Late last spring, Project HOPE’s global staff submitted 20 pioneering ideas to be considered for the first Internal Global Health Innovations Challenge. This challenge encouraged staff working at program sites around the world to submit original solutions to improve health for underserved populations. The entire HOPE organization had the opportunity to vote on one of the 20 promising ideas and four others were chosen by technical staff to each receive a $20,000 innovative grant, supported by HOPE’s long-time partner, Eli Lilly and Company, Inc.
One of the winners was an idea proposed by the Tajikistan team to incorporate global positioning system (GPS) tracking devices to improve TB sputum transportation and patient monitoring thereby increasing the success of TB treatment.
Proper medicine adherence is critical to effective treatment of Tuberculosis. Great sums are invested in resources for Directly Observed Treatment (DOT) for TB, which confirms patients regularly take their drugs and complete treatment under supervision by community social workers (CSW), thus achieving cure and preventing the development of drug resistance.
The results of our test activity showed increased confidence that patients received treatment. Patients, as well as CSWs and coordinators embraced with enthusiasm the system as an additional mechanism, which increased the chances of better control and ultimately for a cure. The information was positively received by NTP, with an interest and readiness to support the system as one of the additional methods to improve the DOT upon broader confirmation of results.
The initial stage of the project began with the project team in Tajikistan conducting a three month demo trial to verify the concept and determine if it was viable.
They worked with the National TB Program (NTP) to outfit two vehicles with GPS devices to better monitor the fuel consumption, ensure the driver is taking the most efficient route and doesn’t deviate from assigned destination, and ultimately deliver higher quality sputum samples for laboratory testing.
They also outfitted two social workers with pocket GPS devices. These pocket devices can track the routing and the duration at various stops such as with patients. Since the expected duration of a Directly Observed Therapy-Short Course (DOTS) session is 30 minutes, tracking the actual amount of time spent at each stop on a planned route can provide an affirmation of potential quality of service (and identify when insufficient time is spent).
The next phase of development is to establish research comparisons to document the efficiencies, quality of services and improved outcomes. The team has begun the process of selecting the company for delivery and installation of the GPS devices, and GPS tracking is planned to begin in early June.
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