It’s a date(a)!

4 August 2023

To secure data for decision-making in Ethiopia, we facilitated a workshop to support the ministry of heath to align all epidemiological data with demography data for over 25,000 kebeles.

Using data for decision-making

With financial support from The END Fund, we’ve worked alongside the Ethiopian Federal Ministry of Health (FMoH) to successfully use an innovative geospatial design to gather and model epidemiological data. This method provides accurate and up-to-date results on disease spread to a small administrative unit, which in Ethiopia are called kebeles – you can learn more about this survey from our video (please note this video was shot when our name was SCI Foundation).

When collecting and analysing data from these surveys, it’s important for the results to reflect a ministry of health (MoH)’s requirements, ensuring data can be utilised for treatment planning. To secure data for decision-making in Ethiopia, we facilitated a workshop to support FMoH to align all epidemiological data with demography data for over 25,000 kebeles.

What is a reassessment survey and why are they useful?

We support MoH in endemic countries to progress towards elimination of parasitic diseases, in alignment with the World Health Organization Neglected Tropical Disease Roadmap 2021-2030. A crucial part of this work is the use of data to inform decision-making, supporting the collection and analysis of epidemiological and operational data to allow for impactful disease interventions through routine surveys.

One routine survey is called a reassessment survey; a type of epidemiological survey that assesses how regular treatment campaigns have changed the spread of disease over time, whilst providing epidemiological data which statistically represent smaller administrative units across the country. This granular data on disease spread allows the MoH to revise their disease intervention strategies to better target available resources, in line with the recently published World Health Organization (WHO) guidelines, to ensure treatment for those in need.

A reassessment survey also involves requesting drug donations from WHO to smaller administrative units. This includes submitting the most up-to-date demographic, epidemiological and operational data for WHO to make decisions on what drug donation a country can receive. Since many countries rely on drug donation programmes, this request is vital to make sure people receive treatment. The reassessment survey in Ethiopia is nearly complete, it’s now the date(a) to practically apply the survey data for use in planning upcoming treatment campaigns.

An important social custom in Ethiopia is the daily coffee ceremony. Often taken after lunchtime, these ceremonies offer an opportunity to get to together with family, friends and colleagues. The honour of performing the ceremony goes to the women of a household, and they often spread loose grass and aromatic flowers on the floor. Green coffee beans are roasted and ground using hot coals and mortar and pestle, ready for pouring for guests at great heights to prevent coffee grounds entering the cup. Traditionally, the coffee is drunk with plenty of sugar or honey, salt, or even butter in some regions, and served with a side of popcorn or sweets. Image by: Unlimit Health

The importance of administrative data

The geospatial reassessment design relies on the use of geographical data, such as shapefiles, to provide the MoH with data required to plan treatment campaigns; the endemicity data of each current administrative area in the country. Over time, the size and shape of administrative areas can change. This can be due to a variety of reasons, such as population increases, changes in governing structures, or simply because the area size covered by an administrative office becomes unsuitable for governing.

I have always found population, administrative, and geographical data fascinating. Although it is vital for public health programmes, in low-income countries these data are often inaccessible or out-of-date. If the number or location of people are not known during planning, it can have knock-on effects in reaching disease elimination.

I have worked on how to translate and evaluate available data to make it suitable for purpose, making sure MoH have the data they require for their treatment campaigns, in formats which are useful and designed with them for their needs.

Alex Carlin (Technical Advisor: Data)

According to records held by the FMoH, Ethiopia currently has around 25,000 kebeles. This means even the smallest changes in administrative areas can have large knock-on effects when planning. As such, the most recent geographic boundary (GIS) data that was used during the reassessment survey was, in our opinion, not up to standard for data decision-making and a solution was needed. In addition, as Ethiopia is the second most populated country in sub-Saharan Africa, with a population of around 123,000,000 in 2022, accuracy is critical to ensuring schistosomiasis treatment can be provided to millions in need.

Celebrating the last day of the workshop with a coffee ceremony together, with popcorn and cake included. Image by: Unlimit Health

Supporting translation of data for decision-making

Recently, we supported a three-day workshop in Ethiopia to record historic administrative changes from 2021 to 2023 with representatives from Ethiopia’s Regional Health Bureaus. The overall aim was to match the most recent GIS data to current circumstances in their administrative logs.

For the representatives, this required going line by line for sometimes thousands of kebeles within their region, coordinating with further administration offices within the region to gather information and context, and using their knowledge on their country to identify and address problem areas in the data for future work.

It was a motivating experience, being part of the process whereby the disease data could be matched with the most up to date demography data for use in effective decision making. Working together, we turned data on spreadsheets into practical, useable information that will enable effective treatment of schistosomiasis for millions of people.

During the three-day in-person workshop, we were able to align 25,000 administrative units across the epidemiological data and demographic data, thanks to the continued work of the Neglected Tropical Disease team in the FMoH and the Regional Health Bureaus.

 Carolyn Henry (Deputy Director: Health Systems) 

We’re proud of the strong relationships we share with our MoH partners, working with them to provide a platform for completing the work needed for delivering successful treatment programmes. Supporting a workshop of this kind highlights the value of co-creation, resulting in data that is fit for purpose and fulfils the specific needs of the MoH.

A big thank you to all those involved in the workshop activities: Fikre Seife (National NTD Program Team Leader Ethiopia FMoH), Ademe Mekonnen (Regional Health Bureau representative of Gambella), Adisu Abebe (Regional Health Bureau representative of Amhara), Seada Ali (Regional Health Bureau representative of Afar), Belachew Bokicho (Regional Health Bureau representative of SNNPR), Assefa Disassa (Regional Health Bureau representative of Benishangul-Gumuz Region), Tufa Abdissa Wayessa (Regional Health Bureau representative of Oromia), Menasbo Gebru (Regional Health Bureau representative of Tigray), Musei Obsiye (Regional Health Bureau representative of Somali), Alemayehu Kulche (Regional Health Bureau representative of Dire Dawa), Abdulaziz Aliyi Abdi (Regional Health Bureau representative of Harari), Birukawite Getachew (Regional Health Bureau representative of South West Ethiopian Region), Amsayaw Tefera (Technical Assistant to FMoH), Birhanu Getachew (Technical Advisor – M&E), and Meron Seifu (Technical Advisor – Finance and Grants).