By: Ariel Frankel, Director of Public Health

The Global Digital Health Forum kicks off today, the leading networking and learning event for policy makers, practitioners, and tech professionals who are passionate about improving health outcomes in low- and middle-income countries through digital innovation. As the Director of Public Health at TechChange, I’ll be there to share one of our latest educational tools on digital health, developed with our colleagues at USAID.

Can you guess what it is? Hint– it’s not a policy paper, text book, worksheet, or even a video. 

It’s a… game.

Surprised? Digital health concepts and tools can be complicated, but they don’t have to be boring. Play is an important – and often underutilized – way that we can put learning into action, in a way that’s fun and practical. 

Players work as a team – online or in-person – to respond to new investments and new shocks to their digital health system – mirroring what happens in real life.

A Collaborative Game with Real-World Elements

Architects of Digital Health is a collaborative game that represents multiple years of building a digital health system in a fictional country that is facing challenges from HIV/AIDs, cholera, malaria and tuberculosis. Players, joined together in a team, have the ability to make investments in digital health tools, for scale or interoperability. Then, just like in real life, unexpected events and pressures cause problems for your intervention and your team has to decide how to handle it. There are new investments and shocks every year, impacting how your interventions unfold. 

The different interventions represent key building blocks of a digital health tool box: 

  1. messaging systems like SMS and WhatsApp; 
  2. community information systems like Commcare or MobileCHT; 
  3. electronic medical record systems; and 
  4. digital systems to train the healthcare workforce. 

In the game, you can add or remove systems, scale them to the next level, or invest in interoperability and governance. The goal is to fight fragmentation and achieve national level scale on coordinated interventions. 

Putting Learning into Practice Through Play 

We use this game as a capstone learning activity in our digital health course, created and hosted by TechChange and supported by USAID, PATH/Digital Square, the WHO and others. Digital Health: Planning National Systems is an online course that teaches policy makers and practitioners the knowledge, skills, and attitudes they need to design and implement digital health interventions. Participants use the key concepts and best practices from the course to play the game, working together to minimize shocks and scale beneficial systems.

More than 200 mid- to senior- level ministry of health officials from a wide range of nations including Laos, India, Zimbabwe, and the Philippines have already participated in the course and used what they have learned to inform their national digital health strategy.

Play Architects of Digital Health at GDHF22 or at Home 

USAID’s Merrick Schaffer leads a round of “Architects of Digital Health” at the Frontiers of Digital Development Forum 2022

Want to learn more about the game or give it a try? If you are attending GDHF, come by our virtual session and we’ll teach you how to play. We’ll also be demonstrating it and playing in small groups at GDHF online (on the TechChange hybrid events platform) on Tuesday, Dec. 6 at 9am EAT / 8am CET / 2am EST. 

If you’re not able to join, you can print your own copy of Architects of Digital Health for free, including all the instructions you’ll need to follow along. Feel free to use this instructional aide in any of your trainings or workshops – we invested in it so that it could become a learning tool for the field. 

It’s not every day that you get up from your desk, walk out of your office, and travel 8,353 miles to check in on a project. But in October that’s exactly what Delanie, Emily, and I did when we went to visit Malaria Consortium in Uganda.

As we walked out the office in Washington D.C., I started a timer on my phone to see what the door-to-door travel time would be. 26 hours later we were in the back of a hired car, dodging the mini-buses that barrel down the road between Entebbe and Kampala.

Why we returned to Kampala
We were in Uganda to check in on one of TechChange’s biggest projects: the “Diagnose and Treat Febrile Illnesses” eLearning course. Last year, we built a course for Malaria Consortium, one of the world’s leading non-profit organizations specializing in the prevention, control, and treatment of malaria. The course was meant to train private sector health workers and Rapid Diagnostic Testing sales representatives in Uganda and Nigeria.

In many malaria-endemic countries like Uganda and Nigeria, the disease has been prevalent for so long that pharmacists and doctors would give malaria treatment to any patient presenting symptoms of fever. Not only is this false diagnosis harmful for the patient, it also leads to the waste of costly treatments that don’t help the patient get better – in fact, their condition could become even more serious. Incorrect diagnoses can even be fatal: pneumonia is the leading cause of death for children under 5 in Sub-Saharan Africa, but it is often misdiagnosed as malaria.

