Abstract
ABSTRACT The increasing availability and capabilities of mobile phones make them a feasible means of data collection. Electronic Data Capture (EDC) systems have been used widely for public health monitoring and surveillance activities, but documentation of their use in complicated research studies requiring multiple systems is limited. This paper shares our experiences of designing and implementing a complex multi-component EDC system for a community-based four-armed cluster-Randomised Controlled Trial in the rural plains of Nepal, to help other researchers planning to use EDC for complex studies in low-income settings. We designed and implemented three interrelated mobile phone data collection systems to enrol and follow-up pregnant women (trial participants), and to support the implementation of trial interventions (women’s groups, food and cash transfers). 720 field staff used basic phones to send simple coded text messages, 539 women’s group facilitators used Android smartphones with Open Data Kit Collect, and 112 Interviewers, Coordinators and Supervisors used smartphones with CommCare. Barcoded photo ID cards encoded with participant information were generated for each enrolled woman. Automated systems were developed to download, recode and merge data for nearly real-time access by researchers. The systems were successfully rolled out and used by 1371 staff. A total of 25,089 pregnant women were enrolled, and 17,839 follow-up forms completed. Women’s group facilitators recorded 5717 women’s groups and the distribution of 14,647 food and 13,482 cash transfers. Using EDC sped up data collection and processing, although time needed for programming and set-up delayed the study inception. EDC using three interlinked mobile data management systems (FrontlineSMS, ODK and CommCare) was a feasible and effective method of data capture in a complex large-scale trial in the plains of Nepal. Despite challenges including prolonged set-up times, the systems met multiple data collection needs for users with varying levels of literacy and experience.
Highlights
The increasing computing power, affordability and availability of mobile phones have made their use feasible and effective as an alternative to paper questionnaires in low-income settings
We reviewed literature describing experiences with developing and implementing Electronic Data Capture (EDC) systems in low- and middle-income countries (LMICs) in the past 10 years and found that mobile devices are widely used in LMICs for healthcare delivery [1,2,3,4,5,6,7,8] including disease surveillance and control [9,10,11,12,13,14,15], epidemiological surveys [16,17,18,19,20,21], other research studies [22,23,24], remote data collection and monitoring [25,26,27,28] and public planning and mapping [29]
Basic phones transmitting coded SMS messages using software such as FrontlineSMS were used for simple information or event notification [33,34,35], and transmission of Global Positioning System (GPS) coordinates was used for mapping [27,35]
Summary
The increasing computing power, affordability and availability of mobile phones have made their use feasible and effective as an alternative to paper questionnaires in low-income settings. We reviewed literature describing experiences with developing and implementing Electronic Data Capture (EDC) systems in low- and middle-income countries (LMICs) in the past 10 years (search strategy available in Supplemental Appendix 1) and found that mobile devices are widely used in LMICs for healthcare delivery (mHealth) [1,2,3,4,5,6,7,8] including disease surveillance and control [9,10,11,12,13,14,15], epidemiological surveys [16,17,18,19,20,21], other research studies [22,23,24], remote data collection and monitoring [25,26,27,28] and public planning and mapping [29].
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