I just returned from Mozambique, where World Vision was kicking off a new project using our core mobile platform, CommCare. In the city of Quelimane, located in Mozambique’s poorest province, World Vision will pilot an initiative to use mobile phones to improve the adherence of Community Health Volunteers (CHVs) to emergency procedures during pregnancy-related visits. The content loaded onto their phones walks them through various first response steps depending on what symptoms the patient exhibits.

One of the major challenges we face when consulting overseas is that when you leave, our work tends to stay exactly the way we left it. Consider a situation where after a few weeks of using a piece of software, it became apparent that the text of the instructions was too long. In an ideal world, as people use an application, these kinds of flaws in its initial conception become clear, and these flaws are fixed. Perhaps the text “Let her lie down or put her in a semi-sitting position and instruct her to get lots of rest” would have a higher impact and fit better on the phone screen if it were replaced by something shorter, like “Lie her down.” Due to the rapid development deadlines, by the time these kinds of problems are identified, the on-site work has already finished.

Now, that seems like a simple thing to change, but making this change requires someone who knows how to edit XForms, a text format that we use to represent all the forms we use on CommCare. To make this change, you’d have to find the place in the code that looks like this:

...
<text id="lie_down">
<value>Let her lie down or put her in a semi-sitting position and instruct her to get lots of rest.</value>
</text>
...

and then just change the text to be the new-and-improved text. It is sometimes possible to lead a non-technical person through the process of making this change and rebuilding the application, but more often than not it takes more time than doing it ourselves. So often what happens is that after we code up the content into forms, they either stay that way forever or they have to deal with asking us to make last minute changes to the forms. Add to this the fact that most forms are not in English, but in the official local language, and this can make the ideal of a quick-turnaround iterative approach to content improvement all but a fantasy.

One of the exciting aspects of the project in Quelimane, Mozambique is that it involves the use of images and audio to quicken the reaction time between seeing and recognizing for low-literate CommCare users. This also makes it especially important to have a system in place for changing content when necessary, because instead of having text, there is text, images, and audio, all of which may need to undergo slight (or drastic) modifications.

In order to address the need for a project model which stays dynamic, Dimagi maintains partnerships with local developers through the Coded in Country Initiative. In Mozambique, we connected World Vision’s project coordinators with a team of developers in Maputo called Afrisis. Afrisis can provide them with great direct support that will let them iterate their content quickly and accurately. They work in the same timezone and speak the same language, Portuguese.

One of our big-picture goals at Dimagi is to help establish self-sustaining in-country ecosystems around the open source software that we write and promote. Ideally, someday Afrisis will be talking with a client and say, “You know what, I have the perfect solution for this problem” and our software can act as the basis for that solution. The more on-the-ground support we have for our platforms, the more scalable our platforms become, and the wider the audience they can reach.

At the same time, back home in Boston, we are working as hard as ever to push out a new set of tools for authoring and organizing forms and packing them together in as few easy steps as possible, opening the doors for non-programmers to edit the content themselves, thus shortening the cycle further. The tools are publicly available online at www.commcarehq.org. Keep an eye out for news regarding exciting improvements we have in store.

Axon

Coded in Country partner in Ghana