A New Digitalisation Effort in Bangladesh Could Change Community Health Globally — Global Issues
DHAKA, Bangladesh, October 31 (IPS) – The digital transformation of thousands of community health workers in Bangladesh has dramatically enhanced their work and enabled database creation and tracking. whether health care covers 64 million people. The resulting model holds considerable promise for the health of the world, especially in the context of the evolving pandemic.
In the midst of the COVID-19 pandemic, BRAC digitize the work of 4,100 shasthya kormi, specially trained community health workers, in Bangladesh. Shasthya kormi are women with experience in health education, antenatal and postpartum care, non-communicable disease prevention, reproductive health and nutrition. The digital transformation of their work has benefited on several notable levels, underscoring the vast potential to scale further and deliver insights directly relevant to the business. improve the quality of healthcare globally.
Each shasthya kormi is given an android tablet and trained on how to use it. That allows for immediate time savings in countless ways: faster and more accurate record keeping; reports are conveyed online instead of in person; training is done online and at convenient times instead of just in person at designated times; and related and avoidable administrative travel costs. The retention time may exceed one day every two weeks. Digital devices also allow us to save approximately $3.8 million per year in surveillance costs.
But that’s just the beginning of the benefits. Digital tablets enhance the credibility of shasthya kormi, as they now have access to vital information at their fingertips. They can screen for diseases and conditions, confirm diagnoses, have complete confidence in describing the required treatment and management, and arrange video chats with doctors and specialists . Their decision-making is faster and more accurate, improving the quality of care and giving them more time to be with the patient.
Electronic reporting enables the creation of a database that we expect to grow to cover 76 million people. That database can now be tracked and analyzed for trends – incidence of diseases or other conditions, in service delivery and outcomes. Those trends can be analyzed and addressed in real time – locally and nationally, like BRAC’s shasthya kormi covers 61 of 64 districts of Bangladesh.
Because COVID-19For example, reports of symptoms and test results can be followed, as well as immunization results and results. Found rate of positive test results in the border regions of Bangladesh is particularly valuable for understanding how trends develop across regions.
For tuberculosis, 1.4 million samples were collected and monitored. Similar, non-communicable disease such as hypertension and diabetes, both of which have an increasing incidence in Bangladesh, can be monitored and addressed. If anyone has high blood pressure, shasthya kormi can record accurately. A blood glucose test performed by shasthya kormi can detect abnormal blood glucose levels that indicate the possibility of diabetes. The database can track the percentage of women with high-risk pregnancies.
The master database – with 150 data points to date – also allows for cross-tabulation of site- and community-specific data. It makes it possible to merge BRAC trend analysis with data from government and other organisations. It responds to internal migration status, with each individual’s medical record linked to their government-issued national identification card – so each person’s health record moves with them. .
When these benefits are combined with the cost-effective nature of this digital approach, the potential for scaling increases dramatically. Each digital tablet costs about $100, so 4,100 shasthya kormi can be fitted for less than half a million dollars. In addition, they save money thanks to the effects described above. Patients also save – Out-of-pocket spending accounts for 63% of health expenditure in Bangladesh, and the tests performed by shasthya kormi usually cost a tenth of what they do in a private clinic. This also puts pressure on medical facilities.
This initiative has great potential to scale further – within Bangladesh and around the world. Shasthya kormi can be recruited locally and trained in weeks. They can be equipped digitally without great expense. The quality of their work can be digitally tracked, and everyone benefits from improved access to healthcare.
The key to scaling is a number of insights that emerge as we coordinate this digital transformation.
First, it’s important to keep a close eye on the input from the start, to identify anyone struggling with the conversion. One of the first clues was a lot of data being entered after 5pm. Not because people don’t know how to type, but because they’re too nervous to use devices in public and don’t want to make mistakes in front of people who trust them.
Once we see this in the data and figure out the reason behind it, we can easily work with each one to fix it. From the very beginning, we formed a team of 40 technicians who provide additional training and support to anyone experiencing difficulties. Help is available in some cases over the phone, but otherwise in person. In the beginning most people needed it, but now only about 10% of people need it.
Second, digital tablets enable continuous, on-demand professional development. Needs, equipment, and trends change frequently in the medical field, and these changes can happen quickly. Shasthya kormi can assess their skills at any time convenient for them using tests available on tablets and modules that will identify weaknesses and recommend further training to address them. that problem. Managers can also track their supervisor’s progress. This has greatly enhanced the expertise of the network.
Third, we observed a tendency to skip entering important but harder to obtain inputs, such as National Identification numbers and birth registration numbers. Fortunately, we can often fill the gap by cross-tabulating with our mobile-based remittance system. We also found that consulting information is not recorded as rigorously as service data. Repetitive training has gradually addressed these challenges.
Fourth, digital transformation has tackled a decades-old challenge – credibility. Shasthya kormi are often taken for granted, and sometimes they are welcome, sometimes not. However, in order to establish a relationship, they need to do their job, which is often sensitive in nature, especially in conservative communities, where it is important that they are accepted into each household. family. Digitization has enhanced the level of respect they receive in the community, especially among men.
The success of this digital transformation, if scaled up, could transform public health globally. The result will be delivering superior primary care, operational efficiency, and establishing the infrastructure to analyze health trends in real-time, in a time when we’ve never had to. grappling more with the quality and accessibility of healthcare around the world.
Morseda Chowdhury is the Director of Health, Nutrition and Population Programs at BRAC in Bangladesh.
IPS UN Office
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