Product Requirement Document

HCM - Indoor Residual Spray (IRS)

Executive Summary

Objective

1. Define the scope for the DIGIT HCM for managing IRS campaigns

2. Present the use-cases for IRS campaigns and the corresponding capabilities and features needed to cater to them

3. Present the mockup wireframes for the user interface

4. Estimate the changes/improvements needed in the DIGIT HCM to cater to IRS use cases in the frontend, backend, and registries

5. Define the indicators and visualisations for the dashboard for campaign supervisors

Background

Vector control is the key intervention for global malaria control and elimination efforts. It is critical for the reduction and, ultimately, for the interruption of malaria transmission. Currently, the two most common vector control interventions are long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). Together, these account for almost 60% of global investment in malaria control.

IRS is the application of a long-lasting, residual insecticide to potential malaria vector resting surfaces such as internal walls, eaves and ceilings of all houses or structures (including domestic animal shelters) where such vectors might come into contact with the insecticide. When carried out correctly, IRS is a powerful intervention to rapidly reduce adult mosquito vector density and longevity and, therefore, to reduce malaria transmission. The effectiveness of IRS as a malaria control intervention arises from the fact that many important malaria vectors are endophilic. That is, when searching for blood meals they enter human habitations or animal shelters where they rest on the walls, ceilings and other interior surfaces before or after feeding on the residents. When a vector comes into contact with a sprayed surface, it absorbs a lethal dose of insecticide, thereby reducing its lifespan. This results in a progressive decline in vector density and longevity, especially among older female mosquitoes, and a reduction in overall vectorial capacity, thereby contributing to a reduction in malaria transmission. IRS is most effective against indoor feeding (endophagic) and indoor-resting (endophilic) vectors.

One significant difference between the use of IRS and the use of treated mosquito nets is the point at which each intervention works to the greatest effect. IRS may provide a small amount of protection to an individual house by repelling and reducing the number of vectors that come into the house. However, the greatest impact of an IRS intervention takes place after feeding, when the anopheline mosquito is more likely to rest on a sprayed surface and pick up a lethal dose of insecticide, thus preventing it from going on to transmit the malaria parasite to others in the vicinity. This means that for IRS to be effective, there must be high coverage1 (usually > 85%) of all structures that are potential resting places to obtain the “mass effect” on the vector population: in other words, being the only sprayed house in the neighbourhood will do little to protect the residents. LLINs, however, inhibit feeding before the mosquito can inoculate the person with sporozoites, and the insecticide component of the net provides a degree of lethal effect on the

vector. This provides both personal protection and, at high coverage rates, a “mass effect” on the vector population. Therefore, being the only house in the neighbourhood with residents sleeping under a treated net will provide some degree of protection, even if the neighbours are not covered.

The various selection criteria for IRS are as follows:

IRS is a suitable form of vector control when:

The following sources/partners/activities were instrumental in developing the DIGIT HCM for the IRS use case:

1. WHO - IRS Operational manual

2. Discussions with Good Bye Malaria

3. Discussions with NMCP Mozambique

4. Field Study

A field study was conducted in the district of Machava of Maputo province to understand the different actors, their actions, needs, and pain points. Simulation of spraying for one household was done by a team of spray operator, mobilizer, and team lead.

Value Proposition

DIGIT HCM for IRS will enable the various actors involved in the campaign to achieve their goals without hindering their routine activities and help to track and monitor the campaign coverage and progress and help to take appropriate interventions that leads to better campaign coverage, increased efficiency for campaign workers, and reduced costs due to beter management of inventory and operations.

Scope

This document covers only the use cases and features that are different or in addition to the existing DIGIT HCM. Modules such as warehouse management and supervision for which use cases are similar to the existing ones are excluded unless specified otherwise.

Goals and Objectives

Primary Goals:

1. To reduce the vector’s lifespan to less than the time it takes for the malaria sporozoites to develop so that the vector can no longer transmit malaria parasites from one person to another

2. To reduce vector density by immediate killing, IRS can lead to the local elimination of important malaria vectors

3. To reduce human–vector contact through a repellent effect, thereby reducing the number of mosquitoes that enter sprayed rooms

Key Metrics:

The success of the product will be measured based on the following key metrics

App:

1. The SUS score from the UAT for the application

2. The average time taken to complete registration and spray details for a house

3. Total number of crashes observed across all users

4. Number of technical complaints generated by users about the application

5. Total number of stock transactions captured by warehouse managers

6. The average number of stock transactions made by warehouse managers in a day

7. Total number of times the supervisors made checklist entry

8. Average number of times a supervisor made checklist entry per day

Dashboard:

1. The SUS score from the UAT for the dashboard

2. The number of average active dashboard sessions per user

3. % of total supervisors who have used the dashboard at least once

User Personas

Supervisors

Supervisors operate at various organisational hierarchies such as National, Provincial, and District. The primary function of supervisors is to ensure all the other actors are following the protocols and procedures. This is ensured using checklists.

