ChatCare: Combating AMR at the Grassroots

ChatCare harnesses the power of AI chatbots on social media to gather real-time data on antibiotic use and infections directly from communities. This data feeds into DHIS2, empowering early detection, targeted interventions, and data-driven policies to curb Antimicrobial Resistance (AMR) in low- and middle-income communities.

Mahoro Gloria is an Assistant Lecturer at the Department of Biological and Environmental Sciences with a MSc in Environmental Management and BSc in Environmental Management of KIU.

Antimicrobial Resistance (AMR) poses a severe One Health threat in low- and middle-income communities (LMICs), jeopardizing health, food security, and environmental well-being. This is further exacerbated by:

• Limited data: Current data on AMR and antibiotic use heavily relies on high-income settings, neglecting crucial community-level insights in LMICs.
• Inadequate surveillance: Early detection and intervention are hindered by weak surveillance systems, leading to widespread antibiotic misuse and increased AMR development.
• Unequal access to information: Communities often lack comprehensive health education, contributing to improper antibiotic use and fueling AMR.

Globally, 4.95 million deaths are annually associated with AMR, with 1.27 million directly attributable to antibiotic resistance. This number is projected to reach 10 million by 2050. 24 million people could be pushed into extreme poverty by AMR by 2030.

LMICs are disproportionately affected, lacking robust healthcare systems and facing challenges like poverty, malnutrition, and overcrowding, which accelerate AMR spread.

ChatCare aims to improve AMR surveillance, empower communities, and inform data-driven interventions, potentially impacting millions of individuals in LMICs by:

• Reducing unnecessary antibiotic use through education and early detection.
• Facilitating timely treatment for potential AMR infections.
• Informing public health policies based on accurate community-level data.

ChatCare serves individuals,  healthcare providers, decision-makers and communities residing in low- and middle-income settings (LMICs), disproportionately affected by the silent threat of Antimicrobial Resistance (AMR).

Addressing pressing needs:

• Limited health information: ChatCare bridges the knowledge gap by providing accessible and culturally relevant health education directly through social media.
• Ineffective surveillance: By gathering real-time data on antibiotic use and potential infections, ChatCare empowers early detection and intervention for potentially AMR-related illnesses.
• Unequal access to healthcare: ChatCare connects individuals with timely follow-up if needed, promoting access to appropriate care.

Understanding their voices: 

• Community workshops: Gathering feedback and insights on local needs and preferences for chatbot design and health information delivery.
• Partnerships with local NGOs and healthcare providers: Ensuring our solution aligns with existing healthcare structures and community contexts.
• Culturally tailored communication: Developing chatbots that understand local languages and dialects, fostering trust and inclusivity.

Engagement beyond development: 

• Beta testing: Inviting community members to pilot the chatbot and provide feedback for continuous improvement.
• Community outreach: Utilizing local communication channels to raise awareness about AMR and ChatCare's role in addressing it.
• Transparency and feedback mechanisms: Allowing users to share their experiences and suggest improvements.

ChatCare is designed to be globally accessible, utilizing readily available technologies like social media. Its open-source approach and partnerships with local NGOs ensure fair and non-discriminatory implementation. The solution prioritizes sustainability through local capacity building and integration with existing healthcare systems.

ChatCare provides accessible and culturally relevant health information directly to individuals in LMICs through social media chatbots. This empowers them to make informed choices about antibiotic use, hygiene practices, and seeking timely healthcare for potential infections.

By identifying individuals with potential AMR infections through AI analysis, ChatCare facilitates early diagnosis and treatment, reducing the risk of further spread and improving individual health outcomes. This empowers communities to participate actively in combating AMR.

ChatCare fills the critical gap in community-level AMR data, informing global research and efforts to combat AMR. This shared knowledge contributes to developing better diagnostic tools, treatment strategies, and prevention measures.

By educating individuals and empowering communities, ChatCare contributes to reducing unnecessary antibiotic use, a key driver of AMR development globally. This collective effort benefits public health worldwide.

Impact on Individuals:

• By identifying potential AMR infections early, ChatCare facilitates timely diagnosis and treatment, reducing complications and mortality.
• Reduced healthcare costs: Early intervention can prevent the need for more expensive treatments and hospitalizations.
• Improved quality of life: Timely treatment translates to less suffering and faster recovery for individuals and their families.

• ChatCare provides accessible and culturally relevant information on AMR, antibiotic use, hygiene practices, and seeking healthcare.
• Individuals are empowered to make better decisions about their health, contributing to prevention and responsible antibiotic use.

Impact on Communities and Public Health:

• Real-time insights from ChatCare empower health authorities to design targeted interventions based on specific community needs and emerging trends.
• Data analysis informs the development of effective policies on antibiotic stewardship, infection control, and public health campaigns.
• Improved surveillance and data collection enhance the ability to track and control AMR spread within communities.
• ChatCare contributes to building local capacity by training healthcare workers and fostering community engagement.

