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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 DataHow 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 - StagesStage 1

DemonstrationStage 2Iteration

Stage 3Value

Creation

Stage 4Scale-up

Stage 5Sustain / 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 – CapabilitiesStage 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

ScaleDesigning and

demonstrating with small number of users

Fully deployed to target userbase

SustainabilityFocus 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-office585 Massachusetts Ave

Cambridge, MA 02139 USAT: +1.617.649.2214F: +1.617.274.8393

For more InformationE: information@dimagi.com

W: www.dimagi.comW: www.commcarehq.org

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