When data efficiency leads to improved healthcare: our work in the field with Madagascar-based NGO PIVOT

Developers are studying to what extent a new integrated healthcare management tool being trialled in Madagascar will have the capacity to predict future healthcare needs. 

It started as a way of storing and sharing anonymised patient data, staff information, and data on clinical programmes, including treatment of diseases such as malnutrition and tuberculosis. But now collaborators on this project believe it will be able to actually help predict further outbreaks and allow a better healthcare response. The Madagascar-based NGO PIVOT and the humanitarian tech company Relief Applications are delivering a game-changing platform to manage medical data in the field.

Health center in Kelilalina, Madagascar

Leaving spreadsheets behind

This new system allows the anonymous tracking of patients from the moment they walk in to a healthcare facility through to any treatments they receive, via a personalised ID number. It also allows for the management of staff data, for example, easily enabling users to track how many staff have undergone specialised trainings.

Member of the Monitoring&Evaluation processing data

Users are able to access indicator charts through a simple dashboard interface, while staff are able to input data directly into the system using a mobile app. Data can easily be filtered so that information related to specific health centres can be examined, allowing for a more localised focus. If a malaria outbreak is expected in a certain region, for example, it would take seconds using the PIVOT app to find out how many workshops on malaria prevention had been held in that area. 

“We collect large amounts of data on a daily basis. Previously there was no efficient way to manage this and, in an ideal world, we want this information to be readily accessible.”


Laura Cordier, Monitoring and Evaluation Coordinator at PIVOT, said: “We strive to be a data-efficient organisation so we put out a call for a consultant to help us reconstruct our databases and help us evolve our information systems. We collect large amounts of data on a daily basis. Previously there was no efficient way to manage this and, in an ideal world, we want this information to be readily accessible. Relief Applications proposed a system that allows us to put all of our data together so we are able to manipulate patient-level data and feed that directly into our reporting.”

“The system was developed from scratch by Relief Applications, with the use of some Open Source libraries.”

Data to prevent outbreaks

PIVOT and Relief Applications have a number of ideas for how the platform can be expanded for future use. Cordier said: “We have big plans for the future. We have a statistician working on malaria modelling and we are planning on integrating this into our platform. We also hope to be able to say, based on a given health facility, location, geography and climate, that we can predict when a specific season will be more malaria heavy. Malaria is one of the biggest killers in Ifanadiana District and we would be able to better estimate how many malaria medications we need to order. This platform could be very powerful indeed.” 

Malnutrition test at Tsaratanana Reserve, Madagascar

The system was developed from scratch by Relief Applications, with the use of some Open Source libraries. Development was a lengthy process with many complex technical barriers to overcome, particularly developing the app for use offline. It is already being used by PIVOT in Madagascar but it will be continuously grown and refined. “One thing that has been very unique is that Relief Applications has placed a lot of importance on training,” said Cordier. “We didn’t have a technical team that could operate this tool and they invested a lot of time training two of our workers. We are an organisation that wants to share knowledge and to build capacity to the point where one day we will no longer be needed. We have hired two Malagasy developers to maintain the app because it made sense to build in-house capacity. I appreciated finding that same kind of open-mindedness with Relief Applications.

Pivot Monitoring & Evaluation team

“The process has definitely been a big investment of time and resources, but with the notion of it being a tool built to serve our patients for the long run, and we are really pleased with how it is working for our organisation.”

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