This article is written by Fredrik Galtung, CEO TrueFootprint and Edwin Bos, Chief Product Officer, TrueFootprint.

By the end of August, over 7,000 frontline health workers had died from Covid-19 infections. Many of these deaths were caused by an absence of proper protective equipment (PPE).

Public officials are tasked with helping control the safety of communities — and the safety of the country’s health workers — but are too often frustrated in doing so: either by a complete lack of data from the field, data coming in too slowly or inaccurate data.

Cases of ghost workers have been reported, where health workers exist solely on paper, yet someone is receiving funds for their salaries and their expenses. There are even cases of ghost doctors, where people who are not doctors pretend to be doctors to get their higher salaries. And cases of public health servants distributing necessary equipment that never is received, never used or even resold.

Our solution is to get data from the field, and to use that data to enable public health authorities to respond to capacity problems in real time.

We are a sustainability start-up. Our technology empowers people to collect data and take ownership of solutions to improve their lives and the businesses they work in. Our purpose is to produce the outcome-focused, material and constantly updated sustainability and impact information that all stakeholders can use to better communicate their individual journeys towards sustainability. While we had set out this year to help solve social issues such us child labour and environmental issues such as biodiversity, our technology is sector-agnostic, so when the coronavirus epidemic came we decided to apply our solution to the health sector.

We know many of you in the public service may be apprehensive; public health data is a sensitive topic, and many ethical questions abound. But whether you think this should be solely the work of government or whether you are open to public-private participation, we hope you will see the value in the approach, which we outline below.

Data from the frontlines is key

In our solution, the data isn’t updated by sending someone from headquarters to each health centre to check. That is slow and costly, and will not necessarily solve the problem. Instead, our data comes from the very people who face the problems first hand: the health workers who have no PPE. And the patients who are at risk if health policies are not being followed.

This thought is not new. Other examples of so-called bottom-up data collection do exist.

Our special sauce though is agency: we empower the people on the ground to identify the issues and to solve them — and we crowdsource the innovations that people have successfully implemented to solve specific problems in real-time.

Armed with real-time data, which is credible because it comes from the very people affected by the situation, health decision-makers can act swiftly and are no longer left in the dark or misled by false data

They do this on an app, intended to help them solve the problems they care about, and the by-product of them using the app is data that flows to health authorities. The challenge is that if people only use an app to give data, they will soon stop using it. In our case, they enter the data to help themselves. We are closing the loop where other systems don’t, or do so too slowly.

The people on the ground, we call them monitors, can share the issues and resolutions between them. It’s a social network for problem-solving.

Meanwhile, real-time and accurate data can directly be accessed by health authorities, answering questions such as “Where are there issues with Covid-19 test kits?”, “In which health centres are issues with separating covid-19 patients from others?” and “What are the unforeseen consequences of our health policies?”.

Decision-makers in the dark

We are running pilots in 25 countries to help mitigate exactly these kinds of problems, and more. Countries in dark orange are those with live pilots. Countries in light orange are preparing pilots:

Of the 233 monitors using our app, 73% have reported running out of test kits once or multiple times. And they have reported over 300 instances of Covid-19 patients who had not been separated from other patients.

All the data that public servants can access in our dashboards is anonymised, timestamped and geotagged. The questions we are currently asking in the app are based on the World Health Organisation’s guidance. But our solution is flexible — we can target the questions based on the needs and standards of the local health authorities.

One example is a set of questions for patients of chronic diseases, many of whom are experiencing severe disruptions to their treatment because of the pandemic. In our pilots we only have a dozen at-risk patients as monitors, but five of them report that they have trouble accessing their regular medications. Armed with real-time data, which is credible because it comes from the very people affected by the situation, health decision-makers can act swiftly and are no longer left in the dark or misled by false data.

In some countries pilots are still ongoing. These are short pilots with just a handful of monitors at just a handful of health centres. But the results have already led to nine Ministries of Health agreeing to scaling this up at national and sub-national levels.

Work with us

Building trust between all key stakeholders — health workers, authorities, patients and communities — has never been more important.

Trustworthy data from the frontline will contribute to saving lives and keeping people safe. We are engaging some of the world’s foremost experts in evaluation to be partners with us in this process to generate evidence of the effectiveness of this approach. If it works for Covid-19, it can also easily be adapted for other frontline reporting issues to capture verifiable outcome and impact data from the ground up.

We would be delighted to work with the Apolitical community, especially with public officials from Health Authorities, national government and even larger subnational units to support the deployment of our solution.

Fredrik Galtung and Edwin Bos

If you would like to hear more, please get in touch with [email protected].