mHealth4Afrika undertook Needs Assessment and Baseline study with health clinics in South Africa, Malawi, Kenya and Ethiopia

06 January 2016

mHealth4Afrika is a three year collaborative Research and Innovation project, co-funded under ICT-39-2015 of Horizon 2020. It addresses maternal and newborn healthcare delivery, a key requirement of end-user communities in developing countries, and priority area in both the 2015 Millennium Development Goals and Post-2015 Sustainable Development Goals. It aims to leverage ICT to strengthen the quality of maternal, new born and infant healthcare delivery at clinic level, based on end-user requirements in the participating countries.

mHealth4Afrika is focused on co-designing an open source, multilingual mHealth platform to support quality community-based maternal and Newborn healthcare delivery at clinic level, based on end-user requirements in Southern Africa (Malawi, South Africa), East Africa (Kenya) & Horn of Africa (Ethiopia).

During November and December 2015, IIMC (mHealth4Afrika Coordinator), Nelson Mandela Metropolitan University (South Africa), Chancellor College, University of Malawi (Malawi), @iLabAfrica, University of Strathmore (Kenya) and University of Gondar (Ethiopia) undertook a needs assessment and baseline study with the health clinics that will participate in the co-design and evaluation of the platform over the coming three years.

The intervention sites in South Africa are based in the Eastern Cape Province, which is the largest and poorest provinces in South Africa. A focus group was undertaken by IIMC and NMMU in Cofimvaba on 01 December with representatives from the Cofimvaba District Hospital, the maternal child and women health coordinator, sub-district manager and 5 healthcare clinics in the area (Sabalelo Clinic, Banzi Clinic, St Marks Clinic, Ntsingeni Clinic and Qamata Clinic). The focus group provided a lot of insights into the clinic environment, staff and skills, the level of computer literacy, range of equipment currently used in different clinics and available infrastructure. Data is currently primarily collected through a paper-based maternal health registry, with monthly reporting of health indicators. The focus group participants provided a lot of insights into the types of functionality that would support their day to day activities. It was also possible to visit some of the clinics to get a better understanding of their environment and available infrastructure.

The intervention sites in Malawi are based in the Zomba district in Southern Malawi. Site visits and interviews were undertaken by IIMC and Chancellor College to a range of rural and deep rural clinics from 04 - 11 December to engage with healthcare workers, get insights into the clinic environment, current work processes, available infrastructure and relevant functionality. There are a range of specific challenges for rural and deep rural clinics that need to be considered in the platform design.

In Kenya, the administration of public health facilities is now devolved to county level. The intervention sites in Kenya are based in Bungoma County in north west Kenya. A briefing meeting was undertaken with County Director of Health. Site visits and interviews were undertaken by IIMC and @iLabAfrica to a range of urban and rural clinics from 14 - 18 December 2015. This facilitates additional insights to be gathered from clinical officers and maternity nurses in relation to their day to day activities, current infrastructure, use of technology and levels of digital literacy and useful functionality.

In Ethiopia the intervention sites are based in the Amhara Region in Northern Ethiopia. IIMC and University of Gondar undertook site visits and interviews with heads of clinics and maternity nurses in a range of deep rural, rural and semi-urban health clinics from 21 - 25 December 2015. It was both interesting and necessary to see the range of infrastructure and human resources that are available across the different clinics. It provided an opportunity to see the systems that are currently being used within the clinics and the limitations that mHealth4Afrika can address. It also provided an opportunity to visit a health post, interview health extension workers about the maternal-related services that they support and the potential role of technology in the future. Briefing meetings were also held in Addis Ababa on 29 December 2015 with the State Ministers in the Ministry of Communications and Information Technology (IST-Africa partner) and the Director of Maternal and Child Health in the Ministry of Health.

This initial base line study and needs assessment provided necessary insight as part of the co-design process of the mHealth4Afrika platform.