Warehouse Managers

Similar to supervisors, warehouse managers also operate at various organisational hierarchy levels. Generally, warehouse managers manage the stock transactions across various warehouses situated at national, provincial, district, or locality levels.

Field Teams

The field team typically consists of 4-5 spray operators, helpers, team leads, and mobilizers. Team lead manages the on-ground operations and is also in charge of stock (insecticides and PPEs) distribution to the spray operators. The spray operators are in charge of registering and/or capturing the household and spraying data. The mobilizer visits households to convince the households to accept the spraying

User Needs and Pain Points

Supervisors

Needs:

• Effectively manage and monitor the progress of spraying operations;

• Filling in essential forms for control and monitoring;

• Visualize the progress of spraying operations, stock levels, campaign coverage and other relevant metrics on dashboards to make informed decisions about team management and operational strategies.

Pain points:

• Challenges in collecting and compiling data in real-time;

• Possible lack of communication between field supervisors, difficulties in solving problems in real-time during field operations;

• The need to carry out data quality checks on a specific percentage of the operator files at each operational base, ensures the accuracy of the records.

Warehouse Managers

Needs:

• Data management and warehouse targets;

• Documentation and tracking of insecticide shipments;

• Record daily stock transactions, from initial receipt to the end of the campaign, including daily withdrawals and returns;

• Monitoring team performance and stock levels via dashboards to track operational efficiency.

Pain points:

• Time-consuming manual checking processes, depending on human observation can be prone to errors, and potential security errors that can go unnoticed;

• Challenges in carrying out manual checks and counts of equipment and inventory, which can result in discrepancies between actual and recorded physical stock;

• Ensuring the safety of the warehouse on a daily basis during the campaign, reporting any anomalies that occur in order to maintain the integrity and safety of the materials.

Mobilizers

Needs:

• Ensure that all communities have access to the necessary information about the spraying program and that this information is understood effectively, overcoming possible language or educational barriers;

• Ensure that all families are aware of the impending spraying and are prepared to receive the Spray Operators.

Pain points:

• Possible lack of access by communities to essential information about the program, making it difficult to understand the instructions;

• Possible resistance or lack of understanding on the part of communities regarding the spraying programme, along with logistical challenges in organizing door-to-door visits;

• Challenges in organizing and carrying out door-to-door visits to mobilize families and ensure their readiness to receive the Spray Operators.

Spray Operators

Needs:

• An intuitive and easy-to-understand interface to make the application easier to use;

• An effective search function to quickly locate registered houses based on geographical proximity or the name of the head of the house;

• Ability to record the accurate receipt and return of insecticides and other materials using checklists in the app:

• Tools to identify high-risk groups, such as pregnant women and children under the age of 5;

• Access to a summary of recorded data for accuracy checks;

• Ability to record all activities related to spraying, including quantity and type of insecticide used, to keep records of each intervention.

Pain points:

• Lack of technical skills to operate the application, especially for those from rural areas or with little technological experience;

• Risk of exposure to chemicals during the handling and application of insecticides;

• Difficulty in carrying bottles and equipment needed to mix and apply insecticides;

• Challenges in correctly following all Standard Operating Procedures (SOPs), which can affect the effectiveness and safety of the process;

• Problems with the quality of recorded data, including data inflation errors or theft of materials.

Team Leads

Needs:

• Visualize targets to effectively manage and monitor the progress of spraying operations;

• Precise stock control;

• Adequate distribution of insecticides;

• Spray Quality Control;

• A performance evaluation form for each team member;

• Visualise the progress of spraying operations teams on dashboards, to promptly identify anomalies and areas of underperformance.

Pain points:

• Difficulties in accurately tracking inventory;

• Challenges in simultaneously monitoring several Rociators during operations;

• Difficulties in optimizing routes for efficient coverage;

• Problems with non-compliance with Standard Operating Procedures (SOPs);

• Need to reconcile data in real-time with the time constraints of daily reconciliation, ensuring accuracy in logistical and operational records.

Product Capabilities

The document only covers the features that are in addition or changing with respect to the HCM application currently available for other campaign types.

