MobileActive.org

Handheld computers have untapped potential to improve HIV/AIDS programs in sub-Saharan Africa, particularly in the collection of survey data. We conducted an experiment in three neighborhoods of Luanda, Angola to assess the impact of the technology on people’s comfort and willingness to disclose sensitive personal information, such as sexual behavior.

Participants were asked about their HIV/AIDSrelated knowledge, attitudes, and practices by local interviewers using either handheld computers or paper surveys. T-tests showed no differences between participants’ self-reported comfort across handheld and paper conditions. However, participants in the handheld condition were more likely to give socially desirable responses to the sexual behavior questions than participants in the paper condition. These results suggest that using handheld computers in data collection in sub-Saharan Africa may lead to biased reports of HIV/AIDS-related risk behaviors.

A PDA-based program for data collection was developed using Open-Source tools. In two cross-sectional studies, we compared data concerning sexual behavior collected with paper forms to data collected with PDA-based forms in Ancon (Lima).

The first study enrolled 200 participants (18–29 years). General agreement between data collected with paper format and handheld computers was 86%. Categorical variables agreement was between 70.5% and 98.5% while numeric variables agreement was between 57.1% and 79.8%. Agreement and correlation were higher in those who had completed at least high school than those with less education.

The second study enrolled 198 participants. Rates of responses to sensitive questions were similar between both kinds of questionnaires. However, the number of inconsistencies (p = 0.0001) and missing values (p = 0.001) were significantly higher in paper questionnaires.

This study showed the value of the use of handheld computers for collecting sensitive data, since a high level of agreement between paper and PDA responses was reached. In addition, a lower number of inconsistencies and missing values were found with the PDA-based system. This study has demonstrated that it is feasible to develop a low-cost application for handheld computers, and that PDAs are feasible alternatives for collecting field data in a developing country.

Providing health information to low health literate audiences remains a challenge. Beyond message design, realistic delivery models are needed for delivering information to a traditionally hard-to-reach audience. This study investigated two e-health interventions to provide health information on mobile devices – one providing diabetes information and one offering childcare information. Both were well-received, and most of the subjects’ usability issues related to the translation of these interventions to the mobile device’s smaller screen. The diabetes website was effective in providing information to study participants (as measured by pre- and post-tests of knowledge), while the childcare website was not. Continued work in this area could explore improved design strategies for mobile devices – a delivery model that could be used in doctors’ offices, for example. Effective delivery of health information to low health literate audiences is an important issue, and this research highlights a critical element by targeting another potential delivery model.

The overall goal of the PDAs for Malaria Monitoring in Maputo and Gaza Provinces, Centre was to improve the management of public health dat using handheld computers in order to provide the malaria program the Lubombo Spatial Development Initiative (LSDI) with appropriate assessment tools and the ability to make informed decisions.

The specific objectives of the project that would contribute to the achievement of the overall goal were

1. to enable personnel from District level of the health service to collect data and provide it to the Provincial level in a timely fashion;
2. to develop training courses and appropriate collection tools designed for use with handheld computers; and
3. to evaluate the utility of handheld computers for the malaria control program to provide data rapidly and accurately to allow better targeting of interventions and resources.

AED-SATELLIFE developed and successfully deployed electronic data collection tools which catalog drug and rapid diagnostic test stocks; spray operators daily work performance; weekly health facility data; localization of individual households with GPS, including demographic data on household members, house structure and divisions; and health facility surveys linked to GPS positioning. Training materials were developed inPortuguese.

Independent evaluation confirmed that the electronic data collection/transmission tools proved to be a useful, adoptable, and result in higher user satisfaction compared to paper based approaches. Some challenges need to be addressed before there can be widespread adoption of the technology, such as limited infrastructure, especially cellular coverage.

What prevents humanitarian non-government organizations (NGOs) from adopting technology that can potentially improve their operations and response time? Global Relief Technologies, a producer of handheld data collection devices, asked a New York University Capstone Team to research the barriers to NGO PDA adoption. The Capstone Team conducted 17 interviews with nine organizations, from animal welfare to humanitarian relief, to discover the financial, technical, and institutional barriers preventing groups from implementing technology into their field programs. The Team also conducted two case studies of groups currently using PDA technology, one domestic and one international, to explore in depth the factors that went into the decision making processes these groups followed in their technology acquisition decisions.

Every year almost 10 million children die before reaching
the age of five despite the fact that two-thirds of these
deaths could be prevented by effective low-cost
interventions. To combat this, the World Health
Organization (WHO) and UNICEF developed the
Integrated Management of Childhood Illness (IMCI)
treatment algorithms.
In Tanzania, IMCI is the national policy for the treatment
of childhood illness. This paper describes e-IMCI, a system
for administering the IMCI protocol using a PDA. Our
preliminary investigation in rural Tanzania suggests that e-
IMCI is almost as fast as the common practice and
potentially improves care by increasing adherence to the
IMCI protocols. Additionally, we found clinicians could
quickly be trained to use e-IMCI and were very enthusiastic
about using it in the future.