Boresha Afya ya Msingi Vijijini

1. PROBLEM STATEMENT: Failure in primary health care system responsiveness in Tanzania, East African Community, and Africa as whole is due to limited investment in access to care through informed decision making.
   1. Scale of the problem locally and globally: many people particularly in rural setting lack adequate information and understanding about their health conditions. Health literacy levels in Tanzania are very low. For example in Tanzania we have 15.3 million doses of COVID 19 vaccines given only 10.5 million people are full vaccinated representing only 17 percent of the national population of approximately 60 million people. The majority of the unvaccinated are rural population. Longido District, Arusha Tanzania has an estimated population of 123, 153 people according to 2012. In three villages of Ketumbeine, Gelailumbwa, and Irkaswa EAHP sensitized a total of 4, 608 on COVID 19 vaccines, but only 34% equivalent to 1,568 were vaccinated during the campaign that lasted for three months March to June 2022. This shows high level health illiteracy and inadequate information to access healthcare services. Global trends show somewhat the same, 12.4 billion doses given, with 4.88 Billion people vaccinated representing 62.6% of world population fully vaccinated. 
   2. Factors contributing in accessible healthcare in rural setting include but not limited to health illiteracy due to lack accurate and time data and information on health situation of the population in rural setting.

SOLUTION: Boresha Afya ya Msingi Vijiji support the ability of the ministry of health to make primary health care equitably accessible to rural communities by availing timely data on diseases and the extent to which communities are affected and inform decision for provision of primary health care goods and services.

We provide real time information to the ministry of health - linked to public and private health facilities to offer timely equitable access to primary health care to rural communities, in the treatment of endemic and pandemic. 

TARGET POPULATION 

1. Rural Communities in need of primary health care goods and services but their state of health is not know by the ministry of health. 
2. Community Health Workers with community based health information but lack the means to deliver the same to the ministry of health for actions 
3. Health care facilities within or nearby target communities willing to offer primary health care goods and services but lack the information on the state of communities health.
4. Healthcare suppliers - medicines, vaccines, medical and laboratory equipment.

With Boresha Afya ya Msingi Vijijini, we are going to bridge the information gap for the ministry of health and health facilities to provide timely accessible and equitable primary health care goods and services to rural communities. 

Our vision is to scale up the project beyond Tanzania, to all seven East African Community (EAC) and the whole of Africa with a population of more than 1.3 billion people by using both offline data collection techniques complement with online data entry analysis and reporting of primary health data to the ministry of health and health facilities. 

Why Apply - Barriers

1. FINANCIAL: In EAHP pilot project to collect information on COVID 19 vaccination in three villages we spent $10,000 (This means $3,000 per village) to understand the state of primary healthcare in managing COVID 19, launch a campaign facilitate public hospitals to administer COVID 19 vaccines to 1,568 people out of 4,608 sensitized. The funds were not adequate to reach the remaining 3,040 people with vaccines which were available at the Arusha region Medical stores. To reach the remaining 12,317 villages (of which we had a budget of $10000 for three villages) we will have 4,106 groups of three villages each in the whole of Tanzania to collect healthcare data on accessibility and bridging the gap by bringing in the ministry of health to satisfy the needs of primary healthcare. may require an estimated $10,000  to include inter village, inter district and inter regional transportation associated expenses during data collection analysis and reporting to make a total of $41,060,000 to inform provision of healthcare services in the whole of rural Tanzania being able to to reach 20 groups of three villages each, an equivalent of 60 villages at a cost of $2,053,000, every two years.
2. TECHINICAL: There is a technical hurdle to collect, store, retrieve, analyze and report primary healthcare information to inform access to services. This barrier will be addressed through the use of digital devises and soft collect and store data offline and retrieve, analyze and report online a designated center. Purchase hard and soft ware to support primary healthcare data collection with aim of enhancing the ability to expand electronic information exchange for improved primary healthcare
3. LEGAL: Community Health Workers indicated that there are legal obstacles  in collecting, analyzing, reporting and sharing primary healthcare information. There is a need to work with ministry of health and ministry of justice to eliminate hurdle in generating and sharing primary healthcare information for informed access and delivery of primary healthcare services. 
4. CULTURE: Delivery of cultural competent healthcare to a number of minority communities in rural setting in terms of access to and understanding primary healthcare information for informed decision on primary healthcare. In addition communication problems in verbal and non verbal interaction that need to bridge in primary healthcare service delivery.
5. MARKET: Primary Health Care in Tanzania covers almost 95% of the total population. It is important therefore, to generate information on the quality of infrastructure development to improve health service utilization and quality of service delivery.  

