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Tajikistan: Life - Saving Data at Your Fingertips

For far too long, providing quality maternal and newborn care in Tajikistan has been a major public health challenge. That was largely due to limited information to make evidence-based care decisions. But that’s changing. And Gulnora Akhmedjanova is one reason.

Back in January 2021, the obstetrician/gynecologist (Ob/Gyn) from the National Reproductive Health Center’s Dushanbe State Facility attended a three-day training session with 23 colleagues on how to move from paper-based processes to digital health care assessments. In a country where 93 percent of the land is mountainous, moving paper to collect and share accurate data was extraordinarily difficult. The digital approach was transformative. “We used tablets to enter data, and this made our work much easier,” Akhmedjanova said.  

The training is the product of a partnership between the U.S. Agency for International Development’s (USAID) Healthy Mother, Healthy Baby (HMHB) Activity and the Tajikistan Ministry of Health and Social Protection of the Population (MoHSPP). They adapted and digitalized the World Health Organization’s (WHO) paper-based Rapid Health Facility Assessment (RHFA). Digitalization simplified and expedited data collection in such areas as infection control, equipment use, and compliance protocols.

For Akhmedjanova, assessing the quality of outpatient care during pregnancy and in the postpartum period for women and newborns is critical. “It allows you to comprehensively assess the situation and make the most rational recommendations for improving the quality of medical care,” she said. Ultimately, the digital RHFA helps the MoHSPP pursue its goals of improving health services and nutritional status and preventing needless morbidity and mortality of mothers and children.

The digital transformation involved the MoHSPP and HMHB collaborating to digitalize the WHO’s 2000+ question paper-based RHFA tool using a platform and operating system called CommCare. The operating system can be uploaded onto tablets and phones. Data collectors used the CommCare application to enter qualitative and quantitative data. With a push of a button, CommCare interfaces with a DHIS-2 dashboard system, Abt’s Monitoring and Evaluation Ecosystem (AMEE). AMEE enables real-time analysis for USAID, MoHSPP, and health facility managers by generating graphics for data visualization and enhanced decision-making.

The RHFA provides the foundation for score cards, which the 12 HMHB Khatlon districts will use. These score cards provide regular monitoring of health facilities and hospitals.  Beyond score cards, the system will avoid long waits for test results and enrollment of patients for treatment. The system also will enable timely and accurate reporting.

The changes have given birth to new opportunities for Akhmedjanova and other Ob/Gyns. “We do not need to manually fill out a lot of questionnaires, calculate the average score, create tables and charts for reports as this is digitally done by CommCare and AMEE,” she notes. “Instead, we have time to provide supportive supervision and work with medical personnel to refine action plans to enhance quality improvement and conduct educational sessions.” Health facilities now can perform more efficient and effective self-diagnostics, increase evidence-based decision making—and deliver higher quality healthcare for Tajikistan’s mothers and their babies.

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