LocalLens

LocalLens is a mobile app that facilitates citizen science-driven antimicrobial resistance monitoring within communities. Citizens crowdsource data on antibiotic availability, use, disposal, and resistance threats while participating in sample analysis, statistics interpretation, and public awareness campaigns. This grassroots, data-powered approach empowers communities to combat antimicrobial resistance from within.

The Team Lead for LocalLens is Anisia Kyebela, who has 8 years of experience building community engagement programs around public health issues in rural Africa.

The specific problem LocalLens is working to solve relates to gaps in data and community awareness and engagement around antimicrobial resistance issues in Tanzania. 

In Tanzania, accurate data on antibiotic use and resistance patterns outside of hospitals is scarce. However, studies show that over 60% of antibiotics are sold over the counter without a prescription. If left unaddressed, experts project that antimicrobial resistance could cause 23,000 annual deaths in Tanzania by 2050. 

On a continental level, the World Bank estimates that antimicrobial resistance could push up to 24 million Africans into extreme poverty by 2030. In Sub-Saharan Africa, common bacterial infections like pneumonia and diarrhea are among the top causes of child mortality, yet lack of data hinders effective response.  

Globally, the UN estimates that drug-resistant diseases could cause 10 million annual deaths by 2050 and squeeze $100 trillion off global GDP. The origins and spread of resistance are complex, exacerbated by factors like lack of sanitation, poor infection control, and overuse and misuse of antibiotics in humans and livestock across Africa and other developing regions. 

LocalLens aims to address major data gaps on antibiotic use practices and resistance patterns in Tanzanian communities to inform better policymaking.  

LocalLens primarily serves the approximately 230,000 rural communities across Tanzania, home to over 70% of the country's population. 

The solution addresses several needs of these communities. It seeks to provide access to hyperlocal data on antibiotic use patterns and resistance threats to empower communities to take ownership of mitigation efforts. It also aims to raise awareness on prudent use and disposal through culturally-relevant campaigns designed by community members themselves based on analyses of their own crowdsourced data.

To understand user needs, LocalLens is conducting field visits and focus group discussions with village health committees and other community stakeholders in 5 pilot regions. These gather insights on prevalent use behaviors, hygiene and disposal practices, as well as preferences for data visualization and campaign formats.

LocalLens will also establish an online user panel composed of 100 community members, health workers and leaders from the pilot regions to continuously solicit feedback during solution development and refinement over the next 3 years as the platform scales nationally.

LocalLens provides four key public goods as outputs of its work:

1. Open data portal: A publicly accessible online database will aggregate anonymized antibiotic resistance and use surveillance findings from across Tanzanian communities over time, identifying hotspots and trends. 

2. Training resources: Standard operating procedures, lesson plans and materials developed through LocalLens' community health worker training program will be available for wide replication and adaptation.

3. Behavior change materials: Educational plays, songs, posters and other culturally-tailored awareness resources designed by communities through the app will be documented and packaged for dissemination nationally.

4. Policy briefs: Regular issue briefs analyzing geospatial policy gaps, best practices and program optimization recommendations derived from LocalLens analytics and partnerships will be openly distributed to guide Tanzanian and African policymaking on prudent antibiotic use and resistance mitigation. 

By making knowledge, data and resources from its community-powered surveillance network freely available, LocalLens aims to be a catalyst for global progress against the growing threat of antimicrobial resistance at both local and continental levels.

LocalLens primarily serves the approximately 230,000 rural communities across Tanzania, home to over 70% of the country's population. 

By empowering these communities with hyperlocal data on antibiotic access, use practices and resistance threats, LocalLens expects to:

1) Engage 10,000 community health volunteers to establish an ongoing network of active AMR surveillance sites nationwide within 3 years, informed by ongoing digital training via the app.

2) Mobilize community-designed behavior change campaigns reaching at least 500,000 citizens annually with culturally-tailored messaging to optimize antibiotic access and demand prudent use. Studies show such peer-to-peer interventions can significantly increase appropriate medication practices. 

3) Inform national policy revisions like integrating targeted subsidy programs and prescriber protocols to address resistance hotspots identified through analytics of aggregated community data baseline. The WHO estimates such measures could avert up to 25% of unnecessary antibiotic use.

4) In independent research, subjects exposed to interactive data sharing platforms like LocalLens' reported feeling greater ownership over resolving issues affecting their health. By democratizing information and response, the app aims to tangibly impact stewardship from the ground up.

Over the next 1 year, LocalLens aims to:

- Pilot the full app in 3 new districts, training 100+ community health volunteers to establish additional data collection sites. 

- Refine analytics and interfaces based on 5000+ rural users' feedback to optimize usability and insights.

- Design and evaluate rollout of 2-3 community-led behavior change campaigns reaching 100,000 people that target top priorities identified through pilot data. 

Over the next 3 years, LocalLens plans to: 

- Scale nationwide by end of year 2, tapping 10,000 community health volunteers to establish sites in all 130 districts of Tanzania. 

- Partner with government and organizations to integrate 50% of sentinel sites' data and best practices into national policy by year 3, guiding more equitable resource allocation.

- Enlist 170,000 active users by year 3 to generate a robust, sustained data ecosystem and collectively design campaigns impacting 230,000 people annually through iterative improvements.

- Continuously build analytic and predictive capacity through integration of new data streams, powering increasingly targeted hyperlocal responses over time. 

By democratizing data and localization of solutions, LocalLens seeks to nourish a systemic yet grassroots fightback against growing AMR across Tanzania.

LocalLens is measuring success against our impact goals through both quantitative and qualitative indicators:

Quantitative:
- Number of community members registered on the app and actively contributing data each month  
- Volume of antibiotic usage data, environmental samples collected, and resistance patterns identified through community-generated reports
- Uptake and reach of behavior change campaigns designed and promoted via the app  

Qualitative:
- Community satisfaction surveys on the usefulness, usability and trust in the data being collected
- Focus groups and interviews with local stakeholders on perceived value of the surveillance insights for prioritizing response programs  
- Assessment of collaboration with local health departments on integrating community findings into formal reporting and planning

During our 6-month pilot project:
- Over 500 community members registered on the prototype app and submitted data
- 80% of survey respondents said they found value in seeing local antibiotic usage trends  
- Workshops with 20 village leaders informed the development of 3 behavior change campaigns 
- County health officials participated in analyzing aggregated pilot findings

We will continue to refine both qualitative and quantitative indicators quarterly to benchmark meaningful progress and share learnings as we scale our community-based AMR monitoring approach.

Over the next 1-3 years, key barriers for LocalLens include:

1. Infrastructure: Reliable mobile/internet access in remote areas could hamper app use. We will utilize offline data collection/sync when reconnected to minimize disruptions. 

2. Education: Low digital/health literacy may pose challenges. We will deliver in-person trainings with CHWs and offer ongoing local support via call centers. 

3. Cost: Sustaining network operations requires funds. We will pursue partnerships for integration into government programs and impact investment. Pilot cost-recovery models like subscription micro-payments. 

4. Policy: Data sovereignty/sharing policies could delay insights application. We will engage policymakers to establish favorable regulatory frameworks through participatory design workshops. 

5. Scale: Effectively incentivizing/supporting a large CHW network is difficult. A tiered responsibility-based model linking social recognition, skills development and microfinancing aims to optimize motivation.

By proactively addressing contextual constraints through adaptive, community-driven solutions we strive to successfully establish an impactful decentralized surveillance system nationwide. Partnerships will be key to overcoming barriers to scaling access and sustainably strengthening resilience.