A Framework for Assessing Responsibility in Intergovernmental Partnerships.

Advancing the health of the poor requires aligning a wide array of interests, all of which influence how health care is delivered. Global health professionals often face difficult decisions that can affect their working relationships with government officials, local colleagues, nongovernmental organizations (NGOs), and private sector interests. This article proposes a "compass-based" framework that urges global health professionals to act in a way that is both morally sound and pragmatically effective. Global health professionals must follow their "moral compass" and act in alignment with the interests of the communities they seek to serve while, at the same time, utilizing their "effectiveness compass" to navigate complex situations in ways that ensure achievement of practicable change that can motivate better health outcomes for those in need.

Introduction of Mobile Health Tools to Support Ebola Surveillance and Contact Tracing in Guinea.

Challenges in data availability and quality have contributed to the longest and deadliest Ebola epidemic in history that began in December 2013. Accurate surveillance data, in particular, has been difficult to access, as it is often collected in remote communities. We describe the design, implementation, and challenges of implementing a smartphone-based contact tracing system that is linked to analytics and data visualization software as part of the Ebola response in Guinea. The system, built on the mobile application CommCare and business intelligence software Tableau, allows for real-time identification of contacts who have not been visited and strong accountability of contact tracers through timestamps and collection of GPS points with their surveillance data. Deployment of this system began in November 2014 in Conakry, Guinea, and was expanded to a total of 5 prefectures by April 2015. To date, the mobile system has not replaced the paper-based system in the 5 prefectures where the program is active. However, as of April 30, 2015, 210 contact tracers in the 5 prefectures were actively using the mobile system to collectively monitor 9,162 contacts. With proper training, some investment in technical hardware, and adequate managerial oversight, there is opportunity to improve access to surveillance data from difficult-to-reach communities in order to inform epidemic control strategies while strengthening health systems to reduce risk of future disease outbreaks.