Operation ASHA and Tableau Employees Teamed Up to Stop the Spread of Tuberculosis in India

Alexandra

Program manager at MovingWorlds.org

Data matters. The right data in the hands of the right people can help nonprofits make more effective decisions, do more with less, and improve more lives. Tableau is the global leader in helping people see and understand data, and its employees are among the best equipped to help nonprofits do the same. To help nonprofits unleash the power of their data, Tableau partnered with MovingWorlds to help get Tableau employees, and their considerable know-how, into the field to support nonprofits on the cusp of something world-changing. 

After a competitive application process, two employees were selected to participate in the Tableau Foundation’s new Tableau Service Corps Mission Projects program. Employees selected through the program have the opportunity to spend up to three weeks onsite with a Mission Grant Partner engaging in meaningful Tableau training, consulting, and project-based work to build long-term capacity and advance Tableau’s mission of using data to solve real-world problems. For the inaugural project, Tableau partnered with Operation ASHA, a nonprofit in India, to use data to track, treat, and prevent the spread of Tuberculosis. Continue reading to see how these two volunteers created meaningful change abroad, while being changed in return.

The Partner: Operation ASHA

Tuberculosis (TB) is a worldwide problem, and is particularly endemic among underserved communities. The disease disproportionately affects people experiencing poverty due to the link between TB and malnutrition, and the ease of transmission due to the close proximity that people tend to live in when they are affected by poverty.

Skills-based volunteers from Tableau follow Operation ASHA staff into a crowded part of Tekhand Village in India
Michael following Operation ASHA staff into a congested part of Tekhand Village

Treatment for TB involves strong antibiotics that must be taken every single day, but a lack of local clinics accessible to some populations means that many patients in underserved communities either don’t pursue treatment at all, or start treatment but don’t finish it. Particularly in the initial phases of treatment, skipping doses can lead to drug-resistant TB, one of the leading preventable causes of untold misery, suffering, and economic loss to those who are already living below the poverty line.

To address this challenge, Operation ASHA uses a ‘directly observed treatment protocol’ to improve last-mile delivery by making treatment both accessible and verifiable. Rather than expecting these patients to spend a full day traveling to a faraway clinic, Operation ASHA brings the clinic to them. These “pop-up” clinics are established in partnership with local businesses that are already integrated into the patient’s day-to-day life, such as grocery stores and temples, saving patients the bus fare and loss of wages involved in traveling to other clinics. 

An Operation ASHA community health center in India with patients awaiting TB medication
Visiting a Community Health Clinic

Community members are hired and trained as healthcare workers to administer and record the doses using a tablet app with a biometric reader. If a patient doesn’t show up for their dose, the healthcare worker can then easily follow up with them or go to their home. The app is also used to collect information about treatment outcomes. Operation ASHA’s model is local, high-impact, and low-cost. Adoption of these programs has already helped over 75,000 patients access treatment, though there is potential for even more impact. To reach the next level of impact, Operation ASHA turned to Tableau and MovingWorlds for help.

Community health workers administer TB medication to patients at a pop-up community health center in Tekhand Village India
Community health workers administer medication to patients at a pop-up community health center in Tekhand Village

The Volunteers

The two volunteers selected for the program are standouts in their own roles, and together, made a powerful duo. Lauren, a Technical Support Manager, shared this about her motivation for applying to the program:

There are many volunteering opportunities out there, but very few where my unique skill set and experience would matter; fewer still that would offer the chance to immerse myself in another culture and help make a dent in a large-scale public health crisis. Knowledge is my passion. I love learning, teaching, and sharing ideas, and the chance to do so in a way that matters–to use my Tableau expertise, ingenuity, and communication skills to bring a little more hope into the world in a time of so much despair–is irresistible.

Michael, a Principal Software Engineer, shared a similar motivation:

I believe in Tableau’s core mission of helping people see and understand data. I would love to leverage my skills and experience to help the Foundation make a difference in the world through data.

Together, they brought the needed skills to support the technical requirements, operational adoption, and people training required to help Operation ASHA achieve transformational change.

