Improving Community Health Reporting:
The case of m-JALI, Makueni County
Mbinda, M (AMREF Kenya)
Gitimu, A (AMREF Kenya)
Ofware, P (AMREF Kenya)
Background Information
- CHS seeks to strengthen linkages
communities and the formal health systems
between
- Within its framework lies the CBHMIS – for providing
information to monitor and evaluate the CHS
- Policy makers and health service providers at all levels
need accurate data in order to gauge the effectiveness
of existing policies and programs and to shape new
ones
Background Information (cont.)
- This information needs to be – not only accurate – but
also reach the decision maker(s) soon enough to be
meaningful (timeliness)
Time lapses
Time lapses
Issues
- Accuracy and timeliness of community health reporting
has been one of the primary challenges – hence a
major drawback for the CHS
- Structures for capturing this data have been largely
manual and where efforts have been made to
automate, these efforts have been partial
- In most cases the time lapses indicated in the figure
above range between a few days to several months
- There have been calls for efforts to improve efficiency
of the systems by innovating to cut these time lapses
Description
- AMREF has designed and developed an initiative
aimed at further cutting these time lapses
- Working within a MNCH project being implemented
under 3 building blocks
- HRH
- CSS
- HMIS
- Mobile technology has revolutionized nearly every area
of life – from health to education to finances…..
Description (cont.)
- Recent advances in mobile technology have made it
practical to automate some aspects of health care
delivery in low-income countries
- With universal coverage and decreasing costs, mobile
phone access and use has substantially improved over
the past half decade (ITU, 2014).
- The use of mobile phones to support the practice of
medicine and public health (m-Health) has seen an
increase in intervention in the past few years
- One of the objectives of the HMIS building block is to
improve reporting rates and timeliness of information to
support planning and decision making
Approaches for Automating CBHMIS
DHIS2
CBHMIS on Mobile (M-JALI)
- M for Mobile and JALI for (Jamii Afya LInk)
- The software package consists of two applications
Transmission
Retrieval
Device-side
Server-side
CBHMIS on Mobile (M-JALI) …….cont.
Device-side application
- Easy to use application (running on Android platform)
incorporating all tools for CHS data
- Capture, transmission and retrieval of data to and
from the server/web database
- Runs on both 2G and 3G networks – with best
performance on 3G
- Offline capability – access network, download existing
data to the phone memory, go to the field
- Timed synchronization to the CBHMIS database/web
application
CBHMIS on Mobile (M-JALI) …….cont.
Server-side application
- Runs on a web server with a SQL Server database
and application code in ASP.NET
- The API handles device authentication and provides a
set of functions for devices to transmit data to and
from the server
- Web pages enable users at higher levels to monitor,
view and verify data uploaded to the database
CBHMIS on Mobile (M-JALI) …….cont.
- Application
has
been
developed,
commissioned and fully functional
tested,
- 1 CU is fully implementing paperless reporting (50
CHWs, 3 CHEWs trained and using the application
and implementing paperless reporting for CHS data
- Substantial improvement on timeliness, accuracy and
mechanisms for validating data collected by CHVs
Sample Screen-Shots – mobile application
Home Screen
Login Screen
Tools Home
Sample Screen-Shots – mobile application
Household List preview
Specific household summary
Sample Screen-Shots – mobile application
Sample Output Screen-Shots – Web Application
Lessons Learnt
- Solutions developed for communities need to offer
more value than merely automating manual processes
- Wide opportunity for incorporating other functions of
community health e.g. diseases surveillance to benefit
from improved timeliness of reporting
- On-ground support can be better managed by building
champions from among the users (CHWs and
CHEWs)
Next Steps
- Roll-out to other CU’s
- Complete reporting cycle – production of MOH 515
summary (automated) through the web-based
CBHMIS under development
- Web-API to push/pull data to/from DHIS
- Research to gather scientific evidence on the costeffectiveness of the three approached for managing
community health data – in progress