BORESHA AFYA YA MSINGI VIJIJINI INNOVATIVENESS 

COVID 19 taught us a lesson on level of stress primary healthcare service delivery. And how important it is to revitalize community based primary healthcare system. Prevention, Testing, and Management of cases at primary level is challenging and dependence on secondary level primary healthcare is ineffective. Thus collecting, analyzing, reporting and sharing primary healthcare system to relevant stakeholders to include ministries of health, health financing institution will enable countries to position themselves in a position in disease control in a well designed and operational primary healthcare systems.   

BORESHA AFYA VIJIJINI IMPACT GOALS 

1. Provision of informed and timely comprehensive, systematic and optimized primary healthcare service delivery that promote, prevent, cure and rehabilitate rural communities in a more accessible and equitable manner.

1. The extent to which health decisions are informed for comprehensive, systematic, and optimized primary healthcare service delivery that promote, prevent cure, rehabilitate rural populations.

1. IMPACT: Health and product African Regional Population.
2. OUTCOMES: Accessible and Equitable Comprehensive, Systematic, and Optimized Primary Healthcare Service delivery that promote, prevent, cure and rehabilitate rural communities populations.
3. OUTPUTS: Functioning primary healthcare systems  supported by local, national and international partners able to create public awareness - health literacy of preventable illness and empowering rural communities.
4. ACTIVITIES: Generate and make use primary healthcare information among local, national, and international partners for government, Primary Healthcare Service Providers, Manufacturers and suppliers of medicines, medical and laboratory equipment and devices for improved service delivery.    

1. GO-SURVEY - An offline software for data collection software based on a designed questionnaire. Collects data without internet and later upload data using internet into cloud and then convert into Microsoft excel for download and further analysis.
2. MOBILE TECHNOLOGIES - use of iPad, Tablets, and phone devices to install the software with questionnaire for data collection. 

Data will be collected by Community Health Workers (CHW). They will collect data using mobile devices (mobile phones or tablets) that can both be used offline and online using data collection software (Go Survey) installed in those devices. The data collected will be uploaded into clouds analyzed and shared with the ministry of health and respective primary healthcare facilities for action. 

CHW's in EAC region are integrated into the National Health System meaning that they are in the payroll. This financial incentives need to be complemented with non financial incentive the like of public recognition of their effort in provide health information to the ministry of health primary healthcare facilities to increase their responsiveness in addressing health problems, preventing, controlling, and curing diseases.  

DIVERSITY EQUITY AND INCLUSIVENESS 

1. Boresha Afya ya Msingi Vijijini is designed to capture and satisfy the needs of marginalized rural communities in terms of access to equitable primary healthcare to both men, women, girls, boys, young and old.
2. The solution team management has two male and two female.
3. Data collection to inform primary healthcare service delivery will be disgregated by sex and gender to ensure inclusivenes.    

BUSINESS MODE 

VALUE PROPOSITION 

1. Government - through the ministry of health - will be able to get reliable and accurate data on the state of primary healthcare in rural setting to make informed decision to promote, prevent, cure and rehabilitate peoples health 
2. Manufacturers and suppliers of medicines, vaccines, medical and laboratory equipment, and devices will be access the market to supply goods and services for improved primary healthcare in the regions. 
3. Community Healthcare will be employed for data collection and they will participate in provision of primary healthcare from an informed point of view 
4. Rural communities populations - Access to equitable primary healthcare services to be healthy and productive. 

BORESHA HUDUMA ZA AFYA YA MSINGI VIJIJINI SOLUTION  BUSINESS MODEL

EAHP has an already piloted e - learning platform known as ujuzi.health. This platform is designed provide digital courses for health professionals in the East African region at fee, in addition to hosting health events and performing primary health research  consultancy all at a fee. All this intervention will be designed based on primary health information generate to inform engagement with local and national and international partners. Please refer to the piloted ujuzi.health through this link  https://ujuzi.health/

SOLUTION SUSTAINABILITY 

We have just passed the pilot phase and we are working on the business plan for the e - learning platform ujuzi.health to inform future viability.