Project Lead(s): Duncan Maru
Globally, impoverished communities suffer needless barriers in obtaining healthcare, and care offered through the public sector is often of low quality and of limited availability.
As a result, those of low income often lack access to effective care and must rely on unregulated, expensive private-sector providers who provide up to 90% of care in South Asia.
Implemented in Nepal, the project team developed a mobile phone application to be used by community health workers (CHWs) in rural Nepal to rapidly generate real-time, community-level data.
The goal of the app was to increase the responsiveness of the public healthcare system, by providing accessible reports on diarrheal diseases, respiratory tract infections and pregnancies.
When coupled with healthcare facility audits, these reports could improve the responsiveness and accountability of public sector healthcare delivery across the tiers of the district healthcare system, from primary clinics to hospitals.
In addition to the app, the project team also implemented an approach to mobilize community health workers (CHWs) and better integrate the healthcare system as a whole.
The model is distinct from the status quo, as it:
1) Incentivizes providers to deliver quality care, rather than excess care
2) Re-frames the focus of the care delivery system on chronic disease management, with an emphasis on follow-up and self care
3) Integrates care across sites of care provision and across the lifespan of patients’ diseases.
The project team recorded 12,810 unique mobile health encounters via the mobile application.
The program has been expanded from its initial reach to 14 village clusters (totaling over 36,000 people), six new primary care clinics and 151 CHWs.
A primary care facility scorecard to evaluate human resources and supply chain issues has been introduced.
The project team has applied for scale-up funding from Grand Challenges Canada and the Government of Nepal has committed $1,090,000 to expand the work in the Achham District.