Academy Impact -

ACADEMY FOR HEALTH INNOVATION

Call for Life

A Tale of Innovation and Impact

In Uganda, a country where healthcare resources are scarce and the disparity between patients and healthcare providers looms large, a ground-breaking solution has emerged to bridge this crucial gap. The shortage of physicians and nurses, with ratios as staggering as 1 doctor for every 24,725 people and 1 nurse for every 11,000, has long been a challenge in a nation of over 45 million individuals. This disparity particularly burdens rural communities, compelling them to traverse great distances for medical care, while urban dwellers endure agonizingly long wait times.

In the face of these challenges, a ray of hope emerged in the form of Call for Life, an avant-garde platform that redefines patient care by breaking down barriers between healthcare providers and their patients. This innovative system empowers healthcare providers by providing real-time feedback on patient status, arming them with vital information precisely when and where it’s needed the most.

Originally designed to provide vital support for HIV and TB patients, Call for Life has expanded boundaries, making its mark in various healthcare interventions. Its integration into Uganda’s National Guidelines for COVID-19 Management exemplifies its adaptability. From facilitating psychosocial check-ins for discharged COVID-19 patients to training healthcare workers in pandemic management, this digital solution has been a game-changer.

Recent studies unveiled its remarkable impact on TB treatment success rates, attributing significant improvements to patients who received software-assisted support compared to conventional care. Notably, this translated to fewer missed visits, amplifying the realization that digital health innovations possess the transformative power to educate and embolden patients, elevating their treatment outcomes.

With over 140,000 patients and 13,000 healthcare workers in Uganda actively utilizing Call for Life, this ground-breaking initiative conducts nearly 5000 daily calls, driving behavioural change and enhancing health literacy. Beyond Uganda, the innovation has transcended borders, finding resonance in Malawi, where its voice call and text message system spearheads public health surveys, symbolizing the potential for technological partnerships to redefine healthcare paradigms.

Innovation has taken the reins, weaving a tapestry of hope and progress, redefining the boundaries of healthcare and transforming countless lives through the amalgamation of technology and compassion.

Birds in The Sky

Medical Drones Revolutionise Healthcare Access in Uganda

In the heart of Lake Victoria lies Kalangala island district, a remote archipelago serving as a home to 67,000 resilient souls. Despite its stunning vistas, this secluded community faces a healthcare conundrum unlike any other in Uganda. The isolation of its 84 scattered islands, with only 64 inhabited, presents a significant challenge in delivering crucial medical supplies to its 17 health facilities.

While Uganda has made remarkable strides in combating HIV, Kalangala grapples with persistently high infection rates, standing significantly above the national average. The geographic hurdles exacerbate the problem, making healthcare services a distant dream. Travel between islands involves perilous journeys on small boats, both irregular and financially burdensome for residents and healthcare workers alike.

Enter Drake, a 35-year-old father of four, and among the 1.5 million Ugandans living with HIV. His life once revolved around selling fish to sustain his family. However, the dire situation emerged when his dwindling health forced him to exhaust his meagre earnings on gruelling six-hour trips to distant health facilities for his multi-month ART dosage.

As his health declined and income sources vanished, Drake teetered on the brink of abandoning treatment altogether, until a beacon of hope emerged: the “birds of the sky.” The Medical Drones Research Project, launched in 2021, became a game-changer for Kalangala residents like Drake. In collaboration with the Infectious Diseases Institute, Johnson & Johnson, the Ugandan government, the United Nations Capital Development Fund, and the Rakai Health Sciences Programme, medical drones began delivering life-saving drugs directly to those in need. And for Drake, the bird in the sky arrived just in time.

These drones have revolutionized healthcare access by ensuring timely delivery of medications across the four supported islands, averting a potential crisis for those dependent on ART treatment. Drake’s story echoes the transformative impact of this initiative, relieving him from the arduous journeys and financial strains, while eliminating the stigma associated with obtaining essential medication.

Through this innovative approach, Kalangala residents no longer endure the burden of traveling vast distances or facing medication shortages. Drake, once on the precipice of abandoning treatment, now spends his days securing a future for his family, freed from the shackles of health concerns. The uninterrupted flow of medication has brought not only health but renewed hope and brighter prospects to countless families like Drake’s.

The medical drones soaring above the skies of Kalangala represent more than a delivery service; they symbolize a lifeline, bridging the gap between remote communities and vital healthcare. As Uganda continues its battle against HIV, this pioneering initiative stands as a testament to innovation fostering health, resilience, and brighter tomorrows in the most challenging of terrains.

