By Hailemariam Kassahun, System Strengthening and Quality Assurance Director 

The conflict in northern Ethiopia has severely impacted accessibility of essential health services, with widespread damage to infrastructure and removal of hardware used to document and report health care data.  Damage to health management information system (HMIS) infrastructure and tools have made access to medical information impossible, and clinical decision-making increasingly difficult. As a result, clients, and particularly those living with chronic conditions requiring streamlined care continuums, are left with inadequate care.

The USAID-funded Digital Health Activity (DHA), with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), designed and deployed an electronic emergency response reporting tool (ERRT). The ERRT is built on an open-source platform from Metabase.  As an interim solution, the tool is designed to increase availability and utilization of high-quality data on HIV care and treatment and other essential services in health centers and housing locations for internally displaced people in conflict settings, until routine services are restored. 

Health centers and hospitals under emergency status were provided mobile phones and training on a platform called Open Data Kit, a data collection tool. Using these resources, health workers in conflict zones can submit client data on a weekly basis to the central emergency response database. The data allows regional health bureaus and the Ministry of Health to receive critical information, particularly around supply needs in these settings. ERRT is also customized to provide data analytics, visualization, and generate reports during emergency response situations.

Sample Dashboard shows trends in the number of facilities reporting on emergency indicators in Tigray Region.

Prior to ERRT, the national health sector had no data on clients in chronic care requiring medical management in conflict-affected settings. The tool enabled the national health sector to identify the number of individuals requiring treatment for TB, hypertension, HIV, etc. To date, the system enabled 78.2% of clients lost-to-follow-up during conflict in Tigray to reconnect to HIV care and treatment. 

Further, 1.1 million client records in Ayder referral hospital were scanned and sorted into an electronic medical records system implemented by DHA. The Activity also restocked the health facility with equipment stolen or destroyed during the conflict. These infrastructure improvements enable momentum toward a digitized health care continuum in the very near future. 

Before and After Scene in record room at Ayider Hospital, Mekelle, Tigray Region. 

The success of this intervention highlights the importance of investing in digital tools to strengthen health systems and improve health outcomes, particularly in crisis situations.