Screen Shot 2015-12-01 at 2.16.19 PM

An e-learning solution to train health workers
The goal of the elearning training is to reach roughly 5000 health professionals in both Uganda and Nigeria and provide in-depth training on how to diagnose diseases that can present fever-like symptoms, like malaria, pneumonia, typhoid, and others. The two-day training provides a hybrid learning experience with off-line elearning modules and in-person trainings, created with local content to make the training as culturally-relevant as possible.

The training teaches healthcare workers the basics of how the malaria parasite works, how to conduct a malaria Rapid Diagnostic Test (RDT), how to diagnose patients for other illnesses, and how to provide treatment depending on the results they find.

It’s been a year since the training was implemented, so we were curious to see how the training fared. Was a computer-based training actually useful to trainers? Did students enjoy the training? Were there better learning outcomes?

Training 5

So, how is the training going so far?
We found that even with minor technical considerations, the training was a stunning success! Yes, there were certain drawbacks to having a computer-based training compared to a traditional lecture format. Among the biggest disadvantages were the possibility of power-outages, finding computers with adequate RAM and processing power to play the training, and also updating Adobe Flash (one of the requirements to run the training). However, with the help of an in-country technical setup team, these issues were controllable.

What do the trainers think?
Most importantly, trainers told us that the benefits of the blended learning style far outweighed any drawbacks caused by being dependent on computers. Students and trainers alike told us that the format allowed students to learn the content at their own pace, compared to a lecture where the instructor may move too quickly or slowly through content.

Malaria Consortium

What do the students think?
Students also told us that the interactive format made the learning experience much better than a lecture accompanied by slides. The visual nature of the training came up again and again as an aspect of the training that helped students learn.

Malaria Consortium

Students who had completed the pilot program took the training to heart. One pharmacist referred to the training as she told us about about her neighbor, who had recently come into her shop asking for antimalarials to treat his fever – but, his test result was negative, so she advised him to seek treatment at a health facility. After visiting the clinic, he stopped by the pharmacy to let her know that he had been diagnosed with Typhoid fever; if the pharmacist had misdiagnosed the fever and provided treatment for malaria, it would only have allowed his case of Typhoid to get worse.

This is just one anecdote of many. While concerns about electricity and infrastructure remain very real, it is exciting to see the training accomplishing it’s goals. We are excited to continue supporting and improving the delivery of this training with Malaria Consortium!

Is your organization looking to train your teams online? Besides online facilitated courses, we also also create custom offline computer trainings that can be used in settings where internet connectivity is a non-starter. See our different projects on our Enterprise page and feel free to reach out to us enterprise@techchange.org.

How can mapping the geolocations of tweets tell a story about global atrocities? How can digital mapping be integrated as a learning tool for university classes?

As part of his final project for TechChange’s online course, TC141: Mapping for International Development in Spring of 2014, GIS professor Tom Mueller wanted his students to explore these topics. In Professor Mueller’s course, “Introduction to Geography” at the California University of Pennsylvania in Pittsburgh, he had his students look for patterns in social media during humanitarian crises such as Ebola outbreaks and conflict casualties, and visually display the spatiality of those events.

Throughout the semester, Tom held several discussions with his students on various topics using social media to map out crises. In his course’s final assignment, Tom had about 100 students in the geography class work in groups to map various Sudan/South Sudan incidents by following several Twitter handles and categorized tweets. After examining their papers, he decided to ask them to choose a country and possibly use CrisisNet as several students became more concerned about gathering tweets rather than the information itself. He felt students would take more ownership of their projects if they independently selected their country, region or topic of choice. So, he is having them search topics on CrisisNet to understand the information that can be part of a tweet. Subsequently, they will examine some news sources and choose a country, topics, etc.

We sat down with Tom Mueller to learn more about incorporating digital mapping into his university class.

1. What is your background in mapping? What interested you in taking TechChange’s Mapping for International Development class?

I have been a GIS professor at a small school just southeast of Pittsburgh called California University of Pennsylvania. I read about crisis mapping and wanted to learn more. When I read about TechChange’s Mapping for International Development online course, it seemed like a great way to acquire more knowledge.

