Healthcare resilience through fruitful mobile data
In places like Europe and the United States, it is easy to take the pharmacy for granted. Picking up products and prescriptions and getting good advice is a regular process. In low to middle-income countries though, often poorly trained staff have to work harder with less and people in need are not always able to get the medicines they need. Andrew Wyborn, Founder and Director of Greenmash has created a system that uses mobile data to improve healthcare no matter where medical facilities are — so long as they can access a mobile signal.
Andrew Wyborn has spent the best part of thirty years working on the creation and growth of technology companies. Having observed a number of systems he says that the simplest solutions are often the best, “A well-designed commodity management system does not have to be complicated, expensive or take a long time to implement or return on investment. We created Mango to capture data from very remote areas, using simple mobile phones and automatically turning that data into meaningful information for decision makers who can then take effective action.”
Currently, the state of rural pharmacies in low and middle-income countries (LMICs) can vary. Wyborn says that the privately owned ones are usually better funded but in other cases, for example in rural Africa, people may have to walk many miles to find a trained health worker with the right treatment. Some facilities run out of stock due to paper spreadsheet systems, meaning that by the time data reaches decision makers, it is no longer relevant and in some cases inaccurate.
Mango has been deployed to provide a wide range of solutions in more than 14 countries, 12 of which are in sub-Saharan Africa. It helps to improve supply chain management, support demand creation, track referrals, distribute electronic vouchers, track and support patients for a range of conditions and improve access to medicines.
“The common thread in these cases is that they all involve capturing data from a variety of sources in low-resource countries, automatically generate reports, charts, maps and dashboards, and trigger workflows and alerts to make sure the right people get the right information in a timely fashion,” Wyborn explains.
Mango management for NCDs
The system is well-suited to so many situations, including noncommunicable disease (NCD) management — this includes things like cardiovascular diseases, asthma, diabetes and cancer. According to the WHO, 15 million people die from an NCD between the ages of 30 and 69. More than 85% of these premature deaths occur in LMICs. Wyborn says that because chronic illnesses need early detection and long-term, ongoing treatment, new methods are required to ensure access to affordable medicines where people often have limited resources.
In 2015, Novartis launched a program to fight chronic diseases in LMICs called Novartis Access. The Access initiative in Pakistan uses a Mango application to register and track patients using key indicators and biometrics. The system also automatically tracks the dispensing of allocated treatments and reduces available stock levels to enable accurate stock tracking and management.
“Mango automatically generates a rich set of reports, charts and maps providing Novartis, and the Ministry of Health with clear and accurate real-time information to support decision making,” Wyborn says. “The system automatically notifies patients of their next appointment, identifies the patient (or their representative) removing opportunities for fraud, tracks the dispensing of treatments and provides essential information to monitor, manage and plan.”
Supporting existing health systems through the pandemic
Like many people, Wyborn heard about the COVID-19 pandemic and assumed it was something far away like SARS. “How wrong I was!” he says, “As the virus evolved and spread, it became apparent that technology was going to play a key role from home working to improving patient care.”
The teams at Greenmash looked at the growing problems and quickly created configurable tools to help track essential commodities and support the tracking and tracing of positive patients. “These tools are all derivatives of solutions we have been deploying for the past ten years,” Wyborn says. “This enabled us to respond quickly with proven solutions at a fraction of the cost of starting from scratch.”
“We believe countries need to act smarter, making better use of less money as donors reduce their budgets. One way to do that is to make more effective use of data and that means making better use of appropriate technologies.”
As the pandemic became a global issue, Mango proved to be suitable in a number of ways. It is language independent and users can be assigned access rights and language preferences specific to their needs. As COVID’s impact varies in different countries this flexibility is particularly apt.
Bringing up supportive systems quickly during a pandemic is vital and can save lives. “Health workers are always busy,” notes Wyborn. “In a pandemic their workload can increase exponentially but other diseases do not stop happening just because there is a new virus.” Supportive systems like Mango are especially helpful in identifying who needs aid, where new cases are prevalent, what treatments are available and to inform health workers quickly, easily and affordably.
When it comes to the further management of COVID-19, he is pragmatic, “We believe countries need to act smarter, making better use of less money as donors reduce their budgets. One way to do that is to make more effective use of data and that means making better use of appropriate technologies.”
A fruitful future
The adaptable nature of Mango means that it can be used in a number of ways to support healthcare in many more countries. “We have a continually evolving roadmap,” says Wyborn. “We want to make scaling up and down faster, easier and cheaper and we’re moving to an infrastructure based on Kubernetes, an open-source system for automating deployment, scaling and management of applications.
“We’re also making Mango more component-based so that clients can make use of the parts of the system they find most useful — like data collection, integration and visualisation, rather than having to take on full systems.”
At COVIDaction we are proud to be supporting Greenmash in its development of Mango and the admirable flexibility of its future plans. “We are always looking to introduce new data sources such as earth observation satellites, biometrics such as iris and fingerprint scanning, and make use of more automation with AI and powerful algorithms,” says Wyborn.
Wybron is driven to focus on making Mango a tool that can save many more lives, “It’s a great way to help improve the use of actionable data to make informed decisions that lead to better outcomes for people living in low and middle income countries. Who wouldn’t be inspired by that?”
Finding solutions for LMICs that are able to work on mobile networks is inventive work. Wyborn and his team continue to track the pandemic’s impact in different countries and work to find solutions to new problems along the way. With such ambitious ideals and so much labour ahead, why name the product after a more humble fruit? “We wanted a name that was easy to remember, non-offensive in any language and that conjured up an attractive image,” says Wyborn. “I wanted to call it apple or blackberry but someone beat me to it!”
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