Shifo/Smart Paper Technology (SPT)

Every year, more than 4 million children die of preventable or curable diseases like measles, pneumonia, diarrhoea, sepsis/meningitis and malaria and/or suffer from malnutrition and stunting. Sub-Saharan Africa carries 25% of the global burden of disease but has only 4% of the health workers.

Through its previous engagement on the veterinary side, IKARE knows only too well the importance of access to knowhow, products and reliable data for creating awareness at community as well as government level. In order to undertake targeted interventions, as well as address gaps in disease surveillance, diagnosis and follow-up, access to quality data at individual, health centre, district and national level is critical. Without basic health management information systems and structures in place to provide the necessary services and data, measuring progress and the impact of activities is near impossible, just as is informed decision making. So when IKARE came across the founders of Shifo Foundation and their solutions for improving quality of health services delivery, it became natural to engage.

IKARE and Shifo first partnered together when they launched a joint pilot project (MyChild Solutions) in Dokolo District, Uganda, in September 2015. The purpose was to implement and evaluate eHealth solutions for digitising individual health records of children aged under five, bring data visibility from the last mile and establish the process of continuous quality improvements in health facilities. Through IKARE’s support, Shifo developed a unique solution called Smart Paper Technology (SPT), which can replace the Health Management Information System (HMIS) forms. SPT has brought about higher data quality, minimised health workers’ time spent on administration, and empowered health facilities and provinces/districts to use data for continuous quality improvements. Since then, IKARE and Shifo have extended their collaboration in: 

  1. Mukono District in Uganda, for expanding SPT to cover reproductive, maternal, newborn and child health (RMNCH), with Plan International and the Ugandan Ministry of Health as implementing partners; and 
  2. The Gambia, for national implementation of SPT including vaccine inventory and supply chain management. Additional funding partners in The Gambia are Gavi, the Vaccine Alliance; the af Jochnick Foundation; and the Swedish Postcode Foundation. Implementing partners are ActionAid International and the Ministry of Health and Social Welfare, Gambia.

SPT is the first solution globally that has integrated the versatility of paper and information technology with the aim of reaching children and women in the most rural and isolated areas and enabling health facilities and health workers to have reliable and relevant data from every corner of the country. The solution has proven that it can work in any context including rural, urban or insecure environments, and does not depend on electricity or network coverage at the point of care. This solution has been developed based on the lessons learnt and failures in point-of-care electronic systems from low-resource settings that Shifo and IKARE have worked with before, while delivering all the benefits of electronic health record systems. 

Outcomes and Impact
For full details on the findings, conclusions and recommendations of the respective external valuations undertaken as well as progress reports see the Shifo website (www.shifo.org).

Since 31 March 2020 and the start of the SPT activities in Mukono, 62,531 children have been registered (43,359 on 31 March 2019), 73,396 SMS reminders have been sent (52,535) and 19,315 children have been fully immunised (13,023). By the end of the pilot in Dokolo in September 2017, 12,560 children had been registered, 35,327 children’s visits had been recorded, 3,829 sms reminders had been sent and 4,423 children were fully immunised.

The corresponding numbers for The Gambia as at 31 March 2020 were 150,262 registered children (102,432 as at 30 September 2019), 179,223 sms reminders sent (80,661) and 45,476 fully immunised children (24,190).

Picture by Nargis Rahimi
Picture by Nargis Rahimi

smart paper technology (SPT)
Integrating the versatility of paper and information technology, SPT has brought about higher data quality, minimised health workers’ time spent on administration, and empowered health facilities and provinces to use data for continuous quality improvements.

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