2. What were the most useful tools that you became familiar with in Mapping for International Development online course? How are you applying what you’ve learned in the class?

The two most important tools I found to be useful were MapBox and CrisisNet. While I encouraged my students to use ArcGIS Online in my course, learning about MapBox and its use cases helped me see the connection. It made me realize that this type of project could work with an introductory class with no GIS experience since all we needed was
latitude and longitude of the location. This may sound silly, but after going through it on MapBox, I thought I can do this in ArcGIS Online.

Now I know I should have realized it before but going through the process let me step back and understand the power this project might have on the students.
Hopefully, they understand the power of location, social media, etc.

The most important aspect of the Mapping for International Development course was the feedback from the global class participants and TechChange instructors. It was their discussions that helped me design the project guidelines to let students follow certain Twitter accounts to gather information and attempt to investigate locations based on those tweets.
All the topics we discussed in the TechChange online course helped me to understand the beginnings of this type of geographical analysis and build my ideas. As I started formulating my ideas, I could put this information on the discussion board and the TechChange course participants would give me their comments, and suggestions or ask questions. All this information allowed me to build my university class project from the ground up for my own students.

An ArcGIS map produced by one of Tom Mueller’s students indicating the locations of early Ebola incidents.

An ArcGIS map produced by one of Tom Mueller’s students indicating the locations of early Ebola incidents.

3. What inspired you to create this digital mapping exercise for your university students?

In my “Introduction to Geography” class at California University of Pennsylvania in Pittsburgh, my students and I examine geography through a global and regional lens. Sometimes geography might not be the most attractive topic for students, so I needed a hook to pique their interest. Humanitarian issues and genocide seemed to catch the students attention the most. I also knew that the situation in Sudan / South Sudan was active and the students would be able to get a lot more current information from Twitter than other sources.

4. How did your students respond to the digital mapping exercise? What were the results?

My students really enjoyed the assignment as it allowed them to learn about an unfamiliar part (at least to them) of the world. A few students said they could not believe the issues in this area since it did not seem that the popular media was covering the events. If I include a digital mapping exercise again in future classes I teach, my only change would be to may let them choose a developing country and use CrisisNet as their data source. Then they would present their findings to the rest of the class.

5. What is your advice for other professors looking to incorporate digital mapping/blended learning (offline +online) into the courses they offer at universities?

Professors need to be flexible when experimenting with new technology tools in the classroom. For this project, we changed our plans slightly about three times based on conversations with the students and events around the world. The key for my class was not to write a “thesis”; it was for students to understand the power of social media during crises and the spatiality of those events.

About Thomas Mueller

Tom-Mueller

Dr. Thomas R. Mueller is a professor at the Department of Earth Sciences at the California University of Pennsylvania and an alumnus of TechChange’s Mapping for International Development online course. His research agenda has grown dramatically throughout his career at California University of Pennsylvania. He applies spatial theory to the real world, particularly using Geographic Information Systems. His key to building a successful research agenda is to produce work through a variety of scholarly endeavors, including conference presentations, grants, technical reports, book reviews and publications in professional journals. He also has taught numerous GIS workshops for members of the local community, professors at Cal U and other campuses, and for the K-12 community.

Interested in learning different digital mapping tools for the context of humanitarian crises around the world? Enroll now in our upcoming Mapping for International Development online course.

Filming of Malaria Consortium staff doctor counselling a client on proper treatment of malaria. Uganda. (Photo credit: Maddy Marasciulo-Rice, Malaria Consortium)

Malaria in Context

There is an undeniable malaria problem in the world today. According to the World Health Organization (WHO) in March 2014, half of the world’s population is at-risk, hundreds of millions of cases are reported each year, and hundreds of thousands die annually of this disease. Around 90% of these cases occur in Africa, with children under 5 years old making up the largest demographic affected.

The burden of this disease on the health care systems of developing countries is immense: Uganda has the highest malaria incidence rate in the world with 478 cases per 1,000 population per year. Fully half of inpatient pediatric deaths in Uganda are caused by this disease and in Nigeria, the most populous African country, 97% of the population is at risk.

(Source: WHO 2013 Global Malaria Report)

How are the countries of Uganda and Nigeria addressing malaria?

