Maxmilla Kangechi has brought her two and a half year-old daughter Brandy at the Beyond Zero health facility Makina, Kibra for treatment. The young one has not been feeding well, is feverish and her eyes are sore. At the health facility she is attended to by Waida Kasaya, a clinical officer who diagnoses and prescribes treatment for Malaria. Waida says that usually parents would tend to ignore minor symptoms of ailment that their children would exhibit though its necessary to go for check up.
“A parent won’t normally bring their children to the clinic when their eyes are sore or teary. To them these are just mild symptoms that would go away with time, but with fever and loss of appetite they would show up. For children, the so called minor symptoms may be a hidden illness that needs check up,” she says .
Private health care providers (PHCPs) in Kibera informal settlements usually operate from small clinics or chemists and they are often the first source of care for a sick child. Parents of sick children who seek care from these PHCPs may receive an incorrect diagnosis and inappropriate counterfeit medication. Referral systems for children who fail to respond to treatment are weak or non existent and little effort has been made to constructively engage these PHCPs in ensuring that these highly marginalized children living in slum area have access to quality basic health services.
Solution for diagnosis and treatment
The introduction of MEDSINC, a web enabled health platform has enabled Waida and other medical practitioners issue a correct diagnosis and treatment of children in their different medical institutions.
“The Medsinc app was launched in 2017 and so far it has given us a good experience as the medical officers. It has eased our work due to the steps structured to be followed when attending to a patient as well as making a correct diagnosis. We can also attest that it has instilled discipline to the clients who prefer over the counter medication,” says Agnes Obanda, a facilitator at the Ministry of Health, Kibera Health Center.
The gadgets were distributed by Save the Children in partnership with THINKMD, a University of Vermont affiliated social impact benefit corporation and healthcare technology company to enable access to quality health services and especially in urban informal settlements.
It is fully functional with or without access to cellular connectivity. The facilities involved in this project are trained on how to use the tablets when attending to the patients. “The tablet is easy to use and isn’t different from how we were taught to initially use it It’s like having most of your medical tool kit at the palm of your hand,” said Peres Odero, a community health worker.
The app has proprietary platform logic guided by World Health Organization (WHO) algorithm used for integrated management of newborn and childhood illness (IMNCI) together with evidence based medicine to facilitate non physician health workers inpatient assessment using the same logic and approach as physicians do. As a result, it creates WHO’s IMNCI compliant assessments, triage, treatment, and follow up recommendations especially for the 5 named killer diseases.
“For the longest time, diagnosis of pneumonia was a challenge. Initially we used to miss out on proper diagnosis of pneumonia either just terming it as URTI or sometimes misdiagnosing it. But now we can properly distinguish between pneumonia and a common flu with the gadget. We can also diagnose other conditions like anaemia,” said Wilfred Riungu clinical nurse, Beyond Zero clinic in Gatwekera, Kibera.
The reception of the digital tool by the parents, however, is sometimes good but not completely as others think it is unprofessional to use it. “Some parents are not okay with us using the gadget to treat their children. They sometimes think we are searching the web for treatment and we don’t know what we are doing. Some even ask you not to use the tab even after explaining to them the need of it. Sometimes power blackouts pose a challenge as the tablet relies fully on electricity for charging,” added Waida.
“More tabs should be provided at least each facility to have more than two devices so as to serve more clients in a shorter time. Having one tablet in every hospital makes it hard to see every client attending the hospital using the tab.
As much as this programs has helped in providing quality services it still takes a longer time thus patients queue for a longer period to access the facility. According to Wilfred, the app would be improved by providing a section to capture the total number of patients attended to in a day.