A community-led monitoring digital application developed by ASD in association with Dure Technologies to empower people affected by TB to claim their rights and generate essential information and data to improve care and support service access, coverage, and quality. The CFCS (Round-9) has supported the adaptation, piloting and evaluation of “OneImpact” use and staff led engagement of TB survivors at six public BMUs in a selected district of Punjab (Nankana Sahib), Punjab, and CFCS (Round-10) has supported its scale up at 10 PMDT sites for DR-TB care. The evidence suggests the digital application to be acceptable, feasible (both for providers and patients) and effective as community engagement tool in local socio-cultural context. The application has five main features: 1) Get Information: Information content (disease, care, and prevention) for a person to access online, as and when deem needed; 2) Get Involved: An opportunity for people with TB and DR-TB to report (online) challenges faced in their access or availing of care at respective BMUs and PMDT sites; which in-turn forms basis of facility level action to make TB care responsive to patient needs; 3) Get Connected: An opportunity for people with TB and DR-TB to seek peer support for practicing the recommended treatment and/or transmission prevention protocols and/or addressing social challenges to seek/adhere TB and DR-TB care at public BMUs and PMDT sites; 4) Get to know your rights: A section that details the rights of people living with TB and DR-TB according to the regional and international laws: and 5) Get Access: A section that offers locating that helps users find nearby health facilities and provides information about the facilities.
A local tailor-made digital application developed by ASD (as funded by TB Reach Wave 7) to refer individuals with symptoms for testing at program-endorsed facilities. The digital application developed locally and initially was used by allied providers to refer people with symptoms for smear-testing at designated private laboratories. The application has three main features: 1) BHU staff enters the core details of a person with symptoms getting referred for smear-testing at a designated BMU and the respective BMU staff gets the information in-advance about the referred person (with symptoms); 2) The referred patient gets entertained, as he/she arrives the BMU that includes patient: clinical examination; smear-testing; and additional investigation, as deem needed (e.g., CXR). Those diagnosed TB get registered; and others advised/offered non-TB clinical care, as needed; and 3) The referred individuals failing to reach BMU get tracked and followed (by BMU or project staff) for their assessment at BMU.
In light of encouraging initial experience with allied providers in terms of the EngageAll application, it was further adapted on the request of the program and tested for the BHUs to refer patients with symptoms to get tested (diagnosed and treated) at respective BMUs. The digital application, BHU-BMU TB Linkage, was adapted and piloted, in partnership with Punjab TB control program, in two selected districts of Punjab. The application has three main features: 1) BHU staff enters the core details of a person with symptoms getting referred for smear-testing at a designated BMU. The respective BMU staff gets the information in-advance about the referred person (with symptoms); 2) The referred patient gets entertained, as he/she arrives the BMU. This includes patient: clinical examination; smear-testing; and additional investigation, as deem needed (e.g., CXR). Those diagnosed TB get registered; and others advised/offered non-TB clinical care, as needed; and 3) The referred individuals failing to reach BMU get tracked and followed (by BMU or project staff) for their assessment at BMU.
On the need for technology assisted care-link between BMUs, Xpert sites and PMDT sites (identified by PTP), ASD developed BMU-PMDT Linkage, a response – tailor-made digital application developed (through IT vendor) and piloted in 2 districts. The application helps in engaging TTAs in sample-transport role from BMUs to respective Xpert and PMDT sites for universal Xpert testing of TB patients.
Prevent TB Pakistan is an electronic medical record (EMR) application for management contact screening and TB preventive treatment data. Apart from data management, the application has Knowledge section that can be used by facility staff for guiding contacts on TB screening and TB preventive treatment. The application also generates alerts for TB screening, TB testing and TB preventive treatment follow-ups.
EngageAll NCD Pakistan is a digital health application developed by Association for Social Development (ASD), to enhance and support community-led NCD care. This application aims to promote human rights-based, people-centered approaches to care, advance community-driven responses, and improve access to and the quality of services. It incorporates: 1) Get Information: Provides knowledge about NCD/COVID-19 care; 2) Get Involved: Facilitates users to report medical complaints and care challenges; 3) Get Connected: Connects peers within the community to discuss and address care challenges; 4) Tele-consultation: For patients to seek medical support from healthcare staff; 5) Get Access: A service locator app that helps users find nearby health facilities and provides information about the facilities and; 6) Get to Know Your Rights: Details the rights of people living with NCDs according to the regional and international laws.
ASD, in consultation with the NCD program, updated the existing EMR (with assistance from the Punjab Information Technology Board (PITB)) on the basis of a few important indicators and fields (on which data is to be reported) for monitoring care performance at primary healthcare facility and district levels (as funded by WDF). The updated EMR records and maintains all the clinical data recorded on the NCD cards, and has turned out to be efficient, feasible and replicable.