Digital Scorecards Provide Citizens with Information on Neglected Tropical Diseases Malaria & Neglected Diseases 11/01/2022 • Joy Phumaphi & Yacine Djibo Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Members of a community group in Ghana vote on measures to address malaria. In the wake of the COVID-19 pandemic, putting communities and countries at the centre in the fight against Neglected Tropical Diseases, which affect some 1.5 billion people globally, is more important than ever before. New digital health tools can help us increase transparent reporting on progress and setbacks in achieving the NTD-related Sustainable Development Goals. The severity of neglected tropical diseases (NTDs) has been overlooked and underestimated for generations – and in the wake of the COVID pandemic, multiple WHO and other reports have revealed how longstanding prevention, diagnosis and treatment measures have stagnated or even rolled backwards in many countries. Africa carries nearly 40% of the NTD burden. And with a disproportionate number of people and communities continuing to suffer from malnutrition, stunted growth and cognitive impairment caused by diseases like intestinal worms and lymphatic filariasis, we need to look at new ways to keep this agenda uppermost in the minds of policymakers. More transparent, digitalized reporting of progress and setbacks can be part of the solution – insuring that NTDs remain priorities in global and continental health agendas. Digital Health Week observed in early December has reminded us of how better data can help enhance decision making and propel action. ALMA scorecards and hub A page from Rwanda’s digital malaria and NTD scorecard The African Leaders Malaria Alliance (ALMA) Scorecard Hub, launched this year by Kenyan President Uhuru Kenyatta, is a game-changing digital health solution that can help revolutionise how countries and national programmes can share information. The hub is the first open-access platform dedicated to scorecards including on health-related NTDs, allowing countries to regularly post their scorecards on the website for every citizen to have access to the latest data. It also is a knowledge platform, sharing country best practices to improve scorecard management tools for accountability and action in malaria, reproductive maternal neonatal and child health (RMNCAH), and NTDs as well as online learning material. The platform makes use of the ALMA Scorecard for Accountability and Action as well as country-owned scorecards, which track progress, enhance community engagement, quickly identify bottlenecks and steer action in the fight against NTDs. The ALMA scorecard, which provides key data in a colour-coded user-friendly way, is used primarily by Heads of State and Government, ministers, other high-level national leaders and key partners to strengthen accountability and action to address public health priorities. It tracks progress in the fight against malaria, RMNCAH, HIV/AIDS and more recently NTDs. Over 40 African countries have scorecards Over 40 of Africa’s 55 countries have developed malaria, RMNCAH, NTDs, nutrition and/or community scorecards. Reviewing such scorecards, allows one to see where bottlenecks to access remain – such as children’s access to HIV/AIDS diagnosis and treatment, and in the case of NTDs, coverage of Mass Drug Administration. For example, the third quarter of the year illustrated strong progress in the total population living with HIV who have access to antiretroviral therapy at 64%, up from 58% in the previous year. The percentage of children receiving the same treatment, however, is almost half of this, at 39%. In addition, only 54% of children have access to vitamin A, despite this being a simple and cost-effective intervention. These figures highlight the notable challenges that countries in Africa face when addressing these critical diseases. As the health crisis goes beyond national borders, it must also be addressed by regional and global actors. In the fourth quarter of 2017, ALMA in collaboration with WHO and Uniting to Combat NTDs, added the NTD coverage index to the ALMA scorecard. This is an indicator on NTDs used to track progress in the coverage of drugs distributed for the five NTDs amenable to preventive chemotherapy (trachoma, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths). The index is based on the geometric mean of coverage rates for those interventions for which data are routinely reported by countries to WHO and is calculated by WHO/Headquarters on an annual basis and submitted to ALMA for dissemination via the ALMA scorecard. To accommodate the scorecard “traffic light” system, countries are categorized as “On track” (green) when the coverage index is >75%; “Progress but more effort required”,(orange) when the coverage index between 25-75%; and “Not on track”, (red) when it is below 25%. The 75% threshold is based on the WHO NTD Roadmap target coverage overall for the five NTDs eligible for preventive chemotherapy. The NTD coverage index is methodologically comparable to the Universal health coverage (UHC) index. The ALMA scorecard is helping to ensure that these often-forgotten diseases are visible at the highest level. The national scorecards are composed by priority indicators selected from the national strategic