BMC Med Inform Decis Mak - Comparing a paper based monitoring and evaluation system to a mHealth system to support the national community health worker programme, South Africa: an evaluation.

Tópicos

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Resumo

CKGROUND: In an attempt to address a complex disease burden, including improving progress towards MDGs 4 and 5, South Africa recently introduced a re-engineered Primary Health Care (PHC) strategy, which has led to the development of a national community health worker (CHW) programme. The present study explored the development of a cell phone-based and paper-based monitoring and evaluation (M&E) system to support the work of the CHWs.METHODS: One sub-district in the North West province was identified for the evaluation. One outreach team comprising ten CHWs maintained both the paper forms and mHealth system to record household data on community-based services. A comparative analysis was done to calculate the correspondence between the paper and phone records. A focus group discussion was conducted with the CHWs. Clinical referrals, data accuracy and supervised visits were compared and analysed for the paper and phone systems.RESULTS: Compared to the mHealth system where data accuracy was assured, 40% of the CHWs showed a consistently high level (>90% correspondence) of data transfer accuracy on paper. Overall, there was an improvement over time, and by the fifth month, all CHWs achieved a correspondence of 90% or above between phone and paper data. The most common error that occurred was summing the total number of visits and/or activities across the five household activity indicators. Few supervised home visits were recorded in either system and there was no evidence of the team leader following up on the automatic notifications received on their cell phones.CONCLUSIONS: The evaluation emphasizes the need for regular supervision for both systems and rigorous and ongoing assessments of data quality for the paper system. Formalization of a mHealth M&E system for PHC outreach teams delivering community based services could offer greater accuracy of M&E and enhance supervision systems for CHWs.

Resumo Limpo

ckground attempt address complex diseas burden includ improv progress toward mdgs south africa recent introduc reengin primari health care phc strategi led develop nation communiti health worker chw programm present studi explor develop cell phonebas paperbas monitor evalu system support work chwsmethod one subdistrict north west provinc identifi evalu one outreach team compris ten chws maintain paper form mhealth system record household data communitybas servic compar analysi done calcul correspond paper phone record focus group discuss conduct chws clinic referr data accuraci supervis visit compar analys paper phone systemsresult compar mhealth system data accuraci assur chws show consist high level correspond data transfer accuraci paper overal improv time fifth month chws achiev correspond phone paper data common error occur sum total number visit andor activ across five household activ indic supervis home visit record either system evid team leader follow automat notif receiv cell phonesconclus evalu emphas need regular supervis system rigor ongo assess data qualiti paper system formal mhealth system phc outreach team deliv communiti base servic offer greater accuraci enhanc supervis system chws

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