ICRC: Digitally supported patient consultations in Somalia

In Somalia, access to health care is precarious for an estimated 45% of the population, especially for those living in the south-central region; among the most vulnerable are children under five years old. The mortality rate of children under five years old is among the highest in the world. The leading causes of infant and child mortality are illnesses such as pneumonia, diarrhea, and measles. Owing to insecurity and displacement, reportedly, many children have not been vaccinated. Health infrastructure is small, dilapidated, and concentrated mainly in towns; health, water, and sanitation facilities that have been damaged by conflict or lack of upkeep put people at greater risk of contracting preventable diseases.

A weakness of many healthcare systems, including Somalia’s, is a lack of adherence to clinical guidelines that can lead to incorrect diagnosis and inadequate treatment. Other potential consequences include lack of adherence to vaccination plans, overuse of antibiotics and inadequate or non-existent treatment of malnutrition and preventable diseases.

ICRC and its partners decided to bring the ALMANACH to conflict-affected regions where medical services are not always accessible/available.

ALMANACH (Algorithm for the Management of Acute Childhood Illnesses) is a mobile application that provides real-time, context-specific support to inform healthcare workers’ decisions about patient care. The tool guides users through the consultation steps required to collect all relevant information (eg a patient’s vaccination status or weight). Based on the information entered, it then provides the likely diagnosis along with treatment and dosage recommendations tailored to medication availability.

ICRC has found that using ALMANACH not only significantly improves the treatment provided by its healthcare workers but also increases workers’ motivation and patients’ trust in the care they receive. With the help of this tool, health staff at the supported centers are able to provide quality services for sick and malnourished children.

The purpose of ALMANACH is to better protect children under the age of five against preventable diseases by helping healthcare staff at supported ICRC health centres deliver good-quality and evidence-based treatment, especially in volatile settings where care is inadequate, and it is difficult to provide adequate supervision to healthcare workers.

The ALMANACH is now being used in 12 primary-health-care facilities in the south-central region and shall be deployed in one more health facility by the end of 2022. 

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