In 2008, I worked for Uganda Chartered HealthNet, deploying PDAs to health workers, so that health records could be transferred to the Ministry of Health using a gprs-enabled access point mounted at a wall in the health facility. We were leaders in the work to digitize health records. OpenMRS was in its infancy while DHIS2 had just been released. The platform that would change the way we support frontline health workers was named GATHERdata. Meanwhile another company, FrontlineSMS was threatening to move our cheese. Frankly the writing had been on the wall. SMS was gaining traction. Essentially, any health worker anywhere, could send in a report without needing a central place to “sync” data. (Can you imagine we did that over an infrared beam??). Here you can see Dr. Elioda Tumwesigye, rally community health workers.
In the same year, i joined an africa-wide advocacy association, the Free Software and Open Source Foundation for Africa – FOSSFA. People always wonder, what is the difference between Free Software, and Open Source software. According to the Free Software Foundation, for a piece of software to be considered truly “free,” its license must guarantee four essential freedoms to its users:
- The freedom to run the program as you wish, for any purpose.
- The freedom to study how the program works, and change it so it does your computing as you wish. Access to the source code is a precondition for this.
- The freedom to redistribute copies so you can help others
- The freedom to distribute copies of your modified versions to others. By doing this you can give the whole community a chance to benefit from your changes. (Again, access to the source code is a precondition for this).
When you make access to the source code possible, you make it open. When you allow modifications to come right back in, and also be available to everyone else, you become truly open, and truly free. By this time, you are going to need a community, as you will no-longer retain the capacity to work on the tools alone.
First it was hardware – PDAs to Smartphones, and then delivery (from infrared beams, to SMS, to native apps) now the shift (4IR) is to think platform (OpenMRS, DHIS2 and, gladly, Community Health Management System). But can a platform for healthcare tools be free, and open source?
Since 2010, Medic Mobile (formerly FrontlineSMS:Medic) has supported community health systems in more than 23 countries and is one of the largest implementer of digital health systems in lower-income settings. Medic builds mobile applications for community health workers (CHWs), household caregivers, and patients. We see communication gaps through the eyes of health workers and patients, and employ a human-centered design approach to co-designing health care delivery systems with local implementing partners. Medic Mobile has worked with over 60 partners across Africa, Asia, Latin America, and the US. Based in San Francisco with regional offices in Africa and Asia, Medic Mobile’s technology supports over 25,000 front-line health workers, workers as they coordinate care for over 14 million families in some of the worlds hardest-to-reach communities.
The open-source software that Medic Mobile stewards, contributes to, and deploys is called the Community Health Toolkit. The CHT, a global public good to advance Universal Health Coverage (UHC), can be configured in each health system to serve the needs of that health system.
The CHT has been designed as a care-first platform, solving problems for CHWs and families. Care guides allow health workers to confidently treat at the doorstep and build credibility in their community. Tasks help direct health workers back to the right homes at the right times. Making work visible enables fair pay. It’s obvious, but this utility to people has been key to its adoption and use. Tools can be set out to collect data. Platforms, on the other hand, are set out to solve people’s problems. System owners get high-quality, longitudinal data as a by-product.
We have designed for and developed tools for Improving child health (Immunization, Nutrition, Integrated community case management), Reducing maternal and neonatal mortality (Antenatal care (ANC), Postnatal care (PNC), Family planning) and Strengthening community health systems (Health worker performance, Health system performance, Outbreak surveillance, Direct to Client Communication, Supervision). The platform includes analytics for more complex data visualization and analysis (including geospatial data and map-based visualizations). Medic Mobile’s web-based dashboard pulls data automatically, and can be accessed securely through a web-based login.
The questions for digital tools for the future are going to be beyond just measuring and managing towards quantity at the provider, manager, and health system levels; and we start to look at performance in regards to speed of care (after onset of first symptom), (universal health) coverage, quality of care, and equity (getting care today, to the family that needs it the most today). Platforms in healthcare should extend to allowing patients to provide feedback on services provided at the home and in health facilities.
