Original Research

Value of a mobile information system to improve quality of care by community health workers

Mark Tomlinson, Mary Jane Rotheram-Borus, Tanya Doherty, Dallas Swendeman, Alexander C. Tsai, Petrida Ijumba, Ingrid le Roux, Debra Jackson, Jackie Stewart, Andi Friedman, Mark Colvin, Mickey Chopra
South African Journal of Information Management | Vol 15, No 1 | a528 | DOI: https://doi.org/10.4102/sajim.v15i1.528 | © 2013 Mark Tomlinson, Mary Jane Rotheram-Borus, Tanya Doherty, Dallas Swendeman, Alexander C. Tsai, Petrida Ijumba, Ingrid le Roux, Debra Jackson, Jackie Stewart, Andi Friedman, Mark Colvin, Mickey Chopra | This work is licensed under CC Attribution 4.0
Submitted: 03 June 2012 | Published: 12 April 2013

About the author(s)

Mark Tomlinson, Department of Psychology, University of Stellenbosch, South Africa
Mary 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.


Keywords

Mobile phones; community health workers; supervision; management; mHealth

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Crossref Citations

1. Diffusing and scaling evidence‐based interventions: eight lessons for early child development from the implementation of perinatal home visiting in South Africa
Mark Tomlinson, Xanthe Hunt, Mary Jane Rotheram‐Borus
Annals of the New York Academy of Sciences  vol: 1419  issue: 1  first page: 218  year: 2018  
doi: 10.1111/nyas.13650