SentinelHealth: AI-enabled proactive mHealth & education to combat AMR

Leveraging our existing telehealth infrastructure in coastal Bangladesh, we propose a pilot project, utilizing Real-time CRD, Disease Surveillance, Point-of-Care Testing, Predictive Analytics, and mHealth to combat AMR in climate change-affected rural villages, and harnessing AI-powered advocacy tools for promoting antimicrobial stewardship among communities, frontline healthcare workers, and local pharmacies.

Nusrat Aman, CEO of AYAT Education, brings extensive experience in spearheading health behavior, education, community health, and digital health projects, collaborating with reputable academic institutions and public health organizations

Our focus is on tackling the alarming rise of antimicrobial resistance (AMR) in climate change-affected, salinity-prone regions of Bangladesh, specifically within the 124 villages served by our partner, Amader Gram, in the Khulna Division. The prevalence of bacterial infections like Tuberculosis, UTI, STI, Strep Throat, and Salmonella is driving the overuse and misuse of antibiotics, heightening the risk of escalating AMR.

This challenge has substantial implications, affecting approximately 150,000 individuals in these vulnerable communities. In 2019 alone, Bangladesh witnessed 26,200 deaths attributed to AMR, underscoring the severity of the issue. Causes include unrestricted access to antibiotics, insufficient awareness among healthcare providers and the public, and heightened antibiotic consumption during the COVID-19 pandemic.

Another significant hurdle is the shortage of trained frontline healthcare workers, hindering efforts to promote antimicrobial stewardship in communities. Empowering community health workers (CHWs) and other frontline healthcare personnel through training is crucial. They can play a pivotal role in educating community members, local pharmacy owners, and medical assistants (village doctors), about responsible antibiotic use and hygiene practices, contributing to a comprehensive solution to the AMR crisis in these areas.

The proposed project primarily serves communities in climate change-induced salinity-affected areas of Bangladesh, focusing on approximately 150,000 people in 124 villages in Khulna Division. The target audience includes community members, frontline healthcare workers, local healthcare professionals, and local pharmacy personnel. The project aims to address the pressing issue of antibiotic resistance (AMR) by leveraging Real-time Citizen-related Data (CRD), Disease Surveillance, Connected Point-of-Care (POC) Diagnostics, Predictive Analytics, and Telehealth.

To understand the needs of the community, the project will analyze Electronic Medical Records (EMRs) from Amader Gram's existing model, identifying prevalent health issues like Blood Pressure (BP), liver diseases, post-surgical complications, cancer care, and bacterial infectious diseases. Disease surveillance data will be collected through enhanced mobile apps and POC tools to test various health parameters. The predictive model will provide data-driven initiatives to combat AMR.

Community engagement is central to the project, involving educational initiatives through AI-powered advocacy tools and social media campaigns. These efforts will inform the community about the spread of bacterial infectious diseases, promoting antimicrobial stewardship to reduce the impact of AMR. The collaboration with on-the-ground implementing partner Amader Gram ensures the project is attuned to the local context and addresses the specific needs of the community.

The proposed project by AYAT Education and Amader Gram aims to address the pressing public health issue of Antimicrobial Resistance (AMR) in Bangladesh. By leveraging GIS-based Real-time Citizen-related Data (CRD), Connected Point-of-Care Testing, Predictive Analytics, and Telehealth, the project seeks to reduce the impact of antibiotic resistance in bacteria in climate change-induced salinity-affected areas. The public good provided by this solution is multifaceted. 

Firstly, it aims to improve the health outcomes of communities by enhancing disease surveillance, enabling early detection, and informed decision-making through real-time data. 

Secondly, the project promotes antimicrobial stewardship, educating and empowering community members, local healthcare workers, and pharmacy personnel about responsible antibiotic use, thus contributing to global efforts in tackling AMR. 

Thirdly, the integration of technology and data-driven communication campaigns ensures a more resilient healthcare system, capable of responding to emerging health threats effectively. 

Ultimately, this initiative seeks to protect public health, improve healthcare access, and contribute valuable data to global efforts in combating AMR, aligning with the broader goals of public health and sustainable development.

Our initiative is designed to significantly impact climate change-impacted, salinity-prone areas in Bangladesh by addressing AMR through a fusion of real-time data, point-of-care diagnostics, predictive analytics, and telehealth. By employing AI-driven advocacy and social media, we aim to raise awareness among communities, healthcare providers, and pharmacists on bacterial disease spread and the critical need for AMS.

Tangible impact:

• Communities will become more informed about bacterial infections and AMR, leading to better healthcare decisions and antibiotic use.

• Healthcare Workers will be supported in adopting responsible antibiotic practices, thanks to training and access to real-time data.

• Public Health Authorities will gain insights from disease and usage data to tailor policies and interventions, tackling AMR effectively.

• Overall Health is expected to improve with reduced bacterial infections and sustainable health practices fostered within communities.

This effort directly benefits rural Bangladeshi communities through enhanced access to diagnostics and health advice, combating antibiotic misuse. Our approach, evidenced by Amader Gram’s pilot data and stakeholder interviews, underscores the need for and potential of this integrated strategy. By closing the AMR data and intervention gap, we not only address the immediate resistance challenge but also contribute to global health security, ensuring healthier outcomes through informed decisions and actions.

