MGHD 2021

Background In Malawi, mHealth has been used to improve health in areas like antenatal care, maternal health services, nutrition, and health information system. In 2018, Partners In Health (PIH)-Malawi in collaboration with Medic Mobile designed an mHealth digital tool called Yendanafe to improve the HouseHold model used in the community health program and address some of the challenges caused by using physical/paper-based data collection tools. In 2019, mHealth, Yendanafe system was piloted in 2 out of 14 catchment areas, yet its scale up has been slow, and no evaluation of the system has been done. Objective: To assess the effect of the mHealth, Yendanafe system on report completion, program indicators tracking, and program performance assessment in Neno district, Malawi. Methods: The first part of the study was a pre and post study that analyzed secondary data to assess the effect of mHealth, Yendanafe system on monthly report completion and program indicators. The second part was a cross-sectional study that analyzed primary data to assess how often the implementation team utilized the system to assess the performance of CHWs and programs indicators. The study was approved by UGHE Institutional Review Board (IRB) in Rwanda and the Neno District Health Research Committee in Malawi. All data collected was aggregated in excel sheets. Descriptive statistics summarized all four key measures, and Mann Whitney test was performed to assess the pre and post implementation report completion rate. All analysis was conducted using SPSS version 27 with a P value set at 0.05. Results: In total, 44 monthly reports were included to assess pre and post program report completion rates. No statistical significance was found between paper based and Yendanafe report completion rates (P=0.149). The Yendanafe system could capture 88.4% of the required program indicators compared to 48.2% by the previous paper-based system. 23 out of 24 CHWs performance indicators were always/sometimes used by the majority of the implementers, while only 15 of the 29 program performance indicators were always/sometimes used by the majority of the implementers. Some challenges of using the system were reported. Conclusion: The findings showed that the system did not change the monthly report completion rate but increased the percentage of program indicators captured. The system was used to assess CHWs performance but not so much for program indicators performance. Some implementers had some challenges using the system and did not like some of the features. Follow-up studies need to be done to evaluate the system before scaling it up