ARTAccess

ART Access App: Scaling Up Antiretroviral Therapy at The Next Door

Meet Namusisi Jessica, a resilient 62-year-old who, for 25 years, journeyed 26 kilometres each month to her health centre for ART refills. Her experiences were marked by anxiety, uncertainty, and financial strain, often unable to afford transport or sustenance during these lengthy clinic visits.

However, Jessica’s life took a transformative turn with the introduction of the ART Access app—an mHealth innovation developed by the Infectious Diseases Institute (IDI). This ground-breaking tool streamlined the process, linking patient information and viral load data to guide community pharmacies in dispensing ART without the need for additional staff.

For Jessica, this innovation meant no more arduous journeys. Instead, she simply walked to her nearest selected pharmacy for her ART refill. The convenience and relief were palpable. “At first, the idea sounded crazy. I couldn’t believe it. The innovation has changed everything. I no longer experience anxiety,” shares Jessica, reflecting on the immense impact of this simple yet revolutionary change.

Her husband, too, echoes the sentiment, expressing relief at the newfound ability to allocate saved transport funds to other crucial needs.

The ART Access tool, pioneered by IDI, supports a community pharmacy refill programme, strategically partnering with select private pharmacies to provide high-quality HIV services, including ART refills, for qualifying stable clients under IDI-KCCA care.

Initially developed to alleviate strain on government health facilities in Kampala Capital City Authority (KCCA), this innovation has expanded to serve over 25,000 HIV-positive clients across various KCCA facilities. By addressing overcrowding, long waiting times, and patient frustration, the programme significantly enhances client retention and adherence to treatment.

Aligned with the WHO’s differentiated service delivery models, this initiative exemplifies IDI’s commitment to innovative healthcare. Through private-public partnerships and leveraging technology, the ART Access App has not only bolstered health systems but also propelled strides toward achieving UNAIDS 90:90:90 goals, ensuring improved access, retention in care, and ultimately transforming lives within the HIV programming landscape.

PACT-Karamoja

Revolutionizing Tuberculosis Treatment through Digital Adherence Support

Isiro Peter’s life took an unexpected turn when a persistent cough and chest pain led him on a medical journey that uncovered a diagnosis far from what he anticipated.

A 61-year-old retired civil servant from Amuria district, Peter had been diligently managing chronic renal disease at Matany Hospital for three years. However, in August 2020, new symptoms emerged, triggering concern of a possible COVID-19 infection. His referral to Matany Hospital for evaluation unraveled a different diagnosis—tuberculosis (TB).

“I was in bad shape. Admitted as a COVID-19 suspect, only to find out it was TB. I never expected it,” Peter recounted. He commenced TB treatment but encountered significant challenges in adhering to the prescribed medications at home. The fear of the drugs’ impact on his health loomed large.

Amidst his trepidations, a ray of hope emerged in the form of a telephone call from Patrick, introducing him to a digital platform, Call for Life®. Developed by the Infectious Diseases Institute, this innovative digital adherence support system aims to improve treatment outcomes for TB patients under USAID Program for Accelerated Control of TB in Karamoja (PACT Karamoja).

Call for Life® offers personalized daily medication reminders, weekly health education messages, and monthly clinic appointment alerts in patients’ preferred languages and at convenient times. It also enables patients to report medicine side effects, seeking prompt advice from healthcare workers.

For Peter, enrolment in Call for Life® transformed his treatment journey. “I rely on the Call for Life service as one would on a friend,” he expressed gratefully. His family actively supports the regimen, ensuring he’s ready for the 9 pm call—a lifeline that assures proper medication intake.

Previously sceptical about the medications’ effects, Peter found reassurance and motivation through healthcare workers on the digital platform. Encouraged by their advice, he hasn’t missed a single TB medication dose. Moreover, through Call for Life®, he proactively tested his family, ensuring their well-being.

Inspired by his own progress, Peter shared Call for Life® with fellow TB patients, emphasizing its invaluable support for long-term treatments like TB and HIV. “Call for Life is a must-have,” he asserted.

As he navigates the dual challenge of managing renal disease and TB, Peter remains grateful for the continuous support. “I feel motivated to battle two diseases,” he said. Initially feeling somewhat patronized, he now sees the system’s meticulous care as an essential pillar.

Healthier Manyatta!

Communities Transforming TB Care in Uganda’s Manyattas

Nestled within the serene landscapes of Natapar-Kocucue village in Moroto district, Lucia Pedo’s story unfolds, echoing the resilience and triumph over the harrowing grasp of tuberculosis (TB). With her children by her side, Lucia’s recounting of her battle against this insidious disease offers a glimpse into the transformative efforts taking root in this remote region of Uganda.

