Dimagi CEO, Jonathan Jackson, presented CommCare to the Maternal and Child Health Integrated Program (MCHIP) at USAID. The webcast, including the PowerPoint presentation and a Question/Answer session are available here.
MCHIP’s is an arm of USAID with a vision to accelerate the reduction of maternal, newborn and child mortality in the 30 USAID priority countries facing the highest disease burden.
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To improve access to protection services and reduce HIV’s impact for women and children, UNICEF worked with the Malawi government to established a Community Survivor Support Unit (CSSU) in Malawi’s 300 traditional authorities. CSSUs provide psychosocial support, mediation, and referral services for women and children survivors of abuse, exploitation, and neglect. CommCare is strengthening CSSU monitoring, activities, and information systems.
In rural Jharkhand, Rural Health Care Providers (RHCP) and Lab Technicians (LT) use CommCare to improve TB case detection, follow-up rates, symptomatic case management, and DOTS adherence.
RHCP refers symptomatic cases to LT where sputum is tested for TB. If lost to follow up, an SMS is sent to the patient, RHCP, and LT. An SMS is also sent to the patient with lab results.
ICAP is using CommCare to improve treatment outcomes of TB patients and household contacts by strengthening their DOTS system and follow-up.
Nurses use CommCare in government clinics to register TB patients, schedule appointments, and follow up on missed appointments. CHWs use CommCare during home visits to screen contacts for TB and refer potential cases to clinics. CommCare helps ICAP supervise DOTS supporters and provide TB education and counseling through multimedia.
SNEHA implemented CommCare to replace its manual data collection and entry system to track mothers and newborns in Mumbai’s slums, accompanying a programmatic scale-up in strengthening referral linkages within the municipal health system. The CommCare application allows individual children’s weights to be updated on a monthly basis, and support the health worker to follow-up with malnourished children. [CommCare Application]
RMF implemented CommCare to assist Community Nutrition Educators (CNEs) in identifying children with Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) through measuring MUAC. In addition to tracking MUAC over time, the application supports counseling to families of malnourished children and refers these children to government treatment facilities for rehabilitation in villages of Madhya Pradesh. Their work was previously recorded in paper format and implementation of mobile data collection has reduced the latency period from 45 days to eight hours. [Published Study]
Pathfinder International, in collaboration with Dimagi, USAID, and the Haitian Ministry, has trained more than 300 CHWs under the mSante mHealth Project. This mobile application focuses on case management, health service delivery, referrals for tracking patients between home and the health facility, and features modules focused on interventions targeted at family planning and maternal and child health. Pathfinder and partners are currently working toward scaling this project to the national level.
In partnership with Dimagi and the Grameen Foundation, World Vision has deployed the MOTECH Suite for maternal, newborn, and child health (MNCH) and nutrition mobile applications in ten countries, including Afghanistan, Burundi, India, Indonesia, Mozambique, Niger, Sierra Leone, Sri Lanka, Uganda, and Zambia. These applications are designed to support CHWs to deliver MNCH and nutrition services more efficiently by reinforcing intervention protocols, serving as job aids and acting as monitoring tools.
Under the APHIAplus project in Kenya, Pathfinder, with the support of USAID, has worked with Dimagi to monitor and track the health of pregnant mothers and orphans and vulnerable children. Using CommCare, CHWs are better able to monitor maternal and newborn health indicators, keep women informed of their expected delivery date and signs of complications, and help women prepare for delivery. As of spring 2014, over 260 CHWs trained through mHMtaani were using CommCare. The application also contributed to an increased number of facility-based deliveries as a result of due date reminders.
The Harvard School of Public Health, in collaboration with the Indian government, the World Health Organization, the Gates Foundation and Population Services International, aims to assess whether the introduction of the WHO Safe Childbirth Checklist results in a decline of maternal and newborn deaths. Outcomes of 172,000 births will be tracked, in addition to the provision of essential supplies for safe birth. Dimagi is supporting the research data collection process through CommCare and CommCareHQ, where managers, supervisors, and researchers on the Better Birth Project will be able to access and analyze submitted data.
The ReMiND project in Uttar Pradesh, India is well known as a leading example of best practices for using mobile health technology to increase key maternal and newborn health practices. Through ReMIND, Catholic Relief Services (CRS) and Dimagi are using CommCare to help Accredited Social Health Activists (ASHAs) counsel and evaluate women and their newborns for danger signs both before and after birth. Case management allows ASHAs to register and track every pregnant patient through pregnancy to the postpartum period, as well as the newborns through their first year of life. Over 200 ASHAs have been trained to use these applications, ultimately reaching over 20,000 women and their children.
