Staff Blog

Staff Blog


by Dimagi

17 July 2009

Strengthening Community Health Workers

Community health workers (CHWs) have demonstrated a potential to substantially improve health outcomes in areas of extreme poverty. However, community health programs are difficult to run effectively because CHWs tend to have little training and operate independently.

CommCare is a case management solution for CHWs. Each CHW is equipped with an inexpensive phone running our free and open source software that contains registration forms, checklists, danger sign monitoring, and educational prompts. CommCare helps manage enrollment, support, and tracking of all of the CHW’s clients and activities. CommCare captures data from each home visit and sends the data to our central cloud, CommCareHQ for program improvement, health surveillance, and workflow interventions. CommCare is easily customizable for widely different environments; it can run on inexpensive Java-enabled phones or higher-end Android phones, easily handle multiple languages, and incorporate multimedia elements for low-literate users.

CommCare is currently being piloted in ten countries by 19 public health organizations. Forms for over 90,000 home visits have been submitted thus far. The majority of these projects are tailored to strengthen community-based efforts to improve maternal and child health. From these pilot studies we are accumulating a wealth of experience and training materials deploying CommCare in the field, as well as building an evidence base that confirms CommCare can improve a community health program

Collaborative Approach

Dimagi and D-Tree international are leading CommCare, a mobile-phone based application that will enable CHWs to provide better, more efficient care while also enabling better supervision and coordination of community health programs. Dimagi is leading the development of the open source, phone and web-based application, building on years of experience in mobile health. D-Tree International, a frequent partner and implementer with Dimagi, is leading the implementation of CommCare deployments, currently focused in Tanzania. This effort is a collaboration with local researchers and implementing organizations, and will be built on top of the open source JavaROSA platform.

Scaling Up

Dimagi has recently launched a cloud-based, enterprise level platform to deploy CommCare globally (www.commcarehq.org). The platform includes two-way synchronization of client data which allows data to be shared between CHWs, promotes links between community- and clinic-based health, and restores a CHWs data in case of phone damage or loss. We are adding authoring tools to allow organizations to adapt or create their own CommCare modules.

We are focusing our immediate scale up efforts in India to deploy CommCare with the new Accredited Social Health Activist (ASHA) program. Over 750,000 ASHAs have already been trained and are financially incentivized to conduct community-based interventions known to improve maternal and child health. We are on track to launch beta tests of CommCare-ASHA with at least 10 different organizations throughout India by the end of 2011.

Pictures below are courtesy of researcher Brian DeRenzi, a PhD student at the University of Washington who has led much of the field work to develop CommCare.

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