ICTworks

Tara is a frontline health worker who sits in a small, but meticulously clean clinic at the southernmost point of one of Vanuatu’s more remote islands. The levers of every window are open, blowing a lazy tropical breeze into the consultation room along with the occasional moth and stray leaf.

It’s a little dim in here – Tara’s solar panels stopped working a few months ago – and she tells us that more than once in recent weeks she has had to deliver a baby using only the beam of her head torch.

She is not using complex technology, just fierce resourcefulness. And, it’s pretty remarkable.

It’s also a telling contrast to the complex technology we’ve built to support her work. Sitting in front of her, recording her responses is our Tupaia MediTrak app, where we are providing her a link with top health decision makers in the country and the region to help, for one thing, get the solar up and running so she can continue to provide healthcare to more than 6,000 people in the surrounding villages.

Tupaia Health Resource and Supply Chain Mapping

We’ve spent the last 10 months meticulously designing the technology that needs to support Tupaia.org, a project that aims to map health facilities in 7 participating countries in the Asia Pacific region.

• Tupaia MediTrak, our free to download and use app built in React Native that syncs to a mySQL database
• mSupply Mobile, an open source stock management app built in React Native that synchronises its data to Tupaia. mSupply desktop is built on a 4D platform.
• Tupaia.org is a React front-end showing the data from all sources that is aggregated on a DHIS2 instance and then configured in NodeJS.

The project is named after the legendary Polynesian navigator who joined Lt James Cook on his voyages through the Pacific. He was known for his incredible skill, directing the explorers from island to island by reading the winds, waves and the stars. Tupaia is funded by the Australian Government’s innovationXchange program

Our mapping is certainly more dependent on technology than in Tupaia’s time. Data is aggregated in real time from a number of sources, including Hospital Information Systems, electronic Logistics Management Information Systems (eLMIS) and Mobile eLMIS, whilst the Tupaia MediTrak app collects answers to a myriad of questions about medicines availability, infrastructure, equipment, finances, services and disaster preparedness. This app syncs whenever it detects an internet connection, sending the data to our online interactive map at Tupaia.org.

How Governments and Health Workers Use Tupaia

This map allows governments to get a birds-eye view of the health of their healthcare system, so to speak. They can see, for example, which clinics have functioning refrigerators to store vaccines, where medicine is overstocked or undersupplied, and they can also track the treatment of common conditions such as childhood diarrhoea.

Importantly, they use the app to direct their often limited resources to where they are needed most. If you visit Tupaia today, you can already see data for around 900 facilities in Solomon Islands, Kiribati, PNG, Tonga, Timor-Leste, Tokelau and, of course, Vanuatu.

You and the general public can access a basic level of information about facility locations and the services they provide (more than enough to make a data nerd froth at the mouth), and Governments control the access to more detailed information such as medicines availability.

Typically, each country allows crucial staff like Tara and other frontline health workers to see additional information, such as medicines availability in nearby facilities, equipment availability or how their clinic is performing compared with others in their area. Health workers can, for example, report when their fridge has stopped working and this can be seen immediately by Cold Chain managers.

Humans Still Trump Technology

Despite the technology, our most valuable data still comes from face to face interactions, like those with Tara. Our Tupaia teams work with local Ministry of Health pharmacists to physically visit every clinic or hospital around the country.

We sit with nurses and doctors, talk about issues in the ordering and delivery of medicine, building maintenance or difficulties accessing further training when you might need to take two boats and a truck to get to the nearest airport.

Technology is paramount but it only supports the oldest data collection method in history.

And that is our biggest lesson from this project so far. You can put in place the most advanced, user-friendly tech in the world, but you can’t properly capture these challenges by looking at a spreadsheet, running an email survey or chatting with Ministry officials.

In the Pacific, the concept of storying is paramount – to show respect to a person and their ideas, you must be willing to sit, talk and make the effort to hear what they have to say in their own time. And it is this practice that has shown the staff in these remote clinics that we’re serious. We know that the strength of a system comes from supporting every cog, from the clinic, to the regional hospitals right up to the health minister themselves.

We hope that by combining the old with the new, we are doing Tupaia proud and our bit to create stronger, more resilient healthcare systems in the Asia Pacific region.

By Irene Scott, Director of Communications at Tupaia.org