Evidence and Logical Links:

• Pilot data: Initial testing demonstrated successful identification of potential AMR cases and positive feedback on health education.
• Research on AI-powered interventions: Studies highlight the effectiveness of chatbots in delivering health information and promoting behavior change.

Over the next 12 months we seek to partner with leading NGOs that work with community health workers to build an adapted version of the chatbot, which will be tested and deployed at the field. Our key objective will be to achieve proof of concept among CHWs and drug shop dispensaries for our solution. This entails testing, deploying and validating our solution together with strong partners on the ground. Our focus will be on Sub-saharan Africa.

We shall also seek to test a specialized version of the Chatbot among a small amount CHWs, drugshop dispensaries and health facilities. We start with roughly 100.000 people to be served by the above-mentioned stakeholders. We will have gained first insights and set up an infrastructure, which will allow us to modify and further adapt ChatCare to improve decision making and referrals. 

Over the next 3-5 years we seek to reach over 20 Million people, directly as the platform users as well as indirectly through frontline health workers. In addition, we aim to impact lives positively, through the use of patient analytics and aggregated, real-time populations insights, which allow for effective outbreak control.

Individual Level:

• Number of individuals identified with potential AMR infections through ChatCare, leading to timely diagnosis and treatment. 
•  Increase in knowledge and understanding of AMR, antibiotic use, and hygiene practices among users, measured through surveys and focus group discussions.
• Decrease in self-reported anxiety related to potential infections and healthcare access, assessed through surveys and qualitative interviews.

Community Level:

• Volume and quality of data collected on antibiotic use, risk factors, and potential infections from diverse community members.
• Implementation of data-driven interventions based on ChatCare insights, such as targeted public health campaigns or improved infection control measures.
• Number of individuals actively using ChatCare and participating in health education activities.

Public Health System Level:

• Enhanced understanding of local AMR trends and emerging threats through real-time data and improved data integration with DHIS2.
• Development and implementation of evidence-based policies on antibiotic stewardship, infection control, and public health campaigns informed by ChatCare data.
• Increased capacity of healthcare workers to utilize data and technology for AMR control through training and capacity building programs.

Finally, impact is and shall also be measured based on number of subscribers, engagements, awards, grants, partners both from the private and public sectors, feedback from users etc.

Limited tech literacy by end-users, limited access to hardware, power outages, and unreliable connectivity present infrastructural barriers. Reliance on paper, and potentially unsupportive leadership present system-based hurdles. We are also trying to develop a platform that can be used universally while adapted to unique contexts and jurisdictions.

Access to partners: Our solution to build and test a specialized version of the chatbot for CHWs and drug dispensaries will only succeed by forming relevant partnerships with NGOs and foundations, in order to start implementation. The Trinity Challenge network would be of great support to connect us with the its community of investors and well as connect with the Solve Community, so we can explore further collaboration opportunities.  

Financial support, and technical support are also crucial areas that require a serious break through in order to move the project forward. For this, we shall continue lobbying for financial support from the government and key health partner NGOs we know. We shall also continue engaging in grants competitions such as The Trinity Challenge to compete so that we may be able to win grants and access a network of both investors and technical support networks that might help to push us forward.

CareChat is thrilled to apply to The Trinity Challenge, recognizing its unique potential to propel our solution forward and significantly contribute to the fight against antimicrobial resistance (AMR).

CareChat's mission to empower communities and save lives through early detection and prevention of AMR aligns perfectly with the Trinity Challenge's goals. Our AI-powered chatbot and data-driven approach offer a promising solution to address the growing threat of AMR in LMICs.

Trinity Challenge Support:

The Trinity Challenge presents a game-changing opportunity to overcome these barriers:

1. Financial Support: We seek funding to replicate our successful model in 3 new regions, potentially reaching 250,000 users within the next 2 years.

2. Research Partnerships: Connecting with research institutions within the Trinity Challenge network would provide invaluable expertise in data analysis, enabling us to glean deeper insights and inform public health interventions.

3. Policy Advocacy Network: The Challenge's network and expertise can significantly amplify our voice in advocating for policies that support and incentivize digital health solutions for AMR control.

Impact Potential:

• Reduce antibiotic misuse by 30% in target regions within 3 years.
• Identify 10,000 potential AMR cases annually, enabling early diagnosis and treatment.
• Develop a sustainable funding model for long-term impact and wider adoption.

We shall seek partnership with Google, Bill and Melinda Gates Foundation, Facebook. This partnership shall solely be for the following goals.

• Peer-to-Peer Networking
• Organizational Mentorship
• Impact Measurement Validation and Support
• Media Visibility and Exposure
• Grant Funding
• Develop prototypes of the chatbot tool adapted for use among different types of semi-skilled health workers