The well manicured grass felt bouncy as we queued up to share President Obama’s hand, and take a picture. It was when he saw the sticker on the back of my phone, “We Are All health Workers” – that he got interested, arranged for us to meet separately, so I could share with him what that was all about. This is how I got to share the story of my work.
The alarm always rings, at the best part of the dream. Time check, 515am.
reBlogged from Amplify…
My dearly beloved late mother desired that I should become a medical doctor. As it were, I gravitated to computers instead. In my short professional career, I have found my place using computers — and information systems — to improve health outcomes. From the linux based African access point, to becoming part of the Uganda EMR Society, I have marveled at the way information technology is utilized in the Ugandan health system. Suffice it to say, progress has been slower than my liking. But that’s another story.
When I realised I would not attend medical school, I decided that I would pursue something closely connected. A computer science graduate, my work experience experience has spanned Netmark Nigeria household surveys to telling the story of pediatric HIV in Uganda. Along this journey, my colleagues have included architects, designers, communications specialists, and data scientists, to name a few.
Find the rest of this post on GHC’s Amplify publication.
I too will one day be 60, and I know i will not be useless to the younger generations, but to claim to energetically hold the flag and lead the charge, that would be pretentious. I will lead, but I will lead from the back.
This is the line i draw, what do you stand for?
Leadership is a significant lever of change, and in young democracies, you can set about doing this with a great constitution – there are far too many countries in the world for us to cherry pick the best, and no, we do not have enough able bodied Ugandans to pay a bloodied price. So no, let’s not even think about it.
I grew up in this city, and my first experience with road carnage did not take a while, a school mate of mine, at Bat Valley Primary School was de-skinned under a speeding taxi between Little Flowers and YMCA. Needless to mention, it was the first of many lives to waste on our roads.
It is amazing but a boda boda may kill you faster than HIV Aids and Malaria! The thing is, we have to do something drastic, something disruptive if we want to see different results on our roads.
#1 – Age of Our Vehicles
We must make a conscious decision about how old the cars we let into this country are. Note that age alone doesn’t make a car less useful, but a significant percentage of the cars we import are used. Wear and Tear cannot be masked by a cute coat of paint or a new registration, we must consciously decide that this country is worth progressively newer cars that tend to carry with them newer features and technologies for safety. We need to invert the bell shape for taxation of cars around the 5 to 6-year-old mark. These cars will already contribute various taxes through regular consumption of materials (such as fuel and lubricants) and services (such as insurance and jobs in maintenance).
#2 – Road Worthiness Check for Vehicles
Every 2 years, without fail, every car in and around Kampala must attend a road worthiness check, a criterion that must be developed not democratically, but by law. We may not get it right the first time, but we have to start somewhere. Computerized checks would reveal the condition of cars – especially if they are not older than a certain age.
This certificate will not ensure less accidents, but it will guarantee that any we have will not have their effects multiplied because of the condition of the car. Still, I think that we deserve this for the future of this nation.
If you have sat in a taxi lately, ramming 12 people in the back, it is a maddening surprise that we expect people to come out alive.
#3 – Driver Qualifications
I sat a driving test, but all I ever drove was the safety of Naguru’s deserted colonial streets. I wonder if the officer who gave my test would be willing to take it to the busy highway sections of Kakira and the Northern Bypass.
Do we need a simulator for road tests, just like pilots do? Perhaps we can resort to a low tech projected mobile phone car game – because these do a better job of simulating traffic conditions on the road, far more than anything I have experienced in real life.
Then there is the occasional boda that will cut you in, and the self-entitled taxi driver who cuts you off because he keeps left.
How many hours, simulated or real, does one need before a driving license can be issued? And why do we issue 3-yr licenses to first time drivers?
#4 – Digitized Road Signage
I have seen solar powered digital road signs used during construction, and they come in handy no matter the visibility, but usually the next time you will see them is when another road section is under construction.
They work so well, use very little power, are mobile and can be deployed in the unique of the moment yet we do not use them. Every consignment for arms and riot gear should include a significant amount of these signs as the effects on the roads kill more people every month than riots ever do in the whole year.
