eHealth Africa: An Unwavering Focus on Revolutionising Public Health

Founded in 2009, eHealth Africa aims to build more robust health systems by designing and implementing data-driven solutions that respond to local needs and provide underserved communities with tools to lead healthier lives.

In an interview with Olivia Kolbe-Booysen, the Program Manager at eHealth Africa, and Uche Ajene, the Senior Communications Manager at eHealth Africa, they spoke exhaustively about the organization’s projects and their plans for improving the African healthcare system.

In a nutshell, please discuss the mission and vision of eHealth Africa.

Olivia: eHealth Africa was founded in 2009 with a clear objective; that communities in developing countries could have better healthcare when providers can make data-driven decisions. We have partnered with governments and non-governmental organisations in several countries across Africa and beyond to improve African healthcare systems using data-driven solutions.

We have several key focus areas;

Health delivery systems – to improve the quality and availability of health care, particularly for the underserved population, through data management and logistics support to enable better decision-making.

Public health emergency management systems – Developed tools to prepare for and respond to public health emergencies, including ebola, polio, and many others across rural areas. In addition, we also work with stakeholders to devise ways of responding to disease breakout to either eliminate or lessen the effect on the populace.

Disease surveillance systems – We leverage technology to collect, analyse, and interpret first-hand information from the field in different communities to devise early warning systems of any impending disease outbreak. 

Laboratory and diagnostic systems – We develop and maintain infrastructure, people, and processes required to effectively classify human-collected or environmentally obtained samples of potential health threats and the mechanisms and interactions needed for that system to drive an appropriate public health response.

Nutrition and food security systems – We provide data-driven, technological approaches to improving the quality and availability of nutritious food products throughout West Africa.

Headquartered in Nigeria, eHealth Africa has offices in Germany and Sierra Leone. We execute projects throughout Africa- We have projects in Cameroon, Chad, DRC, Liberia, Sudan, Tanzania, and much more. Furthermore, we have about 500 staff working across all of our offices.

We have expertise in global health informatics, using geospatial data to create solutions across the public health sector. We also have expertise in the supply chain, last-mile delivery, infrastructure services, ICT-as-a-service to support these projects, field operations, monitoring evaluation, capacity building, and project management.

How do you leverage GIS to drive sustainable development across Africa? 

Olivia: We have worked with a large GIS team at the organisation built on our core focus- GIS data is crucial in delivering health systems strengthening interventions. We have a virtual cycle where we gather and analyse data from different sources and partners, considering the area’s various peculiarities.

For example, in 2010, during the polio eradication initiative, we realised that the severity was a result of missed vaccinations in settlements that were not captured on the map. So we supported the eradication initiative in Nigeria by collecting geo-spatial data to create more accurate micro plans for these areas to ensure that we didn’t miss any settlement. The improvement we made would allow us to identify the different points of interest, such as health facilities and other buildings serving as a vaccination site. This led to a significant improvement, and we also recorded a substantial reduction in the cases in these regions. As a result, by 2020, we were able to eradicate wild polio in Nigeria completely.

We have open-sourced this data so that individuals or organisations can access the data and utilize it to provide solutions. We have curated different points of interest for data collection, and they can essentially be used for planning. Our data portal comprises relevant data, including administrative boundaries, settlement data, population estimate, and several data points covering the health sector, educational sector, and much more. We have structured all this data into the data portal and made it available to facilitate sustainable development across African states.

Local communities, government agencies, ministries, etc., without any data management experience, can easily access and generate plans and maps for their activities straight from our data portal. Moreover, the data is updated regularly with new information, allowing organisations to focus on implementing solutions rather than data collection.

Uche: The most important question for us at eHealth Africa is – how the data contained in the data portal help organisations to make better decisions.

If you’re planning an intervention, knowing the lay of the land and coverage areas will determine how much ground one would be able to cover. 

Olivia: We have tried to create new ways of improving the use of geodata for optimising, planning and monitoring because we recognize the time and resources that can be lost in these projects.

Recently we piloted PlanFeld, a mobile and web-based application that helps organisations plan field logistics for public health interventions. PlanFeld makes all aspects of field logistics easier for all types of field activities, including large-scale data collection exercises and health service delivery. PlanFeld is an easy-to-use and highly intuitive tool that removes all the technical details, making it easy for users to use all the advanced analytics and geospatial data to generate robust plans, monitor field interventions and make improved decisions in near real-time.

It also helps us monitor what we are doing from the field, using the GiS tools to verify coverage in real-time. We can also tweak the design to show various indicators to assess the performance of field activities. For example, malaria, measles, yellow fever, polio- we have used this across different campaigns with quite a lot of success.

You have been collaborating closely with a strong network of organizations and foundations across both the public and the private sector to strengthen the health system in Africa. Can you list some of your key partners?

Olivia: Since the organisation started operations, we have been collaborating with several different organisations and institutions in the private and public sector, particularly in the West African region. Our donors and partners include the Bill and Melinda-Gates Foundation, the Centre for Disease Control (CDC), World Health Organization (WHO), World Food Programme (WFP), United Nations International Children’s Emergency Fund (UNICEF), International Rescue Committee (IRC), and many more.