To improve access to protection services and reduce HIV\’s impact for women and children, UNICEF worked with the Malawi government to established a Community Survivor Support Unit (CSSU) in Malawi’s 300 traditional authorities. CSSUs provide psychosocial support, mediation, and referral services for women and children survivors of abuse, exploitation, and neglect. CommCare is strengthening CSSU monitoring, activities, and information systems.
In South Africa, CARE provides Integrated Access to Care and Treatment (iACT) literacy programmes for registered clients in local communities. They are using CommCare to register participants and provide follow up services and education for both HIV and TB, including making client referrals to clinics, recording client attendance during iACT sessions, and schedule automatic reminders for client follow up.
MSF tested a proof of concept CommCare App in the community of Khayelitsha, Cape Town to keep track of patients in ART Adherence Club (AC) clubs. By using the application, MSF staff would be able to track club attendance in real time, make referrals to clinics, and identify defaulters. The system also enabled individual feedback to facilitators based on their mobile activity, and regular email reports of clubs activities available for M&E team, as well as raw data to identify and trigger alerts for high-risk or defaulting clients
The IMAGE Project combines a microfinance intervention with a gender and HIV awareness curriculum with the aim of improving the social and economic well-being of households and reducing the risk of HIV infection and gender-based violence. The IMAGE Project is currently working with 5000 households in 300 rural villages across 4 South African provinces – Limpopo, Gauteng, Northwest and KwaZulu Natal. The nature of the program is highly decentralized – with 35 field staff that work in small, dispersed teams. The project has additional replication sites in Tanzania, Kenya, Zimbabwe and Peru.
Dimagi partnered with Boston’s Brigham and Women’s Hospital and Social & Scientific Systems, Inc. (SSS) to develop a scalable text messaging (SMS) system to improve HIV medication adherence in 14 countries in Africa, Asia, and the Americas. The SMS intervention is part of an ongoing clinical trial, A5288, supported by the Aids Clinical Trial Group (ACTG). The system was designed to optimize combination therapy for HIV-infected patients, who currently struggle with treatment and have demonstrated resistance to common anti-retroviral drugs.
With support from Econet Wireless and the Zimbabwean Ministry of Health and Child Care, Global Solutions for Infectious Diseases (GSID) created a mobile system with Dimagi and ODK Diagnostics to better process rapid diagnostic tests for HIV and malaria. The system utilizes CommCare’s case management and reporting features to digitize health workers’ workloads, and ODK-Dx’s ability to process, analyze, and return RDT results with computer vision algorithms. The system was used in five sites in Manicaland province, including three hospitals and two health centers.
The postpartum IUD initiative aims to address the postpartum contraceptive needs of women by training community midwives, health workers, doctors and delivery unit staff in postpartum IUD counseling and insertion. As part of this project, project staff are using CommCare to collect baseline and intervention data, including data with women at the hospital after delivery, at nine months, and at 18 months after delivery.
Together with the London School of Hygiene and Tropical Medicine (LSHTM) and International Medical Corps (IMC), IPA developed a two-armed cluster-randomized trial to evaluate the effectiveness of a smartphone-based CommCare data capture and management system relative to the current paper-based system for Ebola contact tracing and monitoring in Sierra Leone. The 11 chiefdoms in Port Loko district were randomized to receive either the CommCare intervention or the paper-based system control.
In Guinea, the Earth Institute, UNFPA, and the Guinean Ministry of Health have adapted the standardized Ebola contact-tracing form to a CommCare application. Available in both English and French, the application was designed to be quickly deployed, updated with changing protocols, and includes an instructional module with videos that contact-tracers can view for post-training guidance. The Earth Institute uses a dashboard developed by Tableau and also employs user-configurable reports that are viewable directly in CommCare. A pilot was deployed in December 2014 and has since scaled up to 5 of the 8 prefectures (Conakry, Coyah, Dubreka, Forecariah, and Boffa) that currently have Ebola, with 317 contact tracers and 50 supervisors on CommCare.
IntraHealth and Dimagi have worked together to develop and deploy a CommCare Supply application for the management of all family planning commodities in 1,400 facilities across Senegal. In this deployment, mobile logisticians equipped with commodities travel to each facility to perform inventory management tasks, track indicators, calculate resupply levels, and deliver commodities on the spot. Each logistician is equipped with a tablet running CommCare Supply which allows them to easily record, manage, and review stock information for hundreds of facilities. This intervention is currently being scaled nationally in Senegal.
