 So I think Pamod needs no introduction. I just wanted to thank him again and once more for having the time to explain a little bit here and take some time to explain you how he or he Sri Lanka has used Android on their implementations. Thank you very much, Pamod. The floor or the screen or the world is yours. Thank you so much, Highway. Yeah. So what I'm planning to do in the next 10 to 15 minutes is to present to you the implementation that we have in Sri Lanka on a mobile-based nutrition project. So specifically, now this project we have presented even before in a couple of other forums. But today what I'm trying to focus is not on the technical part of it, but mostly on the implementation considerations and specifically on a particular district, which is in the post-conflict setting. So a little bit of background about how this project started and what we are trying to do. So one major reason why we started was Sri Lanka in general compared to other countries in the South Asia region is performing quite OK when it comes to most of the public indicators. Two of them are mentioned here. But nutrition has been an area where our country has been mainly struggling. So because of that, there has been a lot of initiatives to address this issue. Mainly the current initiative is to have a multi-sector approach where at field level, we identify the nutritional vulnerable children under five years and try to have all their multi-sector, not only health, even other sectors, they get together and try to address the issue. So what happened was to do this, we required a tool, a monitoring tool, where the field health workers could monitor the nutrition status of vulnerable children at field level. So to do that, these are the broad set of requirements that came up. So mostly they wanted to identify and register the children who are having nutrition problems. And to monitor their parameters, mainly height and weight in the field and also to identify the household risk factors which can contribute to this issue. So to do that, what we did was we thought of we have this field health worker. We call her public life. So she collects all the, she does the field or community visits and identify the children who are having nutrition issues by weighing and measuring nutrition parameters. And at field level, what we wanted was her to capture some information in a mobile device, which of course we transmit into the central DHS2 based solution, which then can be accepted, approved and shared with the other stakeholders. Now, I will just mention here one thing like Jaime also mentioned, now in DHS2, we have the standard Android capture application, which is a standard mobile application. But for this instance, because this is a project that we started a couple of years back, we went ahead with the custom Android application, which communicates with the central DHS2 instance through web-based. So that's the technology that we use, which we started around five years back. So specifically this implementation has been continuing for the last around five years and we have implemented in several districts in Sri Lanka. But I'll be mainly focusing on this Jaffna district of Sri Lanka and the implementation considerations around this mobile-based implementation, specifically because it is from a post-conflict setting. So a little bit of information about the Jaffna district, it's the topmost part of Sri Lanka that you see here, this is India, Sri Lanka is an island nation and this area, this particular district was, I mean, suffered severely because of a three-decade war that was ongoing, a civil war in Sri Lanka. So right now the district as well as the entire country is in a kind of a post-conflict state. But the issue is like there have been a lot of, I mean, resource issues. And in fact, like this area, which is very far from the capital city, which is in Colombo, it was a South and West region of Sri Lanka. So there are some, I mean, access-related issues also with the capital city, but mostly the resources and the entire environment, I mean, in the sense like the motivation of the people, I mean, all these have been severely affected due to the ongoing wars in the last three decades. So with this set of challenges that we initially anticipated, we went ahead to implementing this information system, a mobile-based one in the Capital District about two years back. So I will be discussing on certain implementation considerations that we considered while we did this implementation. So the first consideration that we had was to establish the local governance mechanism. So as I mentioned before, like the main issue that we had was like, we had this particular district in a quite remote area. So we had to establish some capacity or some mechanism within the district so that we could establish more sustainability. So our major focus is to in fact establish whatever we had at national level, at the central level in the capital, also in the district. So to do that, we identified a champion. So this champion was a public health doctor who was working at the district level. So he was the one who was really competent on all the technicality and the public health domain aspect of it because he's a public health doctor by origin. But we had to kind of establish him on the technical aspect of using and training and implementing this mobile application. So we kind of wanted, even though from the national level our engagement is minimal for him to take it forward. And this is something that we were able to achieve. So he kind of advocated all the stakeholders at district level. Mind you, this is a multi-sector engagement. So he had to talk other local ministries operating at the district level, like from the agriculture, social services and other fields. So he communicated with all of them about multi-sector requirements and he established his team. Like we always talk about the DHS to core team for a country. So we kind of set up, it's not a DHS to core team, but a core team under him at district level who were empowered with the conducting, training, troubleshooting and even like some maintenance work of the application as well. And then of course, one major issue that we had was infrastructure. So initially we started off with some devices that were donated for another project. So all the public health midwives and users had the devices. But then again, we had major issues after like two, two and a half years when some of these devices started malfunctioning and we did not have a proper, because we have a mechanism to replace them during the warranty period. And we also have some mechanisms to buy new devices, but like sometimes there are some gaps where like, which is not actually covered