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Assessing the functionality and utilization of the mHealth, Yendanafe electronic mobile reporting system in community health and clinical programming in Neno district, Malawi.
Date Issued
2021-09
Author(s)
Dorothy Mkwezalamba
University of Global Health Equity
Elissa Dushime
University of Global Health Equity
Abstract
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
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
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