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Project title[1]
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Dynamic electronic decision trees for managing childhood illness (DYNAMIC)
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SDC priority theme[2]
Health
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Project no.
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7F-10361.01 (single phase)
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Country or region[3]
Tanzania, Rwanda
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Lead (max. 5 lines)
Every year, more than five million children die before the age of five due to preventable or treatable causes, most of them in developing countries. New technologies combined with rapid tests can improve diagnosis and management of sick children and reduce health costs. This collaborative research project makes use of Switzerland’s knowledge in digital technologies to improve the health of children and reduce unnecessary antibiotic prescriptions in low resource settings.
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Context (general and related to relevant
area):
Children are a vulnerable population group that suffers most of acute illnesses. In most low and middle-income countries significant improvements in healthcare have been achieved in the last decades. However, the diagnosis and management of sick children at primary care level often remains inadequate. Health professionals have limited skills, diagnostic tools are missing, and practical guidelines are inconsistent and quickly outdated. Digital decision making tools for primary health care workers are very cost-effective instruments that can greatly improve care for sick children, rationalize antibiotic use, and strengthen referral decisions. The safety of a novel electronic point-of-care clinical algorithm (ePOCT) was validated through a first clinical trial conducted in Tanzania and supported by SDC in the framework of its research for development (r4d) programme. Further validation studies are now needed to improve and extend the scope of the ePOCT tool.
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Overall goal
To improve the quality of care for children aged 0-12 years in low resource settings by validating and implementing a novel electronic point-of-care clinical algorithm (ePOCT) that guide and train health workers in the diagnosis and management of sick children.
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Key results and insights from previous phases (or baseline for first phase)
The safety of ePOCT was asessed and validated through a first clinical trial conducted in urban Tanzania. The use of ePOCT led to an improvement in clinical outcome while reducing by 88% the proportion of antibiotic prescriptions.
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Outcomes (objectives) of the planned phase
Outcome 1: Integrated management of children with acute illnesses at primary care level is improved
Outcome 2: The national health information system for disease surveillance and early epidemic detection is enhanced
Outcome 3. Clinical algorithms are improved and continuously adapted to geographical and seasonal variations using machine-learning
Outcome 4: Antimicrobial drug pressure in the community is decreased
Outcome 5: The environment for sustainability of electronic clinical decision support algorithms and framework for larger-scale implementation is supportive
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Key outputs of the planned phase
A range of specific outputs are defined for each outcome (see logical framework)
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Target group/s
Primary beneficiaries: sick children aged 0 days to 12 years and their families attending primary health care facilities
Secondary beneficiaries: surrounding communities, health workers, health administrators and managers, health ministries
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Contract partner/s
Centre universitaire de médecine générale et santé publique Unisanté, Lausanne
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Coordination and synergies with other projects and actors
Synergies with SDC interventions in Tanzania and Great Lakes region (health sector)
Foundation for Innovative New Diagnostics FIND, Botnar Foundation, UNICEF and WHO Tanzania and Rwanda
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Start of phase: from 15.11.2019
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End of phase: to 31.12.2022
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SDC Budget of phase
CHF 3’000’000.-
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Total SDC expenses already spent since 1st phase (including opening credit)[4]
n/a , single phase
(ePOCT received a grant from the r4d programme of CHF 438’000 for the period 2013-15, i.e apprx. CHF 330’000 from SDC)
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Total budget of phase including local partners and external contributions
Total: CHF 9 m
CHF 4.3 m (Botnar Foundation)
CHF 1.7 m (SNSF, FIND)
CHF 3 m (SDC)
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Estimated Swiss/SDC budget for the duration of the whole intervention
CHF 3’000’000 – single phase 2019-22
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