Compassionate Cartography
How geospatial technology is transforming HIV treatment in Zimbabwe
Danile wakes up bright and early during the rainy season in her village in Gwanda District, Zimbabwe to check on her crops and go fishing for her family. Her commitment to the well-being of others extends to the rest of her village, as well.
“I have always been a person who likes helping others. I have a passion for it,” Danile reflects, with a smile.
For several years, Danile has worked to prevent the spread of HIV in her village. As a community health worker, she goes door to door providing her neighbors with peer support, health education, resources for self-testing, and health facility referrals for HIV treatment services.
She is employed by the Organization for Public Health Interventions and Development (OPHID) under USAID’s Target, Accelerate, and Sustain Quality Care for HIV Epidemic Control Project (TASQC).
As an individual living with HIV, Danile is especially passionate about the role.
“I feel comfortable describing the services I can assist others with owing to my own status as a person living with HIV,” she said.
HIV is one of the leading causes of death in Zimbabwe, and addressing the epidemic in more rural areas of the country has been an ongoing challenge.
Paper-based data management systems complicate community health workers’ ability to record and access data remotely, which causes inefficiencies in service delivery.
For Danile, who used to regularly travel by bicycle up to 30 kilometers in each direction to the nearest clinic, spending nearly an entire day in transit limited her ability to meet with patients and file the necessary paper reports.
To solve this problem, USAID and OPHID partnered with the Zimbabwe Ministry of Health to develop and launch a location-based, real-time data management system in four provinces.
Built on a web-based, open-source platform, the TASQC Management Information System (T-MIS) tracks which services are being delivered and where, enabling the health system to address unmet needs for testing services in hard-to-reach areas.
With the T-MIS in her toolbox, Danile can now file reports and coordinate service delivery on a tablet from her village using the system’s geospatial mapping capabilities. The T-MIS also has SMS-enabled offline capabilities when Danile is in an area with limited network coverage.
This has saved her considerable travel time, allowing her to dedicate her time to the work that brings her the most joy — diligently tracking her clients’ health.
Danile recounts how the digitized data system enabled her to quickly arrange for treatment for an HIV-positive individual who was initially resistant to getting tested.
“Because of this system, I quickly managed to call for help from the clinic, and the client was quickly given medication,” she said. “It makes me happy that the client now regularly passes through my home and feels free to ask when more medicines will be delivered.”
The T-MIS has become an essential mechanism for health facility staff and community health workers in Zimbabwe to coordinate their efforts.
Health facility and TASQC project staff use the location-based data to find areas with unmet needs, where they strategically deploy community health workers to community gathering sites, such as town halls, schools, public meeting points, and churches. The T-MIS data is also used to make performance-based payments to the community health workers.
Furthermore, data shared and accessed from the T-MIS helps health facilities and community health workers to coordinate patient follow-ups and facility referrals. Integration into the district health information system allows the government, health facilities, and community health workers access to robust analytics and visualizations to help inform decision making.
Since the launch of this data management system in 2021, community health workers have reached more than double the typical number of clients for HIV testing and service delivery.
The T-MIS has also enabled an expansion of the community health service offerings, supporting the screening for noncommunicable diseases like cancer, hypertension, and diabetes for over 70,000 clients in 2023 alone.
As Zimbabwe continues to grapple with the HIV epidemic, Danile’s story highlights the power of innovation and community-driven solutions to support healthcare access for remote populations.
For Danile and her fellow community health workers, she said:
“It is our wish that the TASQC program be expanded beyond our district to all provinces. This could go a long way in fighting HIV/AIDS prevalence.”
USAID’s Target, Accelerate, and Sustain Quality Care for HIV Epidemic Control (TASQC) program, implemented by OPHID, was selected as a winner of USAID’s 2023 Digital Development Awards.
