Bill & Melinda Gates Foundation

New App Means Better Healthcare for Underserved Communities

August 08, 2013

Every week here on Impatient Optimists, you’ll find stories written by one of the Frontline Health Workers Coalition’s 30+ member organizations. Stories feature the inspiring work of health workers on the front lines of care in developing countries and how United States leadership can help ensure that everyone has access to basic care by skilled, supported and motivated frontline health workers.

In places like the Deep Sea Slum of Nairobi, Kenya, the dangers associated with pregnancy and childbirth are not to be taken lightly.

Maternal mortality still claims far too many lives and quality maternal health services are not universally available or accessible to expectant mothers.

That’s where community health workers like Elizabeth Mueni come in.

A Pathfinder-trained frontline health worker in Nairobi, Elizabeth conducts regular home visits to 40 households throughout her community—all with the help of a mobile phone. She’s part of a new initiative called “mHMtaani,” or “mobile health for our communities.”

Through the USAID-funded APHIAplus project and support from Dimagi, Inc., mHMtaani aims to equip up to 3,000 community health workers like Elizabeth with mobile phones to support maternal and child health goals in Kenya’s Nairobi and Coast provinces. Each mobile phone includes a maternal and child health application, or "app," hosted by the CommCare software platform.

 It can cost as little as $300 to train a community health worker, and these workers form the backbone of the health system. They serve thousands of individuals who live in communities beyond the reach of hospitals and clinics.

For Elizabeth, the app is a powerful case management tool that helps her with many of her duties, including registering clients, keeping track of their prenatal care visits, and counseling them on the importance of delivery in a facility. The app also helps her calculate and track the due dates of expectant mothers like Miriam Nduku.

Elizabeth worked closely with Miriam throughout her third pregnancy, tracking her due date and providing counseling on pregnancy danger signs. When the time came, Elizabeth made sure Miriam was transported to the APHIAplus-supported Westlands Health Center where she received the care needed to safely deliver her new son, Richard.

Miram Nduku with son Richard. Courtesy Pathfinder International.

Elizabeth is an excellent example of why training frontline health workers is not only a smart investment, but is essential to achieving the global health goals of the United States and partner countries. It can cost as little as $300 to train a community health worker, and these workers form the backbone of the health system. They serve thousands of individuals who live in communities beyond the reach of hospitals and clinics.   

Frontline health workers play a powerful role in their communities. As natives of the communities in which they work, these providers foster trust and build relationships with their clients with an understanding and respect for local tradition and values.

And with the possibilities created by mobile health programs, community health workers are able to impact their communities in an even bigger way. In addition to urban communities like Elizabeth’s, Pathfinder also works in remote, rural communities, where one of the key barriers to accessing reproductive health is distance from a health facility. When women like Elizabeth are well-trained and equipped with mobile phone case management apps, they can provide lifesaving counseling, information, and services to underserved populations in the most remote villages.

Many of these workers are volunteers who are given only a small stipend to cover their travel costs. But with the tremendous value they represent to communities—likely saving millions of lives each year—these workers deserve to be fairly compensated for the time spent away from their families and other, income-generating work. Providing adequate compensation also gives workers the incentive to dedicate more time to the communities they serve when they might otherwise be focused on the necessity of earning an income elsewhere.

That’s why we are thrilled to be working with partners like Visa and NetHope in Kenya. They recently selected Pathfinder for a Visa Innovation Grant, which will help us to introduce a mobile payroll for community health workers in Kenya. The project will implement a pay-for-performance plan whereby data collected through the mobile phone application will be linked to mPesa, a mobile money service, to deliver performance-based payments to community health workers via their mobile phones. The project aims to improve the transparency and quality of services delivered, while recognizing worker performance. It is hoped that this, in turn, will lead to even better health outcomes for patients.  

Time and time again, we see that frontline health workers are the first and most effective line of defense in communities facing high maternal mortality rates and those in which there is a high unmet need for contraception. By equipping them with tools to perform their jobs better, including mobile phones, they can continue to play a crucial role in delivering the community-based interventions necessary to achieve universal sexual and reproductive health care.

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