A Digital “Yellow Book” of Medical Facilities in Tanzania Case Study

How do you keep a list of medical facilities and services current and available to a population of over 49 million? You digitize it. The Tanzanian Government MeLSAT directory is the country’s first online laboratory directory.

How Solutions Meets Need

Built using PHP/Laravel, the USAID-funded Strengthening Health Outcomes through the Private Sector (SHOPS) MeLSAT online laboratory services directory was developed in June 2015 with the public population in mind. Working with Abt Associates’ International Health Division (IHD) staff, with team members in country, the Client Technology Center (CTC) defined system requirements for the website, including a facility listing and database, a categorization of medical services, and other laboratory information to provide to the public. The website uses English and Swahili and is mobile-accessible.

The MeLSAT online directory uses a relational database backend to store and display laboratory and medical test information on the website. This allows administrators to dynamically change and reorder information easily, based on preferences. The website incorporates additional features such as geo-mapping, automatic email notifications, automatic backups, and the ability to export data as an Excel or Word document.

The directory is fully scalable to the size of the database, allowing the MeLSAT directory to grow with time and use. Users can turn to the MeLSAT directory for the latest and most up-to-date medical laboratory information in Tanzania.

Principles Addressed

Design with the User: In collaboration with the SHOPS project, CTC designed the MeLSAT website and interface to be user-friendly. Through several online demonstrations and screen shares, the CTC worked with project staff in Tanzania to design a website that was intuitive and simple to use. In addition, the website is mobile-accessible.

Understand the Ecosystem: Following the success of the MeLSAT printed directory, CTC and SHOPS understood that a digital directory was necessary to keep information up-to-date and relevant. Yet, the functional use of a printed directory remained. With this in mind, CTC developed an export feature which allows administrators to download and print the online directory as an Excel or Word file. This and other features were designed to ensure that the website complemented existing MeLSAT practices.

Design for Scale: Knowing that medical laboratories and tests change frequently, the MeLSAT online directory was built with a relational database structure that allows information to be changed easily and displayed dynamically. New users, facilities, and tests can be added as needed, with database storage being the only limitation.

Be Collaborative: With the knowledge that laboratory information is only useful if it is up to date and relevant, the MeLSAT directory allows laboratories to edit their own online profiles. By delegating information management to the community, information is more likely to stay current. This also encourages laboratories to collaborate to provide the best medical services available.

Outcomes and Lessons Learned

• To overcome barriers to designing with the end user, Abt Associates conducted online demos and screen sharing sessions. However, it is preferable to have at least one face-to-face meeting during the design phase.
• To ensure quality, the online directory was made available to a MeLSAT QA team in Tanzania
prior to launch.
• To overcome issues of scalability, the website was built with a relational database and limitations to test categorizations were enforced.
• Staffing issues represented a barrier for the project. This issue continues
as a technical point of contact and administrator for the website has yet to be identified.
• Designing with the end user was challenging due to the time and geographic difference between the US and Tanzania. This was mitigated through the support of local staff from SHOPS.
• The hierarchy of tests represented a barrier to building for scalability since the categorization of tests can be infinite. As a result, tests are limited to a maximum of three categorization levels.
• Encouraging users to collaborate is always a challenge. The MeLSAT online directory depends on laboratories to independently maintain their profiles. However, website administrators also have the ability to edit profiles on their behalf.

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