Data-Driven Global Health Research in the Time of COVID

The COVID-19 pandemic has highlighted the value of innovative, real-time data and analysis when it comes to making fast, consequential decisions about global health policy. Last week, Measuring Development: Emerging Data and Methods in Global Health Research, a virtual conference co-organized with the World Bank, showcased how researchers are using new types of data and data-intensive approaches to address critical public health challenges, especially in low- and middle-income countries. In this post, CEGA Program Manager Sam Fishman and CEGA Communications Intern Yevanit Reschechko briefly summarize talks from MeasureDev 2021.

A nurse checks the temperature of a patient at Redemption Hospital in Monrovia, Liberia (Credit: Dominic Chavez/World Bank)

On March 31st and April 1st, CEGA joined forces with two teams from the World Bank — the Development Impact Evaluation (DIME) group and the Tools and Analytics Unit — to host Measuring Development: Emerging Data and Methods in Global Health Research (MeasureDev 2021). The conference highlighted ways that new analytical methods (such as applications of artificial intelligence), and growing troves of new data (produced by social media platforms, internet searches, sensors, and cell phones) are allowing researchers to track, measure, and respond to health interventions and phenomena in real-time, and at lower cost than traditional person-to-person survey methods. This is particularly helpful in a crisis situation like the COVID-19 pandemic, where traditional data collection is infeasible and real-time insights are required for public policy responses.

In honor of World Health Day, we share a roundup of the innovative research presented at MeasureDev 2021 and its implications for policy makers around the world (videos are linked in the text, with more added as they become available). Please visit our website for a complete list of speakers with links to presentation videos.

MeasureDev Research Roundup

Keynote: AI and Health

In the keynote, Ziad Obermeyer, CEGA affiliated faculty and professor at the University of California, Berkeley, discussed the uses of predictive algorithms in health, and the ways bias seeps in. Obermeyer highlighted his research showing how black patients assigned the same level of health risk by an algorithm are actually sicker than white patients. He further showed how the CARES act introduced bias in COVID-19 relief funding. Targeting based on patients who use lots of resources (revenues) rather than patients who need lots of resources (COVID-19 severity) disproportionately disadvantaged black counties. Despite serious problems, he explained that ML/algorithmic approaches remain critical cost-efficient tools for informing public policy, and charted a path for weeding out bias in algorithmic targeting (video).

Tracking and Responding to COVID-19

Presentations in this session highlighted the rich, non-traditional data sources researchers have leveraged to inform COVID responses, including: internet data (more than half the world population is counted as active-internet users), cell phone data (cell phones now outnumber people), social media use, geospatial and remotely sensed data. We also saw critical new research around COVID testing, including a timely presentation on high-frequency pooled testing.

• Robert Marty (DIME) showed that increases in COVID-related google searches were predictive of surges in caseloads at the national and subnational levels, suggesting policy-makers could look to google search data for early indicators of COVID-19 spikes (video).

Robert Marty (DIME) presents his research on Google trends and COVID-19.

• Frauke Kreuter (University of Maryland) discussed a collaboration with Facebook to design and roll out a survey tool for assessing COVID-19 symptoms, social behaviors, mental health, economic security, vaccination status. The survey supports syndromic surveillance and can provide early warnings of caseload increases (video).
• Ernest Mwebaze (Sunbird AI) shared work with the Ugandan Ministry of Health to provide retrospective and real-time analysis of public perceptions about messaging around the virus and prevention protocols, to inform public health communications (video).

Ernest Mwebaze (Sunbird AI) presents his research using social media to understand public perceptions of COVID-19 messaging in Uganda.

• Shankar Iyer (Facebook) discussed how Facebook’s Data for Good colocation maps — which show how often individuals are close enough to one another to potentially spread COVID-19 — can support contact tracing and modeling of social distancing (video).
• Ahwaz Akhtar of the Indus Health Network presented on work using privacy preserving geocoding with Google maps API to pinpoint information related to COVID-19 response, including contact tracing and testing. This approach can inform case detection and could prove a scalable technology for community-level health informatics.
• Sveta Milusheva (DIME) presented work combining cell phone call detail records (CDR) with Demographic and Health Survey data to produce Agent Based Models on the spread of disease. The framework can help governments predict the course of disease, assess different risk scenarios, and calibrate response efforts.
• Jon Kolstad (University of California, Berkeley) demonstrated the efficiency and cost-effectiveness of high-frequency pooled testing for COVID, a particularly promising approach for reducing prevalence of disease within organizations (schools, factories, etc.).

