Covid-19 Surveillance through community pharmacies
In 2021, Jeeon partnered with Yale University and Innovation on Poverty Action (IPA) to launch a Pharmacy-based Covid-19 Surveillance Project to gather patient data from the point of care and develop an early warning system to detect Covid-19 hotspot that will enable Government and NGOs to take precautionary measure to harness the onslaught of this pandemic.
Unlike the first wave in 2020, the second wave of Covid-19 infection spread like wildfire in the rural areas of Bangladesh. Since 65% of people in our country live in villages and they consider pharmacies/RMPs as reliable primacy healthcare providers, we expected to capture actionable information on Covid-19 at the Union level.
The operation of this project commenced on the 1st of June’21 covering geographical areas of 24 Districts, 59 Sub-districts, and 300 Unions across Bangladesh; we onboarded over 1700 rural pharmacies to build the reporting network and engaged an incentive system to sustain them in our network for at least 5 months. To do this, we recruited 55 volunteers from 59 Sub-districts to build rapport, train and manage these pharmacies throughout the project timeline.
The pharmacies and RMPs were instructed to capture patients’ symptomatic data, related to Covid-19 of course, anonymously and send it back to our call centre on a weekly basis. Our call centre team maintained regular communication with these pharmacies and motivate them to contribute to this noble cause.
During the project timeline, we faced several challenges that were new to us and we did not have any prior learning to address the issue, we had to move forward rapidly and learn on the way to mitigate the challenges. The second wave of Covid-19 created a massive problem for us as we were restricted to moving in the field in person, and most of the pharmacies closed their shop in rural areas. However, we kept constant communication with the pharmacies and made them socially responsible in the time of this pandemic and contributed to this great initiative.
Throughout the program, we incentivized pharmacies at a rate of 160tk/month/pharmacy. During the first four months, we saw an active pharmacy rate of 65%. However, when we reminded pharmacies of the certification and letter of appreciation at the end of the third month of this project , we saw an uptick in the active ratio to 80%. However, if we were to redo this program, we would start by revising the base incentive for pharmacies to BDT 160 tk per month of activity. In addition, we would layer a second incentive of 50tk per month for regularity of data submission. A third incentive layer would encourage pharmacies to send in the data themselves and relieve pressure of the CCAs, which will give us a scope to hire less call center agents.
We are proud to have successfully pulled off the whole operation remotely, starting from onboarding the pharmacies, recruiting volunteers and call centre teams, and monitoring the whole data collection process without having a single in-person meeting. The project ended on the 31st of October’21 gathering over 295 thousand patients’ symptomatic data over 5 months. The cost per pharmacy per month was BDT. 800. Unfortunately, we have not been able to find a comparable surveillance option as a benchmark to evaluate the cost effectiveness of such a surveillance system. Our success with this project emboldens us to experiment with pharmacies as a surveillance network for a wide variety of diseases like Dengue, Chikungunya, NCDs, etc in the future.
Md. Monower Hossain
Project Manager
Jeeon Bangladesh
Jeeon has been working for the last 7 years with the pharmacies and RMPs across Bangladesh to build their capacity and increase the service portfolio. Jeeon has developed an extensive network of IHPs containing over 40 thousand members who directly and indirectly have been working with Jeeon to bring about positive change in the healthcare service delivery at the community level.
