Use of mobile phones for program monitoring at community-level: Nepal's Chlorhexidine Cord Care Program Experience

"Chlorhexidine (CHX) gel 4% w/w has been used for cord care in Nepal since 2011 at both facility and home births. Currently around 80% of the population has access to the CHX program. Use of CHX for cord care is monitored at health facility and beneficiary level through routine health information systems and surveys. The routine information system is used at health facilities and provides information about availability and use of CHX. Surveys have also been used to monitor use of CHX for cord care, e.g. Multiple Cluster Indicator Survey 2014, Demographic and Health Surveys 2011 & 2016, Health Facility Assessment 2015 and Technical Support Visits (TSV). In the TSV, implementing partners' staff use android-based mobile apps to collect information about knowledge, use and compliance of CHX cord care and availability and distribution of CHX. TSVs collect information from women with a live birth within the last six months, pregnant women in the 8th or 9th month of pregnancy, female community health volunteers and health workers. Information collected by the mobile apps was transferred directly to a central server and provided coordinates of both the facility and beneficiary. This enabled real-time monitoring of the program and spatial analysis of the data through use of geographic information system. This information assisted in prioritizing support, identified hard to reach areas and improved access to the program. Information about CHX was captured through the routine information system and surveys, enabled with modern technology and enhanced data use for decision-making. Key Words: Health information systems, Research/knowledge translation, advocacy Key Messages 1. Routine health information systems and periodic surveys are important source of information for community health programs monitoring. 2. Use of mobile improves effectiveness and efficiency of community health programs monitoring. 3. Mobile monitoring with spatial data enhanced evidence based decision making."

Penelope (PENNY) Dawson

JSI Research & Training Institute Inc. (JSI)

I am a Canadian physician and have worked in developing countries for more than 35 years in various fields of public health, from “hands-on” clinical practice in a remote, rural hospital in the Himalayas to implementation of integrated programs on a national scale. In Nepal, I have contributed to the expansion of several community-based (CB) child health initiatives including vitamin A distribution, pneumonia/diarrhea treatment which evolved into CB-IMNCI, neonatal health initiatives (including use of chlorhexidine for umbilical cord care) and programs to improve rational commodity management and distribution. During my career I have worked in Canada, India, Nepal, Ethiopia, Pakistan, Namibia, Madagascar and Myanmar. I am currently Sr. Technical Advisor for JSI based in Kathmandu, Nepal and provide technical support to the Chlorhexidine Navi (Cord) Care Program.