Digital health

- Development of software to enable the modelling of long-term early warning systems (taking into account short-term early warning systems and disease surveillance). This open-source platform is integrated into a database of climate and health data currently used by countries.
- An integrated surveillance database on climate change and human health has been created using data from national and international sources.
- A digital atlas, which also serves as an integrated database on climate and epidemiology, has been created to illustrate the results of the software’s projections. The atlas allows users to view the results of the projections on maps according to various parameters (e.g., health impact, time horizon, country and climate scenario)
- Improved knowledge and understanding of the relationship between climate change and human health, through capacity building of human resources in climate adaptation within the health sector, and the sharing and dissemination of knowledge products and the promotion of advocacy.

The technical assistance supported the Ministry of Health in leading a participatory and inclusive process aimed at developing the National Digital Health Policy and Strategy, as well as a costed multi-year operational plan, aligned with national priorities for strengthening the health system and international standards.
Results:
1) Development and validation of a comprehensive National Digital Health Policy and Strategy document defining a vision, mission and strategic objectives, based on an in-depth analysis of the existing landscape and a gap analysis.
2) Definition of a national digital health conceptual architecture including key components (electronic health records, central registries, hospital and laboratory information systems, PACS, public health systems, telemedicine solutions and data exchange platforms), along with clear guidelines on interoperability, technical infrastructure and data governance.
3) Development of a costed multi-year operational plan setting out short-, medium- and long-term priorities, budgetary requirements, the human and technical resources required, institutional responsibilities, identified risks and mitigation strategies, incorporating legal, regulatory, data protection, equity and inclusion considerations.

This Technical Assistance (TA) aimed to support the Food Security Commission (CSA) in establishing a reliable monitoring and evaluation system that meets international standards.
Results:
1) The TA developed a general M&E manual and five specific manuals for the operational bodies of the national food security system (DNSA), which served as the main source for the development of the national IT platform.
2) The M&E system is operationalised across all stakeholders in the National Response Plan (NRP) so that the CSA can report on the results of the various stakeholders’ interventions at the end of the campaign.
3) The establishment of an online DNSA M&E IT platform enabling the updating of and access to real-time analysed data on the situation, operations and activities of the food security system to assist and support steering and management decisions.

Establishment of a health information system designed to support the development of sector-specific health policies and strategies, the allocation of human, financial and material resources, the monitoring of the population’s health status (epidemiological situation), and the ongoing assessment of curative and preventive health services in terms of quantity and quality.
The expected outcomes of this project related to the implementation of the electronic health record (EHR) across departments and services at the pilot sites:
1) The EHR centralised patient data, enabled clinical documentation and incorporated decision-support tools.
2) It was interconnected with auxiliary systems (laboratory, radiology, etc.) and existing applications to ensure a seamless exchange of data.
3) Access to the EHR was secure and personalised according to the roles and needs of medical staff.
4) EHR data was anonymised and transferred to a national decision-making system for analysis and continuous improvement.

The Cardiovascular Disease Diagnostic Centre at Shastin Hospital received technical support. The aim was to improve the early treatment of diseases and reduce the need for costly and unsustainable treatments. A mid-term evaluation was carried out to assess the use of telemedicine and distance learning in achieving these objectives.
The results were:
1) The project assessed and improved the state of equipment and skills in interventional cardiology, strengthening regional capacity for telemedicine and distance learning.
2) An evaluation and analysis of training initiatives for cardiologists and the effective use of the medical records system were carried out.
3) A SWOT analysis assessed coordination among stakeholders, and the evaluation report highlighted lessons learnt and paved the way for the replication of best practices, whilst assessing the project’s relevance, effectiveness, efficiency and sustainability.

- Oversight of a surveillance system for the COVID-19 pandemic as part of the Pandemic Action Plan (PAP), in close collaboration with the National Emergency Management Agency and the Ministry of Health.
- Implementation of digital tools to plan and monitor Covid-19 activity in real time, using data dashboards, migration maps, travel histories, and real-time data from smartphones and wearable technology.
- Implementation of an AI-powered tool for screening individuals for infection.
- Piloting of contact tracing to enable individuals to check whether they have been in contact with an infected person, using geolocation systems, mobile phone apps, and real-time tracking of mobile devices and the use of credit cards, mobile payments and other digital personal identifiers, whilst respecting individuals’ privacy.

The overall objective of the ACA mission was to support the implementation of the PBF in five health districts in accordance with the national Performance-Based Financing (PBF) manual.
The results were as follows:
1) Contribute to strengthening the National Health Information System (NHIS) and integrating data on the use of health services into the DHIS-2 portal.
2) Negotiate and develop contracts with service providers in the region, in accordance with the national PBF manual.
3) Conduct audits of the quantitative results of contracted service providers, carried out by medical auditors.
4) Participate, alongside regulatory bodies and through coaching, in improving the quality of services provided, in accordance with the quality of care standards established by the Ministry of Health and Population.