Beyond Essential Systems (BES) is supporting the Fiji Centre for Communicable Disease Control (FCCDC) in conjunction with the World Health Organization (WHO) to undertake a targeted Mass Drug Administration (MDA) project.

Neglected tropical diseases (NTDs) are tropical diseases that can be eliminated and controlled, and which tend to disproportionately affect low resource settings. Interventions like this current MDA are lifechanging for the people of the Pacific due to the physical and socioeconomic impact these controllable diseases have on human lives.

MDA’s can effectively eliminate disease when communities collectively take medications which will treat the illness, all at approximately the same time. Rolled out across Fiji one division at a time, this MDA is targeting Lymphatic Filariasis; Scabies and Soil Transmitted Helminth (STH) which incorporates Ascaris, whipworm, and hookworm.

Filariasis disease can cause lymphedema and elephantiasis and is a leading cause of permanent disability worldwide.

Communities often shun and reject women and men disfigured by the disease. Affected people often are unable to work because of their disability, and this harms their families and their communities.

Like Filariasis, scabies causes sufferers an intense itch, which can lead to infection and include the secondary infection of impetigo; it has a high mortality rate in areas where it’s endemic.

Scabies and STH are also associated with poor sleep, missed school and work, and social stigma, isolating community members and causing shame and social alienation.

The MDA project will use the survey functions of Tamanu

A group of women are in a building undertaking training on tablets to prepare them to take part in a mass drug administration.

Tamanu training, preparing nurses and community health workers to roll out the mass drug administration.

Health professionals need tools they can rely on to store and process data collected while working within communities to ensure accuracy, efficiency, and trustworthy, high-quality data. Data systems need to present a continuum of care so that program staff know which community members have been dosed and which subsequently become sick (if any).

Tamanu will allow patient interactions with the health system to be documented in a single platform, at the time of MDA delivery.

This data feeds from Tamanu into Tupaia to show de-identified aggregate data, which will be displayed at the relevant entity on the map showing the MDA coverage.

Tamanu is a patient-level electronic medical record (EMR) designed for both desktop and mobile. It enables health workers to track individual patients, provide clinical support and ensure consistent management of patients through the continuum of care in any health setting.

Tamanu allows health workers to monitor patients in hospitals, health centres, clinics and even out in the field. The system is offline-first across both mobile and desktop, with syncing capabilities, allowing users to work seamlessly in both offline and online modes.

Group of women in a building facing a projected screen in a training session for Tamanu.

Tamanu training, preparing nurses and community health workers for the mass drug administration.

Training for nurses and community health workers was conducted in the Eastern division, Levuka on 10th of May 2023.  These sessions provided training on Tamanu Mobile including completing surveys, searching for patients, and creating new patients. Training materials were developed for the MDA staff including a presentation deck, user manuals specific for the MDA project and testing scenarios to use in the Tamanu demonstration environment.

The trained participants will utilize Tamanu in the field in the next few weeks. Despite most not having used Tamanu before, participants overwhelmingly agreed (in anonymous follow-up surveys) that Tamanu is easy to use and the training easy to follow. Equipped with Tamanu on mobile devices, participants felt confident and ready to undertake the MDA using Tamanu.

It is exciting and humbling to be working at the forefront of the human fight against disease in the Pacific, and BES is proud of the tools we have created to facilitate these important life changing programs. Tamanu training workshop video and song