Over the next year, the project will focus on developing and implementing the pilot research in 124 villages in climate change-induced rural communities. The emphasis will be on leveraging GIS-based CRD, real-time disease surveillance, predictive analytics, and telehealth to assess the impact on antibiotic resistance. The project aims to establish a robust data collection infrastructure, integrate POCT into existing healthcare practices, and deploy AI-powered advocacy tools and social media campaigns for community education.

Over the next three years, the project will scale its impact by refining and expanding its model based on the learnings from the pilot. The goal is to extend the reach to additional regions, involving more frontline healthcare workers and scaling up the telehealth services. The project also aims to establish partnerships with additional stakeholders, including government health agencies, NGOs, and other healthcare providers. The incorporation of scalable technologies and strategies will enable the initiative to influence antimicrobial stewardship, reduce antibiotic misuse, and combat antimicrobial resistance on a broader scale in low- and middle-income communities. The experience gained during the initial years will inform the development of a sustainable and scalable model that can be replicated in diverse settings, contributing to a global response against antibiotic resistance.

Our success measurement plan aligns closely with our impact goals, focusing on real-time monitoring and evaluation to ensure effective antimicrobial resistance (AMR) management in Bangladesh's salinity-affected areas. Key performance indicators (KPIs) include:

1. Reduction in Antibiotic Misuse: Measured through the decrease in non-prescription antibiotic sales in targeted communities, aiming for a 30% reduction within the first year, based on baseline data collected at project inception.
2. Increase in Healthcare Engagement: Tracked via telehealth consultations and diagnostics tests conducted, targeting a 50% increase in engagement from community members and healthcare workers within six months.
3. Awareness and Education: Quantified by the reach and engagement levels of our AI-powered advocacy and social media campaigns, with a goal to achieve a 40% increase in targeted audience understanding of AMR risks and stewardship practices, assessed through pre- and post-intervention surveys.

Performance from our Amader Gram pilot indicates significant early success: reduction in inappropriate antibiotic requests at local pharmacies and increase in telehealth consultations, demonstrating the potential effectiveness of our comprehensive approach. These metrics not only guide our ongoing adjustments and scalability plans but also serve as tangible proof of our solution’s capacity to make a meaningful difference in combating AMR.

AYAT Education and Amader Gram face challenges in combating antimicrobial resistance, outlined with strategies to address them:

• Resource Limitation: To combat financial and human resource constraints, we plan to seek funding and partnerships with health organizations for necessary support.

• Technology Infrastructure: Overcoming rural technology gaps will involve leveraging mobile technology and partnering with tech firms for affordable solutions to enhance data collection and telehealth services.

• Community Awareness and Digital Literacy: Customized education campaigns and training community health workers will target the challenge of raising awareness and improving digital literacy among diverse populations.

• Regulatory and Ethical Compliance: Early engagement with regulatory bodies and adherence to laws will ensure project integrity and compliance.

• Healthcare Professional Engagement: Certified training programs, created with prestigious partners like Harvard Medical School and Mass General Hospital, aim to gain healthcare professionals' collaboration in antimicrobial stewardship.

This strategy, focusing on leveraging resources, technology, education, compliance, and professional engagement, is designed to overcome barriers to successful antimicrobial resistance intervention in rural Bangladesh, aiming for sustainability and significant global health security impact.

We are applying to The Trinity Challenge because we recognize the critical importance of addressing antimicrobial resistance (AMR) as a global health threat, particularly in low- and middle-income communities like those in Bangladesh. The Trinity Challenge offers a unique opportunity to harness the power of data and analytics to develop innovative solutions that can effectively reduce the impact of AMR.

Our proposed project, in collaboration with partners like Amader Gram, Harvard Medical School, Mass General Hospital Global Health, and others, aims to leverage real-time citizen-related data, disease surveillance, connected point-of-care diagnostics, predictive analytics, and telehealth to combat AMR in Bangladesh. By integrating these technologies and approaches, we seek to promote antimicrobial stewardship among community members, frontline healthcare workers, and local healthcare professionals.

The Trinity Challenge provides a platform for multidisciplinary collaboration, access to funding, and support for innovative projects that have the potential to make a real difference in addressing global health challenges. We believe that by participating in The Trinity Challenge, we can advance our efforts to develop data-driven solutions that will contribute to mitigating the impact of antimicrobial resistance and improving health outcomes in vulnerable communities.

To initiate, accelerate, and scale our solution, we would like to collaborate with the following organizations:

• Patrick J. McGovern Foundation: As a committed partner in advancing artificial intelligence, data science, and social impact, the foundation's expertise aligns well with our goals of leveraging technology for community health empowerment and antimicrobial resistance reduction.

• Ineos Oxford Institute for Antimicrobial Research: Being a world-leading center for antimicrobial research, training, and education, collaboration with the institute will enrich our solution with cutting-edge insights, methodologies, and best practices in combating antimicrobial resistance.

• World Health Organization (WHO): For access to global health expertise, AMR surveillance data, and policy guidance. This collaboration would enable us to align our solution with international health standards and practices.
  

• Institute of Epidemiology, Disease Control and Research (IEDCR): Their expertise in disease surveillance and control in Bangladesh would provide invaluable insights into local AMR patterns, enhancing our solution’s effectiveness and relevance.
  

These partnerships will enable us to combine resources, expertise, and networks to effectively implement, evaluate, and scale our solution, ultimately contributing to the mitigation of antimicrobial resistance in low- and middle-income communities.