1. Register a new household and capture details required for the IRS campaign

User persona: Mobilizer/ Registrar

Purpose: Register a new household and capture details required for IRS campaign. The following parameters are required to be captured:

1. Date of registration

2. Household location details (Address, GPS)

3. Household member details (Total number of people, pregnant women, children)

4. Household identify details (Household head name, age, gender)

5. Total number of rooms

6. Type of structure

2. Capture the spray details post-spraying

User persona: Spray Operator

Purpose: Capture the details of the spray after the spraying is done for a structure. The following parameters are required to be captured:

1. Date of spray

2. Number of rooms sprayed

3. Type of insecticide used

4. Type of spray (Primary/Secondary)

5. If the mobilizer visited the household?

6. Quantity of insecticide used per house (Out of Scope)

7. Time taken for spraying (Out of Scope)

8. Concentration of insecticide used (Out of Scope)

3. Track the time spent per household

User persona:

Registrar / Spray Operator / Mobilizer

Purpose: To measure if the registrar/spray operator/mobilizer is spending an adequate amount of time required to do the following tasks per house.

Tasks for a registrar/mobilizer:

1. Travel from the previous house to the current one (A)

2. SBCC communication required for acceptance of the spray (B)

3. Capturing the household and structure details (C)

4. Travel to the next house (D)

Total time spent =A+ B+C+D

Time spent for actual relevant task = B+C

Capturing time spent per house will help to evaluate if the mobilizer/registrar is spending sufficient time at each household delivering the key Social Behavioral Change Communication (SBCC) messages to the households

Tasks for a spray operator:

• Travel from the previous house to the current one (A)

• Preparation of house for spraying (B)

• Preparation of insecticide solution (C)

• Spraying the eligible structures (D)

• Post-spray activities (cleaning, setting up the house, etc.) (E)

• Entering the spray data in the application (F)

• Travel to the next house (G)

The total time spent by a spray operator is the time spent for activities A to G. The time of interest is the time spent at a household which is B+C+D+E+F. The time spent only for spraying (D) is relevant however is out of scope for this release. For activities B to F, the coordinates captured will be more or less equal within 5-10 meters at any given time. For activities A and G, the coordinates captured will vary temporally.

Capturing the time taken at each household location will help to assess if the time spent per household is proportional to the number of rooms in a house. This is an indication of the efficiency of the spray operator as well if they are spraying all the rooms or not.

4. Filter the household search results

User persona:

Registrar/Spray Operator/Mobilizer

Purpose: For any campaign there are cases where multiple visits will be required for a household due to any of the following reasons:

1. House closed

2. House refused

The registrar/spray operator is required to register the households even if the above reasons hold true. This is done to estimate the number of households required for mop-up campaigns or revisits as well as their locations. During the 2nd visit, the registrar/ spray operator is only required to update the spray details against the previously registered households. To enable the user to identify households that need to be revisited quickly, it is required to add a status filter while searching for the household name. Using the filter in conjunction with the proximity search (available) will help to navigate to the households needing revisits.

5. Integration of IoT devices such as Goizper smartlight/wearable sensors that can capture spray details, GPS, etc.

This is being explored and is out of the scope for the current version

6. Track the performance of the team members in the application

User persona: Field team lead

1. Number of households sprayed for each spray operator

2. Average time taken by each spray operator to spray a house

3. Total time spent by each spray operator for spraying

4. % target achieved by each spray operator

5. Last synced time

The key performance indicators to track are:

Purpose: As a team lead, it is important to track key performance indicators and coverage indicators for each team member. This helps the team lead to reach out to the specific individual and instruct/assist them with course correction.

7. Capture the GPS location while filling out checklists

User persona: Supervisors

Purpose: The GPS location helps to evaluate if the supervisors are visiting the field operations and monitoring the campaign staff in the respective administrative hierarchy they are assigned to. The current checklist in DIGIT HCM needs to be enhanced for this.

8. Capture GPS location for stock management

User persona: Warehouse managers

Purpose: The GPS location helps to evaluate if the warehouse managers are making the stock entries at the respective warehouses that they are assigned to or not. It also helps to identify the temporary facilities that were built for the current campaign and build geocoded facility registries that can be used for future campaigns.

9. Capture Closed Households

User persona: Spray Operators

Purpose: The spray operators can visit the houses when it is closed. However, it is important to capture the location (GPS, address, boundary) of this household so that the campaign planners can plan resources and time for mop-up campaigns. They need to know how many houses were in all villages/districts to plan revisits. Also, the spray operators can plan their route based on the proximity search where the GPS coordinates captured in the first visit will help.

Why separate flow for Closed Households?

