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How we measure the impact of our ECHO Tele-mentoring Clinics

25 March 2021

With the rise of COVID last year, it was not only our product development work that ramped up, but even more significantly, our ECHO tele-mentoring program.

Suddenly faced with many requests to train many clinicians, quickly and remotely, on providing respiratory care, professional associations turned to Equalize Health for help. Like in many countries, the Indian health workforce is concentrated in urban areas: only 40% of the health workforce is in rural areas, where 72% of the population resides. Reaching clinicians where they are, with curricula that are relevant to them and their local infrastructure, are key drivers of our tele-mentoring model. Furthermore, by investing in healthcare workers -- particularly those who can provide specialized care -- we are strengthening the overall ecosystem.

Our ECHO program scaled up quickly to meet the demand spurred by COVID, and by the end of 2020, we had trained almost 1,500 clinicians across thirteen clinics (each clinic, or consult, runs for one to twelve sessions) on topics important to each region. As a point of comparison, prior to COVID, we had run two well-received, multi-session clinics.

Our tele-mentoring clinics have taken different forms over the last year, but now that we are past the pilot phase, we are introducing more systemic monitoring and evaluation (“M&E”). A key differentiator between Equalize Health’s tele-mentoring and other similar programs is our focus on measuring outcomes. For example, how do we know if clinicians have learned new skills in the sessions? How do we know if those skills are being used? Months later, do clinicians still retain what they’ve learned? The newly published overview of our ECHO program and M&E strategy, explains how we measure these outcomes and calculate our estimated impact, from improvements in knowledge to patients treated by ECHO-trained clinicians.

Equalize Health's M&E Strategy begins with a theory of change focused on improving clinician knowledge, then practice & performance, through expert consults & peer-to-peer learning.

Seventy percent of the clinicians whom we reached through our clinics last year showed a demonstrable improvement in specialized knowledge, and we are also seeing direct applications in their practice: just a few sessions into a new clinic this year focused on nurses working in public district hospitals in India, the nurses are posting at least two real-time case-based questions to WhatsApp per day to their cohort (including our experts) so that they can administer correct and timely treatment.

Based on early positive indicators like this, and with the support of key supporters, we are expanding our ECHO work in the East Africa region later this year. We look forward to sharing what we learn and the impact we’re seeing.

Many thanks to: Lakshmi Nair (ECHO Program Manager), Kezia Yonzon (Social Research Manager), and Akansha Singh (ECHO Program Associate).

Special thanks to the Vitol Foundation for its support of our ECHO program.