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OGOW EMR

Easy to-use application connecting Frontline workers and Caregivers to improve infant vaccination coverage in Somalia.

Photo of Khalid Hashi

Written by

Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

Our primary goal is to improve the delivery of immunizations in Somalia by empowering and equipping practitioners and caregivers with digital solutions that are easy-to-use, customizable and in the Somali language.

Explain the idea (less than 2,000 characters)

Following the 1991 civil war, Somalia's infrastructure, including its health systems, was destroyed. The private sector accounts for health care delivery of 90% of the Somali population. The Ministry of Health’s inability to regulate and control health care within the private sector has created a gap in collection and translation of health data among patients and practitioners, often resulting in inadequate delivery of health care within and between rural-urban care settings. There is tremendous potential for the deployment of medical record keeping and database technology in Somalia. Access to the Internet has dramatically improved in the last 10 years that will facilitate users to use digital solutions. OGOW EMR is designed to improve the health and wellbeing of children and women in both rural and urban settings. Our portal provides tools for practitioners to improve infant vaccination coverage by reaching patients who need specific vaccines. Further, caregivers will be aware of the schedules of vaccinations and will be sent notifications to visit their practitioners. The vaccination scheduler tool available on the portal creates an immunization schedule for each patient. Additionally, our app will grant caregivers access to check medical history, upcoming vaccination dates, and health-related tips. The application will also send notifications and pop-ups to ensure that caregivers conduct regular visits to hospitals and meet all the timelines. Our system includes but is not limited to the following functions: • Available in Somali and English • Immunization tool • Access to new and past results among providers in multiple care settings • Caregiver identification data and assignment of a Medical Record Number; • Mobile SMS based notification reminders to caregivers; • Vaccine Management System includes delivery point, inventory management tool, and stock-out alert.

Which part(s) of the world does this idea target?

  • Eastern Africa

Geographic Focus (less than 250 Characters)

South Central Somalia

Who are your end users and how well do you know them? (750 characters)

Our end users are practitioners and caregivers in resource-constrained communities across Somalia. Caregivers’ positive response is the strength that we are foreseeing and our asset would be maximum use of our solution to obtain improved health outcomes. In terms of patient care, physicians and caregivers will be able to coordinate in an effective manner. Our company places a strong focus on collaboration by aligning our initiatives with the goals and needs of our partner hospitals, as well as the wider community. We recently toured three regions in Somalia to learn more about the challenges practitioners are facing. Through donation and personal investment, we managed to provide ready-to-use systems to 2 hospitals.

How is the idea unique? (750 Characters)

OGOW EMR was designed to bridge the gap between caregivers and FLW's which is unavailable at present. Our portal has been built with the aim of providing maximum accessibility and usability to its users. This means that all features, tools and reports remain intact in Somali. We plan to make our solution available for both iOS and Android, which will include a version of our software for offline access. This effort would be a first in Somalia and will have the capacity to generate high demand from caregivers and practitioners.

Idea Proposal Stage (Select 1)

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

How many months are required for the project idea? (140 characters)

It will take 18 months to implement and evaluate our pilot project.

Organization Name (less than 140 characters)

OGOW EMR

Type of Submitter

  • We are a For-Profit Startup or Startup Social Enterprise

Organizational Characteristics

  • Women’s health/rights focused
  • Youth-led organization
  • Locally/community-led organization

Organization Location (less than 140 Characters)

Mogadishu, Somalia

What is the current scale of your organization’s work?

  • Community (working within one or a few local communities within a region)

Website URL

http://www.ogowemr.com/

Tell us more about your organization/company (1-2 sentences)

OGOW EMR provides digital health solutions in Somali to monitor diagnoses, treatments and trends to minimize the harm caused by outbreaks of communicable diseases. We offer customized solutions to the customers that are easy to use and are designed keeping in view their requirements.

Who will work alongside your organization in the project idea? (750 characters)

This past October, I was invited to present OGOW EMR services in Somalia's first ever Tech Summit in Mogadishu. Through this platform, we connected with hospitals and medical students across the country. We plan to closely collaborate with public, private and social sector organizations. Public sector includes, federal and regional health ministries, whereas WHO Somalia, UNICEF, GAVI, hospitals are private sector and global partners. Since we have a common goal, our success will motivate other partners to collaborate with us and further improve the health services provision through our platform.

How many people are on your team?

3

Tell us more about you and your team

Khalid, Founder • Provide overall governance of initiatives as it relates to both short and long-term goals • Promote profitability and growth in a sustainable and responsible manner • Ensure that our start-up is aligned with UN Sustainable Development Goals • Provide updates to both the funding agency and steering committee using an agreed upon format. Mohammad, Developer Has more than 13 years of experience in software architect, designing, development, testing and of Windows/Desktop applications and Mobile applications. Our steering committee is comprised of Somali doctors and academics that are respected throughout the medical field in Somalia and throughout the Somali diaspora. The committee was established to ensure that OGOW is well executed, ethically operated, professionally monitored and reviewed throughout the period of implementation.

