Community health workers for surgical patients: A pilot study of a mobile health application to enable the early detection of surgical site infection by community health workers in rural Haiti

The project will develop, validate and test the feasibility of an innovative system of outpatient evaluation for surgical patients in rural Haiti using community health workers (CHWs) and mobile phones. It will be the first project to use both mHealth and CHWs to detect surgical site infections (SSIs) in a resource poor setting. The mobile phone application will use a short survey and photograph of the surgical incision taken at two days after discharge from the hospital and thirty days after the operation. The results of the CHW visits will be compared to exams by surgeons during regularly scheduled clinic visits for all patients. Usability, feasibility and desirability of the program from the perspective of the patients, CHWs and surgeons will be assessed using qualitative methodology. Clinical outcomes including rates of re-admission and re-operation will be compared between the intervention group and a control group. The project will increase surveillance for SSI, increase access to healthcare for poor patients, reduce morbidity of SSIs by promoting early detection and treatment, enable task shifting of post-operative follow up for SSI to CHWs, and form the foundation for robust measurement of surgical outcomes in resource poor settings.