Real-time wealth assessment to ensure results‑based financing systems reach the poor

Background

Results-based financing (RBF) can improve the quality and safety of healthcare in low-and middle-income countries (LMICs) by linking funding to specific, verified results. RBF programs frequently focus on reaching the poorest and most vulnerable members of a population, but this cannot be achieved unless the program can ensure care is truly reaching the poor.

Monitoring equity in health system service delivery, therefore, is essential to successfully allocating health finance resources. Measuring equity, however, is typically time consuming and expensive, which creates challenges for LMICs and for individual ministries and programs.

Bluesquare is a global data company focused on digital health in LMICs. Bluesquare develops digital health platforms and tools, and works with local governments to make healthcare data collection and analysis effective for their needs – and the needs of health system clients.

This case study describes how Bluesquare incorporates real-time EquityTool wealth assessment into the health finance information systems it develops for LMICs who are using RBF.1 It also provides recommendations for scaling wealth assessment throughout digital health systems.

Equitytool

  • A simple way to assess if programs are reaching the poor.
  • Works with any data collection system, even paper-based systems, and is well-integrated with standard tools, such as DHIS2.
  • Results are reliably comparable to the country’s DHS.
  • Developed by a panel of experts* in the field of wealth measurement and relative wealth indices working together to create a validated method to simplify equity assessment.

*Experts represented UNICEF, USAID, UCSF, Population Services International (PSI), MSI Reproductive Choices, Results for Development, BroadBranch, and Metrics for Management.

Challenge: reaching the poor with pro-poor health programs

It is time consuming and expensive to collect community and household wealth information. This makes it difficult for programs whose work is focused on reaching the poor to be certain they are achieving their goals. Wealth measurement typically relies on infrequent, labor-intensive population-based surveys, such as the Demographic and Health Survey (DHS).

In addition to being cost-prohibitive, this type of survey is inherently unable to provide ongoing, real-time data. Programs and facilities that need equity information to make day-to-day decisions need a simple, inexpensive, reliable way to assess equity throughout the course of work.

Solution: make regular equity assessment standard practice

As LMICs increasingly adopt technology-based health information systems, they can leverage new opportunities for continuous monitoring by combining simplified metrics and digital tools. The EquityTool is a simple, easy-to-use, and free tool that makes ongoing wealth assessment and equity monitoring practical. It allows users to measure relative wealth by comparing the wealth of survey respondents to the national or urban-only population of a country.

The EquityTool is compatible with all data collection platforms – even paper-based systems. The tool measures household wealth using a short survey of country-specific questions, which can be completed in just a few minutes. Assessment requires only six to 18 questions (depending on the country) from the relevant DHS Wealth Index to reliably assess a respondent’s wealth quintile. This significantly reduces the number of variables needed for real-time, accurate wealth assessment.

EquityTool surveys can be incorporated into any survey platform. Each questionnaire identifies the percentage of respondents in each national or urban wealth quintile, and supplies the appropriate statistical code and assessment instructions for analysis. This facilitates easier and faster – and less expensive – data collection and analysis of wealth distribution and allows for fast and accurate comparisons across programs and populations.

The EquityTool empowers users to make near real-time adjustments in program delivery, in order to increase organizational effectiveness and strengthen program outcomes. It is available for over 60 countries, and survey questions are pre-translated into local languages.

Adding equity assessment to RBF monitoring: use case in Benin

An example of the EquityTool’s application to RBF comes from Bluesquare’s work with the Ministry of Health (MOH) in Benin. Benin introduced RBF in 2012 to increase the quality and reach of public health programs. Their RBF information system includes routinely collecting data from patient exit interviews and satisfaction surveys, and integrates the EquityTool into patient feedback questionnaires. This allows them to conduct real-time equity assessments.

The EquityTool survey for Benin uses eight questions to assess patient wealth. Bluesquare, the MOH’s health information system supplier, worked with the ministry to incorporate these questions into Benin’s RBF information system surveys. The EquityTool allowed the MOH to identify respondents’ socio-economic status, placing them into one of five wealth quintiles, based on DHS data for the country. This enables the MOH and individual programs to understand how many of the people they serve are in the wealth quintiles the program is targeted to reach.

Bluesquare has also worked with MOHs in the Democratic Republic of Congo, the Republic of the Congo, and Zimbabwe to incorporate the EquityTool into health information systems for similar applications.

