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mHealth and CHW Performance Improvement

Neal Lesh, Chief Strategy Officer

CORE Group Fall 2014 Global Health Practitioner Conference

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CommCare in use by a CHW

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mHealth Data Cycle

mHealth for

Service

Delivery

Data-Driven

Management

Better Data

Supportive

Supervision

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Types of Data-Driven Management

Performance Data ● Metadata about CHW visits ● Can re-use across project

types

Programmatic Data ● Project-specific data ● Informs programmatic

decisions vs. direct feedback to CHWs

Programmatic Data CHW Performance Data

How many pregnant women in an

area give birth in a facility?

How frequently is a CHW meeting

with a particular client?

What portion of pregnancies result in

live births, still births, or maternal

deaths?

How long does a CHW spend on a

counseling session?

What percentage of pregnant women

receive 2 tetanus shots

How many clients is a particular

CHW meeting caring for right now?

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Performance Feedback (examples)

Worker Activity Report for field supervisors

Visit reminders / supervisor alerts

Relative ranking feedback

Social recognition

Pay for performance

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Worker Activity Report

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Reminders w/ Escalation (Brian DeRenzi et. al)

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Self Tracking

CHWs shown their performance relative to others:

Results: None overall, but 38% increase in performance of top third of intrinsically motivated CHWs.

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Seems so simple...

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Successful mHealth Requires:

● A lot more than technology ● Organizational change and capacity and thus a fair bit of time...

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Maturity Model - Stages Stage 1

Demonstration

Stage 2

Iteration

Stage 3

Value

Creation

Stage 4

Scale-up

Stage 5

Sustain /

Improve

Example

Proof of concept

tool for using

phones to deliver

protocols

Stabilized and

field-tested tool

Validated tool for

delivering value

to frontline

workers

Packaged

repeatable tool to

scale up

Ongoing stable use

and value extension

of platform

infrastructure at scale

Demonstration

National

Programme

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Maturity Model – Capabilities

Stage 1 - Demonstration Stage 5 - Sustain and Improve

Program Design New content, small number

of use cases

Multiple use cases supported by

the technology platform

Data Driven

Management Data collected but not used

to improve workforce

Increasing levels of automation

for data-driven management.

Data used to improve program

design.

Technical Support Limited technical capacity

among program staff

Technical resources fully

capable of managing program

independent of external support

Training and

Implementation

Training and implementation

policies not yet modified for

mHealth

Training and implementation

practices institutionalized and

improvements rolled out

iteratively

Scale Designing and

demonstrating with small

number of users

Fully deployed to target

userbase

Sustainability Focus within single

organization with single

source of funding

Core solution in national strategy

receiving core programmatic

funding

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Project Maturity Assessment

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Thank you!

Contact: Neal Lesh (nlesh@dimagi.com)

Additional Videos: CommCare Overview Video: http://youtu.be/ZpfvISKxylE

CommCare Demo Video with multi-lingual support from India: http://youtu.be/30Ftk6STM3U

Recorded Webex of CommCare Presentation given to NetHope: http://bit.ly/tiLaYy

Additional Resources: http://groups.google.com/group/ict4chw

http://www.commcarehq.org

http://www.dimagi.com

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Dimagi Global Head-office

585 Massachusetts Ave

Cambridge, MA 02139 USA

T: +1.617.649.2214

F: +1.617.274.8393

For more Information

E: information@dimagi.com

W: www.dimagi.com

W: www.commcarehq.org

W: www.dimagi.com/category/blog/