MIT Solve

Solution & Team Overview

Solution Name:

DIGAMS: Active Digital Community Antimicrobial Stewardship

Short solution summary:

Leveraging digitized community health workers(CHWs) to actively monitor and inform antimicrobial access, usage and outcomes including resistance in communities with loose antimicrobial supply chain.

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

Kampala, Uganda

Who is the Team Lead for your solution?

Miiro Chraish

Head of research and PI, Mobiklinic

Which Challenge Objective does your solution most closely address?

Innovation
Integration
Implementation

What specific problem are you solving?

In low income countries(LICs) like Uganda, proper laboratory investigation before prescription of antibiotics is uncommon, and antibiotics can easily be accessed over the counter from pharmacies. Majority of Ugandans access their antibiotics through prescriptions from poorly equipped public health facilities, self-purchase from drug outlets or lately from community health workers(CHWs) for children under 5.

This laxity in the antibiotics supply regulation has fueled poor antibiotics usage practices, blowing the antimicrobial resistance burden (AMR) out of proportion. As per WHO, 1.27 million deaths and 4.95 million deaths were attributed to, and associated with AMR respectively in 2019. Sub-Saharan Africa has the highest mortality (23.5/100,000) attributable to AMR and the world bank estimates that AMR will wipe 3.8% off the global economy by 2050.

It may take decades to get public health systems in LICs ready to optimally implement antimicrobial stewardship practices like AWaRe protocols, and ensure timely access to essential antibiotics to a poor population. Strict enforcement of antimicrobial regulatory frameworks may deny the ordinary folk access to life saving drugs while the laxity is fueling AMR. We are therefore tasked with finding a middle ground between access and abuse, to be able to safeguard current and future lives.

Who does your solution serve, and what needs of theirs does it address?

Our solution is designed to be used by, and to empower CHWs in community antimicrobial access, usage, and outcomes monitoring and guidance . Through the CHWs supported by professionals, the solution will be able to impact the antimicrobial usage practices of ordinary people in towns and last mile rural areas.

At Mobiklinic, we currently offer digital, logistic and supervisory support to CHWs to extend basic, promotive and preventive health services. Antimicrobial monitoring through the DIGAMS feature is to be part of this buffet of community health services.

We continuously rely on various community health workers who test use the different features and give us constructive feedback that bodes well with theirs’ and communities' preferences. They are key stakeholders from whom we learn about community health services.

We conduct system and UX research using tools like user surveys, non-participant observations and user assessment tests among others which inform our incremental development needs and choices. Agile development is a core component of our technology sustainability.

We deliberately recruit and engage differently abled CHWs to get key perspectives of the unique and different needs of the differently abled communities, anticipate common technology inadequacies and preemptively address them before the technology goes into production.

What is your solution’s stage of development?

Growth: An initiative, venture, or organisation with an established product, service, or business/policy model rolled out in one or, ideally, several contexts or communities, which is poised for further growth