Results: routine equity analysis supports health programs from planning through evaluation

Incorporating EquityTool surveys and analysis into RBF information systems enables MOHs and programs to automate equity assessment as part of ongoing data analysis. This facilitates monitoring to help ensure activities are reaching the intended audiences. The integration of equity data with existing patient data allows for more complex analysis and mapping of data, so MOH and program users better understand the wealth distribution in covered areas. EquityTool assessment in Benin, for example, showed that fewer people in the lowest quintile accessed services.

EquityTool analysis has also enabled Bluesquare and their clients to identify specific health concerns by wealth quintile, and understand how patients from different wealth quintiles make healthcare choices. In Benin’s analysis of reasons why individuals choose one health center over another, individuals in the lowest quintiles were far more likely to value the health center being “nearby.” Patients from higher quintiles – who were not eligible for free care – were more likely to be concerned about the cost of services.

Patients in the higher quintiles were also more likely to choose a health facility based on the competence of its personnel than those in the lowest quintiles. Even the reasons for seeking healthcare differed markedly by wealth quintile. Those in Benin’s lowest quintile primarily sought care only when medication was needed. Those in the highest quintile, however, were much more likely to seek medical consultation and prenatal care. These analyses improve campaign planning, allow facilities to address barriers for the most vulnerable populations, and can inform planning for future facility locations.

The EquityTool is also an effective tool for monitoring and evaluating health programs. Bluesquare is currently integrating the EquityTool into innovative information systems and data analysis, such as an open source health insurance information system. Equity analysis provides valuable insights for linking premiums to socio- economic conditions such as wealth quintile. Bluesquare’s experience indicates that equity analysis also provides opportunities for deeper understanding of behaviors, needs, and potential service-seeking values of target populations.

Current equity measurement is conducted through surveys that are more expensive than adding a few additional questions to a routinely collected questionnaire. Implementing the EquityTool routinely can create substantial savings.

Nicolas de Borman, CEO, Bluesquare

Next steps: planning with equity analysis in mind

Bluesquare has found that it is most effective to include the EquityTool in the program design phase. This reduces learning curves and disruption of established routines compared to altering the system later. They recommend employing equity assessment from initial system design. This ensures that the information system consistently supports the goals of reaching the poor and targeting resources effectively.

The EquityTool is a reliable and cost-effective solution. “Current equity measurement is conducted through surveys that are more expensive than adding a few additional questions to a routinely collected questionnaire,” says Bluesquare CEO Nicolas de Borman. “Implementing the EquityTool routinely can create substantial savings.”

Lessons Learned

• Incorporate wealth analysis into health information systems from the initial design.

• Equity data can be used to improve strategic purchasing.

• EquityTool data alongside other health information helps identify specific health issues and services needed by people in different wealth quintiles.

• The EquityTool is a cost-effective solution for collecting data that can be used for programmatic decision-making, and for monitoring and evaluation program impacts.

M4M can help you use the EquityTool in your project. For more information contact communications@m4mgmt.org .

What the story of the “Three Little Pigs” can teach us about hosting

As a software company, we often design tools for our clients in the scope of a specific project. And a key success factor in any of our projects is the transfer of ownership of these tools and services we’ve designed to our client, often situated in LMIC countries. We advocate for it with tooth and nails.

Yet, we also always advise that any tools we provide remain “hosted” with us, rather than at a local infrastructure. Hosting for us is a zero-sum game, it’s far from being our most profitable line of business and it requires constant maintenance. 

So why do we offer it, and even recommend it? And wait, first, what again is hosting exactly?

Building a house for your data that won’t be huffed and puffed and blown away

You’ve heard the nursery rhyme about the three little pigs, one who built his house with straw out of laziness and whose house got huffed and puffed and blown away by a wolf. One who built it with sticks and whose house, again, got huffed and puffed and blown away by a wolf.

The third one, however, took the long road to the brickworks and built a sturdy house that the wolf couldn’t huff and puff and blow away. 

Well, hosting is very much like having a house. And you can choose the straw one, the stick one or the brick one – at your own peril. Every tool we create needs to be hosted (housed) on what we call a server (the actual house) somewhere. Somewhere with doors that only specific people can enter (enhanced data security), that won’t be easily damaged, etc. 

In fact, losing, damaging or having no steady access to your service can lead to disastrous consequences, especially in the case of health information systems.

