Learning from Others to Design Solutions in Zambia
By Peter Sichilyango, Fred Njobvu and Mathew Mwetela, BID Initiative Zambia
Jun 25, 2015
Posted in Products
Namaila Health Centre is a rural facility in Zambia located 80 kilometers from Mazabuka, the nearest town. There is no electricity nor internet connection. We recently traveled the rough terrain to visit this facility and were shocked at how long it took us– over two hours. The purpose of the visit was to learn how community health workers (CHWs) are collecting information using mobile phones under the Rapid Reporting Initiative led by PATH’s Malaria Control and Elimination Partnership in Africa (MACEPA). The mobile phones used by the CHWs already have a designed reporting template on the phone, where data is entered offline. Thereafter, they go to areas, known to have internet connectivity to send the report. The distances vary from 3 to 10 km to points of connectivity. The data is automatically uploaded onto DHIS2 and they receive a message notification which confirms that the data had been sent successfully. Specifically, we hoped to see how this might inform the BID Initiative’s paper scanning strategy that we are currently testing as an immunization data collection tool at low-volume facilities with lack of internet connectivity and no electricity.
In Tanzania, this type of facility with no connectivity uses a modified paper registry and the information is scanned and uploaded at the district level. However, we quickly realized that the movement of the paper forms in and out of the facility would be met by logistical challenges including the long distance to the district health office, lack of frequent transport, and the possibility of poor handling of the documents. We anticipate that it may take several weeks in the worst case scenario to have the forms from this facility scanned into the electronic immunization registry at the district health office. There could also be further delays at the district health office as they would be receiving these forms from several health facilities creating a huge workload for them to be scanned into the system.
During the visit, we concluded that using mobile phones could make a suitable alternative. The use of mobile phones to transfer immunization data would eliminate the logistical challenges presented by the long distance, rough terrain, and lack of transport. The Rapid Reporting Initiative works with CHWs to collect data and enter it on their mobile devices which is then sent to the central data base, updating it in real-time. Additionally, this approach cuts down on potential delays and challenges such as human resources needed to scan the papers at the district office and the potential for human error in filling out the forms.
From the start, the BID Initiative was not designed with pre-defined solutions and instead is partnering with the demonstration countries and peer learning networks (UAG and BLN) to develop them. We know that what might work in Tanzania may need to be adapted in Zambia as we clearly saw on our recent field visit. And while the paper scanner approach being pursued by the BID Initiative may work in other facilities in Zambia, we are also open to other options and will continue testing, designing, and fine-tuning interventions that work best for different types of facilities such as Namaila Health Centre. Stay tuned for updates as we continue making progress in the Southern Province of Zambia.