We USE HARD DATA TO IMPROVE THE EFFICIENCY & EFFECTIVENESS OF DEVELOPMENT PROGRAMS WorldWide


Our Flagship Projects

+ kuunika: data for action

Country: Malawi

Funder: Bill & Melinda Gates Foundation

Partners: Malawi Ministry of Health, Luke International, Compelling Works

Project start date: 2015

Kuunika: Data for Action is implemented in collaboration with Malawi’s Ministry of Health. Our goal is to improve HIV outcomes in Malawi by making high quality data routinely and sustainably available for decision-makers.

Over the last year, we have also provided support for Malawi’s COVID-19 pandemic response through the President’s COVID-19 Taskforce and the country’s National Emergency Operations Center.

Resources:

+ blantyre prevention strategy

Country: Malawi

Funder: Bill & Melinda Gates Foundation

Prime: Georgetown University

Partners: UCSF, Imperial College, MeSH Consortium, Population Services International, Ministry of Health of Malawi, National AIDS Commision

Project start date: 2020

Global efforts to expand HIV treatment have decreased viral loads and reduced transmission. However, reservoirs of infection remain and will continue to persist unless we deliver effective primary HIV prevention. In Africa, rapidly expanding populations of vulnerable youth and young adults combined with the risk of decreased funding creates further risks and urgency.

Blantyre District in Malawi was selected as the initial test case for establishing an optimized HIV prevention delivery system. This grant allows us to explore new ways of delivering effective HIV prevention programs by building on existing partnerships with government leaders, civil society, and health providers and other partners (e.g., PEPFAR and Global Fund). We hope to generate scalable models that can transform HIV prevention across the region.

Resources:

+ Data Use Partnership (DUP) - Burkina Faso

Country: Burkina Faso

Funder: Bill & Melinda Gates Foundation, The Global Fund

Partner: Burkina Faso Ministry of Health

Project start date: 2019

We are collaborating with Ministry of Health of Burkina Faso as they evaluate their 2010-2020 National Information System Strategic Plan (SNIS) plan and national digital health approach.

Our work is centered around a large-scale "data user study" that systematically catalogues decision-makers, decisions, information, and systems to determine whether the right information is available at the right time to make the right decision. We also mapped the flow of national health data through paper and digital systems and identified opportunities to streamline data collection that we hope will lead to a decrease in duplicative reporting and an increase in data use. The findings from our analysis are feeding into the development of Burkina's 2021-2025 Strategic Plan as well as tailored technical assistance on interoperability and data rationalization.

We also used this grant to support the Government of Burkina Faso with their COVID-19 response, providing the Ministry of Health with COVID-19 risk, economic vulnerability, and epidemiological models. Finally, we also worked with the West African Health Organization (WAHO) to develop a COVID risk model for West Africa.

Resources:

Full report (English): Burkina Faso NHIS Evaluation & Data User Study Final Report

Full report (Français): Évaluation du Système National d'Information Sanitaire et du Plan Stratégique 2010 - 2020

Executive Summary (English, 8 pg): Burkina Faso NHIS Evaluation & Data User Study Executive Summary

+ Digital impact alliance: Mobile Network Operator (MNO) data project

Country: Malawi

Funder: DIAL the Digital Impact Alliance

Partners: Malawi Ministry of Health, Malawi Communications Regulatory Authority

Project start date: 2017

Phase I : Optimizing Health Post Locations

Malawi’s Ministry of Health aims to build 900 new health posts over the next five years. We worked with the Ministry of Health, Malawi’s Regulatory Authority (MACRA), local telecommunications companies, and DIAL, the Digital Impact Alliance to demonstrate how Mobile Network Operator (MNO) data can be combined with health data to better target placement of these new health posts. We developed a analytic model that generates dynamic maps with optimal site locations across Malawi.

The model provide the Ministry with more accurate data on population growth, density, and migration at a granular level. By including the MNO data in our model we estimate that over 226,000 people will now have access to health services.

Phase II: COVID-19 Response

Following requests from Malawi’s Ministry of Health and Emergency Operations Center, we provided epidemiological and risk modelling support for the COVID-19 pandemic.

We developed risk, economic vulnerability, and epidemiological models that we shared with Ministry of Health stakeholders. We incorporated MNO data into the existing epidemiological model to generate hyper-localized analyses that describe the overall ranking of areas in the country.

Use Case 1: We combined a Susceptible-Exposed-Infectious-Removed (SEIR) model’s projections with population mobility insights derived from our MNO data analysis to estimate the epidemic start date at the Traditional Authority (sub-district) level.