So what type of house can you choose from to house your project?

The straw and twigs house: under-the-desk hosting

No, this is not a joke; yes this happens frequently; no not just for unimportant projects.

This kind of  hosting is a laptop dependent server. While this may be fine for people who want their own server, to game or code personally when they want to, it obviously cannot be relied upon for projects impacting the health of thousands of people.

This server is at risk not only of being closed by a well-intentioned coworker, but also of being in an unsafe environment. From high temperatures, to a lack of proper fire safety (computers don’t like water nor fire), non-existent redundancy for electric power or a guaranteed internet connection, etc.

Aside from the risks inherent to the placement of this server, scaling up the infrastructure as the project grows will be really difficult. In any case, it will be definitely harder than a click to get a bigger server or more storage for a few extra bucks paid in an instant with your credit card.

The bricks house: cloud hosting

These have a decent place to store your data: physical access is verified, a cooling system is in place, ideally there’s an uninterruptible power supply, a broadband internet connection, etc.

In the case of international hosting specifically, such as AWS, Azure, Google, etc, they even have all the right certifications in place, give easy access to instant upgrades and promote best practices in terms of keeping your house up to industry standards. In fact, we at Bluesquare use AWS and host our client’s projects on it.

But in both cases, clients still need to build up their experience and skills, and set up some processes themselves in case of an unfortunate event. And, most importantly, the team in charge of the server usually has limited knowledge on health data in LMIC countries (mostly DHIS2 based). They will probably execute some tasks once a year, where our team executes them on dozens of servers per year.

So why do we bother with hosting when it’s more work than profit?

Bluesquare hosts dozens of servers and invests in automation of provisioning (creating “new servers” based on specific characteristics), monitoring, troubleshooting, and capacity planning. On top of offering all that cloud hosting provides, we have a monitoring team expert in the DHIS2 and health data stack dedicated to investigating problems before they occur. We also minimize interventions directly on your servers by automating most regular tasks via our slack channel and bots.

And this is just the tip of what we do to keep our client’s projects from being huffed and puffed.

We do it because we are committed to making our projects succeed in the long term. Because we believe in transferring ownership, while ensuring our clients can make the most out of the tools we created without worry. We are dedicated to our clients, to our work, and hosting tools critical to their health systems is an integral part of it.

View our DHIS2 hosting options →

Bluesquare is one of the 2 organisations officially recommended by the University of Oslo to host and manage DHIS2 instances.

De la collecte à la visualisation de données: le cas pratique de CommCare

Découvrez les principaux atouts d’un outil de collecte de données tel que CommCare

Il y a un mois, Bluesquare et IT4life ont lancé la série de webinaires “Digitaliser vos programmes : outils et conseils” qui vise à apporter un support aux gestionnaires de projets et de Suivi et Évaluation pour à la fois identifier les meilleures solutions digitales pour leurs projets et programmes, et à aborder la meilleure approche en matière d’implémentation. La première session, début juin, portait sur la “Monitorer programme avec DHIS2“. Si vous souhaitez avoir accès à l’enregistrement vidéo, n’hésitez pas à nous contacter. 

Nous avons maintenant le plaisir d’annoncer la deuxième session de la série “De la collecte des données à la visualisation : Le cas pratique de CommCare“. Cette session sera disponible en français et en anglais.

Lorsque l’on s’efforce de collecter des données sur un programme, la suite logique consiste à suivre plusieurs paramètres dans le temps, qu’il s’agisse de personnes, d’équipements, de stocks de médicaments, etc. C’est ce qu’on appelle la collecte de données longitudinales. Dans ce webinaire, nous ferons la démonstration de l’une des plateformes de collecte de données mobiles les plus riches en fonctionnalités : CommCare.

Grâce à ses puissantes fonctions de création de formulaires et de gestion de cas, CommCare vous permet de suivre tous les paramètres nécessaires au suivi de votre programme. Pour vous aider à pousser encore plus loin l’analyse de vos données, nous vous montrerons également comment utiliser des outils de Business Intelligence tels que Tableau et PowerBI pour visualiser vos données.

Enfin, parce que chaque programme a ses propres spécificités et exigences, nous discuterons d’autres cas pratiques potentiels, et les outils les mieux adaptés à chacun d’eux.

À la fin de ce webinaire, vous serez en mesure de savoir si CommCare est l’outil le plus avantageux pour votre organisation et votre programme.

