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. 2024 Dec 31:13:e58389.
doi: 10.2196/58389.

Evaluation of the Development, Implementation, Maintenance, and Impact of 3 Digital Surveillance Tools Deployed in Malawi During the COVID-19 Pandemic: Protocol for a Modified Delphi Expert Consensus Study

Alanna Denny  1   2 , Isaach Ndemera  1 , Kingston Chirwa  3 , Joseph Tsung Shu Wu  1   4 , Griphin Baxter Chirambo  5 , Simeon Yosefe  6 , Ben Chilima  7 , Matthew Kagoli  7 , Hsin-Yi Lee  8 , Kwong Leung Joseph Yu  1   4 , John O'Donoghue  9   10   11
Affiliations

Evaluation of the Development, Implementation, Maintenance, and Impact of 3 Digital Surveillance Tools Deployed in Malawi During the COVID-19 Pandemic: Protocol for a Modified Delphi Expert Consensus Study

Alanna Denny et al. JMIR Res Protoc. .

Abstract

Background: The COVID-19 pandemic has highlighted the importance of strengthening national monitoring systems to safeguard a globally connected society, especially those in low- and middle-income countries. Africa's rapid adoption of digital technological interventions created a new frontier of digital advancement during crises or pandemics. The use of digital tools for disease surveillance can assist with rapid outbreak identification and response, handling duties such as diagnosis, testing, contact tracing, and risk communication. Malawi was one of the first countries in the region to launch a government-led coordinated effort to harmonize and streamline the necessary COVID-19 digital health implementation through an integrated system architecture.

Objective: The aim of this study is to seek expert consensus using the Delphi methodology to examine Malawi's COVID-19 digital surveillance response strategy and to assess the digital tools using the World Health Organization mHealth (mobile health) Assessment and Planning for Scale (MAPS) toolkit.

Methods: This protocol follows the Guidance on Conducting and REporting DElphi Studies. Participants must have first-hand experience on the design, implementation or maintenance with COVID-19 digital surveillance systems. There will be no restrictions on the level of expertise or years of experience. The panel will consist of approximately 40 participants. We will use a modified Delphi process whereby rounds 1 and 2 will be hosted online by Qualtrics and round 3 will encompass a face-to-face workshop held in Malawi. Consensus will be defined as ≥70% of participants strongly disagree, disagree, or somewhat disagree, or strongly agree, agree, or somewhat agree. During round 3, the face-to-face workshop, participants will be asked to complete, the MAPS toolkit assessment on the digital tool on which they are experts. The MAPS toolkit will enable the panel members to assess the digital tools from a sustainable perspective from six distinct, yet complementary axes: (1) groundwork, (2) partnerships, (3) financial health, (4) technology and architecture, (5) operations, and (6) monitoring and evaluation.

Results: The ability of a country to collate, diagnose, monitor, and analyze data forms the cornerstone of an efficient surveillance system, allowing countries to plan and implement appropriate control actions. Malawi was one of the first countries in the African region to launch a government-led coordinated effort to harmonize and streamline the necessary COVID-19 digital health implementation through an integrated system architecture.

Conclusions: We anticipate findings from this Delphi study will provide insights into how and why Malawi was successful in deploying digital surveillance systems. In addition, findings should produce recommendations and guidance for the rapid development, implementation, maintenance, and impact of digital surveillance tools during a health crisis.

International registered report identifier (irrid): DERR1-10.2196/58389.

Keywords: COVID-19; Malawi; consensus; delphi; delphi study; descriptive statistics; development; digital health; epidemiology; expert; impact; implementation; mHealth; maintenance; mobile health; protocol; purposive sampling; surveillance; survey.

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Conflict of interest statement

Conflicts of Interest: AD, JOD, HYL, KLJY, BC, KC, IN, GBC, and MK have no conflicts of interest to report. JTSW is working for the Ministry of Health and Luke International for COVID-19 responses as the Public Health Emergency Operation Centre manager and contributed to the related digital health solution development. However, he has no conflicts of interest in this study since the COVID-19 Public Health Emergency Operating Centre is now deactivated, and he has been dismissed from the EOC manager role. SY worked as Head of Digital Health during the COVID 19 pandemic and oversaw the implementation of the different technologies to sail through COVID-19 period. However, since he was moved to National Statistical Office, he is no longer overseeing such projects. This makes him have no conflict of interest in the study being proposed.

Figures

Figure 1
Figure 1
Delphi study flow diagram.
Figure 2
Figure 2
Recruitment strategy.
Figure 3
Figure 3
mHealth (mobile health) assessment and planning for scale toolkit-axes of scale taken from the World Health Organization mHealth Assessment and Planning for Scale toolkit.
See this image and copyright information in PMC

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