We are focused on creating solutions that are fit for different purposes by working with government institutions and local partners to ensure that our solutions concisely meet the requirements. For example, in Nigeria, we work very closely with partners from the Nigerian Centre for Disease Control (NCDC), the National Primary Health Care Development Agency (NPHCDA), and the Federal Ministry of health. Other relevant organisations such as the National Space Research and Development Agency (NASRDA) and other federal and state institutions, including the emergency operation centres and other organisations responsible for implementing the project we are delivering.

Uche: Our state and government partners are some of the essential collaborators alongside our donors. We have some new partners, and we are always ready to work with anyone who shares the same vision that we do. It is important to note that there is no intervention that we have implemented solely. We always work with partners because most of what we do is strengthen the system they already have in place. 

In addition, we have government partners and funding partners, and we keep getting called back to the table, which is a good indication that we are impacting lives everywhere we go. 

We also have some humanitarian partners who contributed to our work in Borno, Nigeria. Post-polio, we have been able to help Borno state strengthen their effort as they rebuild the state. So now our work not only improves public health but now we are closer to humanitarian work.

We also worked closely with the Borno State Data Centre, where they store and analyse data from numerous sources to kick start their restructuring efforts in the state. In addition, we also helped them set up their infrastructure- both the physical space and data management and help with capacity building, so the state can analyse the data to inform decision-making.

eHealth Africa has been involved in numerous interventions across Africa. Can you highlight some of your milestones? 

Olivia: One of our most significant achievements is the Vaccine Direct Delivery (VDD) project. The VDD is a third-party logistics service provided to the state’s primary healthcare development agencies to efficiently distribute vaccines and dry commodities from the state’s cold stores to health facilities at the ward level. In addition, the service provides quality data for vaccine quantity delivered with remote temperature monitoring of vaccines in transit (Vaccine Quality), delivery planning and scheduling, and driver delivery route optimization, which improves general vaccine management and reporting to aid decision making for the states’ primary healthcare boards.

Through the VDD project, we have been able to:

• Distribute more than 42 million antigens and dry goods moved from inception in 2014 till date for Kano, Bauchi, and Sokoto states.
• Vaccinate 2,785,484 children in Bauchi, Sokoto and Zamfara States.

We have delivered the vaccine to the last-mile health facilities where many of these children were vaccinated. It has helped us to continue our work despite the pandemic. The feedback we got specifically around immunization planning is that more than 60% of the decision-makers we work with utilise the data we provide for them through the VDD project. 

We have several different projects ongoing. We have been working on data collection and field operations. Another project that has been successful this year is the COVID-19 data logistics support project, which we are implementing in partnership with NCDC. We are working with them to increase the speed and accuracy in COVID-19 sample testing, the management of commodities, and the first responders to new covid 19 cases.

We are also doing some projects around the physical infrastructure support for primary healthcare delivery; a good example is the emergency operation centres we have been maintaining specifically for polio over the last ten years. In addition, we have expanded beyond Nigeria through the Bill and Melinda-Gates Foundation to other countries across Africa, and we are currently setting up immunization coordination centres in  Cameroon, Chad, Ethiopia, Liberia, Mali and a host of other African countries.

We are also working on a project in Tanzania focusing on health telematics infrastructure support. So we are diversifying the projects that we undertake to reach as many more people as possible.

Working with various African countries with different modes of operation can be challenging. How have you been able to overcome these challenges?

Uche: More than the cultural or language barrier, the biggest challenge we have encountered while implementing projects across Africa with our partners is access to data.

For the kinds of solutions that we offer, we need accurate data for planning to ensure that we are addressing the problem as holistically as possible. And this is why we continue to emphasise the need for data-driven solutions on every project, intervention, and country that we have worked in because we have realised that access to accurate and up-to-date data can make all the difference. 

Beyond data, another challenge that exists is the knowledge gap. Contrary to popular opinion, our work as an organisation is not to vaccinate people; instead, we enable technologies that allow people already in the system to be more effective. We also advise decision-makers about the necessary steps to take at any point in time. And because of this, we are dealing with a variety of people with different knowledge and background, and we need to bring every local primary healthcare worker up to speed.

When we plan an intervention, we don’t plan on staying there forever. For example, when CDC planned an intervention for ending the 2014 Ebola outbreak in Liberia, Guinea, or Sierra Leone, they initially planned to end the epidemic. However, while working on this, they decided to expand on their work by strengthening the disease surveillance and public health emergency response systems to ensure the health systems in these countries were better equipped to quickly identify and respond to any future public health emergencies, including the Ebola virus. Our plan is always to leave the right system in place so that after our intervention, the local assets can sustain the project effectively. That is why we ensure that all our data are accurate, accessible, and easy to understand.

After every intervention project, we always take the time to address some concerns, including: 

• What happens when we are done with the project? 
• Can the state continue to ensure immunization supervision remains at an all-time high? 
• Can the public health emergency national officer detect infectious diseases outbreak anywhere in the country?

It is not just about creating a system and leaving the system behind; it’s really about making sure that people who would be using the technology after our departure know how to use it, build on it, and effectively pass the knowledge to others.

How do you plan to attract more partners from Africa?

Olivia: We are trying to work on a lot of projects across different regions on the continent. For example, the immunization coordination centres project has expanded our reach to new African nations. The more we work and collaborate with different government partners, the more they realise the importance of our work. Because of our successful interventions, many collaborators would want us to replicate these successes to improve the healthcare system across the continent. So whether we are involved with the interventions in some of these regions or not, we released the data portal to ensure that people have unrestricted access to the data they need; we would be delighted to know that our data is helping decision-makers across Africa.