Rejoignez-nous sur nos plateformes de médias sociaux et rejoignez la discussion!

A propos de l’intervenant

Guillaume Deflaux est le Directeur des opérations de IT4LIFE. Il a 15 ans d’expérience dans le domaine de l’ICT4D. Il a dirigé la conception et la mise en œuvre de programmes dans les domaines de la santé, de la protection de l’enfance et de la justice juvénile au sein de contextes et d’organisations très variés. Il possède une solide expérience avec CommCare. Il a notamment dirigé le déploiement d’outils basés sur CommCare à l’échelle nationale au Burkina Faso et en Afrique du Sud. Il a aussi supervisé l’intégration de CommCare avec l’instance nationale DHIS2 au Burkina Faso.

From data collection to visualization: The CommCare use case

Discover some of the great things you can do with a data collection tool such as CommCare

A month ago Bluesquare and IT4life kicked off their webinar series “Digitizing your programs : tools and tips”. The series aims to help project and M&E managers identify the best digital solutions for their operations, and make the right implementation decisions. The first session looked at  “ Monitoring your program with DHIS2. If you want to have access to the video recording, do not hesitate to reach out.

We are now pleased to announce the second session of the series “From data collection to visualization: The CommCare use case”. This session will be available in both French and English.

When making the effort to collect data on a program, the logical next step is to to track several parameters over time, be it people, equipment, medicine stocks, etc. This is called collecting longitudinal data. In this second webinar we will be demonstrating one of the most feature-rich mobile data collection platforms: CommCare.

Thanks to its powerful form builder and case management features, CommCare allows you to track anything and everything. To help you push your data analysis even further, our expert will also demonstrate how to use common Business Intelligence tools such as Tableau and PowerBI to visualize your data

Finally, because every program has its own specificities and requirements, we will discuss other potential use cases, and which tools may be better fitted to each of them.

At the end of this webinar you will be able to know whether CommCare is worth considering for your organization and program.

Join us on our social media platforms and engage in the conversation. 

About the speaker

Guillaume Deflaux is the Chief Operating Officer at IT4LIFE . He has 15 years of experience in ICT4D. He has led the design and implementation of programs in the areas of health, child protection and juvenile justice in a wide range of contexts and organizations. He has a strong experience with CommCare. Notably, he led deployment of CommCare-based tools at national scale in Burkina Faso and South Africa. He also oversaw the integration of CommCare with the national DHIS2 instance.

New features of D2D, our DHIS2 data integration tool

One of the biggest challenges we face during our monitoring and evaluation projects is the existence of multiple data sources that are not unified nor synchronized, making it difficult to have a steady and constant flow of data. To resolve this, Bluesquare developed D2D.

D2D is Bluesquare’s tool that allows DHIS2 data integration between multiple instances. This tool is very useful in the context of large programs or in countries that have different DHIS2 instances. D2D makes it possible to synchronize the different data sources in order to count on more reliable data. 

Bluesquare has at heart to offer to its partner continuous improvement on its tools and to make them accessible for all. D2D has been upgraded recently in order to make the interface more user friendly and simple to use for non-technical data and program managers. We have been working on 3 aspects to improve D2D. It is now more convenient, faster and more comfortable to use.

  • Convenience

To make DHIS a better partner for data pipelines, D2D gained the ability to export to a CSV directly to your own Amazon S3 Bucket. This CSV file could then be used in a larger data pipeline. This can both be run manually or on a scheduled basis (like all the other D2D tasks)

  • Speed

In our ongoing effort to make D2D smarter and faster we’ve also added features to limit the amount of data that needs to be transferred between DHIS servers. You can now instruct D2D to only handle data that was changed after a specific date (or within the last x days). This will speed up your data flows and make D2D run faster.

  • Comfort

We’ve also added a bit more insight to the D2D process, as a user you can ask D2D for a preview of the data that it will be pushing from the source DHIS to the target DHIS. After viewing this preview, you will be able to cancel or resume the task.

Bluesquare is very attentive to the needs of our partners. We make sure to improve our tools in the direction of their needs. Get in touch with our team to learn more about D2D !

