DigI Meeting (Health team)

= Minutes =

Initial discussion on:

•	Impact: Change practice? Change behavior? Is it sustainable?

•	Pre study: knowledge, attitude, and health seeking behavior - What will the baseline include?

•	People have already information, how can we add value?

•	Post study: knowledge, attitude, health seeking behavior - Ex 20% increase in case detection - Except knowledge uptake increase of 20-30 %

•	Targeting health workers or community, or both? Agreed to both.

•	Anthrax on hold, waiting for Elibariki. Focus on HIV/TB and Cysti in CH PhD

•	Elibariki post-doc – will start next year.

•	Master student requited – Helena. First six months will be spent on protocol work.

•	Cysti platform expand from the web – also teaching in the villages. Can this be used in DigI?

Baseline survey:

•	How many research assistants, and who are providing the research assistants?

•	Need clear questions for the baseline study.

•	Sample size: 1000 people or more.

•	Every village has its own control. Units = individuals pre / post. Follow up the same household pre / post.

•	Start with one villages in the South, Mtera and Izazi

Objective: “Free access to Digital Health Information” to improve KAP and health information seeking behavior

1.	What problem do we want to tackle? – No or very low access to health information thus provide Digital health information

•e-guidelines for each disease for health workers, community members •Education materials for each disease for health workers, community members

2.	How to package the digital contents? – Multiple ways to deliver the information

a.	SMS – subscription is required – charges per SMS and limited information

i.	Interactive messages to prompt an individual for action e.g. go to a facility when some symptoms are observed

ii. Frequency of delivery/access

iii. Costs vs zero rating SMS

b.	mHealth apps in the tablets locally or online

i.	for health workers to support decision

ii. for community to access health information

c.	Local server - digital – website, videos, pictures, audio through tablets

d.	Website - publicly accessible to all

e.	Display screens at the health facilities

f.	Costs for each information delivery mode – SMS, mobile apps, locally contents

3.	Connectivity – Type/Tower (coverage per village) – broadband,

a.	from providers to village – coverage

b.	wifi hotspots, tablets – how many per villages? how many tablets per hotspot?

c.	individual –

4.	What Devices to access digital contents – availability

a.	Simple phones

b.	smartphone and tablets

5.	PhD (Christine) and master students (One from SUA, one master from Cystercosis)

a.	Research activities

b.	Publishing research findings – the students should publish papers (Master – at least 1 paper, PhD – at least 3 papers)

6.	Detailed work plan and budget – who will cover costs of which activity?

a.	Procurement and installation of connectivity and equipment – which equipment, number and who will cover costs

b.	Implementing the project activities (Data collection, daily supervision)

c.	Students allowances, transport,

d.	Human resource –

i.	Project investigators/coordinators

ii. Project administrator at NIMR and one field

iii. Field supervisor(s) to support data collection and day to day project administration in the villages

e.	Dissemination – attending meetings – locally and international

f.	Location of the hot spot – market place or health centre?

7.	Study sites

a.	Mtera and Izazi in Iringa – TB/HIV, Cystercosis,

b.	Selela in Monduli – Anthrax (Elibariki), TB/HIV

Way forward - Contents

1.	Bernard to provide TB/HIV guidelines for health workers, educational materials for community members

2.	Helena to provide Cystersicosis guidelines for veterinarians, educational materials for community members

3.	Elibariki to provide Anthrax guidelines for health workers, educational materials for community

4.	Each should package the information in the form of SMS, mobile apps,

5.	Big part of Christine s PhD – to develop health messages. Design them and hard copies as well. Content for health workers, content for community.

Intervention design

•	Pre post intervention study design – baseline and endline assessment

•	A need to proper design the studies (Overall project and student specific studies) to get ethical clearance from NIMR, COSTECH for the technical/connectivity

•	Overall study protocol needs to be revise and finalized for ethical clearance

•	Specific study protocols for students will be developed and attached to the whole project design

•	Sample size – in each village – can we use this calculator?: https://www.checkmarket.com/sample-size-calculator/

Selela	Izazi	Mtera Population size:	8700	5300	10900 Margin of error:	5 %	5 %	5 % Confidence level:	95 %	95 %	95 % Required sample size:	368	359	372

o	how many workers?

o	how many community members?

o	How to recruit individuals

•	How to motivate community to access information?

o	Transport to wireless hotspots?

o	Air time compensation

•	How do we track an individual who is accessing the information?

o	Number of downloads

•	Location to install wireless hotspots – Technical survey will tell

o	Health facility

o	School

o	Market

•	Data collection (questionnaires) will be done through mobile apps/questionnaire using tablets

Capacity Building opportunities for Digital Health in Tanzania

o	Where will the postdoc be registered and who will supervise? Preferably Oslo/TUM due Digital health capacity?

o	Introduction of Digital Health training programmes/courses

o	Also, possibility of developing a capacity programme for digital health at MUHAS in Tanzania for sustainability