Tableau volunteers Michael and Lauren with Operation ASHA Director Sonali in front of a poster in the Operation ASHA offices
Michael, Lauren, & Sonali Batra, Operation ASHA’s Director of Technology & Development, at the Operation ASHA office

The Project: Building Internal Capacity to Leverage Data for Impact

Through the Experteering Planning Process, Operation ASHA and the Tableau volunteers initially scoped a project that involved using geolocation data to improve active case findings within the affected communities. As the project progressed, Lauren, Michael, and the Operation ASHA team discovered inconsistencies in the existing location data that also needed to be addressed. 

Operation ASHA staff pointing at a computer screen showing data clusters related to tracking TB in India
Operation ASHA team demonstrates work done to cluster GPS coordinates

Luckily, the team remained agile and pivoted their plan, taking a human-centered design approach by seeking feedback to inform each subsequent iteration. First, they identified the necessary data that was missing and helped Operation ASHA put in procedures to collect that data moving forward. Next, they built dashboards based on Operation ASHA’s needs, and conducted trainings to build the confidence and expertise of the local team to gather insights from the data they already had.

Operation ASHA team member holding a tablet in Tekhand Village and giving feedback on the mobile app
Kameni of Operation ASHA gives feedback on the prototype after testing it in the community

As most of us can attest, projects don’t always go according to plan, but the commitment from Operation ASHA and the Tableau volunteers helped ensure a positive outcome. As Lauren shared, “Going into this, I wanted to do a good job representing Tableau, this software company that I love, plus I felt this sense of responsibility and pressure to have the meaningful positive impact for Operation ASHA that we had hoped for – to really leave a lasting legacy.” 

Lauren and Michael jumped into action helping to translate Operation ASHA’s data into meaningful insights to stop the spread of TB. They worked with the local team to further develop a “self-service analytics mindset” so that the team could effectively use data to answer their own questions. They put together a training guide and conducted one-on-one sessions and group workshops, where they shared demonstrations of what the software could do and helped the team to set up improved data sources. 

Tableau volunteer Michael and Operation ASHA staff looking at a computer discussing data modeling options
Michael and Sonali (Operation ASHA) discussing possible applications for the data in Tableau

When reporting back to Tableau Foundation halfway through the project, Lauren shared that,

The work itself has been a similar mix of challenging and rewarding. Seeing how excited people are about how Tableau and the dashboards we are building can impact these communities has, on more than one occasion, given me goosebumps. Even more thrilling is that this is only part of the software they have imagined — there are so many other things they haven’t imagined yet, so many questions left to ask. For me, the ideal outcome is that they can use Tableau not only to identify cases and understand the spread of the disease, but to gain insights about patient outcomes so they can continuously iterate on their approach and make data-driven decisions about resource allocation. These are abstract concepts now, but to me they very clearly translate to healthier people, who can work harder to build better lives, to provide more nutrition and education for their (healthier) children, and to have an overall better life outcomes throughout their communities. That’s the dream. I am excited to see how this evolves moving forward. I think Operation ASHA’s technological approach is already very powerful and can be potentialized with analytics, and all of this translates into better lives for individuals and for communities large and small. Analytics do not need to be complex. With a few very simple line graphs, the team has already been able to identify an under-performing area. Something as simple as a line graph is already helping people receive treatment. This is powerful stuff.

And this is just the beginning of Operation ASHA’s journey.

Four Operation ASHA team members looking at a tablet and pointing at different features of the prototype app
Operation ASHA team members interacting with the prototype

The Outcome: Transformative Change

Towards the end of their time on the ground, Lauren and Michael finalized their project sustainability plan to make sure everyone was comfortable using the updated dashboards and maintaining the proper data inputs. To make this process more interactive, they gathered the local team for a friendly ‘competition’ where they presented a set of Operation ASHA’s data in Tableau about patients and delivery of medication, then gave everyone 2 hours to “do the coolest thing they could” with it and the Tableau software.

Operation ASHA staff pointing at a computer screen showing data modeled in Tableau
Operation ASHA team member asking questions about building different models in Tableau

The local database manager, Ravindar, had the idea to look at missed doses vs. monitored doses to compare the health outcomes (cured, deceased, drug resistant TB, etc.) Ravindar, with a little extra coaching from Lauren and Michael, made an interactive report to correlate the number of deaths with missed doses. The results prompted new questions and ideas. They saw the change in Ravindar as he got into the flow of things, coming up with ideas to make it an even richer data source. At the end of the competition he presented his and model to the entire group, and even some of the local team members who hadn’t been as engaged got into it at that point, asking questions, trying different modifications, and getting excited about how their data could help them accelerate their mission.