Monitoring your program with DHIS2

Get the pointers needed to decide if DHIS2 is the best fit for your program

Bluesquare and IT4life are excited to announce the launch of  “Digitizing your programs: tools and tips”, a series of webinars to help project and M&E managers identify the best digital solutions for their operations, and make the right implementation decisions

The first webinar will explore DHIS2, an open-source software broadly used as a health management information system. Recently the tool has been increasingly used in support of education, WASH, and humanitarian aid projects, or as a monitoring and evaluation platform. DHIS2 allows for better data collection, management, visualization, and data use.

During the webinar, participants will have the opportunity to engage with Olivier Cheminat, DHIS2 specialist at Bluesquare, who will explore the advantages of DHIS2 to support project digitization or M&E processes. Through this webinar, you will be able to better grasp in which situations DHIS2 can be a good fit for your intervention, taking into account human resources and costs constraints

If you are an M&E, MEAL manager, or a project manager, and would like to learn more about the use of DHIS2 and alternative solutions to this technology’s shortcomings, this webinar is made for you. 

Register Thursday 10th June, 2 pm-3pm (Brussels Timezone)

To stay up to date on upcoming webinars in the “Digitizing your programs: tools and tips” series, contact Mireille Ntchagang, mntchagang@bluesquarehub.com.

OpenHexa, Bluesquare’s new Data Integration Platform

We often hear about the scarcity of health data coming from low resource countries. However, in the last decade, we at Bluesquare have experienced a significant increase in the volume of data being collected through the expansion of software solutions such as DHIS2.

However, with the development of data transmission through multiple communication networks, it can become hard to keep track of all the data being collected by public facilities, private actors, NGOs running campaigns, research projects or logistics systems. It is even harder to mobilize these various sources of data to create meaningful analysis and reports that can help guide public health decisions.

To help solve this problem, Bluesquare is proud to introduce OpenHexa, our open-source data integration platform targeted at health data professionals.

OpenHexa’s interface

Solving the key challenges of data processing : Exploration, Extraction, Visualisation

OpenHexa is focused on four key capabilities:

  • Data exploration through the data catalog component, which allows users to browse, search and discuss data from different sources (S3 buckets, PostgreSQL databases, DHIS2 instances…). This will make possible the synchronization of data from different sources and formats.
  • Collaborative interactive computing through the notebooks component, based on Jupyterhub, where users can create and share notebooks. This will allow software users to easily share their ideas and advancements across teams.
  • Automated data extraction and transformation using the data pipelines component, which will greatly speed up the extraction processes.
  • Data visualization through the visualization component, which provides an easy way to use OpenHexa data in different data visualization and business intelligence tools. 

OpenHexa also provides powerful access control features, allowing you to make sure that every user can only see and work on the data he has been authorized to use.

A user oriented open source platform

By developing OpenHexa as an open-source platform, we are tackling two challenges:

  1. The lack of open-source integrated data platforms: there are many  high-quality open-source software tools for data visualization, analysis or automation, but integrated platforms that combine the different aspects of data science tend to be proprietary, expensive, and plagued by opaque pricing structures.
  2. The brittleness of data workflows in public health projects: when working with health data, experts are often confronted with heterogeneous data, tasks that require manual operations, and siloed information, leading to analyses that are disorganized and difficult to reproduce .

OpenHexa offers a novel solution that is both integrated and 100% open-source (codebase available on Github). We can host the platform for you in our cloud infrastructure, or you can deploy it yourself on any cloud provider – even in your own infrastructure.

Exploration in OpenHexa

Our aim with developing this platform is to offer our partners and future partners a tool that enables programs and managers to automate processes that are often manual, time consuming and error-prone. We had at heart to make it open source and to have a user friendly interface to allow a great number of administrators and projects to benefit from it.

Are you as excited about the launch of Openhexa as we are? Participate in the development of the source code on Github or request a demo session with one of our experts.


Use case: Improving the national surveillance system for infectious diseases

While not limited to health-centric workflows, our platform has been developed with health data as the primary use case. 

OpenHexa offers an ideal environment for local universities, analytical units within Ministries of Health, Institutes of Public Health, National Statistical Institutes or international partners to implement a wide variety of data analysis, at national or sub-national level.

As an example, let’s consider an epidemiologist who is interested in improving the national surveillance system for infectious diseases. This system relies on weekly data collection on about 20 diseases collated at the district level. Each week, data is aggregated manually by a data manager in a provincial bureau and sent to the national surveillance team at the MOH. Then analysts from the national surveillance team evaluate the data using Microsoft Excel and try to identify outbreaks.

