A mobile app to manage acute malnutrition

A mobile app to manage acute malnutrition

Severe Acute Malnutrition (SAM) is responsible for between 1–2 million preventable deaths every year and affects around 17 million children under five. Community based Management of Acute Malnutrition (CMAM) is a proven approach to identify and treat SAM cases. However its effectiveness is limited if treatment protocols are not followed and data is unreliable. A mobile health (mHealth) application was developed and piloted in five countries by World Vision, Dimagi, Save the Children and International Medical Corps (IMC) to help health workers follow treatment protocol and generate accurate and timely data to respond to changes in caseloads. Programme staff in Niger, Chad, Mali, Kenya and Afghanistan discuss the challenges they faced adapting the mobile app and rolling it out in some of the most remote, hard to reach health facilities in the world and make valuable recommendations for other mobile health application developments.
 
Recommendations:
  • when introducing a new mobile health app to health workers, particularly in remote locations, significant on-site support is necessary for both health workers and supervisors. This has budget and staff implications to support travel to remote clinics
  • the app should be tested in non-remote health facilities and all major bugs fixed before rolling it out to remote settings. Rapid assessment and mapping of phone networks and electricity should be used to develop contingency plans in the event of failure, and agreed to with MoH partners, as well as mobile network operators
  • the technology partner should provide considerable in-country presence and support, either through country representatives or frequent site visits, to build national capacity, fix bugs and update the app
  • health workers are more likely to use the app if it is aligned with national healthprotocols, health information systems, and health worker training and job targets. It is critical to plan and budget for local and national government engagement and uptake from the start. For scalability, the app should also be linked to a wider continuum of care and other maternal and child health services
  • standard CMAM protocols take time, especially where caseloads are high and staff numbers and capacity is low. Simplifying the treatment protocol and reflecting these simplifications in the app should be considered to prevent health workers taking their own short cuts
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