Scaling up a Digital Tool to End TB in Bangladesh
Last October, Bangladesh’s Directorate General of Health Services (DGHS) went digital—that is, it initiated a national digital health strategy to improve the accessibility and quality of its health services. The USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) program is helping the country realize its goals by supporting a national scale up of e-TB Manager, a web-based patient management tool.
Bangladesh has among the highest rates of TB and multidrug-resistant TB (MDR-TB) in the world. Digital health technologies promote more effective, efficient patient care for TB and help programs manage medicines and cases, particularly for complicated MDR-TB. e-TB Manager captures data across all aspects of TB control and management, including presumptive and confirmed patients, medicines, laboratory testing, diagnosis, treatment, and outcome.
TB and Leprosy Control Assistant (TLCA) working in Teknaf Upazila.
The country has already made significant progress in e-health. Working with MTaPS’ predecessor program, the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program, the National Tuberculosis Control Program (NTP) has been using e-TB Manager since 2010. The tool reduces paper-based errors and reporting time, improves the quality and use of data, and ultimately cuts costs. Users overwhelmingly report that it works well and increases their efficiency.
With MTaPS support, the NTP has made e-TB manager a universal and mandatory tool for recording and reporting TB cases. It is now used in 382 of the 876 TB reporting sites in the country, including all MDR-TB sites, and had a database of 503,170 individual cases as of March 12, 2020. MTaPS will conduct training on data entry and use at all levels and will support the NTP as it takes complete ownership of the tool, helping ensure sustainability.
“I can easily find any registered case. Preparation of quarterly reports and case analysis by type, sex, age, category, facility, which took a minimum of two days previously are easier and take only few seconds.” — Md. Bahauddin, Atpara sub-district TB and Leprosy Control Assistant
Ensuring interoperability with central information systems
Having necessary health data available at every level of the health system contributes to better decision making, which ultimately leads to better outcomes. MTaPS is supporting the Ministry of Health and Family Welfare (MOHFW) to link e-TB Manager data to the national health data platform. Linking the systems while adhering to health data standards is challenging, but MTaPS devised a standard web application programming interface to ensure data flow from one to another. Interoperability will make TB data more easily accessible to MOHFW-level decision makers, allowing them to take quicker action on needed activities. It will also increase district user accountability and data quality.
The NTP’s e-health initiatives have the potential to move fully to scale and help Bangladesh make significant progress its fight against TB. MTaPS will continue to support the country to scale-up high-quality digital technologies for more effective and sustainable TB care.