Project Lead(s): Astrid Christoffersen
Issue
Community Health Workers (CHWs) are vital to maternal and child health in developing countries but lack appropriate tools to enhance their ability to make health decisions, and to link women and infants to appropriate care.
Solution
The mHealth for Maternal and Newborn Health project was a randomized controlled trial to test the hypothesis that community health worker (CHW) services improve with access to mobile phone software.
Applications were provided that allowed CHWs in Kenya to view patient data, display health education materials, identify nearby health resources and services, fill out patient-specific Smart Forms and transmit data securely. The approach was compared to the current use of paper forms and job aids.
Outcome
Among those women served by health workers equipped with ‘smart’ phones, a higher proportion received prenatal counseling, attended a facility for delivery, received a postnatal home visit, and opted for long-term family planning.
As a result of the project, 80 CHWs were able to abandon paper-based government registers in one area, Kosirai, in favour of internally developed and field-iterated software that optimized workflow, maintained data security, drew on existing connectivity and was cost-effective to the government.
The CHWs provided with mobile phones delivered care to 2,120 women and infants, and submitted 3,381 forms, with a total of 48,435 clinical observations.
The study did not have the power to predict or report change in morbidity and mortality at a population level.
Results of the project have helped foster a primary healthcare program that puts Maternal, Newborn and Child Health (MNCH) at the forefront of its activities. Through USAID support and additional funding, the team from AMPATH (the Academic Model Providing Access to Healthcare) has implemented novel approaches in MNCH in seven innovative sites covering a population of 750,000 since 2010. This program has produced significant gains and was renewed to cover a population of 3.5 million people.
The study team has been invited by government and USAID leadership to lead discussions and showcase the clinical decision support platform, both in Kenya as well as in other parts of East Africa.
Drawing on this experience, AMPATH has since designed and launched a point-of-care electronic medical record system for health providers across its sites.