Touch Screens Touch Lives in Benin

Evan Fowler is a Peace Corps volunteer based in Benin. In this piece, Fowler shares how in three months she transitioned from being a first-time smartphone owner to building an app to support Malaria prevention in Benin. Photos taken by Jake Meyers, Benin Peace Corps volunteer.

As Peace Corps Volunteers, we have had our fair share of success stories during our two years in Benin; helping a trash collection business manage its finances and become profitable, teaching young seamstresses business skills, and sharing meals with our neighbors, among others. However, until recently, we encountered consistent issues collecting pertinent data and eliminating paperwork. The data we needed was always out of reach.

Despite efforts to manage project data, such as creating participant lists for trainings and collecting semi-annual reports that focus on Peace Corps-specified indicators, the collated data was never accessible on the ground after it was reported. Projects like bed net distributions were tedious because of all of the paperwork they entailed.

Peace Corps Benin Meets CommCare

I first learned about CommCare back in September. I was halfway through a long day at an intensive pan-African Peace Corps conference about Malaria. My interest in CommCare was piqued after listening to Claire Cravero, a former Peace Corps volunteer and current senior field manager at Dimagi. Although there was only time for her to give a broad overview of Dimagi and CommCare, I caught a glimpse of the potential impact a mobile technology data collection system could have on a frontline program. I left the session with confidence that Dimagi staff would provide support if—and when—I decided to build an app.

Although I had never built an app before (and in fact had just purchased my first smart phone a couple of months before), I felt empowered to experiment with CommCare’s user-friendly interface. I learned the basics using an online course on Dimagi Academy, which is an online learning center that hosts a variety of courses to equip individuals and organizations with the knowledge and skills they need to build mobile applications. This course was a small private online course specifically tailored to Peace Corps and built by Dimagi. The more I learned from the course, the more convinced I was that CommCare provides an exciting way to collect data (which is an oxymoron in my book).

Getting Started: what problem did we need to solve?

I started thinking about where an app might be useful in Benin. What data is really pertinent to our communities, donors, and Peace Corps itself? Peace Corps Volunteers in Benin are exceptionally well-placed to find gaps in bed net coverage and to distribute nets to fill those gaps. Roughly every three years, the Beninese government, with the support of several international partners including USAID, distributes nets to all of the households in Benin. Inevitably, there are people who are missed in these large distributions. Nomadic groups, orphans, and students who live away from home to attend high school in larger towns are often overlooked. However, finding these individuals is a relatively easy task for volunteers and their work partners. For example, the Programme National de Lutte contre le Paludisme (an initiative of the Beninese government and supported through PMI) is responsible for providing the nets that Peace Corps Benin is distributing. This organization is now asking for information regarding missed populations, so they can be more comprehensive in the next national distribution. In addition, Peace Corps Benin also has information on net utilization that they seek to collect.

Up until February, this whole data collection process was paper-based. Paperwork is bulky, difficult to decipher due to illegible handwriting, and, if left sitting in a corner for too long, it can become a home to mouse nests and spiders. The documentation end of bed net distributions was a barrier to volunteers who, like most people, would usually rather avoid paperwork when possible.

It became clear that a CommCare application to capture the data from the bed net distribution process would be useful to Peace Corps, donors, and the Beninese population. With a goal in mind, I approached Peace Corps Benin’s Malaria Program Coordinator, Hannah Eisen, and Monitoring and Evaluation Officer, Benjamin Lavin. Together, we made a plan to collect all of the data previously captured through paperwork in a streamlined mobile CommCare application.

Building the App

The app design started as a plan on paper, and slowly grew into a functional mobile app. We spent hours figuring out how to make all of our hidden values work, building skip logic, and discussing validation conditions, until we achieved the outcomes we wanted. CommCare’s ability to build apps with case management capabilities was integral to making the app effective and more efficient than its paper counterpart. For example, as soon as the app calculates that a family does not need to receive nets, their case is closed, streamlining the case list when distributing nets.

Another design feature we had to take into account was translation. Although we built the app in English, all of our users would be out in the field collecting responses in French. Translation was a challenge because we had to ensure the language was clear and easy to understand for individuals who often have only a middle school level of education. After several iterations of the app, with input from our staff Grants Manager, and our Health Program Manager, we were ready to test. Kelli Schmitz, a rural community health volunteer field-tested the app in her community. Her work partners’ education levels ranged from college to middle school. With a tablet in hand, they administered surveys to 60 households and distributed 132 nets, returning with valuable feedback from the field.

After incorporating their suggestions, such as integrating definitions of key words under certain questions and making sure our looped questions worked flawlessly, we moved forward with our plan for training volunteers and homologues on how to use the app. We adapted the Dimagi-provided template to make a guide on how to use the application in both French and English, incorporating plenty of visuals. During the Bed Net Distribution seminar, interested volunteers and their work partners spent two and a half hours learning about the app and practicing surveying. By the end of this short training, everyone felt confident that they could use the app for a distribution in their community. The most popular feature, especially among work partners, was signature capture. People’s faces lit up as they watched their finger leave a mark on the screen.

With the help of the app we built on CommCare, today Peace Corps volunteers and their community partners are using mobile technology to conduct standardized surveys about bed net coverage in their villages, asking community members to sign with their fingers on smartphones as they pick up their new nets, and tracking the demographics of the people sleeping under the nets that Peace Corps Benin has distributed. All of this information is easily accessible to those who have been invited to view it and easily formatted for Peace Corps reporting purposes or for distribution to healthcare workers in the areas the nets are being distributed. CommCare helped us streamline a once arduous task by digitizing how volunteers collect information.

The Future of the Peace Corps Benin CommCare App

Before the end of their service, all of the Peace Corps Benin volunteers who finished the training intend to complete a bed net distribution using our CommCare app. One volunteer, Jake Meyers, has already surveyed and distributed bed nets to an entire Fulani camp. The process took him two days to survey 150 households, with the average survey taking two minutes and 37 seconds to complete. As soon as he had synced his phone, our Bed Net Officer could see how many nets he was going to need to distribute and start working on the logistics of moving the nets to the region.

The Benin Against Malaria committee recently welcomed new members in March. Benjamin and I have trained four people on how to manipulate the Bed Net Distribution Application, and explained future possibilities (behavior change communication through diagrams and videos that are integrated in the app, for example.) We have also gone over how to collect and disseminate the data so that it is useful for Peace Corps, donors, and the Beninese community. There is a five-month overlap between training these officers and when Benjamin and I will finish our Peace Corps service, leaving plenty of time for a complete transfer of knowledge, as well as space for collaboration. We envision this app will be sustainable for years to come, growing and shifting as data-collection needs change. Peace Corps Benin has invested in 20 Android devices to be made available to volunteers and their work partners as they use the app.

Our Bed Net Distribution app has been published on the CommCare exchange here. Anyone can download it and make changes so that it fits their own country’s needs. The Peace Corps Benin team hopes that this tool is useful in other countries and can help facilitate the distribution of treated mosquito nets. Please feel free to reach out to me at evanrosefowler@gmail.com or Benjamin at benjaminlavin17@gmail.com if you have any questions.