Digital Antimicrobial Resistance Surveillance System (DARSS) Uganda

Introducing DARSS Uganda: A state-of-the-art Digital Antimicrobial Resistance Surveillance System. DARSS features a user-friendly digital platform enabling real-time data collection, analysis, and reporting across healthcare facilities. Blockchain integration ensures data integrity and privacy. Through capacity building and partnerships, DARSS drives sustainable impact in combating antimicrobial resistance in Uganda.

EDEMA FRED OTTO, a Medical doctor with an IT background

In Uganda, the current antimicrobial resistance (AMR) surveillance landscape faces significant limitations. Existing efforts primarily focus on specific diseases like tuberculosis, malaria, and HIV/AIDS, with sporadic surveys and research conducted by academic institutions. However, these initiatives suffer from constraints such as limited geographical coverage, inadequate resources, and outdated data management systems.

According to a 2014 situation analysis conducted by the Uganda National Academy of Sciences through its Global Antimicrobial Resistance Partnership committee, only 2 out of 7 regional referral hospitals had adequate equipment, personnel, and a reliable supply of consumables for routine testing. Three hospitals had fair resourcing, while 2 were poorly resourced. This disparity extended to private not-for-profit facilities. Mulago and Butabika National Referral Hospitals were better equipped, but many laboratories faced challenges including lack of standardization in testing protocols and inadequate quality control. Consequently, the reliability of data from some laboratories for surveillance purposes is questionable.

Furthermore, Uganda lacks comprehensive guidelines for AMR data collection and management, with most laboratories relying on outdated paper-based systems. Even electronic Health Laboratory Information Management Systems (e-HLIMS) are inadequate for capturing critical information necessary for AMR surveillance.

Our initiative, the Digital Antimicrobial Resistance Surveillance System (DARSS) Uganda, targets healthcare professionals, laboratory personnel, policymakers, and public health officials across Uganda. We aim to provide them with access to reliable data through a user-friendly digital platform for real-time data collection and analysis. Through comprehensive training programs and ongoing technical support, we seek to enhance their capacity in utilizing DARSS effectively, ensuring accurate data collection, analysis, and interpretation. DARSS facilitates evidence-based decision-making among policymakers and public health officials by providing insights into antimicrobial resistance patterns and trends, enabling the development of targeted interventions and policies to address the growing threat of antimicrobial resistance. To understand their needs, we engage in stakeholder consultations, seek user feedback, and establish collaborative partnerships with local healthcare facilities, academic institutions, government agencies, and international organizations. Through ongoing engagement and collaboration, we aim to develop and implement a solution that effectively addresses the challenges of antimicrobial resistance surveillance in Uganda, ultimately contributing to improved patient care and public health outcomes.

The Digital Antimicrobial Resistance Surveillance System (DARSS) Uganda embodies innovation in several ways:

1. Integration of Blockchain Technology: DARSS stands out by incorporating blockchain technology into antimicrobial resistance surveillance. Blockchain ensures the security, transparency, and integrity of the data collected, addressing concerns related to data privacy and unauthorized access. This application of blockchain in public health surveillance is relatively novel and distinguishes DARSS from traditional surveillance systems.

2. Real-Time Data Collection and Analysis: DARSS facilitates real-time data collection, analysis, and reporting of antimicrobial resistance data across healthcare facilities in Uganda. This approach enables timely detection of AMR trends and emerging threats, enhancing the effectiveness of surveillance efforts and enabling proactive interventions.

3. User-Friendly Digital Platform: DARSS offers a user-friendly digital platform accessible to healthcare professionals and stakeholders across Uganda. The platform streamlines data entry, analysis, and interpretation, making it easy for users to contribute to AMR surveillance efforts effectively. By prioritizing usability and accessibility, DARSS maximizes engagement and participation among key stakeholders.

4. Capacity Building Initiatives: DARSS goes beyond technology by incorporating capacity-building initiatives aimed at training healthcare professionals and laboratory personnel on effective platform usage. These initiatives empower users to leverage DARSS effectively, ensuring accurate data collection and informed decision-making.

The Digital Antimicrobial Resistance Surveillance System (DARSS) Uganda is expected to have a significant impact on the target population through several key mechanisms. Firstly, by providing a user-friendly digital platform for real-time data collection, analysis, and reporting, DARSS enables healthcare professionals to access timely and accurate information on antimicrobial resistance (AMR) trends. This empowers them to make informed decisions regarding patient treatment and public health interventions, ultimately leading to improved health outcomes.

Additionally, DARSS includes capacity-building initiatives aimed at training healthcare professionals and laboratory personnel on effective platform usage and best practices in AMR surveillance. By enhancing the skills and knowledge of healthcare workers, DARSS strengthens the capacity of the healthcare system to address AMR challenges comprehensively.

Moreover, DARSS facilitates collaboration and knowledge sharing among stakeholders, fostering a culture of cooperation in addressing AMR at local, national, and global levels. By promoting interdisciplinary collaboration and information exchange, DARSS facilitates the development of evidence-based policies and interventions to combat AMR effectively.

