In many low- and middle-income countries in Africa, health workers faced challenges responding to the COVID-19 pandemic due to understaffed, under-supported, and under-prepared facilities. Health care workers needed to test new equipment and update registers to accommodate clinical features of the disease, which added to their workload of caring for patients and managing reporting.
During this time, health care workers needed digital tools, such as rapid diagnostic test (RDT) kits, which provide timely data for decision-making.
PATH Diagnostics program and PATH's Living Labs program, a human-centered design initiative for inclusive innovation, partnered with FIND to develop Digital Solutions to Support COVID-19 Antigen RDT Rollout (dSTARR), a project that aimed to increase access to RDTs and facilitate effective COVID-19 data management across select countries in Africa.
A data management tool to support health care workers
The dSTARR project aimed to develop data standards and improve the interoperability of patient and diagnostic data collection platforms, with the goal of incorporating these standards into leading mobile health tools.
The dSTARR tool also reduces data storage needs, makes report generation faster and more versatile, and enables communication with regional health offices.
While developing the data management tool for Africa, PATH’s Living Labs engaged frontline health care workers as well as district, provincial, and national ministry of health stakeholders to not just understand needs but also to co-create the product, from design to usability testing.
This involved site visits and iterative user testing workshops in Senegal and Zambia. PATH also worked with the stakeholders to complete a market needs assessment and published a common data model for RDT data exchange.
Digital Systems and User Requirements for COVID-19 Antigen RDTs
With these user insights, the dSTARR team collaborated with global and local vendors to develop a contextually informed digital solution that was evaluated in an implementation study.
The process of using human-centered design to build a digital tool was packaged as a blueprint for others to follow in Digital Systems and User Requirements for COVID-19 Antigen RDTs—a guide for ministries of health or other stakeholders looking to improve digital COVID-19 data management. This tool is part of the suite of resources that distill World Health Organization guidelines and operational requirements into a standardized format that can be more easily incorporated into digital tracking and decision support systems.
This guide aims to improve the functionality and user experience for incorporating RDTs into health systems, using recent experience from the COVID-19 pandemic. It provides a comprehensive framework to guide the system’s design, development, implementation, and evaluation.
Using the tool, health program managers and their counterparts in digital and health information systems can collaborate to ensure that the system supports COVID-19 testing and data management in their respective countries in a user-friendly, efficient, and effective manner and can be adapted for other RDTs and contexts.
To facilitate smooth user feedback sessions that ensure the tool is user-friendly and could be integrated into existing health care workflows, Living Labs and other partners provided a framework for iterative user testing and co-designing solutions with the end users.
This process gathered feedback in rapid cycles, allowing the tool to be refined with growing insights during the pandemic response.
“Having been part of the team that helped in developing the dSTARR app was thrilling because all our feedback was taken into consideration from the beginning. There has been continuous communication between us and the Living Labs team to ensure that all our thoughts about the app are documented and improvements are made,” said Hitler Chishimba, Clinical Officer General, Maramba Clinic, Livingstone, Zambia.
What comes next
Better data management tools have great potential to help health officials respond to outbreaks more quickly. Senegal will be the first country in Africa to begin using this data management tool to help manage COVID-19 data.
PATH plans to disseminate the project’s implementation and operational planning documents to the Senegal Ministry of Health and other stakeholders. With these resources, partners can improve their approaches to digital solutions development and continue improving the sector for all.
PATH Diagnostics, Living Labs, Center of Data Excellence (CoDE), Digital Square, and external partners such as Dimagi and Connection Loops are committed to developing and refining tools that meet the specific needs of end users in Africa.
The development of digital solutions such as dSTARR can also aid in the approaches to improve health care workflow efficiency, reducing the workload burdens through digitization. Furthermore, incorporating co-creation and human-centered design promises to serve as a model for similar initiatives in other regions facing similar challenges, contributing to the global effectiveness and efficiency of health care systems.