Quality TB Care: Using Smartphone Technology for Data-driven Improvements in Nigeria
Jan 3 2012
Using Smartphones in Nigeria to collect TB data has eliminated the need for printed forms, minimized human error in data entry, reduced the lag time of availability of data for policymakers and managers, and helped pinpoint ways to improve delivery of care.
.jpg "State Supervisor Akinbola collects data during a visit to the Ikeja Local Government TB/Leprosy Centre in Lagos. Credit: Oluwaseun Adeleke")
Health Systems 20/20, in collaboration with the National TB and Leprosy Training Centre in Zaria and the Boston-based firm Avid Database Solutions, piloted the use of personal digital assistant (PDAs) in 16 facilities in 8 local governments in 4 states to strengthen supportive supervision (SS) of TB treatment, diagnosis, operational procedures, and data reporting at the facility and local-government level. During scale-up, the project migrated from PDAs to Smartphones to enable enhanced data sharing capabilities and easier analysis on the phone itself so that quality improvement (QI) plans could be made on the spot during a supervision visit.
The QI plans highlight the most pressing areas for improvement and identify and prioritize interventions. In many cases on-the-spot corrections are made and in other cases, systemic problems are fixed. As a result, drug stock-outs have decreased and long-term initiatives to reduce defaulter rates have been introduced.
SS visits are done either monthly or quarterly at the facilities to provide comprehensive monitoring of all clinical, commodity, and laboratory functions that support TB care. The use of a checklist on the Smartphone allows for immediate data analysis and creation of data-driven QI plans. Checklists including information on labs and drug supply are programed and loaded onto PDAs and now Smartphones.
Use of the PDAs/Smartphones succeeded in replacing an existing paper-based system for collecting facility-level TB data. Concurrently, the project designed and launched a web-based database to house the data collected to more easily aggregate and report information to the national level. The project has begun scale-up to all local government areas in Lagos and Abia, impacting an additional 200 facilities and 50 supervisors.
