Dynamic electronic decision trees for managing childhood illness (DYNAMIC)


Every year, more than five million children die before the age of five due to preventable or treatable causes, most of them in developing countries. New technologies combined with rapid tests can improve diagnosis and management of sick children and reduce health costs. This collaborative research project makes use of Switzerland’s knowledge in digital technologies to improve the health of children and reduce unnecessary antibiotic prescriptions in low resource settings.

Country/region Topic Period Budget
Tanzania
Health
Primary health care
Medical services
Health systems strengthening
15.11.2019 - 31.12.2022
CHF 3'000'000
Background Children are a vulnerable population group that suffers most of acute illnesses. In most low and middle-income countries significant improvements in healthcare have been achieved in the last decades. However, the diagnosis and management of sick children at primary care level often remains inadequate. Health professionals have limited skills, diagnostic tools are missing, and practical guidelines are inconsistent and quickly outdated. Digital decision making tools for primary health care workers are very cost-effective instruments that can greatly improve care for sick children, rationalize antibiotic use, and strengthen referral decisions. The safety of a novel electronic point-of-care clinical algorithm (ePOCT) was validated through a first clinical trial conducted in Tanzania and supported by SDC in the framework of its research for development (r4d) programme. Further validation studies are now needed to improve and extend the scope of the ePOCT tool.
Objectives To improve the quality of care for children aged 0-12 years in low resource settings by validating and implementing a novel electronic point-of-care clinical algorithm (ePOCT) that guide and train health workers in the diagnosis and management of sick children.
Target groups

Primary beneficiaries: sick children aged 0 days to 12 years and their families attending primary health care facilities

Secondary beneficiaries: surrounding communities, health workers, health administrators and managers, health ministries

Medium-term outcomes

Outcome 1: Integrated management of children with acute illnesses at primary care level is improved

Outcome 2: The national health information system for disease surveillance and early epidemic detection is enhanced

Outcome 3. Clinical algorithms are improved and continuously adapted to geographical and seasonal variations using machine-learning

Outcome 4: Antimicrobial drug pressure in the community is decreased

Outcome 5: The environment for sustainability of electronic clinical decision support algorithms and framework for larger-scale implementation is supportive

Results

Results from previous phases:   The safety of ePOCT was asessed and validated through a first clinical trial conducted in urban Tanzania. The use of ePOCT led to an improvement in clinical outcome while reducing by 88% the proportion of antibiotic prescriptions.


Directorate/federal office responsible SDC
Credit area Development cooperation
Project partners Contract partner
Swiss Academic and Research Institution
  • universitelausanne


Budget Current phase Swiss budget CHF   3'000'000 Swiss disbursement to date CHF   838'600