Use Case 2: Using the MNO data, we developed a model to detect anomalous mass gatherings. Understanding when and where there was a large gathering of people helped the Government of Malawi proactively target potential COVID-19 hotspots. We also used these data to determine where potential COVID-19 infection risk or likelihood of spreading. We were able to generate a ‘risk score’ for areas surrounding the event. All information on identified mass events and the associated risk were updated daily on dashboards for and were MoH decision-makers.

Resources

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Our Work

+ Behavioral Insights in Supply Chain (BISC)

Country: Kenya

Funder: Bill & Melinda Gates Foundation

Project start date: 2019

Significant strides have been made to improve supply chain outcomes in low- and middle-income countries. New technology and systems, such as bar codes, bar code readers, and electronic logistic management information systems (LMIS), have been introduced in many countries, and the bulk of technical assistance and data-strengthening activities have focused on better tools, training, and technology, primarily for forecasting, inventory, and central planning. These technologies, however, have not solved all supply chain challenges. Outcomes remain suboptimal in many areas and studies have shown that even with complete information, the best decision is often not made by supply chain workers.

To meet this challenge, we are conducting formative research in Kenya to understand the behaviors, motivations, relationships of health care workers, and barriers around supply chain data tracking, management, and use.

Resources:

BISC Overview Deck

+ Country Owned Real Time Resource Tracking (CORRT)

Country: Multi-Country

Funder: Bill & Melinda Gates Foundation

Partners: Global Financing Facility, The Global Fund, WHO, Gavi the Vaccine Alliance

Project start date: 2019

Most countries do not know the totality of health resources they have available in a given year. Total budgets, expenditures, and how these expenditures translate to health gains - are often unknown.

Thanks to funding from the Bill & Melinda Gates Foundation and the World Bank's Global Financing Facility (GFF) and a collaboration with The Global Fund, WHO, and GAVI, we are aiming to strengthen country-owned, real-time, health financial resource tracking tools/platforms. Through this work, we conducted a deep dive into Malawi, Liberia, and Rwanda's current health financing systems, looking at their existing capabilities; documenting minimum information system capabilities and architecture, as well as missing or common gaps. We are also providing a series of recommendations to the global community on ways that we can better align global technical availability to country needs.

Resources: CORRT White Paper

+ COVID-19 Dashboards | USAID Transition

Funder: Pro-bono

Project start date: 2020

As COVID-19 wears on, more data emerges about the pandemic response and policymakers face pressing questions about how to allocate foreign aid for COVID-19. Is it going to the right places? Are resources aligned to need?

With this pro-bono effort, we wanted to make data accessible for policymakers as they make decisions on where additional resources may be needed. We created a set of dashboards to display a range of financial and epidemiological data within simple and intuitive data visualizations, embedded in an easy-to-use website format.

Resources:

COVID Foreign Assistance Websiten

+ Data Use Acceleration and Learning (DUAL)

Country: Multi-Country

Funder: Bill & Melinda Gates Foundation

Partner: PATH

Project start date: 2020

PATH and Cooper/Smith are documenting and sharing findings from five countries: Burkina Faso, Ethiopia, Malawi, South Africa, and Tanzania, that are improving the use of their health data in decision-making under the Data Use Acceleration & Learning (DUAL) project. These five countries received funding from the Bill & Melinda Gates Foundation under the Data Use Partnership. The Foundation has asked PATH and Cooper/Smith to better understand, document, and share what has worked in improving the digital systems in these countries and their use of health data, as well as areas for improvements. We will share these learnings with governments, implementers, policymakers, and funders to better align financing, normative guidance, and programmatic approaches.

Resources:

DUAL Two Page Overview

DUAL Overview Deck

+ Global Family Planning Visibility and Analytics Network (GFP-VAN)

Country: Malawi

Funder: USAID

Fiscal Partner: PATH

Project start date: 2021

Beginning in Malawi, we are supporting the Reproductive Health Supplies Coalition as they expand the Global Family Planning Visibility and Analytics Network (GFP-VAN) to initiate automated linkages with local electronic logistics management information systems. Governments and global procurers need time-sensitive, accurate visibility into supply chains to better estimate need and meet demands. This means facilitating access to planned orders, having information on shipment progress, and understanding country level inventory. We are working with the Government of Malawi to integrate one of their logistics management systems with this global network. Our aim is for key users to have access to information flowing to and from this global network, allowing for better decision-making around commodities.

