In response to research efforts to combat the COVID-19 pandemic, the Aga Khan University was awarded a research grant for the COVID-19 Innovation and Response Project (CIRP), funded by the International Development Research Centre (IDRC) and the Aga Khan Foundation Canada (AKFC) in 2020.

CIRP, led by the Aga Khan University’s Digital Health Resource Centre, proposes to investigate the effectiveness of developing and scaling up three digital health innovations in strengthening health systems and improving access to care in at-risk populations in select areas in six countries, Afghanistan, Pakistan, Tajikistan, Syria, Kenya and Tanzania.

CIRP seeks to conduct operational research to assess whether the following three COVID-19 innovations are effective, feasible, usable and sustainable within health systems in target geographies:

1. CoronaCheck: an AI-based mobile application, which aims to contribute to early detection of COVID-19 and positively influences health-seeking behaviour among at-risk populations;

2. VirtualDoc: a mobile-based teleconsultation application, which aims to improve access to health care for remote, underserved population. The VirtualDoc application has been customized as Pigia Daktari for Tanzania and Kenya and Elaj Asan for Pakistan.

3. Personal Protective Equipment Mobile Application (PPEMA): an educational mobile app equipped with best-practice PPE guidelines for health workers in light of the COVID-19 pandemic. The app educates health workers on the correct uses of PPE, as recommended by the World Health Organization to limit the spread of COVID-19 within health facilities, help raise awareness and improve behaviour of health care providers.

The project was launched in September 2020 in all countries through an online project kick-off workshop. Since the launch, various activities including, recruitment of project staff, receipt of country-specific ethical approvals, development of research study protocols, development of gender equality strategy, interviews with sexual and gender-based violence support organizations, customisation of the VirtualDoc app for Pakistan, Kenya and Tanzania, and launch of the PPE app, launch of the CoronaCheck app in all countries have taken place. Moving forward, research versions of all three applications will be published, stakeholder engagement and marketing activities will take place along with data analysis and monitoring.

With the COVID-19 pandemic, telemedicine has emerged to become the quickest and safest method of interaction between patient and clinician.¹

To help populations access hassle-free, safe, high-quality care, AKDN dHRC deployed an end-to-end telemedicine mobile app, VirtualDoc, in Pakistan and Tanzania in collaboration with the Aga Khan Health Services in each country. VirtualDoc was customised and launched as "Elaj Asan" in Pakistan and "Pigia Daktari" in Tanzania to cater to the specific needs and priorities of country populations.

The app is an Android-based, patient-centered platform, which provides access to specialists via teleconsultation services offered by AKHS. With video calling and online payment features, VirtualDoc allows patients to seamlessly schedule appointments, make payment, consult doctors, upload prescriptions and diagnostic reports and maintain their personal health record in the comfort of their home. The app also allows elderly patients, who may be limited to travel due to illness and those experiencing symptoms of COVID-19, to consult physicians from home. The application allows teleconsultations to be conducted through either Wi-fi or cellular data services available on smart phones, instead of computer-based teleconsultations, which require internet connectivity. It also generates and manages patient-specific records related to prescriptions and radiology and laboratory tests, while also ensuring privacy and confidentiality. In Pakistan, a full-fledged pharmacy delivery component allows users to order, pay for, track and receive pharmaceutical goods at their doorstep.

Through the COVID-19 Innovation Research Project, in addition to Pakistan and Tanzania, VirtualDoc’s implementation is planned in Kenya in Kisumu, Mombasa and Nairobi.

In efforts to curb COVID-19 infection rates and reduce footfall at the Aga Khan Development Network health facilities during the pandemic, AKDN dHRC developed and launched the CoronaCheck application in 2020. It is an Android-based mobile application, which consists of a self-assessment tool to help the general population safely screen themselves at home and educational videos to raise awareness among the masses and fight the COVID-19 “infodemic.”

The self-assessment tool is an interactive Artificial Intelligence (AI) -based survey, which enables users to determine their risk of acquiring the disease based on an intelligent analysis of their responses regarding their symptoms and medical history. A counseling preface then guides the user to either take appropriate physical distancing measures or to get tested. The educational videos are sourced from the World Health Organization (WHO) and focus on physical distancing measures, symptoms of the virus and how to spread infection. A list of national helplines is also provided.

CoronaCheck has been launched in Pakistan, Tanzania, Tajikistan, Kenya and Mozambique. The application along with the self- assessment tool is translated into the local languages, i.e., Urdu for Pakistan, Swahili for East Africa and Tajik for Tajikistan, to help populations gain a comprehensive understanding of the virus and methods to lower their risk of infection from an authentic source. An audio feature is also included in the local languages to enhance accessibility and interaction.

