Project Everest

A Healthy Start to a Busy Month: Malawi Health Assessment February

Isaac Crawford
Isaac Crawford | Feb 13, 2018 | in Health Consulting


Carrying on from the submission of a Research Protocol to the Blantyre College of Medicine Research and Ethics Committee (COMREC) on the 3rd of January the February Health Team has focused on further research into Blantyre’s healthcare system. This has come in the form of a series of Situational Analyses in both publicly registered and private health clinics in rural and urban Blantyre.



30 Data Points - Situational




150 Your.MD Tests


1 USSD Prototype


1 Business Designs of


Your.MD to structure how it will



run in the first sale.




The Situational Analysis is crucial in order to help the team understand the patient demographics, medical resource availability (medicines, rubber gloves, stethoscopes etc.) and working conditions of public and private clinics throughout the Blantyre region.

These analyses will also help the team suggest the most suitable clinics for Your.MD testing alongside Pensulo Clinic which was noted as the prefered  testing facility in the Research Protocol. Currently 17 clinics have been surveyed with the goal of 30 aiming to be complete by Friday.

The Your.MD testing goal is dependent on the timing and outcome of the Research Protocol. No decision has been made as of yet.

The USSD Prototype is a concept the team has experimented with and provides a separate business model to the Your.MD healthcare solution. As previously noted the major barriers to healthcare in Blantyre and Malawi more broadly are; long travel distances to clinics, long wait times to see clinicians once at health centres, a limited number of trained healthcare professionals and low health literacy among locals.


The conceptualized USSD Prototype is a triage based mobile phone system that will help users determine the urgency of which they need to seek medical attention. This urgency would be ranked in three tiers; self-treatment suggested, seek medical attention, seek urgent medical attention. These suggestions would work through a flow-chart system where certain options would flow to certain questions to do with symptoms and signs of life-threatening disease.

The benefit of a USSD system alongside the Your.MD system is that Internet penetration is at 9.61% in Malawi, whereas mobile phone penetration is far higher at 25% as of 2016. This means that with regards to impact on individuals a USSD system wil have a far greater reach. If patients are able to self-diagnose the urgency of their illness in their own home, this will further help reduce over congestion at health facilities in conjunciton with Your.MD.

The business designs for Your.MD are to help enable futue teams to have an easy to understand document covering the full scope of the projects business plan and give clarity on suggested partners, detailed preliminary cost predicitions and the primary revenue streams.


The stage at which this project is at is rather exciting, with the scope of positive impact continuously growing. Eager local support accompanied with a continued druve and hustle from the current team will see this project left an exciting point for future teams to pick up on.

Feedback on how to flesh out and itirate these ideas or other directions for the project to look into are much appreciated.

Venture On.

edited on Feb 13, 2018 by Isaac Crawford

William Lee Feb 14, 2018

What does a USSD prototype look like and how will you test the accuracy of the triage system? Do hospitals/clinics currently have a triage system in Malawi? Surely hospitals in Australia will have a triage system in place, are there resources online or otherwise that can help you build out initial questions to build into your prototype?

Reply 1

Isaac Crawford Feb 15, 2018

A USSD triage system would take the form of a back-end system flow chart. What I mean by this is if one questions asked;

“Do you feel any of the following symptoms:

1. A headache
2. A fever
3. A dry cough”

By selecting option ‘1’ the system would then flow down to a new set of symptoms that are associated with a headache. Progressively becoming as specific as possible to then recommend a course of action based off; “Self-treatment”, “Seek medical attention within the next two days” and “seek urgent medical attention.”

The accuracy of the triage system would need to be tested in a clinical setting in which the triage recommendation could be compared to the diagnosis of a medical professional. This may require further ethical clearance from the COMREC board as it would be a new form of medical research.

Currently Baobab, a Malawian organization that helps provide digitalized ID numbers for patients in clinics has implemented a form of triage system. This takes place on a computer when patients are registering to see a clinician. This system similarly prioritizes patients in terms of a Green, Orange and Red emergency level. This system has had issues as clinicians find the process overly complicated and often the doctors will not submit their final diagnosis into the system.

The USSD system differs from this in the way that rather than triaging patients already at the clinics, it has the potential to triage patients while still at their own home.

Further research into Australian triage systems will need to be conducted.

Reply 2

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