By Malcolm Quigley, Head, Strategic Partnerships, PSI
At PSI, we work to tackle multi-layered and complex global public health challenges. Addressing such challenges requires us to think beyond our team, and to build collaborative partnerships and innovative strategies to strengthen health systems. Listening to consumer needs and the experiences of health providers is an essential first step in designing partnerships that aim to improve community health and address systemic health challenges.
Innovation – a means to address societal challenges – can take the form of reconfiguring what already exists, creating something new that the consumer has clearly articulated, or creating a new approach that no one knew they needed. However, it requires that we first listen to the needs of consumers and gather data that speaks to their lived experiences and the health barriers and challenges they face.
Training Healthcare Workers During COVID-19
Because of the COVID-19 pandemic, organizations working in public health were confronted with the danger of conducting in-person health interventions, and forced to build creative, socially-distanced alternatives. Nearly all the 40+ countries where PSI operates required a rapid response to the challenges of the pandemic.
PSI works to build health workforce capacity by facilitating health worker training, but in-person training was halted in response to COVID-19. Instead, we used existing technologies to train health workers safely and partnered with local organizations, Unilever, and the Kenyan Ministry of Health, to take advantage of popular messaging platforms to deliver training. PSI worked with the Kenyan Ministry of Health to plan, design, implement, and scale, a remote capacity-building solution using the messaging platform to deliver certified COVID-19 training to over 6,000 private sector health workers. The training modules were designed to be easily accessible and on-demand.
After taking the courses, half of the providers achieved a quality score above 80%. This improved quality score reflects the effectiveness and efficiency of the courses and the program is now being scaled across Kenya. PSI is working with other partners to explore opportunities to distribute health training courses in more countries and with additional training modules.
By leveraging technology that consumers were already using daily, PSI was able to engage health workers online and eliminate the need to provide in-person training..
Partnerships to Improve Malaria Care
PSI’s innovative partnerships do not stop with COVID-19. Our malaria prevention work in Kenya would not be possible without the support of collaborative partnerships aimed at strengthening Kenyan health systems. Malaria remains a significant public health concern in Kenya, where three-quarters of the population are at risk of infection.
One of the effective solutions to diagnose and investigate malaria is the Rapid Diagnostic Test (RDT), which helps to quickly and accurately diagnosis malaria. RDTs help strengthen malaria health systems to more effectively prevent the disease, but they are highly susceptible to human error. It is reported that each year more than 10 million RDTs are misinterpreted or improperly administered.
Both Community Health Volunteers (CHVs) and private sector health workers play a critical role in the malaria healthcare system. When using RDTs alone, CHVs and private providers must manually document and report cases and results which takes time and effort.
To improve the use of RDTs and testing accuracy, PSI partnered with Audere, who created new technology to remotely read test results using a smartphone’s camera and verify the result for the consumer. This resource can be embedded in an app, or over a messaging channel using a bot, and helps consumers, CHVs, and public and private providers with easily accessible and accurate malaria testing.
One such app piloted in Western Kenya has reduced RDT administration and interpretation errors to below 2%, and even identifies faint positive malaria result lines better than experts. The app also tracks cases, test kits, and prescriptions, and can pass the recorded information directly to public health institutions to help with tracking and surveillance.
Not only did the app improve malaria testing and surveillance, it was also identified as the preferred method of malaria testing among health providers. Approximately 85% of CHVs and roughly 65% of private clinic workers involved in the pilot preferred the app to recording test results on paper and felt that the app would save time. More than 80% of participants found the app to be “very useful” and 90% of participants found the app to be “easy” or “very easy” to use.
Looking Forward
For both the RDT app and remote COVID-19 training, our approach was built in collaboration with consumers and their needs. Delivering and scaling remote COVID-19 training was best accomplished using the technology people were already using and efficiently diagnosing and tracking malaria with real-time reporting required a user-friendly app. In both cases, collaborative and localized partnerships were essential.
Technology innovation is a valuable tool in global public health. Working with communities, public and private providers, and technology providers, was essential to the success of these initiatives. As we continue to address complex health challenges, and work with consumers to build sustainable solutions, we rely on partnerships that can identify consumer needs and deliver impact.
