Identify and prioritize adaptations to adherence platform to enable necessary improvements to support roll out. Whichever type of DAT ( EMM, VOT e.t.c) is selected, it should be adapted to fit the country context and within the local treatment setting or target population. These adaptations should be guided by global best practices and and should seamlessly fit the country settings for easy change management.
After reading this section, you will understand:
The different ways digital adherence technologies can be adapted to fit your country settings.
How to implement these adaptations to the digital adherence technology.
Prioritize the adaptations in a checklist and customize the DAT for your country setting:
Determine technology adaptations;
Determine platform adaptations;
Develop and test all adaptations;
Develop a manual of operations to specify how the DAT intervention should be implemented;
Finalize customization of DAT(s).
Adaptations to the 99DOTS sleeves and adherence platform for Tanzania
All instructions on the sleeves are in the local language (Swahili)
Icons were adapted to fit local context (example, TZ shilling with red strike to indicate calls are "toll free"), and custom cut-outs to clearly display the expiration date on the blister pack
Adaptations to the DATs for The Philippines
All instructions on the sleeves are in the local language (Filipino) and English
The texting guidance was formatted to match familiar labels - modeled to match the consumer outreach labels for texting on Coca Cola bottles
Adaptations to the DATs for Ukraine
evriMED box for Ukraine was supposed to be designed with images or slogans on the outside to brand the box, however patients and providers feedback was a preference for a white box (blank - no design) to reduce potential stigma. All instructions on how to use the box were printed on the inside of the box instead.
Adaptations to the Adherence Platform
The 99DOTS mobile app has been translated into several languages, and translations to more languages is underway.
Specific adaptations for patient registration include:
More than 2 gender types for Ukraine
Occupation list for Tanzania
All TB case treatment and management data entry fields disabled for Tanzania, as the country already uses a TB and Leprosy electronic system
The registration page was adapted to fit the data sets and data format used during patient registration in several countries.