Malawi is a country of more than 17 million people stretching over 118,000 sq km in Southern Africa. The country is called the warm heart of Africa for the friendliness and compassion of its people and the beautiful warm waters of Lake Malawi. However, there are multiple challenges facing Malawi’s economy and public health sector. These challenges range from fragmented health data systems to insufficient data on population demographics, characteristics, behaviors and trends. These challenges act as a barrier for policy makers and health service providers from deploying targeted resources more effectively and efficiently for improved health outcomes.
The potential that mobile (and other types of data, including geospatial and digital) holds to generate insights for improved health outcomes is immense. Despite the advent of Big Data for social good, scale and sustainability continue to be a challenge for initiatives that lie at the intersection of data-driven insights and health outcomes. DIAL, in partnership, with Cooper/Smith intend to demonstrate the value of analyzing and mapping data from Mobile Network Operators (MNOs), population census, settlements mapping and geospatial data to routine patient or aggregate data collected through the Malawi health system.
The ultimate user and consumer of such insights is the Ministry of Health. DIAL will provide capital investments and technical resources, such as analytics, through its partners Infosys. Cooper/Smith will work with the Ministry of Health to verify data from health facility systems, establish new ways to seek and utilize data. In the long term, Cooper/Smith will support the Government to set the stage for long term programmatic use of MNO data in order to answer key questions on Malawi’s disease burden.
In October 2017, teams from DIAL, Cooper/Smith and Infosys went to Malawi to engage with various stakeholders that are key in making this 6-month study and demonstration of data for public health outcomes a success. The team started off by meeting with the Secretary for Health in the Ministry of Health; Dr. Dan Namarika. As the ultimate consumer and client of this study, the Secretary reiterated the value of such data insights in improving health outcomes. He intimated, that while equity is sought in distribution of resources across health facilities and diseases units, there is also need for this D4D demonstration to likewise consider cross sectorial use cases in the health domain.
An interesting use case of mapping and analyzing MNO data for health outcomes was raised when the team met with the Community Health Services Section which is within the Department of Preventive Health Services. Through the Health Sector Strategic Plan’s Capital Investment Plan the Ministry of Health plans to deploy over 900 health posts over the next 5 years across the country. Use of MNO data would shed light on the relevant migration patterns of communities, ultimately providing insights on where best to deploy new health posts and resources. This is a typical example of a use case where analytics from telco data can directly improve health outcomes.
The team also met with the Director of Policy and Planning, Deputy Director of the Central Monitoring & Evaluation Division (CMED), Director of HIV and AIDS, and the Malaria Program Manager in the Ministry to discuss modalities of deploying this data for development study. A recurring theme in discussion with all these departments was the inability to track migration of patients and how to differentiate between drug defaulters and compliant migrants. A typical example of such a case is when communities migrate to urban areas in search for seasonal jobs such as within the Tobacco industry which is Malawi’s largest forex earner. How does the Health System adequately target resources based on movement patterns of people? Our goal is to explore how Telco and geospatial data may be the answer. It was also eminent that there is need to integrate the multiple health systems available in the country to enhance efficient data use. Cooper/Smith, is also working on supporting the Ministry of Health to enhance integration and interoperability of the health systems through the Kuunika Project, that our joint investigations will support.
The Ministry of Health also works closely with key stakeholders such as the National AIDS Commission (NAC) and the Malawi Network for AIDS Service Organizations (MANASO), organizations that are critical in coordinating HIV/AIDS programming across the country. As such, the team also paid courtesy calls on these two entities. Once again, the issues of migration patterns of people as relates to health outcomes and deep insights in understanding certain demographic segments to manage HIV/AIDS were key. For example, adolescent girls and young women are at a higher risk of contracting HIV/AIDS than their male counterparts, yet there is limited understanding of their behavioral patterns and trends that can help deployment of interventions and resources. MNO data has the potential to help unlock insights into this group and allow better targeting for HIV prevention and treatment services.
Finally, the team met with the Malawi Communications and Regulatory Authority (MACRA), the Department of E-Government, the National Commission for Science & Technology, and the two leading Mobile Network Operators in Malawi, Airtel and TNM. The conversations with both Airtel and TNM highlighted the shared value in using telco data to identify trends and patterns in population density, migration, lifestyle and movement that can be triangulated with site level health program data to predict health outcomes or provide insight on health interventions and deployment of resources. Data privacy and protection remain key themes in the deployment of this study in ensuring anonymity of user data sets.
Within the next few months, together with the Ministry of Health and mobile network operators, we are hoping to demonstrate the value in mapping and analyzing telco data alongside health systems data to inform health outcomes. With valuable lessons learned from this study, DIAL will advance the impact made possible by unlocking mobile, digital and geospatial data for social good, ultimately acting as a springboard for entities in other geographies to replicate, customize and scale digital health data solutions. Consequentially, we anticipate that these solutions can enable policy makers in the health sector to make efficient and informed decisions to improve health outcomes. Our expectation is that Malawi may become one of the model countries in demonstrating tangible use of big data for social good and truly drive data-driven societal transformation.
Rachel Sibande joined DIAL in September 2017 as Programme Director, supporting DIAL program partners in selected countries. She works to demonstrate sector wide collaboration between D4D players in deploying initiatives that enhance data use for evidence based decision making. Prior to joining DIAL, Rachel established Malawi’s first technology hub; mHub. She has over 11 years industry experience spanning academia, development and social enterprise domains.
Hannah Cooper is the Co-Founder and Managing Director of Cooper/Smith, a technical assistance organization that uses hard data to improve the efficiency and effectiveness of health and development programs. Throughout her career, she has helped governments and organizations plan development projects and achieve lasting results. Prior to founding Cooper/Smith, she served as Team Lead for Monitoring, Evaluation, and Quality at the Office of the U.S. Global AIDS Coordinator, President’s Emergency Plan for AIDS Relief (PEPFAR), U.S. Department of State. Hannah was also a Results Specialist at the World Bank and led an online community of practice for African civil servants on Managing for Results. Hannah also was responsible for strategic planning and performance at Canada’s Department of Foreign Affairs – where she developed metrics to measure Canada’s diplomatic work.