Residents in Kenya’s northeastern Mandera County are no strangers to emerging disease threats. According to the Kenya Ministry of Health, habitants there are vulnerable to at least two major outbreaks of cholera and measles each year – a phenomenon county health officials are concerned with controlling.
“The county’s cross-border trade and nomadic activities pose a unique challenge, making monitoring and managing diseases difficult,” said Hassan Mohammed, MD, country director of public health in Mandera County. “For instance, travelers may have breakfast in Mogadishu, Somalia, and then arrive in Mandera town, Kenya’s entry point, after just a few hours. Due to the difficult terrain, they may need to spend a night in Mandera before continuing their journey to Ethiopia or other parts of Kenya. The same applies to long-distance truck drivers transporting large amounts of goods across the region. These movements pose a health concern in cases of outbreaks,” he said.
The county, one of 47 in Kenya with a population of about 1,025,756 people, shares borders with Ethiopia, Somalia, and Kenya’s Wajir County. The area is an arid semi-arid region, and the residents, who are nomads, cross borders in search of food and pasture. Furthermore, the county is in the dry northern Kenya region, so the turnover of health care workers is a major challenge. Insufficient disease surveillance data collection and storage methods means valuable information may be lost when a health care worker leaves their post.
To address this challenge, with support from the U.S. Centers for Disease Control (CDC), ICAP in collaboration with the Kenya Ministry of Health, developed a comprehensive disease outbreak tracking tool – the All-Disease Outbreak Module (ADaM) – an electronic Integrated Disease Surveillance and Response (eIDSR) platform, which facilitates real-time reporting, monitoring, prediction, mitigation, detection, prevention, and response to disease outbreaks. The tool integrates functionalities such as contact tracing, collecting basic demographic information, capturing laboratory results, case outcome tracking, and geolocation mapping. It also features detailed and aggregated data dashboards and is compatible with any Android device, with or without internet connectivity.
As the Mandera County Public Health Director, Dr. Hassan is deeply involved in disease surveillance in the region. During a three-day ICAP-supported training from August 6 to 9, 2024, for over 100 health care workers from the three frontier counties of Mandera, Garissa, and Wajir on the ADaM tool, he emphasized the importance of real-time data and analyses for public health action. “For years, we have relied on Excel spreadsheets painstakingly maintained by health facilities, each working in isolation. The result has been fragmented data—line lists stored locally, often tampered with or lost, and always difficult to retrieve when required. After this three-day training in Kiambu, I have learned firsthand how transformative the ADaM tool can be for our county. We are not just reacting to diseases but taking control of the response.”
This new ADaM tool also offers county and government officials a central resource repository for disease surveillance. “One of the significant challenges in disease surveillance is getting data in real-time across the health ecosystem from different locations,” said Aden Hassan, the County Director of Public Health for Garissa County, who also participated in the training. “For the first time, we now have an outbreak storage hub that shows us previous outbreaks and how responses were coordinated. All this is available with the click of a button. We also expect to notice a significant decrease in workload in the field, ensuring efficiency in gathering quality data for decision-making.”
With the adoption of the ADaM tool by county officials, the Kenya MoH, in collaboration with its partners, aims to facilitate timely data transmission and response to public health threats by utilizing information technology.
Garissa County, ICAP, and MoH Group Photo
About ICAP
A major global health organization that has been improving public health in countries around the world for two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 40 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at icap.columbia.edu
