BackgroundWe describe the development and initial achievements of a participatory disease surveillance system that relies on mobile technology to promote Community Level One Health Security (CLOHS) in Africa.ObjectiveThe objective of this system, Enhancing Community-Based Disease Outbreak Detection and Response in East and Southern Africa (DODRES), is to empower community-based human and animal health reporters with training and information and communication technology (ICT)–based solutions to contribute to disease detection and response, thereby complementing strategies to improve the efficiency of infectious disease surveillance at national, regional, and global levels. In this study, we refer to techno-health as the application of ICT-based solutions to enhance early detection, timely reporting, and prompt response to health events in human and animal populations.MethodsAn EpiHack, involving human and animal health experts as well as ICT programmers, was held in Tanzania in 2014 to identify major challenges facing early detection, timely reporting, and prompt response to disease events. This was followed by a project inception workshop in 2015, which brought together key stakeholders, including policy makers and community representatives, to refine the objectives and implementation plan of the DODRES project. The digital ICT tools were developed and packaged together as the AfyaData app to support One Health disease surveillance. Community health reporters (CHRs) and officials from animal and human health sectors in Morogoro and Ngorongoro districts in Tanzania were trained to use the AfyaData app. The AfyaData supports near- to real-time data collection and submission at both community and health facility levels as well as the provision of feedback to reporters. The functionality of the One Health Knowledge Repository (OHKR) app has been integrated into the AfyaData app to provide health information on case definitions of diseases of humans and animals and to synthesize advice that can be transmitted to CHRs with next step response activities or interventions. Additionally, a WhatsApp social group was made to serve as a platform to sustain interactions between community members, local government officials, and DODRES team members.ResultsWithin the first 5 months (August-December 2016) of AfyaData tool deployment, a total of 1915 clinical cases in livestock (1816) and humans (99) were reported in Morogoro (83) and Ngorongoro (1832) districts.ConclusionsThese initial results suggest that the DODRES community-level model creates an opportunity for One Health engagement of people in their own communities in the detection of infectious human and animal disease threats. Participatory approaches supported by digital and mobile technologies should be promoted for early disease detection, timely reporting, and prompt response at the community, national, regional, and global levels.

BackgroundThe response to the 2014-2016 Ebola epidemic included an unprecedented effort from federal, state, and local public health authorities to monitor the health of travelers entering the United States from countries with Ebola outbreaks. The Check and Report Ebola (CARE) Hotline, a novel approach to monitoring, was designed to enable travelers to report their health status daily to an interactive voice recognition (IVR) system. The system was tested with 70 Centers for Disease Control and Prevention (CDC) federal employees returning from deployments in outbreak countries.ObjectiveThe objective of this study was to describe the development of the CARE Hotline as a tool for postarrival monitoring and examine the usage characteristics and user experience of the tool during a public health emergency.MethodsData were obtained from two sources. First, the CARE Hotline system produced a call log which summarized the usage characteristics of all 70 users’ daily health reports. Second, we surveyed federal employees (n=70) who used the CARE Hotline to engage in monitoring. A total of 21 (21/70, 30%) respondents were included in the survey analytic sample.ResultsWhile the CARE Hotline was used for monitoring, 70 users completed a total of 1313 calls. We found that 94.06% (1235/1313) of calls were successful, and the average call time significantly decreased from the beginning of the monitoring period to the end by 32 seconds (Z score=−6.52, P<.001). CARE Hotline call log data were confirmed by user feedback; survey results indicated that users became more familiar with the system and found the system easier to use, from the beginning to the end of their monitoring period. The majority of the users were highly satisfied (90%, 19/21) with the system, indicating ease of use and convenience as primary reasons, and would recommend it for future monitoring efforts (90%, 19/21).ConclusionsThe CARE Hotline garnered high user satisfaction, required minimal reporting time from users, and was an easily learned tool for monitoring. This phone-based technology can be modified for future public health emergencies.

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In 2009, the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) counted over 10 different health facility lists managed by donors, government ministries, agencies and implementing partners. These function-specific lists were not integrated or linked. The ministry's Health Sector Strategic Plan included the development of an authoritative source for all health facility information, called the Master Facility List (MFL). During development, the ministry adopted the term Health Facility Registry (HFR), an online tool providing public access to a database about all officially recognized health facilities (public and private). The MFL, which includes the health facility list at any specific point in time can be exported from the HFR. This chapter presents the Tanzanian case study describing the work and lessons learned in building the HFR—focusing on software development, introducing geographic positioning systems and harmonizing MFL data. MoHCDGEC launched the HFR public portal in September 2015.

In 2009, the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) counted over 10 different health facility lists managed by donors, government ministries, agencies and implementing partners. These function-specific lists were not integrated or linked. The ministry's Health Sector Strategic Plan included the development of an authoritative source for all health facility information, called the Master Facility List (MFL). During development, the ministry adopted the term Health Facility Registry (HFR), an online tool providing public access to a database about all officially recognized health facilities (public and private). The MFL, which includes the health facility list at any specific point in time can be exported from the HFR. This chapter presents the Tanzanian case study describing the work and lessons learned in building the HFR—focusing on software development, introducing geographic positioning systems and harmonizing MFL data. MoHCDGEC launched the HFR public portal in September 2015.