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Webinar

Improving quality of care at community level in Malawi with the help of mobile phone based applications. Webinar. IMPACT Background. USAID/PEPFAR-funded GDA serving 100,000 OVC and PLHIV, July 2010 - June 2014 Designed to complement WALA Program in 9 districts in central and southern regions

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  1. Improving quality of care at community level in Malawi with the help of mobile phone based applications Webinar

  2. IMPACT Background • USAID/PEPFAR-funded GDA serving 100,000 OVC and PLHIV, July 2010 - June 2014 • Designed to complement WALA Program in 9 districts in central and southern regions • Collaboration with Government of Malawi through MoGCSW, MoH, NAC & OPC/DNHA and US Peace Corps • Improve wellbeing of OVC and increase access to treatment and care for PLHIV • SO1: Improved wellbeing of 60,000 OVC • SO2: Access to treatment and care for 40,000 PLHIV enhanced

  3. IMPACT Background - IMPACT Consortium Members

  4. Mobile applications • Three mobile applications to support the IMPACT program at community level: • Child Status Index (CSI) • Supporting OVC committees • Community Case Management (CCM) • Supporting Health Surveillance Assistants • Mother-infant pair follow up (MiP) • Supporting Health Surveillance Assistants • Working in IMPACT catchment in three districts: Lilongwe, Zomba, Ntcheu

  5. ICT implementation • Mobile applications developed on CommCare platform • Applications run on Nokia 2700c and C2-01 with GPRS data transmission at $0.00003/Kb (compared to $0.03 for single SMS) • Data send to cloud server • Basic troubleshooting once application is developed and users are trained

  6. CCM application • Health Surveillance Assistants (HSAs) conduct Community Case Management (CCM) protocol for children from 2 months up to 5 years at village clinics in hard to reach areas • Mobile application implements Government of Malawi protocol • Mobile application guides HSAs through protocol, enforcing better adherence to the guidelines • Currently 53 HSAs trained and using application • Over 7000 children assessed with the application

  7. CCM application

  8. CCM application Main menu Registration Screening child Treatment

  9. Perceptions about CCM application • HSAs: • ‘The phone is like a colleague reminding us about things we would otherwise forget’ • ‘The phone prevents you from making mistakes’ • ‘The phone guides us, it tells what to prescribe according to the age of child treated’ • Caregivers: • ‘When a child is sick, the doctor can sometimes mistakenly prescribe wrong medication as he is human but when they use the phone, they confidently prescribe or send the child to a referral hospital.’ • ‘Changes which I have observed with the introduction of the phone is that we are now receiving the correct quantity and type of medication because it’s the phone that guides them.’

  10. Why the CCM application? • Better adherence to the sick child form, insight in deviations from the protocol • Increased completeness (90% vs. 100% of visits) • Increased referrals (5% vs. 11% of visits) • Increased follow-up (0% vs. 26% of visits) • Real-time service data, also about drug consumption and stock outs • Increased satisfaction caregivers about services

  11. MiP application • Mobile application implements Government of Malawi protocol for mother-infant pair follow up by HSAs, for following up infected women and their exposed infants during antenatal, post-partum and postnatal home visits until child is aged two • Application guides HSAs through content on each home visit • Currently 65 HSAs trained and using application • 187 women registered of which 134 HIV positive: • 64 antenatal visits • 9 postpartum visits • 111 postnatal visits

  12. MIP application Main menu Registration Antenatal visit

  13. MIP application Postnatal visit Post-partum visit Postnatal visit

  14. Why the MiP application? • Application has helped HSAs understand CBMNC guidelines better • Improved adherence to protocol • Application has improved relationship between HSAs and clients: clients more open to HSAs during follow-up visits • Continued counseling on drug adherence for both mother and child at each visit to avoid defaulting • Referrals are being made during home visits

  15. Challenges • CCM application • Paper register and application used concurrently • MOH reporting and supervision • MIP application • Time span for testing application (pregnancy – 2 years) • Confidentiality issues • General • Eyesight problems • Life time batteries

  16. Lessons learned • CCM application has potential to improve the effectiveness of service delivery at village clinics in Malawi. • MiP application can help improve PMTCT when exposed women are fully followed up and visits done correctly as per protocol

  17. Conclusion Mobile applications improving quality of care at community level

  18. Acknowledgements: CHIKWAWA DIOCESE

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