How Dimagi is Helping to Eliminate Malaria

In 2017, there were 219 million new cases of malaria, resulting in 435,000 deaths. But there is hope in this fight.

Armed with over $3 billion in total funding for malaria control and elimination, programs all over the world are working to reduce contraction and mortality rates associated with the disease. Recently, a genetically modified fungus garnered some positive press for killing 99% of mosquitos in its trials. Just days earlier, organizations working with the Bill & Melinda Gate Foundation and WHO announced progress on a new malaria vaccine that has been over 30 years in the making.

At Dimagi, we are using our own expertise and resources to help in these efforts. With global partnerships with USAID’s VectorLink program, advisory roles with global communities of practice like the Digital Solutions for Malaria Elimination to tactical, and on-the-ground technical solutions with organizations like Global Solutions for Infectious Diseases (GSID), we are diversifying our approach across they many needs and use cases in Malaria from diagnosis to treatment to elimination. 

With CommCare, organizations can develop comprehensive community-level malaria systems that allow for registration and follow-up of households and individuals for interventions, such as case investigation surveys, household campaigns for treatment and bed net distribution, integrated community case management for children 0-5 years to identify, diagnose, and treat malaria, sentinel site surveillance, and last-mile malaria stock management. CommCare can also support more advanced integration needs for your intervention such as integrations with point of care diagnostic tools like RDTs and BI solutions for reporting and analytics.

We are proud to work with many organizations looking to continue the fight against malaria, each taking a different approach to tackling the disease:

Malaria Zero – Household Level Treatment Campaigns for Malaria

Today, Haiti suffers from the highest number of malaria cases in the Caribbean. In response, a host of organizations, including the CDC, the Ministry of Public Health of Haiti, and the London School of Hygiene & Tropical Medicine helped form Malaria Zero, a Haiti-based program aimed at the treatment and prevention of Malaria in local communities. Field teams use CommCare in a mass treatment campaign, delivering household-level services in selected target areas. The application serves as a job aid and case management solution for frontline workers, helping them to determine correct dosages of anti-malaria medication for family members in each household at risk of or suffering from malaria. This program aims to target malaria hot zones on the island, and specific efforts are being made this year to relieve the burden on the data management team and improving the potential for actionable insights to be drawn from the captured datasets.

Digital Solutions for Malaria Elimination (DSME) – Community of Practice

Dimagi has been involved with the DSME Community of Practice since May 2017. The community represents a diverse set of stakeholders who are committed to leveraging their resources toward the elimination of malaria. On monthly calls, a representative from our Global Services team works with implementation focal points at other technology organizations and NGOs to review and refine a common set of best practices and guidance materials to help National Malaria Control Programs and Ministries of Health on their own programs, answering frequently asked questions and supporting field-based troubleshooting. Leveraging their experience on similar implementation programs, the collective community is able to support and ensure the dissemination of lessons learned and foster collaboration within the DSME community.

PMI VectorLink – Indoor Residual Spray Campaigns

Since 2017, we have been working with Abt Associates to implement the U.S. President’s Malaria Initiative (PMI) VectorLink Project, a program that aims to reduce the burden of malaria in 25 countries through robust entomological monitoring and vector control, such as insecticide-treated nets (ITNs) and indoor residual spray (IRS) campaigns. This initiative follows our initial collaboration from 2013-2017 under the PMI Africa Indoor Residual Spraying Project (PMI AIRS), which was also implemented by Abt Associates.

Our PMI VectorLink initiatives are supported by four CommCare workstreams ensuring the safe and effective implementation of spray campaigns. These include:

1. Broadcast messages push for behavior change and to share key campaign updates
2. Structured SMS reporting on daily spray progress from field-based implementation teams
3. A CommCare application digitizes a supervisory checklist to ensure proper support and monitoring of field-based teams
4. Custom daily reports are sent to country-based administrators for monitoring the campaign’s overall effectiveness and compliance with key safety protocols.

The most rewarding aspect of this partnership for us is the meaningful relationships we have developed with all of the countries where we collaborate and drive forward these implementation efforts. The in-country capacity these programs have built to independently lead the implementation of these tools and promote data-driven decision-making shows us that every community can fight back, and we learn from these end-users every day. In fact, many of CommCare’s features have been enhanced based on feedback from VectorLink users over the years.

