbalists Or Traditional Healers
• Percentage Of Languages In An Area Used In Disseminating Health Messages
• Percentage Of Health Messages Transmitted In A Particular Language
• Percentage Of Health Workers With Chronic Diseases
• Percentage Of Female PHC Providers
• Percentage Of Meals With Balanced Diet Given To Inpatients
• Percentage Of Frontline Staff Involved In Budgeting, Planning And Programming
• Number of collaborative meetings between health workers and herbalists. Number of outreach visits to older or disabled people.
• Number of Feedback from the community about the health services,
• Number of Suggestion Boxes at a health facility.
• No of attacks on Health workers by community.
• Number Of Human resource plans.
• Number of financial reports prepared and submitted

The following are my impact goals for the next year and next five years: Achieving promotion, prevention, treatment, rehabilitation and palliative care and universal health coverages as well as, physical, mental, social health and wellbeing; and also Sustainable Development Goals like SDG 3:Good health and Well-being, SDG 1:No poverty, SDG 5:Gender Equality, SDG 6: Clean Water and Sanitation. These Sustainable Development  Goals will be  achieved by measuring the PHC indicators through Monitoring and Evaluation; and then take corrective actions or make informed decisions  based on the results of the indicators. 

I will measure my progress toward my impact goals by monitoring and evaluating the the theory of change. I will compare the results of baseline survey with the results of endline survey. I will also be monitoring and evaluating trends of Primary Health Care indicators like percentage of reduction in deaths and diseases; GNP or GDP per capita per head and percentage of people have accessing to safe drinking water.

Activities

(1) Training of Primary Health Care stakeholder on how to use BarEl Software.

(2) Baseline survey on PHC indicators

(3) Endline survey on PHC indicators

(4) Purchase of computers, other devices and accessories for

(5) Monitoring and evaluations

(6) Preparing reports and making recommendations

Outputs

(1) Trainings counducted

(2) Baseline surveys done

(3) Endline surveys done

(4) Computers, other devices and accessories purchased

(5) Monitoring and evaluations done

(6) Reports and recommendations done

Short term Outcomes

(1) Frontline workers able to use and make decisions by using PHC indicators

(2) Improved Performance health care

(3) It improved purpose for data collection;

(4) improved quality of data; and use of practical data;

(5) Provision for measurement that primarily informs all primary health care providers for practical performance improvements.

(6) Generation of real-time digital data.

(7) Enhancement of communication among information or data systems.

(8) Eradication or reduction of burden of data collection being borne by frontline health workers;

(9) Provision of instant feedback mechanisms for data collectors themselves

Longterm Outcomes

Achieve Improved PHC performance Measurement; thereby achieve Sustainable Development Goals like SDG 3: Good health and Well-being, SDG1: No poverty, SDG5: Gender Equality,SDG6: Clean Water and Sanitation

The core technology that powers my solution is the computer software called BarEl. It has a number of modules, one of which is the health module. Primary Health Care Performance measurement is a sub-module of health module.It was developed using Microsoft Access.  I upgraded it to  SQL Express using Microsoft SQL Server Migration Assistant for Access. It has the potential to be scaled, and to be used on all sorts of devices, including; mobile phones, because it can also easily be upgraded to SQL Azure, which is convenient for cloud computing.

Primary Health Care frontline staff and data entry clerks.

TK Computers & Consultancy embodies and addresses diversity, equity, and inclusion through their solution. In fact, TK Computers & Consultancy has a policy that addresses diversity, equity, and inclusion

My business model is a combination of the following business models:

The Service Subsidization Model

 TK Computers uses the revenue and profits generated to fund social programs.

 Hiring Model

TK Computers & Consultancy employs someone who might not be able to access employment

The One for One Model or its versions For every product we sell,

 So far, we have donated some cash to Ekwendeni School of the Blind and the Charity Missionaries who take care of orphans.

I will bring in money to fund my work through a combination of donations and grants, selling products and services, and service contracts to governments.

I do not have concrete examples of how my plan to achieve financial sustainability has been succesful so far. However, I was given allowances by the University of Livingstonia for an activity involving my firm. I was given a sum of money amounting to $200. I will be selling the software.