This was a moment which Lauren will never forget: “As Ravindar finished his presentation, he said ‘This would’ve taken me 2 days to do this before, and we just did it in 2 hours.’ It brought tears to my eyes because it confirmed that we did what we came to do – we did add value and make a difference, we did help people see and understand data in a new way, and seeing that transformation happen right in front of our eyes was incredibly fulfilling.” 

Michael added on to that, “Our underlying mission all along was to bring them into self-service analytics. Overall, we want to cause this organizational transformation by introducing this tool. The local team was already very data oriented, but doing its analysis in a less efficient way, wondering if the underlying data was correct… After the competition, everyone was asking questions about the data and seeing how they could tweak the data or reports in real time based on different factors. It was incredible seeing everyone not only recognize the value of it, but recognizing that even people without previous know-how of data analysis COULD use these tools to improve outcomes.” 

Operation ASHA staff smiling at a tablet with the Tableau app
Operation ASHA team member Surya getting excited about the possibilities, while colleagues Anoop and Ravindar look on

The Impact to Operation ASHA and the volunteers

As Operation AHSA shared with us,

WE LOVE TABLEAU! The volunteers helped us both brainstorm as well as implement the project. Their ideas added a new dimension to the project, while their expert Tableau skills helped us develop an improved app on Tableau mobile that will be used in the field to effectively detect TB patients. They also gave multiple trainings to the entire organizational staff on Tableau skills, and they were very patient with answering questions. They also made multiple data sources and published them in Tableau Online for us to use in the future so that we would not need to do much heavy lifting while looking at our data and asking or answering questions.

In the survey sent after, Operation ASHA confirmed what Michael and Lauren witnessed: A core problem was addressed that will help Operation ASHA touch more lives, the local team is more confident in their skills to move the mission further forward, and the operational strategy of ASHA improved in ways that will help save more lives. 

Tableau volunteer Lauren giving a demo of the Tableau software to Operation ASHA team members around a table who look on and take photos
Lauren delivers a demo of Tableau to the Operation ASHA team

As for Michael and Lauren, they returned to their full-time roles at Tableau with fresh perspectives that continue to have a positive ripple effect on their work. As Lauren shared,

The whole experience really made Tableau’s mission statement REAL – helping people see and understand their data is meaningful. I intellectually understood that we help people find trends in data, but until I saw it, I didn’t realize how doing so can be up to and including life-changing depending on its application. You have people saying, ‘Now I have new questions I didn’t even know to ask before that will make our public health service better.’ That is real, meaningful, tangible impact. It gives me a different perspective when working with customers and in terms of leading my team – reminding them that they are supporting something bigger. It gives us more empathy in supporting others, helping humanize that and helping people remember the actual, real power of what we’re doing and its value to other people in the world. This centered for me that Tableau is a business – and even world – critical software, prompting me to seek new opportunities to even better support customers based on what we’ve experienced.

Takeaways

This story represents a very real challenge facing many global development organizations like Operation ASHA: they have great teams already doing great work, but sometimes lack access to the leading technologies or methods that can help them be more efficient and effective. By investing in making sure Operation ASHA had the right tools AND knowledge, Tableau’s relatively small investment will continue to pay dividends for years to come for Operation ASHA, their team, and most importantly, the populations they serve. We applaud Tableau and the Tableau Foundation for living their mission of helping all organizations benefit from using data. A special thank you also goes out to Michael and Lauren, who not only worked tirelessly to support Operation ASHA, but who also modeled best practices in skills-based volunteering to ensure that they created real impact that was sustainable and in the best interest of the organization and its team. And of course, we are endlessly inspired by the life-saving work that Operation ASHA is continuing to do in the field!

If you’re a Tableau employee interested in using your skills to help nonprofits like Operation ASHA leverage data for impact, learn more and apply to a future Service Corps Mission Project here

MOVINGWORLDS.ORG BLOG