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Bill & Melinda Gates Foundation

Records for Life: Saving Lives by Design

June 03, 2013

When I worked for the US Centers for Diseases Control and Prevention (CDC) in 1994, I came to appreciate firsthand the importance of child health records.  My first day on the job found me on a plane to Zaire (now the Democratic Republic of Congo) where millions of refugees had recently arrived from Rwanda. Crowded together in makeshift lodging with few health and sanitation facilities, people in refugee settlements  are prone to large epidemics of diseases like cholera, dysentery, meningitis and measles.  Careful assessment and planning to reduce the risk of outbreaks can mean the difference between life and death for thousands.

My job was to determine the level of risk for different diseases. To my surprise, more than 60% of the parents I surveyed in the refugee camps had their child’s health record with them. The records gave our team valuable information like which vaccines children had received that helped us to prioritize care, better allocate resources and ultimately protect more children from the diseases that remained risks.  What struck me was that these mothers and fathers, who were able to bring so little with them when they fled their homes, chose the child health record as one of the few possessions to take.

Despite their value, getting, keeping and using health records isn’t nearly as easy as it should be. For example, records don’t always have enough space for the information that health workers want to document, such as when the child should return to the health center or which vaccines were given during a particular campaign. Also, the health records are usually printed on basic paper, which means they can easily be destroyed if they get wet or torn.  

These cards are particularly important in the developing world where electronic health record systems are almost non-existent. Historically, these cards have been developed for national immunization programs by health care providers who have little, if any, design experience to maximize the cards’ utility.

For those reasons, the Bill & Melinda Gates Foundation is launching an international contest to redesign the child health record.  Winners of the contest- as determined by judges Melinda Gates, Anthony LakeWalt Orenstein, Margaret Chan, and Robert Fabricant- will receive up to US $50,000 and may have part or all of their design piloted and scaled in as many as 10 countries by 2018.

The Gates Foundation is seeking your help to redesign the child health record. We are looking for innovative approaches to the records to improve their use and   accuracy. We know they are valued by health professionals and families but believe the current records can be improved upon so they are longer-lasting and adaptable to accommodate evolving health systems.  

Guidelines for the contest are available here.  We encourage anyone and everyone to participate. We are depending on your ideas to improve the child health record. A major improvement to a seemingly mundane component of child health could dramatically improve information systems, and better empower health workers and families to protect children from vaccine-preventable diseases.

 To learn more about this contest, visit our application page.

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