Introduction of Mobile Health Tools to Support COVID-19 Training and Surveillance in Ogun State Nigeria

Abstract

Mobile health (mhealth) tools delivered through wireless technology are emerging as effective strategies for delivering quality training, ensuring rapid clinical decision making, and monitoring implementation of simple and effective interventions in under-resourced settings. We share our early experience of developing and deploying the InStrat COVID-19 health worker training application (App) in Ogun State, Western Nigeria where the country's first COVID-19 case was reported. This App was designed to directly provide frontline health workers with accurate and up-to-date information about COVID-19; enable them to quickly identify, screen and manage COVID-19 suspects; provide guidance on specimen collection techniques and safety measures to observe within wards and quarantine centers dealing with COVID-19. The App was deployed in 271 primary health care facilities in Ogun state and a total of 311 health workers were trained to use it. Of the 123 health workers who completed knowledge pre- and post-tests, their average test score improved from 47.5 (±9.4) to 73.1(±10.0) %, P < 0.0001 after using the tutorial. Rapid adoption and uptake were driven largely by public-private sector involvement as well as certification of health workers with reported satisfaction levels of over 95% among those who completed pre- and post-test surveys. Challenges encountered included a lack of universal availability of android phones for frontline health workers, lack of internet access in remote areas and a need to incentivize the workers. The timely deployment of this App targeting primary health care workers, mostly in hard-to-reach areas, obviated the need for conventional didactic training with potential of savings in training costs and time and could be applied to similar contexts.

Sustainability of the Effects and Impacts of Using Digital Technology to Extend Maternal Health Services to Rural and Hard-to-Reach Populations: Experience From Southwest Nigeria

“…Insight from the stories of MSC suggests that implementing multiple digital health interventions for 2 years within a supportive policy environment in Ondo State had generated significant interest in government and from other stakeholders in the health sector to adopt eHealth innovations. An example of increased adoption of eHealth innovations by the Ondo State Government is the launch in December 2019, of a new electronic Contributory Health Insurance Scheme (eCHIS) as a pathway to promoting equitable access to essential healthcare services and accelerating universal health coverage ( 34 ).…”

Training health workers at scale in Nigeria to fight COVID-19 using the InStrat COVID-19 tutorial app: an e-health interventional study

“…Details of the deployment of this app have been reported previously. 15 The app allowed for (1) training of health workers on COVID-19; (2) provision of users with desk guides to rapidly screen, identify and manage suspected COVID-19 cases. 16 This app was subsequently deployed at scale to 25 states of Nigeria.…”

“…Details of the deployment of this app have been reported previously. 15 The app allowed for ( 1) training of health workers on COVID-19;…”

What Are the Contextual Enablers and Impacts of Using Digital Technology to Extend Maternal and Child Health Services to Rural Areas? Findings of a Qualitative Study From Nigeria

“…Regarding private-public partnerships ( 34 ), analysis revealed that this eHealth project was a promising example of public-private partnerships (PPP) between local technology companies and the governments in Nigeria for designing and delivering digital health initiatives for public benefit. The PPP approach provided a viable chance of success for sharing resources, capabilities and project risks.…”

“…In a public-private partnership with InStrat, the Ondo State Government has (in December 2019) adopted a package of inter-related digital health innovations (including digitization of health data and an electronic health insurance platform) to facilitate equitable access to essential healthcare services as a pathway to achieving universal health coverage. This new project, currently implemented in nine general hospitals in the Ondo State, is being incrementally expanded to 203 PHC facilities in the state; (ii) partnership between InStrat and the multiple State Governments using an adaptation of the VTR Application to develop a COVID-19 training App to provide FHWs with accurate and up-to-date information about COVID-19 to enable them to quickly identify, screen and manage COVID-19 suspects across multiple states in Nigeria ( 34 ).…”