Using m-health applications for improving primary care delivery by community health worker in underserved areas of Pakistan
Community Health Sciences; Women and Child Health; Paediatrics and Child Health; Office of the Provost
Context: Pakistan has one of the largest workforce of community health workers (CHWs), however weak supervision and poor quality reporting has raised questions on effectiveness of service delivery. We evaluate whether use of M-Health Android application for real time reporting by CHWs can improve delivery of child health preventive care.
Methods: Our hypothesis is that timely and quality data leads to increased frequency and better quality of community activities which result in improved household awareness and practices. Assessment is carried out in 2 rural districts across demographically similar control and intervention clusters and having comparable density of CHWs. A double difference design is applied to estimate pre-and post intervention change across control and intervention areas. Mixed methods are used for assessment that include household survey of mothers of >5 years children, focus group discussions, structured interviews with CHWs and MIS record review.
Results: Detectable change in frequency of health worker visits and range of child health services provided during household visits is reported. We also report on changes in household awareness and practices in the core areas of childhood disease management, early referral, hygiene, young child feeding practices and immunization. Qualitative insights from CHWs and district supervisors are analyzed on ease, acceptability and perceived benefit of using M-health application. Validity and completeness of CHW record is examined to detect pre and post intervention improvements.
Conclusion: Android applications for improving health worker performance accountability must be assessed in terms of delivery as well as qualitative experience of data reporting and use.
Taha, R. N.,
(2019). Using m-health applications for improving primary care delivery by community health worker in underserved areas of Pakistan. APHA 2019.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/709