from the warranty period as well as it is much earlier than the next procurement cycle. So this was kind of a major challenge. So what we did was like at the local level, we kind of, because I mean, from the end users, there can be resistance if you try to enforce something which they don't like. So at the district level, they kind of took an initiative to highlight the use of using, having this kind of a tool. And with that, they were able to convince the different devices in case, in situations where they had this issue. So even in high news presentation, the ring your own device was highlighted. So we use this concept in implementation in this particular district as well, which has been a major success because they don't, I mean, in fact, some of them, they didn't like carrying two devices. So that was a, that's something that they really liked. So all these aspects of governance were key considerations in our implementation in districts. And then one major thing is about capacity building. So in Sri Lanka, we have at higher level a health informatics capacity building where we try to train medical doctors in health informatics so that they can go back to the ministry and the district level and they can implement and sustain the information system. So thereby we try to minimize the dependence on the development partners and outside stakeholders. So this is a long term approach which was initiated about 10 years back. I'll be discussing more about this topic, I think next week on a separate session. So I'm not going into too much of that, but we have that at the national level. And in addition, we mainly concentrated on building the district core team and the district capacity so that they can sustain all the operations because in other districts, we have some level of district level freedom in operationalizing, but there is a very close connection with the national level in providing troubleshoot. But in this district, we kind of, there were inherent issues also. For example, one issue was like the distance and also there were some language issues because our core team was mainly speaking one particular language. And in this area, we had very few people in the core team in national level who are competent in conducting proper training programs. So that, I mean, that kind of motivated us, but then we realized that it would be a very sustainable method if we build capacity there. And they also conduct, they had a separate program for refresher training in case a new health worker arrives at the district. They, I mean, the same training they have to undergo in getting orientation in other aspects when functioning in the district level. That program, we also included some training on the mobile application as well. And also we devised this peer training. So what we actually try to do is in one medical officer of health areas that is like public health. So we have this public health workers who are in charge of couple of villages, right? So in each of these villages, we have one data and repersonal field health staff. So what we try to do is like in one of these areas we identify, like if you have about 20 midwives out of them, during our training, we identify around five of them who are kind of tech savvy. So we train them something in advance to provide troubleshooting. So they kind of provide peer training, whenever they, I mean, midwife gets an issue. So they don't contact the district or national level, but they will first ask from these peers and they try to clarify that level. So with that, we were able to minimize the request that we are getting at national level. Then of course the use of support mechanisms. We had several of them implemented. So we had multi-level support. What I mean by multi-level support is we have that national team who's right at the top for main, say major user level support or technical support. But at district level, what we provided them was, we provided them with simple user guides which they translated and kind of used in their training programs that they are using. And the peer support I mentioned to you before, like that is in case someone, some midwife has, I mean, like an issue, they will initially ask from their friends or colleagues because they will also be more comfortable than not talking to a official at district level where the interaction is much more formal. And we also have this Viber group. I think this is something which I think even, this has already been mentioned in some other sessions as well. So Viber is an instant messaging platform, just like WhatsApp. So we have, as you can see here, we have one Viber group that we are operating in this particular district. So they are of course, this is a district level thing. So that's why the language and everything is a local language. So they will ask questions and we have the district team to support it then and there. And also we have some instances where we use remote desktop and mobile-based solutions. So for example, if a district level person encounters some issue, we from national level try to connect the district level using remote desktop solutions. So there are a couple of them available. We have team Viber, any disk. And even at mobile level with some, of course, I mean, like there can be challenges because if it is their own, the person or device, then using a mobile remote solution to connect to the mobile may be a bit of a sensitive issue. So we are kind of careful of that as well. But in some situations we have used that also to provide support. And also we have this concept called monthly conference. So what this monthly conference means is, as I mentioned to you, we have this public health doctor area. It's a kind of a collection of villages. So all these field level staff, once a month, they come to this doctor's office. So we have a full day session where we are discussing traditionally about different mental and child health care, service delivery related problems and some capacity building activities also happen. So what we did was we tried to make this item, you know, like this, the data review and talk issues about the information system, a part of, kind of a agenda item of this monthly conference. So with that there were, I mean, there was some opportunity to provide support even during this conference. And of course, we try to create a culture of data use. So traditionally these field health staff are collecting data, but we try to make them use the data. So at two levels, we try to do it. So the first thing is at the field level, so the field level, we have this, you know, like the growth charts. So it kind of gives them an idea where the child is heading because we give this longitudinal graph. So with that, there is