While both Uganda and Nigeria have national malaria control and elimination programs, due to long waiting periods and frequent stock outs of the appropriate medications at local health facilities,  individuals prefer to go to private clinics, pharmacies and local drug shops to solve their health needs. When these pharmacists―often untrained in accurately diagnosing febrile illnesses―see a client complaining of fever, they often presumptively prescribe antimalarial medicines. The reverse scenario is also a common problem: pharmacists do not always give out artemisinin-based combination therapy (ACTs) when it is actually needed.

Pharmacists in Uganda

Pharmacists in Uganda assist customers with recommending antimalarial medications (Photo credit: Maddy Marasciulo-Rice, Malaria Consortium)

Presumptive treatment ― the overuse of antimalarials greatly increases the chances that malaria parasite resistance will develop and spread. In the future we might have one less weapon in our arsenal against these parasites. This overuse also means that the medicine is put over

How can rapid diagnostic tests (RDTs) help treat malaria?

Fortunately, rapid diagnostic tests, or RDTs, allow malaria to be diagnosed quickly, accurately, and cheaply, using only a drop of blood and a few drops of a solution. The problem is―there is no official quality control within the private healthcare sector―the pharmacists who provide the RDT to the patient have no way to choose a good RDT from the many options on the market and the wrong choice could lead to inaccurate diagnosis. Furthermore, many of the RDT sales representatives haven’t been trained to properly explain their product to their clients.

Challenges of RDT Training for Malaria in Uganda and Nigeria

RDTs to test for malaria and drugs to treat the disease are currently available in the private healthcare sector. However, there are several challenges to scaling up RDTs in this sector in Uganda and Nigeria.

1. Lack of training with Rapid Diagnostic Testing Materials

The primary barrier to appropriate care is the lack of training among pharmacists and RDT sales providers about how to use the test and interpret the results correctly to effectively diagnose and treat a range of febrile illnesses.

Malaria Consortium, based in the UK, is one of the world’s leading non-profit organizations specializing in the prevention, control, and treatment of malaria and other tropical diseases. Their projects can be found across twelve countries in Africa and Southeast Asia. The organization strives to find effective and sustainable ways to control and manage malaria through research, implementation, and policy development. They came up with the design for a plan that could greatly help manage the disease in both Nigeria and Uganda:

If the RDT sales representatives and RDT providers can be trained to correctly use the RDTs and recognize the symptoms associated not only with malaria but with other common illnesses, then the burden of misdiagnosis and mistreatment can be greatly reduced. Furthermore, as the sales representatives travel and frequently interact with providers, they can act as trainers and further disseminate the knowledge and skills necessary to accurately diagnose and treat these diseases.

2. Prohibitively high costs

The costs associated with arranging such a training are enormous―between transporting the students and teachers to a centralized location, renting a venue, arranging lodging, and coordinating a schedule, the budget for a large-scale training would quickly be out of control. Additionally, pharmacy owners and other stakeholders working in the private sector would most likely have to assume a loss of revenue during their time away from their business while at a training.

3. Technical limitations

An eLearning platform is much more ideal for these circumstances―it’s flexible, participants don’t need to travel far, you need fewer instructors, and the information can be processed at the student’s pace and repeated when necessary. The information is also standardized and consistent, which means that a large number of people can benefit from a high quality training experience.

 But how do you deliver an eLearning course when your audience has intermittent power and whose computers are not only often out-of-date, but lack the RAM, bandwidth, and software standards that such hi-tech learning platforms have come to expect?

eLearning Solutions for Reaching 3000+ Healthcare Providers for Malaria

Malaria Consortium partnered with TechChange to build a comprehensive digital course to train private sector health workers and RDT sales representatives in this context. This 11 module course includes around 400 slides for 6 hours of content takes participants through the biology behind the malaria parasite, discusses the medical philosophy behind diagnostic practices, and walks users through interactive scenarios for patients presenting a range of symptoms.

Testing TechChange Malaria Consortium modules in Uganda

Sales representatives and drug store owners in Uganda testing eLearning modules designed by TechChange and Malaria Consortium on rapid diagnostic testing for malaria. (Photo credit: Catherine Shen, TechChange)

1. Offline access and Ease of Use

Despite significant benefits such as flexibility and scalability, e-learning courses also face challenges in the developing world. Lack of sufficient internet bandwidth, reliable computers, and computer skills can pose major barriers to a training’s effectiveness.