In HCM without the mandatory fields such as Household Head name, Location, Household details, etc, the record cannot be created in the registry. Hence this is a unique case compared to other scenarios such as ineligible where the household details can still be collected.

Specifications

Field	Data Type	Data Validation	Mandatory/Not?	Comments
Name of Head of HH	Text field - String	Min. length= 3 characters Max. length= 64 characters	Mandatory
Total no.of houses sprayed	Metric card Read only	Number	Mandatory	To follow comma separation
Total no.of revisits	Metric card Read only	Number	Mandatory	To follow comma separation
Village Name	String (Read only)		Mandatory	Auto populated from Master data. Non editable
Landmark	Text field - String	Min. length= 0 characters Max. length= 64 characters	Non-mandatory
Lat	Numeric		Mandatory	Latitude of the household. Fetched by the system.
Long	Numeric		Mandatory	Longitude of the household. Fetched by the system.
Accuracy	Numeric		Mandatory	Accuracy of lat-long captured
Date	String (Read only)	Must display the current date	Mandatory	Displays the date of registration
Total no. of members living in the household	Counter	Min = 1 Max = 20	Mandatory	Increment counter
No.of pregnant women in the household	Counter	Min = 0 Max = 10	Mandatory	Increment counter
No.of children less than 5 years in the household	Counter	Min = 0 Max = 20	Mandatory	Increment counter
Type of structure	Selection card	Select only one	Mandatory
No. of rooms in the house	Counter	Min = 1 Max = 20	Mandatory	Increment counter
Name of the individual	Text field - String	Min. length= 0 characters Max. length= 64 characters	Mandatory
Age	Number field	Min = 1 Max 150	Mandatory	Auto populated Can edit
Gender	Radio button	Male Female Other	Mandatory	Auto populated Can edit
Mobile Number	Number	9 digits	Non Mandatory
IEC visited or not?	Selection card	Yes/No	Mandatory
Date of visit	String (Read only)	Must display the current date	Mandatory	Displays the date of visit for spraying
No.of rooms sprayed	Counter	Min = 1 Max = 20 Should be <= to the total no.of rooms	Mandatory	Increment counter
Insecticide used	Selection card	Single select	Mandatory
Reason for non-spray	Selection card	Reasons: Multiselect	Mandatory	Multi select. Ineligible card should be auto selected if the type of structure is not compatible

Functional Specifications

1. Register a new household and capture details required for the IRS campaign

a. Able to register new households by capturing the following data elements - Happy path

1. Date of registration

2. Household location details (Address, GPS)

3. Household member details (Total number of people, pregnant women, children)

4. Household identify details (Household head name, age, gender)

5. Total number of rooms

6. Type of structure

b. Able to mark households as closed after capturing only the following data - Unhappy path

1. Date of registration

2. Administrative hierarchy

3. Household GPS

4. Placeholder for household head name

i. Can be auto-filled with a template name (eg: “Closed household”) if the household is marked as closed

c. Able to register a new household, submit the record, sync the record, and search the registered household with the household head name

d. Able to view registered households nearby based on proximity search

e. Able to sort the registered households based on the following filters

1. Closed

f. Capture GPS at regular intervals (every 5 minutes) and compute the time spent at each household

g. The registration module can be assigned to specific roles without the spraying module and should work independently

h. Able to down sync the registration data for a specific boundary

Statuses

The following statuses are valid for each household:

1. Not Visited

2. Registered

3. House closed

4. Refused

5. Ineligible

6. Sprayed

• Not visited → For households enumerated in previous campaigns such as bednet/SMC but not yet visited for the IRS campaign.

• Registered → Households that were registered as part of the IRS campaign

• House closed → Households that were found closed during the registration or the spraying

• Ineligible → Houses that were built with materials not compatible with IRS

• Refused → Houses that were registered but refused for spraying

• Sprayed → Houses that were registered and underwent successful spraying

The statuses will move across as follows:

Not visited →

(Registered / House closed) →

(Sprayed / Refused / House closed / Ineligible)

Only households with the status ‘Registered’ will be able to go through the spraying process and record spaying details against them.