1. Year 1 (Next Year):

   • In the next year, DARSS will expand its pilot implementation by collaborating with local health authorities and healthcare facilities across Uganda. This entails onboarding new users and integrating DARSS into existing healthcare systems. Concurrently, DARSS will prioritize capacity-building initiatives, offering training programs to healthcare professionals and laboratory personnel. These efforts will empower users to leverage DARSS effectively, ensuring accurate data collection and analysis. Additionally, DARSS will actively solicit user feedback to identify areas for improvement, facilitating iterative updates to the platform.

2. Next 3 Years:

   • Over the next three years, DARSS aims to achieve nationwide rollout and adoption in Uganda. Collaborations with government agencies, international organizations, and funding partners will support scaling efforts. DARSS will work towards seamless integration with national health information systems, enhancing data exchange and interoperability. Sustainable funding models will be developed to support ongoing operations and expansion. By implementing these strategies, DARSS seeks to catalyze transformative change in antimicrobial resistance surveillance and management, contributing to a healthier future for all.

To measure success against our impact goals, we have developed a comprehensive monitoring and evaluation plan for the Digital Antimicrobial Resistance Surveillance System (DARSS) Uganda. Key indicators include:

1. User Engagement and Adoption: We track the number of healthcare facilities and professionals actively using DARSS, as well as their frequency of usage and engagement with the platform. This indicator reflects the extent to which DARSS is integrated into routine practice and informs our efforts to improve user experience and satisfaction.

2. Data Quality and Accuracy: We assess the quality and accuracy of antimicrobial resistance data collected through DARSS, including the completeness of data entry, adherence to standardized protocols, and consistency of reporting. This indicator enables us to identify areas for improvement in data collection practices and ensure the reliability of surveillance data.

3. Capacity Building Impact: We evaluate the effectiveness of capacity-building initiatives through pre- and post-training assessments of healthcare professionals' knowledge and skills related to antimicrobial resistance surveillance and DARSS usage. This indicator measures the impact of training programs on enhancing the capacity of users to contribute meaningfully to AMR surveillance efforts.

Several barriers may impede the accomplishment of goals for the Digital Antimicrobial Resistance Surveillance System (DARSS) Uganda in the next year and the next three years:

1. Financial Constraints: Limited funding may hinder the expansion and sustainability of DARSS. To address this, we plan to pursue diverse funding sources, including grants, public-private partnerships, and donor support. Additionally, we will explore cost-effective strategies for platform development and maintenance.

2. Technical Challenges: Technical infrastructure limitations, such as unreliable internet connectivity and inadequate hardware resources in remote areas, may hinder DARSS implementation. To overcome this, we will prioritize the development of offline functionalities and optimize the platform for low-bandwidth environments. Collaborations with local technology providers and infrastructure development initiatives will facilitate access to necessary technical resources.

3. Policy and Regulatory Hurdles: Unclear regulatory frameworks and data privacy concerns may pose legal barriers to DARSS adoption. We will engage with relevant government agencies and policymakers to advocate for supportive policies and regulatory guidelines. Additionally, we will ensure compliance with data protection regulations and ethical standards in data management and sharing practices.

We are applying to The Trinity Challenge because it offers a unique opportunity to amplify the impact of our Digital Antimicrobial Resistance Surveillance System (DARSS) Uganda project. One of the key barriers we face is limited access to resources and expertise necessary to scale up our solution effectively. The Trinity Challenge provides access to a network of global experts, resources, and funding opportunities that can help us overcome these barriers.

Specifically, we aim to leverage The Trinity Challenge's platform to:

1. Access Funding: The financial support provided by The Trinity Challenge can help us secure the necessary resources to expand DARSS implementation, enhance technological infrastructure, and sustain long-term surveillance efforts.

2. Gain Expertise: By engaging with The Trinity Challenge's network of experts, we can access valuable insights, guidance, and best practices in addressing antimicrobial resistance challenges, enhancing the effectiveness and impact of DARSS.

3. Foster Collaborations: The Trinity Challenge offers opportunities to collaborate with other innovators, organizations, and stakeholders working on similar issues, enabling knowledge sharing, resource pooling, and collective action to combat antimicrobial resistance on a global scale.

In Uganda, our collaboration extends to pivotal local institutions and government bodies essential for implementing the Digital Antimicrobial Resistance Surveillance System (DARSS):

1. Ministry of Health, Uganda: We engage with the Ministry of Health to align DARSS with national health priorities, policies, and regulatory frameworks, ensuring its integration into Uganda's healthcare infrastructure.

2. National Drug Authority (NDA): Partnership with NDA ensures regulatory compliance and quality assurance in antimicrobial drug usage, fostering safer and more effective treatments within DARSS.

3. Uganda National Health Research Organization (UNHRO): Collaboration with UNHRO facilitates access to research funding, expertise, and data repositories, enhancing epidemiological studies and health systems research.

4. Major Academic institutions including Makerere University, Mbarara University of Science and technology etc

On a global scale, we aim to collaborate with renowned organizations such as:

1. World Health Organization (WHO): Engagement with WHO provides access to global expertise, standards, and guidelines, ensuring DARSS aligns with international best practices in antimicrobial resistance surveillance.

2. Centers for Disease Control and Prevention (CDC): Partnership with CDC offers technical support, capacity building, and data validation, strengthening DARSS's capabilities in infectious disease surveillance and control.

3. Pharmaceutical Companies and Research Institutions