How can OpenHexa improve this workflow?

  1. Using the data pipelines component, automated extraction pipelines are implemented to ensure that up-to-date data is consolidated every week. Current use cases include data coming from DHIS2, Excel systems, EpiData collection systems, Access databases
  2. Within the notebooks component, a data scientist develops an outbreak detection algorithm in collaboration with national experts and academic teams and colleagues within and outside the country
  3. The data scientist can share the outbreak notebook with their colleagues and local experts
  4. The outbreak algorithm is then deployed as a data transformation pipeline and scheduled to run every week using the latest data
  5. Using a third-party visualization tool (such as Tableau or PowerBI) connected to OpenHexa, a data visualization expert creates a dashboard to visualize the outbreak data
  6. A local monitoring and evaluation team is trained to use the data integration platform, operate the outbreak detection code, and evaluate the data visualized in the dashboard, and oversees regular updates to the surveillance system. They can zoom on specific zones, compare outbreak cinetics from different years, articulate various relevant data series.

Thanks to OpenHexa, we have moved from a manual, error-prone process to an automated and reproducible solution which allows in-country teams to generate better insights into district-level epidemiological trends.

Webinar series : Digitizing your programs: tools and tips

Are you struggling to choose the right digital tools to monitor your program and leverage data ?

Digitizing project processes can lead to a significant improvement in data availability, timeliness, quality and consistency. However, with the array of digital solutions now available, project and M&E managers are left with a burning question: “what digital tools are best suited to monitor my program and leverage data for my specific needs and budget?”

And that is exactly the question we will offer an answer to in this series of webinars focused on real-life use cases. We will explore the best-in-class software and hardware solutions available for various use cases and openly discuss their advantages, constraints, deployment requirements and costs. As we know that technology is only a means to an end, we will also discuss change management practices that will allow you to get the best organization value and impact out of your digital investments.

Join us to get answer on issues such as :

  • Is DHIS2 a good platform to manage my M&E processes? 
  • What is the best mobile data collection tool for my specific use case?
  • How can I digitize beneficiary management? 
  • What are the best digital tools for stock management? 
  • Are there efficient solutions for activity tracking – and how can it be linked to M&E?
  • What are the best and most cost-efficient solutions for data visualization? 
  • What are the conditions for proper digital tools deployment ?
  • What is the best and most cost-efficient hardware to digitize my workflows ?
  • Practical considerations to scale digital tools within your organization
  • What does it take to create a data culture within your organization?

Digitizing data collection and management tools for the monitoring and evaluation of programs can bring a significant improvement in data availability, timeliness, quality and consistency. Numerous digital solutions are now available to support various data workflows, leaving M&E managers with a burning question: “what tools are the best fitted for my specific needs and budget?”

Sign up now for the first webinar in the series: “Monitoring your program with DHIS2” And stay tuned for the other webinars in this series to:

  • Get a clear understanding of the digital solutions for M&E environments
  • Get straightforward feedback from our pool of experts on your current challenges
  • Connect with an active community involved in setting up digital tools for M&E.

Stay up to date by signing up for our newsletter.

Strenghtening public health emergency operation centers through data support

Bluesquare is delighted to announce the launch of a new intervention in four West-African countries : Niger, Burkina-Faso, Cameroon and Ivory Coast. Funding for the project is provided by the Bill & Melinda Gates Foundation.

The objective of this intervention is to provide operational tools and processes to these four countries in order to improve rapid and appropriate decision-making in health crisis contexts. This project will benefit from the technical advances on which Bluesquare invested heavily in recent years.

We are honoured to be part of a project that contributes to improve global health, which lies at the heart of our values.

The intervention

Bluesquare is leading an intervention aimed at strengthening emergency operation centers (EOCs) by improving data management and data use across stakeholders and fostering health emergency preparedness through a sound use of data. Beyond providing EOCs with data management systems, the project leverages our solid engagement with IT teams in Ministries of Health to promote structural improvements for health information systems in these countries: mapping of health facilities, geospatial data to enhance campaign planning, program monitoring (especially Malaria programs).

Data use is of particular importance to promote next-generation, results-driven health policies, delivering on the promises of technology in deprived socio-economic context.

Our intervention is structured around four main areas :

  1. COVID-19 data system integration,
  2. Malaria and Reproductive Maternal Newborn Child and Adolescent Health (RMNCAH) data system integration,
  3. Support the development of a Health Facility Registry,
  4. Support the setup of common geo-registries.