In 2016 Dimagi was awarded an innovation grant from the Human Development Innovation Fund (HDIF) in Tanzania. Building on the success of mLabour in India, Dimagi will leverage the HDIF grant to adapt mLabour to the Tanzanian context and build upon its impact through two tracks: Adaption & Validation and Diffusion.
Adaptation & Validation: Dimagi, in partnership with FHI 360 and other local research partners, will conduct focused user-centered design activities and engage a wide range of stakeholders to understand the requirements for scaling mLabour throughout Tanzania. During the first year of the project, Dimagi will conduct an initial 3-month study to validate the safety, usability, and suitability of mLabour. In the second year, additional studies will be conducted to assess how quality of care is impacted through the use of mLabour.
Diffusion: Through the Diffusion Track, Dimagi aims to deploy mLabour to five organizations in Tanzania, spanning both the private and public sector. Diffusion activities will include capacity building of two Tanzanian technical organizations to support mLabour, engagement with a range of private and public providers, and engagement with the Ministry of Health and Social Welfare.
World Vision has initiated an innovative IMCI mobile application to increase integrated community case management (iCCM) and ensure higher healthcare quality through job aids, referral support, and supervision checklists. Mobile phones equipped with the MOTECH suite are enabled with iCCM-specific modules. Job aids using response-triggered decision tree algorithms will ensure adherence to standardized protocols, improving diagnosis and treatment.
TulaSalud’s mHealth program in Guatemala, KAWOK, uses CommCare for its maternal and neonatal care application, in addition to others for auxiliary nurse services, community surveying, and malaria monitoring and treatment. Features include remote decision support, SMS alerts, and local language customization, and incorporating open-source products such as Google Earth for GPS tracking. A central function of the app is to strengthen Guatemala’s Zero Hunger Pact to reduce chronic and seasonal child malnutrition and child deaths among indigenous communities.
In collaboration with the London School of Hygiene and Tropical Medicine and University College of London, Malaria Consortium implemented inSCALE to demonstrate that government-led Integrated Community Case Management (iCCM) can improve healthcare services and expand coverage in Mozambique. The project uses CommCare to strengthen communication between community health workers (CHWs) and health facility supervisors, and with heavy involvement of the Ministry of Health. InSCALE has the potential to expand into other areas of the health system, with the goal of improved diagnosis, treatment, and monitoring of disease throughout Mozambique.
D-Tree International designed a CommCare application while providing technical assistance to the USAID-funded “Integrated (HIV Effect) Migration and Positive Action for Community Transformation” (IMPACT) project. This project aims to improve the quality of life of orphans and vulnerable children in three target districts in Malawi. The application functions as a job aid to health surveillance assistants (HSAs), providing decision support to accurately treat sick children and follows Malawi’s government-designated IMCI protocol.
Through funding from the Bill & Melinda Gates Foundation, Terre des Homes is deploying CommCare to 400 clinics in Burkina Faso to improve IMCI adherence. Terre des Hommes adopted the Integrated eDiagnostic Approach (IeDA) utilizing the Electronic Consultation Register (REC), a simple and low-cost IMCI diagnostic support tool to help nurses comply with IMCI protocols to ensure data accuracy. REC 2.0 is built on CommCare and includes both a tablet-based mobile app in addition to a web dashboard.
The cStock system is scaled nationally to calculate just-in-time stock needs of the over 3,000 community health workers (CHWs) in Malawi as part of the Bill & Melinda Gates Foundation-funded JSI Supply Chains for Community Case Management (SC4CCM) initiative. In Malawi, CHWs provide Community Case Management (CCM), carrying and prescribing a defined list of essential medicines such as Oral Rehydration Salts, anti-malarials, antibiotics, and family planning commodities. Built on CommCare Supply, cStock allows CHWs to use their personal phones to submit SMS with stock information, allowing community level data, previously unavailable, to be visible to decision makers at all levels of the system. A recent paper in the Journal of Global Health found that the use of cStock in Malawi contributed to significant reductions in stockout rates and lead times for resupply, as well as improvements in overall stock management [Shieshia, 2014].
The EWS system was designed to provide real-time stock status information on reproductive health commodities to decision-makers at all levels and to provide early warning of a drop in supplies. Its goal was also to foster effective supervision of ordering and delivery, reinforce the availability of all essential health commodities by improving the timeliness and accuracy of paper-based ordering and reporting from the SDPs, prevent widespread emergency ordering by aiding districts and facilities in planned ordering through effective, automated data analysis tools. In Ghana, the USAID | DELIVER PROJECT (implemented by JSI) and the Ghana Health Service have deployed the EWS in 677 public health facilities and community health compounds across 162 districts in all 10 regions, including all antiretroviral therapy (ART) facilities, teaching hospitals and regional medical stores in the country.
