The MomCare Digital Adaptation Kit (DAK)

Background.

The Digital Assessment Kit (DAK) is a World Health Organization (WHO) initiative designed to streamline the development and implementation of effective digital health solutions in low- and middle-income countries (LMICs). It provides a standardized framework and a set of tools to guide stakeholders through the process of assessing the feasibility, effectiveness, and scalability of digital health interventions.

The DAK framework emphasizes a user-centered approach, ensuring that digital health solutions address the specific needs and challenges faced by healthcare providers and patients in LMIC settings. By following the DAK guidelines, developers and implementers can increase the likelihood of developing digital health solutions that are sustainable, impactful, and contribute to improved health outcomes.

Steps.

Transforming Maternal Healthcare

This document outlines the technical requirements for the MomCare Nairobi project, which leverages technology to improve maternal healthcare. Built on the World Health Organization’s DAK framework, it guides the system’s design and development.

The Challenge:

Despite global efforts, maternal health in Nairobi faces a burden of high mortality and morbidity rates.

MomCare’s Solution:

MamaToto tackles this challenge through:

  1. Enrollment: Self-registration via WhatsApp and clinics.
  2. Data Tracking: Shared Health Record (SHR) for mobile and clinic access.
  3. Improved Care: Data exchange through a Health Information Exchange (HIE).
Benefits:
  1. Increased antenatal visit attendance.
  2. Optimized resource allocation.
  3. Improved program evaluation (e.g., MomCare).
Next Steps:

This document details the project’s specifics using the DAK framework.

Core Data Elements in MomCare

MomCare leverages a comprehensive set of data elements to track and manage the health information of pregnant women. These elements are captured at various points, including enrollment, antenatal visits, and data exchange.

A dedicated “Data Dictionary” appendix within this guide will provide detailed definitions, data types, and how each element is used.

Here’s a categorized overview of some core data elements you’ll find in the Data Dictionary:

  1. Patient Sociodemographics: Name, date of birth, address, phone number.
  2. Pregnancy Information: Estimated due date, gestational age, pregnancy history.
  3. Antenatal Visit Data: Blood pressure, weight, fetal development observations.
  4. Referral & Service Utilization: Referrals to specialists or additional services.
  5. Immunization Records: Tracking of vaccinations received during pregnancy.
  6. Laboratory Test Results: Integration of relevant lab test results.

Sample Business Processes and Data Elements:

The DAK also outlines data elements linked to specific business processes within MomCare. Here are a few examples for illustration:

  1. Create Beneficiary: This process captures basic information like name, date of birth, and contact details (MMT.A.DE1 - MMT.A.DE9).
  2. Add Beneficiary to Policy: This process includes details beyond basic demographics, such as beneficiary type, occupation, and insurance membership (MMT.B.DE5 - MMT.B.DE23).
  3. Download Bulk Enrollment Status: This process manages uploading beneficiary data in bulk. It tracks the reference ID, processing status, and error details (MMT.D.DE01 - MMT.D.DE06).
  4. Validate Policy: This process ensures a policy is valid by checking factors like the number of beneficiaries (MMT.E.DE01) and integration errors (MMT.E.DE02).

Note: This is not an exhaustive list, and the specific data elements used may change based on evolving needs.

Functional and Non-Functional Requirements

This section summarizes the key functional and non-functional requirements for the MamaToto system, ensuring it meets user needs and operates effectively.

Functional Requirements:

  1. Interoperability Layer (IOL): Acts as a central hub for HIE services, enabling data exchange and message routing between healthcare providers. It also facilitates complex transactions, error management, and secure communication.
  2. Shared Health Record (SHR): Serves as a repository for patient clinical data, offering functionalities for data storage, retrieval, querying, and export. It prioritizes data integrity through versioning and audit logs.

Non-Functional Requirements:

  1. Performance: The system should deliver minimal response times and handle asynchronous processes efficiently.
  2. Security: Robust security measures are essential, including user authentication, password encryption, data access controls, and audit trails.
  3. Usability: An intuitive user interface is crucial for users with varying technical skills.
  4. Reliability: Regular system testing ensures accuracy, reliability, and performance under high data loads.

These are general highlights, and specific requirements will be further elaborated upon in the project documentation.

Overall Description

MamaToto is a cutting-edge project transforming maternal healthcare in Nairobi, Kenya by leveraging advanced technology. Built on the robust DHIS2 platform and embracing modern tools, it aims to revolutionize data management and analysis for improved maternal health outcomes.

Key Focus Areas:

  1. Data Quality: MamaToto tackles inaccurate or incomplete data through innovative solutions, ensuring reliable information for informed decision-making.
  2. Reporting Efficiency: By streamlining processes and automating tasks, MamaToto empowers stakeholders to meet reporting deadlines consistently.
  3. Interoperability: Designed with an open approach, MamaToto seamlessly interacts with other health information systems, facilitating data exchange and eliminating silos.
  4. dvanced Analytics: Modern tools enable in-depth analysis of maternal health data, providing valuable insights for targeted interventions and resource allocation.
  5. User Empowerment: MamaToto prioritizes user needs, offering intuitive interfaces and comprehensive support, making the system accessible and efficient for all stakeholders.

Overall Impact:

Through its multifaceted approach, MamaToto aspires to:

  1. Enhance the quality of care for pregnant women and mothers.
  2. Strengthen decision-making with accurate and insightful data.
  3. Optimize resource allocation for maximum impact.
  4. Improve overall efficiency and effectiveness of maternal healthcare services.

Product Features

Client Management
  1. Client Registration: Initial registration of new patients, including demographics, contact details, and other relevant personal data. Duplicate record flagging and merging capabilities.
  2. Client Search: Enables healthcare providers to quickly access patient demographic records.
Clinical Data Management
  1. Clinical Information Capture: Capture and document clinical information obtained during antenatal visits, including medical history, symptoms, diagnoses, treatment plans, medications, lab results, imaging reports, and other relevant data.
  2. Clinical Information Retrieval: Access patient data from the SHR when needed for patient care, decision-making, and/or analytics.

Reporting & Analytics

The SHR provides mechanisms for reporting and generating reports to support decision-making within and outside health facilities.

Data Integration

Data Import & Export: Ability to extract data from the SHR and ingest data in bulk into the SHR or another system.

Operating Environment

Technical Specifications

Backend Services 1. Hardware Platform: Standard desktop computers, laptops, and mobile devices. 2. Operating System: Windows, macOS, Linux. 3. Network Connectivity: Internet connection required for backend services.

User-facing Services 1. ardware Platform: Standard desktop computers, laptops, and mobile devices. 2. Operating System: Windows, macOS, Linux, iOS, and Android. 3. Web Browsers: Chrome, Firefox, Safari, and Edge. 4. Network Connectivity: Internet connection required for backend services.

User Documentation

Well-detailed system documentation will be provided to guide administrators and users on the system architecture.

Assumptions and Dependencies
  1. Cloud-based deployment environment.
  2. Applications accessing the service require a constant internet connection.