some empowerment which they didn't have. Sometimes when they're having a busy field level, I mean, round, they could not do this, but now then and there they can have a look at this graph with other nutrition and risk factors, everything and give them and conduct counseling and provide them advices. So that level, it happens. And also we have this, I previously mentioned, we have this monthly conferences. So because it's an agenda item, the public health doctors are encouraged to discuss the performance in their area. And also the issues the individual midwives are having. So for example, what you can see here, like they are presenting, they present their dashboards as well as they also even do PowerPoint presentations on performance and few other topics that they have selected during this monthly conference. So with that, of course, there's a data use culture and also the end users are getting some feedback. So with this feedback, they are motivated and they are encouraged to use the system more. And then of course, finally, what I would like to highlight here is like, as you can see here, now this is the data coming from the last year from this nutrition monitoring system in this Chaffner district. So basically the X-axis is the months in year 2020. And these are the events like only the malnourished children's events as in like encounters are mentioned here. So obviously you see like there is a major dip in these monitoring activities in the initial part with COVID. And of course the country was in full curfew or lockdown from March to May, right? So there is obviously a very major reduction of the nutrition encounters because the field level weighing post services were not conducted. But what is interesting to notice just after the curfew was lifted, we kind of see that there's a plateauing of the number of events. Of course it is not as high as this. One reason is the same field health staff is also engaged in COVID related activities. So there is some, I mean, some reduction of their field level activities as well. But what is interesting to notice like even during this kind of problematic time, even afterwards our system bounce back to kind of previously. So this is a feature and attribute of resilience that we try to build in the, I mean about the information system resilience. So we thrive to kind of maintain this and take it forward so that we can also scale it up to other districts as well. So those are a few implementation considerations I mentioned in a kind of a very short span of time. So that's it, thank you. Pamod, thank you very much again. Thank you very much for the next presentation. So some people have been asking about the demo I presented. So I know we have like two minutes before we conclude and then there is an extra session. So I'm just gonna share my screen again, putting this, I think you should be able to see it now. And we can take some questions if they arise at the moment. So basically, sorry, how do I do this present? So basically, if you download the application, if you have not done so, you could write here on the upper right, I'm talking right, yeah, okay. So you can put up there the URL that I have also linked down here, oops, sorry. But also if you scan, if you click up here on the right thing, it will pop up the screen and you can scan the record which will auto-complete. This is the username Android underscore academy and this is the password, this two one. And I'm gonna leave. So ideally we will have this at the very end, this is a tablet mode. So you will not be able to see it like this, but in another way that I'm gonna show you now. And this is basically how you should register yourself if you want again here. So this is the COVID program that I've slightly modified to include the latitude and longitude that you can see on the very last screen, screenshot here. So basically you can register, put your name, put whatever you want, but what is important is that you put this latitude and longitude at the very end. And this will allow, allows us to see you on the map. Of course you need to synchronize. So once you have created the user, you will be seeing something that I'm gonna show you now. So let me see, how can I do this? So I'm still sharing my screen. Caroline or Martin, anyone there can confirm that you're semi-swing? Yes, you're sharing your screen with the Android images. No, I don't wanna, okay, no, I don't wanna share that. I wanna share. You can probably stop sharing and start sharing again. Yeah, I'm gonna share everything. So what I wanted to share is this. So these are my tablets. Yes. So there's the details. Okay, so whenever you enter a person here, as I explained, so for example, I'm gonna register John Joe. So I'm just following the steps that are in the presentation that I will publish again. It's not found, so I can click on the plus here. I can register, put any organization you need, not a big deal, any dates, but here I am gonna put the map. If you click there, it will be auto-populated. I am there. It's my hometown, if you wanna say hi. No, Spain. So when I do this and I register, as I explain at one point in the presentation, so this is the new student, you will be able to see this thing. This means that it's not synchronized, but if I click here, it's gonna perform a synchronization to the server by doing this. There you go, it's been synchronized. And actually now I'm gonna go back to the server side. So this, I should see here are two patients now. Underweight Academy. So now coming here at one point, I should see, I don't know where I've registered them. Well, I don't know where I have put them. Well, I'm gonna check, but anyway, let's try it, but putting it there at one point here, we will be able to see them by putting omics there there. So eventually when we switch to the map, we will be able to see now we will have two people. So feel free to include yourself there. And then we will, at one point we will show them how we'll maybe take a screenshot. There you have. So I'm gonna be sharing this. Gonna actually, I don't know if I can leave it here. I don't know what's, I think I'm already running late. But anyway, I'm uploading the slides to the drive folder that has been shared with you. So feel free to get them from there to follow these steps. I don't think it's complicated. If at one point you have managed, I'm gonna create a post in announcements so you can like it or do something like this. So we know that some people are doing it. And eventually at one point we will be showing them. Maybe a Monday in my next session. Again, thank you very much for your time on the other side. I know this is not ideal, but I hope you enjoyed and do not hesitate to come to us for questions.