Digital health solutions for non-communicable disease care in Zimbabwe

Zawya

2 days ago

Sharing data in real time to make critical health care decisions
Connecting rural and remote communities to Zimbabwe 's primary health system used to include delays of up to one month and loads of paperwork. Now, with the support of UNICEF and partners, the Ministry of Health and Child Care has equipped Village Health Workers with data-driven tools to make timely and lifesaving health care decisions. Digital health solutions like the use of a smartphone to transmit patient data in real time have empowered these workers to improve outcomes for children living with non-communicable diseases.
Village Health Workers, trained volunteers who provide essential health and nutrition services to families and children, often work in remote areas that have limited access to health facilities. In the past, they recorded patient notes during their rounds that were then shared with the public health system, often long after the visit.
'We used to compile reports in a book which we would submit at the clinic at the end of the month. Now it is smoother and faster. Cellphones have been a game-changer,' says 52-year-old Margaret Denhera, a Village Health Worker in Luwana, Zimbabwe.
Village Health Workers in Zimbabwe receive regular training on the digital medical equipment and devices they use on their rounds. © UNICEF
'I move around the village collecting information on non-communicable diseases. At the end of the day, I punch it into my phone,' says Denhera. She sends the data to the nearest health facility about 10 miles away.
As the front line in Zimbabwe's public health system, Village Health Workers are often the first to identify non-communicable diseases like high blood pressure, chronic respiratory illness, cancer and diabetes. These diseases disproportionately affect people in developing countries, leading to the death of nearly 1 million people under age 20 each year worldwide. In Zimbabwe, NCDs are on the rise.
Non-communicable diseases: A growing burden on Zimbabwe's health system
Many, but by no means all, NCDs are preventable and treatable with early intervention and education on risk factors like excessive alcohol, inactivity, poor nutrition and tobacco use. Left undetected and untreated, NCDs can rapidly become life-threatening. Village Health Workers educate families on these risky behaviors and are trained to detect and test for NCDs on their rounds. The prompt reporting of a patient's symptoms to the nearest health facility can save a child's life.
'Village health workers are our foot soldiers,' says Yemurai Chamburuka, a primary care nurse at Patchway Clinic. 'When they see patients with abnormalities, they can easily call us or send the data by phone. It is to our advantage because we have the information as early as possible rather than waiting until the end of the month,' she says.
'If, during my checkup rounds, I test someone and observe, say, abnormal blood glucose levels, which is a sign of some non-communicable diseases, I refer the person to the clinic and send their test results ahead,' Denhera explains. Clinic nurses can review the real-time data and develop an action plan before the patient even reaches the facility.
Video: Digitizing health systems in Zimbabwe
Because they come to know their clients and their environment so well, Village Health Workers often identify trends or potential disease outbreaks in their recordkeeping. The data they capture in real time is analyzed so that public health officials and policymakers can respond swiftly and efficiently.
Dr. Robert Gongora, a digital health specialist who has led implementation of the Zimbabwe Ministry of Health and Child Care (MoHCC) Electronic Health Records (EHR) system since 2017, commends the seamless flow of patient information.
'With more and more connectivity, we begin to learn immediately what's happening in that area because the moment we receive the information, we plan for that client ahead of arrival,' he says.
Dr. Justice Mudavanhu, National Coordinator for Non-Communicable Diseases in the MoHCC, says the Ministry's head office uses VHW-submitted data to map the country's response to the growing incidence of childhood NCDs.
'In the program, we have technical experts who apply evidence-based interventions that help us to develop guidelines, standard operating procedures, algorithms and strategies for chronic diseases in children,' he said during a recent tour of rural Zimbabwe.
Digital tools help identify and map disease incidence for better intervention
'There are systems at community level, at health facility level, and, as you go up, there are non-location-specific systems that enable data visualization. When we know what we are facing, we can target and measure our interventions better,' Dr. Mudavanhu adds. 'It's better not to shoot in the dark, especially where resource allocation is concerned.'
We call them 'Digital Health Workers.' — Dr. Robert Gongora, Zimbabwe Ministry of Health and Child Care
Equitable access to health care requires decision-making based on accurate and timely data. Authorities see vital interlinkages between the MoHCC digitization program and UNICEF's support for capacity building of the public health system. UNICEF, with the support of partners, is helping the MoHCC revolutionize community-based primary health care to strengthen NCD diagnosis, prevention and treatment within primary health care and referral facilities.
Dr. Gongora suggests the title 'Village Health Worker' is outdated. Instead, he says, they should be called 'Digital Health Workers.'
This vital work is made possible by a donation from Eli Lilly and Company (Lilly) to UNICEF USA. UNICEF is strengthening health systems and preventing, detecting and treating NCDs for children and adolescents in Bangladesh, Malawi, Nepal, India, the Philippines and Zimbabwe.
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