Kenyan experience highlights potential of Situation Room HIV mobile app
Just over a year since launch, a new mobile app is helping Kenya track progress, plan and allocate resources for the HIV response, providing useful learning for other countries.
In 2015, mobile analytics experts iVEDIiX and UNAIDS united to create a mobile app, the Situation Room, to help people in Kenya find their nearest HIV services and to provide better data for those responding to the epidemic.
Launched in January 2016 the system has been providing a vastly improved real-time picture of the HIV epidemic in Kenya over the past year, and is leading its developers to look to create new partnerships for similar systems in other countries in the region and beyond.
So how has it worked?
A single room at UNAIDS’ headquarters in Geneva had previously been used to provide static reports from Kenya. But the Situation Room mobile app created a comprehensive overview of prevention efforts, testing and treatment throughout the country’s 47 counties. By using the functions of Google Maps, the system has enabled decision-makers to identify a wide range of patterns and trends, from the number of people receiving HIV counselling to the number of skilled nurses available for each child in a specific region.
"It also allows users to annotate the maps and communicate with each other – so a hospital where stocks of antiretroviral drugs are running low, for example, can work with a nearby hospital with a three-month supply of the same treatment to avoid provisions running out."
In developing the system, the data team used the Android capabilities of Google Maps to build the main interface of the HIV map, which contains the most accurate and up-to-date data for Kenya.
It taps into three sources: HIV estimates made by UNAIDS, Kenya’s District Health Information System – containing everything from the number of people treated in hospitals to condom distribution figures – and community level data, which includes survey responses from the public about the quality of the services they access.
“More than 80 percent of adults own a cell phone in Kenya, and Android is by far the most popular operating system,” says Brian Annechino, of iVEDiX, the team which helps provide the data.
“Google Maps APIs [functions] are available across all platforms, including native APIs for Android, and Google Maps also offers the kind of fine-grained detail we needed — for example, the locations of more than 7,500 Kenyan healthcare facilities servicing the HIV and AIDS epidemic.”
Aiming to accelerate and improve communications between policy-makers and healthcare teams, the Kenya HIV Situation Room allows quick feedback on results at county and community levels, and picks out bottlenecks and access issues.
In a demonstration of its agility, it also allows users to annotate the maps and communicate with each other – so a hospital where stocks of antiretroviral drugs are running low, for example, can work with a nearby hospital with a three-month supply of the same treatment to avoid provisions running out in a country where restocking can take as long as a month.
Programme staff are able to identify where efforts need to be intensified through a more accurate programme which feeds information from each facility and service delivery point back to the Situation Room.
The app’s people-centred approach is designed to ensure that no-one is left behind in Kenya’s response to HIV. Despite significant progress, the country still falls well short of the 90-90-90 targets – the number of adults receiving antiretroviral treatment, for example, remains around 58%.
Of all the stakeholders involved, political support was particularly important in gaining access to crucial data. Kenya’s President, Uhuru Kenyatta, immediately offered his support, speaking of a “one-stop shop” which allows counties to track their progress, plan effectively and allocate resources.
The information is anonymous and confidential, and the maps can be conditionally formatted by professionals, who can overlay any number of indicators over the regions and track data live while online or offline.
Staff at the National Aids Control Council, in Nairobi, have received comprehensive training in using the Situation Room, with the aim of allowing staff to train other professionals as part of a self-sustaining model.
Kenyatta has praised the potential the app holds for “infinite expansion”, and Taavi Errkola, a senior advisor on monitoring and evaluation at UNAIDS, says the app was tested in Kenya because of the country’s “strong appetite” for using technology to benefit its population.
The National AIDS Control Council, the Kenya Medical Supplies Authority and the Ministry of Health all play key roles in informing the data and enhancing the way it is used, and UNAIDS has placed a strong focus on sustained access to treatment, viral suppression and areas around child and maternal health.
One of the team’s ambitions is to identify every individual requiring treatment to prevent mother-to-child transmission, but the analysis of the data also takes a holistic approach, setting the epidemic in the context of areas such as education and the Kenyan economy.
Accessing the right sets of data in real time is critical to the success of the system, resulting in better resource deployment at community and neighbourhood levels.
“End user adoption is the holy grail,” says Annechino, who believes the collaboration is on the right path. “If it’s not being used, it’s a failure”.
“As you can imagine with a project like this, stakeholder involvement and making sure we were doing things at a slow enough pace to make sure that the adoption was happening with all those stakeholders at the right time actually benefitted us.”
The project took six months to be fully realised, including training summits with users from various countries. The hope is that it could be rolled out in dozens more countries by 2020, and iVEDiX are continuing to take further steps and form more partnerships, including link-ups with telecom companies to deepen their understanding of the needs of communities.
“For example, if there are 300 people in a particular week in a neighbourhood using a health messaging system, and they are saying they need better access to medicine or counselling, that information can now reach the Situation Room platform,” says Annechnio.
“It can be provided to the people who can make those decisions anytime, anywhere in the world. There are a lot of very unique partnership opportunities.”