9 January 2016

Zimbabwe: Realtime Disease Tracking System Long Overdue

editorial

The Ministry of Health and Child Care's plan to roll out a monitoring and tracking system for patients with infectious diseases is long overdue. It is unfortunate that people, through ignorance or sheer irresponsibility, will ignore instructions from health personnel and expose their families and members of the public to the risk of contracting communicable diseases such as TB.

An effective monitoring system will not only allow the ministry to keep track of such people, but will also help in instilling discipline in people undergoing treatment.

The Electronic Patient Monitoring System (EPMS) is to be rolled out at 348 health care centres with installation of infrastructure and internet provision services expected to be in place by mid-April this year. The whole country should therefore theoretically be covered, meaning that infectious disease outbreaks can be contained in small areas before they become a pandemic.

While we understand the urgency in addressing infectious diseases, we hope the ministry will not stop there as there is a need for a comprehensive health map of the country at any given time. The importance of realtime collation and distribution of statistics and data in the health delivery system cannot be overstated. The cholera outbreak of 2008 which claimed an estimated 4 000 lives could have been contained faster and at a lesser cost in lives had there been an effective realtime alert system in place.

The ministry should have a constantly updated database of all health related statistics accessible by stakeholders, including policy makers and health delivery practitioners.

It should be possible for a director in the ministry to know the exact number of people across the country who seek medical attention for diarrhoea, snake bites, syphilis, and physical trauma on any given day without having to wait for cumbersome reports that take ages to compile and pass through the system.

Right now the media relies on figures released by organisations like the World Health Organisation to inform the public on key matters pertaining to the country's health. Zimbabwe had to learn from those agencies that cancer had become the biggest killer in the country ahead of HIV related illnesses. How empowered can we be when such vital information still comes to us from the outside?

We appreciate the need to match world class standards and in a perfect world, we too, would want an alert system like those in countries like the United States of America where the Centre for Disease Control (CDC) is up to scratch in raising the alarm and moving in to act on any worrying health trends as soon as they emerge. They do this because they keep track of the mundane religiously and that is what we also need to do.

At the moment we do not have the resources to do it their way and must make the best out of what we have and take advantage of easily available technology. This is an area where the ministry needs to become more proactive by utilising simple technologies that are already on the market while mobilising funding for more sophisticated systems.

While we understand the dangers of using open access systems like simple messaging and social media platforms, we believe the ministry could use them for a provisional comprehensive data base while compiling confirmed reports which can be released after verification. Such a simple approach would ensure that even cases of illnesses and deaths in rural and farming areas are also captured by exploiting community based non-official personnel like home-based care-givers.

That is the only way that policymakers can come up with meaningful guidelines in time to respond, react and be proactive when this can make a difference. There is little point in trying to address a problem in retrospect. Chances are by then the map would have shifted, which means we are forever trying to play catch-up while lives are lost which could have been saved.

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