I’ve taken part in a growing number of conversations related to COVID-19 response and I wanted to share an update about what people in the CHT community are doing. Our community has responded to major outbreaks in the past as well as other fast-moving crises (like major earth quakes in Haiti and Nepal), and we’ve learned a few lessons from these experiences that I hope we will apply to the present situation.
We’re starting by educating ourselves
This is a diverse community and while there are a number of epidemiologists on the forum, many others have less public health background. While you can go to The New York Times for COVID-19 live news, here are some articles that we’ve found helpful for more of a general overview of key points to inform COVID responders:
Short take aways: 1. there’s much the scientific community is still learning about COVID; 2. we know it will disproportionately impact the poor and vulnerable; 3) let’s take this opportunity to strengthen health systems, because:
In the context of an emerging viral pneumonia epidemic in LMICs, effective implementation of pneumonia control strategies can also serve as pneumonia “preparedness” efforts, reducing the risk that novel pathogens like COVID-19 will derail health progress to date, especially on child survival.
Supporting government-led responses and existing digital health deployments is smart
When the global community began responding to the major Ebola outbreak of 2013-2016, there was a chaotic mess of poorly thought through “digital solutions” to the crisis. As was noted in the news media at the time, and as I’ve commented on in my scholarly work on Ebola, many of these projects vastly underappreciated the complexity of the crisis, and failed to pragmatically support the staff, stuff, space, and systems that needed strengthening.
One opportunity to do better is to start by effectively accompanying our partners in Ministries of Health as they lead nationally coordinated responses. We’ve always said we don’t start with tech, we start with people, and this human-centered message is never more important than in a time of crisis. The team at Medic Mobile supports large digital health projects led by government partners in Nepal and Kenya in particular, and our initial offer of support to them has not been new tech, but staff time. Living Goods is another major CHT implementer who I know is thinking not only about what their tech can do, but also how they can free up staff time to work collaboratively on the COVID response.
Another key message is that COVID responses can and should, wherever possible, build on existing deployments. This allows us to take advantage of existing infrastructure, which could increase the success with which we address COVID, and it also stands to strengthen responses to other health issues that stand to get worse in places where COVID takes a real toll on routine healthcare delivery. In some cases these existing systems are already suited to outbreak response, like the Event Based Surveillance system that we currently support in Kenya, and which will hopefully soon have a lay case definition for COVID added to the mix. As Asif and Andrew from Living Goods shared with me the other day, it likely also means adding COVID-related content to existing integrated care apps. This leads me to the next point:
We’re coordinating with the wider digital health community
We’ve also been coordinating with the wider digital health community, and we’re seeing a similar pragmatism around wanting to build on systems that have already been deployed and can be adapted/strengthened. I’ve been in touch with folks from Dimagi about their concept note on CommCare for the COVID response, and we’re reviewing the info the DHIS2 community just shared, and trying to figure out where we can share content, ideas, coordinate. The CHT was featured in an ICTWorks post as one of 10 digital health solutions for the COVID response, and some people from Medic will soon be participating in COVID response workshops facilitated by the Global Digital Health Network. The spirit of cooperation and solidarity in this agenda is deeply heartening.
If you want to stay up to date about what this community is doing, feel free to like this post or leave a comment and (depending on your user settings with this forum) you should get updates when others post in this thread. I’m hoping that others will share info about what they’re working on, as well as updates and requests for help as the situation evolves. Thanks in advance everyone.