#5 – Reputation as a Deterrent
It’s time to add to the fines. You need to pay the fine, for the offence you have committed, but you need to be a part of the solution going forward.
How can we use something so precious as reputation to drive the point home? We need to be able to withdraw driving rights and privileges – in fact we can make a mess of it by publishing offenders who we do not expect to be driving, for regular periods such as a month, 3, 6 or even 12.
Every offending driver will suffer reputational risk on 2 fronts, Suspension and Withdrawal. Every repeat offence while under suspension automatically extends your penalty. If caught driving under a withdrawal ban, you will start with Community service (directing rush hour traffic) and progress to jail.
#6 – Complimentary Services
So we can renew car insurance at the point of road worthiness check, right? We can also supply First AID boxes that are suited to a particular vehicle type, at the same check. And we can ask that suppliers of car materials provide for at least 2 year guarantee on materials such as tires. The point is, when you begin to do one thing, and you bring all complimentary services around it, so that drivers can be saved the burden of picking up services from various points.
Insurance companies should have higher premiums for cars with accidents, and should consider excepting cars driven by drivers on the permit withdrawal plan. Comprehensive premium covers should be favored over third-party covers, so that we can begin to count the medical and life costs of road carnage. Cars with regular service schedules and manufacturer guided part replacements should be incentivized.
#8 – Road Safety Investment
Now how do we invest for all these things to happen? We need a percentage of that traffic fine to go financing road safety. Your fines should contribute directly to purchase of road signs, painting of tarmac signage (did I mention community service above?) and sustenance of research and planning for road safety.
Of course this is multi-sectoral, lest an entity takes the power and control and we see exponential road fines being handed to offenders. The solution here is not to banish you beyond returning to the roads, it’s to engage more of you in the solutions to problems caused by your behavior on the road.
#7 – Analytics and Data
Finally, we need to tie this all together in a simple data and information system – no expensive procurements, we already have the passport recognition system at the airports, and we already have barcode scanners which we can use to pull up a history. Yes, we also have 3G and 4G in many places in this city, and we can get 4G SIM cards for free (or as part of community support) from the telecoms.
If a traffic officer cannot tell my driver history within 2 minutes of holding my driving permit, and cannot tell if the car am driving has been involved in an accident before, then he has already lost the mind game, and (possibly) the moral authority to hold me accountable.
But of specific value is the level of relationships we can create from data mined by whipping up a simple information system. The devil is always in the details, and currently we lack these and are not able to make any informed management decisions.
Unless we are willing to be intentionally disruptive to the habits of drivers, and the ecosystem of vehicle operation and use in this country, we may huff and puff whenever we have a significant life-sucking accident, but may never muscle the changes we need to see, in order to save lives on the roads.
Thanks to @jameswire for this piece – I absolutely agree.
A visit to the Kampala Capital City Authority (KCCA) Website led me to read about the Directorate of Physical Planning and I saw these opening lines, “To plan the development of the functional urba…
THE FOSSFA CHAIR SPEECH AT THE OCCASION OF THE LAUNCH OF IDLELO7
23rd MARCH 2016.
The Right Honorable Prime Minister of Uganda,
The Permanent Secretary, Ministry of ICT of Uganda,
The Executive Director of National IT Authority of Uganda,
The Executive Director of Uganda Communications Commission,
The Council, Free Software and Open Source Foundation of Africa,
Members of the African Open Source Community,
To all FOSS Developers, Users and Supporters,
My name is Seun Ojedeji (@seun_oj), FOSSFA Chair and it is on behalf of the FOSSFA community that I invite you all to IDLELO7 –
For more than 15 years, the Free Software and Open Source Foundation of Africa has held Africa’s premier open source summit, for Africans, on the African continent. We have been to Johannesburg (2006), Dakar (2008), Accra (2010), Abuja (2012), Nairobi (2014) and now we are excited to be coming to Kampala- for the 7th African Summit on Free Software and the Digital Commons which will hold in August 15th to 19th of 2016
The Free Software and Open Source Foundation for Africa (FOSSFA) has its origin in the ICT Policy and Civil Society Workshop in Addis Ababa, Ethiopia held between 6th and 8th November 2002. The United Nations Economic Commission for Africa, convener, was acting on the mandate given to it by the Bamako Bureau established by the African Council of ICT ministers in the continent’s preparation towards the World Summit on the Information Society – WSIS. As a pan-African FOSS Foundation, the vision of FOSSFA is to promote the use of FOSS and the FOSS model in African development
FOSSFA exists to:
• Promote the use of the open source model in African development.
