SPAQ

Neglected Tropical Diseases (NTDs) are widespread in 149 countries and regions around the world, and the number of infected people is about 1 billion. In addition, two types of NTDs are prevalent in 100 countries and regions, and more than six types of NTDs are prevalent in 30 countries and regions.

In the Democratic Republic of the Congo, 17 NTDs are covered by multiple programs by the Ministry of Health. Initial diagnosis is often made by community health workers (CHWs) in the community, as outbreaks of the disease are infrequent and need to be detected quickly. Each program or campaign trains CHWs, but it is difficult for CHWs to properly carry out the defined process, because of the low frequency of each illness, the need to deal with many types of illnesses, and the need to report in different formats for each program.

The report is sent from CHW to the health area, health zone, provincial department of health and the Ministry of Health, but since it is basically reported on paper, it is very time consuming and the information is inaccurate. The lack of therapeutic agents frequently occurs because the therapeutic agents stored at the health area and health zone levels are not well managed in the field, and information management and coordination are not sufficiently functioning.

As a result, there are major challenges in the rapid and accurate diagnosis of illness, appropriate treatment, data management and quality of community awareness.

SPAQ is a digital health platform with smartphone apps and cloud web apps. By combining it with a label or personal ID card with a QR code, it is possible to handle a large amount of data appropriately and realize digital transformation of the process corresponding to NTDs.

At the CHW level, indicators to be confirmed in interviews/diagnosis with villagers (patients) who complain of abnormalities are displayed in screen, and necessary photos and other data are acquired by CHWs. The smartphone app suggests whether it is necessary to report to the health area or health center based on the algorithm. The recorded data is linked with the patient's personal information and stored in a cloud database. Information that patients and their families should know is stored as text and video data on smartphones for each disease, and it is possible to provide standardized knowledge regardless of the quality of CHW.

At the health area and health center level, medical workers will be notified in the event of an abnormality. If uncertain, it is possible to share patient medical data and seek instructions from a specialist through telemedicine. Data can be saved by associating the diagnosis contents and the treatment performed, including the prescription of the medical drug, with the patient ID. Data on prescription medications and consumables used are also stored.

In the health zone and the state health department, the above data can be statistically analyzed, and the usage and stock status of consumables can be confirmed in real time. Based on this information, it is possible to supply necessary goods and execute, monitor and evaluate plans for infectious disease control.

Target users are CHWs and nurses in small health centers without doctors. Currently, there are not enough training opportunities and resources, and it is required to handle a wide variety of tasks. Smartphone apps support and confirm their diagnostic process. If they still have questions, they can remotely seek advice from a specialist in the city. The one-stop app eliminates the need to manage multiple report formats, and the data entered into the app during the patient diagnosis process automatically becomes the report. The enhanced drug and consumables management system will enable the prescription of appropriate drugs after diagnosis.

The beneficiaries are patients with NTDs. Diseases that were left unattended until they became severe can be treated early by improving the quality of the initial diagnosis of CHW. Digitized educational materials allow patients to have more accurate knowledge. This has not only a medical benefit but also a social impact such as discrimination. By improving the quality of coordination, it is possible to realize the stock of necessary medicines and prescribe the necessary medicines in a timely manner.

The Ministry of Health of the Democratic Republic of the Congo and SOIK have signed a public-private partnership partnership agreement. As an official technology partner, SOIK has signed a contract to jointly work on innovation through digitization in the field of health, and is in a position to be easily involved in innovation of the public health system regarding rare diseases. Regarding the functions related to SPAQ's maternal and child health services, which are ahead of the others, more than 2000 prenatal medical examinations have already been conducted at more than 10 medical facilities, and there is already some commercial track records as well. Through this experience, there is a human network to the central government, state health departments, health zones, health areas, health centers, CHW and even communities. SPAQ enables to connect each layer digitally and to manage databases related to obstetrics and vaccination status.

Through the activities so far, the central government, the state health department have repeatedly requested to consider the digitization of infectious disease surveillance systems, especially NTDs. For this reason, we have been investigating local issues and examining specifications with the Program National de Lutte contre les Maladies Tropicales Négligées à chimiothérapie préventive (PNLMTN), a program of the Ministry of Health in charge of NTDs. Currently, some functions are ready as prototypes, and we are planning to start the first pilot project in this September.

The first is to add functionality to the current prototype to develop a product that can be piloted. The second is to use the product and carry out pilot activities with the Ministry of Public Health in DRC. It is expected that the funds for that will be obtained from this challenge.

Also, with the Advisory team of the Challenge, we would like to take advantage of the experience of other innovative solutions to improve product specifications and develop business models.

Above all, the health ministry officials are concerned about the current reporting system. CHW, health center, health area, health zone, state health department and each report will be published in paper format, but it will take a very long time and the data will be inaccurate. With the system using a smartphone, the data input by CHW can instantly obtain accurate information at each layer of the system.

The second is to improve the quality of business through the digitization of CHW's business tools. With the digitization of community awareness content, quality will be uniform and improved. The diagnosis support application will also make the contents of the diagnosis uniform. It is especially useful for diagnosing rare diseases that one CHW cannot experience many times.
Finally, make it an integrated platform for multiple NTDs programs. As a result, CHW's operations will be greatly simplified, and the data that has been collected separately will be unified. This will make it easier to carry out cross-program NTDs cross-sectional responses and campaigns.

During the next year, pilot applications will be introduced in the three target states of the Democratic Republic of the Congo. Initially, morbidity is expected to increase as NTDs, which have been overlooked so far, are discovered by improved diagnostic ability. However, it is expected that the number of cases will decrease in about 3 years because appropriate treatment will be given after the discovery. After that, community-level deaths will decrease and life expectancy will increase in the future.

Number of SPAQ installations

Population of the target community
Number of CHWs that can be diagnosed with a certain level of quality
Number of CHW reports submitted by the deadline
Incidence and morbidity of 17 target NTDs
Number of appropriately treated NTDs

Combination of to G and to B. 

We are already financially sustainable.

The provincial government of Kwango in DRC has secured its budget to expand our solution among 32 health centers.