A research study has found that an innovative electronic mobile system can be useful in malaria control programmes in remote and rural settings.
Many health information technologies fail when they are implemented in low-resource settings despite being promising. As such, researchers tested the use of a Deki Reader — an electronic diagnostic device for performing rapid diagnostic testing (RDT) of malaria and data capture of patients’ records — in eleven sites made up of a sub-district hospital, ten health centres and dispensaries in Kenya’s Kisumu County.
In each site, two health workers used the Deki Reader, which is compatible with Fionet portal, an integrated digital health collection and reporting system that automatically collects and distributes data to a central web portal.
The study published in Malaria Journal in November 2015 shows that during an eight-week period in May and June 2013, researchers conducted 5,812 malaria RDTs. The researchers indicate in the journal that 86 per cent and 96 per cent of completed records were received within 24 hours and one week, respectively.
“Quality, complete and timely data collection by health workers in a remote setting in Kenya is feasible,”
David O Soti, a co-author of the study and the head of the Division of Health Informatics and Monitoring Evaluation in Kenya’s Ministry of Health said that electronic data collection by health workers is workable.
“The Deki Reader enabled real-time data collection and sharing even in places with electricity and internet limitations, besides added advantage of easing determination of quality assurance and control issues,” says Soti.
Soti noted that it could also be used for rapid diagnostic testing of other infectious diseases in remote settings. The need for real-time data and ability to match resources to outputs such as patients diagnosed in low-resource settings, he says, are key data elements in health systems management.
“In reality these are hard to come by in public sectors and more so in the small and remote health facilities,” he explains. “The Deki Reader, therefore, presented an opportunity to prove that real-time data collection was feasible”.
Willis Akhwale, country director at the International Training and Educational Center for Health, Kenya, an agency of the University of Washington in the United States, agrees with the finding, saying they are in line with the adoption of health technologies for strengthening health services.
But he says: “A rigorous data quality assurance programme needs to be put in place since in many malaria endemic regions mobile-based technologies penetration is still limited and thus paper-based records remain the gold standard.”
According to Akhwale using the tool is feasible on a large scale but a costing analysis needs to be done based on the malaria burden. “There could still be room for paper-based recording in very small facilities based on a cost analysis study,” he said.
“It is also possible to have a hybrid of both paperless and electronic if the whole country is to be covered.” However, he explains, the technology holds a lot of promise for malaria control in Africa where complete and accurate data are very crucial to inform policies and strategies in malaria epidemic control.
“[But] ministries of health should also come up with clear policies and strategic plans of moving from paper-based records to paperless,” he says.
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