• Promote the integration and adoption of FOSS in national policies
• Coordinate Africa’s Free Software efforts
• Use its expertise to add value to FOSS initiatives in the continent
• Act as Africa’s FOSS voice
• Play an interface role between international and continental FOSS efforts
• Contribute FOSS applications towards the achievement of women empowerment, the Millennium Development Goals and sustainable development in Africa.
• Promote African FOSS expertise, creativity and industry
• Partner with development organizations who share same goals with FOSSFA
FOSSFA is incorporated (72193 C2/GB) under the Section 24 of the Companies Act of 2001 as a non-profit Pan-African organization in the Republic of Mauritius. Its members are individuals, organizations and agencies that share similar goals across the world. FOSSFA is headed by an elected council, which chooses from within itself, members to act as its executives. Every 2 years, on the occasion of each Idlelo, the Foundation hosts a General Assembly of its members to renew the mandate of the council.
http://www.fossfa.net is the official website.
What is the Open Source Model?
The term open source began as a way to describe open access to software source code and the collaborative model for how it is developed around the following principles: Openness, Transparency, Collaboration, Diversity, and Rapid prototyping.
The open source model is more than a software development model, it’s a culture. A culture that intentionally establishes an all inclusive approach to solving community problems using technology. The open source way is about applying the principles of open source software development beyond software and technology.
We can learn more from each other when information is open. A free exchange of ideas is critical to creating an environment where people are allowed to learn and use existing information toward creating new ideas. When we are free to collaborate, we create. We can solve problems that no one person may be able to solve on their own. Rapid prototypes can lead to rapid failures, but that leads to better solutions found faster. When you’re free to experiment, you can look at problems in new ways and look for answers in new places. You can then learn by doing.
In a meritocracy, the best ideas win. Everyone has access to the same information. Successful work determines which projects rise and gather effort from the community. Communities are formed around a common purpose. They bring together diverse ideas and share work. Together, a global community can create beyond the capabilities of any one individual. It multiplies effort and shares the work. Together, we can do more.
Free and Open Source Software also known as FOSS solutions enable us to work with legal and secure software that can be integrated with both older, legacy and new systems. Specifically, FOSS solutions provide access to software that can be localized, both in terms of language and specific contexts. They can also be adapted to specific organizational or project needs. Whilst uptake may yet have some challenges in the short term, IDLELO7 shall strive to plead the case for FOSS as a more sustainable and economically viable option for Africa.
IDLELO7 shall provide us with the privilege to participate and interact with a lineup of experienced presenters working on FOSS projects, platforms and rapidly evolving social network tools and applications.
Why is FOSSFA coming to Kampala for the 2016 Summit?
FOSSFA continues to enjoy a significant community of active FOSS advocates who live and work here in Uganda. The FOSSFA Council and executive has enjoyed the expertise and energy of committed Ugandans since inception.
It is the effort of these Ugandans, together with the National IT Authority that was recognized in an excellent bid to host the 7th African summit, beating strong competition from Durban South Africa, and Calabar International Conference Centre in Nigeria.
We also recognize that NITA-U has taken steps in drafting the National FOSS Policy and as FOSSFA, we are excited to bring our continent-wide experience to partner with the government of Uganda on charting the course towards a sustainable Free Software and the Open Source model.
Uganda is also uniquely placed as a leader in the region, stabilizing and pacifying neighbors. Uganda remains integral to the Great Lakes region of Africa. Two years ago, COMESA issued FOSS adoption guidelines, and now Kampala has an opportunity to lead the conversations on the review of adoption of these by COMESA member states.
