LLIN Overview

Overview

The National Malaria Control Program (NMCP) transitioned to a digital system for their bed net distribution campaign in 2022/2023, moving away from their previous paper-based method. However, the team faced numerous issues with the new tool, such as synchronisation errors, data quality issues, inadequate visualization and analysis of geolocation data, and ineffective bednet tracking during the campaign.

To address these challenges, NMCP partnered with eGov to develop DIGIT HCM, a Digital public infrastructure. This collaborative effort resulted in the creation of an open-source digital public infrastructure (DPI) with interoperability and scalability. Customised as Salama (implying health in Swahili), the aim was to mitigate the above challenges and support multiple campaigns efficiently.

Salama and LLIN

Salama was rolled out as part of the Long Lasting Insecticidal Nets (LLIN) campaign for the periodic distribution of bednets in the Tete and Gaza provinces.

The main players involved in the campaigns in Tete and Gaza are listed below:

1. National Malaria Control Program, Mozambique: Provided overall strategic direction for the campaign, part of the Ministry of Health (MISAU).

2. DIS (Information System Directorate): Provided support during the requirements discussion and the implementation of the campaigns, part of MISAU.

3. DTIC (Information Technology and Communication Directorate): Technical team that was trained and helped manage technical training and issues during the campaign, part of MISAU.

4. World Vision: Implementation Partner for the BedNet campaign in Tete and Gaza.

5. Bill and Melinda Gates Foundation: Funder of the DIGIT HCM platform.

6. The Global Fund: Funds campaign implementation across Africa.

The other partners include PNCM, World Vision, the Foundation for Community Development (FDC), Food for The Hungry Association (FHA), Aid for Develop.

Besides the different players mentioned above, a core group called Nucleo Duro, consisting of members from all groups was formed to lead all decision-making aspects of campaign implementation and digitisation.

Lessons learned from the Tete implementation spurred enhancements in Gaza, and underscored the flexibility of Salama. NMCP successfully conducted campaigns with reduced eGov assistance and effectively addressed many campaign-related issues. During the campaign, NMCP noted that the platform was user-friendly for registrars, and the dashboard's clear presentation negated the need to work on different formats in M&E meetings. Notable improvements in the Gaza campaign encompassed enhanced real-time syncing efficiency, prompt access to team performance reports, and a significant decrease in incomplete records.

Key Takeaways from Salama Implementation

The NMCP highlighted the points listed below as things that went well while implementing DIGIT HCM (SALAMA):

• Automatic synchronisation in areas with internet connectivity: The Salama application has enabled automatic synchronisation in intervals of 5 minutes, which resulted in near real-time data synchronisation in areas with internet connectivity. This was observed during the campaign in Gaza.

• Ability to check teams' progress against daily targets: In the application, there is a progress bar that each team can use to verify their progress when compared to the target. This feature was appreciated by NMCP as it gave the local monitors the ability to check the targets and motivate the teams to achieve at least the daily target.

• Automatic collection of GPS data on each Household registered: The collection of GPS coordinates for a household is done in the background of the application. Whenever a household is registered, the registrar does not have to click any button to initiate the capture of geo coordinates. This made the user experience for registrators better and was in turn well received by NMCP.

• Dashboard was flexible, interactive, and user-friendly: The dashboard was used in the daily review meetings as the main monitoring and evaluation tool and saved time as it was not necessary to develop a PowerPoint presentation for those meetings.

• Automatic calculation of the bednets to be delivered: The application was able to recommend the number of bednets to be delivered to a household based on the number of members, which removed the cognitive effort of the registrar to calculate these numbers by themselves.

• Indication of duplications at the end of the day: The custom reports generated at the end of the day indicated duplications of registration and delivery, It further provided details of duplicate households created by the same registrar and the ones duplicated by different registrars.

• Application easy to learn: During the training, it was noticed that it took less time for the trainees to understand the application and flows. Thus, the training was more practical and focused on simulation-based learning rather than on training the users on how to use the applications.

Throughout the campaign, numerous training sessions were conducted to enhance the capacity of NMCP in managing and utilising Salama, with additional capacity-building activities scheduled for post-campaign implementation. Key recommendations include linking credentials to performance, enhancing microplan estimates, improving warehouse manager training, addressing bed net scanning issues, and shifting the focus to monitoring and correcting supervision results.

In summary, the successful digitalization of Tete and Gaza using Salama facilitated accomplishing essential campaign objectives. While recognising areas for improvement, the standardised data format enabled thorough analysis across campaigns, ensuring ongoing enhancement in effectiveness and efficiency.