An integrated dashboard to support health deciders in Ivory Coast

April 6th, 2023

About the author

Amaury van Kesteren, is a Data Science Project Manager at Bluesquare. With a background in economics and business and a strong data science education, Amaury manages our data science projects across different countries such as Côte d’Ivoire, Burkina Faso, Niger and Senegal.

With a population of over 27 million people, the government of Ivory Coast recognizes the need to invest in healthcare infrastructure to ensure that its citizens have access to quality healthcare services. As part of this investment, the Bill and Melinda Gates Foundation (BMGF) funded Bluesquare, to set up a fully automated, real-time dashboard to monitor health metrics for the General Directorate of Health (DGS) in the Ministry of Health (MOH). This grant was designed to reinforce the Public Health Emergency Operating Centers (PHEOC) across Burkina Faso, Niger, Cameroon, and Ivory Coast.

The dashboard in Ivory Coast monitors health metrics across five main axes. 

  • The first axis is the availability of tracer products such as drugs and bed nets that are essential to meet the priority healthcare needs of the population. This axis is critical because logistics management is key to provide continuous provision of quality healthcare services. For example, if an HIV drug is not available in one health district, the Ministry of Health can quickly respond by sending additional supplies to the district or investigating why the drug is not available.

Example 1 - Low levels of tracer products in the Yakasse-Attobrou district.
Example 1 – Low levels of tracer products in the Yakasse-Attobrou district.
  • The second axis is the surveillance of epidemic diseases such as yellow fever, dengue fever, and meningitis. Having a system that can detect and track these diseases in real-time is crucial in managing outbreaks and reducing their impact on the population.
  • The third axis is Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH). This axis focuses on maternal and child health, which is a significant priority for the Ivorian government. Using this dashboard, the government can track and monitor RMNCAH metrics and implement targeted interventions to reduce maternal and child mortality rates. For example, if the dashboard shows that a certain health district has a high maternal mortality rate, the Ministry of Health can investigate the causes and implement targeted interventions to improve maternal health outcomes in that district.
Example 2  – Rates of deliveries assisted by a skilled birth attendant by region and district in Ivory Coast showing that not one district had lower than 50% rates in March 2023.
  • The fourth axis of the dashboard covers malaria and HIV. Malaria is a significant public health concern in Ivory Coast, with approximately 7.5 million cases reported in 2020. Similarly, HIV remains a significant health concern in the country, with a prevalence rate of 2.7%. For example, if the dashboard shows that a certain health district has a low test rate for malaria, the Ministry of Health can investigate why this is the case and therefore implement targeted interventions to improve testing and treatment for malaria in that district.
Example 3 – An overview of the distribution of insecticide-treated bed nets to 1 to 5 years old children  in the different regions and health districts of Ivory Coast.
  • The fifth and last axis of the DGS dashboard is patient satisfaction surveys. Measuring patient satisfaction is critical in ensuring that healthcare services meet the needs of the population. With the dashboard, the government can better understand patient satisfaction, making it easier to identify areas that need improvement and enhance the quality of healthcare services.

The dashboard provides a wide range of visuals, maps, and tables regarding data since 2017.

It offers possibilities to filter, order, and focus in order for the Ministry of Health of Ivory Coast to manage the country’s health system with a cockpit overview. It includes four complementary axes that interest specific programs and actors: universal healthcare coverage, COVID-19 vaccination rates, indicators followed by the Global Financing Facility, and availability of delivery kits and cesarean section kits. 

The implementation of the DGS dashboard is significant for the Ivory Coast healthcare system. It provides the government with simplified access to priority health indicators, making it easier to monitor and track healthcare services and make informed decisions across domains and public health challenges.

A collaborative work between the DGS and Bluesquare teams

The PHEOC project in Ivory Coast started in December 2020 when Bluesquare started collaborating with the General Directorate of Health (DGS) to gather input about the key needs for information, and to define how a central dashboard could serve the needs of the DGS. In this first stage, the main 5 axis information were defined, and their content was drafted by our partners at the Ministry of Health.

In a second stage, technicians from various directions and programs of the Ministry of Health held a series of meetings with Bluesquare’s technical team to identify the data sources that should be used to answer the identified needs. A complete mapping of data sources, data transfer methods and needed computations was drawn out to guide the upcoming technical work.

For the rest of the project, Bluesquare and its partners at the DGS and other departments of the MOH iterated between three types of activities:

  • Technical development of the different pieces that would be used to build the dashboard and its underlying infrastructure, such as data visualizations, data pipelines, or indicators computations
  • Presentation, test and feedback gathering. We held a series of meetings and workshops with various stakeholders to present the progress of our work, and were able to receive extremely valuable feedback from the DGS and its colleagues to validate our work, challenge our approaches, or change course when some ideas proved to be unfit to their needs. As the work progressed, the growing understanding and collaboration with the MOH allowed us to exchange ideas and build an end result that corresponds as closely as possible to the DGS’ needs.
  • Capacity strengthening. To be able to use and maintain the new tool that an integrated dashboard constitutes, we offered a series of capacity building workshops, that ranged from simple dashboard utilization for decision making to data analysis training in R and basic training on data integration methods.

The closing workshop in Abidjan on the 16th of March 2023 allowed us to deliver the final version of the dashboard under the auspices of the General Director of the Health of the Ministry of Health.

Ivorian press (here and here) and TV were present and demonstrated the interest raised by this work. The data integration effort and the dashboard were welcomed with enthusiasm as the standard tool to bridge the gaps between the different data systems for health in Ivory Coast.

In the upcoming months and years, Bluesquare will build on that achievement to further integrate other data systems such as the health products supply chain and the laboratory data systems but also continue to strengthen the fight against malaria by bolstering the NMCP (PNLP) in its data integration effort and data usage.

The General Directorate of Health, Pr Mamadou Samba, speaking at the closing workshop!
Nicolas de Borman, CEO of Bluesquare, speaking at the closure workshop in Abidjan, 16/03/2023

Wilfried Oro Akre Junior, Project Manager for the PHEOC project and focal point in Ivory Coast, at the closing workshop in Abidjan