CoronaCheck, available on the Google Play Store, aims to strengthen existing health systems by addressing the need for rapid and early testing, screening and awareness raising during the pandemic. This leads to reduced number of visits to health facilities, thereby ensuring critical resources such as testing kits and health workers’ time are allocated toward those most in need.

Hayat Surveillance is a tablet-based, digital surveillance tool, which provides population-level surveillance and reporting in terms of COVID-19 disease tracking in remote regions.

The app was developed by AKDN dHRC in collaboration with the Aga Khan Health Service, Pakistan (AKHS, P) and is designed for use by health workers and select community volunteers working at AKHS, P clinics and labs in the Gilgit-Baltistan and Chitral region.

The app aims to trace and track patients, who are suspected, probable or confirmed to have contracted COVID-19, through home care, referral for advanced care, lab results (PCR and immunoassays), and disease outcome and to trace and track close contacts of probable and confirmed patients with COVID-19.

The tool will help develop a database for the monitoring and reporting of COVID-19 cases, their progress and isolation efforts. It will assist health care administrators and policymakers with identifying geographic spread and mapping hotspots of outbreaks for timely and effective prevention and response strategies.

The Hayat Surveillance tool is Android-based and is a component of the Hayat app, which is already being used by over 650 health care workers in select regions in Afghanistan and Pakistan.

The misinformation pandemic, termed as ‘infodemic’ by the World Health Organization (WHO), has become just as dangerous as the COVID-19 pandemic. Informal sources of information on social media platforms and the web have been overwhelming populations with misleading information, causing confusion and risk-taking behaviors harmful to health.

To help combat the infodemic, the Aga Khan University’s Digital Health Resource Centre recently launched the Personal Protective Equipment Mobile Application (PPEMA), an app to help health workers understand the best practices around the use of personal protective equipment (PPE) during the pandemic. The PPEMA, launched in six countries, including Afghanistan, Pakistan, Syria, Tajikistan, Kenya, and Tanzania, helps fight unauthentic information regarding PPE use and the lack of knowledge among populations, which is putting healthcare workers and the general public in these countries at an even greater risk.

A review of PPE best practice guidelines and alternative PPE use in resource-constrained environments of these countries revealed that the main challenge regarding PPE use was the lack of knowledge regarding its correct usage among target populations. As a result, AKU developed the PPEMA, focusing on the correct usage and improving knowledge regarding PPE, as suggested by the WHO.

Overall, the PPEMA aims increase the knowledge of the health care providers and facilitates the safe, sustainable, and effective use of PPE, thereby contributing to the capacity building of health workers. It will also help fight the mistrust in health authorities and uplift public health response.

The app has been launched under the COVID-19 Innovations Research Project (CIRP), which aims to conduct operational research on the effectiveness of three digital health interventions amid the COVID-19 pandemic, including the PPEMA. CIRP aims to assess PPEMA’s effectiveness in increasing awareness and improving practices related to the use of PPE among health care workers, specifically in the COVID-19 environment.

The CIRP is a two-year initiative led by the Aga Khan University, with support from the International Development Research Centre (IDRC) in Canada and the Aga Khan Foundation Canada (AKFC).

PPEMA is available for download on the Google Play Store.

During 2021, AKDN dHRC developed the CoviTrac app, which is an Android-based mobile app that provides frontline healthcare workers with a hassle-free tool to register patients and record information on vaccine administration activities and any adverse effects associated with the COVID-19 vaccine. The app allows healthcare workers to conveniently create a profile; record information on risks and co-morbidities and vaccine administration; track vaccination schedules of patients for follow-up doses; and document any resultant reactions associated with the vaccination.

To serve the global audience, the CoviTrac can be customised as per local needs and can be made available in different languages. One of the unique features of the app is that it operates fully in the offline mode, eliminating dependency on internet connectivity in the field, in remote locations, where access to connectivity is either limited or absent. Data is then synchronised as connectivity becomes available.

CoviTrac provides a safe and effective way for healthcare providers to digitally manage COVID-19 vaccine administration and related documentation. A reporting dashboard is being developed, which will allow health care administrators to view reports on registered individuals, eligible individuals, those who have received the first dose of a vaccine, those who are fully vaccinated and those experiencing side effects.

The application was implemented in 2021 in select areas of Tajikistan.