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Episode 33: Reducing Health Inequities Through Digital Innovation with Olukunle Akinwusi of FIND & Erica Troncoso of Jhpiego: Dispatches from the Global Digital Health Forum 2022 - Dimagi


Reducing Health Inequities Through Digital Innovation with Olukunle Akinwusi of FIND & Erica Troncoso of Jhpiego: Dispatches from the Global Digital Health Forum 2022

Episode 33 | Dispatches from the Global Digital Health Forum | 16 Minutes

Jonathan Jackson sits down with Olukunle Akinwusi, Technical Officer for Digital Access at FIND & Erica Troncosco, Technical Advisor and Portfolio Lead for Frontier Technology Solutions at Jhpeigo, at the Global Digital Health Forum, to discuss the value of innovation in improving health equity through thoughtful diagnostics, involving the user in the design process, investing in the digital literacy of the Frontline Worker, and engaging country stakeholders to ensure buy-in.

Some topics covered in this conversation include:

  • The importance of diagnostics in improving access to care and curbing disease prevalence
  • Addressing the biggest diagnostic gaps at various levels of care
  • The experiences and lessons learned from working on digital health projects
  • Balancing the use of technology with ensuring that those new technologies are actually helping Frontline Workers provide better care
  • The value of innovation and involving the user in the design process
  • The need for investment in health worker digital literacy and the accessibility of infrastructure in more remote settings for digital health interventions
  • The importance of engaging the countries or stakeholders in which the solution or innovation will be designed, understanding the context of use, and getting user buy-in

Show Notes


This transcript was generated by AI and may contain typos and inaccuracies.

Olukunle Akinwusi: Okay, So my name is Olukunle Akinwusi, I am a Technical Officer for Digital Access at Find the Global Alliance for Diagnostics based in Geneva. Um, by background. I’m computer scientists and, uh, basically my, I mastered in advanced computing, uh, data mining, machine learning, high performance computing. Um, 25% of my professional life has been in the private sector, some 5% in the public sector, and, uh, the public sector specifically.

Uh, nonprofit and that has been, uh, public health sector, not public sector. Public health sector. Yeah. And, um, it has been me working across different disease and program areas. Speaking of about reproductive maternal, newborn and child health, malaria, vaccination, hiv, tb, and yeah. And, um, my work has cut across from building capacity of health workers.

to setting up systems to improve system efficiencies, health system strengthening, um, supply chain, um, applications, frontline applications, surveillance platform. Um, I joined find almost over a year ago, and basically it’s, uh, An extension of what I’ve been practicing in terms of implementation and development and rollout of digital health interventions.

Uh, my lead is, uh, digital health, the head of digital health card, uh, and our. Cuts across these areas, TB C and many other NCDs, and we design interventions in the area of digital health and deploy them in low and middle income countries to ensure that we improve predictable access to diagnostics technologies.

Thank you. That’s great. Thank you.

Jonathan Jackson: That’s great. Thank you Conley. And we at tamagi have had a long and and strong relationship with Find, working with Veta and others on different diagnostic applications. Um, you know, we think. Digital diagnostics and the integration of physical diagnostics with these digital health platforms such as Comcare or DHS two and other platforms can be a huge improvement on health outcomes.

What drew you to digital diagnostics and, and working in this particular area after such a broad background?

Olukunle Akinwusi: So, um, what drew me to digital diagnostics. I actually found out that, um, There’s been a lot of focus around actually ensuring people. And go through the cascade of care and complete the care. But however, when I started working the HIV space, I, I remember the, the, uh, units 19, 19 90 where it’s critical to even identify and diagnose people before they can even then start the necessary.

And there was no way to achieve the goal of ensuring more people get care and get treated without being diagnosed at first. So, um, I saw that diagnostics was very pivotal into improving access, uh, to care, and of course, carbon, uh, disease prevalence as well. So, What can we find is actually a support, that opportunity to ensure that no one is left behind, people are tested and in a timely manner, diagnosed and of course linked to treatment, which is one of the core components of our strategy.

Digital, her strategy as fine.


Jonathan Jackson: That’s great. One of the areas that is of critical importance in a lot of the value we need to create. You know, there’s not enough money to go around, there’s not enough donor funding, is how do we improve the effectiveness of these cascades of care and understanding the population segmentation, who needs to be receiving that care is such a critical aspect of.

And one of the areas that we’re really excited about in our partnership with Find is kind of pushing out those diagnostics to the community level, enabling community healthcare workers to be able to provide these tests. And as you said, looking at the 90, 90 90, which for those of you who are not familiar with those terminology, that’s 90% of patients know their status.

90% of patients who are positive or on a r t and 90% of those patients on a r t are virally. And as you look at that cascade of care, um, as anybody knows who manages marketing funnels, segmentation is absolutely critical. And knowing how and where to invest across that cascade of care is also critical.