plans and other country guiding documents. The data are real-time data coming from the country’s Health Information System and programmes. Scorecards are country-managed and used within the national systems, hosted on the Scorecard Web Platform which is an online service to manage the scorecard tool. The scorecard accountability mechanism serves to visually highlight in which specific areas countries are doing well and in which areas they are experiencing bottlenecks to facilitate action, as a key step towards identifying African-owned and led solutions. ALMA continue to maintain, support and update the online service and to train countries on the proper use of the tool. Demonstrated to lead to better health outcomes The ALMA scorecard has demonstrated how a data-driven approach can contribute to better health outcomes, leading to rapid policy change, enhanced donor and domestic resources, accelerated procurement to avoid stock-outs and addressing emergencies. The Republic of Congo is an example of a country that has adopted the NTD country scorecard with positive change. The development of the scorecard there revealed supply chain problems, which allowed the Ministry of Health to react quickly and restock. This resulted in significant improvement of therapeutic coverage for onchocerciasis and Lymphatic Filariasis, from 79% in the second half of 2018 to 83% in the first half of 2019, illustrating the game-changing impact of this tool. The scorecard is now incorporated in the country’s NTDs Annual Report. In 2019, using the scorecard to present the programme gaps, the National NTDs programme mobilised funds from the government and a budget line on NTDs was created with a commitment of 100,000 million CFA francs (nearly US$170,000) to support the four NTDs programmes. Community scorecard tools Community scorecard tools, in particular, are used to engage the community for assessment, planning, monitoring and evaluation of health services, and joint action. Used during routine community meetings such as town halls, they allow members of the community to rate the local health facilities, using quality of care indicators such as waiting times or availability of medicines. Actions are then taken and monitored to improve the quality of service and facilities. The Community scorecard approach is a crucial initiative in global health as it provides a mechanism for accountability that is community-owned and led. Civil Society are critical partners Civil Society Organisations (CSOs) are a critical pillar, working as active community agents driving change through health campaigns but also playing a powerful and critical role in health campaigns, bringing together communities for collective action, mobilizing the population to articulate demands, and voicing concerns across all levels of society. The involvement of CSOs, combined with utilising mechanisms like the community scorecards, will see an increase in accountability for countries across Africa, fuelling progress in the fight against NTDs. The results of civil society action are evident. The CSO Network on NTDs, established in 2019 is providing a platform for CSOs to consult and collaborate to beat NTDs, with the ambition to increase sustainable funding and accelerate progress across the continent. Already the No to NTDs Civil Society Network has engaged more than 647 stakeholders across Africa. Through this network parliamentarians in Guinea are now committed to increasing the budget allocation to the National NTDs Programme, helping 6.5 million people who are unable to receive fundamental treatment in the country. To achieve the 2030 sustainable development goal and reduce the number of people requiring NTDs treatment by 90%, greater, and more urgent action is needed. As we come to the end of another challenging year, shaken by the COVID-19 pandemic, we must make sure we are utilising all the available tools to end suffering from NTDs once and for all. Joy Phumaphi is the Executive Secretary of the African Leaders Malaria Alliance. She also serves as co-Chair of the Independent Expert Review Group, for Every Woman Every Child, reporting annually to the UN Secretary General on developing country progress on Women’s and Children’s health. She also sits on the Board of several international non-profits in Global Health, including CIFF (Children’s Investment Fund Foundation); ACHAP (African Comprehensive HIV/AIDS Partnership; MMV (Medicines for Malaria Venture); RBM (Roll Back Malaria Partnership), and is an advisor for Hilleman Laboratories, the Gates Foundation Malaria Program, and the Harvard Health Ministerial Leadership program. Yacine Djibo founded Speak Up Africa in 2011 to discover and implement effective, sustainable solutions to the most challenging problems facing the African people. Focusing on strategic communications, policy and advocacy, Speak Up Africa is dedicated to empowering African leaders and citizens to take on issues such as malaria, neglected tropical diseases and sanitation in order to save and improve lives. Previously, she worked as the Senegal country director for Malaria No More, where she developed and managed high-profile national programs and campaigns to promote malaria prevention and treatment. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.