Geographic technology helps put Ethiopia on map of global health success

This map, made with GIS, shows the frequency of DKT Ethiopia sales contacts in 2012.

NOTE: This originally appeared in the Huffington Post on April 24, 2013.
 
ADDIS Ababa, Ethiopia -- In just six years, DKT Ethiopia has transformed its system for tracking contraceptive sales from pins and pencils to computers and satellites and, in the process, helped create a family planning and HIV prevention success story in the Horn of Africa.

DKT Ethiopia is an affiliate of DKT International, a non-profit organization that seeks to provide couples with affordable and safe options for family planning and HIV prevention in 19 low- and middle-income countries. In Ethiopia, DKT uses social marketing to distribute three brands of condoms (and eight variants), three oral contraceptive pills, two IUDS, two injectables, one brand of emergency contraception and several other health products.

It was in 2007 that DKT Ethiopia started using GIS (Geographic Information System), a tool to display and analyze sales, finance and inventory information geographically and, particularly, to plot every one of its 30,000+ direct and indirect sales outlets. This has made an enormous difference in DKT's ability to know how its contraceptive sales are going in every corner of Ethiopia.

Before 2007, DKT used pins, pencils and Excel spread sheets to track this information, making it difficult and sometimes impossible to produce the desired information.

Quacks, traditional healers and village doctors: Informal providers emerge as force in health care

An advertisement for a traditional healer in Zambia.

This piece was originally published on the PSI Impact Blog on April 9, 2013.
 
In my nine years managing social marketing programs for PSI in Africa, Asia and Latin America, I had two significant encounters with the category of health workers now known as “informal providers,” in Zambia and Bangladesh. In both cases, my PSI staffs and I decided to try to work with them because it seemed like folly not to work with them, given their numbers and their influence.

In Zambia, where I founded and managed PSI’s social marketing program, I became aware of the large and prominent role of traditional healers in the health system. They were everywhere – including where there were few or no formal providers – and were a respected part of the health landscape. Eventually, I became convinced that we should engage them in our HIV prevention condom social marketing program.

Realizing that traditional healers, like most players in the private sector, are motivated by financial gain, we recruited them as condom vendors, just as we had recruited wholesalers and retailers like pharmacies and grocery stores. Traditional healers saw condoms as a business opportunity and started out as good sales agents. Unfortunately, they were not always trustworthy business people: They insisted on buying on credit, but would not settle their accounts after making sales, so we had to terminate our relationship with them. Nonetheless, it was my first lesson in the importance of trying to engage traditional healers and other types of “informal providers” outside the formal health system, challenging though they could be.

Earlier this year, I started learning more about informal providers from the Center for Health Market Innovations (CHMI) which has supported studies of informal providers and focused a lot of attention on their contributions to health systems around the world.