250155 Using a mobile technology platform to empower community health workers to improve newborn care at the household level

Monday, October 31, 2011

Sarah Searle , CommCare, Dimagi, Inc., Charlestown, MA
Ken Bayona , CommCare, Dimagi, Inc., Charlestown, MA
Deborah Gitonga , CommCare, Dimagi, Inc., Charlestown, MA
Amelia Sagoff , CommCare, Dimagi, Inc., Charlestown, MA
Neal Lesh, PhD, MPH , CommCare, Dimagi, Inc., Charlestown, MA
Objective: To develop mobile applications to strengthen community-based neonatal health efforts.

Background: CommCare is a mobile phone application designed to support community health workers (CHWs) during home visits. In Tanzania, where there is a high neonatal mortality rate, CommCare stands well-poised to improve consistency and effectiveness of newborn care through automated checklists, multimedia prompts, and collection of useful data.

Methods: In Dodoma, Tanzania we developed a neonatal CommCare module containing the following elements: emergency signs for referral; newborn health promotion checklists; multimedia prompts featuring pictures from Hesperian materials and audio clips.

We assessed and improved the module through hundreds of uses, both during home visits immediately after a birth and under more controlled conditions with women of reproductive age. In the controlled environment, we quizzed 91 women before and after sessions with a CHW to assess client knowledge. We compared the results across sessions conducted with and without the CommCare application.

Results: While our data is insufficient for quantitative analysis, our investigation suggests that mothers appear much more engaged during the picture sections of the CommCare module, which seems to elicit more thoughtful responses. There is a need to prompt CHWs to cover each element, which the audio prompts could potentially fill. Despite initial worries over screen size, we have found that the pictures are still useful even on smaller phones.

Conclusions/Implications: Mothers and CHWs respond well to the use of images for health promotion. Health content is just one part of an effective module; our next step will focus on behavior change. Structuring the content and narrative material of a community health visit, with or without ICTs, may help improve the interaction between the CHW and their clients.

Learning Areas:
Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related education

Learning Objectives:
1. Assess the potential for using mobile applications to strengthen community-based neo-natal health efforts. 2. Describe the outcome of introducing mobile technology to CHWs on the health literacy of their clients. 3. Identify ways to improve the use of mobile technology as a tool to support CHWs, improve health outcomes, and influence behavior change.

Keywords: Community Health Promoters, Information Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the research being presented
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.