2017 ICT4D Conference

Growth monitoring (GM) aims to detect children at risk of malnutrition, provide resources for children with growth faltering, track nutrition trends, determine eligibility for counselling/other services, and to increase visibility of malnutrition. GM’s impact is limited by poor data quality, long delays in data collection and dissemination that prevent timely response, and weak interpretation and use of data. The Institute of Development Studies and World Vision (WV) evaluated the use of a mHealth application (app) for community-based GM created and deployed by WV. The app was used for national GM system delivery through health posts (posyandu) over a 12 month period in rural and urban sites in Indonesia. Objectives were to assess impact on: data accuracy, accuracy of GM status classification, timeliness of data submission, real-time responsiveness and feedback to mothers. Quantitative analysis involved 747 matched mobile phone and paper-based child records, time records of 52 posyandu sessions and 2,276 direct observations of GM activities. Qualitative analysis involved 42 focus group discussions.

Results included: 1) Improved accuracy of child growth status classification. 2) Improved timeliness of data submission 3) Accelerated data collection via quicker retrieval of child details and automated classification of GM status. 4) Length of posyandu session increased with the app, mainly because cadres were more likely to provide counselling to mothers; Mothers actively requested counseling based on the app and were willing to wait for it. 5) Cadres with the app were more likely to provide feedback and arrange follow-up counselling/referrals. 6) Where cadres were unsure how to calculate/interpret growth charts, the automated calculation and visual presentation on the app enabled them to more easily provide feedback. 7) Unintended positive changes (higher regard for the posyandu and the cadres) and negative changes (tensions and changed power dynamics within the posyandu, and tensions with local health workers) also were identified. http://bit.ly/mPosyandu-Eng