Este Geraghty, Chief Medical Officer at ESRI, led a panel showcasing uses of GIS tools to inform the COVID-19 response.

• Thiago Rocha (Duke University) shared how GIS tools and satellite imagery can support low-resource countries generate up-to-date population density estimates and identify regions without health centers. This is essential in planning for COVID-19 prevention and vaccine rollout, especially where census data is outdated.
• Jisoo Kim shared how the Pan American Health Organization (PAHO) has helped countries across their region track, compile, and share COVID-19 caseload data utilizing GIS mapping tools to share data at the sub-national level and identify cross-border trends.

Jisoo Kim (PAHO) presents her work on new mechanisms for collecting and sharing health data in the Americas

• Juan Pimento, from Panama’s National Authority for Government Innovation, demonstrated how GIS tools and data analytics helped his team analyze contact tracing and COVID-19 case data at the local level to understand the evolution of the pandemic. They are now using these tools to help determine vaccination priority, locate priority groups, understand cold-storage chain logistics, and track vaccination progress.
• In a series of workshops, Jared Shoultz, Mike Schoelen, and Este Geraghty from Esri (video) and Karen Byrnes, Deven Desai and Shurti Jain of Atlas AI (video) demonstrated how their companies’ geospatial data and analytical tools can be leveraged for a variety of public health efforts, including COVID-19 response.
• Trevor Monroe (DEC Analytics and Tools) reviewed the World Bank’s work on open data and analytics for development research including the “Open Data Product Starter Kit” (see the last slide for links to numerous resources). He highlighted the World Bank’s partnership with CEGA (through the Berkeley Initiative for Transparency in the Social Sciences) and GitHub accreditation as drivers of more collaborative and open research (video).

Climate and health

CEGA affiliated faculty Gordon McCord (UC San Diego) and Tamma Carleton (UC Santa Barbara) led a panel with Jesse Anttila-Hughes (USF) on the impacts of temperature and climate regimes on health outcomes. Together, these talks provide compelling evidence on impacts of climate on vulnerable regions, and suggest new directions for policy response and for assessing the cost-benefit of climate change adaptation and mitigation policies (video).

• Both McCord and Antilla-Hughes explored impacts of climate on nutritional outcomes, suggesting the importance of timing policy responses to weather events and heat waves. McCord’s research on El Niño’s (ENSO) impact on child nutrition finds strong negative effects trailing El Niño, citing impacts on agriculture. Anttila-Hughes’ work on impacts of high-temperatures on child under-nutrition in sub-saharan Africa finds serious regional impacts through agricultural and sanitation channels. Tamma Carleton presented a model for valuing the mortality consequences of climate change that accounts for new data on the ability of different regions to adapt to climate change. The estimated $17-$37 mortality cost to each ton of carbon produced suggests current measures underestimate the social cost of carbon.

Measuring Quality of Care

A number of presentations from the World Bank (including a panel on day 2) focused on the importance of measuring healthcare access and quality of care, especially in low and middle-income countries.

• Damien de Walque (World Bank) emphasized that coverage does not necessarily translate to quality care, and presented a new “effective care” metric, which offers a deeper understanding of gaps in healthcare provision.
• Anja Sautmann emphasized the importance of daily diary data as a means of measuring healthcare needs and understanding misallocation of limited healthcare resources, drawing on two studies which used this type of data to understand parents’ propensity to seek clinical care for their children.
• Eeshani Kandpal showed how information, rewards, and penalties in pay-for-performance contracts for healthcare professionals impact service quality. A randomized evaluation demonstrated that financial rewards and penalties were similarly effective for improving healthcare workers’ likelihood to perform important tasks, whereas simply providing information had little effect.
• Guadalupe Bedoya (World Bank) discussed a new tool tool to assess compliance with infection prevention and control (IPC) practices across multiple domains and contexts, demonstrating that both supply constraints and behavior limit compliance. The tool would be useful for policymakers interested in assessing and improving compliance (video).