D-tree - Child Status Index (CommCare)

Child Status Index &
Community Case Management
mobile applications
Marije Geldof
D-tree International
Background IMPACT
• IMPACT is a USAID/PEPFAR-funded GDA serving 100,000 OVC
• Funding: $28 million – half provided by alliance partners as
privately leveraged funds
• Duration: 4 years (July 2010-June 2014)
• Designed to complement WALA Program
• 9 implementing partners & 3 technical assistance partners
• 9 districts in central and southern regions
• In collaboration with Government of Malawi and relevant
The IMPACT Consortium
National Partners
International Partners
• Chikwawa Diocese
• Dedza Catholic Health
• Lilongwe Catholic Health
• Zomba Catholic Health
• National Association of people
living with HIV (NAPHAM)
Emmanuel International
D-Tree International
CRS (Prime)
Opportunity International Bank
Project Concern International
Save the Children
World Vision
• Improve wellbeing of OVC and increase access
to treatment and care for PLHIV
– SO1: Improved wellbeing of 60,000 OVC
– SO2: Access to treatment and care for 40,000
PLHIV enhanced
D-tree’s role in IMPACT
• Developing 3 mobile applications to support
the IMPACT program at community level:
1.Child Status Index (CSI)
• Supporting OVC committees
2.Community Case Management (CCM)
• Supporting Health Surveillance Assistants
3.Mother-infant pair follow up (MiP)
• Supporting Health Surveillance Assistants
• Working in IMPACT catchment areas in three
districts: Lilongwe, Ntcheu and Zomba
ICT implementation
• Mobile applications developed on CommCare
• Applications run on Nokia 2700c with GPRS
data transmission at $0.00006/Kb
• Basic troubleshooting once application is
developed and users are trained
• Capacity for continuation of applications being
transferred from D-tree to CRS Malawi
CSI application
• Child Status Index (CSI): case management
tool for assessing the well-being of children
• IMPACT CSI forms collected every 6 months by
community volunteers for beneficiary children
• Mobile application in Chichewa to enter CSI
forms, which prompts for referrals & follow-up
• Data from paper forms entered into
application by OVC secretaries
• Currently 82 OVC secretaries trained
CSI application
CSI application
Main menu
Follow up
CSI form
Important events
Why the CSI application?
Data entry at community level
Increased data completeness
Increased referrals through referral prompts
Reduced loss to follow up through follow up
CCM application
• Health Surveillance Assistants (HSAs) conduct
Community Case Management (CCM)
protocol for children from 2 months up to 5
years at village clinics in hard to reach areas
• Mobile application implements Government
of Malawi protocol
• Mobile application guides HSAs through
protocol, enforcing better adherence to the
• Currently 30 HSAs trained
CCM application
CCM application
Main menu
Screening child
Perceptions about CCM application
• HSAs:
– ‘The phone is like a colleague reminding us about things
we would otherwise forget’
– ‘The phone prevents you from making mistakes’
– ‘The phone reminds you of everything’
• Caregivers:
– Caregivers from other areas come to the village clinics with
the mobile application, because they feel these are now
providing better care
– ‘When the phone was used my child got a proper
Why the CCM application?
• Better adherence to the sick child form,
insight in deviations from the protocol
– Increased completeness (90% vs. 100% of visits)
– Increased referrals (1% vs. 5% of visits)
– Increased follow-up (0% vs. 26% of visits)
• Real-time service data, also about drug
consumption and stock outs
• Increased satisfaction caregivers about
• CSI application
– (Literacy) level of CSI users
– Phone theft
– Data entry not at point of care
• CCM application
– Paper register and application used concurrently
– MOH reporting and supervision
• General
– Eyesight problems
• CSI application has potential to improve
support to vulnerable children and reduce loss
to follow up.
• CCM application has potential to improve the
effectiveness of service delivery at village
clinics in Malawi.
• Partnership between CRS Malawi and D-tree
International successful

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