Resources:

Global Family Planning Visibility and Analytics Network

+ Global Fund Malawi: Monitoring and Evaluation

Country: Malawi

Funder: The Global Fund

Project start date: 2016

What does it take to get to a unified system for monitoring and evaluation of health programs? Most donors, including The Global Fund, are looking to optimize their health investments in partner countries as needs increase and global health investments plateau. Optimizing programs means employing high-quality and relevant data to plan programs that will have maximal returns on health benefits. Having the best data means investing in monitoring and evaluation (M&E) systems that are efficient, well-coordinated, easily accessible, and promote a culture of data use at all levels.

We developed a report that discusses gaps in performance and limitations of M&E systems in Malawi, reviewing barriers to data access and use, barriers to systems integration, and recommendations to address the principal gaps and barriers. The analysis brings together findings from previous assessments and maps the flow of data for HIV, TB, and malaria programs in Malawi.

Resources: Medium Article: Steps to Connect Fragmented Health Data

+ Global Health Supply Chain - Procurement and Supply Management (GHSC-PSM): Thailand

Country: Thailand

Funder: USAID

Partners: Chemonics, Ministry of Health, Thailand

Project start date: 2018

In Thailand, we supported Chemonics under GHSC-PSM and the Bureau of Vector Borne Disease (BVBD) within the Thai Ministry of Health to assess their malaria logistics management information system (LMIS). We carried out several activities: 1) an inventory and capability analysis of major supply chain information systems, 2) an exercise validating data flows, reporting processes, procurement and approval processes, as well as roles and responsibilities within the health supply chain.

We also assessed opportunities for interoperability and data exchange across information systems, documenting user perspectives and requirements for an LMIS and identifying current gaps, data needs, and system requirements. We then developed recommendations and created an overarching roadmap for adopting a standardized LMIS for the Thai Ministry of Health.

Resources:

Thailand National Malaria Control Program LMIS Landscape Analysis

Thailand National Malaria Control Program LMIS Roadmap

+ International Medical Corps: Indonesia

Country: Indonesia

Funder: International Medical Corps

Partners: Dompet Dhuafa, Rumah Zakat

Project start date: 2020

In Indonesia, we are training two national NGOs in Monitoring, Evaluation, Accountability, and Learning. Funded by the USAID Bureau of Humanitarian Assistance, and in collaboration with International Medical Corps (IMC), we are working to better prepare these NGOs to engage with the International Humanitarian Architecture in their role leading local humanitarian response efforts.

Resources:

International Humanitarian Development and Coordination Architecture

+ Measuring Resilience in Malawi (MIRA)

Country: Malawi

Funder: USAID

Partner: Catholic Relief Services

Project start date: 2018

With the increasing severity of weather-related shocks threatening food security, there is demand for a comprehensive protocol to monitor and evaluate resilience in the context of development. Launched as a collaboration jointly conceptualized by the monitoring, evaluation and learning unit (MEAL) within the Southern African Regional Office (SARO) of Catholic Relief Services (CRS) and the Charles H. Dyson School of Applied Economics and Management at Cornell University, we worked to conduct a proof-of-concept study for resilience measurement that would make progress toward meeting this need.

+ Novel data ethics panel

Country: Multi-Country

Funder: Bill & Melinda Gates Foundation

Partner: Georgetown University

Project start date: 2020

Novel data (such as call detail records and social media platforms) provide insights into people's behavior, movement, relationships, preferences, attitudes, and beliefs. These insights can potentially help low-income countries more optimally allocate resources and public services. There are, however, risks and ethical issues inherent in capturing, storing, and using these data.

In partnership with Georgetown University, we convened a panel of experts (bioethicists, information and data protection lawyers, computer and data scientists, IT professionals, health economists, and HIV advocates) to advise and make recommendations on issues such as ethics, security, and privacy. These recommendations will be shared with local and global policymakers and implementers.

Resources: Resources will be posted as they come available.

+ Short Message Service (SMS) Viral Load Results Return

Country: Malawi

Funder: Bill & Melinda Gates Foundation

Partners: Ministry of Health, Malawi., Compelling Works, Luke International

Project start date: 2020

In Malawi, we are working with the Ministry of Health on a pilot to develop a software platform that provides the viral load test results via SMS to people living with HIV (PLHIV). This information should help PLHIV better engage in their own care and achieve (and maintain) long-term viral suppression. We are also leveraging the national health data architecture and working hand-in-hand with the Ministry of Health's Digital Health Division. As the first direct-to-patient communication channel in Malawi, we hope this platform can expand to other MOH programs to improve communication and continuity of care.

