What makes ACT differenT
- Developed with doctors: ACT was developed in close coordination with Doctors without Borders and as a result responds directly to needs from the ground, as articulated by the organization that has been on the front lines of the fight against ebola from the beginning. MSF made ACT an official pilot of the organization - something MSF has never done for a tech intervention during a crisis.
- Local knowledge: the team that built ACT has lived and worked in the same countries where the system will be deployed. We additionally consulted with a diverse group of individuals in-country throughout the concept development process, from the Speaker of the House of Liberia to rural community organizers.
- Dialect-specific IVR: all contact interactions are pre-recorded in dialect specific IVR to make the system feel familiar and trusted for local populations.
Diaspora involvement: the system strategically leverages pre-existing trust networks (of friends and family both in and out of the region) to create a patient-centric survival system. By directly involving the diaspora in dissemination of vital information, ACT works in a way that is fundamentally different from the many other systems out there.
How Does ACT Work?
1) Doctors at EVD clinic take down patient information, including phone numbers and dialect preferences of contacts.
(2) Field supervisor or data manager enters patient and contact information into computer with ACT installed. ACT extracts contact phone numbers and dialect preferences and sends these via USSD to central server.
(3) Health Workers responsible for contact tracing make first communication with EVD contacts either by calling or an in person visit. During this initial interaction, Health Workers give essential information about Ebola and the ACT system.
We Prioritize Awareness And Trust Building: targeted awareness campaign with culture-specific messaging conducted through (i) Diaspora Mobilization campaign, including religious networks (ii) In-country radio (iii) Community Health Workers involved in patient intake at clinics and contact tracing (iv) existing information channels created by UNICEF, UNMIL, WHO, CDC, and other organizations.
(1) ACT system automates dialect-specific IVR calls to each contact for 20 consecutive days and asks two questions: 1. Do you feel sick? 2. Does anyone in your family feel sick?
(2) If contact reports no, response and location data are recorded in ACT system.
(3) If contact reports yes, response and location data are recorded in ACT system: alert protocol is launched.
(4) ACT system sends SMS alert to clinic Field Office. SMS alert includes contact phone number, dialect preference, and last location.
(5) Field Office delegates contact follow-ups to appropriate health workers, who are able to provide sick contacts with medical attention.
Our Technology Works With Existing Systems To Scale Contact Tracing.
System Integration: Clinic loads ACT software onto a field office laptop through a GSM modem, which additionally acts as a data bridge in areas without access to internet. Once an account is activated, ACT pulls specific patient and contact information required to follow up through IVR.
Intake And Follow Up: A health worker at a clinic interviews an EVD patient, logs phone number and the cell phone numbers of patient’s contacts. Patient and contacts opt-in to system. IVR system automates dialect-specific, daily follow up with contacts after initial call from health worker for 20 days and alerts the health worker if symptoms present.
Data Storage And Flow: Information from patients and contacts is stored on InSTEDD server networked with a Cellcom VPN. ACT generates real-time mobility models based on low-resolution location grabs from cell phones that have opted in to service. CDC controls access to data. Analysis teams at Healthmap visualize data on a map that can be used by stakeholders.