eSante-COM (mHealth)

The Ministry of Health, with technical support from the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), implemented a project from 2010 to 2013 to boost the reduction of maternal, neonatal and child mortality in the Northern and North Central Regions, with funding from the Bill and Melinda Gates Foundation. The project consisted of six intervention areas, the main one being community IMCI. This allows community health workers (CHWs) to treat, screen or refer children aged 0-5 years for the most deadly diseases such as malaria, pneumonia, diarrhoea and malnutrition at home.
An evaluation of the process of implementing community IMCI and the quality of services provided by CHWs was conducted in 2013, and highlighted the ability of most CHWs to correctly classify and treat these childhood conditions.
However, many challenges remained, including the poor availability and quality of case management data, very frequent drug shortages and inadequate supervision of CHWs. It is within this framework that a project has been initiated to set up an information system which will overcome these difficulties.

In order to overcome the low Internet coverage in the area, the project has used SMS technology to communicate data between community level actors and their health centre managers. Cheaper mobile phone applications (java phones) have been developed for CHWs, and Android applications have been developed for their head nurses, who are equipped with smartphones or tablets.
CHWs fill in the forms that are installed on their phones every week and send the data to an SMS exchange platform called RapidPRO. This data is sent to the head nurses by SMS. The message received by the head nurses is loaded on an Android application that presents the data in report tables. On the one hand, this presentation-style aims to facilitate the reading of data and of certain indicators (completeness and speed), and on the other, it aims to assist in the analysis and monitoring of the quality of data transmitted by the CHWs of their healthcare area.
At the same time, the data received by the head nurse from the CHWs are duplicated on a server hosting a DHIS2 (District Health Information System) platform, accessible via the internet for use by actors at the health district, health region and central directorate levels of the Ministry of Health. An interoperability system has been set up in order to connect all of these applications.

The project aims to improve the completeness, accuracy and precision of the data transmitted, the speed of data transmission, the monitoring of IMCI management activities, decision-making, as well as the monitoring of health product stocks among community health workers.
The added value of this solution lies mainly in taking into account the difficulties concerning poor internet coverage in Burkina Faso, the optimal integration of the solution into the structuring and organisation of the National Health Information System (NHIS), the interoperability of its applications, as well as with the SNIS computerised systems (e.g. the National Health Data Warehouse of Burkina Faso), and finally the attractiveness of the solution to the beneficiaries because of their involvement and the fact that their concerns/needs are taken into account throughout the implementation of the project.