Overview of How Your Concept Has Evolved (5-6 sentences):

The user experience activity helps us visually monitor the patients’ journey at a quick glance. We realized that Luul’s journey was relatively smoother than those of the majority of caregivers. Awareness messaging in rural settings will be much more challenging. We developed another illustration map for rural communities. Webinars on UNICEF’s human-centered and SURGO Foundation physio-segmentation challenged us to add activities to better understand the needs, behaviour and attitudes of caregivers. To achieve this, we plan to incorporate short physio-segmentation surveys through our solution to better understand patient’s experiences with immunization delivery while placing a focus on reasons for vaccine hesitancy.

Viability (3-4 sentences and activity upload):

https://canvanizer.com/canvas/ruUa9eWDiEYMZ We intend to refine our solution by conducting beta tests, consultations, and assessment interviews. We plan to incorporate short surveys to our solution to better understand Caregiver’s experiences with immunization delivery. Development of Mobile version: Deploy our solution for both iOs and Android platforms. Community Champion Outreach Incentive: Deploy local Community Champions to raise awareness about the importance of vaccinations and the diseases they prevent. Our Community Champions will introduce offline resources, vaccination messages, and activities to rural communities.

Feasibility (3-4 sentences):

OGOW EMR automated immunization-scheduling tool is designed to enable practitioners to reach patients who need specific vaccines through OGOW’s mass mobile-based texting message system. I visited three representative areas of the Somali Republic: Mogadishu, Kismayo and Garowe to consult with future beneficiaries on how best we can make OGOW as user-friendly, accessible, culturally sensitive, and effective public health innovation in the country. Following these consultations, we identified traditional elders, community activists and religious scholars as key partners.

Desirability (3-4 sentences and activity upload):

Beneficiaries are the children and their immediate duty bearers (caregivers). OGOW EMR was founded to allay the underlying socio-psychological biases held by large segments of these caregivers against vaccinating their children. During our visit we held meetings with representative samples of parents to see how best we can mitigate their biases against child vaccination. We will employ cultural and religious myth outing strategies to counter these anti vaccination propaganda. We will use paid traditional elders and religious scholars through our Community Immunization Champion Program to convince holdout caregivers.

Community Focus (2-3 sentences):

Somalia has one of the worst health indicators in the world. Health workers lack effective tools to track and monitor immunization programs. Furthermore, caregivers are unaware of the benefits that come with routine vaccinations. Our innovation bridges this gap by offering FLW’s tools to reach patients who need specific vaccines; while simultaneously following up by sending automated SMS reminders followed up with pertinent health-related tips. We plan to work closely with health agencies, regional health ministries and civil society groups to increase community trust and awareness.

Community Impact (2-3 sentences):

By Dec 2019, we plan to enroll and train 25 hospitals in Mogadishu and nearby villages, and by Jan 2021 we plan to replicate our model in other parts of the country. Mogadishu is the largest and most populous city in Somalia. Caregivers will receive SMS reminders to improve infant vaccination coverage. The follow up includes health tips to lessen caregivers’ hesitancy on vaccines. We will monitor this by evaluating our screening tool and SMS program adherence. We plan to develop a consortium with community organizations, WHO, GAVI and Ministry of Health to scale up our activity and outreach.

14 comments

Join the conversation:

Comment
Photo of Jamal Mohamed
Team

Dear Khalid.
Glad to see you in the challenge, and good lucky your innovative idea as you tackling immunization challenge, however as you mentioned your application will be free for caregivers.
are you planning to distribute smartphones for health workers/caregivers, in my experience, we currently piloting Safe delivery application innovated by from Maternity foundation Danmark with the collaboration of Copenhagen University aimed to improve skill and knowledge of midwives.
One of the biggest challenges that we faced was that 70% of midwives, didn’t have star-phone to install the application which paralyzed the impact of the application.
So my question is how you mitigate like these challenge as you implemented rural and hard to reach areas with limited resource.

Thanks and good luck with your innovation.

Photo of Khalid Hashi
Team

Hi Jamal Mohamed ,

Thank you for your kind inquiry. Almost a year ago, OGOW EMR conducted a situational analysis on the issue of cellular connectivity and how it can be tapped for healthcare delivery in desolate areas. In it, we discovered, that the vast majority, in fact, close to 90% of Somali households have access to SMS capable devices. To answer your question about the provision of Smartphones which alludes that they are necessary to the effectiveness of our intervention, we do not plan to distribute smartphones to caregivers for the purpose of having them send vaccination due date alert SMS to caregivers. It is important however to note that our solution is an integrated approach designed to marry technology to tradition. We are confident about not only the effectiveness of our technology as its sustainability. It is important to note that UNICEF which uses mobile messaging to advance WASH activities over believes that about 72% of Somali adults carry mobile phones which according to OXFAM, UK, translate into over one mobile device per every 10 people or roughly one in each household. https://www.unicef.org/esaro/UNICEF-FN-Somalia-Mobile-low-res.pdf
The World Bank also confirms that Somalia ranks among the highest users of mobile-based money transfer https://www.worldbank.org/en/news/press-release/2018/09/13/somalia-economic-update-rapid-growth-in-mobile-money

OGOW EMR’s strategy is to replicate this time tested Private sector success story into the delivery of vaccinations to children. We will use this in conjunction with the utilization of rotatable tablets in both the rural areas where we will provide each community with a number of pre-charged tablets, ready with video-messaging about the date, location, and more importantly the importance of vaccinating children. These tablets will be moved from community to community on the basis of the scheduled vaccination dates and will be handled by OGOW EMR trained paid Community Immunization Champions. The messages in the tablets will be recorded by health care professionals and their utility will be validated by respected religious scholars and local tradition elders trusted by the caregivers.