And so I think diagnostics play an exceptional role, not just top of the funnel of getting patients to know their status and get into the system, but also for some diseases, you know, repeated diagnostics. So, you know, are you sufficiently virally suppressed? Are you able. Um, you know, ensure that you’re decreasing the disease burden in a given population.

So as you think strategically at find, how do you think about which diseases to target with diagnostics and where the biggest diagnostic gaps are at the various levels of care?

Olukunle Akinwusi: So I must say, um, when I can find, I joined during the Covid period and, uh, as you may be aware, uh, find. Was the, um, fines mandate is more around the, uh, diagnostics, uh, pillar and basically we all know the importance of diagnostics in, in actually curbing the spread of Covid 19. Uh, so. One thing that we did, um, was to actually leverage our experience and lessons from setting up systems for surveillance systems.

And, uh, we used that to then inform and, uh, to work with ministries of health to actually get them to understand. They should target Covid response. We’ve done so in some of our, um, work with, uh, countries in Africa, uh, where we worked with the countries to actually set up systems. And as a matter of fact, the market played a very good role in this collaboration.

Uh, like the work we did with Rwanda, where we leveraged the RDT two kit. Uh, Worked with the, uh, MOH to be able to adapt that and use that for, uh, decentralized, improved decentralized testing. Uh, that is the use of RD Antigen RD for ING testing. And of course, um, that gave insight into where these tests need to be deployed and then helping to then, Cast resource in terms of diagnostic technologies available for covid.

So that is how we have actually, so sort of a cycle. We’ve used data to inform what we need to design and deploy, and we’ve used the insights got from those deployments to then inform response and the cycle continues. That’s great.

Jonathan Jackson: That’s great. One of the areas in our five year strategy is very aligned to this run thinking through better jobs for better outcomes. And on the one hand, um, you could think about a better job because you have this digital enablement and now you can give Covid RDT antigen tests. But we have talked both with find and, and.

Around the other kind of more surveillance aspect of it, which is maybe this feels, um, like you’re, you’re watching too narrowly what the CHW is doing or what the frontline worker is doing. So there’s this balance of making sure we can collect the data that can be useful for program managers and epidemiologists and surveillance people while still making sure we’re creating an empowering experience for the end user that’s leading to a better.

and demo fine. Spent a lot of time together trying to make sure the technology we were creating was usable and adaptable and fit with the local setting. But you know, it’s something we think a lot about to make sure, yes. When you digitize these tests or when you support these workers on these tests, is it really creating a better job or is it giving us the data we want, but actually making the job worship for the frontline worker?

How do you think about that challenge in terms of making sure that we’re really, truly empower? , you know, the frontline worker with these digital solutions that we’re building, as opposed to just kind of making these data collection systems that, that draw data out, but don’t necessarily provide value back to the provider.

Olukunle Akinwusi: So as find, uh, when we wanna implement digital health projects, uh, we ride on the principles of digital development and part of it is to engage. The users to build with the users. So in coming up or conceptualizing which solution, , we ensure that we engage, we understand the need, and we use that to inform the solutions we are gonna design.

And then we identify partners as well, locally, globally, with the experience to actually transcribe or translates that particular uh, uh, uh, knowledge we’ve gotten from engaging the users. Technical requirements that are used to carry out this design. So what then happens is that in the cost of designing and bringing up these requirements and then developing the system, there is that continuous engagement of stakeholders.

In country stakeholders includes the health workers, the friendly health workers, the decision makers. Uh, we continue to engage them so that the end product is then targeted and designed to work with the workflow. It is, it is. It can function. Very well in the context for which it is designed to work. So that is how we, we, we ride on the principles of digital development to come up with digital solutions that we roll out.

And within that,

Jonathan Jackson: And within that, uh, work of design with the end user. In the several years that you’ve been working in, in this particular space or even in a prior area in public health, has there been anything that really surprised you that came up in the user testing or in the user feedback that kind of gave you an aha moment?

One, I. This was probably 15 years ago when I was, uh, in the field and we were testing a, uh, calendar date picker that I made. And I was watching the users use the application. I had like these big buttons. It was a touch screen and the nurse would pull up the calendar, go to the Windows system date, change the date, and then click today because I’d made the button so big for today.

Cause I figured most of the data entry would. Today, but it usually happened in the past. And so I remember just having this aha moment of like, oh, you know, my mental construct of what’s gonna be helpful or efficient should be thrown out the door. And I’m just curious if you had any of those moments in, in the design of the solutions you’ve been building where you’re like, oh, wow, that’s very different than the the perspective I thought I was gonna get when, when talking to these users.

Olukunle Akinwusi: So the, her moment for me, um, passionately, uh, was when it. Time where I rolled out a digital health solution sometime in the past about, um, eight years ago. And basically, uh, one thing when we went into the field to do some form of, uh, observatory evaluation of what the out workers were doing, uh, found out that this solution we developed, uh, which was supposed to help with patient monitoring.

