Mobile Health Around the Globe: IRC Uses Mobile to Track Mortality in Africa
The International Rescue Committee conducted two mortality surveillance projects using community health workers who visited homes and collected vital events data with mobile phones. The project in Sierra Leone was completed, but the project in DRC (Democratic Republic of Congo) was interrupted because of rebel conflict.
In both Sierra Leone and DRC, it is extremely difficult to obtain acurate mortality counts. Many children die before their fifth birthday. In Sierra Leone, malaria, diarrhea and pneumonia account for the majority of deaths in the under-five population. Many of these deaths are not detected by the government agencies. The IRC wanted to initiate a program to better collect, record and collect vital event data. This would happen with better training, better equipment and better guidance.
The overall objective of the studies was to evaluate the effectiveness of a using mobile phones to document vital events by community health workers who were to report on all deaths, births, and childhood illnesses. Results were to be analyzed against a pre- and post-program census. Initial household census counts were done using a questionnaire that detailed household members, sick child treatment behavior ahd migration information. Then each week the community health workers documented births and deaths using mobile phones.
The results of both studies was encouraging. The completed study in Sierra Leone showed the following results:
- Weekly reporting percentage averaged 93% over the course of the twelve month project.
- Power sources for phones and supervision were key challenges for data reporting.
It was thought that the community health workers were a good choice to use for this project. They were well-respected, knew the population and understood the difficulties involved. Also, in the DRC, they were considered humanitarians and therefore not targeted in rebel conflict.
Many health workers already had mobile phones, or at least were familiar with them, so there was no issue of learning a new technology.
There were however some concerns about phones being lost or stolen and solar chargers not working. Some of the health workers had to walk long distances (3 hours or more) to charge their phones and this often presented a problem.
Paul Amendola concludes in his report,
" The project, aside from the calculation of mortality surveillance, has increased the overall knowledge of mobile phone-based reporting data. The high reporting rate suggests that collection of data, even from rural, low-resource areas, is feasible, and can be reliable. There were certain programmatic and reporting considerations that need to be included into future projects that will help enhance the reporting and allow for lessons learned. Solar chargers, and the unreliable power supply in developing areas continue to be a component of mobile-reporting that needs to be explored.
Mr Amendola goes on to say,
"Prior to project initiation, the IRC technical unit did not have any mobile phone-based collection projects. As a direct result of this project, there are currently 31 mobile based data collection projects in place. There were a lot of lessons learned from this project – challenges of supervision, solar chargers, and clear reporting areas, but the overall effect of the development will have, and has already had a positive effect on additional projects."
I had the great pleasure of interviewing Paul Amendola who was there during the study. In the following video, Paul gives us his personal thoughts on the study - the challenges, the opportunities and the bright future of using mobile in global health.
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source: Amendola, Paul, IRC, MOVERS Final Report, November 2012
Joan Justice is currently the Senior Curator for HealthWorksCollective. She holds both a nursing and a graduate business degree, and has worked in domestic and international marketing management for several major healthcare corporations. She lives in Charlottesville, Virginia.