To troubleshoot the technical issues, this course is designed to require nothing more than a computer and headphones – it comes preloaded onto USB drives so not even an Internet connection is necessary, allowing health workers in even the most rural areas to access this training. A computer tutorial is also included for health workers with little to no prior experience with computers. Our tech team is also devoted to helping solve any other technical issues that arise due to out-of-date software and hardware malfunctions, working as a remote IT team as Malaria Consortium rolls out the project.

 2. Localized content

In addition to including the relevant national laws, case studies, and local examples, the narration features Nigerian and Ugandan voice actors, art, and scenarios to make the training as culturally-relevant as possible.

 3. Hybrid learning

Only one part of the training won’t be computer-based; participants will still practice actually conducting the RDT tests in a face-to-face session before they begin pricking patient’s fingers for diagnosis.

The course is designed to reach upwards of 3,000 healthcare providers in the two countries and build their capacity to effectively serve their community’s needs. We look forward to seeing the impact of this training in improving quality of care in Uganda and Nigeria hopefully in the near future.

To learn more about TechChange’s custom training solutions, please contact us at info@techchange.org.

Emily Fruchterman, Catherine Shen, & Charlie Weems contributed to this post.

In a timely visit to Washington, DC that aligned with the 25th Anniversary of the World Wide Web, one of the handful of inductees in the Internet Hall of Fame, Marc Andreessen, dropped by 1776 for a fireside chat earlier this week. The co-founder of VC firm, Andreessen Horowitz, who has made early investments in high-profile tech companies including Facebook, Twitter, Pinterest, and Airbnb, chatted with The Atlantic’s Editor-in-Chief, James Bennet, and members of the DC tech community on a wide range of technology topics including the future of “Silicon Valley(s)”, bitcoin, drones, MOOCs and online education, and how technology will impact the developing world.

Here are five highlights of his views on the future of online education:

1. The world will be a better place when everyone is educated and online using cheap smartphones. According to Marc Andreessen, what will most profoundly change the world is for every kid on the planet to have a world class education. The developing world will benefit most from high quality education as this content becomes accessible via cheap smartphones, which we’ve already begun seeing earlier this year. The global economy could be growing faster if more people were educated.

2. In 20 years, online learning will completely dominate education of all levels.
With the exception of elite academic institutions such as the Ivy League (which would only continue to exist as a luxury good), online learning will take over many traditional schools. New software and educational content will be delivered online with the help of new devices. Also, for-profit businesses will play a big role in driving innovation in this space.

3. Great teachers and professors will continue to be central to online learning.
Despite all current and future technological developments in education, quality education will always depend on great teachers. With online education and edtech, the best teachers in the world will become available to more students. Marc Andreessen sees online education scaling like Hollywood, in that the best professors (as content producers) will be like the “Steven Spielbergs” of specialized topics that can reach huge audiences, or student populations.

 Marc Andreessen Twitter 2

4. Hybrid learning models have tremendous potential to make e-learning more social & engaging.
Marc Andreessen also spoke of the potential of hybrid learning models that could make the educational experience engaging. One of the best benefits of bringing education online is the ability to connect students via an online platform, regardless of where they are in the world. Experienced students of courses could tutor new students, which we have seen time and time again with the TechChange learning model when course participants become guest experts, and even course facilitators like Timo Luege. Other examples of engagement that can happen online with platforms like TechChange include crowdsourcing past study resources, video conferencing (which we do with our “Live Events”), and online social networking.

5. Successful online learning will require long-term investments
The opportunity for MOOCs and online learning is gigantic, but it won’t happen overnight. Andreessen Horowitz has been some in investment in Sebastian Thrun’s
Udacity. Marc Andreessen sees online education as a long-term investment.

 

What do you think? Can online learning really be scaled comparably to Hollywood? What are some examples of how online education in the developing world has already made an impact? What are the best hybrid learning models? Let us know in the comments, or tweet us @TechChange.

To check out the entire one-hour recording of the Marc Andreessen interview, please see the recorded session, courtesy of The Atlantic LIVE and The Atlantic Exchange here.

