For 40 years, community health workers (CHWs) have been at the forefront of Benin’s community health strategy, and with the government’s support, are now taking a greater lead in data management using regularly updated registers. However, the data contained in these registers is often not systematically transferred to a central database and mired with frequent calculation errors, hindering the proper use of community data for decision-making around allocation of resources for community health.
Despite numerous past pilots conducted by projects to digitalize community data, the successes of these interventions have not lasted beyond the life of these projects. As such, ensuring the continuous availability of quality community data at the central level remains a challenge for Benin.
At the request of the MOH, the USAID Integrated Health Services Activity, implemented by Management Sciences for Health (MSH), developed a community health app that is interoperable with the national data platforms, the District Health Information System 2 (DHIS2) and the Système National d’Information et de Gestion Sanitaires (SNIGS), and can be used by all partners implementing community health activities. Unlike the apps developed previously, the MOH has made it a priority to develop an app that is both efficient and sustainable and that they themselves and implementing partners will be able to use in the long-term for community health interventions and at the national level.
In collaboration with partner DIMAGI and with the support of the Direction des Systèmes d’Information, the AlafiaComm app, was developed in line with the existing registers used by CHWs, and the preliminary validation by stakeholders was conducted ahead of piloting the app. Once the pilot test has proved the relevance of the app, AlafiaComm, derived from Commcare, will be adapted, fine-tuned, and scaled up gradually to aid CHWs in data collection and to support the provision of quality integrated services at the community level, including malaria diagnosis and treatment. The app will also be used to facilitate awareness-raising activities in the community through the use of images and audio and video messages available in local languages.
For Mr. Léandre Sohounde, M&E Senior Technical Advisor for the Activity, some of the key advancements noted have been in improving data quality and provision of care thanks to the application. He states that “AlafiaComm provides a secure process for patient treatment. When a CHW enters a child’s age, they can only provide whatever treatment dosage is indicated in the application. On the other hand, the application also allows you to notice danger signs based on the symptoms described by the person. When the CHW enters this information, and if necessary, an alert will appear on the screen to indicate that the patient needs to be referred to a specialist.
Prior to the official national roll out of AlafiaComm, the Activity organized a pilot phase from November 1, 2020 to February 28, 2021 with 50 CHWs covering two health zones: Natintingou and Tchoumi-Tchoumi (Atacora). Trained by the developers of the app, and fully equipped with a protective case, solar charger, and internet package, the selected CHWs were able to test the application during this period and were able to complete at least one submission on the platform to confirm its functionality.
CHWs who participated in the pilot phase expressed their satisfaction with this new application. Mr. Théophile Kouagou, a CHW working in the village of Koussantikou (Natintingou) said "the application catches any errors that I would have unknowingly made when using paper registers. […] When you make mistakes, the application signals it in red and we must immediately correct it in order to be able to continue onto the next section. I can now feel confident about the quality of data entered. In addition, the application saves me time, especially for monthly reports because the data entered in the application is automatically sent to our supervisors.
In addition to improving the quality of work and saving them time, the CHWs have been very satisfied with the additional resources as well as how the application has helped strengthen their confidence in their work. Clément Teho'Nta, a CHW in the village of Koutie-Chatido, stated that “what we really like about AlafiaComm are the audio and video messages. It is easy to explain to the mother how the mosquito can bite and transmit malaria and how the products we provide can help. It is much easier to understand something if one can see it.
Thanks to AlafiaComm, community health workers are empowered to collect accurate and timely data that will ensure real-time analysis and empirical decision-making at different management levels. This will allow health professionals to better understand the needs of the population and target interventions accordingly. As for the population as a whole, this application will guarantee better access to quality care that is based on need.
Photo: Sénan Zinsalo