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Covid-19 Update: New CHT app for port of entry surveillance in Nepal

Covid 19 Surveillance

March 22, 2020

Posted by: Alix Emden

Post Authored by Shreya Bhatt, Director of Partnerships and Sudip Pokhrel, Government Partnerships Manager. 

This post is a continuation of our blog series to share important updates and commentary on our Covid-19 response efforts and updates.

In the past several weeks, airports and other major ports of entry around the world have become the new frontiers of care and response in the fight against Covid-19. Many countries have imposed travel restrictions, and implemented stringent surveillance at airports to detect travelers with suspected Covid-19 infections and trigger quarantine and follow-up measures to contain the spread of the disease within their borders.

As we accompany our Ministry of Health partners in their response efforts, the need for support in surveillance activities at ports of entry has emerged as a strategic priority for many health systems. Based on their needs, this was one of the first areas we started to work on. 

In partnership with the Ministry of Health and Population (MoHP) in Nepal, we designed and launched a port of entry surveillance app powered by the Community Health Toolkit to enroll all incoming travelers entering Nepal through Kathmandu Airport, facilitating more effective screening of Covid-19 as well as follow up for travelers advised to self-quarantine. The app we designed and built adheres to MoHP and WHO guidelines for the detection and management of ill travelers suspected to have Covid-19 at ports of entry.

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A man arriving at Kathmandu Airport was detected to have a fever. He was counseled by the Health Desk staff to self-quarantine for 14 days. His travel history, contact details and symptoms were entered into the CHT-powered app for future follow-up. 

This was an enormous feat achieved in a sprint-fashion with collaboration between Medic Mobile, the Ministry’s Health Emergency Operations Centre (HEOC) and Epidemiology and Disease Control Division (EDCD). Our designers and technical leads worked closely with the focal points of HEOC and EDCD to understand the user requirements and scope of the project. Our mandate was to build a simple system that could be deployed quickly at Kathmandu International Airport to start capturing data from paper-based forms implemented by the Ministry to record travel history and contact details, and monitor symptoms of arriving passengers. The system was deployed last week at the Ministry’s Airport health desk, and the health desk staff have begun entering data into the system. 

Our team has already begun to incrementally enhance the system based on additional requirements and functionalities including data analytics and visualization. As the Government of Nepal’s Covid-19 response efforts continue to evolve, we will seek to incorporate self-quarantine follow-up workflows into the system and also deploy it at other major ports of entry. More broadly, we are also exploring how this system can be easily reused in other settings where we work globally. 

At the sub-national level, we are working with local municipalities to support Female Community Health Volunteers (FCHVs) in delivering behavioral change messages to households. More than 8,000 FCHVs already use our SMS tools in Nepal to coordinate maternal and child health, so we are able to quickly send critical messages around Covid-19 prevention, detection and response. This week, we supported the Biruwa municipality of Syangja district in western Nepal to deliver health messages to over 70 FCHVs. The SMS messages are curated by the MoHP and approved by the municipality, which informs the FCHVs on COVID-19 symptoms and asks them to refer symptomatic cases to a nearby health facility. FCHVs also receive a separate message promoting hand hygiene and social distancing, both for their own safety and protection as health workers and for awareness generation to the households they serve.

We’re humbled and honored to work in accompaniment with the health desk staff, HEOC and EDCD teams, local governments, and leadership of MoHP, as they continue their Covid-19 surveillance and containment efforts. We'll continue to share more updates on our Covid-19 response efforts in the coming days. 

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