The Eck Institute for Global Health at the University of Notre Dame is launching a  pilot initiative with TechChange to experiment with blended learning online and offline on the topic of mHealth: Mobiles for Public Health. As part of Notre Dame’s continuing experiments of best practices in online and hybrid learning,  this initiative of the Master of Science in Global Health program will be combining an on-campus class on mHealth taught by Professor Joseph Bock with TechChange’s mHealth online course. According to Dr. Bock, “This pilot course is an exciting initiative and we are eager to promote it.”

Notre Dame’s Master of Science in Global Health program is sponsoring 11 students and program directors to join TechChange’s mHealth online course in conjunction with Professor Joseph Bock’s face-to-face offline mHealth class, which aims to equip students with technical knowledge to apply mobile and Information Communications Technology (ICT) for global health challenges. The school will be receiving data on the students’ participation on the course platform from TechChange, which along with their written assignments for the Master of Science in Global Health class, will factor into determining the students’ grades. As the students will be logged in and participating in TechChange’s online learning platform, Professor Joseph Bock will be meeting in person with the students weekly to discuss the content on the TechChange mHealth course and the professor’s assignments.

In partnership with the mHealth Alliance, TechChange has offered this mHealth: Mobiles for International Development online course four times since 2012.  The course, which has been mentioned in the New York Times, has welcomed over 450 doctors, nurses, community health workers, and global public health experts who regularly participate in this online course from over 75 countries. Participants have included representatives of organizations such as the World Health Organization (WHO), National Institutes of Health (NIH), Medicin Sans Frontieres (MSF) / Doctors Without Borders, Johns Hopkins Bloomberg School of Public Health, Cleveland Clinic, Global Health Corps, officials from ministries of health of several countries, and many more.

Notre Dame’s MS in Global Health students have been enthusiastic about beginning the mHealth course, which will run March 31 to April 25, 2014 – just before final exams and before the students travel abroad to pursue summer global health field and research projects. Several students plan on tying in their mHealth online learnings into their planned field work after this semester, including Michael Clark, who believes this mHealth course will help focus his current project to track mosquito-borne disease in Belize using a mobile database platform by meeting other global mHealth practitioners in the online class.

“The mHealth course will help focus my efforts in Belize as it teaches best practices learned through collaboration with local partners across the world,” says Michael Clark. “Further, I look forward to the invaluable tips for implementing ICT4D in previously technology-deprived areas, like rural Belize, that the expert lecturers and current global health practitioners will be able to provide.”

Jingmeng Xie plans to build upon her past experience at a Nairobi maternal health clinic (a Ford Family Program) by applying the content she learned in the mHealth classes to explore the roles mobile technology can play in public health. The MS in Global Health students, through the mHealth initiative, are diving deeply into the role that mobile data collection, electronic health records, and Information and Communications Technologies can promote better health for populations even in the most remote areas in the world. Another student, Thomas Ulsby, is preparing for his summer research trip to India where he hopes to learn how electronic reporting of blood glucose levels via mobile phones has impacted treatment plans for type I and type II diabetes.

We’re very excited to welcome these students from the University of Notre Dame and can’t wait to see how they’ll be applying their experience in mHealth to their summer field projects in India, Belize, Kenya, and beyond!

Interested in learning about mHealth this spring as well? Register now for our mHealth: Mobiles for Public Health online course.

 

We’re excited, honored, and humbled to be featured in Fast Company as one of the “best learning resources for aspiring social entrepreneurs”, with recognition for the “hybrid” online/offline learning category!

Here are some highlights from the article:

  • “Their open courses draw an international audience of participants, interested in social media and social change. They also create custom courses in partnership with organizations such as the United Nations, World Bank, USAID, UNICEF, Red Cross, US State Department, training student leaders in Pakistan, civil society leaders in Sudan, or international aid workers.”
  • “Nick Martin, one of the founders of Techchange, saw a growing need in his field for continuing professional education. “We took dozens of online courses from all kinds of providers and found that most of them were pretty awful. So we set out to build a model that was more social, interactive, scalable, and suited to the needs of the social change community.”

See the full article on Fast Company here.Fast company logo_blog post