demonstration of mobile phone deployment to support the treatment of acutely ill children under five in Bushenyi district, Uganda

Jerome Kabakyenga, Celestine Barigye, Jennifer Brenner, Samuel Maling, Denise Buchner, Alberto Nettle-Aquirre, Nalini Singhal, Teddy Kyomuhangi, David Tumusiime, Janet Finch, Stuart MacLeod

Abstract

Background: Benefits of mobile phone deployment for children <5 in low resource settings remain unproven. The target population of the current demonstration study in Bushenyi District, Uganda, presented with acute fever, pneumonia, or diarrhoea and were treated by community health workers (CHWs) providing integrated community case management (iCCM).

Methods: An observational study was conducted in five parishes (47 villages) served by CHWs well versed in iCCM with supplemental training in mobile phone use. Impact was assessed by quantitative measures and qualitative evaluation through household surveys, focus group discussions, and key informant interviews.

Results: CHWs in targeted sites improved child healthcare through mobile phone use coupled with iCCM. Of acutely ill children, 92.6% were correctly managed. Significant improvements in clinical outcomes compared to those obtained by CHWs with enhanced iCCM training alone were unproven in this limited demonstration. Nonetheless, qualitative evaluation showed gains in treatment planning, supply management, and logistical efficiency. Provider confidence and communications were enhanced as was ease and accuracy of record keeping.

Conclusion: Mobile phones appear synergistic with iCCM to bolster basic supportive care for acutely ill children provided by CHWs. The full impact of expanded mobile phone deployment warrants further evaluation prior to scaling up in low-resource settings.

Keywords: mobile phone deployment, ill children under five, Bushenyi district, Uganda