eDOTS : obtenir des résultats fiables pour le traitement contre la tuberculose

Since the primary objective of eDOTS is to ensure the reliability of data, unauthorized access to the system has been a major concern. In order to prevent unwanted registration or editing of events on the clinic’s netbook when the counselor is not present, the terminal requests that a counselor (or program manager) scan their fingerprint when registering new patients or editing patient data. Because the time and date of the access will be monitored, individuals who tamper with the data during off-hours can be tracked and confronted.

One hurdle of introducing eDOTS to new areas is the re-training of staff members. During the first months of the project, there may be some difficulties in the adoption of the terminals. Because of this, OpASHA will send a senior program manager to its centers to ensure proper training and implementation of the biometric system. When designing the software, OpASHA and Microsoft Research made a special effort to use a minimal amount of text so that the system was easy to use in illiterate areas.

Another potential problem is the fingerprint recognition software’s failure to recognize a patient, and thus failing to register their attendance. Impoverished populations are particularly prone to have cracked or calloused hands due to the large amount of physical labor. Operation ASHA plans to overcome this barrier in two ways. First, a wet pad is made available to all patients, which improves the chance that the fingerprint is recognized. If this fails, counselors have the option of scanning the left hand backup finger.

The biometrics system behind eDOTS was co-developed with Microsoft Research and Innovators in Health. Their pro-bono work with Operation ASHA is valued at over $200,000, and has been essential to the eDOTS program’s success. They have also made the software open source so that it can be freely adopted by other TB organizations.

Another important partner has been MIT’s Poverty Action Lab, which has been conducting control trials with Operation ASHA to measure and improve its impact. After their work has been completed, a second study is planned to assess the effect of eDOTS in comparison to pre-biometric performance.

Other partners have been LGT Venture Philanthropy, who has given OpASHA considerable grants and has paid for highly qualified personnel; The Michael & Susan Dell Foundation; The Marshall Foundation; and the Sahayak Foundation. Many other organizations have provided additional financial and technical support.

The Government of India has also been an essential partner with OpASHA. Grants through the Revised National TB Programme have provided funding for recurring operational expenses in addition to the free medication, lab tests, etc. This scheme has been pivotal in OpASHA’s long-term sustainability.

Two years after Operation ASHA cures a patient of TB, it is awarded a small grant from the Government of India. The lag time means that outside funding must be acquired to start-up each clinic. However, after two years of operations, the clinic becomes fully sustainable through the grant. The initial start-up costs are funded by individuals, foundations, and businesses as a one-time expenditure.

The eDOTS program supplements Operation ASHA’s existing procedures, and is primarily funded by private donations and grants. Implementing biometrics costs about $2.50 per patient, which is a small fraction of the estimated $900 it costs for the overall TB treatment. Because eDOTS also increases the productivity of OpASHA’s health workers, counselors can cover more patients in the same amount of time. Thus, a portion of the government grant can act as a secondary support for biometrics.

As previously mentioned, Microsoft Research and Innovators in Health have played a major role in developing and maintaining the biometric system. Their assistance has made eDOTS a reality.