Clear Solutions and partners have now completed 3 months of distributions in our ORS+zinc program “Phase 3” in Dambatta LGA in Kano state, Nigeria.
We made digitisation of distribution tracking - a key requirement for rigour at scale - our primary focus for this phase. By equipping the community health workers who perform our ORSZ distributions with smartphones, recording their GPS tracks and simple survey inputs, we can clearly understand the coverage achieved and monitor day-to-day progress.
Let’s take a closer look at the mapping and digitisation methods.
Distribution Planning
Our Phase 3 approach has been to distribute to children under-5 across whole geographic wards. Depending on ward size, this typically means 5,000-15,000 under-5s. We refer to population data from the Local Government Primary Healthcare teams, from the ward itself, and also estimates from WorldPop (which fuses satellite imagery with models based on census data).
For detailed mapping of the distribution areas, we use Geographic Information Systems (GIS) data from sources including GeoPode. The image below shows part of Dambatta, the Local Government Area (LGA) in which we have worked in Phase 3
Planning and supervision of distributions involves close collaboration with the local primary healthcare teams, and they assign specific communities to individual distributors. We define target areas in our digital maps to correspond with the intended distribution coverage, fusing settlement boundary data with expected under-5 population from WorldPop.
The distribution target area maps are split into grid squares in which it is expected that at least one under-5 is resident. Distribution teams do not refer directly to these GIS maps - they use their local knowledge and on-the-ground observations - but we can track their progress against the expected areas of distribution to estimate our effective coverage.
Tracking the distribution and estimating coverage
As the Community Health Worker teams proceed on their distributions, they carry a smartphone to record GPS positions along their paths.
We used low cost Android phones with Geospatial Tracking System (GTS), a tool originally developed for supporting polio immunisation campaigns by Novel-T Sàrl.
GTS consists of a smartphone app with a backend (cloud) data store and dashboard web app. The mobile app runs as a GPS location tracker to record ORSZ distributors’ paths, and as a survey tool (integrating Open Data Kit, ODK Collect app) for capturing operational monitoring data.
The individual distribution paths are aggregated by GTS into a map of the areas that have been reached within the distribution round, and those in which we expect there to be under-5s who have not yet been reached. Each handover of ORSZ is also recorded to monitor for stock levels and detect potential losses.
A coverage map builds up during the distribution, pictured above with target areas reached in green, and not yet reached in red. The geo coverage is a pure % of target areas reached, with the % of under-5s (according to GIS data, “GIS u5s” in the image) accounting for more densely populated areas. This gives us a robust indication of the reach of distributions, and enables us to iterate upon the planning and operational methods to further increase coverage.
Incorporating digital monitoring going forward
As we reflect on Phase 3, this digitisation of distribution monitoring has provided crucial practical insights into the operation, enabling continuous iteration and improvement. We expect to incorporate these methods as a standard component of our distribution campaigns going forward.
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