Online Program

Applying mhealth to improve supportive supervision of a large scale maternal and newborn health program in Ethiopia

Wednesday, November 6, 2013

Ali Mehryar Karim, PhD, Last 10 Kilometers Project, JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
Nebiyu Getachew, MA, The Last Ten Kilometers Project, JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
Wuleta Betemariam, MA, MPH, The Last Ten Kilometers Project, JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
The Last Ten Kilometers (L10K) project strengthens the link between Ethiopia's health extension program (HEP) and households to improve community-based maternal and neonatal health (MNH) services in 115 districts covering about 14 million people in 3,000 kebeles/communities. The HEP services to a kebele are provided by two female health extension workers (HEWs). Seventy-two L10K field coordinators (FC) provide supportive supervision (SS) to the HEWs using a checklist. A limited number of checklist items were being analyzed, while programmatic feedback was often delayed. M-health was implemented to address the issue. This study assesses its adequacy in improving the quality and performance of the SS.

Using web based EpiSurveyor, the SS checklist was installed in smart phones given to the FCs. The smart phones allowed offline data collection during SS which were uploaded to the web whenever network was available; allowing program managers to access the data from anywhere to provide feedback.

The system improved the efficiency of the central, regional, district-level program managers to give feedback to the FCs by reducing the cycle from every three months to every month. Although the FCs usually visited the target number kebeles, there were kebeles that were not visited; while checklist items were often missed. Between April 2012 and January 2012 the SS coverage of kebeles increased from 30% to 70% while the missed items reduced from 25% to 5%. The m-health also provided information on the variation in maternal health care coverage according to the different in L10K strategy areas.

Learning Areas:

Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Public health or related research

Learning Objectives:
Demonstrates that m-Health a) improves the quality and performance of supportive supervision; and b) improves the data quality and efficiency of a program’s monitoring and evaluation (M&E) system. Describes that the implementation of simple m-Health is not very costly. M&E team with basic skills in survey database design and analysis can implement simple m-Health technologies that are freely available in the web. As such, the cost for using m-Health can be limited to the investment in smart phones.

Keyword(s): Community Health Programs, Health Management Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Developed and implemented the m-Health strategy. Analyzed the data. Wrote the abstract.
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.