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Optimizing vaccine delivery by teaching healthcare workers digital skills

Countries around the world are developing and executing national plans for COVID-19 vaccine delivery, balancing short-term goals — accelerated mass vaccination to reach herd immunity — with efforts to strengthen long-term health systems. Many, if not all, will be using digital technologies to face the scale and complexity of accelerated mass vaccination administration. Their intended users will need to be equipped with the right digital skills if these digital tools and platforms are to be successful. Likewise, the public health ecosystem needs to acquire the capabilities to develop, operate, maintain, and sustain the underlying databases, services, systems, and infrastructure necessary for the tools to work correctly.  

How can investment in digital skills help? 

Equipping community health workers with digital skills can increase the adoption of digital tools for registering and managing beneficiaries, improving communication, collaboration, data accuracy, and reporting adverse events . Evidence suggests that there has been a significant digital transformation already. There are many examples of digital tools helping health and community workers respond to the COVID-19 pandemic. Digital communications have been critical to providing regular updates to healthcare professionals. In the last two decades, a flurry of eHealth applications has been developed with a mobile-based interface. These are intended to help digitize the manual, paper-based reporting performed by health care workers like patient data and vital signs, vaccine administration, and inventory management. eRwanda, one of the earlier projects using information and communication technology (ICTs) to improve health financed by the World Bank Group, helped promote mobile-based applications by Voxiva to create mHealth (through the Tracnet mHealth app, co-funded by the CDC) and mAgriculture applications (eSoko, co-funded by USAID ). These applications were successful due to the ease of use of the mobile interface, available in both English and local Rwandan language, and the quality and intensity of the training provided for the intended users.  

The World Health Organization’s 2020 discussion paper, Digital education for building health workforce capacity, shows that the effectiveness of digital health education and outcomes varies widely depending on assessment methods, delivery mode, instructional methods, learning objectives, learning pedagogies, modality, target population, and topic. A number of recommendations have emerged in recent years to equip and support health professionals. These include tailored training programs on digital skills (from early training to professional development programs), updated national health guidelines that include digital health solutions, and healthcare and community worker input in designing and testing digital solutions. Investment in some of these areas while addressing the pandemic — rapid training programs, updated guidelines, and opportunities for feedback on the emerging vaccine delivery solutions — can serve longer-term ambitions to strengthen health systems.  

In-depth training is required to understand digital solutions and their purpose, including features and functionalities, reporting capabilities, and any data-driven aspects that require importing, exporting, merging of data, and the use of data analytics tools and visualization. This, in itself, is specialized training requiring dedicated time and resources from both the developers of the health applications and its users/stakeholders in the public health ecosystem. The successful technology transfer from the developer to the users and administrators of the digital health solution is key to the sustainability of the solution and the return on investment for governments and donors. 

Advanced digital professionals will be key to the safe and sustainable implementation of digital solutions, development of information systems, and maintenance of digital infrastructure . Data literacy, data governance, data science, data visualization, AI, and other areas of expertise are critical for ensuring governments are empowered to make data-driven decisions when it comes to the distribution of vaccines, evaluating outcomes, ensuring data protection and privacy, and communicating statistics and results to the public. Experts in IT systems and cybersecurity will be essential for ensuring the soundness and safety of critical digital assets.  

Basic digital skills enable people to benefit from mass digital outreach campaigns, access vaccine information, and register online . Because of reliance on digital systems and mobile applications for information, registration, follow-up, and reporting of adverse reactions, those without basic digital literacy or unable to use the web or mobile applications may be limited in their access to information, vaccines, and care — and risk exclusion. While it may be desirable to have a digital-first vaccination strategy, additional assistance to use web or mobile applications and analog methods must be made available, including to those lacking access to a digital device.  

What is being taught in basic or foundational Digital skills courses, and who are the providers? 

Many basic, foundational digital skills courses already exist in several languages in the free and open space. We recently created a knowledge map of this space. 

One of the providers of foundational digital skills, ICDL, a non-profit foundation created by the European Union, offers foundational courses on “computer, online, and applications” essentials. These quickly provide students an understanding of how computers, tablets, mobile phones, and the internet work. They also teach skills in using email and social media, accessing information, and basic office productivity (for example, in word processing and spreadsheets). These are the foundational skills needed for front-line health workers to use mobile applications for vaccine administration and provide data in an accurate and error-free way, to ensure a robust and reliable vaccination process.  

In many cases, it may be difficult for the public, STEM professionals, and health workers to adopt digital health solutions due to unfamiliar or complex tools, language, lack of technical support, and internet connectivity issues. To address these challenges, existing tools, and user-friendly digital health solutions should be prioritized and accompanied by training, including distance learning provisions. 

This work is supported by the Digital Development Partnership, which is administered by the World Bank. For more information or how you can receive assistance with these topics, please contact Digital4Vaccines@worldbankgroup.org. 

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