Child Count for A growing mHealth scene in Kenya


As the pivot25 competition progresses,  I have been getting curious over the nature of applications coming up in the category for mHealth. I thought to myself that perhaps an analysis of locally existing albeit underutilised mHealth applications will help to manage my curiosity.

Useful perspective

For some reason a lot of my last 8 years was spent working on information systems to improve community based health services. It is a shame that I did not get myself interested enough in SMS based data collection platforms for health service delivery  until recently. Earlier in the year, while reading through @mberg's blog post I was even surprised by a prediction to see a lot less discussion about the differences in particular platforms (CommCare, ChildCount+, FrontlineSMS:Medic, Mwana, MoTeCH). I could be excused for my apparently slow uptake of these tools because the Kenyan Health IT scene to which I vainly contributed has over the years been mark-timing. The apparent stalling of Health IT in Kenya seems to be caused by a 7+ year old inconclusive debate of which tools are best for electronic medical records (EMR) systems.

First encounter

Great initiatives like ChildCount have a way of eventually popping up the stack despite being implemented with muted marketing effort. I first heard about ChildCount in one of the annual OpenMRS meetings. I was not only impressed that ChildCount seamlessly integrates with OpenMRS for its master database. The SMS based platform impressed me further with its easy application in Kenya’s remote areas empowering communities to improve child survival and maternal health.

How it works

ChildCount uses  uses SMS text messages to facilitate and coordinate the activities of community health care workers (CHWs). CHWs are community based health care providers. Any standard phone can be used by CHWs to register patients and report their health status to a central web dashboard for as long as there is a slight mobile carrier signal. The system supports messaging features for communication between members of the health service provision system alongside an automated alert system which all combine to reduce gaps in treatment for local communities. By providing a central web dashboard with information based on the processed SMS messages, ChildCount also provides a real-time view of health of in a community.

The new improved ChildCount+ works slightly differently from the initial deployment but the overall approach remains fundamentally the same.

A combination of noble efforts

The ChildCount platform is developed by the Earth Institute in collaboration with the UNICEF Innovation Team for the Millennium Villages Project. ChildCount is now free and open-source software available under the GPL License. It is build on yet another open source framework - RapidSMS. An important provision of phone handsets for CHWs to initially launch the service was facilitated by Sony Ericsson in early 2009. Airtel Kenya, then known as Zain also assisted in setting up a toll free number for the project . The project has also benefited from having in its team Matt Berg, as its Technology Director. Matt was in the 2010 list of Time’s top 100 influential people of the world

Deployments

Like many other open-source platforms, it is difficult to know how many installations of ChildCount exist across the globe. For sure though, after interacting with some good people at the millenium villages project like Maurice Baraza, I know that ChildCount is instrumental to their exemplary service delivery at their project in Sauri in Kenya’s Siaya County. At Sauri, the project covers over 65,000 people  with child and maternal health care services. They have also deployed the system at the Dertu millenium village project in Kenya’s Garissa County.

In the larger East Africa, ChildCount is deployed in at least one millennium village in Tanzania. In regional health informatics circles, word has it that the Rwanda government is considering a national deployment of ChildCount to support its community based health service delivery system. This does not come in as a surprise as the Rwanda government has recently been a regional leader in taking up ICT to improve its service delivery with more action than speak.

Less speak for more action

More information on ChildCount can be found on the project’s website. This pdf report might be useful for those wishing to dig deeper into the rationale behind the project and its initial success as a pilot. It should interest local mobile application developers and mHealth enthusiasts to consider building on ChildCount’s successes as they seek to further innovate mobile solutions in health services. RapidAndroid is definitely a natural platform to look at in keeping this innovation wheel spinning. We can only hope that pivot25, the Android Developer Challenge and other developer competitions will spur innovation in this direction. I shall leave readers with a video of the health care service delivery works going on at Sauri Millenium Village that I found useful