DoseSmart: The App for AMR Stewardship

DoseSmart, an inclusive app, empowers users in informed antibiotic decisions, serving patients, nurses, physicians, lab technicians, and veterinarians. It addresses knowledge gaps on antimicrobial resistance, usage, and access, functioning as a stewardship tool by leveraging technical working groups for effective information dissemination and education on AMR issues

KANEZA Belise

Team leader

holds bachelor's degree in biomedical laboratory sciences 

Holds masters of science in Health informatics 

Antimicrobial Resistance (AMR) is a global threat with severe implications for public health, driven by the widespread misuse and overuse of antibiotics. The global consumption of antibiotics is on the rise, reaching approximately 70 billion doses annually. Current estimates indicate that drug-resistant infections cause about 7 million deaths

The reasons behind AMR are debatable, with consensus pointing to the misuse and overuse of antimicrobials among physicians, veterinarians, and farmers. Studies in Ethiopia reveal a significant knowledge gap among healthcare providers, leading to complacent behaviors in antibiotic use(ref). In Rwanda, research indicates a low rate (38.6%) of appropriateness in antibiotic prescriptions, contributing to antimicrobial resistance (Vedaste et al., 2022).onother research done in Rwanda about Assessment of antibiotic use in farm animals in Rwanda was found that 44.4 and 26.5% of respondents reported that they used antibiotics for disease prevention and growth promotion, respectively. The use of non-prescribed antibiotics in animals was also reported by more than the half of respondent farmers (55.6%).

This solution addresses knowledge gaps and promoting responsible antibiotic use across diverse sectors for mitigating the consequences of antibiotic resistance.

PIH/Inshuti Mu Buzima  is already involved in many community programs including antimicrobial stewardship initiatives through microbiology services, pharmacy support, clinical and community engagements, and farming in Rwanda.Building upon this foundation, our solution aims to bridge the gaps identified in communication and awareness among various stakeholders: physicians, nurses, veterinarians, community members, patients, lab technicians, and community pharmacists. Our overarching goal is to -demystify antimicrobial resistance (AMR) for each of these groups and empower them with actionable insights tailored to their respective sectors.

To truly understand their unique needs, we are currently conducting thorough research. This research focuses on identifing gaps in understanding related to AMR, including aspects such as usage, accessibility, and the importance of responsible antimicrobials use. By delving into their perspectives, practices, and existing knowledge about AMR, we gain valuable insights that will shape the development of our app.

Throughout the solution development process, we actively engage with the target audience. By seeking their input, feedback, and recommendations, we ensure that app resonates with their requirements. This collaborative approach ensures that the app is not only informative but also user-friendly, effectively addressing the diverse needs of the AMS community.

Our solution, a comprehensive mobile app addressing Antimicrobial Resistance (AMR), distinctly offers a public good in the form of knowledge dissemination and accessibility. By delivering vital information on responsible medication use to physicians, pharmacists, lab technicians, veterinarians, and the community, the app directly contributes to public well-being. This knowledge is globally accessible through the app, ensuring a broad impact on diverse communities worldwide.

The app's educational content serves as a digital public good, promoting awareness and best practices in the fight against AMR. Users globally can access this knowledge under fair, reasonable, and non-discriminatory terms, aligning with the Trinity Challenge's criteria. The app's inclusive design and free availability embody the essence of a public good, fostering a shared global responsibility in combating AMR. In this way, our solution not only educates but also actively contributes to the collective well-being of the public on a global scale.

Here's a simple breakdown of how and why we expect our solution to have a positive impact on the target population:

Knowledge Dissemination:

How: The app disseminates crucial information on responsible medication use.

Why: This empowers healthcare professionals such as physicians, pharmacists, lab technicians, and veterinarians with the knowledge to prescribe and administer antibiotics more responsibly.

Accessibility:

How: The app ensures community accessibility, reaching diverse communities.

Why: This broadens the reach of responsible medication practices, addressing AMR on a global scale rather than being confined to specific regions or communities.

Targeted Professionals and Community Engagement:

How: The app targets healthcare professionals and the general community.

Why: By engaging both professionals and the public, we create a comprehensive understanding of responsible medication use. This dual approach is essential for addressing AMR at both the provider and consumer levels.

Community Empowerment:

How: The app empowers communities to take an active role in combating AMR.

Why: By providing information directly to the community, the app encourages individuals to make informed decisions about their health, reducing unnecessary antibiotic use and contributing to the overall fight against AMR.

Next Year

Pilot Expansion: After the initial launch, we plan to expand the pilot to additional healthcare settings and communities. This will allow us to gather diverse data and feedback.

User Engagement Initiatives: Advertise and engage users with focused efforts. Partner with health, government, and education groups to promote the app widely.

