Abstract
Health surveillance assistants (HSAs) in Malawi have provided community case management (CCM) since 2008; however, program monitoring remains challenging. Mobile technology holds the potential to improve data, but rigorous assessments are few. This study tested the validity of collecting CCM implementation strength indicators through mobile phone interviews with HSAs. This validation study compared mobile phone interviews with information obtained through inspection visits. Sensitivity and specificity were measured to determine validity. Using mobile phones to interview HSAs on CCM implementation strength indicators produces accurate information. For deployment, training, and medicine stocks, the specificity and sensitivity of the results were excellent (> 90%). The sensitivity and specificity of this method for drug stock-outs, supervision, and mentoring were lower but with a few exceptions, still above 80%. This study provided a rigorous assessment of the accuracy of implementation strength data collected through mobile technologies and is an important step forward for evaluation of public health programs.
Highlights
As the 2015 deadline for achieving Millennium Development Goals 4 and 5 approaches, maternal, newborn, and child health programs are being scaled up in low- and middle-income countries (LMICs)
This study aims to test the validity of community case management (CCM) implementation strength data collected through mobile phone interviews with Health surveillance assistants (HSAs)
This study was designed to validate CCM implementation strength data collected through mobile phone interviews with HSAs by comparing HSA responses with information obtained through inspection visits to the health center to review supervision/monitoring records and the village clinics to observe medicine/supply stocks and the CCM sick child register
Summary
As the 2015 deadline for achieving Millennium Development Goals 4 and 5 approaches, maternal, newborn, and child health programs are being scaled up in low- and middle-income countries (LMICs). Global awareness of the importance of program accountability has increased, pushed by the 2010 Commission on Information and Accountability (CoIA) for Women’s and Children’s Health convened by the United Nations Director General. Mobile phones are a burgeoning technology in LMICs. Mobile cellular subscriptions in Africa have increased from 87 million in 2005 to 545 million in 2013.2 Mobile health (mHealth) is a growing field that uses mobile technology to provide health services, access patient data, track disease, and support health information systems (HISs).[3] This technology holds potential to improve the quality, timeliness, and availability of data on health programs in LMICs, but there are few rigorous assessments of their use. This technology holds potential to improve the quality, timeliness, and availability of data on health programs in LMICs, but there are few rigorous assessments of their use. mHealth pilot projects to date have not been fully integrated into the HISs and have been largely developed to respond to the needs of projects rather than Ministries of Health (MOHs).[4]
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