Thank you again

Photo of Jamal Mohamed
Team

Thanks, Khalid for your information. good lucky.

Photo of Shahed Alam
Team

Hi Khalid Hashi interesting to see the use of technology for immunization. Has the WhatsApp usage increased among the targetted population? It'd be interesting to see if you can gamify users experience who are regular at immunization by giving them virtual badges, points.

Photo of Khalid Hashi
Team

Hi Shahed Alam 
Thank you for your message. Yes, WhatsApp is the most used messaging app in the country. We are currently in the process of designing a point-based incentive program for our app soon-to-launch. I will be reaching out to you soon about the virtual badge suggestion!

Best,
Khalid

Photo of Shahed Alam
Team

Thanks, Khalid Hashi, Please do, I am happy to be involved.

Photo of Estela Kennen
Team

Hi Khalid, On the user journey, how does Luul find out that immunization services are available in her community, and how does she know to go the nearest medical facility? Would this be something that the radio announcement does? And if so, that's external to your intervention, correct?

Photo of Khalid Hashi
Team

Hi Estela Kennen ,

Thank you for your question. Luul lives in Mogadishu which is an urban environment. She will have first received an OGOW EMR generated SMS through her mobile device or a similar one belonging to someone in the same household. Radio advertisements by WHO, GAVI, their subsidiary organizations, government interventions to the same effect, as well as word of mouth within the community, will all be welcome platforms that reinforce our own. Our objective is the message to vaccinate children to reach virtually everyone but we are realistic that we alone cannot do that without employing financial and human substantial resources.

Photo of Marichu Carstensen
Team

Hi Khalid, I like your digitized idea. I am just wondering if this will cover enough of your community? Only 6 million has access to mobile phones out of 14 million. What can you do to the 8 million that are not connected? What are the future prospects of Somalia in terms of connectivity in the future?
Good luck on your project.

Photo of Khalid Hashi
Team

Hello Marichu Carstensen 

Thank you for your question. Through a collaborative scheme with the vaccinating agency whether it is the Ministry of Health or a designated INGO like GAVI, OGOW EMR will deploy portable tablets which will be rotated across vaccine ready rural communities. A per/diem paid cadre of traditional elders and community activists will be used to convey members of the community OGOW EMR’s vaccination promoting messages. Battery-operated tablets and solar charged Nokia phones will be used to reach as many pastoralists and sedentarized rural communities. Pastoralists will be targeted around common water wells where they rely for the drinking water.

Photo of Manisha Laroia
Team

Hi Khalid Hashi 
Thank you for sharing your idea in the challenge.
I love the idea of using the video to explain the core idea and its features. Great Job!
_
We would encourage you to also look at our other OpenIDEO vaccine challenge and share your innovation there also. Your idea would make a good fit there and can be used in urban highly populated areas to track vaccines using your idea on a tablet.
Please have a look and apply soon. The deadline for it is March 20, 2019.
https://www.openideo.com/challenge-briefs/infuse-urban-immunization

Photo of Khalid Hashi
Team

Hello @ManishaLarola, thank you for informing me of the Infuse-urban immunization competition. I look forward to participating in the challenge. I reframed my initial proposal here by focusing on the demand side. I added functions that will connect practitioners to caregivers in Somalia. This challenge really helped me evolve our solution and I hope that we have an opportunity to continue to develop and our prototype.

Photo of Isaac Jumba
Team

Hello @Khalid Hashi, great reading through your idea. I'm impressed by the strides OGOW EMR has already made in the healthcare space in Somalia, and I'm looking to learn more.

Some quick thoughts:
1. I like that your idea is targeting medical practitioners and how to help improve service delivery. I wonder how you might reframe your idea to focus on the demand side (for purposes of this challenge) and put caregivers as your target users. Manisha Laroia  any ideas here?
2. Could you share more on the tests that you carried out?

It will get great to refer to the Demand for Healthcare Services Field Guide available under the resources section.

Photo of Khalid Hashi
Team

Hi @IsaacJumba, I totally agree with you and appreciate your feedback. I reviewed the resources again, and yes target users equally would also be caregivers. I will highlight how our solution will benefit caregivers along with medical practitioners in my proposal before submission to you. There will be functions for caregivers such as their medical history, calendar to pop up when immunizations become due, health tips etc. Further we will provide measures in proposal for ensuring regular comeback of caregivers to practitioners as their medical history, calendar to pop up when immunizations become due, health tips etc.

Thank you for challenging us to reframe and evolve our solution. By doing so we will have a greater impact in improving health outcomes across Somalia.