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Original Research
Value of a mobile information system to improve quality of care by community health workers
Submitted: 03 June 2012 | Published: 12 April 2013
About the author(s)
Mark Tomlinson, Department of Psychology, University of Stellenbosch, South AfricaMary Jane Rotheram-Borus, Global Center for Children and Families, University of California, United States
Tanya Doherty, Health Systems Research Unit, Medical Research Council, South Africa
Dallas Swendeman, Global Center for Children and Families, University of California, South Africa
Alexander C. Tsai, Robert Wood Johnson Health and Society Scholars Program, Harvard University; Center for Global Health, Massachusetts General Hospital, United States
Petrida Ijumba, Health Systems Research Unit, Medical Research Council, South Africa
Ingrid le Roux, Philani Nutrition and Development Project, Cape Town, South Africa
Debra Jackson, Health Systems Research Unit, Medical Research Council; School of Public Health, University of the Western Cape, South Africa
Jackie Stewart, Department of Psychology, University of Stellenbosch, South Africa
Andi Friedman, Clyral, Durban, South Africa
Mark Colvin, Maromi Health Research, South Africa
Mickey Chopra, UNICEF, New York, United States
Abstract
Background: We will be unable to achieve sustained impact on health outcomes with community health worker (CHW)-based interventions unless we bridge the gap between small scale efficacy studies and large scale interventions. Effective strategies to support the management of CHWs are central to bridging the gap. Mobile phones are broadly available, particularly in low and middle income countries (LAMIC), where the penetration rate approaches 100%.
Objectives: In this article, we describe how mobile phones and may be combined with mobile web-based technology to assist in the management of CHWs in two projects in South Africa.
Methods: This article is a descriptive study, drawing lessons from two randomised controlled trials outlining how a mobile phone information system can be utilised to enhance the quality of health interventions. We organised our comprehensive management and supervision system around a previously published management framework. The system is composed of mobile phones utilised by CHWs and a web-based interface utilised by CHW supervisors. Computerised algorithms were designed with intervention and assessment protocols to aid in the real-time supervision and management of CHWs.
Results: Community health workers used mobile phones to initiate intervention visits and trigger content to be delivered during the course of intervention visits. Supervisors used the web-based interface for real-time monitoring of the location, timing and content of intervention visits. Additional real-time support was provided through direct support calls in the event of crises in the field.
Conclusion: Mobile phone-based information system platforms offer significant opportunities to improve CHW-delivered interventions. The extent to which these efficiency gains can be translated into realised health gains for communities is yet to be tested.
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