Bill & Melinda Gates Grand Challenges Malaria Initiative – Cross Border Malaria Elimination using Data Analytics

Recently, we worked with a predictive analytics platform to support National Malaria Control Programs in the Gambia and Senegal’s vision for their innovative cross border malaria elimination strategy. Rather than design a CommCare app, we used data collected by CommCare and integrated Ilkrea’s geospatial data to predict the location of border villages and households that were otherwise not being served by the malaria surveillance program, effectively prototyping a cold-spot detection approach. The initiative has led to further discussion around the use of technology for cross-border malaria surveillance, and we believe the possibility of running much more targeted interventions based on this program’s insights will help the Gambia and Senegal reach their malaria pre-elimination certification goals in 2020 as well as their full-elimination goals by 2030.

Senegal’s National Malaria Control Program (PNLP) – Suite of Community Level Malaria Tools

Between 2015 and 2018,  we worked with Senegal’s Ministry of Health to support their National Malaria Control Program build a suite of digital tools to support four of their community-based programs: (1) an SMS-based application for nurses at the health post level to track the stock of 10 high priority anti-malarial products on a weekly basis; (2) an SMS-based application for 24 sentinel sites to carry out targeted malaria surveillance and reporting to signal key trends; (3) a prototype Integrated Community Case Management (iCCM) application used by malaria-focused community health workers to identify children 0-5 years of age with signs of malaria, diarrhea or pneumonia and (4) a series of aggregated data dashboards across all programs for an overall surveillance of the NMCP’s efforts across all three programs. This initiative also received significant support from the Senegal Peace Corps, who were available to support on the ground  training, user feedback, and technical support to nurses, administrators, and health workers.

Global Solutions for Infectious Diseases – Rapid Diagnostic Testing

In Zimbabwe, 50% of the population is at risk of contracting malaria (UNAIDS, WHO). Unfortunately, diagnostic tests for the disease were often carried out in outpatient clinics by health workers who had received only basic RDT training. And in areas without laboratories, diagnoses are based on the patients’ symptoms alone, which are not unique to malaria.

To combat this growing public health crisis, Global Solutions for Infectious Diseases (GSID) and Dimagi created a mobile application to process rapid diagnostic tests (RDT) in rural clinics using CommCare and ODK Diagnostics. We enabled an image recognition system powered by AI/ML to automatically read photos taken of an RDT for malaria and HIV test results. The app helps both health workers and supervisors track and manage patients’ cases.

Strategic product partnerships and integrations between CommCare and ODK-Dx enabled us to build an advanced digital job aid that can accurately guide health workers in administering point of care diagnostic tools in a step by step manner and then automatically analyze, and deliver results to health workers and program staff. 

Benin Ministry of Health – Community-level Malaria Diagnostic and Treatment for Children Under Five  

With over five years of support from USAID in Benin, Dimagi has worked with the Ministry of Health, and partners University Research Co. and more recently, Management International to support a national scale up for CommCare at the community level. The CommCare application we developed includes a comprehensive set of modules covering high impact community level interventions such as Integrated Community Case Management of Childhood Illness (iCCM) services, enabled with audio messages in multiple local languages for community sensitization. iCCM is well known community health strategy that trains CHWs to provide diagnostic and treatment for malaria, diarrhea and pneumonia. Dimagi has supported organizations deploy iCCM applications in Benin, Madagascar, Ethiopia, Niger and many more countries around the world. 

Dimagi has also supported organizations like Terre des hommes in Burkina Faso develop a related but more advanced case management protocol that support the diagnosis and treatment of malaria symptoms for children under 5 based on the WHO protocol for Integrated Management of Childhood Illness (IMCI). This protocol is designed to be used by trained nurses at the health center levels. Organizations have used CommCare to support IMCI interventions in Burkina Faso, Mali and Nigeria. 

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To learn more about how Dimagi and CommCare can help with disease treatment initiatives around the world, visit our sector summary on Disease Treatment.