The data systems consolidation part of the project (areas 1 et 2) revolves around the implementation of a data integration platform. This platform is configured as an open-source data warehouse, combined with powerful analysis tools enabling the management, use and sharing of health data by different partners.

The module dedicated to the strengthening of Health Facility Registries and common geo-registries is a key component of our interventions to strengthen health systems in low and middle-income countries in the long run. It is essential for us to improve the geolocation of essential health information (like health facilities location, service availability, villages location, population estimates, etc.) in order to improve general health policies and emergency responses.

Health Facility Registry in DRC

A collaborative project

Success will be achieved through close collaboration with the national authorities of the four partner countries (Ministry of Health, Statistical Institutes, authorities in charge of planning) but also with other non-governmental organisations and corporations working in the health sector in these countries. We are pleased to announce the successful start of this collaboration with national authorities in all four countries and active joint initiatives with other partners in our intervention.

Our goal, through the implementation of the data integration platform and support of the construction of an up-to-date digital health map, is to rapidly improve the general enforcement of health policies starting with the COVID-19 pandemic response, the Malaria elimination campaign and the improvement of mother and child health with possible extension to other priority topics in the future.

Improving school mapping in DRC thanks to consolidation of geospatial data

The implementation of information systems for government ministries in the health system is Bluesquare’s core business. In this innovation project, carried out in partnership with Cordaid, a similar approach was taken in the field of education, aiming to set up a school map for the DRC using the tools already available in the health system.

Building a school registry platform

This innovation project aims to provide the different partners (Ministry of Education, NGOs, private partners) with a platform, integrated to the DHIS2, to monitor in real time indicators related to education in the DRC. The 2 main objectives are i) to enrich the school map by integrating different existing databases and ii) to make available a set of tools and propose a methodology to improve the school map.

Currently, there are no readily accessible tools for partners and decentralized levels (divisions and subdivisions) to collect and update information on schools. As a result:

  • Each partner collects information on schools in different regions, but there is no real integration of these data into the Ministry’s tools at the national level.  
  • Lower administrative level (divisions, sub-division) reports information back to the national level (paper forms) but receives very little feedback or access to their own data
Section of the “Carte scolaire” or national school map. It shows the percentage of girls in the schools in Sankuru province.

Why is this important ?

Correct information about the location and functionality of schools allows better evaluation and planning in order to satisfy local populations needs. Once the database is completed, and in combination with other data such as population density, it will be easy to answer questions such as

  • Where do children have to walk particularly far to reach a school ?
  • Where are there too many children compared to the existing schools capacities ?

The challenges of the database construction

As in the health sector, from one datasource to another, the same school often has a slightly different name with no common identifier. Using algorithmic tools, based not only on name, but also on belonging to different provinces/divisions/ subdivisions and different geographical criteria (e.g. GPS positions when available) these sources can be reconciled. Once the different sources are put into our common repository tool Iaso, the different metadata, mainly on location, type of school, but also functional data when available can be added (e.g. number of students or classes by schools). All these steps of database construction are done in a facility registry matching software which allows to update the information, continuously, with validation processes, before being pushed to the DHIS2 school map (secured) on which is also connected to a public visualization platform.

Results of the integration of the different data sources: location of over 10.000 schools in the DRC.

Our georegistry platform in action

As mentioned, combining, harmonising and merging different data sources is a job for our georegistry software. Iaso combines a web dashboard and management interface with a mobile data collection tool. It allows easy query and display of geographic data, geared particularly towards the specific goal of data integration.

In the health sector, DHIS2 is the standard data management platform. In this project we used DHIS2 for handling the school data. Iaso is seamlessly integrated with DHIS2 allowing easy integration of DHIS2 data into Iaso for comparison with new data sources, and pushing the results of analysis in Iaso to DHIS2.

Innovation for a better society

Through this project, we wish to make accessible a national platform, piloted by the Ministry of Health, which could be digital, interoperable with the Ministry’s tools (eiter DHIS2 or SIGE) and continuously updated. For Bluesquare, innovative processes and the high-performance tools put in place are more important than the completeness of the data, which will follow.

From the positions of the schools and their belonging to a division and sub-division, we were able to artificially reconstruct a first version of the DRC geographical contours. This mappinp is still in the process of being improved.