Continuous Improvement: Regularly update the app based on user feedback, technological advancements and emerging best practices in AMS.

Next 3 Years

National Rollout: Collaborate with health authorities at the national level to facilitate the widespread adoption of the AMS app. Customize content to align with regional guidelines and languages ensuring cultural relevance.

Global Partnerships: Partner globally with organizations, NGOs and health agencies to expand the app's reach. Collaborate on research, share knowledge and address global AMR.

Scalable Technological Infrastructure: Allocate resources to scalable tech infrastructure, cloud solutions, advanced AI and a user-friendly interface for a seamless, efficient user experience.

Community Empowerment Programs: Initiate community-focused efforts, empowering individuals and healthcare providers through training, awareness campaigns and collaborative projects to foster AMR advocacy.

Monitoring and Evaluation Framework: Create a strong evaluation system, assess app impact on AMS, share insights globally and contribute valuable data for addressing AMR.

Pilot Expansion:

Metric: Number of healthcare settings and communities added.

Progress Measurement: Track the expansion rate against the initial launch, aiming for increased coverage and diversity.

Performance from Pilot: Assess the pilot's success in terms of diverse data collection and feedback.

User Engagement Initiatives:

Metric: User adoption rates, collaboration with health, government, and education groups.

Progress Measurement: Evaluate increased app downloads and collaboration levels, reflecting heightened engagement.

Performance from Pilot: Analyze user engagement metrics and partnerships formed during the pilot.

National Rollout:

Metric: Level of adoption at the national level.

Progress Measurement: Evaluate the extent of national adoption compared to the initial pilot phase.

Performance from Pilot: Examine the success of the pilot in preparation for national rollout.

Community Empowerment Programs:

Metric: Number of initiatives launched, community engagement.

Progress Measurement: Evaluate the impact of community-focused initiatives and increased engagement.

Performance from Pilot: Analyze the success of any community-based programs during the pilot phase.

Monitoring and Evaluation Framework:

Metric: Strength of the evaluation system, data contribution.

Progress Measurement: Assess the effectiveness of the evaluation system and its contribution to the broader field.

Performance from Pilot: Examine the pilot's impact on AMS practices and the valuable data generated.

Financial Barriers: Barrier: Limited funds for app development, expansion, and scaling.

Mitigation: Pursue grant opportunities as we are applying for this challenges, engage with potential investors, and explore partnerships to secure necessary funding.

Legal Barriers:

Barrier: Regulatory challenges, obtaining necessary permissions for app deployment.

Mitigation: Form a legal team to navigate regulations, advocate with authorities, and ensure compliance. Clearly convey app benefits for approvals.

Cultural Barriers:

Barrier: Resistance due to cultural beliefs or practices.

Mitigation: Create culturally sensitive content, participate in community dialogues, and collaborate with local influencers to boost cultural acceptance. Conduct thorough sensitization programs.

 Policy Barriers:

Barrier: Lack of supportive policies for widespread app adoption.

Mitigation: Promote policies supporting digital health in antimicrobial stewardship. Engage policymakers, emphasizing the app's positive impact on public health.

Market Barriers:

Barrier: Limited awareness and acceptance of digital health solutions in the target market.

Mitigation: Execute focused marketing and awareness efforts to educate stakeholders on the app's advantages. Partner with healthcare groups, NGOs, and government bodies.

Education Gaps:

Barrier: Lack of understanding about antimicrobial stewardship practices.

Mitigation: Create and execute educational initiatives for healthcare professionals, communities, and stakeholders. Utilize multimedia and community-based efforts to address educational disparities.

As a dedicated health organization striving to enhance healthcare quality within the Rwandan community, Applying to The Trinity Challenge aligns with our mission of improving the  quality of care that  is delivered, one way is  to combating Antimicrobial Resistance . The barriers we face include financial constraints for impactful implementation. Winning this challenge would alleviate these constraints, providing substantial resources to fulfill our solution's potential.

Additionally, The Trinity Challenge offers a platform for visibility, enabling us to showcase our innovative AMS app. overcoming regulatory hurdles is another challenge, and the recognition and support from The Trinity Challenge can facilitate engagements with policymakers, aiding in obtaining necessary approvals.

 The challenge's network and resources will enhance our global reach, fostering collaborations with health authorities and NGOs for a more extensive impact. Overall, The Trinity Challenge is a catalyst for surmounting financial, regulatory, and visibility barriers, propelling our solution to effectively address AMR.

Applying to The Trinity Challenge holds the promise of invaluable connections with their esteemed collaborators, offering mentorship, financial support, and potential partnerships.

1. Ineos oxford institute for antimicrobial research

2. Wellcome

3. Patrick J McGovern

4. Bill &Melinda gate Foundation

5. Clinton health access Initiative