The Ministry of Health (MoH) in Tanzania, with support from JSI through the USAID | DELIVER PROJECT has deployed the ILSGateway on a national scale, with over 4,600 Tanzanian facilities active today. In Tanzania, 93% of facilities are reportedly counting stock and managing bin cards more regularly and 97% of facilities are submitting requisition reports more regularly. 82% of districts reported improved visibility into tracer commodities. Users responding to the pilot evaluation in Tanzania indicated that the increased recognition and real-time nature of the SMS system was as powerful an incentive as monetary rewards, and reporting rates for the pilot were comparable with other systems that provided a monetary reward for reporting, demonstrated the feasibility of maintaining high and consistent user reporting rates without the need for supplementary monetary incentives.
HOPE is a system to pay existing incentives directly to mothers/ASHAs in their bank accounts. HOPE currently allows computer-based input of events for mothers. These are approved by the block accountant, which triggers payment to the bank account. An API has been developed to integrate data captured through another CommCare app with HOPE. The API exposes a list of all mothers and the “HOPE” events that have occurred for those mothers, which will eventually lead to payment. The API matches mothers with those in HOPE using the bank account number.
TechnoServe is partnering with a national South African bank to provide business development services to beneficiaries of a regional business-grouping scheme. Technoserve business advisors provide tailored support to entrepreneurs by providing business development services that drive the competitiveness and sustainability of beneficiary businesses. The business advisors run CommCare on both tablets and laptop computers to improve timeliness of beneficiary visits and quality of services delivered. The application enables tracking of financial health of the beneficiaries as well as tracking services delivered to beneficiaries over time.
The Government of the Republic of Zambia (GRZ), with support from DFID, UNICEF and Irish Aid, is currently implementing social cash transfers (SCTs) in 13 districts with the objective of reducing extreme poverty and vulnerability. The program is transitioning from a paper-based system used since 2004 to CommCare, with the aim of addressing problems of data accuracy and completeness during registration and follow-up activities. Enumerators, CWAC leads, and District officers are equipped with a CommCare application to manage the enrollment, support, and tracking of all beneficiaries in the system. Case management enables field staff to review and update details to existing beneficiary data within the mobile application. Follow-up visit forms take into account beneficiary details and are customized according to the history of a given case. SMS reminders enable communication with beneficiaries and field staff without direct access to the application. Reminders are automated based on the information stored in each beneficiary’s case record. This solution goes beyond accurate data collection and closes the loop in the approval, payment distribution and follow-up processes.
The Intervention with Microfinance for AIDS & Gender Equity (IMAGE Project), an NGO linked to the University of the Witwatersrand School of Public Health, combines a microfinance intervention with a gender/HIV awareness curriculum with the aim of improving the social and economic well being of households and reducing the risk of HIV infection and gender-based violence. The IMAGE Project is currently working with 5000 households in 300 rural villages across four South African provinces – Limpopo, Gauteng, Northwest and KwaZulu Natal, with 35 field staff working in small, dispersed teams. The IMAGE Project uses CommCare to track the progress of individual loan clients with respect to economic well being, assess performance in the microfinance intervention, and collect periodic data on health and social outcomes. The IMAGE project also uses CommCare to conduct routine performance monitoring for program staff to assess the quality intervention delivery and the support and supervision received. The CommCare platform is digitizing paper-based routine assessment forms to achieve transparent, bi-directional and regular feedback.
Small Enterprise Foundation (SEF) is a non-profit, pro-poor microfinance institution working towards the alleviation and eventual eradication of poverty. SEF targets female-led small and medium enterprises with credit and savings services to foster sustainable income generation, job creation, and social empowerment throughout South Africa. The CommCare application helps SEF to ensure that all activities are performed according to internal policies and procedures; corrupt and/or fraudulent activities are prevented, identified and reported on; special assignments requested by senior managers are executed; weaknesses and/or threats to SEF are identified and preventative measures are recommended; and ensure the overall service to clients is of the highest quality.
Pollinate Energy is an Indian-based NGO whose mission is to eradicate energy poverty through clean energy solutions, including solar-powered lights. Pollinate Energy’s CommCare application is used by the NGO’s “pollinators” to manage their energy solutions stock, complete community profile surveys, and ensure that communities provide accurate and timely repayments for solar-powered lights. In addition to supporting Pollinators, the application also provides a solar-powered light installation guide for beneficiaries [Article].
