Bophelo-Ka-Mosebeletsi Application’s Main Interface
Prior to identification and development of the solution, VHWs have already been tasked with COVID-19 community activities such as awareness campaigns, assisting the community governance structures to enforce COVID-19 regulations, monitoring of individuals in home quarantine and reporting suspects of COVID-19 to healthcare facilities. The developed solution encapsulates all these tasks, with majority of activities now being automated to reduce the period of interaction with the gadget, and the physical contact with individuals during data collection when assessing and monitoring individuals in communities.
The application is an innovation from the Lesotho Accelerator Lab in cocreation with the Ministry of Health and its health partners; and it was formally launched at Villa Maria Healthcare Facility in Quthing on the 15th October 2020 by the United Nations (UN) and Ministry of Health. To execute this assignment, the Lab partnered with The National University of Lesotho (NUL) through deployment of two technical developers to assist the technical expertise already inherent within the Lesotho Accelerator Lab. The Lab also partnered with Econet Telecom Lesotho (ETL); a private telecommunications company through a Memorandum of Understanding to support with free network and internet access through zero-rating of application use by VHWs and Ministry of Health. ETL also assessed regions within two districts of Mokhotlong and Quthing which have limited mobile network coverage, for a network extension process in the year 2021. This was in support to Bophelo-Ka-Mosebeletsi digital initiative and the overall support to implementation of e-government strategy and enabling opportunities for the National Strategic Development Plan (NSDP II)’s innovation and technology requirements. The VHW were handed tablet computers to enable access to technology and ease use of the application, procured by UNDP under the joint UN MPTF – funded project for strengthening community health systems in response to COVID-19. The efficiency introduced through the inception of the new system has influenced quick turnarounds in strategic decision making in response to COVID-19 in the two pilot districts of Mokhotlong and Quthing. While the application currently has COVID-19 related module only, a process of incorporating other modules to revamp general health activities conducted by VHWs in communities has been initiated.
Solution Deployment and Performance Assessment
The solution was deployed on the 08th September 2020 and the Lab has enrolled training of 682 VHWs, 18 nurses and 8 data clerks at healthcare facilities in two districts of Quthing and Mokhotlong. From this, 98% of participants were female, underlining the low involvement of men in health-related initiatives in Lesotho. In the first four months of application deployment in two districts, the system has accumulated the following COVID-19 alerts statistics:
- Total COVID-19 Alerts – 24,481
- Quarantined individuals – 16,785
- Symptomatic – 9,396
- Asymptomatic – 15,085
- Finished Quarantine – 7,196
- Contact with COVID-19 Patient – 1,112
- International History in the Past 14-days – 22,817
The application has not only provided a database for surveillance analytics and intelligence by the Ministry of Health, but it has also contributed to saving on time and monetary cost previous incurred by VHWs. Before the deployment of the application, VHWs had to use own funds for transport and other expenses to collect data and submission of paper-based reports to healthcare facilities. For VHWs weekly travel expenses to and from the healthcare facility, the system has saved a minimum of M256.00 (appr. $17.00) for each VHW residing closer to the healthcare facility who spends the minimum of M16.00 (appr. $1.10), while a VHW living furthest to the healthcare facility spends M64.00(appr. $4.00) in one week, saving of more than M1024.00 (appr. $69.00) in the 4-months of application operation. This is a considerable amount of money saved for each VHW considering high poverty rate in Lesotho with almost 50% of population surviving on a maximum of $1.25 per day.
The application pilot area is yet to be expanded to other districts after the planned assessment to be conducted by the Ministry of Health and WHO.