2. Capture the spray details post-spraying

a. Ability to register a new household with the data fields mentioned above -

b. Able to mark households as closed after capturing only the following data - Unhappy path

1. Date of registration

2. Administrative hierarchy

3. Household GPS

4. Placeholder for household head name

i. Can be auto-filled with a template name (eg: “Closed household”) if the household is marked as closed

c. The spray operator should be able to capture only the spray details against an already registered household

d. The spaying module should work independently to the registration module

e. Both the registration and spraying modules can be stitched together back to back depending on the program requirements (eg: Mozambique IRS)

f. The spray operator should be able to down sync the registration data for a specific boundary

g. The spray operator should be able to search for registered households with household head name

h. Ability to view registered households nearby by proximity search

i Ability to filter the registered households by the following statuses

a. Closed

b. Refused

j. The filter and proximity search to function independently as well as in combination k. Ability to capture the following data fields for successful spraying - Happy path

1. Date of spray

2. Number of rooms sprayed

3. Type of insecticide used

4. Type of spray (Primary/Secondary)

5. If the mobilizer visited the household

6. Quantity of insecticide used per house (Out of Scope)

7. Time taken for spraying (Out of Scope)

8. Concentration of insecticide used (Out of Scope)

l. Ability to update the status of households to the following

1. Refused

2. Closed

3. Ineligible

m. Able to mark already registered households as ‘Closed’

n. API endpoints to integrate with data from IoT devices in the future

3. Track the time spent per household

a. Track coordinates of the spray operators/mobilizers/registrars at regular intervals (5 minutes)

b. The interval time should be configurable depending on program requirements

c. Compute the time spent at each household GPS coordinate (where there is relatively no movement of coordinates)

d. The total time taken by each user and the average time taken by each user to be tracked in the dashboard (DSS) as well as the Team lead (Mobile dashboard)

e. This should be captured in the background and also in offline mode without any user action needed

f. The time tracking should start and end at a specified time of the day and should be configurable for different implementations

4. Filter the household search results

a. The household search results should be able to be filtered based on different statuses

b. The filters should be able to be configured for different roles. For eg: a registrar should be able to see only the filter ‘Closed’ whereas a spray operator should be able to view the filters ‘Refused’ and ‘Closed’

c. The filters should work seamlessly without any lags

d. The filters should work seamlessly along with the proximity search as well as without the proximity search

5. Integration of IoT devices such as Goizper smartlight/ wearable sensors that can capture spray details, GPS, etc. This is being explored and is out of the scope for the current version

6. Track the performance of the team members in the application

a. Able to view the aggregates of team performance as well as individual team member performance in the application

b. Able to view the team indicators in near real-time provided the teams as well as team leads have internet connectivity

c. The key performance indicators to track are:

1. Number of households sprayed for each spray operator

2. Average time taken by each spray operator to spray a house

3. Total time spent by each spray operator for spraying

4. % target achieved by each spray operator

5. Last synced time

d. The indicators are to be updated automatically without any action required from the team lead based on the upsync of data from the teams

7. Capture the GPS location while filling out checklists

a. Capture the GPS location for each checklist filled

b. The GPS is to be captured in the backend without any action by the user

c. The coordinates captured need to be shown in the dashboard

8. Capture GPS location for stock management

a. Capture the GPS location for each stock transaction

b. The GPS is to be captured in the backend without any action by the user

c. The coordinates captured need to be shown in the DSS

9. Capture Closed Households

a. Capture the following details for a closed household:

1. GPS coordinates

2. Date and time of record creation

3. Village/Lowest level of boundary

4. Name of Household head (This can be made optional and can be made mandatory based on the implementation requirements)

5. Voucher scanning (This should be made customizable at the implementation level since not all countries will have a voucher-based campaign)

6. When revisiting the house, the house details should be listed by proximity calculated based on the GPS coordinate captured. The name of the household head should be displayed if it was captured.

7. The status of such household records created should be marked as ‘Closed’

Non-functional Requirements

Performance:

1. The battery consumption of the device with the addition of time tracking needs to be comparable to the current version of DIGIT HCM

2. The data consumption should be comparable to the current version of DIGIT HCM

3. The memory storage and usage should be comparable to the current version of DIGIT HCM

4. The data download and aggregation from the team members' mobiles to the team leads’ mobile should be seamless to have near real-time visibility of the key indicators provided there is internet connectivity

5. The application should work offline and also in the background to capture the coordinates at regular intervals

Usability:

Intuitive interface suitable for people with limited mobility, limited smartphone, and feature phone proficiency.

The following new components need to be built to enable this:

1. Box selection for choices (instead of radio buttons) - P0

2. Help text beneath each data capturing field explaining how to fill those fields - P0

3. Images/figures for each screen that summarises the action/data fields in those screens - P1

4. Voice-enabled search - P2 (to test)

5. A progress bar that shows pages completed and pages yet to complete - P2

The following design aspects need to be considered.

1. No drop-down fields unless the selection list is more than 5 - P0

2. No/limited open text fields

3. No vertical scrolls - P1

4. Not more than 2 data fields per screen - P1