14 December 2017
The first iteration of the mHealth4Afrika beta application was validated with health facilities in Southern Malawi during December 2017.
The intervention health centers are: Naisi (semi-urban) and Ngwelero (deep rural) in Zomba and Gawanani (rural) in Machinga Districts in Southern Malawi. Naisi Health Clinic serves 49 villages with a catchment area population of 17,144 and is 11 kms to the nearest hospital. Gawanani Health Clinic (rural clinic) serves 17 villages with a catchment area population of 10,668 and is 16 kms to the nearest hospital. Ngwelero Health Clinic (deep rural clinic) serves 74 villages with a catchment area population of 33,206 and is 49 kms to the nearest hospital.
In preparation for the installation of mHealth4Afrika into the clinics, a site visit was undertaken during July with each health clinic to determine the necessary equipment to be installed, including a router to support interaction between the tablets and laptop hosting the system. The network was set up in Naisi Health Centre and Ngwelero Health centre, followed by digital literacy training and then application training. The staff in Naisi Health Centre had been using the mHealth4Afrika application for some time prior to the formal evaluation.
The feedback provided by nurses and other clinical staff in the health centres was very postive. They validated the data sets and workflow for medical history, obstetric history, maternal healthcare (antenatal care stages and delivery) and initial data sets and stages proposed by the Child Under 5 program. They also validated usability issues from a user interface, workflow, functionality and data collection perspective. Healthcare workers were observed interacting with different functional areas of the mHealth4Afrika beta prototype and were given minimal guidance in using the platform. As they completed using each functional area, they were requested to provide detailed feedback on each aspect of the user interface, functionality and workflow. Each validation session lasted a minimum of two to three hours.
The healthcare workers found the profile pages which summarised information about the patient and the data visualisations of readings across visits to be very useful. They found the workflow to be easy to follow. They used the sensors to take readings, selected the patient and added the reading to the electronic patient record. As well as validating the data sets for medical history, obstetric history and ANC visits, they also provided feedback on the initial data points and stages for the Child Under 5 program.
Following an evaluation session with the health centres, a briefing meeting was undertaken with the District Health Office in Zomba on 13 December 2017. This was attended by the mHealth4Afrika team (IIMC and Chancellor College) and a number of officials responsible for different areas within the District Health Office. This meeting was very useful, providing insights in the mHealth4Afrika objectives, achievements to date and providing a demonstration of the platform, sensors and Android application to capture sensor readings and transfer using HL7 FHIR to the electronic patient record.
The feedback received during the evaluation in the four beneficiary countries during November and December fed into the updated specifications for future iterations of the beta platform.