Using Mobile Phones to Improve Child Nutrition Surveillance in Malawi

Malawi’s current system for child nutrition data collection, the Integrated Nutritional and Food Security Surveillance (INFSS) system uses a random sample of children visiting growth monitoring clinics (GMCs) throughout the country to measure trends in child nutrition. However, the system faces challenges of poor data quality, time delays between data collection and analysis, and high participant dropout. Since chronic and widespread child malnutrition remains a serious problem in the country, the limitations of the INFSS system are a serious threat to the country’s ability to anticipate and plan for current and future nutrition and food security crises.

To address these problems, the team explored the use of mobile phones as a tool to collect and transmit child nutrition information via text messages (SMS). Using an open-source software platform (RapidSMS), the mobile phone can function as an electronic input device for health workers in the field, allowing them to send raw data directly to a central server at the national government level.

This study is the result of a collaboration between Columbia University’s School of International and Public Affairs, UNICEF Malawi, UNICEF’s Division of Communications Innovations Team, and Mobile Development Solutions (MDS) in an attempt to use mobile communication devices to facilitate the surveillance of child nutrition in Malawi. As part of the pilot study, health workers at three district growth monitoring clinics were trained to submit child nutrition data via mobile phone SMS (text messages).

This report describes in detail the successes and shortcomings revealed in this pilot study and, more generally, the issues associated with using mobile technology to address development challenges.

This pilot study yielded a number of findings that may be applicable to other development projects using similar mobile phone technology. The results of this particular program included:

• Significant reduction in data transmission delay compared to Malawi’s current paper-based system.
• Increase in data quality reported by health workers.
• Elimination of the need for time-consuming manual data-entry.
• Increased two-way flow of information between stakeholders at the national government level and health workers in the field.
• Increased system and personnel monitoring capabilities.
• Elimination of costs related to transporting paper forms and manually entering data.
  

• Rapid SMS should be gradually deployed for nationwide child nutrition surveillance.
• Rapid SMS should not be considered AN appropriate platform for all data collection purposes.
• A national rollout of Rapid SMS will require strong ownership by the national government and coordination with all key stakeholders.
• Local technical capacity should be developed to enable maintenance and future changes to Rapid SMS platform.
• The Malawi Rapid SMS platform should be upgraded to newer versions as they become available.