A View from the Inside: Is Your Technology Solution Ready for Your Mass Campaigns?
When it comes to mass campaigns, health and humanitarian organizations are increasingly turning to integrated campaign management systems to improve program efficiency, manage millions of services, allocate resources, and control costs, even in low-bandwidth areas. But what sort of system architecture is needed to scale up?
Mary Cox, Head of Digital Health Programs at RedRose, a social enterprise dedicated to providing technology solutions to the humanitarian sector, has some reflections on what it takes to manage the complexities in scaling mass health campaigns while keeping a program viewpoint and beneficiary-focused approach.
A campaign management system can be likened to a skilled conductor guiding an orchestra. Just as the conductor ensures each musician plays their part harmoniously and in sync, systems like RedRose ONEsolution seamlessly coordinate each function of a mass health campaign.
At the same time, a specialized distribution management system should complement the ecosystem of tools used by governments and partner implementing agencies to manage the big picture and increase the evidence base for effectiveness.
At the core of RedRose lies an unwavering commitment to innovation based on true context experience. We emerged as a partnership between humanitarian experts and IT engineers, united by the vision of leveraging technology for the humanitarian and development sectors on a mass scale.
As we come up on our 10th birthday, we have a few insights under our belt we would love to share. Our experience shows that the design and stress testing to develop a system that manages tens of millions of beneficiary profiles is different from the coding of one for tens of thousands.
Bake the Field Requirements into the DNA of the System Architecture
The first consideration is ensuring the system is developed with a deep understanding of its operational environment. Creating something in a controlled office setting just won’t cut it.
Building and testing the solution in a live campaign environment is vital, accounting for complexities like connectivity issues, staff dynamics, and beneficiary requirements. The difference between requirements given by a select set of stakeholders in a workshop setting and the reality where thousands of users find all kinds of ways to break those rules is stark. There are no shortcuts and a lot of exception scenarios. This demands significant time, investment, and a commitment to rigorous design, testing, and iteration by engineers in a live scenario.
ONEsolution, RedRose’s comprehensive program management solution, was initially conceived, coded, and rigorously tested under challenging campaign conditions in Nigeria. The team also imagined what the future could hold, as any sustainable system must be able to adapt as context, guidelines, and conditions change. The initial design was created to be a solid foundation, that could be built upon, and we have continued to co-design on-site as programs have scaled up to millions of beneficiaries.
Since then, it has been deployed in 58 countries, meaning the flexible foundation created for the local system admins to configure is adaptable and continually enhanced in many contexts. Taking the approach of “build once and be done” creates stagnant technology solutions that can’t grow and leave local systems teams struggling. In sustainable, scalable systems, “the build is never complete!”.
System Performance – Make it Non-Negotiable
System performance of the campaign management system is critical for the success of program delivery. Deficiencies in these areas can lead to distribution disruptions, unpaid health workers, increasing operational costs, and compromising the welfare of beneficiaries.
This brings us to the all-important topic of optimization. Once the foundation is built, and you are adding enhancements to service delivery processes or new features to complement new programs, data payloads can balloon. This, coupled with the increase in the number of beneficiaries involved, creates exponential growth.
We often see in low bandwidth environments managing data volume during peak periods is a challenge that needs to be addressed. To maintain system efficiency, it is crucial that the system architecture incorporates considerations for data compression rates, quality retention, and error correction.
Where operating procedures require that tens of thousands of field teams collect data during the day and sync all at the same time, it is important to be ready. Data capture in mass campaigns sees peaks at certain points within the projects. Coordination among programs and IT is critical to be ready across your servers, firewalls, load balancers, etc.
The importance of these factors was highlighted in our 2023 Seasonal Malaria Chemoprevention (SMC) campaign in Nigeria. Dialing into a peak, this campaign successfully registered over 10 million children in less than 10 days with no interruptions and no stress on any infrastructure. This is thanks to the optimization work done as campaigns grew from 2,000 devices to more than 45,000 devices working.
Build for PROGRAM Success
There are many digital solution options, however they focus on only one piece in the puzzle. Some solutions will find implementers piecing together three or four systems to manage a program. At first glance, this can look cost-effective, but a solution architecture that, when drawn, looks like a bowl of spaghetti can have many hidden costs.
A key principle in solution development is to Design with the User in Mind. We say, “Design with the users – all of them – in mind.” Quality data starts with adequately managing the point of service (the visit with the beneficiary where data is registered) and turns into quality information for thousands of other users and external stakeholders. Each member of a program team deserves a design focus to make their effort more efficient.
The positive impact of effective digital campaign management is now widely recognized and accepted in the public health sector. Paper-based systems have become outdated, slowing program delivery as teams navigate between physical ledgers, tally sheets, and beneficiary files. Systems overly reliant on manual data processing or standalone packages are prone to errors. It can be difficult to relate the data from one component of the program to another. This potentially impacts program effectiveness or delays important milestones like payments to staff.
The journey of scaling up program management through technology is both challenging and rewarding. RedRose’s journey underscores the critical importance of designing and testing campaign management systems in real-world conditions, emphasizing adaptability, system performance, and an unwavering focus on the whole program. Program stakeholders, once accepting offline contexts, now rely upon and demand near real-time data for decision-making. As we look to the future, it’s clear that continuous innovation, grounded in the realities of campaign environments and the evolving needs of beneficiaries, will be key to achieving sustainable and impactful health programming at scale.
You can contact Mary Cox at RedRose via email Mary @ redrose.io or on LinkedIn. Find out more about RedRose at www.redrose.io