Leveraging the Potential of mHealth: The Impact of a Mobile Health System on the Quality, Coverage and Responsiveness of Community Health Workers to Support Healthy Pregnancies and Newborn Care

Session: Technology to Improve Coverage and Quality of Maternal Newborn Care

Presenter: Anuraj Shankar, Harvard T. H. Chan School of Public Health and SUMMIT Institute of Development

Background: OpenSRP is an open-source integrated electronic register-based mobile data platform that supports urban and rural community health workers (CHWs) to deliver core interventions along the RMNCH continuum of care. OpenSRP Indonesia, is exploring the potential of mHealth to use real-time data as a catalytic tool for improved performance and job satisfaction of CHWs crucial for continuous quality improvement and sustainability of mHealth approaches.

Methodology: In collaboration with the Government of Central Lombok District, Indonesia, we are currently implementing a 6-month trial of OpenSPR with 40 community midwives using a randomized controlled trial design; covering ~5800 pregnant women and their children. We developed indices of usability, quality and proficiency (Head, Heart, Hands Score) regarding the use of the OpenSRP application in the field. These allow routine assessments of provider performance enabling a dynamic process of continuous quality improvement through real time rapid analysis of their individual scores and feedback through coaching and supervision.

Results: Initial formative work revealed that CHWs reported their time-management was sub-optimal due to burdensome reporting requirements, lack of decision support tools and rudimentary paper registers. Preliminary results from piloting OpenSRP Indonesia suggests it is able to reduce the reporting workload, prioritise service provision based on risk and improve worker engagement a. A critical piece of improving the CHWs performance and responsiveness and ability to manage their caseloads more effectively is the rapid feedback and customized coaching, and the ability of CHWs to adjust this process to suit their needs.

Conclusion: OpenSRP as a mobile data platform and as a rapid data analytics tool, has the potential to increase CHWs quality, coverage and responsiveness to provide vital services to pregnant women and newborns. Our approach of user-centered design and rapid feedback also provides a way of ensuring continuous quality improvement and engagement with CHWs.