In an effort to improve access to woman and child protection services and reduce the impact of HIV on women and children, UNICEF worked with the government of Malawi established a Community Victim Support Unit (CVSU) in each of the 300 authorities in the country. CVSUs provide psychosocial support, mediation, and referral services for women and children survivors of abuse, violence, exploitation, and neglect. CommCare has been used to strengthen monitoring and support the activities and information systems of CVSUs.
Since Sept 2013, Dimagi has been collaborating with its partners St. John’s Research Institute to apply CommCare to help auxiliary nurses and other health workers identify and manage cases of GBV. CommCare helps the health workers follow tested, standardized protocols and inform survivors of their rights and options, provide counseling messages, and facilitate support services. CommCare reduces the burden of paper-based reporting and increases adherence to tested protocols that accurately screen for GBV.
Anseye Pou Ayiti (Teach for Haiti) seeks to raise education outcomes in rural Haiti by recruiting, training, and equipping teacher-leaders to promote teacher excellence and student success. Their CommCare application enables pedagogical coaches to track teachers’ growth according to their individual professional growth plans and the organization’s competencies framework, and assists pedagogical coaches in conducting classroom observations and coaching sessions with teachers.
UNICEF Ghana is using CommCare as an e-checklist to track and assess child-friendliness of schools around Ghana. The checklists monitor teacher and student attendance, assess facilities for safety and sanitation, track lesson plan adherence and classroom behavior, and compare results to a school’s past performance and community involvement. Field workers have the ability to enter data in real time for supervisors to assess schools’ performance on relevant indicators.
Save the Children Thailand created a CommCare application for School Monitoring that enrolls students in schools along the Thai-Myanmar border. The app keeps official enrollment records and tracks attendance and reasons for absenteeism. Students are visited at the beginning of the school year, at mid-year, and at end of the year to assess progress. Information from the app can also be used to create student ID cards, complete with photos of each individual student. The app was translated into multiple languages so it could be deployed in other regions. Dimagi trained the first 23 users and Save the Children is now scaling up to 100 users.
Dimagi has been running several trials of food distribution programs for rural schools in Zambia. CommCare has been deployed to link schools to grain and cooking oil silos. Teachers send an SMS stating their attendance levels over a period, as well as on-hand levels of cooking oils and grain. CommCare is able to calculate consumption rates based on this data, alerting silo managers to when particular schools will require a resupply and at what levels. The instantaneous nature of data processing ensures neither wastage nor under-supply of commodities for the nearly 5000 children in 88 schools that rely on this program for food.
Dimagi is launching a pilot with MIA to help with premiums calculations. Household members are registered and asset values are calculated programmatically, allowing for frontline workers to focus on providing counseling videos on claims coverage. Data collected is stored on CommCareHQ to allow for swift payouts in the event of a claim. This system is designed to expand into extremely low-resource settings while shifting claims management to an off-site, remote setting to reduce overhead expenditures.
Technoserve supports agriculture extension workers and supervisors to track crop status, financials, and payroll information. The CommCare application records farmer information for easy access by extension workers and contains multimedia counseling materials such as the safe use of pesticides and seedling growing techniques.
Catholic Relief Services is using CommCare to support an agriculture project in India through the Gates Foundation’s initiative: Improved Rice-based Rainfed Agricultural Systems. This tests the extension agents and supervisors to track the progress of farms growing these various varieties of rice. Each rice variety’s effectiveness is tracked and evaluated, leading to better livelihood outcomes in this agriculturally dependent region.
Since 2013, Dimagi has been working on the CARE Pathways project, which is focused on helping female self-help agricultural groups improve their productivity and increase incomes. Dimagi has set up a custom, tablet based scheduling and activity tracking system for CARE’s extension workers, providing a “Knowledge Base” for on-site refresher training, as well as a complex data collection system to track group and individual performance on yield, income, and empowerment indicators. All content is locally contextualized and summarized in easily parsed custom reporting.
Dimagi is working with UGPCL to help better manage their cooperative of over 1,000 farmers. Cooperative supervisors track the entire value-chain of small-scale farmers from the initial loan through its repayment, the output and quality of crops during the growing season, the farm produce’s contract sale for processing, as well as value addition by third parties. By providing a mobile-based system for tracking key metrics, cooperative managers can make informed decisions about the future of their cooperative, as well as estimate future cash flow requirements based on yield and sales data. Examples of features in the application include tools to help farmers calculate planting density, step-by-step guidance that helps farmers prepare for harvest, GPS tracking, and a module with instructional videos about how to use the application.