Actually, uh, there was a function that we had sort of developed that sort of gave the autos, uh, an idea of using the tablets we have given to them to set reminders to actually follow up with patients. Uh, we didn’t plan that when we did that designer roll out, roll out that technology, and then where we saw that they actually were using that as a way of actually nudging them to follow.

Patients we found that there is actually that need that we’ve not really thought about and actually speaks to the creativity of even the health workers, particularly when you design a solution that meets their need as find. One thing that we do is we write on research, we try and we use the outcomes of the research to innovate and, um, that innovation actually happens, not.

By our own knowledge or capacity, but also the close working with these health workers. So we, I would say as fine, we do get the heart moment a lot, uh, because we engage them, we ask them questions, and even when we learn from them, when they say some things, we’re like, oh, okay. Ha. This would be something that would actually help you in ensuring that you’re able to deliver that diagnostic services necess.

For this identification in the country. So yeah.

Jonathan Jackson: And, um, that, that’s great. And do you have any, um, advice or guidance for our listeners who are embarking on, you know, similar undertakings, whether diagnostics or just the digital project in general that you would recommend they follow or steps to avoid, you know, that you’ve seen, um, the challenges or failures and, and products you might.

Olukunle Akinwusi: I, I think, uh, one cannot overemphasize the need to engage the countries in which, uh, these interventions or the solutions are gonna be designed. One, we cannot over, uh, be road, sorry. We cannot overemphasize the need to actually. Engage, uh, uh, them. Uh, I think that’s the first bit. Then the second bit is we should, uh, whereby looking to come up with solutions that will work.

It’s important that a workflow of the context in which the solution will be used is taken into consideration because if a solution is designed or developed and it does not align with the work, Uh, where it’s going to, of where it’s gonna be deployed, then the adoption is unlikely. Then the third bit, first consulting.

Second consulting is stakeholder. Second bit is actually designing with alongside workflow. And the third bit is the buy in. It’s important to secure the buying of the end users. If the, uh, if that is not secured, uh, the product will be developed and it’ll not be used. And then the pop is then defeated and we are back to square one.

So I think those. Uh, that’s not exhaustive, but I think those three are very pivotal to the success of the digital health interventions building up.

Jonathan Jackson: And building on that last thing that you just said, can we, I wanna recommend, uh, to, to our listeners when we talk about that buy-in, it’s critical that all the stakeholders and partners have defined what we mean by buy-in, right? Somebody could mean they don’t hate it, somebody could mean they love it.

Somebody could mean it saves them time, or improves the client experience or all of those. And, um, digital solutions, particularly ones that are building with a user centered design approach, they have to make trade offs. You know, you can’t necessarily solve everything. And so having that definition of what buy-in really means, particularly for the stakeholders and the government, um, actors that you mentioned, and, and the partners, can be really critical.

And I think as often an overlooked step of really defining and doing the hard work to think through. What do we mean by buying? What would it look? , if the users are bought into the solution, how would we measure that? How would we quantify that? And how would we prove to ourselves that we built a solution that’s worth having the users really, you know, adopt and use at scale?

Any final words you wanna reflect on?

Olukunle Akinwusi: So, um, my final words will still be titted towards, uh, diagnostics, which, uh, is the bias I. Working, we find, I still think there’s a lot to be done, uh, a lot to be done in terms of improving access to a diagnostic technologies in a timely manner. And I, I think, uh, a lot of partners, in terms of partners, a lot of partners should actually look for that pinpoint across different disease areas that pinpoint that needs to be addressed.

To actually increase, uh, diagnostics in the country, leveraging the health technology. I think that is very important. And on the side of the donors as well, like to call on donors to actually again, uh, coordinate these resources and work closely. Uh, which is part of our find Those, we link donors. We partners actually to carry out interventions in, in countries.

So we want donors actually to take more interest, uh, uh, in actually funding digital health technologies that increases, uh, uh, specifically on, uh, diagnostic technologies.

Jonathan Jackson: Great. Well, can we thank you so much for coming by and we appreciate the timing spot. My pleasure.

Meet The Hosts

Amie Vaccaro

Senior Director, Global Marketing, Dimagi

Amie leads the team responsible for defining Dimagi’s brand strategy and driving awareness and demand for its offerings. She is passionate about bringing together creativity, empathy and technology to help people thrive. Amie joins Dimagi with over 15 years of experience including 10 years in B2B technology product marketing bringing innovative, impactful products to market.

Jonathan Jackson

Co-Founder & CEO, Dimagi

Jonathan Jackson is the Co-Founder and Chief Executive Officer of Dimagi. As the CEO of Dimagi, Jonathan oversees a team of global employees who are supporting digital solutions in the vast majority of countries with globally-recognized partners. He has led Dimagi to become a leading, scaling social enterprise and creator of the world’s most widely used and powerful data collection platform, CommCare.



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