TB, an insidious disease claiming nearly 10 million lives globally each year, found its way into Lucia’s life in 2020, shrouding her days in relentless coughs and weakening her body. Unaware of the affliction’s identity, Lucia’s health dwindled until a vigilant community health worker recognized her symptoms, urging her to undergo TB testing. The diagnosis marked not only Lucia’s journey towards recovery but also unearthed TB’s presence in her 3-year-old son.

Supported by the Program for Accelerated Control of TB in Karamoja, implemented by the Infectious Diseases Institute and funded by USAID, Lucia and her son embarked on treatment. Today, Lucia’s laughter harmonizes with the echoes of her past struggles, proclaiming her victory over TB. “I no longer cough, and the pain has vanished. My son, too, has regained his health,” she shares with a smile.

Mariko Lochoro, an elder and community leader from nearby Tatawo village, mirrors Lucia’s trajectory. His own triumph over TB sparked a mission to guide and encourage his community members. “Listening to health workers’ advice and completing treatment is crucial,” Mariko asserts, leveraging his influence to drive positive responses within his community.

The Karamoja region, home to a resilient pastoralist population of 1.2 million, bears the heavy burden of TB, with staggering rates surpassing the national average. The communal lifestyle in manyattas, housing multiple families in compact spaces, intensifies the risk of TB transmission. Addressing these challenges head-on, the USAID program employs community-owned resource persons (CORPS) like Simon Peter Lobong.

Simon, a community health worker, locally known as Village Health Team (VHT) member, underwent comprehensive training to champion TB health education, conduct screenings, provide counselling, and ensure adherence to treatment.

Collaborating with these VHTs led to a remarkable 44 percent increase in TB cases identified in the sub-region. Treatment success rates doubled in the past year, with 15,687 individuals screened for TB by March 2021, resulting in 966 diagnosed cases under treatment. Additionally, 479 patients resumed treatment, while 200 receive medication quarterly from their communities via VHTs.

The IDI’s proactive community-based approach not only fosters healthier lives for individuals like Lucia and Mariko but also advocates for wider dissemination, supported by the U.S. Government’s commitment through USAID to advance TB prevention, patient-centric care, and global collaboration for better diagnostics and treatments.

Myths Busters!

Local Resource Persons Bridging the Gap in Tuberculosis Care Karamoja Region

In the heart of Uganda’s Karamoja region, where the echoes of rugged landscapes blend with the resilience of its people, a silent battle against tuberculosis rages. The year 2019 witnessed the Ministry of Health’s stark declaration: this region, home to 1.2 million souls, bore one of Uganda’s heaviest burdens of tuberculosis. Amidst this struggle, hope emerged in the form of the Programme for Accelerated Control of Tuberculosis Karamoja (PACT Karamoja) project.

Launched in January 2020 through the collaborative efforts of USAID and the Infectious Diseases Institute, this initiative sought to bridge the gap in TB care, striving to bring essential services closer to those most in need. At the project’s forefront were the “community-owned resource persons,” commonly known as Village Health Team members—individuals without formal medical training but armed with a profound dedication to their communities. Among them was Joseph Aburah, equipped not just with knowledge but also with a fervent desire to dispel prevailing myths surrounding TB.

Aburah said, “Many here believe that TB equates to AIDS—a myth we strive to debunk. Thanks to the health centre staff, I can educate and aid my community.”

Lokoru Lepatabo, the vigilant watchman at Tapac Health Centre III, embodies the project’s impact. Towering over six feet with a robust frame defying his sixty years, Lokoru’s resilience became evident as he continued working during the last stages of his TB treatment. His story, reflective of many in the resource-poor Tepeth-dominated community, sheds light on the challenges faced—long treks to distant health facilitiies being one among many.

Lokoru’s journey to recovery commenced after PACT Karamoja-trained village health teams conducted door-to-door testing, revealing his three children’s positive TB status. Subsequently diagnosed as the sole adult with TB within his family, Lokoru’s determination surged as he battled through the illness’s debilitating effects.

“I appeared ghastly initially, with weight loss and debilitating weakness. Even the medication sapped my strength. But I persevered,” Lokoru recounted.

Guided by community-owned resource persons, Lokoru completed his treatment in August 2023. His tale stands as a testament to the transformative impact of localised interventions and unwavering community support, breathing hope into the fight against tuberculosis in Uganda’s Karamoja region.