Mobile Phone Technology Helps Improve Access to Vital Health Data in Africa

March 6, 2009Bookmark and Share
Two independent projects at Columbia University are using mobile phones to improve the collection of healthcare data in Ghana and Malawi. In both countries, laborious paper forms make it difficult for local health workers to submit accurate field data, and for that data to be properly registered at the national level. Mobile phone text messages, however, transmit data faster and more accurately, allowing officials and health workers to better care for their patients and respond to health emergencies, such as famines.
"A lot of the data that's written down is inaccurate and takes between three months to a year to reach the central [government] level," said Mari Denby, a student who is working on child nutrition surveillance in Malawi with five of her peers from Columbia's School of International and Public Affairs (SIPA). The group is enrolled in SIPA's development practice workshop, which pairs groups of students with clients to work on a specific project. 
Six students from the School of International and Public Affairs won first place in USAID’s “Development 2.0 Challenge” for their innovative use of text messages to monitor children's health in Malawi.
SIPA student Mari Denby trains health workers in Malawi.
Image credit: Mari Denby / Columbia University
Through the workshop, Denby and her classmates—Kirsten Bokenkamp, Roxana Cosmaciuc, Sean Blaschke, Beza Hailu and Ray Short—are collaborating with their client UNICEF to develop and deploy an open-source "Rapid SMS," or short message service, system, which uses mobile phones to instantly communicate data on child nutrition. The project, RapidSMS Child Malnutrition Surveillance, will allow the government of Malawi, UNICEF and other partners to accurately map and track child nutrition trends as they occur. In January, the students' project was chosen from 115 projects as the winner of the U.S. Agency for International Development's first Development 2.0 Challenge, and received a $10,000 grant.
At the start of 2009, three of the students visited Malawi to help set up the system and train health workers to use it. "They were really excited to learn how to text message," Denby said of the health workers she met. "I think that they felt like they finally had the opportunity to see the impact of their work. They loved the idea that as soon as you send the message your work is seen at the central level." In March, Blaschke, Bokenkamp and Cosmaciuc will make a follow-up trip to adjust the system and assist with ongoing monitoring.
Another project, led in part by Professor Jim Phillips of Columbia's Mailman School of Public Health, will create a similar system in Ghana using mobile phones to transmit data relating to maternal and neonatal care. The project, funded by the Gates Foundation, is a collaboration with the Grameen Foundation.
Community nurses in Ghana currently spend a good deal of their time filling out and submitting paperwork that is never properly registered.  This means the nurses receive no feedback on the health data they collect and are unable to make use of it in providing care. Phillips, together with colleagues in Ghana, identified data capture and data use as areas where mobile technology could make nurses' work more efficient and effective.
The Ghana and Malawi projects both seek to improve and modify information technology as opposed to convert or replace it. "A lot of developing countries have skipped the infrastructure step of building land lines," said Jessica Rowe, an educational technologist with the Columbia Center for New Media Teaching and Learning, which is assisting with the project in Ghana. "People may have very little, but they have cell phones." Rather than impose an entirely new system that, for instance, would demand the installation of an expansive Web network, the use of mobile technology draws on an infrastructure already in place. "We don't have to put the system there," Rowe said. "It's there."
For the SIPA students, meanwhile, going forward is a matter of monitoring the progress of their system and keeping up interest in the improvement of data transmission in Malawi.
"SIPA's partnership with UNICEF seems to be very effective," said Pratima Kale, adjunct professor at SIPA and faculty advisor to the development workshop. "Quite often our workshop teams try to work with clients who are not willing to or able to spend adequate time with our students. In this case, the SIPA-UNICEF teams in New York and in Malawi have been working closely. Both view this as a joint project and this is much appreciated."
Likewise, both the workshop students and their UNICEF partners feel the promise of this project is worth following up on.
UNICEF representative Christopher Fabian described the collaboration with SIPA as "a new type of partnership for UNICEF" that is generating excitement within the organization. "We're happy to extend this. I think we can do a whole lot of interesting things next year."