mobile technology | Dimagi | CommCare
Devising Scalable Deployment Strategies for mHealth
Over the course of this academic year, I intend to work alongside D-Tree and Dimagi on developing a sustainable deployment and scale-up model for CommCare, a mobile-based scheduling, monitoring, and referral application for community health workers (CHWs). Through its “Safe Pregnancy” module, CommCare aims to routinize antenatal care by providing CHWs and their supervisors the ability to monitor, in a consistent and standardized fashion, the progress of pregnancies within a defined geographic area. Examples of the types of capabilities CommCare can provide include, but are not limited to, real-time data collection, complication readiness checklists, decision support mechanisms, check-up reminders, and scheduling capabilities.
The question that follows, then, is how best can these types of mobile applications be deployed in a scalable manner? Even more importantly, how can a mobile health (mHealth) application like CommCare serve as a vehicle for empowerment, both at the individual and community level, by enabling community health workers to take ownership over the health of their individual communities? There is considerable debate regarding whether technology limits CHW agency by over-standardizing and mechanizing decision-making, or whether it serves to supplement these existing practices by augmenting the capability of CHWs to make more informed, timely decisions. How can we ensure that the latter holds true?
The other question that arises involves the vehicle through which mHealth applications can best be deployed. Ideally, any development initiative should ultimately be sustained by the public sector – the nonprofit sector, in my opinion, should only play the role of developing, piloting, implementing, and eventually transferring effective social service delivery models to the government.
In the case of mHealth, what vehicles, in your experiences, have worked best as the starting point for the launch of a particular mobile application? How have you leveraged community-based organizations’ capacities to deploy the application in a locally relevant, culturally sound manner?
I realize I’ve asked more questions in this post than I’ve answered, but that’s because this is an emerging field where the experience of practitioners is immensely valued. So please, send us your thoughts!
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4 Comments on “Devising Scalable Deployment Strategies for mHealth”
Exciting stuff! It takes me back to an article in Newyorker from a while back, which examines how checklists can transform healthcare. I would be very interested in following the progress in deployment efforts!
http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande
Thanks for your comment, RD! I actually saw Atul Gawande speak last week, and though I had heard about the idea of checklists before, his conceptualization, coupled with the evidence he presented, was absolutely inspiring. I think the assumption here – that small, incremental changes in behaviour and processes can have a significant impact on health outcomes – is fundamental to CommCare’s work as well. Small can be very powerful.
Prerna, I’m sure you will get plenty of opportunities to test those assumptions in addition to unraveling other insights! Have you guys narrowed down to a site, a community or a hospital, that will serve as test-bed for the product?
Prerna: I stumbled upon your blog thru “TCI” website. I will read your other posts. So far, I am very impressed with what you’ve done with your education background and real work !!
I wonder if you have read the article in National Geographic (Dec 2008) called “Necessary Angels”. It’s about “JAMKHED” , a Comprehensive rural health initiative (actually started more than 30 years ago), in Maharashtra, near Ahmednagar. The website is “www.jamkhed.org”.
I would be really interested to see if the MOBILE TECHNOLOGY that you plan to explore with CLICKDIAGNOSTICS would work for them, and their CHW.
I am myself in I.T. (working here in Detroit, Michigan), and would love to develop technical solution that uses mobile devices but for rural communties. Your experience with SEWA and Clickdiagnostics would be very good to know of.
Good luck.