At a Diabetes Compass workshop on a February day in Colombo, the participants - about 25 Sri Lankan healthcare experts and WDF representatives - divided into four groups. Each group received a profile of a local resident with diabetes.
The profiles, which included text and pictures, described real people who were struggling to control their blood sugar. Several had developed advanced complications. One had recently died from the disease. None of them had received a timely diagnosis.
After absorbing the information, the groups discussed what might have been. What could the local clinic, community, society have done differently to get a different result?
Then they considered the future. How could the Diabetes Compass initiative help? What could the project invent to avoid similar outcomes in the future?
“The exercise put patients and their problems in the centre of our discussions, which is where they need to be,” says Kirsten Lauritsen, an anthropologist working on the Diabetes Compass project. “Our solution has to grow out of the local context and respond to local needs.”
Workshops like this one have been hosted repeatedly as part of the inclusive design process that characterises the Diabetes Compass.
The Diabetes Compass is an initiative to improve the quality of diabetes care in low- and middle-income countries by leveraging emerging digital solutions, and co-creation with local stakeholders is at its heart. During the project’s first year, the WDF team and its global partners have overcome challenges ranging from COVID-19 to an economic crisis in Sri Lanka to meet, learn, listen and find solutions.
Together, they have identified ways to reduce vulnerabilities in the diabetes care pathway in Sri Lanka and Tanzania, the initiative’s two launch countries. Now, solutions are in development. The aim is to put new digital tools in the hands of healthcare professionals in 2023.
“A project like the Diabetes Compass is very important to Tanzania, as it provides solutions to the rise in NCDs including diabetes and hypertension,” says Dr. Ntuli A Kapologwe, director of health services at the President’s office of regional and local government in Tanzania.
“Following Tanzania’s recent investment in primary healthcare in terms of infrastructure and human resources, this project will offer an opportunity to improve the primary healthcare response to NCDs, which is currently highly centralised.”
Establishing partnerships and defining the challenge
First, the WDF established strong partnerships with leading experts globally and identified the first two Diabetes Compass countries - Sri Lanka and Tanzania .
Interactive design workshops in Tanzania and Sri Lanka followed, creating a common understanding of local health needs and systems among local experts, practitioners, and decision makers.
Diabetes Compass partners develop Learning and Performance Support solutions for HCPs during a workshop in Tanzania.
From these meetings, agreement on four ‘opportunity spaces’ emerged. These were specific challenges in the diabetes care pathway that the Diabetes Compass solutions can address:
1) Health information - Strengthening health information capture transfer and use
2) Early Detection - Improving early detection and timely diagnosis of diabetes
3) HCP Learning and Performance Support - Build diabetes related clinical capabilities at primary care level
4) Self-management Support - Connecting people with diabetes to resources that support their self-management efforts
“A number of clear priorities emerged from the early discussions with partners. It was also important that the focus areas for digital health solutions were clearly anchored in national strategies for improving NCD prevention and care,” says Michael Calopietro, Head of Digital Health Solutions at WDF.
Developing the solution
Next, the team developed visions for the products they will develop. Health Information and Early Detection came first.
To help visualise how the digital products under development will be used, the Diabetes Compass team produced two short films. Each describes the product as seen from the eyes of the person using it.
The solutions described in the films are now in development. Solutions for HCP Learning and Performance Support will follow, with Self-management support coming last.
The Diabetes Compass teams in Sri Lanka and Tanzania have recently transitioned into the technical development phase for the Health Information and Early Detection products. The next few months will be busy with requirements definition, prototype development and user testing.
The solution definition phase for Learning and Performance Support has begun in both Sri Lanka and Tanzania and the Experience Vision will be released in December 2022.
Finally, Malawi has joined the Diabetes Compass family and is in the process of launching the project and forming the local partner network that will support the development and deployment of digital health solutions in Malawi.
Malawi Diabetes Compass partners at an introductory meeting in September.
“In Malawi, we are working toward a future free of avoidable NCDs. This will require broad investment and improvements in the health system response to NCDs at the primary care level,” says Dr Jonathan Chiwanda Banda, Head of NCDs and Mental Health at the Ministry of Health in Malawi.
“The Diabetes Compass - with its focus on strengthening NCD health information and the extension of NCD services at the community level - is important,” he adds. “The addition of digital health solutions is a necessary addition to the ongoing efforts to strengthen our national response to NCD prevention and control.”