Resources: SMS-VLRR Project Page

+ Strengthening Data Quality to Improve Immunization and Primary Health Care (PHC) Program Performance Formative Research project

Country: Nigeria

Funder: Bill & Melinda Gates Foundation

Partner: African Field Epidemiology Network (AFENET)

Project start date: 2020

The Strengthening Data Quality to Improve Immunization and Primary Health Care (PHC) Program Performance Formative Research project uses a human centered design study approach to explore the behavioral and other factors that lead to poor PHC data quality.

The study identifies the drivers of data quality at Nigerian health facility and local government area (LGA) levels. The study also documents stakeholder perceptions and attitudes regarding data quality and identifies the motivators and barriers to improving data quality and availability.

We are providing technical support to AFENET, a Nigeria based non-profit, to develop a human centered design research approach, methodology, data collection, and analysis.

Resources: Resources will be posted as they come available.

+ UNICEF Data Analytics services for COVID-19

Country: Malawi

Funder: UNICEF

Partner: Ministry of Health, Malawi

Project start date: 2020

Working in coordination with the Malawi Ministry of Health, we built and are maintaining a dynamic epidemiological and risk model for COVID-19 in Malawi. Our dashboard allows users to choose different policy levers (e.g., masking, physical distancing) and see how these policy decisions affect rates of infection, hospitalizations, ICU stays, and deaths. The model is parametrized with the latest data available, geographically granular, and computationally complex. The real-time, user-driven interface is the first of its kind in low- and middle-income countries and improves accessibility to and use of modeled results by policy makers.


Publications & Reports

+ Human Resources for Health: Workforce Analytics for Design and Planning

Health workers are at the heart of any health system. However, many countries do not have accurate counts of the workforce and their distribution by region, cadre, and sector. This data gap hampers effective health system functioning.

In 2020, we supported Intrahealth International and Vital Wave to conduct an assessment looking at the Human Resources for Health (HRH) information ecosystem across 20 countries, with “deep-dives” in three countries: Burkina Faso, Mozambique, and Uganda. The deep dive research focused on how the health workforce information ecosystems were working in these countries, mapping the administrative processes and data flows for recruitment and deployment, salary payments, and performance management, and also mapping how information flowed across different levels of the health system to identify bottlenecks.

Resources

Human Resources for Health: Workforce Analytics for Design and Planning Full Report

Report Summary

Country Case Study - Oman

Country Case Study - Mozambique

Country Case Study - Burkina Faso

Country Case Study - Uganda

Lessons from the Education Sector - The EMIS in Andhra Pradesh

+ Using Mobile Phone Data for Epidemic Response in Low Resource Settings - A Case Study of COVID-19 in Malawi

The COVID-19 global pandemic has had considerable health impact, including in sub-Saharan Africa. In Malawi, a resource limited setting in Africa, gaining access to data to inform the COVID-19 response is challenging.

Our article, which focuses on the use of aggregated mobile phone data to better understand population mobility and connectedness – a key indicator of COVID-19 response - is in the final stages of publication in Data and Policy Magazine a publication of Cambridge University Press

A link to the article will be published here once available.

+ The Risks and Benefits of Providing HIV Services during the COVID-19 Pandemic

The COVID-19 pandemic has caused widespread disruptions including to health services. In the early response to the pandemic many countries restricted population movements and some health services were suspended or limited. In late 2020 and early 2021 some countries re-imposed restrictions. Health authorities need to balance the potential harms of additional SARS-CoV-2 transmission due to contacts associated with health services against the benefits of those services, including fewer new HIV infections and deaths.

This paper, published on medRxiv which references our latest research developed with the HIV Modeling Consortium and funded by the Bill & Melinda Gates Foundation examines these trade-offs for select HIV services.

Read the full article on medRxiv

+ Development of a Web-Based Dashboard to Facilitate the Application of Mathematical Modeling of COVID-19 to Policy Making – A Case Study in Malawi

Mathematical modeling of COVID-19 transmission has been instrumental in the global pandemic, particularly to governments in many low- and middle-income countries (LMICs), where empirical data and surveillance is limited. Simulations can be used to understand disease trajectory and impacts of policy options at little additional cost.

In this article, we describe an automated, open-source, and web-based dashboard designed to empower Malawi government officials to understand the ramifications of certain policy interventions from a mathematical model of COVID-19 transmission.

The article is presently being reviewed and will be published on medRxiv in the coming months.

A link to the article will be published here once available.