The primary goal of IDLELO7 is to increase the awareness, integration and adoption of free and open source software (FOSS) in Africa within the IDLELO7 theme emphasising how such Free and Open Source solutions are being (can be) used to achieve Open Data and Open Government frameworks.
In Kampala, we expect to learn what the Government of Uganda roadmap to Openness highlights, and also what COMESA and other development partners have planned. We invite NITA-U, UCC and other entities towards FOSSFA Membership, as a sign of commitment to the Open Source Model.
We look forward to welcoming all of Africa to Kampala, this August, exactly 153 days from today. We look forward to gaining more FOSSFA Memberships from the summit in Kampala, both individual and organizational.
FOSSFA Council Chair
Last week, I interacted with a young bespectacled Kenyan girl – she is attending school in my neighbourhood, a proud P.7 candidate. Her testimony, was of being able to score above 95% in a couple of exams and 92% and 94% in the other 2 subjects.
She was happy particularly because she felt that this set of mock exams, taken from another school, was harder than the set of exams of her own school. She went on to say, she would like God to give her wisdom to get the other 2 subjects above 95% because her teacher mentioned to her its the new passmark for getting a distinction.
My jaw could not drop lower. She must be 13 or thereabout.
She went to narrate how her school takes pupils that do not score high grades to other schools for PLE. Apparently, Kampala based schools would like to maintain the impression of a perfect scores, so they offload pupils who are scoring 3rd and 4th grade marks to lower schools where they “fit” in the demographics. For these schools, these students will taint the scorecard, and cause their annual classification to dip when the UNEB comes reading the top 5 schools in each district.
How and when did we get to the deep echelons of such selfishness? And why is the future generation of this country being made to feel that they are inadequate just because they will skew the scores?
Parents, you need to be wary of a school that has no children in 3rd and 4th grade listed on their P7 lists for the last 10 years, because as we all know, academic brilliance is a normal binomial distribution – there will be quartiles, on either extremes.
I went to Kibuli Secondary School and i know that even the creme de la creme of post primary institutions, inspite of their very best selection efforts, still land, atleast in good time, students who cannot remain as good as their 4, 5 or 6 aggregates scored at PLE.
What are we doing to our children? All these teachers who are clamouring for more, for themselves, when silently they are depriving our children of the right to fail – because as we know, and much later in life, failure is a much celebrated ingredient of success. Why do we make our children feel bad because they did not score 95%?
Parents, why do you accept to live under the pressure to pay extra fees to one teacher, so your child can miss their rightful term holidays and weekends? Is it really true that this one teacher will make your child pass? And when that teacher gets hit by a boda boda? Then what, you will move on to pay the next teacher who promises your child a 4?
Why would you expect this teacher to be doubly motivated to help a handful of children pass just because they pay an extra 100,000/= , and get to miss out on their weekends and holidays? If this is what the teacher needs, why don’t we work through the PTA (Parents’ and Teachers’ Association) to motivate all the teachers in the same school so that other children who cannot afford this can also benefit from such a teacher? After all, isn’t sharing caring?
I cry for the children who are moved from one stream to another, and one school to another, and eventually get knocked out of a school because their grades are considered not good enough by the very administration whose job is to increase their confidence and ability to tackle academic and life challenges. For these children, failure will always be a mark on their faces, painted by the system we pay.
I am sick to my stomach that we let such culture take root in our feeble education system.
I am ashamed for the parents who walk out of the headteachers’ offices convinced that their children are not good enough to sit their final exams at a school they have patronised for the better part of 6 years.
I am angry at the idea that you drive back home and find the words to package that hope shattering nonsense, and unwittingly become the postman for your child’s new found future – a future that says they are not good enough; at least not good enough to sit in the school they have sacrificed early morning for all their lives.
This same school, when the results are out, will pay a premium fee to the press, for an advert that says they had 90% first grades, and the other 10% were second grades. They had no 3rd and 4th grades. Oh how conveniently magical!