Em Care Newsletter - February 2022

Overview

Project update

• We reached a major milestone at the end of 2021 with the publication of the first stage of the FHIR Implementation Guide (L3) and the release of the first prototype of the Em Care Reference App (L4).
• The FHIR Implementation Guide (IG) is available on the WHO Github page and will be updated as additional stages are published. This work is helping to develop the FHIR standard as well as the underlying tooling to automate the publication of the FHIR IG from the readable components in the Digital Adaptation Kit (DAK).
• The code repository for the Em Care Reference App will be made open access shortly. The mobile app is built on the Google FHIR Android Software Development Kit (SDK) with inputs from the wider SMART Guideline community. By providing a common set of application components - like on-device storage, data-access and search APIs - the SDK reduces the time and effort it takes to build FHIR-based, interoperable digital health applications on Android devices. More information can be found in a recent Google blog post.
• We’ll be rolling out user feedback and acceptance testing of the L4 Reference App in the coming weeks. If you are interested to take part, please reply to this newsletter and let us know.
• Thanks to all who submitted expressions of interest to join the Digital Reference Group (DRG). We had a lot of interest but have needed to delay the constitution of the group. The scope is being widened beyond Em Care to support the whole of the SMART Guidelines area of work.

Operational update

• A meeting was held with 4 shortlisted country offices in the Africa Region, to present the project and gauge their interest in joining the initial country pilots. Countries are now discussing the next steps with Ministries of Health and we will then agree on 1 or 2 countries to proceed with the pilots in late April / early May.
• Three country offices have similarly been short listed in the Eastern Mediterranean Region and are in the process of determining their capacity to support the pilots in the coming months. 

Featured Story In-Focus - Interview with Dr Neema Rusibamayila Kimambo 

Dr Neema Rusibamayila Kimambo, a Pediatrician in the Child and Adolescent Health Unit, WHO shares her experience on Integrated Management of Childhood Illness (IMCI) and regional perspective of clinical-decision support in the Regional Office for Africa (AFRO).

The WHO guideline for Integrated Management of Childhood Illness (IMCI) was introduced as a strategy by WHO and UNICEF in 1995 to improve access and quality of care for newborns and children in primary health care services. “The IMCI as a strategy aims at improving health worker skills, health system and improving family and community practices. Globally, over 80% of the under five deaths are due to neonatal conditions and infectious diseases like pneumonia, diarrhoea and malaria often compounded by malnutrition. Most childhood deaths can be prevented with effective interventions that are feasible for implementation, even in resource constrained settings.” explained Neema. Evidence suggests that if fully implemented, IMCI contributes to 15% reduction in child mortality when activities are implemented at scale in health facilities.

The AFRO regional perspective of IMCI implementation is unique. Nearly 50% of under 5 mortality occurs in the region. However, there are certain challenges to implement IMCI guidelines in AFRO— “the biggest challenge for the implementation of IMCI is the inadequate resources for countries to scale up training of health workers and ensuring   health system components required for the services. However, these capacities are often hindered by socio-cultural and infrastructure issues.” She further described that “Even in emergency settings in the region, the major killers are the same—malnutrition, malaria, pneumonia, diarrhea and newborn complications.”

By providing access to WHO recommendations (based on the IMCI guidelines) in emergency settings, the Em Care mobile app will help to ensure that clinical decision-making is accurate, effective and comprehensive. 

Call to Action

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